• 대한안전경영과학회지
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• 제15권4호
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• pp.123-129
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• 2013

Among various manual materials handling tasks, pushing/pulling was known to be one of the risk factors for the low back and shoulder musculoskeletal disorders (MSDs). This study was conducted to find out an optimal solution set of the handle height and distance for 4-wheel cart with two vertical handles. Ten male college students participated in the pushing force measurement experiment. The face-centered cube design, one of the central composite designs, was applied for the experiment, and the isometric voluntary pushing force was measured in 9 treatment conditions. The second order response surface model was predicted by using the pushing strength as a response variable, and the handle height and distance as independent factors. According to the 2nd order response model, the handle height and distance showed nonlinear relationship with the isometric pushing strength. To maximize the 2nd order response model (pushing force), the handle height and distance were optimized. The optimal handle height was 'xyphoid process height - stature', and the optimal handle distance was '$1.25{\times}shoulder$ width'. When calculated using the anthropometric data of the subjects of this study, the optimal handle height was $115.4{\pm}3.4$ cm, slightly higher than the elbow height, and the handle distance was $52.9{\pm}2.3$ cm.

• 한국정밀공학회지
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• 제21권8호
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• pp.171-179
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• 2004

The purpose of this study is to generate cycling motion for FES (functional electrical stimulation) using knee muscles only. We investigated the possibility by simulation. The musculoskeletal model used in this simulation was simplified as 5-rigid links and 2 muscles (knee extensor and flexor). For the improvement of the present feedforward control in FES, we included feedback path in the control system. The control system was developed based on the biological neuronal system and was represented by three sub-systems. The first is a higher neuronal system that generates the motion command for each joint. The second is the lower neuronal system that divides the motion command to each muscle. And the third is a sensory feedback system corresponding to the somatic sensory system. Control system parameters were adjusted by a genetic algorithm (GA) based on the natural selection theory. GA searched the better parameters in terms of the cost function where the energy consumption, muscle force smoothness, and the cycling speed of each parameter set (individual) are evaluated. As a result, cycling was implemented using knee muscles only. The proposed control system based on the nervous system model worked well even with disturbances.

• The Journal of Korean Physical Therapy
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• 제31권1호
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• pp.24-30
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• 2019

Purpose: This study compared the effectiveness of three methods, fascial distortion model (FDM), myofascial release (MFR), self-myofascial release (SMR), on the neck range of motion and pain. Methods: In this study, the collected data were processed statistically using SPSS version 22.0 for Windows. Descriptive statistics were used to analyze the general characteristics of the subjects. Repeated measure ANOVA was conducted to analyze the range of motion of the neck of the group and VAS, and Contras was used to see the difference in significance over time. One-way ANOVA was used to compare the differences among the groups and a post-hoc test was used. The significance level (${\alpha}$) was 0.05. Results: In the range of motion, the flexion and extension of the neck, right rotation, and left rotation were significantly different in the SMR, FDM, and MFR groups. The right lateral flexion showed significant differences in the FDM, MFR, and SMR groups. The VAS was similar in the groups at 2 and 4 weeks, but there was a significant difference among the FDM, MFR, and SMR groups at 6 weeks. Conclusion: In this study, MFR and MSR as well as FDM were effective in controlling the range of motion and pain control of the neck. Further studies will be needed to determine the effects of long-lasting treatments other than pain control. These studies and the present study will be used as a basis for ongoing research into the duration and method of application for musculoskeletal therapies.

• The Journal of Korean Physical Therapy
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• 제35권1호
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• pp.31-35
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• 2023

Purpose: This study sought to identify whether fascial therapy using myofascial release (MFR) and Fascial Distortion Model (FDM) techniques affected not only the area where treatment was being given but also remote areas connected to the treatment area by fascial continuity through comparison of the pain pressure threshold (PPT). Methods: The subjects were 16 healthy normal adults in their 20s and 30s who were divided into the MFR and FDM groups before the experiment. The PPT was measured at 4 different points on the body of the subjects. C7, T7, L5, and gastrocnemius along the superficial back line (SBL) before and after the intervention. Results: Only the FDM group subjects showed a significant increase in the PPT at T7 after the intervention. (p<0.05). In addition, the FDM group demonstrated significantly increased PPT at L5 compared to the MFR group. However, neither the FDM nor the MFR group showed a meaningful change in the PPT at the remote area in the lower leg. Conclusion: These findings showed that FDM can affect PPT more and has a positive effect on the pain threshold compared to MFR. However, neither FDM nor MFR showed any effect on the PPT in a remote area.

