• 대한통합의학회지
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• 제11권2호
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• pp.69-76
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• 2023

Purpose : This study aimed to compare lung capacity measures (forced vital capacity; FVC, forced expiratory volume at 1 second; FEV1, and FEV1/FVC) and the activities of rectus femoris (RF) and gastrocnemius (GCM) muscles between young adults prescribed aerobic exercise combined with lower limb strength exercise (complex exercise) and those prescribed only aerobic exercise. Methods : We randomly divided 22 young adults into 2 groups: the complex exercise group that combined the leg strengthening and aerobic exercises (n = 11) and the aerobic-exercise-only group (n=11). Before the intervention, the FVC, FEV1, and FEV1/FVC values and the activities of RF and GCM muscles were measured. Measurements were in triplicates, and the average of the 3 measurements was used. The complex exercise group performed the treadmill exercise followed by squats and lunges, and the group performed only the treadmill exercise. Both groups were allocated the same time. Both groups performed the assigned exercise thrice a week for 3 weeks. After the intervention, the FVC, FEV1, and FEV1/FVC values and the activities of RF and GCM muscles were measured again. Results : The FVC and FEV1 values increased significantly in both groups after the intervention (p<.05). RF activity increased significantly after the intervention in the complex exercise group (p<.05), and the magnitude of change in RF activity after the intervention was significantly higher in the complex exercise group than in the aerobic-exercise-only group (p<.05). GCM activity also significantly increased after the intervention in both groups (p<.05). Conclusion : On the basis of our results, we recommend combining leg strengthening and aerobic exercise to improve leg muscle activity along with lung function.

• 동의신경정신과학회지
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• 제33권1호
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• pp.79-111
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• 2022

Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I²=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I²=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

• 대한통합의학회지
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• 제11권4호
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• pp.41-50
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• 2023

Purpose : The aim of study was to determine the effect of lower trapezius muscle strengthening exercises on the height of rounded shoulder posture and muscle activity in patients with rounded shoulder posture. Methods : Thirty-one subjects with rounded shoulders were selected and assigned, with the use of a random number table, to an experimental group (EG, n=16) that received resistance exercises of the trapezius (lower) muscles or a control group (CG, n=15) that received isometric exercises of the lower trapezius muscles. In the EG, with the subject in a prone position, both arms were abducted at the angles suggested for each posture (145 °, 45 ° abduction), with the hands holding dumbbells to assume a functional posture. The CG performed only isometric exercises without dumbbells in the same conditions. At the start signal, with the thumb raised, the arm was raised to the level of the ear. Both groups were assessed by the height of the rounded shoulder posture (RSP) and muscle activity (EMG). The intervention was performed three times a week. Results : The RSP significantly decreased during the intervention period in both the EG and CG (p<.05), and a significant difference was determined between the RSP of the two groups (p<.05). In the EG, the EMG significantly increased during the intervention period (p<.05), but the CG did not show any significant increase (p>.05). The final EMG was significantly higher in the EG than in the CG (p<.05). Conclusion : Both the EG and CG showed positive improvement in rounded shoulder posture during the intervention period. In particular, lower trapezius resistance exercise appears to reduce shoulder height and positively affects the activity of muscles around the shoulder.

• 대한통합의학회지
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• 제11권4호
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• pp.177-188
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• 2023

Purpose : To identify trends in studies on the intersection of neurofeedback (NF) training and rehabilitation interventions for patients with stroke, as conducted over the past decade. Methods : This review included studies published from 2012 to 2022. A comprehensive database search was conducted using keywords such as "stroke", "electroencephalogram (EEG)", "brain wave", "nerve feedback", and "upper extremity function". Results : A total of 703 studies were initially retrieved. Of these, literature predating 2012, duplicate literature, non-experimental studies, and studies that did not target patients with stroke were excluded. After this screening, we retrieved the full texts of 15 articles and re-checked whether each study met the inclusion criteria of this study. The advisory members who participated in this study consisted of people with doctoral degrees and more than 5 years of clinical experience related to the rehabilitation of patients with stroke. Disagreements were resolved through discussions. Ultimately, 8 papers met the inclusion criteria and were included in the final analysis. Despite differences in the type and duration of NF training, the combination of NF training and rehabilitation intervention was found to be effective in promoting the functional recovery of the upper extremities, eliciting positive EEG changes, and inducing neurological changes in the brain. Conclusion : A meta-analysis involving a wider search range is needed in future studies. In addition, efforts are required to generalize the clinical application of these interventions. This can be achieved by supplementing the research methodologies through extensive review studies that encompass a diverse array of study designs.

