Purpose : Cardiac and lung surgery can lead to decreased physical activity, pain, reduced motion of thorax, and postoperative complications, which may prolong the length of stay in intensive care units and hospitals and increase medical costs. Preoperative rehabilitation aims to enhance postoperative recovery and rehabilitation by improving patients' physical fitness and functional capacity. This can reduce the need for long-term treatment and improve patients' ability to live independently. This study aimed to investigate the effects of preoperative rehabilitation in cardiac and lung surgery patients. Methods : This study was conducted from January 1, 2024, to January 26, 2024, using the PubMed database to identify and analyze recent research findings on the effects of preoperative rehabilitation in cardiac and lung surgery patients. The keywords used included 'preoperative,' 'rehabilitation,' 'pulmonary rehabilitation,' 'respiratory rehabilitation,' and 'chest physiotherapy.' The review focused on studies conducted in the past five years. Seven studies were included, with a total of 267 studies. Results : Preoperative rehabilitation in cardiac and lung surgery patients resulted in reduced length of hospital stay, shorter mechanical ventilation periods, lower complication rates, and improvements in functional capacity, exercise capacity, lung function, oxygen saturation, knee extensor strength, knee flexor strength, and quality of life. Conclusion : Preoperative rehabilitation has demonstrated positive effects on functional capacity, exercise capacity, lung function, oxygen saturation, quality of life, length of hospitalization, duration of mechanical ventilation, and complication rates in cardiac and lung surgery patients. Therefore, incorporating preoperative rehabilitation, along with postoperative cardiac and pulmonary rehabilitation, could be clinically beneficial.

Purpose : The aim of this study was to investigate the inter-rater and test-retest reliability, absolute reliability, and convergent validity of the 30-second chair stand test (30s-CST) in patients with subacute stroke. Methods : The study included 37 patients with subacute stroke. The inter-rater and test-retest reliability of the 30s-CST were assessed using the intraclass correlation coefficient (ICC). To estimate measurement error, the standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. The sensitivity of the 30s-CST was verified using the standard response mean (SRM). The convergent validity of the 30s-CST was evaluated by examining its correlation with the 5-times sit to stand test (5-times STS), the timed up and go test (TUG), the Fugl-Meyer assessment of the lower extremities (FMA-L/E), and the Berg balance scale (BBS) using the Spearman coefficient. Results : The 30s-CST showed high inter-rater reliability (ICC= 0.90[0.818-0.948]) and test-retest reliability (ICC= 0.920[0.849-0.958]). The MDC was 2.21 repetitions for inter-rater reliability and 1.94 repetitions for test-retest reliability, both below 20 % of the maximum possible repetitions (11 repetitions). The SRM after 4 weeks of intervention was 1.97, indicating a large effect. The 30s-CST did not show significant correlation with knee extensor strength (r= 0.21) or ankle plantarflexor muscle tone (r= 0.19), but had significant negative correlations with the 5-times STS (r= -0.94) and TUG (r= -0.72), and significant positive correlations with the FMA-L/E (r= 0.64) and BBS (r= 0.67) Conclusion : The 30s-CST for subacute stroke patients demonstrates high inter-rater and test-retest reliability, with a responsiveness rate of 1.97. The minimal detectable change of 2 repetitions and significant convergent validity. Therefore, the 30s-CST is recommended as a sensitive and easy-to-administer clinical tool for comprehensively assessing lower extremity strength, functional mobility, hemiparetic lower limb motor function, and balance in the clinical setting.

Purpose : This study aimed to identify the effect of mechanical device intervention on improving the arm function of stroke survivors. Methods : Among foreign literature that verified the effectiveness of mechanical device intervention programs conducted for the purpose of improving arm function in stroke patients, a systematic review and meta-analysis, which focused on randomized controlled trials published after 2010, was conducted. The databases selected for retrieval included PubMed, CINAHL, and RISS, and their quality was analyzed using Cochrane's risk of bias. The search terms included 'stroke,' or 'CVA,' and 'robot,' or 'robot-assist,' or 'virtual reality,' or 'VR,' or 'machine,' or 'mechanical device,' and 'upper extremity,' or 'hand function,' or 'arm function' using MeSH keywords. Total effect size analysis through meta-analysis, moderate effect analysis using meta-analysis of variance, and publication bias analysis using Egger's regression analysis were conducted. Results : A total of eight publications were selected, of which one was classified as having a 'low-level bias' in the area of 'incomplete outcome data bias,' during quality verification of the literature. The overall effect size of the mechanical devices intervention program was medium (ES=0.570, 95 % CI=0.254~0.886, p<.001), and for the moderating variable of 'intervention type,' 'robot-assisted type' showed a higher effect size than 'virtual reality type' (ES=0.875, 95 % CI=0.662~1.089, p<.001), and there was statistical difference between groups (Q=12.236, p<.001). Furthermore, no publication bias was observed (p>.05). Conclusion : The mechanical device intervention program showed a medium effect in improving arm and hand functions in stroke survivor. Notably, the robot-assisted type showed larger improvements of arm and hand functions than the virtual reality type. Robot-assisted interventions will be applied to improve arm and hand functions in stroke survivors in the future.

Purpose : The aim of this study was to compare the immediate effects of transfer electrode capacitive and resistive (TECAR) therapy and conventional exercise on craniovertebral angle (CVA), cranial rotation angle (CRA), pressure pain threshold (PPT), neck disability index (NDI), and muscle thickness of the deep neck flexor (DNF) and sternocleidomastoid (SCM) in adults with forward head posture. Methods : Thirty adults with forward head posture were assigned to either the experimental group (TECAR therapy; EG) or the control group (conventional exercise; CG). The clinical outcomes included CVA, CRA, NDI, PPT of the upper trapezius (UT) and mastoid process (MP), and muscle thickness of the DNF and SCM. The EG intervention utilized high-frequency diathermy to generate heat within tissues, promoting muscle relaxation and blood circulation. This intervention was applied to the subjects' suboccipital muscles, sternocleidomastoid muscles, and upper trapezius muscles at a maximum intensity of 40 % for 14 minutes. The CG intervention was based on the principles of McKenzie exercise and supported by clinical evidence related to therapeutic exercises. The CG underwent McKenzie exercises and forward head posture exercises for 14 minutes. Results : The clinical outcome analyses showed that both the EG and CG had significant improvements in CVA, CRA, and NDI (p<.05), but not in PPT or muscle thickness (p>.05). These results indicate that both TECAR therapy and conventional exercise were effective in improving posture and reducing neck disability in adults with forward head posture. Conclusion : Our results provide clinical evidence that TECAR therapy and conventional exercise significantly improve forward head posture symptoms and neck disability in adults with forward head posture. Additionally, these findings highlight the therapeutic potential of TECAR therapy for forward head posture.

