• PNF and Movement
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• 제14권3호
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• pp.219-229
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• 2016

Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.

• The Journal of Korean Physical Therapy
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• 제23권4호
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• pp.45-51
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• 2011

Purpose: To determine the correct measurement methods of the ankle joint complex range of motion for measuring the neutral position and evaluate the rater reliability. In addition, the impact of training on the rater reliability was also assessed. Methods: The subjects were eleven healthy women, who were evaluated by two physical therapists and one physical therapist recorded the results of the study. Standard goniometer was used as the measurement tool. The ankle and subtalar joint neutral position and the active range of motion of the ankle and subtalar joint were measured. Intra-rater reliability and inter-rater reliability measures were analyzed with intraclass correlation coefficients. Results: Intra-rater reliability and inter-rater reliability ranged from high to medium for the neutral position of the ankle joint complex. Intra-rater reliability for dorsiflexion and plantarflexion measurements was medium, while the inter-rater reliability was high. The range of motion of the subtalar joint was measured, and the intra-rater reliability and inter-rater reliability were low and medium, respectively Also, the intra-rater reliability was increased with formal training of the measurement techniques. Intra-rater reliability was reduced in case the raters had not undertaken the training. Conclusion: In summary, the results obtained with the measurement tools and joint measurement of position, indicate the consistency of repeated measurements made by the same observers. Under the same circumstances along with repetition of the same measurement technique during training caused an increase in the rater reliability of formally trained raters.

• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.126-131
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• 2013

This case report described a single case of adult stoke patient due to Moyamoya disease through long-term follow-up observation, which included his demographics, brain images, and change of motor function and functional activities. The subject was the 54-year-old male diagnosed with left hemiparesis from a stroke due to multifocal encephalomalacia in both hemispheres. At the time of the stroke attack, he took brain surgery intervention including external ventricular drain. Physical and occupational therapy for stroke rehabilitation were admitted including muscle strengthening exercises, functional activity/ADL training, neurofacilitative techniques with bobath or proprioceptive neuromuscular facilitation concepts, and compensatory strategy. Patient's MRI showed that right frontal lobe, right peri-ventricular area, left parietal, and left occipital lobes were damaged, and MRA showed that abnormal collateral vessel was richly developed in both hemispheres by occlusion of proximal internal carotid arteries in both sides. His motor strength was improved from poor to good grade in all of upper and lower limb motions, that MBC was improved from stage 1 to stage 5. In FAC and barthel index, at the initial evaluation, he could not perform any functional movement, but his FAC and barthel index were on 3 and 14 points at present, respectively. During long-term follow-up for approximately 4 years, the subject's functional motor ability was improved, as similar with recovery progression of usual stroke patient. We believe that this single case report will provide clinical information and concern regarding Moyamoya disease with physical therapist, in terms of such as epidemiology, pathogenesis, diagnostic procedures, clinical features, recovery process, and prognosis.

• 한국전문물리치료학회지
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• 제19권2호
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• pp.12-19
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• 2012

The purpose of this study was to assess the influence of scapular alignment on the electromyographic (EMG) activity of the trapezius in people with a short pectoralis minor muscle. For the study, we recruited 15 volunteers who had positive results for short on a pectoralis minor muscle length test. We measured the EMG activity of the upper, middle and lower trapezius muscles. The participants lifted their dominant arm to ear level with the thumb up toward the ceiling in the prone position on a table with the shoulder at a flexion angle of 180 degrees and a horizontal abduction angle of 120 degrees. Scapula was manually aligned by an experienced physical therapist prior to arm lift for the scapular alignment condition. A paired t-test was used to compare the effects of scapular alignment on the EMG activity of the trapezius muscles. The EMG activity of the lower trapezius muscle was significantly increased during the test with the scapular alignment compared to that without scapular alignment (p<.05), while the upper trapezius and middle trapezius exhibited no significant difference between the two conditions (p>.05). The findings of this study suggest that a scapular alignment may alter the recruitment of the lower trapezius muscle during arm lifting in the prone position in people with a short pectoralis minor muscle.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.55-62
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• 2014

