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The Effect of Sensory Integrative Intervention on Postural Control and Occupational Performance (Play) of the Preschool Child With Postural Disorder: Case Study Using Goal Attainment Scale (GAS) (감각통합 중재가 취학 전 자세조절장애 아동의 자세조절과 작업수행(놀이)에 미치는 영향: 목표성취척도(Goal Attainment Scale)를 사용한 사례보고)

  • Ryu, Sung-Un;Kim, In-Sun;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.2
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    • pp.1-11
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    • 2013
  • Objective : The purpose of this study is to verify the effect of sensory integrative intervention on postural control and occupational performance (play) of the preschool child with postural disorder. Methods : Subject of this study was a 5 years and 8 month old boy. The subject underwent a sensory integration (SI) treatment which was part of the SI clinic course administered by the Korean Sensory Integration Society, in 2012. The treatment goal and treatment plan had established based on the evaluation results. Treatment was done with 11 sessions, the treatment activities and the adaptive responses of the subject were measured as outcome of the SI treatment. The goal of sessions were measured as Goal Attainment Scale, and re-evaluation was done on December in 2012. Results : During SI treatment, the subject was improved the stability of proximal body parts so that maintained Supine-Flexion Posture more than 20 seconds. He also showed increased attention span continuously about 1 activity on physical play. Conclusion : According to the results of this study, it was verified that sensory integrative intervention has positive effective on postural control and occupational performance (play) of the preschooler with postural disorder.

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Clinical Features according to the Frequency of Acute Exacerbation in COPD

  • Lee, Seung-Jun;Lee, Seung-Hun;Kim, Yu-Eun;Cho, Yu-Ji;Jeong, Yi-Yeong;Kim, Ho-Cheol;Kim, Jin-Hyun;You, Jin-Jong;Yoon, Chul-Ho;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.367-373
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    • 2012
  • Background: Chronic obstructive pulmonary disease (COPD) is now regarded as a heterogenous disease, with variable phenotypes. Acute exacerbation of COPD is a major event that alters the natural course of disease. The frequency of COPD exacerbation is variable among patients. We analyzed clinical features, according to the frequency of acute exacerbation in COPD. Methods: Sixty patients, who visited Gyeongsang National University Hospital from March 2010 to October 2010, were enrolled. Patients were divided into two groups, according to their frequency of acute exacerbation. Frequent exacerbator is defined as the patient who has two or more exacerbation per one year. We reviewed patients' medical records and investigated modified Medical Research Council (MMRC) dyspnea scale, smoking history and frequency of acute exacerbation. We also conducted pulmonary function test and 6-minute walking test, calculated body mass index, degree of airway obstruction and dyspnea and exercise capacity (BODE) index and measured CD146 cells in the peripheral blood. Results: The number of frequent exacerbators and infrequent exacerbators was 20 and 40, respectively. The frequent exacerbator group had more severe airway obstruction (forced expiratory volume in one second [$FEV_1$], 45% vs. 65.3%, p=0.001; $FEV_1$/forced vital capacity, 44.3% vs. 50.5%, p=0.046). MMRC dyspnea scale and BODE index were significantly higher in the frequent exacerbator group (1.8 vs. 1.1, p=0.016; 3.9 vs. 2.1, p=0.014, respectively). The fraction of CD146 cells significantly increased in the frequent exacerbator group (2.0 vs. 1.0, p<0.001). Conclusion: Frequent exacerbator had more severe airway obstruction and higher symptom score and BODE index. However, circulating endothelial cells measured by CD146 needed to be confirmed in the future.

The Comparison of Trunk Muscle Activities During Sling and Mat Exercise (요부 안정화 운동에 따른 몸통 근육들의 근활성도 비교)

  • Choi, Hee-Soo;Kwon, Oh-Yun;Yi, Chung-Hwi;Jeon, Hye-Seon;Oh, Jae-Seop
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.1-10
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    • 2005
  • The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.

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Relationship Among Parents' Quality of Life, Functional Level, Performance in the Activities of Daily Living, and the Quality of Life in School-aged Children With Spastic Cerebral Palsy (학령기 경직성 뇌성마비 아동 부모의 삶의 질과 아동의 삶의 질 및 기능과 일상생활활동 수행 수준의 관련성)

