• 제목/요약/키워드: voluntary health center

검색결과 84건 처리시간 0.022초

고유수용성 신경근촉진법의 앙와위와 복와위로부터 입위로 진행 발전시키는 임상적 접근 (A Clinical Approach of Supine & Prone Progression from Supine to Standing Position in PNF)

  • 배성수;권미지;김수민
    • The Journal of Korean Physical Therapy
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    • 제11권2호
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    • pp.51-59
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    • 1999
  • 특별한 경우를 재외하고 모든 질병 흑은 손상에 의한 환자는 바닥 혹은 침상에서 생활하게 된다. 질병 혹은 손상이 의학적으로 모두 해결되었다 하더라도 곧바로 일어서서 걸어갈 수가 얼다. 모든 환자는 일어서서 나갈 수 있는 준비훈련이 필요하다. 바닥에서부터 일어서기까지의 훈련방법은 여러 가지가 있을 수 있다. 단순한 반사반응의 이용, 수의적인 운동으로 인한 근력의 향상을 할 수 있는 ROM운동이 가장 보편적이나 발달단계에 적합한 임상적 접근이 가장 이상적이라 할 수 있다. 고유수용성 신경근촉진법의 앙와위와 복와위로부터 일어서기까지의 접근방법이 가장 대표적이라 할 수 있다. 이것은 발달단계에 따라서 반사반응의통합, 신경근 통합, 근력의 강화, 운동조절 등을 동시에 적용하게 됨으로 가장 적절하다. 구두명령과 치료사외 손으로 투입되는 인지적, 운동행동, 심리적인 자축이 부가적으로 제공됨으로 입체적인 접근방법이라 할 수 있다. 고유수용성신경근촉진법의 앙와위와 복와위로부터 입 위까지 운동발달단계에 맞추어 제공되는 임상적 접근은 모든 종류의 환자에게 적용할 수 있다.

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PNF 하지패턴이 뇌졸중 환자의 상지 근활성도에 미치는 영향 (The Effects of PNF Leg Patterns on Activation of Biceps and Triceps in Stroke Patients)

  • 이문규;김종만;김원호
    • The Journal of Korean Physical Therapy
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    • 제21권1호
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    • pp.1-7
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    • 2009
  • Purpose: The aim of this study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) leg patterns on muscle activation of paretic and nonparetic arm in post-stroke hemiparetic subjects. Methods: Eighteen hemiparetic patients participated in this study. Each subject was asked to perform four PNF leg patterns against maximal manual resistance on nonparetic leg. EMG data were collected from biceps and triceps on the paretic and nonparetic side. The measured EMG data was digitized and processed to root mean square (RMS) and expressed as percentage maximal voluntary isometric contraction (%MVIC). The data were analyzed using paired t-test and one-way analysis of variance (ANOVA) with repeated measures to determine the statistical significance. Results: The results of this study were summarized as follows: Firstly, during four PNF patterns application, all of the %MVIC values of biceps and triceps in paretic and nonparetic arms increased significantly compared with resting condition (p<0.05). Secondly, there was a significant difference in %MVIC of paretic biceps between PNF leg pattern 1 and 4 (p<0.05). Conclusion: In conclusion, regardless of the kinematic components of PNF leg patterns, all of the muscle activation of biceps and triceps in paretic and nonparetic arm was significantly increased. The finding of this study indicates that irradiation effect caused by PNF leg patterns is beneficial for increased muscle activation of both paretic and nonparetic arms in post-stroke patients.

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무작위 속도 변화에 의한 트레드밀 보행훈련이 뇌졸중 환자의 폐기능에 미치는 영향 (Effects of Treadmill Walking Training with Randomized Walking Speed on Pulmonary Function in Persons with Chronic Stroke)

  • 박성훈;차용준;최윤희
    • 대한물리의학회지
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    • 제11권4호
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    • pp.71-78
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    • 2016
  • PURPOSE: The purpose of this study was to investigate which treadmill walking training mode is more effective strategy for improving pulmonary function of persons with chronic stroke. METHODS: Twenty-one chronic stroke patients were allocated and randomly to an experimental group (treadmill training with randomized speed control, n=11) and a control group (treadmill training without speed change, n=10). All participants received 30 minutes of neurodevelopmental treatment. In addition, the two groups performed treadmill training for 20 minutes each time with or without speed change. Speed change was applied 40%, 50%, 60%, 70% of Heart Rate Reserve. All the exercise programs lasted six weeks, with five times per week. Pulmonary function was assessed before and after exercise program by using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV). RESULTS: In the both groups, FEV1 was significantly increased after training (p<.05). Compared to the control group, the experimental group showed 11.9% larger amount of change (p<.05). In the experimental group, FVC and MVV were significantly increased after training (9.9%, 7.6%, respectively) (p<.05). But in the control group, there was no significant difference in the FVC and MVV after training. CONCLUSION: Treadmill training with randomized speed control will be a better positive rehabilitation program than treadmill training without speed change to improve pulmonary function in persons with chronic stroke.

