• 제목/요약/키워드: Moderate impairment

검색결과 59건 처리시간 0.02초

요통기간에 따른 손상, 장애, 심리적 요인들의 상관성 비교 (Comparison of the Relationship Between Impairment, Disability and Psychological Factors According to the Difference of Duration of Low Back Pain)

  • 원종임
    • 한국전문물리치료학회지
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    • 제18권3호
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    • pp.76-84
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    • 2011
  • The purpose of this study was to investigate the correlations between pain intensity, physical impairments, disability, and psychological factors according to the difference in duration of low back pain. This study was a cross-sectional survey of 102 participants with low back pain, divided into two groups equal in number: The first group consisted of patients with acute and subacute low back pain, while the second group consisted of patients suffering from chronic low back pain. The results showed that gender, age, pain intensity, physical impairment, disability and Fear-Avoidance Beliefs (FABs) for work activities were not significantly different between two groups. FABs for physical activities of the first group were significantly more prevalent than in the second group. More than moderate correlations were found between pain intensity, physical impairment, and disability in the first group. Less than moderate correlations were found between pain intensity, physical impairment, disability, FABs, and depression in the second group. These findings suggest that we must consider psychological factors in the treatment of patients with chronic low back pain. Regression analyses revealed that pain intensity and FABs for work activities significantly contributed to the prediction of disability in the first group. Also, pain intensity and FABs for physical activities significantly contributed to the prediction of disability in the second group. Pain intensity was most important predictor of disability in two groups.

Action observation training enhances upper extremity function in subacute stroke survivor with moderate impairment: a double-blind, randomized controlled pilot trial

  • Kim, Chang-Heon;Bang, Dae-Hyouk
    • 대한물리의학회지
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    • 제11권1호
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    • pp.133-140
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    • 2016
  • PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

Prospective Memory Loss and Related White Matter Changes in Patients with Amnestic Mild Cognitive Impairment

  • Yoon, Bora;Ryu, Sun Young;Yoon, Soo Jin
    • 대한치매학회지
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    • 제17권3호
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    • pp.120-129
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    • 2018
  • Background and Purpose: Prospective memory (PM) has a known relationship with frontal function, and PM decline has been observed in amnestic mild cognitive impairment (aMCI). Cerebral small vessel disease, as evidenced by white matter hyperintensities (WMHs), is linked to frontal dysfunction. This study was undertaken to evaluate the relationship between PM decline and WMHs in patients with aMCI. Methods: Of 74 enrollees with aMCI, 69 completed this prospective study. We compared total scores and sub-scores of the Prospective and Retrospective Memory Questionnaire (PRMQ) administered at baseline and 3 months later, stratifying patients by degree of WMHs. Results: A significant decline was seen in PRMQ total scores and PM scores at the 3-month mark in patients with moderate (vs. mild) degrees of WMHs ($-2.8{\pm}7.2$ vs. $0.2{\pm}7.1$; p=0.032). In addition, patients with moderate (vs. mild) degrees of deep WMHs (DWMHs) showed greater PM decline, whereas PM loss in patients with mild, moderate, or severe degrees of periventricular WMHs (PVWMHs) did not differ significantly. Conclusions: Findings of this study indicate that the burden of WMHs is consistently implicated in PM deterioration experienced by patients with aMCI, and signifies greater PM decline, especially in instances of extensive DWMHs. Greater attention to the change of PM is therefore needed in aMCI patients with WMHs.

식품 섭취와 인지기능장애와의 관계: 체계적 문헌고찰 및 메타분석 (Association between Intake of Food and Cognitive Impairment: A Systematic Review and Meta-analysis)

  • 김유경;김경희
    • 한국식생활문화학회지
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    • 제35권6호
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    • pp.553-568
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    • 2020
  • This systematic review and meta-analysis aimed to determine whether food intake is effective in preventing diseases related to cognitive impairment. We searched English databases namely MEDLINE, PubMed and ScienceDirect from 2000 to May 2020, and Korean databases namely RISS, KISS, and DBPIA from 1990 to May 2020. We divided the data into 15 groups using the food group classification of the Korean Nutrition Society (KNS). The effect size (Cohen's d) was estimated using a random-effect model, and a 95% confidence interval was calculated for each study. We included 17 cross-sectional studies and 7 cohort studies which involved 45,115 participants. As a result of analyzing the subgroups in the Asian population of both sexes, it was observed that grain intake has a protective effect against cognitive impairment. For females, pulses and fish also have a protective role against cognitive impairment. In the case of seaweed, a negative relationship was found with a moderate protective effect against cognitive impairment (Cohen's d:-0.533, 95% CI: -0.939, -0.126; p=0.010) in Korean studies. Dairy products are associated with an increased risk of cognitive impairment in the American and European population but drinking alcohol is associated with a lower impairment risk. These results provide a basis for formulating the dietary guidelines for preventing dementia for each country.