Purpose: This study aimed to understand the characteristics and identify the properties and effects of ICT-based cognitive interventions through an integrated review of ICT-based cognitive intervention studies applied to older adults with mild cognitive impairment (MCI) in Korea. Methods: Studies published between January 1, 2010 and December 31, 2023, were searched using two domestic databases, and 13 studies were identified. This study used the integrative review method proposed to analyze studies related to ICT-based cognitive interventions for older adults with MCI in Korea. Quality appraisal was conducted by applying five levels of evidence (a hierarchy of levels of evidence for evidence-based practices). The derivation studies were analyzed by classifying and analyzing study characteristics by publication year, study design, sample size, and study location, while intervention characteristics were classified by grouping similar types. Results: The ICT-based cognitive interventions for older adults with MCI in Korea were robots (30.76%), virtual reality programs (23.08%), computer-based (23.08%), mobile apps (15.38%), and tablet-based cognitive interventions (7.69%). The most common intervention period for ICT-based cognitive intervention was 2-5 weeks, most frequent application was twice weekly, and most common intervention time was 30 min per session. The dependent variables were cognitive function, depression, quality of life, and daily living function. Conclusion: Current ICT-based cognitive interventions for older adults with MCI in Korea are increasing because of the trend of the Fourth Industrial Revolution. ICT-based cognitive intervention for older adults with MCI was found to affect not only cognitive function but also activities of daily living, instrumental activities of daily living, depression, and quality of life. ICT-based cognitive interventions for older adults with MCI can be customized by adjusting the difficulty level according to the individual level so that it can be adjusted to the functional status of older adults with MCI. Intervention studies combining customized ICT-based and traditional cognitive interventions that consider the individual characteristics of older adults are required.

Purpose : The purpose of this study is to find the effects of exercise intervention on motor symptoms and health-related quality of life (HRQoL) with Parkinson's disease. Methods : A systematic review and meta-analysis research method were used to confirm the clinical effectiveness of exercise intervention on motor symptoms and health-related quality of life with Parkinson's disease. The study was designed and conducted according to preferred reporting items for systematic reviews and meta-analysises (PRISMA) and national entertainment collectibles association (NECA) systematic literature manual. Study selection was based on PICOTS-SD (Participants, Intervention, Comparison, Outcomes, Time Setting, and Study Design). The evaluation tools in this study are movement disorder society revision of the unified Parkinson's disease rating scale (MDS-UPDRS) and the 39-item Parkinson's disease questionnaire (PDQ-39). The version 2 of the Cochrane risk of a bias tool (RoB 2) was used for quality assessment according to the Cochrane guideline. Data analysis was performed using metafor package in R Studio. In addition, a random effect model was used for the meta-analysis model, and the standardized mean difference was calculated to confirm the effect size. Results : A total of 714 studies were screened, and 20 studies were ultimately selected. According to meta-analysis, overall effect size of exercise intervention was MDS-UPDRS III (SMD= -0.23, p= .0021, I²= 34.2 %) and PDQ-39 (SMD= -0.22, p<.001, I²= 0 %). According to the MDS-UPDRS III analysis, endurance exercise reduced MDS-UPDRS III (SMD= -0.47, p= .0001, I²= 5 %). According to the PDQ-39 analysis, multi-model exercise reduced PDQ-39 (SMD= -0.25, p= .0146, I²= 35.3 %). Other exercises were reduced PDQ-39 (SMD= -0.22, p= .0027, I²= 0 %). Conclusion : This meta-analysis concludes that endurance exercise improves motor symptoms, and multi-model exercise enhance quality of life in Parkinson's disease patients. Reducing dropout rates through individualized monitoring and customized programs are essential for future studies. These findings provide clinical evidence for exercise interventions in Parkinson's disease management.

Purpose : This study analyzed the accuracy and temporal characteristics of speech sounds produced by 5- and 6-year-old children and adults. Methods : A total of 75 people participated in this study, including 25 5-year-old children, 25 6-year-old children, and 25 adults. We collected speech sound data using the picture-naming test. We analyzed speech intelligibility, percentage of consonants correct (PCC) at the word level, PCC according to articulatory complexity, initial consonant duration, duration of vowels following initial consonants, and word duration. Results : In the 5-year-old children, speech intelligibility, PCC at the word level, PCC according to articulatory complexity were significantly lower than those of the 6-year-old children and adults. There were significant differences in the duration of glottalized alveolar fricatives and the duration of vowels following glottalized alveolar fricatives between 5- and 6-year-old children. The voice onset time of plosives, duration of aspirated affricates, and duration of liquids were significantly longer for 5- and 6-year-old children than in the adults. For 5- and 6-year-old children, the duration of the following vowel for all consonants was significantly longer than for adults. The duration of words with high and low levels of phonetic complexity decreased with age. Conclusion : The accuracy of speech sound production in 5-year-old children was lower than that of 6-year-old children, and The former showed a lack of sufficient speech motor control to articulate glottalized alveolar fricatives. When producing segmental sounds and words, the 5- and 6-year-old children had lower speech motor control than adults. It was found that articulatory complexity affects the accuracy of production of consonants in 5-year-old children. The findings from this study contribute to a foundation of understanding normal speech characteristics and motor development in 5- and 6-year-old children.

