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Effects of Gym-ball Exercise in Standing Position on Muscle Strength, Balance, Gait and Fall Efficacy in Stroke Patients (선 자세에서 짐볼 운동이 뇌졸중 환자의 근력, 균형, 보행 및 낙상 효능감에 미치는 효과)

  • Lim, Yun-Jeong;Kang, Soon-Hee
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.49-60
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    • 2022
  • Purpose : The purpose of this study was to identify whether gym-ball exercise in standing position was an effective intervention for improving muscle strength, balance, gait, and fall efficacy in stroke patients. Methods : Twenty-four stroke patients were randomized into three groups: experimental group 1 (n=8), experimental group 2 (n=8), and control group (n=8). Experimental groups 1, 2 and the control group performed the gym-ball exercise in standing position, same exercise without a gym-ball, and general physical therapy for 4 weeks, five times a week in 30-minute sessions. Muscle strength, balance, gait, and fall efficacy were assessed using a handheld dynamometer, the Berg Balance Scale (BBS), the wearable BTS G-WALK® sensor, and the Korean version of the Falls Efficacy Scale (K-FES), before and after training, respectively. Comparisons within and between groups were analyzed using the Wilcoxon signed rank test, Kruskal Wallis H test, and Mann-Whitney U test. Bonferroni correction was performed when significant differences between groups were identified (p<.017, .05/3). Results : Regarding muscle strength, BBS score, cadence and FES-K were significantly improved after intervention in all three groups. The weight bearing rate, gait speed and step length in experimental group 1 and 2 were significantly improved after the intervention. The stride length in experimental group 1 were significantly improved after the intervention. Experimental group 1 had significantly improved BBS score and stride length after intervention than experimental group 2 and control group. Experimental group 1 and 2 improved muscle strength, weight bearing rate, and FES-K score more than the control group. Experimental group 1 showed significant improvement in cadence, gait speed, and step length after the intervention than control group. Conclusion : This study showed that exercise with gym-ball in standing position can be an effective intervention to improve balance and gait in stroke patients than the same exercise without gym-ball.

Systematic Review of Assessment Tools for the Housing Environment of the Old Adults Population (노년 인구의 주거환경 평가도구에 관한 체계적 고찰)

  • Lim, Young-Myoung
    • Therapeutic Science for Rehabilitation
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    • v.13 no.2
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    • pp.27-40
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    • 2024
  • Objective : This study aimed to conduct a systematic review of the assessment tools used to assess the housing environment of older adults. Methods : Data were collected from January 2015 to August 31st, 2023, by searching databases including the Cochrane Library, PubMed, and ProQuest. From the 267 articles, nine assessment tools were selected for analysis based on their original instruments. These tools were categorized and systematically organized for analysis based on their frequency of use, assessment purposes, sub-domains, scales, and other relevant criteria. Results : Among the nine tools, HOME FAST and IPAQ-E were the most frequently used (20% each). The objectives of these tools are to assess friendliness, physical barriers, fall prevention, dementia-friendly environments, physical activity, and accessibility. The measurement scope encompassed various factors, such as outdoor spaces, buildings, transportation, housing, and community support. Conclusion : When considering the suitability of housing for the older adults population, providing foundational data for the rational selection of evaluation tools with logical validity is important. This includes factors such as the objectives and measurement scopes of housing environment assessment tools.

Associations among Physical Activity, Comorbidity, Functional Capacity, Peripheral Muscle Strength and Depression in Breast Cancer Survivors

