• Hip & pelvis
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• v.34 no.1
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• pp.56-61
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• 2022

Purpose: Histopathologic analysis of femoral head specimens following total hip arthroplasty (THA) is a routine practice that represents a significant use of health care resources. However, it occasionally results in discovery of undiagnosed hematopoietic malignancy and other discrepant diagnoses such as avascular necrosis. The purpose of this study was to determine the rate of discordant and discrepant diagnoses discovered from routine histopathological evaluation of femoral heads following THA and perform a cost analysis of this practice. Materials and Methods: A review of patients undergoing primary THA between 2004-2017 was conducted. A comparison of the surgeon's preoperative and postoperative diagnosis, and the histopathologic diagnosis was performed. In cases where the clinical and histopathology differed, a review determined whether this resulted in a change in clinical management. Medicare reimbursement and previously published cost data corrected for inflation were utilized for cost calculations. Results: A review of 2,134 procedures was performed. The pathologic diagnosis matched the postoperative diagnosis in 96.0% of cases. Eighty-three cases (4.0%) had a discrepant diagnosis where treatment was not substantially altered. There was one case of discordant diagnosis where lymphoma was diagnosed and subsequently treated. The cost per discrepant diagnosis was $141,880 and per discordant diagnosis was $1,669 when using 100% Medicare reimbursement and Current Procedural Terminology (CPT) code combination 88304+88311. Conclusion: Histopathologic analysis of femoral head specimens in THAs showed an association with high costs given the rarity of discordant diagnoses. Routine use of the practice should be at the discretion of individual hospitals with consideration for cost and utility thresholds.

• The Journal of Korean Academy of Sensory Integration
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• v.11 no.2
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• pp.13-26
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• 2013

Objective : The purpose of the study was to investigate The effects of the sensory integration intervention focused on combined both individual therapy and group therapy for sensory integration ability and occupational performance abilities in children with somatodyspraxia. Methods : Once in a total of 12 weeks, baseline period of four sessions and twenty-four session intervention period, research process had combined individual therapy and group therapy for sensory integration therapy. The Design is ABA design of single-subject research design. For a comparison of each-side of the operation performance change in therapy for children, through the assessment Baseline at four sessions and reassessment at two sessions after intervention, the Occupational performance ability change was measured. During intervention period, Process changed the Sensory Integration ability was measured through the Goal Attainment Scale (GAS). Results : The Sensory Integration Ability combined Individual therapy and Group therapy have effect about improvement of the Sensory Integration ability and the Occupational performance ability for children with Somatodyspraxia. Conclusion : Henceforth, subject will undergo systematized experimental design, and when dependent variable such as Sensory Integration ability and the Occupational performance was measured, effect-measuring study needs through using reliable tools.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.260-265
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• 2013

Purpose: This study was conducted in order to evaluate the quantitative effectiveness of region of interest (ROI) setting in MR-DTI analysis with and without fMRI activation results. Methods: Ten right-handed normal volunteers participated in this study. DTI and fMRI datasets for each subject were obtained using a 1.5T MRI system. For neural fiber tracking, ROIs were drawn using two methods: The drawing points were located in the fMRI activation areas or areas randomly selected by users. In this study, the neural fiber tract targeted the corticospinal tract (CST) Quantitative analyses were performed and compared. The pixel numbers passing through the fiber tract in the individual brain volume were counted. The ratios between the ROI pixel numbers and the extracted fiber pixel numbers, and the ratios between the fiber pixel numbers and the whole-brain pixel numbers were also calculated. Results: According to our results, extracted CST fiber tract in which the ROI was drawn with fMRI activation areas showed higher distribution than drawing the ROI by users' hands. In addition, the quantitatively measured values represented higher pixel distribution: The counted average pixel numbers were 4553.8 and 1943.3. The average ratios of the ROI areas were 33.87 and 22.52. The average percentages of the individual whole-brain volume numbers were 2.06 and 0.87. Conclusion: Results of this study appear to indicate that use of this method can allow for more objectives and significant for study of the recovery of neural fiber mechanisms and brain rehabilitation.

