• Korean Journal of Applied Biomechanics
• /
• v.25 no.4
• /
• pp.441-451
• /
• 2015

Objective : The purpose of the study was to investigate and compare the differences between Parkinson's disease rating, balance, fall and gait scales. Results : Parkinson's disease rating scales include the Hoehn-Yahr Scale and the Unified Parkinson's Disease Rating Scale (UPDRS). The Hoehn-Yahr Scale can measure disease rates easily; however it is not sensitive enough to evaluate the disease's process and management. UPDRS's advantage is in it's higher inter-reliability score; however it is more complicated to use. Parkinson's balance scales are comprised of the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence Scale (ABC). BBS has the advantage in that it is cheaper to measure and simple in use. ABC's advantage is especially in it's ability to measure higher functional levels; however it is more difficult measure responses due to scores appearing in both extremes. The Fall Efficacy Scale (FES) and The Survey of Activities and Fear of Falling in the Elderly (SAFE) are Parkinson's fall scales. FES's leverage over SAFE is that it is simpler to measure; however it does not coincide with responses which proves disadvantageous in measuring balance loss in high-level Parkinson's patients. SAFE's advantage is in it's simpler use and ability to be utilized without encountering the fear of fall; however it's at a disadvantage in regards to its use with multilateral aspects providing insufficient inspection. Lastly, the Dynamic Gait Index (DGI) and the Functional Gait Assessment (FGA) are Parkinson's gait scales. DGI is advantageous in its ability to test gait ability when exposed to a variety of external environments; however it is disadvantageous in that it registers higher scores with activities. FGA's advantage is in it's dynamic balance test; however it at a disadvantage with those unable to walk. Conclusion : A researcher of Parkinson's patients must choose each scale while considering their positive and negative characteristics.

• Journal of rehabilitation welfare engineering & assistive technology
• /
• v.6 no.2
• /
• pp.1-8
• /
• 2012

In previous studies, the dynamic exercise equipment just focused on the trunk stabilization exercise. However, our study is targeted at evaluation for the impact on the postural balance of those researches. Twelve male and twelve female subjects were volunteered for the balance training using this system. They had no medical history of backpain for the past six months. Trunk Stability and postural balance training was performed for 15 minutes a day, three times a week duing four weeks. To evaluate characterization of the postural balance using Balance System SD, Evaluation consist of the postural stability test and the postural limit test. As a result, this training with 3D dynamic exercise equipment help subjects improve the postural balance. These results are expected for using basic materials to the elderly with a high risk of falling and trained athletes needed to be a postural control.

• Journal of Chest Surgery
• /
• v.46 no.2
• /
• pp.130-134
• /
• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• Korean Journal of Applied Biomechanics
• /
• v.30 no.1
• /
• pp.121-129
• /
• 2020

Objective: This study was conducted with the aim of verifying the effectiveness of the duocock exercise, which is being utilized at the newly developed site to promote balance maintenance, basic physical strength and muscle strength among various age groups, in order to prevent fall and successfully age. Method: In this study, we conducted the duocock Exercise Program for 12 weeks (twice a week for an hour) for 10 senior citizens aged 65 or older (68.8±4.76 yrs, height: 15±6.00 cm) using Western-based health institutions in Daejeon, and compared the pre- and post- effects on basic physical strength and posture balance. All the data obtained from this study were used in statistical program SPSS 24 to perform paired t-test. The significance level for all statistical analyses was set at the level of p<0.05. Results: The 12 week duocock program showed statistically significant improvements in lower extremity muscle strength, equilibrium, agility, balance, and coordination in the basic fitness factors underlying successful aging (p<0.05). In addition, the trunk imbalance, which acts as a factor of falls and body balance, was statistically significant (p<0.05) and the posture balance of the sagittal plane also showed the effect of proper body adjustment. Conclusion: Based on the results of this study, duocock provides a new exercise program in the form of a sustainable sport as a two-handed exercise, and is very effective for the elderly to improve their basic physical strength as well as to control postural imbalances, strengthen and increase muscle strength.

• Journal of the Ergonomics Society of Korea
• /
• v.35 no.5
• /
• pp.425-437
• /
• 2016

Objective:The objective of this study is to develop an ergonomic toilet system along with constituent facilities that can be used with the front-entry sitting method when transferring from wheelchair to the toilet stool, instead of using the back-entry sitting method which is currently used. This system can offer more ease, convenience and safety for wheelchair users when using the restroom. Background: For users with disabilities, even a dedicated handicapped toilet requires maneuvering, especially when in a wheelchair. To transfer from wheelchair to the current back-entry sitting toilet, users need to get closer to the toilet and then turn or twist after erecting their body to get onto the toilet. This method induces inconvenience as well as secondary injury by falling when transferring to/from toilet. Method: To design a front-entry sitting toilet system, an ergonomics approach was applied which introduces a new design concept for people using wheelchairs. Using this toilet system, the wheelchair users don't need to turn or twist but can simply slide forward off the wheelchair directly onto the toilet stool in an easier and safer way. Results: The newly developed front-entry sitting toilet system is easier and safer for wheelchair users, and also space efficient requiring only two-thirds of the space of existing handicapped toilet. It is also usable by both individuals with disabilities and the general population. Conclusion: With the spread of the front-entry sitting toilet system developed in this study, wheelchair users can benefit from enhanced convenience and safety as well as significant restroom space savings. Additional effects can also be achieved such as improved self-esteem of people with disabilities by enabling to use the toilet on their own. Application: The newly developed front-entry sitting toilet system should enhance toilet accessibility to wheelchair users and the elderly. Introduction is needed with efforts at the national policy level and a macroscopic objective to promote the health and safety of the handicapped.