Purpose : The purpose of this study was to develop a core competency diagnostic tool suited to the circumstances of U university and to verify its validity. Methods : This study was conducted from September 1, 2022 to January 20, 2023. First, U university's core competencies were analyzed based on literature review and cases of other universities. Second, after reviewing the operational definitions of sub-competencies and confirming detailed components through research team meetings and expert interviews, questions for each primary sub-competency were written. Third, to verify the content validity of the first round of questions, a Delphi survey was conducted on 10 professors majoring in education at U university to construct the second round of questions. Based on this, factor analysis was conducted through a preliminary test on enrolled students to select the final questions. Results : During the first round of question development, 216 questions were developed. As a result of the Delphi survey, questions with a CVR value of less than 0.62 were deleted, and a total of 174 questions were selected as the second round of questions. As a result of a preliminary test for current students based on the second question, the Cronbach' 𝛼 value for each subarea was 0.84~0.97, confirming reliability. Additionally, as a result of factor analysis, the KMO scale was found to be 0.918 and the probability of significance was <.005, confirming that it was a suitable model for factor analysis. The overall cumulative explanatory power was found to be 53.0 %, and two questions were confirmed for each sub-competency in the areas of knowledge, skills, and attitude, resulting in a final 72 questions. Conclusion : The developed tool is expected to facilitate U university's competency-based curriculum operation and quality management, and the establishment of an online diagnostic system is necessary for effective and continuous management of the diagnostic tool.

Purpose : Postural control requires the complex interaction of different structures to maintain and recover balance during the performance of everyday activities. This study aimed to compare the effects of support surfaces and knee positions on the postural balance in normal adults when lifting objects. Methods : The study comprised 21 participants in their 20s whose balance ability was measured using BT4 (balance trainer 4) equipment. A bare floor was used as a stable support surface and balance foam was used to create an unstable surface. Participants were required to adopt squat positions and stoop positions to exhibit different knee positions, and were asked to perform a lifting motion using 15 % of their body weight. The COG (center of gravity) length, COG area, COG angle, and COG velocity were measured for different support surfaces and knee positions. Postural balance during object lifting was compared for different support surfaces and knee positions using two-way analysis of variance. The level for verifying statistical significance was set at 𝛼=.05. Results : There were statistically significant differences in the COG length, COG area, COG angle, and COG velocity for different support surfaces when lifting objects (p<.05). We also found statistically significant differences in the COG length, COG area, COG angle, and COG velocity for different knee positions when lifting objects (p<.05). There were no interactions between the COG angles for different support surfaces and knee positions when lifting an object (p>.05). However, there was an interaction effect between the COG length, COG area, and COG velocity for support surfaces (stable and unstable) * knee positions (stoop and squat) when lifting an object (p<.05). Conclusion : This study scientifically proved that support surfaces and knee positions exert great influence on the postural balance during object lifting. However, studies focusing on a larger number of participants and lifting objects of different weights should be pursued in the future.

Purpose : Patella height is considered to have a pivotal role in the biomechanics of the knee complex. The purpose of this study was to evaluate the influence of patella height on the muscle activity of quadriceps femoris and balance ability. Methods : The patella height was examined in one hundred male volunteers aged 20~29 years who were recruited in this study. Patella height was estimated by measuring the length of patella tendon (LT)/length of patella (LP) ratio using a distal vernier caliper on the dominant leg. The subjects were divided to normal group (LT/LP ratio= 0.8~1.2, n= 35) and alta group (LT/LP ratio>1.2, n= 31). Muscle activities of rectus femoris (RF), vastus lateralis (VL) and medialis (VM) muscles were analyzed by surface electromyography (EMG) during isometric knee extension. Also, balance ability was measured via Biodex balance system (BBS) under the eyes-opened and closed conditions. Results : The EMG activities of both VL and VM muscles were significantly higher in the alta group compared to normal group (p<.01). Furthermore, there was a significant difference of overall stability index under the eyes-closed condition between the groups (p<.05), in particular alta group had reduced balance ability compared to normal group. LT/LP ratio showed the significant positive correlations with RF (r= 0.253), VL (r= 0.430) and VM (r= 0.465) muscles, in addition overall stability index (r= 0.279) and medial-lateral stability index (r= 0.268) under the eyes-closed condition. Conclusion : As the patella showed feature of alta, the EMG activities of both VL and VM muscles were increased, and balance ability was reduced. The findings of this study suggest that muscle activity of quadriceps femoris and balance ability are vulnerable by the change of patella height.

Purpose : The purpose of this study was to identify factors influencing nursing students' behavior toward the aged, and to provide basic data for developing interventions that promote positive behavior in aged care. Methods : The participants were 196 nursing students from K College residing in B City. The collected data were analyzed using SPSS/WIN23. The general and age-related characteristics of the nursing students were analyzed using frequencies and percentages. The levels of their behavior, knowledge, empathy, and attitudes toward the aged were analyzed using means and standard deviations. The relationships between the nursing students' behavior, knowledge, empathy, and attitudes toward the aged were examined using Pearson correlation coefficients. A multiple regression analysis was conducted to assess the effects of the nursing students' knowledge, empathy, and attitudes on their behavior toward the aged. Results : The study results revealed that regarding the aged, the nursing students had an average score of 11.60±3.78 for knowledge, 23.83±4.13 for perspective-taking empathy, 23.09±4.88 for fantasy empathy, 24.15±4.32 for empathic concern empathy, and 21.41±4.87 for personal distress empathy. The average scores for their attitudes and behavior toward the aged were 80.01±12.46, and 46.56±5.41, respectively. There was a significant correlation between behavior toward the aged and empathic concern empathy (r= 0.14, p= .049) and attitudes toward the aged (r= 0.43, p<.001). The factor influencing behavior toward the aged was attitude toward them (𝛽= 0.42, p<.001). This factor contributed 18.7 % of the total variance in behaviors toward the aged. Conclusion : Based on the results, educational programs and practices to enhance empathic abilities among nursing students should be developed and implemented to improve their behavior toward the aged. There is also a need to develop systematic programs and policies to positively improve not only individual but also societal attitudes toward the aged.

