PURPOSE: This study seeks to examine the awareness and need of home visiting physical therapy among physical therapist in Gwangju and Jeonnam province. METHODS: Survey was conducted during the continuing education on physical therapist held in Gwangju in 2015 with 297 participants. The survey questionnaire consisted of 12 questions on the characteristics of physical therapists, 8 questions regarding the awareness of home visiting physical therapy, and 7 questions on need. RESULTS: Significant differences were found regarding service period, according to categories of the inconvenience associated with commuting to/from hospitals, long-term treatment for patients, high quality treatment with intensive care, treatment at a time of patients' choosing. The category of hospital fees reduced due to early discharge from the hospital also saw significant differences, depending on respondents' marital status, dependent family, and service period. Providing treatment without causing discomfort to patients in front of others also saw significant differences according to physical therapist career period. Home visiting physical therapy is easier for family members to take care of patients also saw significant differences according to education and physical therapist career period. CONCLUSION: Survey indicates that physical therapist province feel the need for home visiting physical therapy in many respects. However, since as many as half of the surveyed physical therapists have only heard of home visiting physical therapy or are have no awareness of the this form of treatment, it appears that there is a need to raise awareness of home visiting physical therapy among physical therapist and introduce appropriate policies.
Among disease prevention methods, health education is an excellent and effective method low cost. However, enforcing health education has the following limitations: there is little health education for the supported, health education disregards the characteristics of those educated, education materials are not specified and published satistactorily, and so on. This study suggests systemic health education planning to the Korea Medical Insurance Corporation. The special methods are as follows: 1. Health education for primary prevention a. We educate the insured who are judged to be normal by the results of health screening, dividing them into three groups:completely healthy status, emotionally disturbed status, and early pathologic status. b. We educate the insured characteristically according to occupational disease. c. In an advanced sense, we educate the insured according to their health condition and occupational status. 2. Health education for secondary and tertiary prevention We educate the insured who are judged to be inn a risk group or to be disease group according to the results of health screening. a. Health education for the risk group By health education on elimination of the risk factors, the risk group can be prevented from the disease. b. Health education for the disease group By health education on the therapeutic process and the method of rehabilitation, the disease group can return to the previous state. We conclude that: 1). Reimbursement for preventive activities{health interview, health education) must be realized. 2) A special organization for health education must be established. 3) All of the insured must be educated and managed during their lifetime by a new special organization.
Kim, Dong-Ho;Cho, Byung-Moon;Oh, Sae-Moon;Park, Dong-Sik;Park, Se-Hyuck
Journal of Korean Neurosurgical Society
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제56권5호
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pp.390-394
/
2014
Objective : In most patients with carpal tunnel syndrome (CTS), pain and/or paresthesia disappeared or decreased in a month after endoscopic carpal tunnel release (ECTR). However, subpopulation of patients showed delayed improvement following ECTR. We analyzed the delayed improvement hands to investigate the characteristics of those patients and to determine the predictable factors of delayed improvement. Methods : Single-portal ECTRs were performed in 1194 hands of 793 CTS patients from 2002 to 2011. Five-hundred seventy hands with minimal 1-year postoperative follow-up were included. We divided the 545 satisfied hands into early (group A) and delayed (group B) groups according to improvement period of 1 month. Demographic data, clinical severity and electrodiagnostic abnormality were compared between groups. Results : Group A included 510 hands and group B included 35 hands. In group B, 11 hands improved in 2 months, 15 hands in 3 months and 9 hands in 6 months, respectively. In group A/B, according to clinical severity, 60/1 hands were graded to I, 345/24 hands to II, 105/10 hands to III. In group A/B, based on electrodiagnostic abnormality, 57/3 hands were classified to mild, 221/11 hands to moderate and 222/21 hands to severe group. Statistical analysis between groups did not reach significance but electrodiagnostic or clinical severity had a tendency to affect the delayed response. Conclusion : It is difficult to predict the factors contributing to postoperatively-delayed response in subpopulation of CTS patients. However, we recommend that postoperative observation for at least 6 months is necessary in patients without symptomatic improvement.