  • Vardar-Yagli, Naciye;Sener, Gul;Saglam, Melda;Calik-Kutukcu, Ebru;Arikan, Hulya;Inal-Ince, Deniz;Savci, Sema;Altundag, Kadri;Kutluk, Tezer;Ozisik, Yavuz;Kaya, Ergun Baris
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.585-589
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    • 2015
  • Physical inactivity may an important outcome in the prognosis of breast cancer. Physical activity levels decrease significantly for breast cancer patients following the treatment and remain low after oncology treatment is completed. The aim of this study was to determine physical activity levels and to examine associations among physical activity, comorbidity, functional capacity, peripheral muscle strength, and psychosocial status in breast cancer patients. Forty breast cancer survivors were included in this study. Demographic and clinical characteristics were recorded. Physical activity was assessed with a short form of the International Physical Activity Questionnaire (IPAQ). We defined comorbid diseases according to the Charlson Comorbidity Index (CCI). Functional capacity was evaluated with a six-minute walk test (6MWT). Peripheral muscle strength was measured for quadriceps femoris muscle with a hand-held dynamometer. Psychosocial status was measured with the Hospital Anxiety Depression Scale (HADS). Forty percent of patients were inactive. The IPAQ total score was significantly related with quadriceps muscle strength (r=0.492; p<0.001) and HADS depression score (r=0.341; p<0.05). Marked correlations were also observed between IPAQ walking score and quadriceps muscle strength (r=0.449; p<0.001), HADS depression score (r=0.341; p<0.05), and CCI (r=-0.433; p<0.001). The CCI score was also markedly associated with quadriceps muscle strength (r=-0.413; p<0.001). 6MWT distance was not significantly correlated with any of the parameters. Regression analyses revealed that psychosocial status and peripheral muscle strength were significant predictors of physical activity estimated with the IPAQ short form and when combined, they explained 35% of the variance. Comorbidities, peripheral muscle strength and psychosocial status partially explain the variability of physical activity level in breast cancer survivors. These results suggest that physical inactivity contributes to worsening health in breast cancer survivors.

The Clinical Report on 3 cases of the patient of extruded disc Treated with Motion Style Treatment (동작침법(M.S.T.)을 시행한 요추간판탈출증환자의 보행곤란 환자 치험 3례 보고)

  • Cho, Jae-Hee;Lee, Hyo-Eun;Song, Joo-Hyun;Moon, Ja-Young;Lim, Myung-Jang;Kang, In;Jang, Hyoung-Seok;Park, Young-Eun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.2 no.2
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    • pp.131-140
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    • 2007
  • Objectives : the purpose of this study is to report the improvement of HIVD patients with gait difficulty, who treated by M.S.T(Motion Style Treatment) Methods : the clinical study was done on 3 cases of patients with disc extrusion, whose walking ability was not improved after the admission in Ja-Seng Oriental Medicine Hospital for a week. we checked the walking time and NRS score after the treatment of M.S.T(Motion Style Treatment) each day. Results : the walking time increased after the treatment of M.S.T(Motion Style Treatment). Whereas NRS score decreased after the treatment of M.S.T(Motion Style Treatment). after 2-3 weeks of treatment, 3 cases of patients could walk more than 20 minutes.

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Effect of Muscle Strength Training on Urinary Incontinence and Physical Function: A Randomized Controlled Trial in Long-term Care Facilities (시설거주 노인여성을 위한 근력강화 훈련이 요실금과 신체기능에 미치는 효과)

  • Kang, Hyekyung;HongSon, Gwi-Ryung
    • Journal of Korean Academy of Nursing
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    • v.45 no.1
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    • pp.35-45
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    • 2015
  • Purpose: This study was done to determine whether muscle strength training programs have an impact on improving symptoms of urinary incontinence (UI) and physical function among elderly women with UI who reside in long-term care facilities. Methods: A randomized controlled trial was conducted. Participants had to be over 65 years, score over 15 score on the mini-mental state examination, and be able to walk alone or with an assistant. Seventy residents were randomly allocated to either the training group (n=35) or control group (n=35). The program consisted of 50 minutes, twice a week for 8 weeks, and included Kegel's exercise, Thera-band training and indoor walking. Main outcomes were UI symptoms, peak vaginal pressure and physical functions measured with timed up and go test (TUG), one leg standing test (OLST), activities of daily living (ADL) and grip strength. Changes in outcome measurements were calculated from baseline to 4 weeks and to 8 weeks using repeated measures ANOVA. Results: There were significant differences in peak vaginal pressure (p<.001), TUG (p<.001), OLST (p=.012) and grip strength (p<.001) in the interaction between groups and time. Conclusion: Future studies are suggested to confirm the effect of muscle strength training in long-term care facilities where elderly women with UI reside.

Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk;Kang, Ji-Hoon;Kang, Sa-Yoon;Lee, Jung Seok;Song, Sook-Keun;Oh, Jung-Hwan;Kim, Joong-Goo;Han, Eun Young;Lee, Ho Kyu;Choi, Jay Chol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.102-109
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    • 2018
  • Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

A Case Report on Right Hemiparesis after Left Thalamus Infarction Treated with Boyanghwanoh-tang-gagam and Complex Korean Medicine Treatment (보양환오탕가감방 및 복합한의치료로 호전된 시상 부위 뇌경색 후 우측 편마비 환자 치험 1례)

  • Eun-soo Park;Hyun-seo Park;Seong-hyun Jeon;Jin-won Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.823-829
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    • 2023
  • Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.

A Survey on Experience and Illness Management of Rural Women with Osteoarthritis (농촌 골관절염 여성의 질병 경험과 관리 실태조사)

  • Son, Jung-Tae;Park, Sang-Youn
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.419-427
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    • 2006
  • Purpose: This descriptive survey was done to assess how rural women with osteoarthritis perceive their symptoms, what are their treatment preferences, and how they manage their illness. Method: Individual interviews were carried out with 205 women with osteoarthritis living in rural areas. Structured questionnaires were used and the interviewers were 7 trained research assistants. Descriptive statistics were used for data analysis with SPSS win 11.5 program. Results: Of the respondents, 68.8% were overweight and 15.1% were obese, 86.9% reported pain in the knees, low back, and shoulders and the average pain score was 66.06. Those knowing the exact diagnosis accounted for 73.7% of the respondents but only 49.7% reported receiving medical treatments, and 40.2% who received treatment adhered to their prescription. Folk medicines were used by 14.1% of the respondents, but 65.2% among them reported that folk medicines were not effective. Exercise 2.03 times per week was reported by 17.1% of the respondents and 48.6% reported preferring to walk. Conclusion: Women with osteoarthritis in rural areas need a rehabilitative care program focused on exercise. The community health care system in the rural area should deliver optimal health care for this population. The results of this study can be used as a basis for planning intervention programs for women with osteoarthritis in the rural area.

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A Study of the Clinical Utility of the Four Square Step Test for Predicting Falls in Stroke Patients (뇌졸중 환자의 낙상 예측을 위한 Four Square Step Test의 활용에 관한 연구)

  • Kwon, Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.22 no.4
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    • pp.1-6
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    • 2010
  • Purpose: This study was designed to evaluate the clinical utility of the Four square step test (FSST) for predicting falls in stroke patients, to compare the ability of the FSST test to discriminate between subgroups of fallers, and to determine if the test has any predictive value in identifying stroke patients who will fall. Methods: Stroke patients (N=37) who could walk at least 50 m with minimal assistance were recruited consecutively when attending a physical therapy session during their rehabilitation. Dynamic standing balance was measured using the FSST. The main outcome measures were FSST time and fall number. Numbers of falls were compared with FSST scores. Differences between the groups in FSST scores were examined using a t-test and 1-way analysis of variance. Post hoc analysis using the Tukey B procedure was used to identify specific group differences. Alpha was set at 0.05. Results: A total of 15 participants (40.5%) reported falls 6 had recurrent falls (2 falls) and 9 fell once. The mean FSST time differed significantly between groups with zero and multiple falls. A cutoff score of greater than 17 seconds on the FSST was associated with a sensitivity of 83% and a specificity of 84% for the identification of subjects with multiple risk factors for falls. Conclusion: The FSST is a feasible and valid clinical test of dynamic standing balance and can predict falls in post-stroke patients.

Changes in Balance and Gait Following Backward Walking Exercise in Hemiplegic Stroke Patients (뒤로 걷기 운동에 따른 뇌졸중 편마비 환자의 균형능력 및 보행능력의 변화)

  • Shin, Kyu-Hyun;Kang, Soon-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.21-31
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    • 2017
  • PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.