Purpose : The purpose of this study was to investigate the effects of hamstring exercise using reformer, sling, and foam roller on knee joint angles and MyotonPRO measurements in healthy adults in their 20s. Methods : This study was conducted as a cross sectional study. Thirty participants were randomly assigned into three groups: 10 participants each in the reformer group, sling group, and foam roller group. Knee flexion exercises were performed using the reformer as an open chain exercise. Knee flexion exercises were also performed using the sling as a closed chain exercise. Additionally, hamstring stretching was conducted using a foam roller. Knee angle was assessed using the passive knee extension test, and muscle tone was measured using the MyotonPRO and post exercise measurements were taken using the same method. Results : In terms of knee angles, significant differences were observed within the groups among reformer, sling, and foam roller (p<.05). Between group comparisons revealed significant differences in the reformer group (left and right leg) (p<.05). In the MyotonPRO measurements, significant differences were observed within each group: reformer (relaxation time, creep of the left leg and creep of the right leg), sling (stiffness, relaxation time, creep of the left leg and stiffness, relaxation time of the right leg), foam roller (creep of the left leg and relaxation time of the right leg) (p<.05). Notably, between group comparisons revealed significant differences in muscle relaxation time of the left leg between the reformer and sling groups. Conclusion : Based on the findings of this study, if the primary objective is to enhance changes in knee angles, open-chain exercises using a reformer are recommended. However, if the consideration extends to the biomechanical aspects of the hamstring, closed-chain exercises using a sling are advisable. Therefore, based on the results of this study, it is believed that the applications of the reformer and sling can be appropriately considered and utilized in the rehabilitation of the hamstring in clinical practice.

Purpose : This study was designed to investigate the immediate effects of soft tissue mobilization on the posterior thigh muscles and fascia in subjects with reduced lumbar and pelvic mobility, Our focus was on the immediate impact, and we aimed to determine the changes in muscle thickness and fascial mobility within a short timeframe. Methods : Thirty-eight subjects with reduced lumbar and pelvic girdle mobility in a forward bending posture participated in this study. Soft tissue mobilization using an instrument was applied to the subjects once for approximately 5 minutes. Muscle thickness and fascial mobility were measured before and after the application of soft tissue mobilization using an ultrasound imaging device (Veneu 50, GE Healthcare, UK), and the measurements were compared. Paired t-tests were used to compare the values before and after the application of soft tissue mobilization. Results : The results of comparing the values measured before and after the application of soft tissue mobilization were as follows. When measured in a relaxed position, the thickness of the posterior thigh muscles significantly increased. The thickness of the fascia decreased (p<.05). When measured in the contracted position, the thickness of the posterior thigh muscles increased, and the thickness of the fascia also decreased (p<.05). When measured in the FWB position, the thickness of the muscle increased, and the thickness of the fascia decreased (p<.05). Conclusion : The results of this study have significant implications. When soft tissue mobilization was applied to the posterior thigh muscles, the thickness of the muscle showed positive changes, and the fascia showed increased mobility. This suggests that it is effectively positively changes the muscle thickness and fascia mobility of soft tissues with reduced contractile force due to stiffness. In addition, when soft tissue mobilization is applied to the posterior thigh muscles, it can help increase the mobility of the lumbar, pelvic girdle. and thoracolumbar fascia, which could further enhance the understanding and application of soft tissue mobilization in rehabilitation.

Purpose : This study aimed to investigate the effects of a virtual reality rehabilitation program on upper limb function and activities of daily living in patients with acute stroke. Methods : This study included patients who were referred to the occupational therapy room of D Hospital in Ulsan Metropolitan City between February and August 2022. Thirty patients with upper limb dysfunction were randomly assigned to experimental group and control group. The intervention method was as follows the experimental group received a virtual reality rehabilitation program five times a week and occupational therapy five times a week each for 3 weeks, while the control group received occupational therapy five times a week and 30 min of functional improvement training for 3 weeks. The experimental and control groups underwent the upper limb function test (MFT) and the activities of daily living test (MAL) before and after the experiment to evaluate the effects. Results : There were no statistically significant differences in the scores on the upper limb function(MFT) and the activities of daily living(MAL) between the experimental and control groups before the intervention. When the experimental and control groups were compared after the intervention, there were no significant differences in the frequency of upper limb and hand use(AOU) or quality of movement(QOM), which were affected by the MFT and motor activity scale, which evaluate the activities of daily living. However, it was confirmed that the score difference in the experimental group was large for each intervention compared to that of the control group. Conclusion : The virtual reality rehabilitation program was effective for patients with acute stroke with upper limb function impairment and activities of daily living disorders.

Purpose : This study aimed to identify specific anthropometric and clinical risk factors that could predict age-related sarcopenia in pre-senescence middle-aged community dwelling women. Methods : We analyzed data from a cross-sectional study involving 2,696 community-dwelling women aged 50 to 64. To ensure national representativeness, we employed complex sampling analysis using individual weights from the Korea national health and nutrition examination survey (KNHANES). This approach accounted for the survey’s stratified, clustered, and multistage probability sampling design. Participants were assessed for sarcopenia. The variables considered were mainly anthropometric and clinical risk factor indicators, including age, height, weight, body mass index, waist circumference, skeletal muscle mass index, drinking status, systolic and diastolic blood pressure, fasting glucose levels, triglycerides, cholesterol levels, and drink status. Results : The analysis identified several significant predictors of sarcopenia. Among the anthropometric risk factors, weight, body mass index (BMI), waist circumference, and skeletal muscle index (SMI) were all significant predictors of sarcopenia (p<.05). In terms of clinical risk factors, triglyceride level was recognized as a significant predictor of sarcopenia (p<.05). In contrast, height, fast glucose, systolic and diastolic blood pressure, and drinking status did not show significant associations with sarcopenia (p>.05). These findings underscore the importance of specific anthropometric factors in predicting sarcopenia in this population. Conclusion : The present study highlights key anthropometric factors and clinical risk factors associated with sarcopenia in pre-senescence middle-aged women. These findings improve our understanding of sarcopenia risk factors, highlighting the importance of anthropometric and clinical measures-including height, BMI, waist circumference, SMI, and triglyceride levels in assessing sarcopenia risk in this age group. This study enhances the current understanding of sarcopenia by identifying key factors linked to its development in middle-aged women.