• Health Policy and Management
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• v.23 no.1
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• pp.66-77
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• 2013

The purpose of this empirical study is to investigate the factors of self-leadership depending on individual characteristics, job characteristics, and qualities of leader-member exchange. Additionally, this study aims to discover the effect of self-leadership's outcome factors on organizational citizenship behavior and innovative activities. In order to verify research model and hypothesis, questionnaires were collected from department members working at general hospitals, hospitals, and clinics in metropolitan area of Seoul, which were 85 departments and 344 respondents. Collected data were analyzed with SPSS ver. 19.0 and Amos ver. 18.0 statistical package using Structural Equation Model. The results of the analysis showed that both individual characteristics and job characteristics have significant positive effect on self-leadership. Also, self-leadership had significant positive relationship on innovative action and organizational citizenship behavior. The implications of this study are as follow. First, this study empirically explained how self-leadership is applied in healthcare organizations. Second, it verified the relationship between causal factors and outcome factors of self-leadership. Also, prior researches of self-leadership have been conducted on business companies, but this study explored self-leadership at healthcare organizations, which increased external validity. Nowadays, many people are interested in the effect of leadership in order to overcome issues coming from enlarged organizations and to improve performance. Self-leadership will contribute to maximizing voluntary efforts of human resources and performance in a rapidly changing healthcare industry.

• Journal of the Ergonomics Society of Korea
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• v.29 no.3
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• pp.311-320
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• 2010

This study aimed to examine the development and characteristics of the workers with upper limb musculoskeletal symptoms and disorders and to analyze the upper limb musculoskeletal symptoms and disorders for its relationship with the individual socio-demographic characteristics. This study investigated the effect on the limitations of physical activities using standardized surveillance tool and clinical diagnosis. Musculoskeletal symptoms and the limitations of physical activities were examined. The clinical diagnosis of musculoskeletal disorders were carried out by physical examination, radiological examination and electromyography-electroneuronography for 22 workers in kitchen hood assembly process and 50 workers in toggle process of leather product manufacturing. The proportion of workers with musculoskeletal disorders was higher and the DASH score was also statistically higher in female and aged workers with longer working hours, longer household working hours, less leisure/hobby activity and higher physical load. Physical activities component score increased in the following order: workers in normal health, workers with musculoskeletal symptoms, and workers with musculoskeletal disorders as clinically diagnosed. Score for each DASH component increased in the following order: sports/performing arts ability, social activities, specific physical functional activities, work or other regular daily activities, work ability, psychological activities, insomnia and upper limb symptoms. The overall and each component DASH scores were higher in workers with symptoms of status praesens and of more severity, and receiving medical intervention. Musculoskeletal symptoms and disorders are associated with individual socio-demographic characteristics, and DASH score for physical activities of upper limb was higher in workers with musculoskeletal disorders. Musculoskeletal symptoms and disorders have a remarkable epidemiological significance for physical activities, social activities, work or other regular daily activities, upper limb symptoms and insomnia, where work ability, sports/performing arts ability and preventive measure is needed.

• Physical Therapy Korea
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• v.9 no.2
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• pp.115-131
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• 2002

Functional electrical stimulation (FES) training of the knee extensors is a useful way to rehabilitate the ability to stand and walk. However, training using FES has not been able to solve the problem of fatigue; clinical application of FES quickly produces muscle fatigue, due to the continuous activation of the muscles of the lower extremity. Therefore, reduction of muscle fatigue is an important factor in increasing the effectiveness of FES training in paraplegia. Intermittent high frequency alternating stimulation is a method that combines the advantages of high frequency (leading to strong muscle contractions) and alternating stimulation (reducing muscle fatigue), thereby continuously strengthening muscles. It is not known whether low frequency simultaneous stimulation results in stronger muscle contraction than high frequency alternating stimulation. This study compared the effectiveness of high frequency alternating stimulation with low frequency synchronized stimulation. Muscle power using FES on the quadriceps of 20 normal subjects were compared. Intermittent high frequency alternating stimulation did not produce more powerful muscle contraction than intermittent low frequency synchronized stimulation, because the muscle characteristics differed individually. Significant individual variation according to muscle characteristics was founded when applying FES. Accordingly, when physical therapists use FES to treat patients, they must be aware of individual variation in muscle characteristics.