순환식 유산소운동이 만성 뇌졸중 환자의 폐 기능 및 보행 지구력에 미치는 영향 (Effects of Circuit Aerobic Exercise on Gait Endurance and Pulmonary Function in Patients after Chronic Stroke)

  • 박종준;최윤희;차용준
    • 대한물리의학회지
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    • 제11권4호
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    • pp.33-39
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    • 2016
  • PURPOSE: The purpose of this study was to investigate whether a circuit aerobic exercise program positively affects pulmonary function and gait endurance in chronic stroke patients. METHODS: Twenty-four chronic stroke patients were allocated equally and randomly to an experimental group (n=12) or a control group (n=12). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally performed a circuit aerobic exercise for 30 minutes, while the control group additionally performed a general aerobic exercise, i.e., gait training on the treadmill for 30 minutes. These 30-minute exercise sessions were held three times per week for six weeks. Pulmonary function was assessed using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV), and gait endurance was assessed using the 6-minute walk test (6MWT). RESULTS: In the both groups, FVC, FEV1, MVV, and 6MWT were significantly increased after training. Members of the experimental group showed significant improvements in FVC, FEV1, and MVV, and significantly greater improvements than controls (p<.05). However, 6MWT improvements were not significantly different in the two groups (p>.05). CONCLUSION: The devised circuit aerobic exercise program offers an effective rehabilitation aerobic exercise for improving pulmonary function and gait endurance in patients after chronic stroke.

대학생들의 인터넷 중독 인식에 대한 탐색적 연구 : 포토보이스 적용 (An Exploratory Study on University Students' Perception of Internet Addiction : Using Photovoice)

  • 김수진
    • 한국방재안전학회논문집
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    • 제13권3호
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    • pp.59-74
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    • 2020
  • 본 연구는 참여적 연구방법인 포토보이스 방법을 적용하여 대학생들의 인터넷 중독에 대한 주관적 인식에 대해 심층적으로 탐색해 보고자 하였다. 연구대상은 G대학의 대학생 9명이며, 일반적인 포토보이스 연구절차에 따라 오리엔테이션, 연구 참여자들의 사진촬영을 통한 자료수집, 사진 선정, 맥락화, 범주화 과정으로 자료를 분석하였다. 연구결과 인터넷 중독의 의미, 인터넷 중독이 삶에 미치는 영향, 인터넷 중독에서 벗어나는 방안이라는 주제에 따라 15개의 하위범주가 도출 되었다. 인터넷 중독의 의미에 대한 인식은 '자기조절 능력상실', '출구 없는 습관', '세상과의 단절', '나를 잃어버림', '자발적 감옥'이라는 5가지 범주로 나타났다. 인터넷 중독이 삶에 미치는 영향은 5가지 범주로 '건강 악화, '사회적 고립, '망가진 일상', '익명으로 인한 폭력성', '나의 발견과 삶의 확장'이었다. 인터넷 중독에서 벗어나는 방법에 대해서는 '자기바라보기', '새로운 취미생활', '주변의 도움', '현실속의 만남', '강제적 차단'이 도출되었다. 대학생의 시선으로 바라본 인터넷 중독에 대한 논의와 올바른 인터넷 사용을 조력할 수 있는 상담 프로그램 구성에 대한 시사점을 제언하였다.

Effects of the Short Foot Exercise With Neuromuscular Electrical Stimulation on Navicular Height in Flexible Flatfoot in Thailand: A Randomized Controlled Trial

  • Namsawang, Juntip;Eungpinichpong, Wichai;Vichiansiri, Ratana;Rattanathongkom, Somchai
    • Journal of Preventive Medicine and Public Health
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    • 제52권4호
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    • pp.250-257
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    • 2019
  • Objectives: Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot. Methods: Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention. Results: No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups ($SFE=73.9{\pm}11.0%$ of maximal voluntary isometric contraction [MVIC]; SFE with $NMES=81.4{\pm}8.3%$ of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group ($pre-treatment=218.6{\pm}53.2mm^2$ ; $post-treatment=256.9{\pm}70.5mm^2$ ; p<0.05). Conclusions: SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