Purpose: This study investigates the effects of leg manual lymphatic drainage (MLD) on work-related leg edema and pain in physical therapists. It aims to determine the appropriateness of leg lymph massages as a therapeutic approach for treating work-related leg issues, thereby contributing to the understanding of treatment effectiveness. Methods: Physical therapists objectively measured work-related leg edema and pain using a smart tape measure and VAS before and after applying MLD. The intervention involved 20 MLD sessions, each lasting 10 minutes, conducted daily over 4 weeks. The difference in leg circumference and pain levels were then re-measured and compared. Results: As a result of this study, the changes in leg circumference and pain before and after MLD were performed in the subjects as follows. In the comparison before and after the MLD intervention, there were significant differences in both leg circumference and pain (p<.05). Conclusion: This study showed significant differences in ankle, calf, knee, thigh circumference and pain in the 6 parts of the leg after 20 leg lymph massages for 4 weeks (p<.05). Based on the results of this study, we investigated the effects of MLD on work-related leg swelling and pain in physical therapists and compared whether there were differences in leg swelling and pain before and after MLD. The results showed that both leg swelling and pain were significantly reduced, indicating that MLD is suitable for reducing leg swelling and pain. It may suggest that it can be applied in designing intervention programs to reduce work-related leg swelling and pain in physical therapists.

Purpose : To investigate effects of cognitive-motor exergame dual-task training on balance and activities of daily living (ADL) in stroke patients. Methods : Balance and performance for activities of daily living (ADL) in stroke patients who were hospitalized for recovery were evaluated. Using a computer program, participants were randomly assigned into an experimental group (15 participants with an odd number) and a control group (15 participants with an even number). The experimental group received cognitive-motor exergame dual-task training in addition to conventional physical therapy. The control group received only conventional physical therapy. The intervention was conducted five times a week for six weeks. Balance ability was assessed using the Physiosensing balance pressure platform, measuring weight distribution, movement area, and stability limits. ADL performance was evaluated using the modified Barthel index (MBI). Results : After the intervention, both the cognitive-motor exergame group and the conventional physical therapy group showed significant improvements in weight distribution ratio, movement area, limits of stability, and ADL performance (p<.05). Notably, between-group comparisons revealed that the experimental group demonstrated greater improvements in weight distribution ratio, movement area, limits of stability, and ADL performance than the control group, showing significant differences (p<.05). Conclusion : Results of this study confirmed that both cognitive-motor exergame dual-task training and conventional physical therapy could effectively improve balance and ADL performance in stroke patients. Notably, the experimental group, which received cognitive-motor exergame dual-task training, showed greater improvements in weight distribution, movement area, limits of stability, and ADL performance than the control group. This suggests that cognitive-motor exergame training can be considered an effective rehabilitation method for enhancing balance and ADL abilities of stroke patients. Future studies should explore its long-term effects.

Purpose : Although hospital nurses work in the same environment and care for the same patients, there are variations in terms of nursing performance. Determining nursing performance is an important way of providing quality care in clinical settings. This can aid in identifying the influence of job crafting and job embeddedness on the nursing performance of nurses in medium-sized hospitals as well as in providing basic data to enable increased nursing performance. Methods : This descriptive correlational study examined the degree of job crafting, job embeddedness, and nursing performance among hospital nurses to ascertain the relationships between these variables and their effects on nursing performance. The study participants were 170 nurses from small and medium-sized hospitals in G city. The data were collected from April 11 to 31, 2024, using structured self-reported questionnaires. The SPSS/WIN 25.0 program was used to analyze the data. Results : Depending on the overall amount of clinical experience, the nursing performance score varied, albeit above the median level (F = 2.337, p< .041). Nursing performance had a significant positive correlation with job crafting (r = 0.424, p< .001) and job embeddedness (r = 0.557, p< .001). The regression analysis confirmed that job crafting (β = 0.267, p< .001) and job embeddedness (β = 0.613, p< .001) were influential factors in the hospital nurses' nursing performance. This model explained 31%. Conclusion : Job crafting and job embeddedness were found to be important factors affecting the nursing performance of hospital nurses. Hospital nurses are encouraged to bolster nursing performance in terms of satisfaction with job crafting and job embeddedness, and nursing managers should prioritize the strengthening of job crafting and job embeddedness among hospital nurses. Furthermore, it will be necessary to develop educational programs aimed at enhancing nursing performance.

Purpose : The purpose of this study was to apply IASTM (instrument assisted soft tissue mobilization), proprioceptive neuromuscular facilitation (PNF), and static stretching (SS) to people who have limited range of motion in dorsiflexion due to a shortened gastrocnemius muscle. When applying the above three techniques, we aimed to confirm immediate changes in the dorsiflexion angle at the ankle joint and the muscle tone of the gastrocnemius muscles. Methods : Twenty subjects received all three interventions and participated in the experiment in random order at two-week intervals. All interventions were applied in 3 repetitions. The evaluations were ROM (range of motion) in dorsiflexion of the ankle joint and muscle tension of the gastrocnemius medialis and lateralis muscles, each measured before the intervention and immediately after three repetitions, for a total of four measurements. All measured data were comparatively analyzed using one-way ANOVA for comparison between groups, and one-way repeated measures ANOVA for comparison between repeated measures. Results : The ROM of ankle joint dorsiflexion showed significant differences between repetitions, in all interventions (p<.05), but did not show significant differences between groups (p>.05). The muscle tone of gastrocnemius medialis showed significant differences between repetitions, in all interventions (p<.05), but did not show significant differences between groups (p>.05). The muscle tone of gastrocnemius lateralis showed significant differences between repetitions, in all interventions (p<.05), and significant differences between groups were seen only in repetitions, 1 and 2 (p>.05). Conclusion : The results of this study showed that all three interventions increased ROM of dorsiflexion and reduced muscle tone of gastrocnemius. Therefore, it was found that both IASTM, PNF, and SS were effective interventions for limited range of motion of dorsiflexion, and in particular, IASTM and PNF were more effective in reducing calf muscle tone.

