• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.2
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• pp.67-75
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• 2012

Background: Hemiplegic patients have the problems of the balance and weight shifting to the affected leg in walking. The aim of this study was to investigate the effect of unilateral stepping exercise combined with auditory feedback on balance and walking ability of the hemiplegic patients. Methods: Thirty hemiplegic patients were allocated in study group (n=15) or control group (n=15). General exercise and weight supporting exercise were conducted for the control group, and general exercises and unilateral stepping exercise combined with auditory feedback were conducted for the study group. Exercise were conducted three times a week for six weeks. Balance ability was measured by Berg Balance Scale (BBS), postural assessment scale for stroke (PASS), and performance-oriented mobility assessment (POMA). Walking ability was measured by time up and go test (TUG), 10m walk test (10mWT), and six minutes walk test (6MWT). Results: Balance and walking ability were significant increased in both group (p<.05). Balance and walking ability of the study group were more increased than that of the control group (p<.05). Conclusions: Unilateral stepping exercise combined with auditory feedback is more effective than weight supporting exercise to increase on balance and walking ability for the hemiplegic patients.

• Physical Therapy Korea
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• v.9 no.2
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• pp.157-168
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• 2002

The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) approach on the spasticity of affected side in patients with hemiplegia. Three subjects with hemiplegia participated in this study. In single-subject research design (a multiple baseline across individuals) was employed in this study. The intervention program including PNF to the unaffected side was introduced for 30 minutes each day during each intervention phase. Muscle tone of affected side was measured with Tone Assessment Scale, and active hip abduction distance of affected side was taken with the subject supine. And then the muscle tone and the hip abduction distance were measured again 30 minutes later following the intervention. The results showed that the PNF application had some beneficial effects on both muscle tone and active hip abduction. This result suggest that PNF application to non-paretic limb can be effective in reducing muscle tone and improving hip abduction range on paretic limb in persons with hemiplegia. However, further research is needed to prove the effect of PNF application on functional improvement.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.181-188
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• 2022

Objective: The purpose of this study to investigate the correlations among the motor function, balance, and gait velocity and the strength that could explain the variation of gait velocity of chronic stroke survivors. Design: This was a cross-sectional cohort study. Methods: Thirty hemiplegic stroke survivors hospitalized in an inpatient rehabilitation center were participated. The muscle tone of ankle plantarflexor and muscle strength of ankle dorsiflexor were measured respectively with modified Ashworth scale (MAS) and hand-held dynamometer. And the motor recovery and function with Fugl-Meyer assessment (FMA), balance with Berg balance scale (BBS) and timed up and go (TUG) test were measured. Gait velocity was measured with GAITRite. The correlation among motor function, muscle tone, muscle strength, balance, and gait were analyzed. In addition, the strength of the relationship between the response (gait velocity) and the explanatory variables was analyzed. Results: The gait velocity had positive correlations with FMA, muscle strength, and BBS, and negative correlation with MAS and TUG. Regression analysis showed that TUG (𝛽=-0.829) was a major explanatory variable for gait velocity. Conclusions: Our results suggest that gait velocity had correlations with muscle strength, MAS, FMA, BBS, and TUG. The tests and measurements affecting the variation of gait velocity the greatest were TUG, followed by FMA, BBS, muscle strength, and MAS. This study shows that TUG would be a possible assessment tool to determine the variation of gait velocity in stroke rehabilitation.

• Physical Therapy Korea
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• v.30 no.1
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• pp.1-7
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• 2023

Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

• Journal of Korean Public Health Nursing
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• v.28 no.3
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• pp.495-508
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• 2014

Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

• Safety and Health at Work
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• v.2 no.3
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• pp.260-272
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• 2011

Objectives: The promotion of health and safety (H&S) awareness among hospital staff can be applied through various methods. The aim of this study was to assess the risk level of physical hazards in the hospital sector by combining workers' perception, experts' evaluation and objective measurements. Methods: A cross-sectional study was designed using multiple triangulation. Hospital staff (n = 447) filled in an H&S questionnaire in a general hospital in Athens and an oncology one in Thessaloniki. Experts observed and filled in a checklist on H&S in the various departments of the two hospitals. Lighting, noise and microclimate measurements were performed. Results: The staff's perception of risk was higher than that of the experts in many cases. The measured risk levels were low to medium. In cases of high-risk noise and lighting, staff and experts agreed. Staff's perception of risk was influenced by hospital's department, hospital's service, years of working experience and level of education. Therefore, these factors should be taken into account in future studies aimed at increasing the participation of hospital workers. Conclusion: This study confirmed the usefulness of staff participation in the risk assessment process, despite the tendency for staff to overestimate the risk level of physical hazards. The combination of combining staff perception, experts' evaluation and objective measures in the risk assessment process increases the efficiency of risk management in the hospital environment and the enforcement of relevant legislation.