• 대한인간공학회지
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• 제19권2호
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• pp.15-31
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• 2000

The aim was to evaluate the prevailing ergonomic and psychosocial conditions regarding low back injury in an automobile assembly system. This study consisted of two parts. In the first part of the study, analytic biomechanical model and NIOSH guidelines were applied to evaluate risk levels of low back injury for automobile assembly jobs. Total of 246 workers were analysed. There were 20 jobs having greater back compressive forces than 300kg at L5/S1. Also, there were 44 jobs over Action Limit with respect to 1981 NIOSH guidelines. This might in part be explained by the ergonomic conditions of the company analysed generally being good, with a relatively low duration of 'combined' extreme work posture. The relationship between psychosocial factors and low back injury was examined in the second part of the study. It has recently been recognized that overall reaction to working conditions was influenced by a range of factors, some of which were physical and some psychosocial. The psychosocial environment surrounding the work place may contribute to the perception of risk and eventual ill-health. A battery of questionnaires concerning the psychosocial stress based on PWI(Psychosocial Well-being Index) and musculoskeletal pain symptoms at low back was completed by 246 workers at the same plant. Results showed that 207 out 246 workers experienced the symptoms and 27 workers were diagnosed as patients. Two groups(low stressed, high stressed) based on PWI score had no significant relationships with both symptoms and results of diagnosis. However, sensitivities for symptoms and diagnosis by PWI were 91.3% and 92.6% respectively. Finally, relationships between physical work load and psychosocial stress were analysed. Specifically, some postural factors {vertical deviation angle of forearm, horizontal deviation angle of upperarm, vertical deviation angle of thigh, etc) were highly correlated with psychosocial stress. The results illustrated that PWI scores were associated with some physical workloads. However, psychosocial stress levels couldn't be well related with the pain symptom as well as the actual incidence of low back injury since pain or discomfort regarding low back injury were more complex than that of other musculoskeletal disorders.

• 한방재활의학과학회지
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• 제27권4호
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• pp.55-65
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• 2017

Objectives The purpose of this review is to analyze results of case studies and controlled studies about Carthmi-Flos pharmacopuncture. Based on the review, authors desire to suggest the study model including precise information and evident the effect of Carthmi-Flos pharmacopuncture objectively in treating clinical disorders. Methods We search 44 studies about Carthmi-Flos pharmacopuncture from 6 Korean web databases, using words 'Carthmi-Flos pharmacopuncture' in Korean alphabet. This study had been conducted throughout 1 month (July, 2017). We selected case studies and controlled trials in investigated 44 thesis, excluding experimental research and thesis not using the Carthmi-Flos pharmacopuncture for major treatment. Results We analyze 13 case reports and 7 controlled trials. As a result, Carthmi-Flos Pharmacopuncture was used mostly in musculoskeletal, neurological diseases. But this can be applied to internal diseases. Disorders reported effectively were carpal tunnel syndrome, degenerative knee joint arthritis, posterior neck pain, low back pain, radial nerve palsy, shoulder pain, lumbar compression fracture, alopecia areata, chronic daily headache, duverney fracture, oligomenorrhea, cervical disc herniation, rheumatoid arthritis and cervical headache. Conclusions As we analyzed, Carthmi-Flos pharmacopuncture is specifically effective in musculoskeletal and neurologic diseases. But there are various problems in study design. To design accurately, the study design should include much more specific information. And the result can be more precise by excluding other methods.

• 근관절건강학회지
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• 제1권1호
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• pp.48-70
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• 1994

The purpose of this study was to determine the effects of music therapy on acute, subacute and chronic pain and depression of musculoskeletal trauma patients. The study was designed using nonequivalent control group pretest-posttest design within the framework of an adaptation model. The subjects were composed of forty patients, and twenty of them were assigned to the experimental group and twenty to the control group within the unit of patients. Data were summarized as follows : 1. There were significant changes of pain scores in an experimental and a control group measured before and after the treatment. 2. There were significant changes of pulse rates, respiration rates and systolic blood pressure, but were no significant changes of diastolic blood pressure in an experimental and a control group measured before and after the treatment. 3. There were no significant changes of the amount of ${\beta}$-endorphin in an experimental and a control group measured before and after the treatment. 4. There were no significant changes of depression scores in an experimental and a control group measured before and after the treatment. As a result, music therapy was a useful nursing intervention for relief of acute, subacute and chronic pain. Two suggestions could be made on the ground of the results of this study. 1. On the basis of endogenous pain control theory, it's necessary to research the changes of the amount of ${\beta}$-endorphin as the effect of the music therapy on patients having severe pain. 2. It's necessary to research the changes of the amount of ${\beta}$-endorphin according to the lapse of time after the music therapy for pain relief.