Purpose : Professional self-concept of nurse is a critical factor that strengthens confidence and a sense of professionalism in practice, significantly influencing nurses' intention to stay in their jobs or leave. Establishing a strong professional self-concept during nursing education is essential for shaping a positive professional identity and role. Therefore, this study aimed to examine the level of clinical practice stress, resilience and professional self-concept among third-year nursing students who have completed their first clinical practice, as well as to analyze the relationships among these variables and identify factors influencing professional self-concept. Methods : The study was conducted with 237 third-year nursing students from two nursing departments in H and S cities, all of whom consented to participate in the survey. A structured online questionnaire was used to assess the students' clinical practice stress, resilience, and professional self-concept. Data collection was carried out over a period of approximately three months, from September to November 2023. Data analysis was performed using SPSS 26.0, applying descriptive statistics, independent t-tests, ANOVA, scheffe's test, pearson correlation, and hierarchical regression analysis. Results : Professional self-concept showed a negative correlation with clinical practice stress (r=-0.38, p<.001) and a positive correlation with resilience (r=0.52, p<.001), both of which were statistically significant. The significant predictors of professional self-concept were clinical practice stress (𝛽=-0.45, p=.010), resilience (𝛽=0.36, p<.001), admission motivation*score (𝛽=-0.19, p=.010), major satisfaction*moderate (𝛽=-0.18, p=.004), relationships with friends*moderate (𝛽=-0.13, p=.013), and academic achievement*grade B (𝛽=-0.13, p= .013). These factors explained 45.00 % of the variance in professional self-concept, with clinical practice stress serving as a key predictor. Conclusion : A professional self-concept enhancement program, tailored to individual characteristics, should be developed and implemented from the freshman year to improve nursing students' resilience. This would help reduce clinical practice stress during the clinical performance training phase and establish a positive professional self-concept among nursing students.

Purpose : This study examines the effects of a traditional music program on depression and ego integrity among elderly nursing home residents. Given the limited social activities available in nursing homes, this study focuses on how traditional music interventions can improve the psychological and emotional well-being of nursing home residents. Methods : A quasi-experimental pretest-posttest nonequivalent control group design was used. Forty-three elderly residents from a nursing home in Incheon, South Korea, were selected through convenience sampling. Participants were assigned to either the experimental group (n= 22) or the control group (n= 21). The experimental group participated in an eight-week traditional music program, while the control group received no intervention. Depression levels were assessed using the Cornell Scale for Depression in Dementia (CSDD), and ego integrity was measured using a nurse-administered questionnaire. Data were analyzed using repeated measures ANOVA. Results : The results showed a significant reduction in depression among the experimental group who participated in the traditional music program compared to the control group (t= -1.863, p= .035). However, there was no significant improvement in ego integrity between the two groups (t= -1.863, p= .077). These findings suggest that the traditional music program was effective in alleviating depression but had limited impact on enhancing ego integrity in elderly residents. Conclusion : Traditional music programs can be a valuable non-pharmacological intervention to reduce depression among elderly nursing home residents. While the music program significantly decreased depression, its effect on ego integrity was not as profound, indicating that longer or more frequent interventions might be necessary to influence ego integrity. Further research is recommended to explore the long-term effects of traditional music therapy on psychological well-being in elderly populations, as well as its potential to enhance social interaction and improve overall quality of life in nursing home settings.

Purpose : This study investigated the test-retest reproducibility of two hand strength tests (grip and lateral pinch) and two dexterity tests (box and block test and nine hole peg test) of the paralyzed upper limb in stroke patients. Methods : This study was conducted from February 2024 to March 2024 with 66 subjects diagnosed with stroke who agreed to the study. Using a convenience sampling method that excluded shoulder pain and shoulder subluxation in stroke patients, the test-retest intraclass correlation coefficient (ICC), standard error measurement (SEM), smallest real difference (SRD), and SRD (%) of the four assessments according to the presence of elbow flexor spasticity were investigated. All tests were administered at 7 to 10 day intervals after the first assessment. Results : Comparing the ICCs of the grip strength, lateral pinch strength, NHPT, and BBT of stroke patients showed that the group without spasticity had higher ICC (0.89~0.98) than those with spasticity. The SEM (less than 20 % of the mean score), MDC (less than 20 % of the highest score), and MDC (%) (less than 30 %) of upper limb grip strength, lateral pinch strength, NHPT, and BBT in stroke patients without spasticity were identified as reliable and reproducible. However, in stroke patients with spasticity, the ICC was low in all assessments, and the SEM, SRD, and SRD (%) had high levels of measurement error. Conclusion : Elbow flexor spasticity in stroke patients was a variable affecting grip strength, lateral pinch strength, NHPT, and BBT reliability. High test-retest reliability was demonstrated in patients without elbow flexor spasticity. The SRD of 9.06 kg for grip strength, 2.18 kg for lateral pinch strength, 27.52 seconds for NHPT, and 7.82 for BBT in this study will serve as a baseline for changes in hand function.

Purpose : Identify variables related to metabolic syndrome and the positive effects of complex treatment for elderly people with metabolic diseases Methods : Seawater bathing and circulation exercise for 40 minutes each, twice a week, for 4 weeks for elderly patients with metabolic diseases. Results : As for the body composition, the analysis of interaction after the four-week program showed a borderline significant difference in terms of the visceral fat and waist circumference, which decreased both in the combined group and the seawater group after the program. In an analysis of the grip strength and the SPPB (short physical performance battery), all groups demonstrated a significant increase in grip strength (p<.05). The results of the SPPB analysis showed a significant between-group difference, where the combined group, exercise group, and seawater group revealed a significant increase compared to the control group after the four-week program (p<.05). The results of the analysis of the metabolic syndrome-related variables and insulin resistance showed a significant difference in systolic blood pressure and diastolic blood pressure after the four-week program. The analysis results indicated a significant decrease in the combined group and the exercise group compared to the control group after the four-week program (p<.05). The TG showed a significant difference, where all groups demonstrated a significant decrease after the program (p<.05). The HDL-C, blood sugar, and waist circumference showed an interaction effect, and the post-hoc analysis revealed no significant between-group difference after the four-week program (p>.05). The insulin and insulin resistance showed a significant difference between the time periods, and the control group demonstrated a significant increase after the four-week program (p>.05). Conclusion : The results of the study showed a borderline significant decrease of visceral fat area in the complex group and the seawater group, a borderline significant decrease of waist circumference in the complex group, and a decrease of systolic blood pressure in the exercise group. These results suggest that the four-week circuit exercise and seawater exercise program had a positive effect on improving metabolic diseases. In particular, the borderline significant difference in waist circumference in the complex group after the program can be attributed to be the synergy effect of seawater bathing and exercise treatment. In addition, the increase in systolic blood pressure, insulin, and insulin resistance in the control group after four weeks indicates the importance of health management.