Objective: To study the effects of gait training with additional weight and gait training with non-additional weight on balance ability and gait ability in patients with chronic stroke through comparative analysis. Design: Randomized controlled trials. Methods: The subjects were divided randomly into two groups: additional weight group (AWG, n=12), and non-additional weight group (NAWG, n=10). Both groups received general physical therapy for 30 min in 1 session, 5 sessions per week during 6 months. The AWG practiced gait training with additional weight of 0.1 and 0.5 kg for 20 min a day, 3 days per week for 6 months and the NAWG practiced gait training with non-additional weight for 20 min a day, 3 days per week for 6 months. Patients in both groups were instructed to walk as fast as they could along a 35 m long track (straight for 20 m and curved for 15 m). Patients walked with their hemiplegic side on the inside of the track while a physical therapist followed along to instruct patients to maintain a straight posture. Balance ability was tested with the Functional Reach Test, the Timed Up and Go test, and the Berg Balance Scale, and gait ability was tested with GAITRite. The results of balance and gait ability were analyzed before and after interventions. Results: A significant increase in FRT, TUG, BBS was seen in both groups after intervention (p<0.05). A significant increase in gait ability was seen in the AWG after intervention (p<0.05). For balance and gait ability, the results from the AWG was significantly improved compared with the NAWG (p<0.05). Conclusions: Gait training with additional weight improves balance ability and gait ability in stroke patients, this gait training method is effective and suitable for stroke patients to increase the ability of functional performance.

• 한국전문물리치료학회지
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• 제26권1호
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• pp.37-50
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• 2019

Background: Stroke is one of the most common diseases responsible for physical disabilities. In addition to their physical and occupational therapy, the self-exercise programs were developed for patients with hemiplegia to increase the intensity of their therapeutic exercise. Objects: The purpose of this study was to assess the effect of a customized self-exercise program (CSP) to walking function on improving stroke survivors' muscle strength and ambulation function. Method: To test the effect of the self-exercise program, the following tests were conducted: The functional ambulation category (FAC), Tinetti performance-oriented mobility assessment gait part (POMA-G), timed up and go (TUG), 10-meter walk, and 2-minute walk. The study included 161 consenting stroke patients (FAC score>1) from a randomized, screened sample of 217. The CSP group participated in a 30-minute CSP each day for 10 weeks in addition to completing a routine rehabilitation program. The control group received only a routine rehabilitation program. All the subjects were monitored by a therapist once a week and had to submit an exercise checklist at the end of each session. Result: The strength of the participants' upper and lower extremity muscles showed no significant differences between the CSP group and the control group. The FAC score and POMA-G also showed no significant differences. However, there were significant differences in the TUG, 10-meter walk test, and 2-minute walk test (p<.05). Conclusion: The findings of this study suggest that a CSP may improve gait-related function in stroke survivors.

• PNF and Movement
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• 제19권2호
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• pp.225-231
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• 2021

Purpose: This study was conducted to investigate the type of physical therapist response work and its intensity, along with the prolonged prevalence of COVID-19, to determine the impact on physical therapists' occupational stress and occupational burnout. Methods: An online survey was conducted with 118 physiotherapists and collected the participants' gender, final educational background, clinical work experience, workplace type, additional workload, and fatigue associated with COVID-19. After excluding one participant who submitted an incomplete questionnaire, 117 respondents were included in the final data. Results: Additional COVID-19-related workloads and response reliability for fatigue, occupational burnout, and occupational stress were shown to have Cronbach's alpha measures of 0.76, 0.89, and 0.87, respectively. Groups who had experienced a new epidemic in the past showed higher fatigue levels (3.06±0.94) than those groups who had no such experience (2.49±0.84; p < 0.05). Correlation analysis of COVID-19 work fatigue and occupational burnout scales showed a positive correlation (r = 0.19; p < 0.05). The regression of occupational burnout and occupational stress showed a regression model of Y = 20.00+0.43X₁ (X₁: job stress; p< 0.05) and an explanatory power of 24.8% with an adj.R² = 0.25. Conclusion: Based on the results, it is suggested that various institutions, such as medical institutions, educational institutions, and physiotherapists' associations, should seek ways to manage and alleviate physiotherapists' stress.