• 의학교육논단
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• 제18권2호
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• pp.65-82
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• 2016

This study aimed to identify curriculum gaps and a pilot study to provide the programs for selection during clerkship. Over the course of a clerkship, students analyze the current level and the needs level of TLO (terminal learning objectives) based on the book "Learning outcome of basic medical education: Scientific concept and principle-centered." We conducted a needs assessment utilizing a t-test, Borich Needs Assessment, and the Locus for Focus model. In the investigation of the needs level, the levels of the musculoskeletal and respiratory systems were relatively high and in the investigation of the current level, the levels of the digestive and musculoskeletal systems were relatively high. This study is expected to contribute to reasonable decision-making by utilizing various methods of analysis and providing in-depth results of needs analysis in designing clerkship curriculum.

• 대한약침학회지
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• 제27권2호
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• pp.110-122
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• 2024

Objectives: This study analyzed the Korea Health Panel Annual Data 2019 to investigate factors related to the use of non-insured Korean medicine (KM) treatment in individuals with chronic diseases. The non-insured KM treatments of interest were herbal decoction (HD) and pharmacopuncture (PA). Methods: Among adults aged 19 or older, 6,159 individuals with chronic diseases who received outpatient KM treatment at least once in 2019 were included. They were divided into three groups according to the KM treatment used: (1) basic insured KM non-pharmacological treatment (BT) group (n = 629); (2) HD group (n = 256); (3) PA group (n = 184). Logistic regression analysis was used to explore factors associated with favoring HD or PA use over BT. Potentially relevant candidate factors were classified using the Andersen Behavior Model. Results: Compared to BT, the 1st to 3rd quartiles of income compared to the 4th quartile (odds ratio: 1.50 to 2.06 for HD; 2.03 to 2.83 for PA), health insurance subscribers compared to medical aid (odds ratio: 2.51; 13.43), and presence of musculoskeletal diseases (odds ratio: 1.66; 1.91) were significantly positively associated with HD and PA use. Moreover, the presence of cardiovascular disease (odds ratio: 1.46) and neuropsychiatric disease (odds ratio: 1.97) were also significantly positively associated with HD use. Conclusion: The presence of some chronic diseases, especially musculoskeletal diseases, was significantly positively associated with HD and PA use, while low economic status was significantly negatively associated with HD and PA use, indicating the potential existence of unmet medical needs in this population. Since chronic diseases impose a considerable health burden, the results of this study can be used for reference for future health insurance coverage policies in South Korea.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.361-373
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• 1999

ROC곡선의 AUC는 측전도구의 기준 타당도를 나타내는 가장 일반화된 지표다. 본 연구는 ROC분석법을 이용하여 현행의 근로자건강진단에서 업무관련성 근골격계 질환의 고위험군을 변별하는 표준 설문지를 개발하고자 하였다. 컴퓨터를 이용하는 선박 설계업 종사자 89명, 전화번호 안내원 113명, 일반 직업 여성 79명, 주부 89명 등 총 370명의 일차 연구대상군에 대한 재활의 학과 전문의의 최종 진단결과를 기준으로 1996년에 개발된 '근로자의 신체 증상에 관한 설문지'의 응답결과를 비교하였다. 근골격계 질환과의 관련성이 높은 문항조합을 선정하고 문항별 가중치를 산출하기 위해 로짓회귀분석, 상관분석 등을 실시하였으며, 문항조합 및 가중치 산출방법이 서로 다른 4가지 설문모형에 따른 AUC를 비교 하였다. 또한, 국내 모 자동차조립공장 근로자 225명의 설문결과와 산업의학 전문의의 진단결과 자료를 이용하여 4가지 설문모형의 AUC 재현도를 확인하였다. 분석 결과, 통계적으로 유의 한 차이는 없었으나 문항수를 줄여도 문항별 응답수준별 가중치를 부여하면 AUC가 일관되게 증가함을 확인하였다. 증상문항 4개와 신체부위문항 7개를 통합한 11개 문항에 가중치를 부여하는 모형이 변별력, 재현도, 편의성 측면에서 우수한 것으로 나타나, 이를 기준으로 새로운 업무관련성 근골격계 질환 설문지를 설계할 수 있었다. 문항수가 적으면서도 타당도는 높은 설문지를 개발하고, 상대적인 비교평가에 쓰일 수 있는 정량적 가중치를 제시한 것이 본 연구의 주요성과라 할 수 있다. 본 연구는 전문의 사이의 진단기준 차이를 고려하지 못한 점, 다양한 인구집단에 적용할만한 절대적인 참고치를 제시하지 못한 점 등에서 한계가 있다. 그러나, '측정 도구의 정량적 타당도 검증을 통한 질병 감시용 도구 개발'이라는 본 연구의 기본 취지 및 접근방법은 향후 조직적인 질병 예방활동에 활용될 여지가 있을 것이다.