• Korean Journal of Applied Biomechanics
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• v.28 no.4
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• pp.213-218
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• 2018

Objective: The purpose of this study was to examine the effect of the core muscle strength enhancement of the elderly on 8 weeks training using the core exercise equipment for the elderly on the ability to control the whole-body center of mass in posture stabilization. Method: 16 females (10 exercise group, 6 control group) participated in this study. Exercise group took part in the core strength training program for 8 weeks with total of 16 repetitions (2 repetitions per week) using a training device. External perturbation during standing as pulling force applied at the pelvic level in the anterior direction was provided to the subject. In a UCM model, the controller selects within the space of elemental variables a subspace (a manifold, UCM) corresponding to a value of a performance variable that needs to be stabilized. In the present study, we were interested in how movements of the individual segment center of mass (elemental variables) affect the whole-body center of mass (the performance variable) during balance control. Results: At the variance of task-irrelevant space, there was significant $test^*$ group interactions ($F_{1,16}=7.482$, p<.05). However, there were no significant main effect of the test ($F_{1,16}=.899$, p>.05) and group ($F_{1,16}=1.039$, p>.05). At the variance of task-relevant space, there was significant $test^*$ group interactions ($F_{1,16}=7.382$, p<.05). However, there were no significant main effect of the test ($F_{1,16}=.754$, p>.05) and group ($F_{1,16}=1.106$, p>.05). Conclusion: The results of this study showed that the 8 weeks training through the core training equipment for the elderly showed a significant decrease in the $Vcm_{TIR}$ and $Vcm_{TR}$. This result indicates that the core strength training affects the trunk stiffness control strategy to maintain balance in the standing position by minimizing total variability of individual segment CMs.

• The Journal of Korean Physical Therapy
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• v.33 no.3
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• pp.168-177
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• 2021

Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

• The Journal of Korean society of community based occupational therapy
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• v.6 no.2
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• pp.51-59
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• 2016

Objective : The purpose of study is to provide basic information about the effects of leisure time use and leisure activity performance for intellectual disabilities residing in a residential care facility by participating a regular rehabilitation sports program. Methods : Participants were recruited 8 individual with intellectual disability in a residential care facility in Yong-in city and the study period lasted 12 weeks, from september 1 to November 30 in 2015. As a program, participants participated a muscle strengthening exercise using a Gym-ball and a elastic band. In order to analyze leisure time-use, time questionnaire was used every month to analyze total time and exercise frequency. Also, analyze the effects of leisure activity performance, Canadian Occupational Performance Measure(COPM) was used to performance and satisfaction of dynamic leisure activity. Collected data was encoded by item and analyzed with SPSS ver18.0. Descriptive statistics were used for the participants' general information. A non-parametric test (the Friedman test) was used to analyze leisure time-use. A non-parametric test (the Wilcoxon's signed ranked test) was used to analyze to the effects of leisure activity performance. Statistical significance was accepted outside the 95% confidence interval. Results : The results of the total time and the exercise frequency showed significant increase. Also, the results of the performance and the satisfaction showed significant increase. Conclusion : Thus, the participation of the rehabilitation sports program is a vital element to lead to change leisure time use and leisure activity performance for intellectual disabilities residing in a residential care facility. Also, through the providing and the developing a regular rehabilitation sports program systematically, intellectual disabilities residing in a residential care facility have a higher quality of life and satisfaction of the daily routine and life in a residential care facility.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.