• 기본간호학회지
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• 제2권1호
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• pp.87-101
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• 1995

This study was conducted with the subject of showing the importance of early rehabilitation and exercise therapy in patients who have stroke, of confirming the adavntage of ward exercise conducted by nurse, which had been conducted mainly by physical therapist only in physical thrapy room and of developing the exercise program as the independent rehabilitation nursing intervention. A total of 62 patients were selected as object from April, 5th, to May, 17th, 1995, who had been hospitalized in K medical center, and the half of them were assigned to Experimental group in ramdom assignment using a coin. It was ADL check list tool developed by Kang and Ward Exercise Program developed by the researcher that were used as a treatment. Ward Exercise Program was conducted by the reseacher and the physical therapist measured ADL score before and after Ward Exercise Program. The data were analyzed using ANOVA, pearson correlation, Chi-Square test and the effect of Ward Exercise Program was analyzed by t-tast. The result of this study is as follows. 1. The experimental group showed eminent improvement of ADL compared with the counter group with statistical significance. In eating(t=6.10, df=60, p=.000), personal hygiene performing(t=4.86, df=60, p=.000), wearing(t=5.86, df=60, p=.000), elimination(t=7.89, df=60, p=.000), mobility on the bed(t=13.36, df=60, p=.000), moving(t=9.11, df=60, p=.000), walking(t=7.45, df=60, p=.000) 2. There was no qualitative difference between experimental group and control group with the significance of $p{\le}.05$. 3. There was no relation between the general condition and the difference of ADL, while there was significant relation between the starting point of exercise and the difference of pre-exercise and post exercise ADL. As a result, it should be emphasized that the early rehabilitation and exercise therapy are important in patients who have stroke, and that it is necessary to extend the exercise therapy to the ward. Therefore, this Ward Exercise Program could be recommended as a independent clinical exercise nursing intervention in rehabilitation nursing of patients who have stroke.

• 한국신경인지재활치료학회지
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• 제10권2호
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• pp.45-52
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• 2018

목적: 본 연구는 뇌졸중 환자를 대상으로 BBS, MoCA-K, MBI와의 상관관계를 제시하고 각 변수들과의 영향력을 분석하여 뇌졸중 환자의 기능적 수행능력 평가에 기초연구가 되고자 한다. 방법: 연구 대상자는 고양시에 소재하는 Y재활병원에 입원하여 치료받고 있는 뇌졸중 환자 34명을 대상으로 2017년 12월부터 2018년 3월까지 실시하였으며 선정기준은 첫째, 뇌졸중으로 진단받고 6개월 이상 경과한 자, 둘째, 의사소통이 가능하며 MMSE-K 20점 이상인 자, 셋째, 편측무시가 없는 자, 넷째, 하위운동신경 병변이 없고 양하지 및 척추에 정형외과적 질환이 없는 자, 다섯째, 시청각계 이상이 없고 운동기능에 영향을 주는 약물 또는 수술을 받지 않은 자, 여섯째, 환자본인이 연구 참여에 동의한 자로 하였다. 평가는 재원 중 물리치료사와 작업치료사에 의해 BBS, MoCA-K, MBI를 측정하였으며 균형능력 평가 시 안전을 위하여 한명의 보조자가 동반하여 측정하였다. 결과: BBS와 MoCA-K r=.459, BBS와 MBI r=.550, MoCA-K와 MBI r=.565로 비교적 높은 상관관계가 있었다(p<.01). 결론: 본 연구는 임상적인 평가도구로서 BBS, MoCA-K, MBI의 적극적인 활용과 그 유용성에 대한 근거를 제시하였다는데 의미가 있다.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.124-131
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• 2012

Most conventional instruments measuring disability rely on total score by simply adding individual item responses, which is dependent on the items chosen to represent the underlying construct (test-dependent) and a test statistic, such as coefficient alpha for the estimate of reliability, varying from sample to sample (sample-dependent). By contrast, item response theory (IRT) method focuses on the psychometric properties of the test items instead of the instrument as a whole. By estimating probability that a respondent will select a particular rating for an item, item difficulty and person ability (or disability) can be placed on same linear continuum. These estimates are invariant regardless of the item used (test-free measurement) and the ability of sample applied (sample-free measurement). These advantages of IRT allow the creation of invariantly calibrated large item banks that precisely discriminate the disability levels of individuals. Computer adaptive testing (CAT) method often requiring a testing algorithm promise a means for administering items in a way that is both efficient and precise. This method permits selectively administering items that are closely matched to the ability level of individuals (measurement precision) and measuring the ability without the loss of precision provided by the full item bank (measurement efficiency). These measurement properties can reasonably be achieved using IRT and CAT method. This article aims to investigate comprehensive overview of the existing disability instrument for back pain and to inform physical therapists of an alternative innovative way overcoming the shortcomings of conventional disability instruments. An understanding of IRT and CAT method will equip physical therapist with skills in interpreting the measurement properties of disability instruments developed using the methods.