Purpose: This study was conducted in order to examine how an effective rehabilitation exercise program influences the activity of shoulder muscles, and to help the clinical application of a rehabilitation program, for prevention and relief of pain, adhesion, and joint stiffness of patients who undergo rotator cuff repair. Methods: Nine test subjects were placed randomly into each group for a total of 27 subjects and exercise program interventions according to the group were conducted for six weeks, after which maximum voluntary isometric contraction (%MVIC) value was re-measured for supraspinatus muscle, infraspinatus muscle, serratus anterior muscle, and middle deltoid muscle in all groups in order to compare changes in muscle activity before and after the experiment in order to perform comparative analysis of changes in muscle activity between groups, based on which four experimental hypotheses were confirmed. Results: Changes in muscle activity according to %MVIC showed a statistically significant difference (p<0.01) (p<0.001) in all muscles, except the middle deltoid muscle, and post-verification results showed that changes in muscle activity according to %MVIC were greater in test groups I and II, compared with the control group, for the supraspinatus muscle, infraspinatus muscle, and serratus anterior muscle. Conclusion: Therefore, rehabilitation through use of the methods described above should be applied efficiently in clinical settings and more research in development of much more efficient rehabilitation program interventions must be conducted.
Journal of The Korean Society of Inherited Metabolic disease
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v.4
no.1
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pp.13-17
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2004
Hereditary tyrosinemia type I (fiunarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that results in liver failure in infancy or chronic liver disease with cirrhosis, frequently complicated by hepatocellular carcinoma in childhood or early adolescence. Early detection of this condition is very important to early intervention for better prognosis of patients. Neonatal screening test using tandem mass spectrometry (MS-MS) is performed, and this method facilitates detection of the inborn error of tyrosine. For early treatment of tyrosinemia type I, phenylalanine and tyrosine restricted diet and NTBC (2-nitro-4-trifluoromethylbenzoyl-1,3-cyclohexanedione) for inhibition of succinylacetone production are recommended. We studied a 10-month-old Korean boy with tyrosinemia type I whose condition was not discovered earlier through conventional neonatal screening testing available in Korea. The patient presented hyperbilirubinemia, liver failure, bleeding tendency, colicky pain and skin melanin pigmentation in neonatal period. MS-MS made it possible to detect tyrosinemia type I and allowed immediate treatment of the patient. This was the first successful NTBC trial on tyrosinemia type I patient in Korea.
Background: Hepatocellular carcinoma (HCC) is one of the most frequent cancers in South East Asian countries including Cambodia, where prevalence of chronic carriers of hepatitis B and C virus (HBV and HCV) is reported to be very high. We reviewed HCC cases admitted to a cancer hospital in Phnom Penh, which is the only one hospital for cancer treatment and care in Cambodia during the study period. Materials and Methods: Information was collected from medical records of 281 cases (210 males and 71 females) diagnosed as primary HCC from 2006 to 2011. Results: The subjects were 7-81 years old with a median age of 53 years. Hypochondriac pain was the most common complained symptom (74%). One third of the cases presented with jaundice. Nearly half had ascites at their first visit. One third had liver cirrhosis. Nearly three fourths of the cases presented with tumor sized more than 50 mm in diameter, and in almost all cases (97.4%) the size was more than 20 mm. Among 209 subjects tested, hepatitis virus carriers were 75.6%; 46.4% for HBV only, 21.5% for HCV only, and 7.7% for both viral infections. Median age of patients with HBV was about ten years younger than those with HCV. Conclusions: This study revealed the characteristics of HCC cases in Cambodia, although there were several limitations. Most HCC cases were infected with HBV and/or HCV, and diagnosed at late stages with complications. This implicated that public health intervention to prevent HBV and HCV infection is of high priority.
Objective : Spinal epidural abscess (SEA) is a severe and life-threatening disease. Although commonly performed, the effect of timing in surgical treatment on patient outcome is still unclear. With this study, we aim to provide evidence for early surgical treatment in patients with SEA. Methods : Patients treated for SEA in the authors' department between 2007 and 2016 were included for analysis and retrospectively analyzed for basic clinical parameters and outcome. Pre- and postoperative neurological status were assessed using the American Spinal Injury Association Impairment Scale (AIS). The self-reported quality of life (QOL) based on the Short-Form Health Survey 36 (SF-36) was assessed prospectively. Surgery was defined as "early", when performed within 12 hours after admission and "late" when performed thereafter. Conservative therapy was preferred and recommend in patients without neurological deficits and in patients denying surgical intervention. Results : One hundred and twenty-three patients were included in this study. Forty-nine patients (39.8%) underwent early, 47 patients (38.2%) delayed surgery and 27 (21.9%) conservative therapy. No significant differences were observed regarding mean age, sex, diabetes, prior history of spinal infection, and bony destruction. Patients undergoing early surgery revealed a significant better clinical outcome before discharge than patients undergoing late surgery (p=0.001) and conservative therapy. QOL based on SF-36 were significantly better in the early surgery cohort in two of four physical items (physical functioning and bodily pain) and in one of four psychological items (role limitation) after a mean follow-up period of 58 months. Readmission to the hospital and failure of conservative therapy were observed more often in patients undergoing conservative therapy. Conclusion : Our data on both clinical outcome and QOL provide evidence for early surgery within 12 hours after admission in patients with SEA.
Purpose: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders. Method: This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program. Result: The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired phyical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'. Conclusion: The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.
Purpose: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Methods: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Results: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. Conclusion: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.18
no.2
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pp.9-21
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2012
Background: The purpose of this study was to analysis and to give information about the type of orthopedic manual physical therapy research by KAOMPT Journal from 1995 (Volume 1) to 2011 (Volume 17). The number of research paper were total 212 studies. Method: The studies were analysed with retrospective descriptive study. The results of data analysis was as follow; Results & Conclusion: 1. The studies was analysed 6 study field; manual therapy for disease field (130 studies), the therapeutic (16 studies), the effects of manual therapy education method, learning model (7 studies), medical insurance, history, politics of manual therapy (3 studies), and others (19 studies). 2. In the manual therapy of disease field, there were 4 groups of disease; bone disease (43 studies), soft tissue and muscles disease (57 studies), nerve disease(24 studies), and the others (6 studies). The main disease were low back pain, stroke, HIVD. 3. In the assessment, and intervention field, there were only 5 studies during from 1995 to 2000, but the studies from 2001 to 2011 were more increased 21 studies. 4. In the effects of manual therapy education method, learning model, there were very few studies (7 studies), so it will be needed more studies in this field. 5. In the other fields such as more political issue, history, medical insurance for the manual therapy there were few studies, so it will be needed more advanced studies in this field.
Journal of the Korean Society of Physical Medicine
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v.1
no.1
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pp.59-66
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2006
Purpose : The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of lumbar paraspinal muscles of normal healthy people. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Methods : Sixty male college students ranging 19 to 34 years were screened and % maximal voluntary contraction(% MVC) of trunk muscles on the four positions of back extension exercise was compared during the pre and post of inspiration of diaphragmatic breathing. Results : 1. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic right arm and left leg extension position(p<0.05). 2. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic left arm and right leg extension position(p<0.05). 3. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying prone extension position(p<0.05). 4. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying on prone position(p<0.05). Conclusion : This study will be used as the purpose of data collection of lumbar paraspinal muscles on diaphragmatic breathing and be introduced as the new therapeutic intervention for management of patients with back pain.
Purpose: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. Methods: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. Results: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p<0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p<0.05). Conclusion: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.
Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.
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