  • Lee, Ye-seul;Oh, Duck-won
    • Physical Therapy Korea
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    • v.24 no.1
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    • pp.51-60
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    • 2017
  • Background: In cerebral palsy (CP), parents' quality of life and rearing attitude are considered possible factors that influence patients' quality of life, function level, and performance in daily activities. Despite these facts, little attention has been given to demonstrate a relation between these factors. Objects: This study aimed to demonstrate the relationship between parents' quality of life, functional level, and performance in daily activities, the quality of life of school-aged children with spastic CP. Methods: This study included 24 parents of school-aged children with spastic CP. The KIDSCREEN-52 and World Health Organization quality of life (WHOQOL)-BREF questionnaires (including physical, psychological, social, and environmental domains) were used as research tools to assess the quality-of-life profiles of the children with spastic CP and those of their parents, respectively. In addition, the function levels and performance in daily activities of the children with CP were assessed by using the gross motor function measure (GMFM) and modified Barthel index (MBI). Correlation and multiple regression analyses were performed to clarify the determinants of the quality of life of the children with CP. Results: The KIDSCREEN-52 score correlated with the total score (r=.735, p<.01) and all domains of the WHOQOL-BREF questionnaire (physical: r=.542, p<.01; psychological: r=.690, p<.01; social: r=.568, p<.01; and environmental: r=.783, p<.01). In addition, significant correlation was found between the KIDSCREEN-52 and MBI scores (r=.411, p<.05), and between the MBI and GMFM scores (r=.427, p<.05). After controlling for age, gender, paralytic type, GMFM, and MBI, the WHOQOL-BREF score ($R^2=.621$), particularly in the environmental domain ($R^2=.699$), remained independently related to the quality of life of the children. Conclusion: These findings suggest that the quality of life of school-aged children with spastic CP can be influenced by the quality of life of their parents. This study provides useful information for future studies to investigate the quality of life of children with CP.

Comparison Between Stroke Patients and Normal Persons for Trunk Position Sense and It's Relation to Balance and Gait (정상인과 뇌졸중 환자의 체간 위치감각 비교 및 보행과 균형에 미치는 영향)

  • Yang, Hea-Duck;Kim, Chang-beom;Choi, Jong-Duk;Moon, Young
    • Physical Therapy Korea
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    • v.27 no.3
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    • pp.178-184
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    • 2020
  • Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

A study on the Participation Motivation of Clinical Nurses in Job Training (임상간호사의 융복합적 직무교육 참여동기에 관한 연구)

  • Park, Hyun Hee;Lee, Kwang-Ok;Kim, Soon-Ok
    • Journal of Digital Convergence
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    • v.14 no.8
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    • pp.319-329
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    • 2016
  • This study aimed to identify nurses' participation motivation, its influence factors, and their job training need. A survey was conducted on 345 nurses of general hospitals in Gyeonggi-do. Data was collected from October 5th to 18th, 2016 and was analyzed through t-test, ANOVA, Bonferroni post-test, and multiple regressions using SPSS 21.0. Participation motivation was high in 'expertise capability improvement and development' and low in personal gain and job stability. Job training need was the highest in nosocomial infection management and CPR and was the lowest in hospice and rehabilitation nursing. Participation motivation had significant differences depending on age, marital status, educational level, and clinical experience, and was influenced by the job training need of professional nursing and medical knowledge for disease treatment. Therefore, it is necessary to plan medical educational programs to enhance job training effectiveness, establish a strategy to increase participation motivation; and expand various job training support.

The effects of knee joint position sense following local and general load protocols (국소적 부하와 전신적 부하가 슬관절 위치 감각에 미치는 영향)

  • Hwang, Yoon-Tae;Park, Rae-Joon;Choi, Jin-Ho
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.429-440
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    • 2005
  • The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

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A clinical study about painful manifestation on lumbar with regard to movement change of trunk (체간의 움직임 변화에 따른 요추부 근육의 통증 발현에 대한 임상적 고찰)

