Recently, the ratio of elderly in the population are fast growing due to socio-economical development and the better medical service. Proportionally, the health problems in elderly are increasing, too. Medical professionals must try so that the elderly have the better life through health promotion and disease prevention as well as disease treatment. This study evaluated the effect of walking exercise program on the cardiorespiratory function and the flexibility in the elderly women. The design of research was one group pretest-posttest design. The subjects were eleven elderly women over sixty years old to live in K-city, Kyonggi-do. The type of exercise was walking, which was the most popular exercise in questionnaire. The exercise intensity was 40%∼60% of the target heart-rate by Karvonen's method and maintained by the heart-rate monitor. The exercise period was five weeks and the exercise frequency was three times per week. The exercise duration was forty minutes at first and gradually increased up to an hour. In order to evaluate the effect of walking exercise, we measured VO/sub₂ max, resting heart -rate, systolic/diastolic blood pressure, FVC, FEV/sub₁, the flexibility before and after the five week's exercise program. The data are analyzed by the paired t-test and Wilcoxon signed rank test using SAS package. The results are as follows : 1) The hypothesis that cardiorespiratory function will be improved was partly supported. In VO/sub₂ max(p=0.0001), resting heart-rate(p=0.0030), systolic/diastolic blood-pressure(p=0.0387/ p=0.0024), there was significant difference. FVC and FEV/sub₁ were increased after the exercise, but there were no significant difference. 2) The hypothesis that the flexibility will be improved was supported. There was significant difference in the flexibility(p=0.0140). As the further study, it is necessary to reevaluate the effect with more refined design. We also need to try meta-analysis about the results of previous studies obtained in the experimental setting and compare our result obtained in the field setting with them.
This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 persons responded to the mail survey, through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study, and the unit of analysis is a physician. To examine the change of average income per month, multiple regression was used to test the change according to physician's characteristics, demographic characteristics, scale of clinic, average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was mcreased \4,850,000, but the difference was \6,020,000 under the control of control variables. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.
Background: A physically active lifestyle and regular exercise training incurs many health benefits. One recently recognized benefit of regular moderate exercise is stress reduction and immune enhancement. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Methods: This study was undertaken to investigate the effect of different type of exercise on superoxide dismutase (SOD), neutrophils, and T lymphocytes of Sprague-Dawley rats. Sprague-Dawley rats were randomly divided into three groups; a non-Trained group (NTG, n=6), a swim-Trained group (STG), and a treadmill-Trained group (TTG). The exercise regimen was designed in a treadmill (5 times/5 days/week) during 8-weeks for TTG, and swim training (5 times/5 days/week) during 8-weeks for STG, and the volume of exercise training was the same in both groups. Results: 8 weeks of regular swim and treadmill training significantly increased liver SOD concentration however, muscle SOD concentration was not statistically significant. In the level of neutrophils, TTG and STG showed significant difference, compared to NTG. TTG was the highest level of neutrophils. In the level of immune cell counts, there was significant difference among TTG, STG, and NTG both in the spleen and thymus. Conculsion: In conclusion, it can be stated that eight weeks swim and treadmill exercise training has beneficial effect in improving immune response and antioxidant defence capacity by augmenting immune cells and SOD activities of SD rats.
Purpose. The purpose of this study were to investigate the effects of a 12-week brisk walking program on triglycerides (TG) and apolipoprotein B (Apo B) and to compare these effects to those of a brisk walking plus diet program in middle-aged overweight/obese ($BMI{\geq}23$) Korean women with hypertriglyceridemia. Method. This analysis was done with nineteen middle-aged overweight/obese Korean women who completed either the brisk walking program (9 women) or the brisk walking plus diet program (10 women) for 12 weeks. The brisk walking consisted of walking for 20 to 50 minutes/day at an intensity of 40 to 70% of heart rate reserve (HRR) for 3 to 6 days/week. The diet consisted of 60 minutes of group education and 20 to 30 minutes of individual counseling every week. TG and Apo B were assessed pre- and post-intervention. Results. TG and Apo B decreased significantly after the brisk walking program (Z = -2.31, p = 0.021; Z = -2.59, p = 0.009). TG and Apo B lowering effects of the brisk walking program were not significantly different from those of the brisk walking plus diet program (U = 37.0, P = 0.549; U = 42.0, P = 0.842). Conclusion. Brisk walking can be an effective intervention for overweight/obese middle-aged women with hypertriglyceridemia in reducing cardiovascular risk by lowering TG and Apo B levels. Adding diet to brisk walking may have no additional significant effects on changes in TG and Apo B.
