• Title/Summary/Keyword: physical functioning

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Study of spnial segmental stabilization for OMT in low back pain (요통 환자의 정형물리치료를 위한 척추분절 안정성에 관한 고찰)

  • Chang, Moon-Kyung
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.415-425
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    • 2000
  • It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

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Selecting Common Items for Linking the Oswestry Low Back Pain Questionnaire and a Short Form of Self-Reported Activity Measure for Low Back Pain

  • Choi, Bong-sam
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.61-70
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    • 2015
  • To develop an effective and efficient measurement system for tracking changes of functional status across two measures, it is essential to integrate information and communicate scores across two measures. The lack of communication between two measures leads to score incompatibility. A potential solution would be the development of a crosswalk table between those measures. Prior to creating a crosswalk table, selecting common items between two measures is critical. By using the Oswestry low back pain disability questionnaire (Oswestry) and a short form measuring disability resulting from low back pain, item level statistics as well as differential item functioning (DIF) using the Rasch measurement were investigated. Eighty-two participants with known group validity were recruited. Based on the application of the Rasch measurement model, item difficulties across the two measures were logically and hierarchically ordered. Ceiling effects for both measures were detected, which were not be able to be effectively measured with the two measures. The DIF analysis across the two measures confirmed that five paired items were found to have DIF and five common items were selected for common items. Although five paired items function differently across the Oswestry and the short form, all items of both measures were well targeted study participants. The common items selected by the Rasch measurement model may be effective when creating a crosswalk table between the Oswestry and the short form.

The Effects of Activity and Family Support on the Participation Restriction of Chronic Stroke Patients (만성 뇌졸중 환자의 참여제한에 활동과 가족지지가 미치는 영향)

  • Kim, Won-Ho
    • Physical Therapy Korea
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    • v.19 no.1
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    • pp.76-85
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    • 2012
  • The purpose of this study was to identify the factors determining the participation restriction of chronic stroke patients based on international classification of functioning, disability, and health (ICF) model. Sixty-eight stroke patients participated. The participants were assessed participation restriction using the Korean version of London handicap scale (K-LHS), modified Barthel index (K-MBI) to measure activities of daily living, Berg balance scale (K-BBS) to assess balance, and the center for epidemiologic studies depression (K-CES-D) to gauge depression. Also, 3 minutes walking test (3MWT), gait velocity, asymmetric posture, and family support were assessed. A stepwise multiple regression analysis was used to explore the factors determining participation restriction. There were no significant different in the K-LHS and K-MBI results by gender (p>.05). Correlations between the K-LHS and K-MBI (r=-.656), K-BBS (r=-.543), K-CES-D (r=.266), 3MWT (r=-.363), gait velocity (r=.348), and family support (r=-.389) were significant (p<.05). Also, the K-MBI and family support were the factors that determined participation restriction (p<.05) and that 40.2% of the variation in the K-LHS can be explained. Therefore, it is suggested that evaluation and intervention of patient's activity level and extent of family support is necessary to reduce participation restriction of chronic stroke patients.

A case report of the intervention strategy & documentation in a patient with post stroke applied a International Classification of Functioning, Disability and Health (ICF를 적용한 뇌졸중 환자의 문서 기록과 중재 전략의 실례)

  • Lee, Sun-Ui;Kim, Tae-Yoon
    • PNF and Movement
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    • v.8 no.2
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    • pp.57-67
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    • 2010
  • Background and Purpose : Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF-based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description : The client was 44-years-old man with hemiplegia who was in 1 month post-stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks of intervention was carried out after proposing the short goal and detailed purpose. Outcome : The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion : The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.

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In Search of a Definition of Successful Aging: A Review of Literature (성공적인 노화 정의를 위한 문헌연구)

  • 홍현방;최혜경
    • Journal of Families and Better Life
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    • v.21 no.2
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    • pp.145-154
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    • 2003
  • As the life-expectancy is ever-increasing, and the proportion of the elderly population is growing steadily in every society of the world, it is ever more important to establish what factors allow certain elderly people to age successfully and remain relatively independent while others grow old less successfully and require extensive intervention. However, there is no consensus yet as to what successful aging means. Researchers have defined successful aging in a variety of ways. This study attempted to define the concept of successful aging and to clarify some dimensions of it through literature review. Previous approaches of studying successful aging and related themes were examined. Early perspectives including activity, disengagement, and continuity theories, Selective Optimization with Compensation (SOC) model by Baltes and Baltes, three different conceptions of successful aging, that is, psychological well-being, physical health, and wisdom, and MacArthur research on successful aging have been reviewed for this study. The definition derived from the review is: Keeping up continuous developmental processes to achieve wisdom or ego-integrity, without suffering any major disabilities in either physical or mental functioning, while maintaining psychological well-being and employing SOC strategies, and participating in positive relationships with significant others. The dimensions of successful aging are 1) personal resources, including physical health, cognitive competences, self esteem, and social support 2) adaptation process of SOC, and 3) psychological aspects, including psychological well-being and wisdom.

