Background: Unstable surface-based core training can significantly enhance core strength, but no studies have compared the effects of balance pad- and sling-assisted exercises. Objects: To study the effects of unstable surface-based balance pad- and sling-assisted core strength exercises on muscle activity. Methods: Twenty male students aged 20-25 years participated in this study. The effects of three types of core strength exercises, performed with a sling or balance pad, on the activities of three muscles, i.e., the right musculus obliquus externus abdominis (EO), right erector spinae (ES), and right gluteus maximus (GM), were examined. Results: 1) In the glute bridge exercise, the percentage of maximum voluntary contraction of the EO, ES, and GM were significantly different between the balance pad- and sling-assisted exercises. The relative contribution of the ES and GM activities to all muscle activity were not significantly different between the two training types, whereas that for EO showed a significant difference. 2) There was no significant difference in the percentage value of maximum voluntary contraction (%MVC) among the EO, ES, and GM during the "leg-lifting with flat support" exercise, and there were no significant difference in the relative contributions between the two training types. 3) In the "side bridge leg separation exercise", the %MVC of the ES, EO, and GM were significantly different between the two training types. Conclusion: Sling training for core muscles was generally better than balance pad assist training. The majority of physiotherapy patients require core training. Our results could guide physiotherapists in the choice of targeted exercises for these patients.
Yoo, Jun Sang;Ha, Hyun Geun;Jeong, Ju Ri;Ko, Young Jun;Lee, Wan-hee
Physical Therapy Rehabilitation Science
/
제5권1호
/
pp.47-52
/
2016
Objective: This study surveyed the perceptions of physical therapists on muscle re-education through visual feedback obtained from rehabilitative ultrasound imaging (RUSI). Design: Survey. Methods: For this study, 500 physical therapists who participated in a refresher training held by the Seoul City Association in March 2015 were selected for a questionnaire-based survey. Subjects were randomly selected targets physiotherapists who participated in a refresher training.The questionnaire had 21 items in total. Questions 1 to 15 could be answered by everyone. However, questions 16 to 21 could be answered only by people who used RUSI. Results: The majority of respondents were aged 20 to 30 years. Respondents in their twenties, thirties, forties, and fifties accounted for 32.4%, 40.2%, 21.9%, and 5.6%respectively. Therapists with careers spanning one to 5 years accounted for 27.8%, while those with careers spanning 5 to 10 years and 10 to 15 years accounted for 34.6% and 17.0%, respectively. Those with careers over 20 years accounted for 9.2%. The types of work have not been various including work related to the nervous system (49.0%), the musculoskeletal system (41.5%), sports (0.7%), juvenile physical therapy (4.2%), and others (4.6%). Conclusions: In this study, we examined the perceptions of physical therapists on rehabilitation ultrasound imaging used in muscle re-education. We also examined how to use this technique. Many therapists who participated in the refresher training were found to be unaware of RUSI. In the future, further investigations on RUSI for muscle re-education are required through refresher training or training lectures at the national level.
Purpose: This study investigated the efficacy of task-related circuit training aimed at improving balance in individuals discharged from rehabilitation facilities following a stroke. Methods: We recruited 12 stroke patients (34-66 years of age) to participate in a task-related circuit training program. Baseline assessment included a history of stroke and an assessment using the Mini-Mental State Examination Korea (MMSE-K). After a baseline assessment, follow-up assessments were administered pre- and post-training. These included Berg Balance Scale (BBS), Functional Reach Test (FRT), and the Time Up & Go Test (TUG). Physiotherapists trained study subjects under the one-to-one supervision of students from the department of physical therapy. Circuit class study participants attended 90-minute treatment sessions, one day a week for 12 weeks (from September to December 2008). The program consisted of a light warm-up period (10 min), physical exercises for improving balance (20 min), tasks focused on improving balance (50 min) and a cool-down period (10 min). Results: Scores for the BBS assessment increased significantly (from 43.2 to 49.7) after the training (p<0.05). Reach distance on the FRT increased substantially (from 27.7 cm to 47.0 cm), although the improvement was not significant (p>0.05). The average time on the TUG test decreased significantly (from 23.7 sec to 19.5 sec) after the training (p<0.05). Conclusion: The task-related circuit training program improved the balance and mobility of subjects, indicating that such a group program is useful for stroke patients who are discharged from the hospital. More such task-related programs set in a community environment should be developed.
Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.
