• 대한두개안면성형외과학회지
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• 제15권2호
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• pp.70-74
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• 2014

Background: Many options are available to cover a palatal defect, including local or free flaps. The objective of this study was to evaluate the usefulness of palatal mucoperiosteal island flap in covering a palatal defect after tumor excision. Methods: Between October 2006 and July 2013, we identified 19 patients who underwent palatal reconstruction using a palatal mucoperiosteal island flap after tumor excision. All cases were retrospectively analyzed by defect location, size, tumor pathology, type of reconstruction, and functional outcomes. Speech and swallowing functions were evaluated using a 7-point visual analog scale (VAS) score. Results: Among the 19 patients, there were 7 men and 12 women with an age range of 25 to 74 years (mean, $52.5{\pm}14.3$ years). The size of flaps was $2-16cm^2$ (mean, $9.4{\pm}4.2cm^2$). Either unilateral or bilateral palatal island flaps were used depending on the size of defect. During the follow-up period (mean, $32.7{\pm}21.4$ months), four patients developed a temporary oronasal fistula, which healed without subsequent operative. The donor sites were well re-epithelized. Speech and swallowing function scores were $6.63{\pm}0.5$ and $6.58{\pm}0.69$ on the 7-point VAS, indicating the ability to eat solid foods and communicate verbally without significant disability. Conclusion: The palatal mucoperiosteal island flap is a good reconstruction modality for palatal defects if used under appropriate indications. The complication rates and donor site morbidity are low, with good functional outcomes.

• 한국ITS학회 논문지
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• 제7권5호
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• pp.170-179
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• 2008

한국은 2000년에 고령화 사회에 진입하여 노인인구증가에 따른 노동생산성 정하, 삶의 질 추구, 장애인 증가로 인한 사회 문제가 증가되고 있다. 그러나 정보통신기술의 발달로 고령자들의 이동뿐만 아니라 실내외 생활에 편의를 도모할 수 있게 되었다. 대표적인 서비스로 u-City를 들 수 있으나 국가 계획상에는 아직 구체적인 내용이 없는 상태 또는 부족한 실정이다. 서울시를 대상으로 고령자의 생활 복지를 담당하는 각 구청과 응급상황 처리를 담당하는 소방방재청의 고령자 지원 서비스를 조사한 결과 고령자의 기기에 대한 두려움, 통합서비스부족, 일부 상황에서만 제공되는 서비스 등의 문제점 및 요구사항을 파악하였다. 이러한 문제점을 해결하기 위해 응급상황이 발생해야 제공되던 서비스를 탈피하여 생활 전반에 걸친 검지-확인-조치-대응의 4단계 순환관리 서비스를 제시하였다. 또한 관리체계 및 통신체계를 제시하므로 향후 국가계획 및 시스템 구축 시 참조모델로 활용할 수 있다.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.804-813
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• 2018

Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

• The Journal of Korean Physical Therapy
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• 제31권4호
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• pp.242-247
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• 2019

Purpose: This study examine the functioning level and quality of life (QoL) of people with non-specific neck pain and neck pain with radiculopathy using the neck disability index (NDI), functional rating index (FRI), and short form of health survey 36 (SF-36) and each of linked lCF code lists of those scales. Methods: Each item of the NDI, FRI, and SF-36 were linked conceptually to the ICF code, and the lCF code lists of those scales were produced as iNDI, iFRI, and iSF-36, respectively. Seventy-nine patients with neck pain filled the instruments and its linked ICF code lists. The subjects were divided into two groups based on the diagnosis, non-specific neck pain (Group1), and neck pain with radiculopathy (Group2). A group comparison was performed using an independent t-test. The Pearson correlation coefficient was also used to analyze the relationships between each scale and the linked ICF code list. Results: The participants in Group 2 experienced more difficulties in their daily activities than those in Group 2 when examined in NDI and FRI (p<0.05). This result was also found consistently in the ICF code lists, iNDI and iFRI (p=0.05). On the other hand, the QoL did not show a difference between groups (p=0.06). A strong correlation was observed between the instruments and linked ICF code lists: NDI and iNDI (r=0.90), FRI and iFRI (r=0.91), and SF-36 and iSF-36 (r=-0.61). Conclusion: These findings suggest that the concept of each item in NDI and FRI could be linked to the ICF codes when examining patients with neck pain, but the items of SF-36 were found to be linked and expressed in ICF.

• PNF and Movement
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• 제19권1호
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• pp.19-29
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• 2021

Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.

• The Journal of Korean Physical Therapy
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• 제33권1호
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• pp.7-15
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• 2021

Purpose: This study was examined to improve the standing posture of a scoliosis client using the ICF Tool. Methods: For examination, the study subject was a 16-year-old female student diagnosed with 3curve-pelvic (3CP) type scoliosis. Information about her were collected through a client interview and based on international Classification of Functioning, Disability and Health (ICF). The ICF core set was for post-acute musculoskeletal conditions, and the ICF level 2 items suggested by National Rehabilitation Information Center (NARIC) were added to the recommendations for scoliosis. For evaluation, the ICF assessment sheet was used to identify the interaction among the problems. For the diagnosis, the client's functional problems were described in ICF terms. For the prognosis, the global goals for reaching the client's functional activity and participation level were presented as the long-and short-term goals. For the intervention, a coordinative locomotor training program composed of warm-up, main exercise, and cool-down was applied 3 times a week, 50 minutes a day, for 5 weeks. For the outcome, the differences between before and after the intervention were compared with the ICF qualifier and are shown with the ICF evaluation display. Results: Clinical advantages were observed in body function and structure (7° decrease of thoracic angle, 7 score increase of trunk muscle power, 6.47s improve of one leg standing, 4 score decrease of neck pain). The activity for maintaining the standing posture, in which the client had a primary limitation, was improved. Conclusion: Applying the coordinative locomotor training program is expected to improve scoliosis client's standing posture.

• Clinical Pain
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• 제20권1호
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• pp.25-29
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• 2021

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

• 대한통합의학회지
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• 제10권3호
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• pp.221-232
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• 2022

Purpose : In this study, rectus abdominis relaxation intervention was administered to office workers who were experiencing low back pain due to sitting for extended periods of time in an incorrect posture. This study aimed to develop an effective treatment program for individuals who experience low back pain. This was done by verifying changes using the Korean Oswestry Disability Index (K-ODI) and considering kyphosis. Both factors are related to low back pain. Methods : This study included 39 office workers with low back pain. The participants were randomly assigned to three groups. 1) The functional massage and self-stretching (FAS) group (n=14). 2) The diaphragmatic breathing and self-stretching (DAS) group (n=13). 3) The self-stretching (S) group (n=12). All groups applied the intervention for 30 minutes a day, thrice a week for four weeks. All participants were evaluated using the K-ODI and thoracic kyphosis measurements before and after the intervention. Results : The findings of this study are as follows. All three groups had improved K-ODI scores after the intervention. The FAS and DAS groups showed a greater effect than the S group. However, there was no difference in effect between the FAS and DAS groups. Kyphosis was not improved in any of groups after the intervention, and there was no difference between the three groups. Conclusion : This study showed that the FAS, DAS, and S programs were effective relaxation interventions that improved the K-ODI for office workers with low back pain. The FAS and DAS programs were more effective than the S program. Therefore, it is recommended to combine relaxation and stretching of the rectus abdominis muscle for office workers who experience low back pain. Clinically, a relaxation intervention that is most appropriate for the patient, depending on his or her condition, should be.

• 대한정형도수물리치료학회지
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• 제29권3호
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• 대한물리의학회지
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• 제19권1호
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• pp.95-105
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• 2024

PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.