• 간호행정학회지
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• 제20권1호
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• pp.117-127
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• 2014

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

• 생명과학회지
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• 제22권2호
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• pp.192-199
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• 2012

본 연구는 라벤더(Lavandula angustifolia)향이 뇌기능에 미치는 효능을 객관적인 관점에서 살펴보고자 함에 의의를 두고 뇌파 변화를 살펴보았다. 신체적으로 건강한 20대 여자 성인(28명)을 대상으로 검증된 수면장애 조사를 통하여 수면질을 조사하여 수면에 문제를 가진 대상자를 선별하고 라벤더 향기요법을 실행하여 뇌파의 변화를 분석하였다. 뇌파 전극은 10-20 국제법에 의하여 전부두(F3, F4), 측두부(T3, T4), 후두부(O1, O2), 두정부(P3, P4)에 부착하였다. 향기요법을 시행하기 전 3분, 시행 중 3분, 그리고 시행 후 3분씩 나누어서 뇌파 검사를 시행하였다. 라벤더향은 수면질이 좋은 사람(15명)에서 후두부와 두정부에서 알파파를 감소시키고, 전두부에서는 세타파와 후두부에서 베타파를 증가시켰다. 그러나 수면질이 나쁜 사람(13명)에서는 대뇌 모든 영역에서 수면 입면파인 세타파만을 증가시키는 효능이 나타났다. 따라서 라벤더향은 수면질이 나쁜 사람에게 수면을 유도하는 긍정적인 뇌기능 효능이 있음을 확인하였다.

• 한국산학기술학회논문지
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• 제12권3호
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• pp.1145-1150
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• 2011

본 연구는 발달적 위기에 놓여있는 중년여성의 피로와 스트레스 저항력 그리고 정서와의 상관관계를 알아보기 위하여 뇌신경 생리학적 지표인 뇌파측정을 이용하여 분석해 보고자 하였다. 2005년 3월부터 2009년 6월까지 한국정신과학연구소에 뇌파측정을 의뢰한 우리나라 중년여성 4402명(35세~65세)의 뇌기능 지수(긴장도, 항스트레스지수, 정서지수)를 시계열 선형분석과 상관분석으로 한 결과 중년여성의 피로, 스트레스 저항력 그리고 정서 사이에는 유의한 관계가 있었다. 또한 정서적 성향을 보면 명랑과 우울 성향에서는 명랑 성향이, 긍정과 부정적 성향에서는 긍정적 성향이, 전체적으로는 명랑하면서 긍정적인 성향이 많은 것으로 나타났다. 그러므로 중년여성들의 피로와 스트레스를 감소시켜 삶의 질을 높이는 것이 개인건강은 물론 원만한 가족의 안녕을 유지, 증진하는데 꼭 필요하다고 본다.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.42-56
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• 2019

Background: Individuals with mechanical neck pain show biomechanical and neurophysiological changes, including cervical spine muscle weakness. As a result of deep muscle weakness, it causes stability disability and reduced upper thoracic spine mobility, which finally leads to functional movement restriction such as limited range of motion and dysfunction. Recent studies have shown that thoracic spine manipulation and mobilization could reduce symptoms of mechanical neck pain in patients. Objects: The purpose of this study was to investigate the effects of thoracic mobility exercise on cervicothoracic function, posture feature, and pain intensity in individuals with mechanical neck pain. Methods: The study subjects were 26 persons who were randomly assigned to the experimental (with thoracic mobility exercise) and control groups (without thoracic mobility exercise), with 13 subjects in each group. The cervicothoracic function (neck functional disability level and cervicothoracic range of motion), posture feature, and pain rating (using a quadrupled visual analogue scale [QVAS]) were measured before, after 3 weeks, and after 6 weeks. Results: Statistically significant group-by-time interactions were found with repeated analyses of variance for the Korean neck disability index (KNDI), all cervical range of motion (CROM), all thoracic range of motion (TROM), cranial rotation angle, sagittal shoulder posture (SSP), and QVAS (p<.05). All groups showed significant improvements from all times in all the evaluated methods. The KNDI, CROM, TROM of left rotation, and SSP in the experimental group showed significant improvements after 3 weeks, and the TROM of the right rotation and QVAS in the experimental group showed significant improvements after 6 weeks when compared with the control group. Conclusion: Thoracic mobility exercise during 6 weeks might be effective intervention to improve the functional level, posture feature, and QVAS pain rating for managing individuals with mechanical neck pain.

