• Title/Summary/Keyword: Functional exercise

Search Result 784, Processing Time 0.027 seconds

Variability in physical therapy protocols following total shoulder arthroplasty

  • Samuel Schick;Alex Dombrowsky;Jamal Egbaria;Kyle D. Paul;Eugene Brabston;Amit Momaya;Brent Ponce
    • Clinics in Shoulder and Elbow
    • /
    • v.26 no.3
    • /
    • pp.267-275
    • /
    • 2023
  • Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

Fatigue and Quality of Life of Korean Cancer Inpatients (입원 암환자의 피로와 삶의 질)

  • Byun, Hye-Sun;Kim, Gyung-Duck;Chung, Bok-Yae;Kim, Kyung-Hye
    • Journal of Hospice and Palliative Care
    • /
    • v.13 no.2
    • /
    • pp.98-108
    • /
    • 2010
  • Purpose: The purpose of this study was to identify the relationship between fatigue and quality of life (QOL) of Korean cancer inpatients. Methods: The data were collected from May to August 2007. Study subjects were recruited at D, Y and A university hospitals in Daegu and Kyungpook, Korea. The research instruments utilized in this study were fatigue (FACT-F) and quality of life (FACT-G) in Korean version 4. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation using SPSS Win 12.0 program. Results: Fatigue of subjects showed a significant difference according to the type of treatment, change in weight, performance status, exercise, and sleep. The QOL of subjects showed a significant difference according to the purpose of treatment, change in weight, performance status, exercise, and sleep. The mean score of fatigue was 22.48 and the mean score of QOL was 55.52. The fatigue was negatively related to QOL, physical well-being, emotional well-being, and functional well-being. Conclusion: The results suggest the needs for intervention in order to reduce fatigue and to improve QOL of cancer inpatients.

A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
    • /
    • v.31 no.4
    • /
    • pp.77-99
    • /
    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

  • PDF

Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.7 no.2
    • /
    • pp.265-284
    • /
    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

  • PDF

Preparation of Functional Healthy Drinks by Acanthopanax senticosus Extracts (가시오가피를 이용한 기능성 건강음료의 제조)

  • Sung, Mi-Sun;Jung, Hoe-Yune;Choi, Jun-Hyeok;Lee, Sung-Cheol;Choi, Bo-Hwa;Park, Sung Sun
    • Journal of Life Science
    • /
    • v.24 no.9
    • /
    • pp.959-966
    • /
    • 2014
  • This study was carried out to develop a functional healthy drink using 60% ethanol of dried Acanthopanax senticosus stem extract (ASE). The preparation, physical activity, anti-oxidant activity, and sensory properties of ASE were investigated. The moisture, crude protein, crude lipid, and ash contents of dried ASE were $6.50{\pm}0.12%$, $5.89{\pm}0.16%$, $1.18{\pm}0.11%$, and $3.03{\pm}0.40%$ respectively. The 1,1-Diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity was $87.42{\pm}1.63%$ at 1/10 folds diluted ASE. In total, 40 male ICR mice were divided into five groups including the control (PBS), positive control (Red ginseng 200 mg/kg/day), and ASE-treated groups at doses of 35, 70, and 140 mg/kg/day for five weeks, respectively. ASE was administrated orally one time per day for five weeks before treadmill exercises, and normal and positive controls were fed PBS and red ginseng extract. In the treadmill test, ASE-treated mice (140 mg/kg/day) could run 1.4 times longer than the control mice. Healthy drinks were prepared with the addition of ASE at levels of 0.97% or 0.49% (A, B, and C type). Among the healthy drinks, the B type (ASE, 0.97%) was revealed to have the highest level of taste and overall acceptability through a sensory evaluation. The brix and pH of the ASE health drink (B type) were 14.9 and 4.51, respectively. These results indicated that the dried stem of Acanthopanax senticosus could be used as a functional material in the health drink industry.

A Study of Power Perception between Supplier and Retail Buyer of Agricultural Products (농산물공급자와 대형소매업체 바이어간의 상호 파워 인식에 대한 연구)

  • 서성무;이은정
    • Proceedings of the Korean DIstribution Association Conference
    • /
    • 2003.02a
    • /
    • pp.123-166
    • /
    • 2003
  • Marketing channel is recognized as one of the society systems which have the character of functional organization. These organizations are related to each other for specialized and cooperative work. Channel members in distribution channel are striving to accomplish exchange through reciprocal action. Thus channel members exercise their power to take better position in exchange. There will be struggling between members about satisfaction and conflict during this power exercise. Now a days, buyers use more harsh power as large retail firms are increasing. This phenomenon is occurring in the distribution channel. However, there will be different phenomenon in case of agricultural products. Not like industrial product suppliers, agricultural product suppliers have various supply channels and many agricultural products are seasonal. It has also unstable amount supplies. There should be differentiated marketing in agricultural products. Relatively weaker powered suppliers have to strengthen comparative factors and also have to be technically specialized through assessed experience in order to establish strong product sales chain. Making a brand of agricultural product would be also a good idea to increase the product comparability. Channel members need to be recognized their specialized functions in order to make balanced distribution channel. There have to be conversion of concept of relation between suppliers and buyers from subordinate relationship to cooperative relationship.