2,30대 정상 성인남녀의 몸통 굽힘 시 골반의 기울임과 몸통 움직임 및 몸통 폄 근의 상관관계 연구 (Correlation between Pelvic Tilt Angle with Trunk Motion and Trunk Extensor during Trunk Forward Flexion in Adults Aged 2,30)

  • 박영주;이상열
    • 대한통합의학회지
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    • 제7권1호
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    • pp.81-88
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    • 2019
  • Purpose : The purpose of this study was to examine if there is any correlation between pelvic tilt angle and trunk motion and trunk extensor during trunk forward flexion and to measure trunk motion, onset time of trunk motion, and onset time of trunk extensor activation. Methods : The subjects of this study were 42 healthy adults. The subjects had no back pain due to neurological disease and no experience of back surgery. After pelvic tilt angle was measured, each trunk forward flexion was performed three times. Trunk motion and onset time of trunk motion were measured using Myomotion. Four sensors were used, with one located at the upper thoracic (below $C_7$), the lower thoracic ($T_{12}-L_1$), the sacrum ($S_1$), and at the center of the anterior femur. Onset time of trunk extensors (spinalis, longissimus, gluteus medius, gluteus maximus, biceps femoris, and gastrocnemius) activation was measured using a wireless surface EMG. The EMG amplitude was normalized by using the reference voluntary contraction (RVC). The statistical significance of the results were evaluated using Pearson's correlation test. Results : The correlation between pelvic tilt angle and lumbar motion, onset time of pelvis motion, and onset time of gluteus medius activation was statistically significant in a positive direction (p<.05). The correlation between pelvic tilt angle with pelvis motion, onset time of lumbar motion, and onset time of longissimus activation showed a statistically significant negative correlation (p<.05). Conclusion : The study results provide a significant contribution to our understanding of the lumbar load at the initial stage of trunk flexion. Therefore, it may be possible to provide basic data for evaluation and treatment, such as orthodontic treatment for alignment of the spine and back pain. In addition, it is necessary to focus on normal exercise pattern reeducation as well as pelvic correction during exercise in daily life or in industrial fields.

보건의료빅데이터 연구에 대한 대중의 인식도 조사 및 윤리적 고찰 (The Overview of the Public Opinion Survey and Emerging Ethical Challenges in the Healthcare Big Data Research)

  • 조수진;최병인
    • 대한기관윤리심의기구협의회지
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    • 제4권1호
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    • pp.16-22
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    • 2022
  • Purpose: The traditional ethical study only suggests a blurred insight on the research using medical big data, especially in this rapid-changing and demanding environment which is called "4th Industry Revolution." Current institutional/ethical issues in big data research need to approach with the thoughtful insight of past ethical study reflecting the understanding of present conditions of this study. This study aims to examine the ethical issues that are emerging in recent health care big data research. So, this study aims to survey the public perceptions on of health care big data as part of the process of public discourse and the acceptance of the utility and provision of big data research as a subject of health care information. In addition, the emerging ethical challenges and how to comply with ethical principles in accordance with principles of the Belmont report will be discussed. Methods: Survey was conducted from June 3th August to 6th September 2020. The online survey was conducted through voluntary participation through Internet users. A total of 319 people who completed the survey (±5.49%P [95% confidence level] were analyzed. Results: In the area of the public's perspective, the survey showed that the medical information is useful for new medical development, but it is also necessary to obtain consents from subjects in order to use that medical information for various research purposes. In addition, many people were more concerned about the possibility of re-identifying personal information in medical big data. Therefore, they mentioned the necessity of transparency and privacy protection in the use of medical information. Conclusion: Big data on medical care is a core resource for the development of medicine directly related to human life, and it is necessary to open up medical data in order to realize the public good. But the ethical principles should not be overlooked. The right to self-determination must be guaranteed by means of clear, diverse consent or withdrawal of subjects, and processed in a lawful, fair and transparent manner in the processing of personal information. In addition, scientific and ethical validity of medical big data research is indispensable. Such ethical healthcare data is the only key that will lead to innovation in the future.