Purpose : The aim of this study 1S to investigate the effects of abdominal-muscle strengthening exercises on the neck disability index (NDI), craniovertebral angle (CVA), cranial rotation angle (CRA), and the thickness of the longus colli muscle (LC) and carotid artery (CA) in adults with forward head posture (FHP). Methods : Twenty adult participants diagnosed with FHP were randomly assigned to either an experimental group or a control group. The experimental group performed both dead-bug and plank exercises, aimed at strengthening the abdominal muscles to stabilize the lumbar-pelvic region. In contrast, the control group followed a routine of McKenzie exercises and cervical stabilization exercises, which were designed to improve neck muscle function and alignment of the cervical spine. Both groups participated in their respective exercise programs over a designated period to assess their effects on various physical parameters. Results : In the experimental group, NDI significantly decreased from 4.90±4.33 to 1.50±2.07 (p=0.008), while the control group showed a reduction from 3.20±1.99 to 1.90±2.77 (p=0.109). Both groups showed significant improvements in CVA and CRA (p<0.05), with the experimental group's CVA increasing from 46.51±1.86 to 51.04±3.02 and CRA decreasing from 148.79±2.56 to 142.14±4.79. LC and CA thickness significantly increased only in the control group (p=0.002, p=0.000, respectively). Conclusion : This study confirms that abdominal-muscle strengthening exercises, as well as McKenzie and cervical spine stabilization exercises, are effective in improving FHP and related variables. Notably, the findings indicate that abdominal-muscle strengthening exercises, even when not directly targeting the cervical spine, can still positively influence the correction of FHP, supporting their inclusion in comprehensive posture correction programs.

Purpose : The purpose of this study was to identify the relationship among self-compassion, caring efficacy and clinical competence in nursing students. Methods : The subjects of this study were 240 nursing students from two colleges located in City B, South Korea, during the period from November to December 2023. The qustionnaries included questions about korean version of the self-compassion scale, caring efficacy, clinical competence. The collected data were analyzed using SPSS/WIN 22.0 program to compute frequency, percentage, mean and standard deviation and conduct t-test, ANOVA, Scheffe’s test, Pearson correlation coefficient. Results : The nursing students had average self-compassion of 3.18±0.31, caring efficacy of 3.32±0.31, and clinical competence of 3.59±0.58. The self-compassion of the subjects demonstrated a significant difference according to satisfaction on campus life (F= 16.10, p<.001), satisfaction on major (F= 9.22, p<.001), satisfaction of clinical practice (F= 22.25, p<.001), relationship with students (F= 18.29, p<.001). The clinical competence showed a significant difference depending on gender (F= 3.31, p=002), age (F= 3.56, p<.001), satisfaction on campus life (F= 9.22, p<.001), satisfaction on major (F=6.89, p<.001), satisfaction of clinical practice (F= 18.8, p<.001). A positive correlation was observed between the subject's self-compassion and clinical competence (r= 0.26, p<.001), as well as the self-compassion and caring efficacy (r= 0.2+9, p<.001). However, there was no significant difference in caring efficacy and clinical competence. Conclusion : Based on these results, a repeat study is needed to confirm the relationship between nursing students' care efficacy and clinical performance ability. In addition, it is thought that a study is needed to verify the effectiveness of developing and applying an educational program that can increase self-compassion to improve clinical performance ability.

Purpose : This study aimed to identify the key factors influencing speaking problems in the elderly using data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES). Methods : Data from the 2022 KNHANES were analyzed to assess speaking problems in older adults. Of the 6,265 participants, 4,596 individuals aged <65 years and 387 non-respondents were excluded. The analysis included 1,282 individuals aged ≥65 years. The analysis focused on variables, such as income level, chewing ability, and hearing capacity, and other demographic and lifestyle factors. Results : Lower-income individuals reported approximately twice as much discomfort in speaking as those from higher-income households(odds ratio[OR] = 2.00, p= .017). Individuals experiencing chewing difficulties showed an approximately 30-fold increase in speaking discomfort than those without chewing ability (OR= 29.57, p<.000). Additionally, individuals with hearing discomfort experienced nearly twice the level of speaking discomfort as those without hearing discomfort (OR= 1.67, p= .032). Other variables examined, including sex, age, household size, education, marital status, smoking, alcohol consumption, walking habits, presence of diseases, and stress levels, were not statistically significant in influencing speaking discomfort. Conclusion : The findings suggest that intervention programs to prevent a decline in speaking problems among the elderly should be developed and improved. Such programs should focus on screening and identifying at-risk groups, particularly those with chewing and hearing difficulties, and address individual health factors. Future research should explore additional variables that may be associated with speaking problems in the elderly to enhance the effectiveness of preventive measures and iterventions.

Purpose : This study aimed to investigate the effectiveness of a readily accessible multisensory cognitive training program for older adults with normal cognition and mild cognitive impairment. Methods : This study was conducted with 105 elderly individuals who attended the G-Elderly Welfare Center in Cheongju-si for 12 weeks, from July to September 2023. The evaluation was conducted one-on-one by three occupational therapists with over 7 years of clinical experience. The assessmentincludedthe Korean Mini-Mental State Examination (MMSE-DS), Korean CES-D Depression Scale, and Trail Making Test (TMT). After the initial evaluation and instruction on using the multisensory digital program, older adults with normal cognition participated in the cognitive training program twice a week at the G-Elderly Welfare Center. Moreover, elderly individuals with mild cognitive impairment used the program at home. The final evaluation included 36 elderly individuals (26 with normal cognition and 10 with mild cognitive impairment, excluding 69 who withdrew from the study.) Results : A statistically significant difference was observed in the MMSE-DS and TMT scores before and after using the program in the elderly group with normal cognition and mild cognitive impairments. However, the CES scores in both groups were not statistically significant. Conclusion : Dementia outcomes can vary significantly depending on the motivation for participating in the program. Therefore, developing strategies that stimulate the interest of individuals and foster active participation motivation is essential. This can be achieved by organizing various programs to enhance the effectiveness of the intervention.