• 대한통합의학회지
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• 제10권4호
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• pp.23-34
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• 2022

Purpose : This study examined the effects of pain, neck dysfunction, psychosocial level, headache impact test (HIT), postural alignment, and trapezius muscle tone of the complex exercise program using dynamic taping in patients with tension headache and chronic neck pain with forward head posture. Methods : The design of this is a randomized controlled trial (RCT). Thirty-four patients with chronic neck pain were screened using a randomized assignment program and assigned to experimental group (n=17) and control group (n=17). Both groups underwent a complex exercise program. In addition, the experimental group dynamic taping was applied to the upper trapezius muscle. All interventions were applied three times per week for four weeks. The visual analogue scale (VAS), the neck disability index (NDI), short form-12 health survey questionnaire (SF-12), Headache impact test-6 (HIT-6), Craniovertebral angle (CVA), Cranial rotation angle (CRA), upper trapezius muscle tone were compared to evaluate the effect on intervention. Results : Both groups showed significant differences before and after the intervention in VAS, NDI, SF-12, HIT-6, and CVA, CRA (p<.05). In addition, significant differences in NDI and upper trapezius muscle tone were observed between the experimental group and control group (p<.05). Conclusion : A complex exercise program using dynamic taping for patients with tension headache and chronic neck pain with forward head posture are effective method with clinical significance in improving the function and reducing upper trapezius muscle tone.

• 대한통합의학회지
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• 제10권3호
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• pp.13-25
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• 2022

Purpose : The purpose of this study was to investigate the effects of combined cervical stabilization exercise (CSE) and stretching exercise (SE) on office workers with forward head posture (FHP). Methods : A total of 32 office workers with forward head posture were randomly assigned to experimental (n=16) and control (n=16) groups. The experimental group underwent combined CSE and SE, and the control group underwent cervical self-myofascial release and SE. Both groups performed exercises for 40 min per day, thrice per week for a total of 6 weeks. Craniovertebral angle (CVA), respiration, disability, and joint range of motion (ROM) before and 6 weeks after intervention were measured and compared. Results : There was no significant between-group difference in the general characteristics (p>.05). The intra-group comparison showed significant differences in the visual analog scale (VAS) and neck disability index (NDI) of both groups post-intervention (p<.05). CVA and forced expiratory volume in 1 seconds (FEV₁) were significantly improved post-intervention in the experimental group only (p<.05). In the experimental group, all ROM variables were significantly improved post-intervention. In contrast, in the control group, all ROM variables improved significantly post-intervention, except for extension (p<.05). The inter-group comparison showed significant differences in NDI, left lateral flexion, right lateral flexion, and left rotation between the two groups (p<.05). Conclusion : The combination of CSE and SE, which stabilizes the cervical spine, had positive effects on cranial rotation angle, respiration, disability, and joint ROM in office workers with forward head posture. Therefore, the combination of the two exercises may be an effective option to reduce symptoms and prevent postural problems in office workers with FHP.

• 대한통합의학회지
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• 제11권3호
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• pp.195-204
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• 2023