인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로 (Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches)

  • 차선아;배수영;남상훈;홍익표
    • 재활치료과학
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    • 제12권3호
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    • pp.61-77
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    • 2023
  • 목적 : 본 연구는 노인들의 인지기능과 구강건강관련 삶의 질 사이의 연관성을 분석하기 위해 수행되었다. 연구방법 : 2020년에 수집된 제8차 고령화연구패널조사에 참여한 지역에 거주하는 45세 이상의 중고령자를 대상으로 인구통계학적 및 임상적 특성을 추출하여 활용하였다. 독립변수는 한국형 간이정신상태검사 점수를 기준으로 분류한 인지기능, 종속변수는 구강건강관련 삶의 질을 측정하기 위한 노인구강건강평가지수이다. 인지기능 그룹 간 공변량의 차이를 보정하기 위해 성향점수 활용법 중 역확률가중치를 적용 후 인지기능과 구강건강관련 삶의 질의 연관성을 분석하기 위해 역확률가중치 적용 전의 다중회귀분석과 적용 후의 다중회귀분석 결과에 차이가 있는지 결과를 비교하였다. 결과 : 연구 대상자는 총 6,116명으로 인지정상군 4,367명, 경도 인지손상군 1,155명, 중증 인지손상군 594명으로 구성되었다. 성향점수 역확률가중치 적용 결과로 표준화된 평균 차이(standardized mean difference)를 확인하여 0.2 이상인 변수를 다시 통제하고 분석한 다중회귀모델에서 인지기능 그룹과 구강건강관련 삶의 질 간의 부정적인 연관성이 있었다(정상 vs. 경도: β = -2.534, p < .0001; 정상 vs. 중증: β = -2.452, p < .0001). 결론 : 본 연구 결과에서 인지손상과 구강건강관련 삶의 질은 음의 연관성을 나타내었다. 성향점수 활용 후 중증 인지손상보다 경도 인지손상에서 더 부정적인 연관성을 나타낸 결과는 인지손상은 저하된 정도와 관계없이 구강건강관련 삶의 질에 부정적인 영향을 미치는 것을 의미한다. 따라서 인지기능의 감퇴가 나타난 모든 환자들은 구강관리의 중요성과 교육이 필요하다는 것을 시사한다.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • 제64권7호
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

국내 뇌졸중 편마비 환자를 대상으로 한 건측억제-환측유도 치료효과의 메타분석 (Meta-Analysis of Constraint-Induced Movement Therapy in Hemiplegic Stroke Patient in Korea)

  • 박소연;신인수
    • 한국전문물리치료학회지
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    • 제19권2호
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    • pp.59-68
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    • 2012
  • This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

경도인지장애 및 알쯔하이머형 치매 환자에서의 신경정신증상 (Neuropsychiatric Symptoms in Patients with Mild Cognitive Impairment and Dementia of Alzheimer's Type)

  • 황보람;김현;이강준
    • 정신신체의학
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    • 제20권2호
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    • pp.105-111
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    • 2012
  • 연구목적 : 본 연구는 경도인지장애(Mild cognitive impairment, 이하 MCI)와 알쯔하이머형 치매(Dementia of Alzheimer's type, 이하 AD)의 신경정신증상 빈도와 점수를 조사하고 비교 분석한 뒤, 인지기능과 Korean Neuropsychiatric Inventory(K-NPI) 결과와의 상관관계를 알아보고자 하였다. 방 법 : MCI 또는 AD를 진단받은 163명의 환자들을 세 군으로 분류하였다. K-NPI를 이용하여 MCI 환자 55명, 경도의 AD 환자 56명, 중등도 이상의 AD 환자 52명을 대상으로 신경정신증상을 조사하였고, 세 군간의 K-NPI의 부척도별 빈도와 composite score를 비교하였다. 결 과 : MCI군에서 가장 흔한 증상은 우울/불쾌감, 수면/야간행동, 불안, 과민/불안정 순이었다. 경도 AD군에서의 증상은 초조/공격, 우울/불쾌감, 불안, 무감동/무관심, 수면/야간행동 순으로 빈번하게 나타났다. 중등도 이상 AD 군에서는 무감동/무관심, 우울/불쾌감, 초조/공격, 망상 순이었다. 이 중 망상, 환각, 초조/공격, 무감동/무관심, 이상행동증상, 식욕/식습관의 변화의 빈도는 세 군 간에 통계적으로 유의한 차이를 나타내었다. 총 NPI 점수는 MMSE-KC 점수와는 음의 상관관계를, GDS와는 양의 상관관계를 보였고, 모두 통계적으로 유의하였다. 결 론 : 신경정신증상은 MCI, AD에서 흔히 보이는데, 본 연구에서는 MCI와 경도의 AD에서 이들 증상들이 유사한 양상을 나타내었다. 정신증은 중등도 이상 AD에서 가장 흔하게 나타났고, 이로 인해 더욱 빠른 인지기능의 저하를 초래할 수 있다. 따라서 MCI와 AD의 각 진행 단계에 따른 적절한 치료가 필요하다.