• Journal of Environmental Impact Assessment
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• v.21 no.6
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• pp.841-857
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• 2012

Preliminary ecological environmental assessments including physico-chemical constituents, water quality, fish fauna analysis, physical habitat health, and ecological health assessment were conducted as a primary step for Jeungchon micro-habitat ecosystem restoration in 2012. Water chemistry analysis of conductivity, dissolved oxygen, chlorophyll-a and etc. indicated that there were no significant differences(p < 0.05) among 6 sites between the headwaters and downstream. Multi-metric model analysis of Qualitative Habitat Evaluation Index(QHEI) showed that brooklets were at "good condition" as a mean QHEI of 158.7(n = 6) and the longitudinal differences of the model values between the sites were minor(QHEI range: 153 - 165). Total fish species and the number of individuals were 12 and 481, respectively, and dominant species were Zacco platypus(49.5%) and Zacco koreanus(36.8%). Tolerance guild analysis showed that the proportion of sensitive species($S_S$) had a negative linear function[$S_S=86.35-0.31(D_H)$; $R^2$ = 0.892, p < 0.01] with a distance from the headwaters, while the proportion of tolerant species($T_S$) had a positive linear function($R^2$ = 0.950, F = 90.28, p < 0.001) with the distance. Trophic feeding guild analysis showed that the proportion of insectivore species($I_n$) had a negative linear function($R^2$ = 0.934, p < 0.01) with a distance from the headwaters, while the proportion of omnivore species($O_m$) had a positive linear function($R^2$ = 0.958, p < 0.001) with the distance. Index of Biological Integrity(IBI) model, based on fish assemblages, showed a "fair condition" as a mean IBI of 23(n = 6), and there was a distinct differences of ecological health between the headwaters(S1 = 30; "good condition") and the downstreams(S6 = 14; "poor condition"). Overall, the preliminary environmental impact assessments suggest that water quality, physical habitat conditions(QHEI model), and ecological health(IBI model) were maintained well, even if the state was not an excellent conditions.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.17 no.6
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• pp.61-72
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• 2014

We implemented ecological linkage assessment, through the connection components of the urban forests, rivers and parks, for the ecological connection of the urban parks which are standing out as the core of the urban green networks, so as to suggest basic data to compare, evaluate and improve urban green networks, as a basic study for the evaluation of the ecological connectabilities between the cities. For the ecological linkage assessment, we analyzed to see if the urban parks of Goyang, Ansan and Yongin, which are the subject cities, are actually ecologically connected with forests and rivers, using distance and roads, which are physical connection elements, in consideration of the mobility of the wild animals, and greening ratios and impervious pavement ratios, which are ecological connectabilities in consideration of the ecological values. The overall result of the ecological linkage assessment the physical connection elements and the ecological connection elements shows that the ecological green network ratio through direct connection states is 36.62% in Goyang, 42.55% in Ansan and 64.00% in Yongin, respectively, giving the ecological connectability ratio of less than half, with the average urban ecological green network ration of 47.72%. The comparison result of the ecological connectabilities between the object cities employing the connection elements indicates that when you set up green networks, you should consider together the physical connection elements, such as the roads, which will lower the ecological connectabilities - rather than do it simply based on areas and distances - while the ecological connection elements with the forests and the streams should be reinforced, so that the ecological connectabilities of the urban parks may be enhanced.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.53-58
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• 2010

Purpose: Our goal was to determine the difference in motor recovery between two stroke types: the corona radiata (CR) infarct type and the intracerebral hemorrhage (ICH) type, by using assessment methods for motor functions. Methods: Forty subjects who were diagnosed as having had a stroke with an infarct (men: 11, women: 9, mean age: $62.25{\pm}7.59$) or a stroke with an ICH (men: 12, women: 8, mean age: $59.75{\pm}6.11$) were recruited. In all subjects, motor functions of the affected extremities were measured 2 times: at stroke onset (initial) and 6 months after the onset (final) by the motricity index (MI), the modified Brunnstrom classification (MBC), and functional ambulatory category (FAC). We compared the final assessment with the initial one. Results: Motor functions of all patients improved with the passing of time. All scores of motor function assessment in the ICH type were higher than in the infarct type. Comparing the initial assessment with the final one, upper MI and MBC scores of the upper extremities were significantly different between the two stroke types (p<0.05), but lower MI and FAC scores of the lower extremities were not (p>0.05). Conclusion: These findings imply that patterns of motor recovery in patients with either the infarct type or the ICH type of stroke change for the better over time. The degree of motor recovery in the ICH type was better than in the infarct type. Therefore, one can introduce clinical interventions by the aspect of progress in functional motor recovery.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.114-118
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• 2018

Objective: The left and right sides of the brain has different roles. This study investigated the differences in cognitive driving ability between stroke survivors with damage to the left brain and right brain. Therefore, the purpose of this study was to compare the driving cognitive ability of left and right hemispheric drivers following stroke. Design: Cross-sectional study. Methods: The Stroke Drivers' Screening Assessment (SDSA) from the UK was translated to the Korean Stroke Drivers' Screening Assessment (K-SDSA) to meet the specific traffic environments of Korea. The SDSA is composed of 4 tasks :1) a dot cancellation task that measures concentration and visuospatial abilities necessary for driving, 2) a directional matrix task to measure spatio-temporal executive function required for driving, 3) a compass matrix task to measure accurate direction determination ability required for driving, and 4) recognition of traffic signs and reasoning ability to understanding traffic situation. The SDSA assessment time is about 30 minutes. The K-SDSA was used to compare the cognitive driving abilities between 15 stroke survivors with left and 15 stroke survivors with right brain damage. Results: There were significant differences between the persons with stroke patients with left brain lesions (right hemiplegia) compared to the persons with stroke with right brain lesions (left hemiplegia) (p<0.05). It was found that the cognitive driving ability of those with right brain damage was lower than that of the group of left brain damage. Conclusions: This research investigated the driving cognitive ability of persons with stroke. The therapists can use this information as basis for the driving test and training purposes. It could also be used as a basis to understanding if the cognitive ability of not only stroke survivors but also those with brain damage is adequate to actually drive.