수지 근위 지관절의 전방 회전 탈구는 매우 드물게 발생한다. 저자들은 여자 유도 선수에서 발생한 수지 근위 지관절의 전방회전 탈구를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다. 24세 여자 유도 선수로 총 4번의 근위 지관절 전방 탈구가 발생하였다. 수술 시 회전 손상으로 파열된 척측 측부 인대와 파열 없이 늘어져 있는 중앙 건을 확인할 수 있었다. 수술적 치료로 파열된 척측 측부 인대 봉합술과 중앙 건과 측부대 사이를 봉합하여 근위 지관절의 배측부를 강화 시켜주었다. 술 후 운동시에 탈구는 다시 발생하지 않았다. 수지 근위 지관절의 전방 회전 탈구는 매우 드문 손상이지만 다른 탈구처럼 조기 진단과 치료, 그리고 단계적인 재활이 무엇보다 중요하겠다.
Purpose : The purpose of this study was to examine the oral health state of disabled people with mental retardation in an attempt to pave the way for oral health care planning geared toward the disabled. Subjects and Method : The subjects in this study were 46 mentally retarded people who attended rehabilitation centers for the disabled in the city of Wonju, Gangwon Province. After a survey was conducted, the collected data were analyzed with SPSS 13.0 program, and frequency analysis, percentage, ANOVA and t-test were utilized. Results : The findings of the study were as follows: 1. The simplified oral hygiene index of the mentally retarded people was 1.32, which was on the average. 2. The decayed teeth index and decayed teeth rate of the mentally retarded people were respectively 13.48 and 48.13 percent, which were above the average. 3. The decayed surface index and decayed surface rate of the mentally retarded people were respectively 27.17 and 17.39 percent. 4. The simplified debris index of the mentally retarded people significantly varied with gender(p<.01), and missing teeth index(p<.05) and missing surface index differed significantly with age. Filled surface index was significantly different according to the region. Conclusion : The findings of the study illustrated that their indexes related dental caries experience were high. In order to promote the oral health of the disabled with mental retardation, prolonged research should be implemented, and a dental checkup should be carried out on a regular basis by specialists. Preventive care and early treatment should be provided, and the development of customized oral health education programs tailored to different sorts of disabilities and oral health control methods is required.
Purpose: Although surgical arthroscopic repair of rotator cuff has become much more common as surgeons have developed proficient techniques, it is still technically difficult. The purpose of this study was to evaluate the clinical results and the usefulness of mini-open repair in large and massive size tears. Materials & Methods: From January 2000 to December 2004, sixteen patients were treated with mini-open repair. There were 10 male and 6 female patients with the average age of 62.5 years. The size of tear was massive in 4 cases and large in 12 cases. All tears were repaired with metal anchor sutures. The mean duration of follow-up period was 23 months. Postoperative results were evaluated based on American Shoulder and Elbow Society scoring system. Results: Five patients showed excellent results, five good, and two fair in large tears while one patient showed excellent result, one good, and two fair in massive tears. Poor outcome was not seen during the follow-up period. There was no significant relationship between the patient's age and the size of tear, and postoperative results. However, the relationship between the duration of symptomatic period in preoperation and postoperative results showed significant correlation. Conclusion: Mini-open repair combined with the preservation of deltoid and early rehabilitation is clinically useful in large and massive size rotator cuff tear patients treatment.
