Objectives: The purpose of this study was to investigate the effect of intensive rehabilitation programs on pain, range of motion (ROM), lumbar muscle strength, core muscle endurance, disability, and depression in patients with traumatic low back injuries and to compare the efficacy of this therapy with that of conventional rehabilitation therapy. Methods: The study was performed with a retrospective medical chart review of patients with traumatic low back injury referred to the rehabilitation center at the Daegu Hospital of the Korean Workers Compensation and Welfare Service. Forty-four patients were allocated to either the conventional rehabilitation group (CRG; n = 22) or the intensive rehabilitation group (IRG; n = 22). The CRG group patients, who received 30-min therapist-supervised physical therapy and modality therapy five times per week for four weeks, were compared with the IRG group patients, who received 60-min therapist-supervised physical therapy, 30-min therapist-patient 1:1 matching rehabilitation therapy, and modality therapy five times per week for four weeks. Outcome measures were a numerical rating scale, ROM, lumbar muscle strength, lumbar core muscle endurance, thickness of lumbar deep focal core muscle (transverse abdominis and lumbar multifidus), Oswestry disability index (ODI), and depression (Korean version patient health questionnaire-9). Results: There were statistically significant improvements after treatment in all outcome measures in both groups (p < 0.05). In the intergroup comparison, NRS scores on the activity and thickness of lumbar deep focal core muscles increased significantly more in the IRG than in the CRG (p < 0.05). There were no statistically significant intergroup differences in NRS scores on resting, ROM except left lateral bending, lumbar muscle strength, core muscle endurance, ODI, and depression. Conclusions: We could confirm the superior effectiveness of an intensive rehabilitation program compared to conventional rehabilitation therapy in patients with traumatic low back injuries.
Purpose: In Japan, the Long-Term Care Insurance Act has stipulated visiting rehabilitation since 2000. This study aimed to identify the actual conditions of visiting rehabilitation in Japan through a literature review of reports published by the Japanese government. Methods: This literature review was conducted on eight articles among various government reports on the topic of the actual conditions of visiting rehabilitation. These reports were published by the Ministry of Health, Labor and Welfare of Japan based on their own investigations or reports from an external agency entrusted with the task, and were issued between 2000 and 2021. Results: The characteristics of the visiting rehabilitation offices, their number, manpower allocation, the number of users, and their visits to each office were identified. Also, the characteristics of the users, number of users, age and required degree of long-term care, causative disease, and required medical care were identified. To evaluate the actual status of the visiting rehabilitation service, the service use time, frequency, period of use, intervention by doctors and the degree of such intervention, therapist's service content, visitors' address before the use of the service, reason, and timing of the service introduction, evaluation of the service effectiveness, combination of services and transfer destination after termination, and status after service termination were checked. Conclusion: Based on the Japanese experience where visiting rehabilitation was introduced and applied to long-term care insurance, it would be meaningful to review the factors that required benchmarking among the Japanese service models while designing a similar model in Korea.
Objective: This study was conducted to describe physical therapists' attitudes and beliefs towards Korean Government's National Long Term Care Insurance Program implemented last July 2008. Design: A survey research. Methodology: Participants were 143 physical therapists working in General Hospitals or University Hospitals in Busan, Korea. Each of the participants completed a questionnaire which was comprised of 22 questions. Among the 22 questions, 7 of these were independent variables such as gender, age, career, etc. while 15 of these questions were dependent variables such as the subject's expectations and reactions on the said program, opinions of the participants on the impact of the program to old people's families and relatives, participant's sentiments on social effects of this program to the society, etc. Data collection was conducted from the $20^{th}$ of July to the $5^{th}$ of August, 2008. Data were analyzed by Chi-square test, frequency and cross tabs using SPSS/PC program. Results: Based on the survey conducted, it showed that 50.3% were female respondents, 53.8% were on their twenties, 31.5% of the total respondents were married and that a percentage of 82.4% had working experiences below 10 years. About 80.4% of respondents were satisfied of their jobs and 32.4%of the respondents graduated from three - year college degree, 49.3% of the respondents graduated from four-year college degree. 95.1% of the total respondents knew the existence of the national long term care insurance program of the government and almost 78% got the information of the said program via internet, news paper or T.V. About 86% of the respondents believe that there will be future improvements in the quality of life in Korea through the said program and 82% said that there will be an increase sense of responsibility among family members to take care of their old relatives. 67.2 % of respondents believe that problems regarding old people will be solved through the government's national long term care insurance program. In aspect of Physical Therapy, 50% of the respondents expected generation of more jobs especially to physical therapists and 95% of the respondents want to work in any position in the said program especially those are more experienced ones. Conclusion: Physical Therapists in Korea are aware of the existence of the National Long Term Care Insurance Program of the Korean Government. Based on the gathered results from the survey, many experienced physical therapists of the country wanted to acquire positions in the said program especially that their expertise are needed in the said field. Through this study, it is evident that many physical therapists of the country have positive vibes on the said program and are optimistic on the outcomes of the said insurance program.
