In this study, literature review was done to examine and compare the current status and problems of different evaluation approaches toward permanent impairment in Korea. Alternatives and improvements in the current approaches in Korea were suggested. Series of cases were also examined to compare different approaches applied to the real cases, using 105 cases from a hospital data and another 207 cases from a insurance company data. The main findings of the literature review are as follows; 1. The current evaluation methods of permanent impairment in Korea are grouped into two categories, grading and rating. Gradings of impairments are expressly specified in 17 various statutes. 2. In Grading methods, the rigid system of 74 different grades has been adopted uniformally for the convenience of administration, which may not be, appropriate or valid from medical and scientifical aspect. 3. The adventage of McBride method is assessment of occupational disability rate. However the classified compensable occupations are only 280 and limited to manufacturing industries in 1960s'of U.S.A., which is not appropriate to current Korean circumstances. Especially, the job list does not include managerial officers or mental workers. 4. AMA Guides is the scientific and reasonable method for the assessment of physical impairment rate. However compensation and reparation of impairment case is difficult because this method cannot assess the disability rate according to occupation, age, etc. The results of cases comparative study are as follows: 5. The physical Impairment could be compared in 167 out of total 312 cases, and for the cases of complex impairment, McBride method underestimate physical impairment rate compared with AM A method. 6. When disability late was assessed, occupation was considered the compensation of only 85 cases, and age was used in only 21 cases. This was because occupation and age compensation in McBride method are unreasonable. 7. The most Ideal alternative is to assess physical impairment according to AMA method and then to develop a compensation method appropriate for the circumstances of Korea society.
Osteoarthritis(OA) is a widespread, slowly developing disease with a high prevalence rate increasing with age. The most common big joints involved in OA is the knee, where the disease particulary strikes, causing difficulties in rising from a chair. climbing stairs, kneeling. standing, and walking. The primary complaints of these patients include pain, stiffness. instability, and loss of function. The purpose of this study was to assess the impact of self-reported symptoms and limited flexion, and limited extension on functional impairment in patients with knee osteoarthritis. In the data collection, a total of 206 who had visited the physiotherapy unit at six different departments of orthopedics were interviewed in K City from June to September, 2000. The results of the study summarized are as fellows: 1. There was a significant difference among different degree group of limited flexion(p<0.05). A group difference was demonstrated between <5 ${\sim}$ 15 and 16 > (F=16.21, p<0.05). In the relationship between the degree of limited flexion and the level of functional impairment, the h igher the range of limited flexion, the lower the level of functional impairment. 2. In the relationship between the degree of limited extension and the level of functional impairment, a group difference was revealed between the non-limitation group and the <10 and 11 < However, no significant difference was noted between 11 ${\sim}$ 20 and 21 >(F= 13.37, p<0.05). In conclusion, finding above suggest that functional impairment is closely correlated with limited tlexion and extenion
Purpose: The purpose of this study was to identify cognitive impairment and risk factors among elderly persons aged 60 or more in Korea using raw data from the 2008 Elderly Survey: Basic Analysis Report of Actual Living Condition of the Elderly and Welfare Need Survey in Korea. Methods: This study was conducted using raw data obtained from 13,335 subjects representing elderly persons aged 60 or more in Korea. Data were analyzed using SPSS 19.0 software. Results: The rate of cognitive impairment was found to be 22.0%. Logistic regression analysis became more prevalent with increased aged. In addition elderly subjects with the following factors showed increased cognitive impairment: mails; underweight; slept well for 3 to 4 days per week at most; lack of high intensity physical activity; Eub/Myoun area; did not live alone; did not graduate from high school; un-employed; lack of active social participation, and not computer/Internet savvy. Conclusion: This study identified cognitive impairment and risk factors among elderly persons aged 60 or more in Korea using samples representing elderly persons aged 60 or more throughout the country.
Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.
Journal of the Korean Society of Physical Medicine
/
v.11
no.2
/
pp.41-52
/
2016
PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.
The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.
Prospective memory (PM) is related to remember to carry out a previously intented behaviour. The purpose of this study was to develop a paradigm for measuring PM function to diagnosis in mild cognitive impairment 1 or brain injury in patients 2. among brain injured patients Thirty-eight normal healthy subjects participated in current study. The paradigm was composed of four conditions: a baseline and three intention conditions (expectation, execution 1 and 2). In the expectation condition, subjects were asked to make a new response to intented stimuli during ongoing task, but the intented stimuli never occurred. In the execution 1 (one type of expected stimulus) and 2 (two types of expected stimuli), the intended stimuli did occur in 20% of trials. The reaction time and error rate were calculated in each condition. Repeated measures using ANOVA of subject's mean reaction times (RTs) and mean error rates (ERs) showed main effects of conditions during ongoing task. The comparison of PM tasks in executive condition 1 and 2 also showed significance in RTs and ERs. This paradigm reflects sufficiently the performance of prospective memory function during ongoing task in normal individuals. Thus, we suggest that the paradigm will be helpful to study neural network of PM function using brain imaging techniques and diagnosis of PM dysfunction.