PURPOSE: The purpose of this paper is to provide a review of physiotherapy intervention for patients with COVID-19 during their hospital admission and post-discharge. METHODS: The recommendations and guidelines of physiotherapy management, medical management, and general information of the WHO, Australian Physiotherapist, European Respiratory Society, British Thoracic Society, and American Thoracic Society were reviewed. RESULTS: This paper contains general information on COVID-19, including medical management, and the importance of physiotherapy approaches including an assessment of the patients' function, such as the 6-minute walking test, five sit to stand or sit to stand for one minute to measure their function as their recovery journey. The patients' quality of life, anxiety, and depression should be considered. Physiotherapy management should be based on an assessment of the patient's presenting impairments, including inclusion and exclusion of physiotherapy intervention. The paper also approaches step by step with the disease progress, from an intensive care unit, the general ward in the acute phase, through to the rehabilitation ward if needed, and post-discharge as an outpatient.. CONCLUSION: The paper has a limitation due to the unknown factor of the natural history of COVID-19. Depending on the patients' recovery journey and the rehabilitation needed, any physiotherapy interventions should focus on what the patients' need on their journey to recovery, e.g., pulmonary, cardiac, neurological, and general rehabilitation. In addition, applying personal protection equipment for treating physiotherapists is a mandatory requirement because this protects from the transmission of COVID-19.
Purpose: To identify an associations between health care workers' uniforms and health care-associated infection. Methods: Electronic databases, including Ovid-Medline, the Cochrane Library, CINAHL, EMBASE, KMbase, and KoreaMed, were searched. The search terms included doctor, nurse, health care worker/staff/assistant, clothing, (white) gown, uniform, (neck)tie, and attire. Only papers published in English and Korean were included. Results: 16 studies were selected from 1,900 references screened. All of the studies were non-comparative studies except for one. Four were conducted with doctors, six with nurses, one with health care workers including physiotherapists and one for medical staff plus visitors in a neonatal intensive care unit. Doctors more frequently changed their uniforms than neckties; therefore, the degree of contamination was more serious in neckties. The cuff zone was more likely to be heavily contaminated than other areas of long-sleeve gowns. Coats become contaminated quickly once worn, and colony counts reached a similar level within the first few hours after wearing them. Wearing a plastic apron or protective clothing did not prevent the bacterial contamination of nurses' uniforms, and the best way to decrease the contamination was changing to newly laundered uniforms before starting every duty. Conclusion: Healthcare workers' uniforms are a potential source of health care-associated infection although there was no robust evidence. The government must establish standards for laundering of uniforms or a requirement for institutions to provide a laundering service for healthcare workers' uniforms.
Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.
This study examined the perception and readiness of nursing educators regarding interprofessional education (IPE), and discussed the validity and application of IPE in nursing. From December 2016 to January 2017, 239 nursing professors and nurses completed a structured questionnaire consisting of general characteristics, the Interdisciplinary Education Perception Scale, the Readiness for Interprofessional Learning Survey (RIPLS), and an IPE action plan. The collected data were analyzed by descriptive statistics and t-test using the IBM SPSS ver. 23.0 program (IBM Corp., Armonk, NY, USA). The analysis revealed that 91.6% of the participants had not experienced IPE, and only 11.7% knew about IPE. However, approximately 80.0% answered that IPE is necessary. The results of this study showed that the score of the perceived need for cooperation was higher in nurses than it was in professors, while the score on competency and autonomy was higher in professors than it was in nurses. With reference to the scores on the RIPLS, those of professors were high on the sub-scales of teamwork and collaboration, professional identity, and roles and responsibility. The results revealed that participants considered the upper-grade undergraduate years as the ideal time for imparting IPE, and it was deemed suitable to include communication, simulation, and clinical practice in IPE. Doctors, pharmacists, and physiotherapists were thought to require cooperation for IPE the most. Despite the presence of several barriers to IPE, the participants thought that IPE can achieve learning outcomes such as interprofessional communication and cooperation, conflict resolution, and teamwork. It is necessary to cooperate with professionals in the complex clinical environment as professional areas are specialized and subdivided. Therefore, it is necessary to examine the application of IPE in undergraduate education and in on-the-job training.
Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.
Purpose : The purpose of this paper is to look at educational needs based on the academic background to improve continuing education (CE) for physical therapists in the Republic of Korea. Methods : 350 people who attended the CE were selected for analysis of the need of the education in Gwangju Metropolitan city of the Korean Physical Therapy Association. Final education was classified as college, university, and master of science course (MSc) or higher. The authors selected 11 subjects such as basic education, musculoskeletal system, nervous system, pediatric, cardiopulmonary, sports, senior citizens, physical therapy, women, oriental medicine, and others. Simple linear regression analysis was performed using dummy variable to identify the needs of the CE according to the academic background. Results : The need for CE in the MSc or higher was greater than college graduation in the nervous system (R2=.019, B=.347), pediatric (R2=.028, B=.491), cardiopulmonary system (R2=.038, B=.600), sports (R2=.037, B=.584), geriatric (R2=.030, B=.261), oriental (R2=.033, B=.597), and others (R2=.028, B=.531). University graduation was lower than college graduation in the need of physical agents (R2=.037, B=-.277). Conclusion : Authors infer that CE was not fully satisfied with physical therapists especially according to academic background that's why present study showed no meaningful statistical results were found. Therefore, we still think that a wider survey of CE will be needed, and the efforts are constantly required for both the Korean physical therapy association and people who working as physiotherapists to strengthen their awareness of the education.
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