• 제목/요약/키워드: REHABILITATION

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발목 골절 수술 후 한방 재활치료 프로토콜 적용의 임상적 효과: 증례 보고 (A Rehabilitation for Ankle Fracture in Korean Medicine: A Report of 4 Cases)

  • 하원배;이종하;이윤승;조동찬;이진현;이정한
    • 한방재활의학과학회지
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    • 제27권4호
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    • pp.171-184
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    • 2017
  • The objective of this study was to propose a rehabilitation protocol for ankle fracture in Korean Medicine and to report its effectiveness. Four patients who had undergone ankle fracture by car accident were treated using the rehabilitation protocol in Korean Medicine. We estimated the outcome evaluating physical examination findings of the ankle joint, numeric rating scale, Olerud-Molander score, and walking state. After the treatment, we observed that ankle movement and muscular strength were improved. Moreover numeric rating scale, Olerud-Molander score, and walking state of patients were improved. A rehabilitation in Korean Medicine can be effectively used for ankle fracture patients. The limitation of this study was the insufficient number of cases. Further studies are needed to design a rehabilitation protocol in Korean Medicine.

국립재활원 협진의료 이용실태와 발전방안 제안 (An actual utilization and development plan study of interdisciplinary medical care at the National Rehabilitation Center)

  • 임성민
    • 대한한의진단학회지
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    • 제18권1호
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    • pp.25-31
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    • 2014
  • Objective This study aims to understand the actual utilization of the oriental rehabilitation medicine center of the initial interdisciplinary medical care at the National Rehabilitation Center and to arrange proper development plans for more effective interdisciplinary medical services for future activation of interdisciplinary medical care. Method: The interdisciplinary patient status, composition of patient care, and major disease-related status were studied and analyzed for oriental rehabilitation medication relating to interdisciplinary medical care at the National Rehabilitation Center. Furthermore, the interdisciplinary status and its operating conditions were evaluated to devise a development plan for the National Rehabilitation Center. Results: As a result of the analysis of oriental rehabilitation medical care diagnosing status utilization at the National Rehabilitation Center regarding interdisciplinary medical care, the ratio of the number of those receiving interdisciplinary oriental rehabilitation medical care was less than half of the total receiving interdisciplinary care. As the major disease status from the patients of interdisciplinary care, stroke patients covered the large majority, and musculoskeletal pain patients covered the majority of outpatients. The establishment of additional oriental medication departments and assigning of interdisciplinary coordinators were presented as the goals of a development plan for the manpower and structural side of interdisciplinary medical care at the National Rehabilitation Center. On the institutional and systematic side, improvement in the interdisciplinary hierarchy and interdisciplinary model development based on the number of patients per disease was proposed. In addition, operation on ward bedding and construction of interdisciplinary EMR medical care is necessary on the medical and administration service side. Conclusion: To understand the actual utilization and to arrange development plans aimed at constructing a safe and effective interdisciplinary hierarchy for interdisciplinary medical care at the National Rehabilitation Center, patient-centered care needs to be implemented.

후두전적출환자의 Voice Rehabilitation에 대한보고 (The Report of Voice Rehabilitation after Total Laryngectomy)

  • 최홍식;최성희;김한수;홍진희;남지인;김세헌;김광문
    • 대한후두음성언어의학회지
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    • 제13권2호
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    • pp.155-163
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    • 2002
  • Background and Objectives : Esophageal voice, Silicone voice Prosthesis with tracheo-esophageal (T-E) puncture have been used as vocal rehabilitation methods for postlaryngectomy. However, long-term follow-up in the voice rehabilitation in the total laryngectomees has not been reported. The purpose of this study is to analyze practice of postlaryngectomy voice rehabilitation and to find the effective voice rehabilitation. Materials and Methods : From Jan 1992 until June 2002, 75 patients underwent a total laryngectomy at Yongdong Severance Hospital. We retrospectively studied voice rehabilitation methods commonly used, acquisition levels of esophageal speech, patients satisfaction scale (5 rating scale) according to the methods in 33 of them (40 died, 2 unavailable) by using charts review, telephone interview. Results : T-E speech is most commonly used by 14 patients (42.4%) : A tracheo-esophageal procedure (primary or secondary puncture) by 21 : and 8 patients removed Provox. 1 patient had no voice rehabilitation. 7 patients (21.2%) have used esophageal speech : 4 patients of them have used it after removing Provox. Electrolarynx has been used with other voice rehabilitation methods : 4 patients have only used this method and 3 patients with T-E speech, 1 patient with esophageal speech. However, 6 patients (18%) remained without a substitute voice rehabilitation. In the satisfaction with speech and management of voice rehabilitation methods, patients using esophageal speech were most satisfied (4.1), patients with T-E speech were unsatisfied (2.3). Regarding with the acquisition level of esophageal speech in 33 patients, 22 patients (66.6%) failed without functional speech. Conclusion : To increase patients satisfaction and to achieve successful voice rehabilitation after total laryngectomy, preoperative counseling, pretesting, appropriate patient selection of each method and team decision-making and postoperative voice therapy must be considered.