  • PDF

Analysis of the Importance of Planning Elements for Healing Gardens (치유정원 조성을 위한 계획요소의 중요도 분석)

  • Jung, Myoung-Ja;Park, Won-Kyu
    • Journal of the Korean Institute of Landscape Architecture
    • /
    • v.45 no.4
    • /
    • pp.81-91
    • /
    • 2017
  • The purpose of this study is to establish a system of planning elements necessary for effective healing garden. We suggested new planning parts and elements for healing garden through analyzing prior literature and evaluated the importance of planning elements through expert surveys. The results of the study are stated as follows. First, we suggested five planning parts and 19 planning elements. $\LARGE{\cdot}$ Planning parts: Physical environment, social environment, cognitive environment, functional environment, psychological environment. $\LARGE{\cdot}$ Planning elements: Plant planting, garden view, hydroponic space, shade space, work space, recreation space, community space, exercise space, landmark element, sign system, safe facilities and materials, disaster safety facility, universal design, accessible path, economical maintenance, sight openness, privacy guaranteed, variety of resting space, artistic element. Second, as a result of analyzing the importance of planning elements, the first place was the planting, the second place was the safety facilities for the disaster, and the third was diversity of rest space. In addition, the artistic elements and the landmark elements were ranked 18th and 19th, respectively. Third, we evaluated the level of importance of planning elements and classified it into three groups. The most important A group included two elements(plant planting, disaster safety facility), the next important B group included eleven elements(variety of resting space, community space, hydroponic space, universal design, safe facilities and materials, economical maintenance, accessible path, privacy guaranteed, garden view, work space, sight openness) and the less important C group included six elements(shade space, exercise space, recreation space, sign system, artistic element, landmark element). We suggest that, in creating a healing garden, the two elements in A group are essential elements and the eleven elements in B group should be importantly applied. In addition, the six elements in C group are recognized as arbitrarily selectable elements due to the relatively low importance levels.

Direction of Arms Control to Establish Foundation for Peaceful Reunification in Korean Peninsula (한반도 평화통일 기반구축을 위한 군비통제 추진방향)

  • Kim, Jae Chul
    • Convergence Security Journal
    • /
    • v.15 no.6_1
    • /
    • pp.79-92
    • /
    • 2015
  • It is required to expand area of inter-Korean economic cooperation, being limited to non-military field, to military field and then, to positively promote arms control in order to establish foundation for peaceful reunification in Korean peninsula. Reasons why arms control has not been promoted between South and North Korea in the meantime were such original factors as follows; (1) limit of confidence building between the South and the North, (2) functional limit of arms control itself, (3) institutional structural limit between the South and the North, (4) environmental limit at home and abroad. It is necessary to get out from existing frame and to seek a new paradigm in order to overcome above factors and to realize arms control between the South and the North. First, it is required to have prior political dialog at the South-North high-level talks in order to promote arms control and to exercise 'strategic flexibility' during negotiation and promotion process. For this, 'flexible reciprocity' has to be adopted in compliance with situation and conditions. Second, it is necessary to get out from existing principle of 'confidence building in advance and arms reduction later' but to seek the 'simultaneous driving principle of confidence building and arms reduction' as an eclectic approach. Namely, based on reasonable sufficiency, it is required to promote military confidence building and limited arms reduction in parallel, which is a lower level of arms control. Third, as an advisory body of Prime Minister's Office, it is necessary to install an organization exclusively responsible for arms control and to positively handle arms control issue from the standpoint of national policy strategy. If the South-North high-level talks take place, it is necessary to organize and operate 'South-North Joint Arms Control Promotion Board (tentative name)'. Fourth, it is required to exercise more active diplomatic competence in order to create national consensus on necessity of arms control for peaceful reunification and to form more favorable international environment. Especially, it is necessary to think about how to solve nuclear issue of North Korea together in collaboration with international society and how to maintain balance between ROK-US alliance and Sino-Korean cooperation relations.

Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique (압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Kim, Hyung-Jin;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
    • /
    • v.12 no.2
    • /
    • pp.159-166
    • /
    • 2009
  • Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

Prediction of Maximal Oxygen Uptake Ages 18~34 Years (18~34 남성의 최대산소 섭취량 추정)

  • Jeon, Yoo-Joung;Im, Jae-Hyeng;Lee, Byung-Kun;Kim, Chang-Hwan;Kim, Byeong-Wan
    • 한국체육학회지인문사회과학편
    • /
    • v.51 no.3
    • /
    • pp.373-382
    • /
    • 2012
  • The purpose of this study is to predict VO2max with body index and submaximal metabolic responses. The subjects are consisted of 250 male aging from 18 to 34 and we separated them into two groups randomly; 179 for a sample, 71 for a cross-validation group. They went through maximal exercise testing with Bruce protocol, and we measured the metabolic responses in the end of the first(3 minute) and second stage(6 minute). To predict VO2max, we applied multiple regression analysis to the sample with stepwise method. Model 1's variables are weight, 6 minute HR and 6 minute VO2(R=0.64, SEE=4.74, CV=11.7%, p<.01), and the equation is VO2max(ml/kg/min)= 72.256-0.340(Weight)-0.220(6minHR)+0.013(6minVO2). Model 2's variables are weight, 6 minute HR, 6 minute VO2, and 6 minute VCO2(R=0.67, SEE=4.59, CV=11.3%, p<.01), and the equation is VO2max(ml/kg/min)= 68.699-0.277(Weight) -0.206(6minHR)+0.020(6minVO2)-0.009(6minVCO2). And the result did not show multicolinearity for both models. Model 2 demonstrated more correlation compared to Model 1. However, when we conducted cross-validation of those models with 71 men, measured VO2max and estimated VO2 Max had statistical significance with correlation (R=0.53, 0.56, P<.01). Although both models are functional with validity considering their simplicity and utility, Model 2 has more accuracy.