The author reviewed the effect of psychological factors on the development and course of cancer. Cancer is a bilogical disease, but it also has a large number of psychological aspects. There have been no reports that specific personality types had tendency to cause cancer. In some studies, however, type A personality was reported to have relevance to a higher incidence of cancer and a better prognosis. And in other studies, type C personality was reported to have relevance to a higher incidence of cancer. It was reported that people who had strong tendency to control their anger and regarded the rationality and antiemotionality in their behavior as important things were susceptable to cancer. In the course of cancer, the patients who had more positive and aggressive attitude and 'fighting spirit' to their disease tended to have a better prognosis than those who accepted their disease as fate. Some studies showed that feeling of helplessness and loss of control had a negative offset on cancer. It was reported that, in the early stage of cancer, the psychological factors had great influence on the prognosis, but in the middle and late stage, the influence decreased. For the future studies, cancer should not be regarded as a single disease and a single condition. The kinds and stages of cancer should be difined for studies. The scales for psychological evaluation for cancer patients should be sensitive and selected carefully, considering the complexity of the cancer patients mind. The need for prospective studies is emphasized. Finally, as the cured cancer patients have great difficulties in returning to their work and daily life, rehabilitation of cancer patients is also emphasized.
Hazer, Derya Burcu;Acarbas, Arsal;Rosberg, Hans Eric
The Korean Journal of Pain
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제31권2호
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pp.109-115
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2018
Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy. Results: All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group. Conclusions: Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.
International Seabed Authority (ISA) is currently developing rules with regard to exploitation of manganese nodules which will be contained in its first regulations governing the exploitation of deep seabed mineral resources. A stakeholder survey was conducted in the early 2014 by ISA with the aim of facilitating participation of interested entities in the development process of the rules. The stakeholders who had replied to the survey included existing contractors, sponsoring States, environmentalists, academics, and nongovernmental organizations. Opinions given by them largely reflect their own interests. This paper aims to clarify the scope of the obligations regarding the environmental protection which may be imposed on contractors under the new regulations for the exploitation of manganese nodules. To do so, it first analyses the express provisions on environmental protection applicable to deep seabed mining included in the Law of the Sea Convention, its agreement on implementation of Part XI, and the regulations on exploration for manganese nodules. Secondly, it categorizes these obligations based on the categories of international obligations suggested by Combacau and Alland. Based on the categorizations this paper concludes that, in addition to the existing duties to protect deep seabed environment within the Law of the Sea Convention system, the following new obligations could be added: conservation of exploitation sites for a limited time after the contract is ceased; taking all necessary measures for rehabilitation of destroyed ecosystems that occurredas a result of mining activities; monitoring exploitation sites for a limited period time after the contract is ceased; observing rules and standards on safety of ships and environmental protection adopted under IMO instruments; regulation on the discharge of mine tailings from the facilities used for exploitation of deep sea minerals. Lastly, this paper attempts to provide ways of reflecting national interests in terms of potential obligations which may be included in the new regulations.
Gait initiation is a transitional process from the balanced upright standing to the beginning of steady-state walking. Dysbalanced gait initiation often causes stroke patients to fall. The net center of pressure, measured by two triaxial force plates from twenty healthy subjects and two stroke patients, was investigated to assess asymmetry of gait initiation in hemiparetic subjects. The time interval and distance of the net center of pressure(CoP) moved from the initiation point to the toe off(S1) and from the toe off to the initial contact(S2) were calculated during gait initiation of normal and stroke patients. When the patient with right hemiplegia(A) initiated his gait with right foot, the time interval and the distance of the net CoP in S1 and S2 were smaller than that of normal subjects' values. However, he initiated the gait with left foot(unaffected side) the time interval and the distance of net CoP in S1 were larger than normative values. Differently, the patient with left hemiplegia(B) has shown that larger time interval and distance in S1 and smaller time interval and distance in S2 in both sides. His asymmetry(with which side the gait initiated) was not significant. It is too early to conclude that these results could be general characteristics of the stroke patients because the variations were large and moreover, the level of motor recovery of the patients was different. However, it is expected that these trials could help to set up the strategy of the therapy for the rehabilitation or prevention of fall in stroke patients.
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