Purpose : In this descriptive, correlational study, the relationship between nursing students' adaptation to college life, self-directed learning ability, and learning flow was examined. Additionally, factors influencing nursing students' learning flow were identified. Methods : Data were collected from 101 third-year nursing students at University A in B city between July 10 and August 23, 2024. The evaluation was conducted using frequencies, percentages, independent t-tests, ANOVA, post-hoc analysis with Scheffé's test, Pearson correlation coefficients, and multiple regression analysis for factors influencing learning flow. Results : The scores for the participants' adaptation to college life, self-directed learning ability, and learning flow were 3.27±0.59, 3.68±0.57, and 2.93±0.67, respectively. Additionally, the score for department satisfaction was 6.60±2.06, and that for expectations for future roles was 6.97±2.16. Significant differences in learning flow were observed based on academic performance (F= 11.98, p<.001), school life (F= 5.98, p= .001), department satisfaction (F= 23.35, p<.001), and expectations for future roles (F= 7.93, p<.001). Learning flow was positively correlated with adaptation to college life (r= 0.41, p<.001) and self-directed learning ability (r= 0.71, p<.001). The results of the stepwise multiple regression analysis showed that the factors influencing learning flow were self-directed learning ability (𝛽= 0.648, p<.001), department satisfaction (𝛽= 0.329, p=.001), and school life (𝛽= 0.212, p=.025), with an explanatory power of 54.8 % (F= 41.39, p<.001). Conclusion : This study's results demonstrated that enjoyment of school life, department satisfaction, and self-directed learning ability as significant predictors of learning flow among nursing students, with self-directed learning ability emerging as the most crucial factor. Therefore, to enhance nursing students' learning flow, developing programs that improve self-directed learning ability, promote department satisfaction, and enhance enjoyment of school life is essential.

Purpose : This study aims to investigate the effects of four weeks of circuit training on physical strength and growth hormone levels in middle-aged adults experiencing sarcopenia, suggesting effective exercise plans for the management of sarcopenia patients, and providing basic data for the development of effective exercise programs for the prevention and treatment of sarcopenia. Methods : This study was conducted on middle-aged adults with sarcopenia living in Y-si, Gyeongsangnam-do, Korea, and when diagnosing and evaluating whether sarcopenia falls under the EWGSOP2 evaluation criteria, all were applicable, and the experiment was conducted by dividing into an experimental group (EG, Exercis Group, 9 people) and a control group (CG, Control Group, 10 people) through random allocation. Results : First, As a result of body composition analysis, there were no changes in body composition. Second, As a result of the physical strength analysis, the interaction effect occurred in all items of flexibility (p<.01), muscle strength (p<.001), and muscle endurance (p<.01). As a result of the post-analysis, flexibility increased significantly in both EG (p<.01) and CG (p<.05) in the changes within the group, and EG significantly increased in muscle strength (p<.001) and muscle endurance (p<.05). Third, As a result of the analysis of GH, the interaction effect occurred (p<.01), and as a result of the post-analysis, GH increased significantly in EG in the change within the group (p<.05). Conclusion : In conclusion, it is necessary to clearly analyze changes in body composition in consideration of the reset of the duration and frequency of the exercise program and the participants' basic metabolic rate, nutritional status, and exercise history in future studies, but it was confirmed that circuit training had a positive effect on the physical strength improvement and growth hormone of middle-aged adults with sarcopenia disease. This provides important implications for the future development of exercise programs for middle-aged adults with sarcopenia.

Purpose : To examine a moderated mediation model to explain quality of life (QOL) in patients with stroke. The mediating effect of mental health issues on the relationship between subjective health status and QOL, and the moderating effect of walking on QOL were investigated using a moderated mediation model. Methods : This study used data from the second Korean healthcare panel survey conducted between 2019 and 2020. Data from 375 patients with stroke were analyzed using the SPSS PROCESS macro, version 4.2. The mediating effect was analyzed using Model 4, the moderating effect was assessed using Model 1, and the moderated mediation effect was evaluated using Model 14. Results : First, subjective health status and QOL were directly related. Second, the relationship between subjective health status and QOL was mediated by mental health issues within the past year. Third, low and moderate walking days per week had a moderating effect on the relationship between mental health issues and QOL within one year. However, there was no moderating effect in the group with a high number of walking days per week. Fourth, in the overall path, walking days per week had a moderated mediating effect on the relationship among subjective health status, mental health issues within one year, and QOL. Conclusion : Improving subjective health status, mental health, and walking frequency in patients with stroke can improve their QOL. In particular, the relationship between mental health issues and QOL suggests that aerobic exercise such as frequent walking, may assist in preventing or mitigating the decline in QOL caused by mental health issues. Therefore, the rehabilitation of patients with stroke should include improving subjective health status, mental health, and aerobic training such as walking, to improve QOL.

Purpose : Collaboration and communication among healthcare professionals in medical institutions have gained increasing importance in recent years. consequently, universities face a growing need to develop innovative teaching methods that foster collaboration and communication through effective learning techniques and teamwork. this study aimed to redesign and implement courses using blended learning (BL) to analyze the effectiveness of this instructional approach and propose improvements. Methods : A total of 48 first-year students from the department of dental hygiene at s university in chungcheongnam-do participated in this study. the course "introduction to dental hygiene" was redesigned over 15 weeks using the ADDIE model to implement a blended learning framework. a pre-post single-group design was employed to evaluate changes in students' collaborative self-efficacy. statistical significance was evaluated using paired t-tests, with data analyzed using IBM SPSS version 24. Results : Three distinct BL modules were developed for the course, resulting in participants' collaborative self-efficacy, rising from a pre-score of 3.55 to a post-score of 3.84, which represents a significant improvement of 0.29 (p<.001). additionally, there was an overall average increase of 0.32 points in course satisfaction scores compared to the previous academic year. Conclusion : This study effectively addressed the needs of students, the primary stakeholders in professional courses, through curriculum redesign. the effectiveness of the course was validated, and the findings suggest that implementing blended learning in other subjects or for upper classes, through higher-order problem-solving activities, could provide a foundation for developing diverse teaching.