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뇌졸중 환자의 인지손상을 위한 몬트리올인지평가의 신뢰도 (A Reliability the Montreal Cognitive Assessment on Cognitive impairment Following Stroke)

  • 송창순
    • 한국산학기술학회논문지
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    • 제14권3호
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    • pp.1228-1233
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    • 2013
  • 본 연구는 한국판 만성 뇌졸중 환자의 신경심리학적 평가도구를 결정하기 위하여 한국판 몬트리올인지평가 및 한국판 간이정신상태검사의 신뢰도를 알아보고, 두 평가도구의 상관관계를 알아보았다. 연구대상자는 만성뇌졸중환자 52명을 대상으로 하였으며, 인지손상 진단 여부에 따라서 정상인지 뇌졸중군(20명)과 인지손상 뇌졸중군(32명)으로 구분하였다. 연구대상자는 한국판 몬트리올인지평가 및 한국판 간이정신상태검사를 평가받았으며, 연구기간은 2012년 10월 2일부터 2012년 11월 30일까지 이었다. 연구결과 정상인지 뇌졸중군은 한국판 몬트리올인지평가에서 중등도 이상의 신뢰도를 보여주었으며, 한국판 간이정신상태검사에서 중등도의 신뢰도를 보여주었다. 인지손상 뇌졸중군은 한국판 몬트리올인지평가 및 한국판 간이정신상태검사에서 모두 중등도 이상의 신뢰도를 보여주었다. 또한 정상인지 뇌졸중군과 인지손상 뇌졸중군은 한국판 몬트리올인지평가의 점수가 높을수록 한국판 간이정신상태검사의 점수도 높은 양의 상관관계를 보여주었다. 본 연구의 결과는 한국판 몬트리올인지평가 및 한국판 간이정신상태검사 모두 뇌졸중으로 인한 인지손상을 진단하는데 적합하다고 사료되어, 연구 및 임상환경에서 신경심리학적 평가도구로 사용할 것을 제언한다.

한국인 고혈압 환자의 의료접근성 및 미 충족 의료실태와 위험요인 분석 (Prevalence and Risk Factors of Unmet Healthcare Needs among Korean Adults with Hypertension)

  • 오희영;길은하
    • 성인간호학회지
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    • 제29권1호
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    • pp.22-31
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    • 2017
  • Purpose: The purposes of this secondary analysis study was to examine prevalence, risk factors and unmet healthcare needs among adults with hypertension. Methods: A sample of 3,386 adults over the age of 40 with hypertension were drawn from the Korea Health Panel Study (2013). Using SPSS 22.0 version, descriptive statistics including frequency, percentage, chi-square and logistic regression were performed. Results: Results showed that 18.9% of the sample reported unmet healthcare needs with the most frequently cited one was financial burdens (43.2%). The reported experiences of unmet healthcare needs differed by gender, marital status, vision or hearing impairment, memory problem, impaired mobility, subjective health status, total family income, depressive episode and the difficulty in making decisions. The sample participants were more likely to report unmet healthcare if they had vision impairment, low income and perception that their health status as moderate to poor. Those without vision impairment were less likely to report unmet healthcare needs. Conclusion: The identified risk factors of unmet healthcare needs should be addressed which would enhance access both to health care and to resolution of unmet healthcare needs. Since visual ability seems to impact perception of unmet healthcare needs, it may be useful to find ways to address this factor.