  • Kim, Sung-Ryul;Lee, Suk-Min;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • v.16 no.3
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    • pp.86-96
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    • 2004
  • A clinical study about painful manifestation on lumbar with regard to movement change of trunk The purpose of this study is to present the basis of low back pain therapy which is close examined of back muscle that is the main reason for that case of back pain when trunk rotation, flexion and extension. Therefore this study, which is based on literature review and clinical experience, has tried to figure out that back pain which is considered to be significant for the most increasing time, posture, motion, painful area, involved muscle have any influence on trunk rotation, flexion and extension This study has done with the patients in oriental rehabilitation clinic, K-oriental hospital, from Jan, 2003 to Dec, 2003. Total cases were 145(male:$39\%$-52 patients, female:$64.1\%$-93 patients) those who complained lumbosacral pain with radiating that makes patient unable to bending or extending the trunk. And they were surveyed retrospect way, checking the medical record and that of therapist. Results are as followings. 1. For sprain patient, $34.5\%$ complained pain on extension, and among them, the most remarkably, patients who did right rotation extension pattern were $20\%$. Herniated disc patient shows greater limit on flexion when trunk moves bending route, but right rotation with extension pattern shows the most limitation on flexion-extension according to the rotation of trunk 2. Cases of morning back pain($60.5\%$) showed high value on right rotation extension pattern($18.6\%$), right rotation flexion pattern($16.3\%$) but did not show big difference on left flexion and extension pattern 3. Patients those who complain pain on sitting position showed highest value each left, right $14.6\%$ of left and right rotation extension pattern 4. Among extension painful patient, there showed highest value of each $32.5\%$ on right rotation extension pattern, and $20.0\%$ on right rotation flexion pattern. 5. Tenderness distribution of quadratus lumborum showed $34.5\%$ on right rotation extension pattern, $20.7\%$ on left rotation extension pattern, and that of iliopsoas muscle at right rotation flexion pattern showed right muscle $20.0\%$, left $50.0\%$ Derived from the results of survey above, for sprain and HIVD patient showed greatest pain on right rotation pattern, for pain plus patient on right rotation extension among those who has extreme pain on sitting in the morning described tenderness on right quadratus lumborum, and those who complain pain on left rotation extension described tenderness on left lumborum the most Decisively, it is possible to figure out the problem muscle that involved when I found the time, position, motion that aggravating and painful area. Therefore this study would be expected to be able to be a useful clinical materials on diagnosis and therapy of low back pain.

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The Role of Bone Cement Augmentation in the Treatment of Chronic Symptomatic Osteoporotic Compression Fracture

  • Kim, Hyeun-Sung;Kim, Sung-Hoon;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.490-495
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    • 2010
  • Objective : Bone cement augmentation procedures such as percutaneous vertebroplasty and balloon kyphoplasty have been shown to be effective treatment for acute or subacute osteoporotic vertebral compression fractures. The purpose of this study was to determine the efficacy of bone cement augmentation procedures for long standing osteoporotic vertebral compression fracture with late vertebral collapse and persistent back pain. Methods : Among 278 single level osteoporotic vertebral compression fractures that were treated by vertebral augmentation procedures at our institute, 18 consecutive patients were included in this study. Study inclusion was limited to initially, minimal compression fractures, but showing a poor prognosis due to late vertebral collapse, intravertebral vacuum clefts and continuous back pain despite conservative treatment for more than one year. The subjects included three men and 15 women. The mean age was 70.7 with a range from 64 to 85 years of age. After postural reduction for two days, bone cement augmentation procedures following intraoperative pressure reduction were performed. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period after bone cement augmentation procedures was 14.3 months (range 12-27 months). The mean injected cement volume was 4.1 mL (range 2.4-5.9 mL). The unipedicular approach was possible in 15 patients. The mean pain score (visual analogue scale) prior to surgery was 7.1, which decreased to 3.1 at 7 days after the procedure. The pain relief was maintained at the final follow up. The kyphotic angle improved significantly from $21.2{\pm}4.9^{\circ}$ before surgery to $10.4{\pm}3.8^{\circ}$ after surgery. The fraction of vertebral height increased from 30% to 60% after bone cement augmentation, and the restored vertebral height was maintained at the final follow up. There were no serious complications related to cement leakage. Conclusion : In the management of even long-standing osteoporotic vertebral compression fracture for over one year, bone cement augmentation procedures following postural reduction were considered safe and effective treatment in cases of non-healing evidence.

Exploring the Use of Melody During RAS Gait Training for Adolescents with Traumatic Brain Injury: A Case Study (외상성 뇌손상 청소년 대상 리듬청각자극(RAS) 보행 훈련 시 선율 적용 사례)

  • Park, Hye Ji
    • Journal of Music and Human Behavior
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    • v.12 no.2
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    • pp.19-36
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    • 2015
  • The purpose of this study was to examine the effects of rhythmic auditory stimulation (RAS) on gait parameters, with and without the presence of a melody, for adolescents with traumatic brain injury (TBI). Three adolescents with TBI received a total of ten individual RAS training sessions. At pre and posttest, spatiotemporal parameters including cadence, velocity and kinematic parameters were measured using the VICON 370 Motion Analysis System. The results showed no significant difference in gait velocity between the two conditions, thus the presence of the melody condition did not impact the outcome of RAS gait training. On the other hand, all participants showed improvement in gait function after RAS training. The cadence, velocity, stride length, and symmetry were increased and the stride time was reduced after training. The motion analysis demonstrated that the movement patterns of hip and knee joints improved, as they were more similar to normal gait, which indicates that the walkings tance became more stable. The research findings indicate that rhythm is the primary factor in mediating gait functions via RAS training. This study also supports that RAS training can effectively improve the gait function for adolescents with TBI.