The aim of study was to investigate the effects of 12 forms of Sun-style Tai-Chi for arthritis(TCA) on physical symptom(pain, tenderness, swelling fatigue, and blood pressure), physical function(balance, flexibility, grip strength) and social-psychological health status in osteoarthritis(OA) patients and rheumatoid arthritis(RA) patients. This study was done with one group pretest-posttest design. A total 21 arthritis patients(6 OA patient and 15 RA patient) participated in 60 minute session consisting of warm-up exercise 12-main movement including qigong, and cool-down exercise twice a week for 6weeks. Physiological and social-psychological variables were measured before and after TCA 12 form. The researcher who completed a Tai Chi workshop for exercise leaders in Australia and Seoul taught the Tai Chi movement step by step until the patient felt comfort enough to perform them correctly by themselves during the first 4 weeks. At the last 2 weeks, the subject perform 10-15set of these at a session with traditional music to help patients move in a slow tempo. TCA 12 forms program showed significant improvement in fatigue(p=0.039) of rheumatoid arthritis patient and pain(p=0.006), fatigue(p=0.013), tenderness(p=0.032), flexibility(rt arm up, p=0.014, If arm up, P=0.003), grip strength(rt hand, p=0.002, If hand, P=0.003) of osteoarthritis patients. With assessment by Arthritis Impact Measurement Scale 2 questionnaire(AIMS2), physical component(0.002) and social interaction(0.025) on osteoarthritis patients were significantly improved. Evaluation of the participants about TCA exercise noted that the exercise was fairly easy(23.6%), moderately difficult(57.1%), and fairly difficult(14.3%). Considering the result of this study, TCA exercise program was more effective in pain, tenderness, grip strength, flexibility, and physical and social interaction on osteoarthritis patients than rheumatoid arthritis patients. Tai-Chi for arthritis 12 form was an appropriate intensity exercise for osteoarthritis patients.
This study was done to explore the effects of dance therapy on pulmonary and cognitive functions in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Kyoungi-Do. Fifty eight subjects had normal cognition, sensory function and resting blood pressure. They underwent tests of pulmonary and cognitive function as baseline data before dance therapy, and at 6th week and at the end of 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consisted of 50 minutes session, 3 times a week for 12 weeks. One session consisted of warming-up, expression, catharsis, sharing and closing stage. the intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. The results were as follows : 1. Pulmonary function(forced expiratory volume at one second and forced vital capacity) of the experimental subjects significantly increased over time more than that of the control subjects. 2. The experimental group had significantly higher score for pulmonary function than the control group at the 12nd week after dance therapy. 3. Cognitive function of the experimental subjects significantly increased over time more than that of the control subjects. 4. The experimental group had significantly higher score for cognitive function than the control group at the 6th week and 12nd week after dance therapy. The findings showed the dance therapy could be effective in improving the pulmonary and cognitive function of the elderly.