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국가건강검진의 방사선검사 이용량 및 피폭선량 추정 (Estimated Exposure Dose and Usage of Radiological Examination of the National Health Screening)

  • 길종원;박종혁;박민희;박찬영;김소영;신동욱;김원동
    • Journal of Radiation Protection and Research
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    • 제39권3호
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    • pp.142-149
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    • 2014
  • 한국은 국가건강검진을 시행하여 국민건강증진에 크게 기여하고 있으며 그 수검률 또한 증가하고 있다. 본 연구는 수검률 증가에 따른 방사선검사의 증가가 예상되어 그 이용 빈도(이용량)와 피폭선량을 파악하고자 한다. 본 연구는 2011년 국민건강보험공단 건강검진 분석 자료에서 방사선검사를 분리하여 이용량을 파악하고, UNSCEAR 2008년 보고서의 수록되어 있는 검사별 선량을 적용하여 국가건강검진에서 방사선검사로 인한 피폭선량을 추정한다. 주요 분석결과 2011년 국가건강검진 수검자 1인당 평균 피폭선량은 0.57 mSv로 추정되었고, 최대 11.081 mSv, 최소 0.02 mSv로 추정되었다. 방사선검사의 이용 빈도와 피폭선량은 각각 총 16,005,914건, 6,311.76 person-Sv로, 이중 이용량은 흉부 X선검사가 1,070,569 (69.17%)건으로 가장 높았고, 피폭선량은 위장조영검사가 5,217.94 (82.67%) person-Sv로 가장 높았다. 성 연령별 결과 39세 이하를 제외한 전 연령대에서 여성의 수검비율과 피폭선량이 높았고, 특히 50-54세 여성이 1,674,787 (10.5%)건, 701.59 (11.1%) person-Sv로 가장 높았다. 검사별 선량에서 위장조영검사가 전체 82.67%를 차지하는 만큼 의료상(목적) 반드시 시행하는 경우를 제외하고는 위장내시경검사를 선택하여 수검 받도록 정책적으로 장려하고 외국의 사례와 같이 경제성과 실효성 평가에 따라 폐지된다면 국가건강검진에의 방사선피폭은 현저히 줄어들 것으로 예상한다.

암 등록사업의 현황과 추진방향 (Cancer Registration in Korea: The Present and Furtherance)

  • 안윤옥
    • Journal of Preventive Medicine and Public Health
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    • 제40권4호
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    • pp.265-272
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    • 2007
  • It was not until 1975 that cancer registration was initiated in Korea; voluntary registration of cancer patients of training hospitals throughout the country began under the auspices of the Korean Cancer Society(KCS). However, an official cancer registration, the Korea Central Cancer Registry(KCCR), began on July 1st, 1980. Forty-five training and two non-training hospitals throughout the country initiated registration of patients in whom neoplasms had been found. Data related to case information specified are to be sent to the KCCR at the National Medical Center(it moved at National Cancer Center in 2000). The initial cancer registration of KCS was merged to the KCCR in 1980. Although the KCCR covers most all the large training hospitals in Korea, it cannot provide incidence data. It is, however, the only of its kind in the world, being neither hospital nor population based. The first population based cancer registry(PBCR) was launched in a small county, Kangwha(it has around 80,000 inhabitants), by Yonsei University Medical College in 1983. All data were collected by active methods, and incidence statistics for 1986-1992 appeared in Vol VII of the CI5. Another PBCR, Seoul Cancer Registry(SCR), started in 1991. It was supported by a civilian foundation, the Korean Foundation for Cancer Research. The basic idea of case registration of SCR was the incorporation of KCCR data to PBCR, e. g. dual sources of case registration, i.e., from the KCCR and also including cases diagnosed in small hospitals and other medical facilities. Assessing completeness and validity of case registration of SCR, the program and methodology used by the SCR was later extended to other large cities and areas in Korea, and the PBCR in each area was established. Cancer incidence statistics of Seoul for 1993-1997, Busan for 1996-1997, and Daegu for 1997-1998, as well as Kangwha for 1993-1997, appeared eventually in Vol VIII of the CI5. The Korean or 'pillar' model for a PBCR is a new one. The KCCR data file is a reliable basis, as a pillar, for a PBCR in each area. The main framework of the model for such a registry is the incorporation of a KCCR data file with data from additionally surveyed cases; the data related to cancer deaths, medical insurance claims, and visit-and surveillance of non-KCCR medical facilities. Cancer registration has been adopted as a national cancer control program by Korean government in 2004 as the Anti-Cancer Act was enacted. Since then, some officers have tried to launch a nation-wide PBCR covering whole country. In the meantime, however, cancer registration was interrupted and discontinued for years due to the Privacy Protection Law, which was solved by an amendment of the Anti-Cancer Act in 2006. It would be premature to establish the nation-wide PBCR in Korea. Instead, continuous efforts to improve the completeness of registration of the KCCR, to progress existing PBCRs, and to expand PBCRs over other areas are still to be devoted. The nation-wide PBCR in Korea will be established eventually with summation of the PBCRs of the Korean model.