• PNF and Movement
• /
• v.15 no.3
• /
• pp.253-257
• /
• 2017

Purpose: This study was conducted to predict the risks that arise while standing on mediolateral ramps at various ramp angles by identifying the ratio of medial to lateral gastrocnemius muscle activities. Methods: The subjects were 20 healthy adult men. Seven mediolateral ramp angles ($0^{\circ}$, $2^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, and $25^{\circ}$) were applied for the experiment. The ratio of medial to lateral gastrocnemius muscle activities in each condition was measured using electromyography, and the measured data were converted to root mean square values to calculate the activity ratios. Results: The study results showed statistically significant differences in the ratio of mediolateral gastrocnemius muscle activities according to the selected mediolateral ramp angles. The results of a post hoc test confirmed that the multifidus muscles were asymmetrically used on the two sides at mediolateral ramp angles of $5^{\circ}$ or higher. Conclusion: This study found that an asymmetric use of the multifidus muscles began at a mediolateral ramp angle of $5^{\circ}$, and the provision of propulsion using the ankle joints on mediolateral ramps at $5^{\circ}$ or steeper was maneuvered differently from that on flat ground. This suggests that individuals with balance control disorder have the risk of falling due to ankle sprains and unstable balance control. Therefore, patients and elderly people are required to exercise caution when crossing $5^{\circ}$ or steeper ramps.

• Transactions of the Korean Society of Mechanical Engineers A
• /
• v.38 no.8
• /
• pp.837-848
• /
• 2014

This paper describes the development of a walking assistive robot for effective self-rehabilitation for elderly people facing an inconvenience in walking. The main features of the developed robot are enhanced safety and mobility using the baby walker and electric wheelchair mechanisms and an accurate walking tracking control algorithm using potentiometers and stereo cameras. Specifically, a pelvis supporter is designed to prevent the user from falling down and reduce the burden on their legs, and electric motors are used for easy locomotion with low effort. Next, the walking intention and direction of the user are automatically recognized by using potentiometers attached at the pelvis supporter so that the robot can track the user, and the rapidity and accuracy of the tracking were increased by applying a lower-body motion analysis algorithm with stereo cameras. Finally, the user-tracking performance of the developed robot was experimentally verified through stepwise walking assistance experiments.

• Korean Journal of Adult Nursing
• /
• v.25 no.1
• /
• pp.24-32
• /
• 2013

Purpose: The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting. Methods: This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7. Conclusion: These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

• Quality Improvement in Health Care
• /
• v.3 no.1
• /
• pp.78-93
• /
• 1996

Background : The goal of this study was to establish the QA items and guidelines for preventing and improving of safety management. Therefore we investigated the nurses' recognition and knowledge of the safety and risk procedures and policies, and the agreement between the nurses beliefs on the degree of importance of those procedures and policies, with actual implementation in hospitals. Method : The subjects of this study were 201 nurses who participated in a program called continuing education for nurses, which held in December, 1993. Result: The results of this study were as follows: 1. Among 18 types of hospital risks, the items that scored highest or the need of closer attention in safety management was the needle stick, medication errors, falling, and bed sores. 2. In most questions of the 18 incidences, the nurses showed that the estimated result would have positive signs except for hospital infections, burns, and bed sores. 3. Even though the survey shows that incidences and types of occurences varies according to the person's age and the time of incident, they mostly occur between midnight to 6AM. Falls and bed sores can be seen more in the elderly. Medications errors, hospital infections and burns are frequently found between the ages of one through twenty. 4. There was a higher mean score for recognizing the importance of those items than the importance of implementing them. Conclusion : In summary, nurses did perceive the need of safety management but the hospital policy for proper safety management was not established. So we recommended that the hospital administration would undertake an early detection and proper management system for hospital precautions, based on QA items & guidelines presented in this study.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.19 no.2
• /
• pp.336-342
• /
• 2015

Fall-related injuries are the most common cause of accidental death for the elderly and the most frequent work-related injuries in construction sites. Due to the growing popularity of smartphones, there has been a number of research work related to the use of sensors embedded in the smartphone for fall detection. Falls can be detected easily by measuring the magnitude and direction of acceleration vectors. In general, the direction of the acceleration vector does not show the object movement, but the velocity vector directly indicates the tangential direction in which the object is moving. In this paper, we proposed a new method for computing the fall direction based on the characteristics of the velocity vector extracted from the accelerometer.