The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.
The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, 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. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.
Purpose : Various research studies are needed to raise the perception of the CE of Korean physical therapists. However, there are little studies have been conducted, and relatively few studies are available to read on online. The purpose of the study is to find out the differences in the perception of CE according to the physical therapist's academic background. In this way, this article intends to strengthen the perception of the CE of health-care workers, such as physical therapists and occupational therapists in the Republic of Korea so that contributing to the development of national health. Methods : Present study showed that 431 out of 563 people who participated in the two meetings of CE conducted by the Gwangju Metropolitan City of the Korea Physical Therapy Association responded in the survey in 2015. Among them, only 238 people were surveyed on the awareness of CE in 2014, excluding 181 questionnaires due to poor responses and 112 questionnaires that did not participate in CE in the previous year. Descriptive analyses were conducted to identify the perception among those who experienced CE, and simple linear regression analysis was performed using dummy variables to identify awareness of the education based on their academic background. Results : Question 3 (p=.000, R2=.067) was significant in the significance test of the regression equation for perception of the CE (p<.05). Question 1 (p=.687), 2 (p=.066), 4 (p=.430), 5 (p=.085), and 6 (p=.054), 7 (p=.111), 8 (p=.088), 9 (p=.213), 10 (p=.191) and 11 (p=. 169), the regression formula was not significant (p>.05). Conclusion : Physical therapists had a moderate perception of the need for a CE and had the idea that improvements were required in what was provided in that education. In addition, there was no statistically significant difference, although there was a greater awareness of CE in the Master of Science Course or higher than college or university graduates.
The function of a diagnosis is to provide information that can guide treatment. The physicians provides only a limited amount of information that is pertinent to the physical therapy management of the patient. In only a very general way does the diagnosis direct the physical therapy's treatment. Thus, by the members of the physical therapy profession recognizing their role and responsibility to become diagnosticians, they can begin to classify signs and symptoms more actively and develop the categories that will enhance the effectiveness of their practice and their contributions to health care.
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.
Purpose: This study was to identify the whether there is any correlation between Gross Motor Function Measures (GMFM) and Functional independence Measurement for children (WeeFIM) in order to identify a relevance of daily life motor with gross motor function of children with cerebral palsy. Methods: Subjects were instructed to evaluated by an occupational therapist using WeeFIM (reliability 0.83-0.99) and by a physical therapist using GMFM (reliability 0.93). 10 male children and 13 female children among 23 children being diagnosed as cerebral palsy were targeted for this study. A correlation between GMFM and WeeFIM was analyzed with Kendall correlation. Results: Participants showed significant correlation between GMFM and WeeFIM in all categories, except in the GMFM's walking running jumping category, standing category of GMFM and self care, sphincter control, communication category of WeeFIM. Lying rolling and sitting and crawling kneeling area of GMFM showed a significant correlation with self care(r=0.35, 0.39, 0.4), sphincter control (r=0.45, 0.43, 0.61), mobility transfer (r=0.44, 0.36, 0.64), locomotion (r=0.41, 0.35, 0.74), communication (r=0.4, 0.44, 0.51), and social cognition (r=0.43, 0.51, 0.64) area of WeeFIM (p<0.05). Standing of GMFM and mobility transfer (r=0.74), locomotion (r=0.47) and social cognition (r=0.4) area of WeeFIM showed a significant correlation (p<0.05). Conclusion: These findings indicated significant correlation between activity of daily living (ADL) and gross motor function of children with cerebral palsy. However, because there are a few results that are not significant, both assessment tools should be used for evaluations so that treatment can be achieved with an accurate assessment and establish a therapeutic plan.
This study was introduce to Manual Mobilization of the Extremity Joints of Freddy M. Kaltenborn(1989). Much of Orthopedic Manipulative Therapy is devoted to the evaluation and treatment of joint and related soft tissue disorders and one of the primary treatment methods is mobilization. When examination reveals joint dysfunction, especially decreased range of motion, joint mobilization techniques are often utilized. Kaltenborn's joint mobilization techniques are performed as passive examination or treatment movements by the therapist. There are three basic joint play movements: (1) traction, (2) compression, and (3) translatoric gliding. The purpose of joint mobilization is to restore normal, painless joint function. Mechanically, the goal is to restore joint play and thus normalize roll-gliding which occurs during active movements.
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