This study was performed to investigate the clinical pictures and rehabilitation service patterns of stroke patients in cities of kimchon(kumi), jinju. pohwang, jeonju and jeju from January 1,2001 to march. Authors developed structured questionnaire, and distributed it to each physical therapist. Total number of distributed questionnaire was 400, and 301 questionnaire were col looted and analysed finally.1. The occurrence rate of hemorrhagic stroke(60.5%) was higher than that of ischemic stroke(39.5%). The highest incidence of the stroke was noted in the group of 50 years and ratio of male to female 1.3 : 1. 2. The several warning sign is motor deficit(42.5%). headache. dizziness, vomitting(31.9%) and difficulty speaking or understanding(10.6%). 3. The most important contributing factor of stroke was hypertension both hemorrhagic(50.0%) and ischemic stroke(40.3%). 4. In the painful stroke patients(53.2%). the major problems were shoulder pain(51.3%) and shoulder-hand syndrom(31.3%). 5. In hemorrhagic stroke. the seasonal preference was autumn and summer. In ischemic stroke. the seasonal preference was autumn and winter. 6. In the surgery, hemorrhgic stroke(44.5%) was higher than that of ischemic stroke(20.2%). 7 The major impairment were motor deficit(95.3%), psychological deficits(24.4%), hearing and speech deficit(23.4%). vision deficit(14.7%) and perception deficit(12.7%). 8. The rehabilitation services for stroke patients were physical therapy(98.0%), occupational therapy(41.5%), oriental therapy(35.1%), speech therapy(17.5%) and psychological therapy(7.4%). 9. The start of rehabilitation service was different according to surgery. 36.5% of patients started physical therapy in 4 week and 32.0% of patients started in 8 week later in surgery and 53.1% of patients started physical therapy in 2 week in not surgery( P<0.05). 10. The highest frequency of rehabilitation service was six times per week.
This study was performed to investigate rehabilitation service patterns of stroke patients in metropolis of Korea. Seoul, Taegu. Taejon, Pusan and Kwangju from April-July. 2000. Authors developed questionnair, and distributed it to each physical therapist. Total number of distributed questionnaire was 800, and 622 questionnaire were collected and analysed. 1. The occurrence rate of ischemic stroke$(51.1\%)$ was higher than hemorrage stroke$(48.9\%)$. The highest incidence of the stroke was noted in the group or60 years and ratio of male to female 1.3:1 2. The several warning sign is motor deficit$(50.3\%)$, headache. dizziness. vomitting$(32.6\%)$ and difficulty speaking or understanding$(8.2\%)$. 3. The most important contributing factor of stroke was hypertension both hemorrage stroke$(50.7\%)$ and ischemic stroke$(47.2\%)$. 4. In the painful stroke patients$(53.4\%)$, the major problems were shoulder pain$(55.1\%)$ and shoulder-hand syndrome$(31.9\%)$. There is no clinical method for relieving the pain. 5. The seasonal preference was winter and autumn followed by summer and spring in regardless of diagnosis. 6. In the surgery, hemorrage stroke$(61.2\%)$ was higher than ischemic stroke$(13.5\%)$. 7. The major associated impairment were motor deficit$(99.0\%)$, hearing and speech deficit$(30.9\%)$.perception deficit$(15.9\%)$. psychological deficit$(14.1\%)$ and vision deficit$(10.6\%)$. We need more role of speech pathologist and psychotherapist. 8. The rehabilitation services for stroke patients were given only $15\%$ by onset. 9. Medical doctor did not checking everyday$(41\%)$. 10. Patents said that the physical therapist well understanding$(60.1\%)$ than medical doctor$(36.2\%)$ about their conditions.
Journal of the Korean Society of Physical Medicine
/
v.18
no.1
/
pp.99-110
/
2023
PURPOSE: This study was conducted to suggest a way to easily understand and utilize the International Classification of Functioning, Disability and Health (ICF) or Korean Standard Classification of Functioning, Disability and Health (KCF), a common and standard language related to health information. METHODS: The tools used by physical therapists to evaluate the functioning of neurological patients were collected from 10 domestic hospitals. By applying the ICF linking rule, two experts compared, analyzed, and linked the concepts in the items of the collected tools and the ICF/KCF codes. The frequency of use of the selected tool, the matching rate of the liking results of two experts, and the number of the codes linked were treated as descriptive statistics and the code set was presented as a list. RESULTS: The berg balance scale, trunk impairment scale, timed up and go test, functional ambulation category, 6 Minute walk test, manual muscle test, and range of motion measurements were the most commonly used tools for evaluating the functioning. The total number of items of the seven tools was 33, and the codes linked to the ICF/KCF were 69. Twenty-two codes were mapped, excluding duplicate codes. Ten codes in the body function, 11 codes in the activity, and one code in the environmental factor were included. CONCLUSION: The information on the development process of the code set will increase the understanding of ICF/KCF and the developed code set can conveniently be used for collecting patients' functioning information.
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