The purpose of this study was to determine the effect of Korean traditional dance movement training on balance, gait and leg strength in elderly women who are forced to remain at home. Fifteen elderly women of an experimental group between the ages 65 and 75 years who have normal vision and passed the hearing and Romberg test, participated in the 12 weeks' dance movement training. Fourteen subjects of a control group were selected. Korean traditional dance movement training was developed on the basis of Korean traditional dance and music by the authors. It took approximately 50 minutes to perform the dance movement program. The subjects of the experimental group practiced dance training for 3 times a week during 12 weeks. During the 50 minutes workout, the subjects practiced 15 minutes of a warm-up dance, 25 minutes of a conditioning dance, and 10 minutes of a cool-down dance. The intensity for the conditioning phase was between 60% and 65% of age-adjusted maximum heart rates. The balance, gait and leg strength were measured prior to and after the experimental treatment. Total balance scores of the experimental group were significantly higher than those of the control group. Scores of sternal nudge, one leg standing balance and reaching up among 13 items have significantly increased after the dance movement training. Total scores of gait of the experimental group were significantly higher than those of the control group following the korean traditional dance movement training. Scores of experimental group in step height, path deviation and turning while walking among 9 items have increased significantly following 12 weeks of dance movement training. The leg strength of experimental group was significantly higher than those of the control group following the Korean traditional dance movement training. The balance, gait and leg strength have significantly correlated in the experimental group following the Korean traditional dance movement training. The results suggest that Korean traditional dance movement training can improve balance, gait and leg strength in home bound elderly women.
The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.
The purposes of this study were : 1) to evaluate validity of a pain rating scale using the level of correlation between the Korean Pain Rating Scale(KPRS), Short -Form KPRS(SKPRS) and the Graphic Rating Scale(GRS). 2) to identify sensitivity of the scale using pain behavior of patients with chronic pain. Of the 2025 patients with chronic pain who visited the orthopedic and neurosurgical out - patients departments of 11 university hospitals in various districts of Korea, 520 subjects were selected through convenient sampling and responded to the questionnaires by mail. The results of the study can be summarized as follows : 1. The mean pain score measured by the KPRS was 444,85 : the mean sensory score was 209.47, the mean affective score, 147.63 and the mean miscellaneus score. 87.75. The mean pain score measured by the GRS was 20.11 : the mean sensory intensity score, 10.54. and the mean distress score, 9.57. 2. The average number of hours of rest during the day was 3.3, the average score of discomfort in carrying out ADL was 99, the average frequency of pain relieving practices was 3.0, the average number of pain sites was 3.6. 3. The most sensitive scale to differentiate each group was the GRS, the KPRS and SKPRS were less sensitive than the GRS. 4. The intercorrelation between the KPRS total score and the GRS score(.500) as well as that of the SKPRS score were highly correlated(.652), but intercorrelation between the SKPRS score and the GRS score(.172) was not high. Based on the above results, it was found that the SKPRS must be studied further to obtain validity.
The main purpose of th study was to evaluate he validity of Korean Pain Measurement Tool composed of pain terms. The specific purposes of this study were 1. to examine whether pain intensities of pain terms are congruent with those classified in three previous studies. 2. to evaluate the relative intensity of each term by panel of judges. 3. to explore the difference of ranks of pain terms according to the sex, education, and ages. One hundred and sixty normal individuals were selected by 2$\times$2$\times$4 sampling design. Sex (male, female), education (high school, college), and age (20s, 30s, 40s, 50s) were matched. Each individual was asked to rate the ranks of 3~8 pain terms in each subclass. The data measured by ordinal scale were transformed to the interval scale to compare with the pain intensities gained from the previous study. The pain ranks different from previous results were finally rearranged or cancelled through the consultation of 4 panel of judges and sunmed up to 91 pain terms in the scale. As a result, the ranks of pain terms within each of eleven subclasses among the twenty subclasses completely were congruent with the Previous pain ranks, while the ranks of nine subclasses were different from the previous pain ranks. In addition, there was significant relation between sex and pain ranks in skin punctuate pressure pain and cavity pressure. (sp : $\chi$$^2$=5.18 ø=0.26; cp : $\chi$$^2$=5.83 ø=0.24) In conclusion, seven terms from subclasses of inflammatory repeated pain, traction pressure pain, fatigue-related pain, fear-related pain, dull pain, and pulsation. related pain were cancelled. The ranks of four terms in subclasses of incisive Pressure pain and constrictive pressure pain were tentatively rearranged. Ranks of two terms in the tract pain were left as shown in the third study. As a result, six terms must be studied repeatedly for obtaining exact scores from ratio scale.
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