A Comparative Study of Oswestry Back Pain Disability Questionnaire Versus Computer Adaptive Testing for Measuring Back Pain

  • Choi, Bong-Sam
    • Physical Therapy Korea
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    • v.20 no.4
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    • pp.22-31
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    • 2013
  • The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain ($n_1=42$) and non-back pain group ($n_2=42$). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.

Effects of Action Observation Training and Mirror Therapy on the Electroencephalograms of Stroke Patients

  • Lee, Ho Jung;Lee, Jong Su;Kim, Young Mi
    • The Journal of Korean Physical Therapy
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    • v.33 no.2
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    • pp.106-113
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    • 2021
  • Purpose: This study examined the effectiveness of action observation training (AOT) and mirror therapy in improving the electroencephalograms (EEG) of stroke patients. Methods: Patients were allocated randomly to three groups: an action observation training with activity (AOTA) group (n=12), a mirror therapy with activity (MTA) group (n=11), and an AOT-only group (n=12). All groups received conventional physiotherapy in five 60-minute sessions over six weeks. The AOTA, MTA, and AOT groups practiced AOTA, MTA, and AOT, respectively, in three 30-minute sessions over six weeks. The differences between the pre- and post-treatment EEGs were assessed using a paired t-test. Comparisons between the groups were performed using one-way ANOVA. Results: The participants in the AOTA and MTA groups showed significant improvement in the EEG. AOTA improved the alpha waves of the prefrontal, temporal, and parietal lobes significantly (p<0.05). MTA improved the alpha waves of the temporal lobe significantly (p<0.05). AOT did not result in significant improvement Conclusion: AOTA and MTA improve stroke patients' EEGs. Mirror neuron activation combined with conventional stroke physiotherapy promotes motor recovery and functioning. The effect is enhanced when the actions are executed after observation. Further research into mirror neuron activation will be needed to develop methods to improve the EEGs of stroke patients.

Factors Influencing Discharge Destination and Length of Stay in Stroke Patients in Restorative Rehabilitation Institution

  • Gyu-Bum Lee;Jee-Sun Lee;Jeong Soo Kim
    • Physical Therapy Korea
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    • v.31 no.1
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    • pp.48-54
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    • 2024
  • Background: Promoting patients' safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI). Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors. Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient's medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge. Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay. Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.

Reliability of the Functional Gait Assessment in Patients With Stroke (뇌졸중 환자에 대한 기능적 보행평가의 신뢰도)

  • Won, Jong-Im;Yu, Kyung-Hoon
    • Physical Therapy Korea
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    • v.18 no.1
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    • pp.64-73
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    • 2011
  • After stroke, many people have problems with balance during movement. Balance is essential for the optimal functioning of the locomotor system and the performance of many activities of daily living. The Functional Gait Assessment (FGA) is a clinical tool for evaluating balance ability during walking. The test consists of ten tasks, seven tasks of the Dynamic Gait Index and three additional tasks. The purpose of this study was to evaluate the reliability and internal consistency of data obtained with the Korean version of the FGA when used with people after suffering a stroke. One-hundred participants, at least three months poststroke and able to walk at least six meters with or without a walking aid, participated in the study (age range=30~83 years; $mean{\pm}SD=58.8{\pm}10.9$). Two physical therapists and two physical therapy students rated the FGA. Intrarater and interrater reliability of the FGA were assessed using kappa statistic and intraclass correlation coefficients (2,1). The internal consistency of the FGA was assessed using the Cronbach alpha. The Cronbach alpha was good (${\alpha}$=.86~.93). The intrarater (intraclass correlation coefficient=.92~.95) and interrater reliability (intraclass correlation coefficient=.91, .95) of the total scores administered by the therapists and students were good, whereas the reliability for single item scores when administered by the physical therapists was moderate to good (kapa value=.42~.97). This study found that intrarater and interrater reliability for total FGA scores and internal consistency were good. Therefore, the Korean version of the FGA can be used as a reliable tool to assess the functional gait performance of patients after stroke.

ICF Tool applied Intervention Strategy and Charting on Upper Extremity Functional Recovery of the Frozen Shoulder Patient - Case Study (동결견 환자의 상지 기능 회복에 대한 ICF Tool을 적용한 중재 전략과 문서 기록-사례연구)

  • Kong, Sun-Woong;Lim, Hyoun-Chyoul;Jung, Yeon-Woo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.1
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    • pp.35-44
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    • 2011
  • Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.

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