• 대한통합의학회지
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• 제12권1호
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• pp.73-81
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• 2024

Purpose : The purpose of this study was to identify the degree of occupational therapists' professional identity and examine the correlation between empowerment and burn out. We also investigated the effects of the occupational therapists' professional identity on empowerment and burn out. Through these assessments, we aimed to highlight the importance of professional identity and find methods to improve empowerment and reduce burn out in occupational therapists. Methods : The study was conducted from October 19 to from November 11, 2023. General characteristics, professional identity, empowerment, and burn out were examined using frequency analysis and descriptive statistics. The correlation between these factors was analyzed using Pearson's correlation coefficient. Multiple regression analysis was used to identify factors influencing empowerment and burn out. An α value =.05 was used to verify statistical significance. Results : First, Professional identity was an average 3.24±.37. Second, a significant correlation was found between professional identity and empowerment (r=.417, p<.01) and burn out (r=-.377, p<.01). As a result of the relationship between professional identity sub-factors and empowerment in professional organization (r=.270, p<.01),, belief in self-regulation (r=.258, p<.01), vocational consciousness (r=.348, p<.01), and belief in autonomy (r=.308, p<.01) showed a statistically significant correlation. Professional identity sub-factors were significantly correlated with burnout, professional organization (r=-.199, p<.05), belief in public service (r=-.153, p<.05), belief in self-regulation (r=-.334, p<.01), vocational consciousness (r=-.250, p<.01), and belief in autonomy (r=-.293, p<.01) showed a significant correlation. Third, professional identity sub-factors influencing empowerment were vocational consciousness (β=.154, p<.05) and belief in autonomy (β=.135, p<.05), and those influencing burnout were belief in self-regulation (β=-.389, p<.01) and belief in autonomy (β=-.244, p<.01). Conclusion : The study findings demonstrated that professional identity affects empowerment and burn out. Therefore, continuous study on the professional identity of occupational therapists is warranted.

• 대한통합의학회지
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• 제12권1호
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• pp.109-124
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• 2024

Purpose : The purpose of this study was to examine the effects of a virtual reality-based complex cognitive training program for depression, cognitive function, and digital divide reduction in the elderly who have not been diagnosed with dementia or MCI. Methods : We enrolled 16 participants who were over 65 years old and not been diagnosed with dementia or MCI. We randomly divided into three groups (A, B, C). Participants underwent an 8-week virtual reality-based complex cognitive training program (60 minutes each session, twice per week). At a baseline, all participants completed questionnaires on general features, depression and cognitive function. After four weeks, all participants completed questionnaires on depression and cognitive function. After the end of the last program, participants conducted questionnaires on depression, cognitive function, and usability evaluation. Results : At the 8-week follow-up, 16 participants completed the program. Compared to the baseline, the average score of cognitive function was increased (from 26.5 to 28.5), although it was not statistically significant (p<.061). There were no significant differences between baseline and post-training evaluations on depression scores. The average score of usability evaluation was 75.56, which corresponds to good. Conclusion : Even though the results showed no statistically significant findings in cognitive function and depression after the virtual reality-based complex cognitive training intervention, this pilot study proposed the possibility of utilizing the virtual reality program as a tool that provides active learning opportunities for the elderly and helps improve their cognitive function through multi-sensory components. Also, the findings of this study suggested a positive reevaluation of the elderly's digital access capabilities while reducing the digital divide. A virtual reality-based complex cognitive training program improved the social network of the elderly. We expect that it will expand in size and help with their social participation of the elderly.

• 대한통합의학회지
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• 제12권2호
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• pp.1-10
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• 2024

Purpose : Sarcopenic obesity is associated with adverse health consequences in females. Nevertheless, there has been limited research on the hazardous components and prevailing rates of sarcopenic obesity among younger women. This study aimed to identify the hazardous components and prevailing rates of sarcopenic obesity in younger females. Methods : This study utilized data based on 2008~2011 from the Korea National Health and Nutrition Examination Surveys by the centers for disease control and prevention. The analysis was concentrated on a subset of 1,520 women aged between 30 and 39 years of age. The participants answered a questionnaire to gather demographic information. They then underwent a physical examination to measure the human detention variables, which was conducted utilizing bioelectrical impedance analysis. The blood pressure and blood laboratory tests were determined using established laboratory protocols for evaluating blood parameters. Results : This study included 1,520 patients aged 30~39 years old. The mean age of the participants was 34.97 (years)±2.74 and the overall prevailing rate was 1.84 %. The hazard components in human dimensions were the height, weight, body mass index (BMI), waist circumference (WC) and skeletal muscle mass index (SMI). The hazard components in biochemical and blood pressure were high fasting glucose, increased triglyceride, elevated total cholesterol, high systolic blood pressure, and increased diastolic blood pressure with p-values <.05. Conclusion : This study examined the hazardous components and prevailing rates of sarcopenic obesity in younger women living in the community. The results contribute to the current body of knowledge on sarcopenic obesity and shed light on possible hazardous components in a younger female population. Based on these findings, there should be increased health and medical attention towards the prevention, management, and health promotion related to reducing risk factors for sarcopenic obesity in younger women.