Purpose : This study applied general training (control group) or cranio-cervical flexor training (experimental group) using a pressure biofeedback unit along with general training for 4 weeks to secondary school teachers with moderate to severe neck pain and forward head posture. After that, we tried to compare the effects through differences in neck pain intensity (using numberical rating scale), functional performance (using neck disability index), and cranio-vertebral angle change. Methods : All 50 subjects were randomly assigned to either the "experimental group (n= 25)" or the "control group (n= 25)", and the measurements were evaluated in the same way before the intervention (baseline) and after the intervention (4 weeks). During the intervention period, the subject visited the physiotherapy center and made a reservation three times a week at a fixed time as much as possible, and each training session was thoroughly conducted under the 1:1 guidance of the therapist in charge so that the correct movement and number of times could be performed without compensatory action. Results : As a result of the homogeneity analysis on the general characteristics of the subjects, there were no significant differences between the groups in all variables (p>.05). Compared to the "control group", the "experimental group" showed significant improvement after intervention in all measured variables of neck pain intensity, functional performance, and cranial-vertebral angle (p<.05). Conclusion : For secondary school teachers with forward head accompanied by neck pain, cranio-cervical flexor training using a compression biofeedback unit is an excellent method to show superior pain reduction and functional performance improvement compared to general training alone. In addition, it can be presented as a more effective intervention method that can promote recovery of forward head posture, which is an essential element of the solution.

• 대한정형도수물리치료학회지
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• 제30권1호
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• pp.29-42
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• 2024

Background: This study aimed to determine the effects of training on breathing re-education on pain and dysfunction levels, posture, quality of life (QoL), and pulmonary function in patients. Methods: This study included 34 patients with chronic neck pain and upper thoracic breathing pattern were included. The participants were assigned to either the routine physical therapy program (RPTP) (CG; n=17) or RPTP and breathing pattern re-education training (EG; n=17). The CG and EG groups performed RPTP for 40 minutes, and only the EG groups performed breathing re-education training for 10 minutes. Exercises were performed thrice weekly for both groups. Level of pain and dysfunction, posture, QoL and pulmonary function status were assessed before and after the intervention. Results: After four weeks of intervention, numeric pain rating scale (NPRS), Korean version of neck disability index, cranio-vertebral angle, cranial rotation angle, and 12-item short form health survey-physical and mental component summaries had significant differences before and after intervention in both groups (p<.01). However, only NPRS, forced vital capacity, forced expiratory volume in 1s, and maximum voluntary ventilation showed significant interactions between the two groups and measurement time (p<.01). Conclusion: Breathing re-education training and RPTP may be optimal for patients with chronic neck pain and may be more effective in improving neck pain and pulmonary function.

• Radiation Oncology Journal
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• 제29권3호
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• pp.206-213
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• 2011

Purpose: Intensity modulated radiation therapy (IMRT) is a high precision therapy technique that can achieve a conformal dose distribution on a given target. However, organ motion induced by respiration can result in significant dosimetric error. Therefore, this study explores the dosimetric error that result from various patterns of respiration. Materials and Methods: Experiments were designed to deliver a treatment plan made for a real patient to an in-house developed motion phantom. The motion pattern; the amplitude and period as well as inhale-exhale period, could be controlled by in-house developed software. Dose distribution was measured using EDR2 film and analysis was performed by RIT113 software. Three respiratory patterns were generated for the purpose of this study; first the 'even inhale-exhale pattern', second the slightly long exhale pattern (0.35 seconds longer than inhale period) named 'general signal pattern', and third a 'long exhale pattern' (0.7 seconds longer than inhale period). One dimensional dose profile comparisons and gamma index analysis on 2 dimensions were performed. Results: In one-dimensional dose profile comparisons, 5% in the target and 30% dose difference at the boundary were observed in the long exhale pattern. The center of high dose region in the profile was shifted 1 mm to inhale (caudal) direction for the 'even inhale-exhale pattern', 2 mm and 5 mm shifts to exhale (cranial) direction were observed for 'slightly long exhale pattern' and 'long exhale pattern', respectively. The areas of gamma index >1 were 11.88 %, 15.11%, and 24.33% for 'even inhale-exhale pattern', 'general pattern', and 'long exhale pattern', respectively. The long exhale pattern showed largest errors. Conclusion: To reduce the dosimetric error due to respiratory motions, controlling patient's breathing to be closer to even inhaleexhale period is helpful with minimizing the motion amplitude.

• Clinical and Experimental Pediatrics
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• 제54권6호
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• pp.253-259
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• 2011

Purpose: Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods: We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results: A total of 19 (19.4%) patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P<0.001 and r=0.44, P<0.00, respectively). Sixty-one (62.2%) patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03). The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03). Conclusion: Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.