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Three-dimensional kinematic motion analysis of door handling task in people with mild and moderate stroke

  • Lee, Jung Ah;Kim, Eun Joo;Hwang, Pil Woo;Park, Han Ram;Bae, Jae Hyuk;Kim, Jae Nam
    • Physical Therapy Rehabilitation Science
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    • 제5권3호
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    • pp.143-148
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    • 2016
  • Objective: This study aimed to quantify one of the useful upper extremity movements to evaluate motor control abilities between the groups of people with mild and moderate arm impairments performing a door handling task. Design: Cross-sectional study. Methods: Twenty-one healthy participants and twenty-one persons with chronic stroke (9 mild stroke and 12 moderate stroke) were recruited for this study. Stroke participants were divided into 2 groups based on Fugle-Meyer Assessment scores of 58-65 (mild arm) and 38-57 (moderate arm). All they performed door handling task including the pronation and supination phases 3 times. We measured some movement factors which were reaction time, movement time, hand of peak velocity, hand of movement units to perform door handling task using the three-dimensional motion analysis. Results: The majority of kinematic variables showed significant differences among study groups (p<0.05). The reaction time, total and phase of movement time, hand of peak velocity, the number of movement units discriminated between healthy participants and persons with moderate upper limb stroke (p<0.05). In addition, reaction time, total and phase of movement time, the number of movement units discriminated between those with moderate and mild upper limbs of stroke patients (p<0.05). Conclusions: Three-dimensional kinematic motion analysis in this study was a useful tool for assessing the upper extremity function in different subgroups of people with stroke during the door handling task. These kinematic variables may help clinicians understand the arm movements in door handling task and consist of discriminative therapeutic interventions for stroke patients on upper extremity rehabilitation.

한국형 재활환자분류체계 버전 1.0 개발 (The Development of Korean Rehabilitation Patient Group Version 1.0)

  • 황수진;김애련;문선혜;김지희;김진휘;하영혜;양옥영
    • 보건행정학회지
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    • 제26권4호
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    • pp.289-304
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    • 2016
  • Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

뇌졸중 환자의 재활동기, 자기효능감 및 가족지지가 재활이행에 미치는 영향 (Influences of Rehabilitation Motivation, Self-efficacy and Family Support on Rehabilitation Adherence in Stroke Patients)

  • 박안숙;고은
    • Journal of Korean Biological Nursing Science
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    • 제19권2호
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    • pp.113-122
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    • 2017
  • Purpose: The purpose of this study was to identify influencing factors on rehabilitation adherence in stroke patients. Methods: This study was a descriptive survey. A structured questionnaire was used for face-to-face interviews with a convenient sample of 192 subjects, who were admitted in 5 rehabilitation hospitals located in G metropolitan city. Results: The score of rehabilitation motivation in the subjects was a mean of $2.04{\pm}0.35$, self-efficacy $6.22{\pm}2.32$, family support $3.40{\pm}0.82$ and rehabilitation adherence $3.08{\pm}0.41$. The rehabilitation adherence was a statistically significant difference according to the education level (F= 3.40, p= .035), marital status (F= 4.04, p= .019), number of personal insurance policies (K= 9.80, p= .020), location of paresis (F= 2.72, p= .046), and status of current smoking (M = 657.00, p= .001). There was significant correlation among degree of rehabilitation adherence, rehabilitation motivation (r= .30, p< .001), self-efficacy (r= .14, p= .046) and family support (r= .18, p= .011). Rehabilitation motivation (${\beta}=0.19$, p= .007), self-efficacy (${\beta}=0.14$, p= .035), marital status (${\beta}=0.14$, p= .038), number of personal insurance policies (${\beta}=-0.15$, p= .045) and location of paresis(${\beta}=-0.15$, p= .028) were identified as significant predictors. This model explained 22.6% of variance in rehabilitation adherence (F= 5.92, p< .001). Conclusion: There is a need to develop an effective intervention for rehabilitation adherence improvement considering the identified variables in this study.

쇄골 골절 환자의 수술 후 한방 재활 치료에 대한 증례 보고 (Case Report about Postoperative Rehabilitation of Oriental Medicine for the Distal Clavicular Fracture)

  • 조동찬;문수정;공재철;이삼윤;송용선;고연석;이정한
    • 동의생리병리학회지
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    • 제26권1호
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    • pp.98-104
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    • 2012
  • The objective of this study is to report the effectiveness of active postoperative rehabilitation on clavicular fracture by oriental medical interventions and to suggest the importance of proper rehabilitation after operation. A female patient, 43 years old, who had operation for right distal clavicular fracture was treated by oriental medical rehabilitation. We evaluated the consequence by checking numeric rating scale(NRS), shoulder range of motion and shoulder pain and disability index(SPADI). The pain of the patient was decreased and the shoulder range of motion was advanced. SPADI score was decreased. Postoperative-oriental medical rehabilitation can be effectively used for a patient on postoperative state of clavicular fracture. Further studies are needed to set up a rehabilitation protocol with oriental medical interventions after operation.