• 대한통합의학회지
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• 제12권3호
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• pp.49-59
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• 2024

Purpose : Chronic ankle instability (CAI) can impair strength and balance, leading to activity limitations and restricted participation. Traditionally, ankle stabilization exercises have been applied, and more recently, the effects of hip muscle exercises have been studied. The purpose of this study was to determine the immediate effects of hip exercises (HE) and ankle stabilization exercises (ASE) on dynamic balance, performance and ankle function in subjects with CAI. We also compared the difference in effectiveness between HE and ASE. Methods : A total of 34 subjects with CAI participated, ane were randomly divided into two groups: the HE group and the ASE group. The HE group performed a program consisting of exercises above 70 % MVIC, while the ASE group performed a traditional ankle stabilization exercise program. The subjects in each group completed their respective exercise program for a total of 30 minutes once a day and were assessed before and after the intervention. Dynamic balance was assessed using the Y-balance test (YBT). Performance was assessed using the hop for distance test (HDT), and side-hop test (SHT). Ankle function was assessed using foot and ankle ability measure (FAAM) questionnaires. Results : YBT, HDT, and FAAM values increased significantly in both groups after the intervention (p<.05), and there was no significant difference between the groups. SHT values decreased significantly in both groups after the intervention (p<.05), and there was no significant difference between the groups. Conclusion : Although no significant superiority was observed between HE and ASE in this study, both exercise programs were effective in improving dynamic balance, performance, and ankle function in subjects with CAI. These findings suggest that both HE and ASE can be suitable interventions for CAI, highlighting the need for individualized treatment plans. Future research is warranted to explore the long-term effects of exercise programs on CAI subjects of different ages and occupational characteristics.

• 대한통합의학회지
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• 제12권3호
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• pp.155-161
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• 2024

Purpose : Wearing high-heeled shoes leads to foot and ankle instability, which requires leg muscles to remain in constant contraction. In order to adapt to the instability of the feet and ankles caused by wearing high heels, the muscles of the legs continuously repeat contraction and relaxation. Previous studies of the impact of stair climbing in high-heeled shoes have involved placing the entire stepping area of the shoe on the stair. However, high-heeled shoe wearers sometimes unconsciously contact the stair using only half of the stepping area. Therefore, the objective of this study was to examine differences in leg and ankle muscle activation according to stepping area during stair climbing in high-heeled shoes. Methods : Twenty young women in their early 20s voluntarily agreed to participate in this study. We used surface electromyography to measure gastrocnemius and tibialis anterior activation in the right leg during stair climbing under three conditions: barefoot, using half of high-heeled shoe stepping area, and using the total of high-heeled shoe stepping area. Barefoot, half of high heeled shoe, and total of high-heeled shoe were used to evaluate the effects of different areas of the foot or high heels touching the stairs. Results : Both muscles showed significant activity differences among the three stair climbing conditions. Gastrocnemius activity was significantly different between the high-heeled shoe conditions (p= .032), and tibialis anterior activity was significantly different between barefoot stair climbing and climbing with half of the high-heeled shoe stepping area (p= .021). Conclusion : The stepping area increased as heel size increased, thus increasing excessive gastrocnemius and tibialis anterior activity to control excessive ankle joint movement. We infer that using half of the high-heeled shoe stepping area prevents muscle fatigue by reducing excessive leg and ankle muscle activation.

• 대한통합의학회지
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• 제8권1호
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• pp.47-56
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• 2020

Purpose : The purpose of this study was to determine the effects of upper extremity volume, pain, and range of motion after participation in thera-band exercises according to the hand grip type in patients with breast cancer with upper extremity edema. We also aimed to determine the most efficient type of grip. Methods : The subjects were 10 female patients diagnosed with stage 2 breast cancer who had stage 2 lymphedema. Randomly, 5 patients each were allocated to the experimental and control groups. For six weeks, the patients in both the experimental and control groups exercised daily. In both groups, manual lymph drainage was applied for 1 hour. Afterward, patients in the experimental group placed their hands in the thera-band ring and exercised with their fingers outstretched. Patients in the control group exercised while holding the thera-band ring with a finger. Both the experimental group and the control group underwent measurements of the circumference of the upper extremity, pain, and range of motion of the shoulder joint at weeks 1, 2, 4, and 6 before and after exercise. Results : The upper arm circumference decreased by more in the experimental group in all weeks than before than that in the control group, and there was a statistically significant difference at 6 weeks. Compared with the difference between pre-exercise and 6 weeks post-exercise, the change in pain significantly decreased in the experimental group and showed a statistically significant difference. The shoulder range of motion increased in extension, external rotation, and internal rotation compared with that in the control group, and there was a statistically significant difference. Although the operating range increased in flexion and abduction, there were no statistically significant differences. Conclusion : In this study, we found that thera-band exercises with an open-hand grip are more efficient than thera-band exercises with a closed-hand grip in edema reduction, pain, and range of motion. In addition, it was found that it was more effective to continue the thera-band exercises with open-hand grip extended for at least 6 weeks rather than for a short time.