• The Journal of Korean Physical Therapy
• /
• v.32 no.3
• /
• pp.168-175
• /
• 2020

Purpose: This study aimed to investigate and report the current status of physical therapy (PT) performed in Korean neonatal intensive care units (NICU) to present foundational data that promotes the advances in neonatal PT in Korea. Methods: Based on the Health Insurance Review and Assessment (HIRA) data, we administered a questionnaire survey to 74 hospitals (39 tertiary and 35 general hospitals) in Korea equipped with a NICU and pediatric PT unit. We developed a 32-item questionnaire with reference to previous Korean studies. The questionnaires were distributed and retrieved via regular mail and an online system. Results: Of the 74 hospitals, 58 (78%) practiced neonatal PT and the duration of each session significantly differed according to the hospital rating. PT was given, depending on clinical symptoms, to infants who were preterm and low birth-weight (96.5%), had brain and spinal cord diseases (84.5%), had pathological tonus (94.8%), with respiratory problems (65.5%), for range of motion exercises (82.8%), for neurodevelopment approaches (72.4%), and for positioning (70.7%). Interdisciplinary meetings were held to share clinical decisionmaking in 17.2% of the hospitals surveyed and parent-participating education to ensure a family-centered approach was offered in 63.8% of the hospitals. The barriers of neonatal PT included low insurance fees, insufficient awareness of colleagues, and the severity of the patient. Conclusion: This study is the first report of the current status of neonatal PT in Korea. The findings of this study will serve as foundational data to review the current neonatal PT practice and promote further advances.

• The Transactions of the Korean Institute of Electrical Engineers P
• /
• v.59 no.1
• /
• pp.58-63
• /
• 2010

In this paper, we proposed a wearable respiration measurement system with textile capacitive pressure sensor. Belt typed textile capacitive pressure sensor approach of respiration measurement, from which respiration signatures and rates can be derived in real-time for long-term monitoring, are presented. Belt typed textile capacitive pressure sensor has been developed for this measurement system. the distance change of two plates by the pressure of motion has been used for the respiration measurement in chest area. Respiration rates measured with the textile capacitive pressure sensor was compared with standard techniques on 8 human subjects. Accurate measurement of respiration rate with developed sensor system is shown. The data from the method comparison study is used to confirm theoretical estimates of change in capacitance by the distance change. The current version of respiratory rate detection system using textile capacitive pressure sensor can successfully measure respiration rate. It showed upper limit agreement of $3.7997{\times}10^{-7}$ RPM, and lower limit of agreement of $-3.8428{\times}10^{-7}$ RPM in Bland-Altman plot. From all subject, high correlation were shown(p<0.0001). The proposed measurement method could be used to monitor unconscious persons, avoiding the need to apply electrodes to the directly skin or other sensors in the correct position and to wire the subject to the monitor. Monitoring respiration using textile capacitive pressure sensor offers a promising possibility of convenient measurement of respiration rates. Especially, this technology offers a potentially inexpensive implementation that could extend applications to consumer home-healthcare and mobile-healthcare products. Further advances in the sensor design, system design and signal processing can increase the range and quality of the rate-finding, broadening the potential application areas of this technology.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2002.09a
• /
• pp.90-93
• /
• 2002

In particle radiotherapy, a shape of the beam to conform the irradiation field is statically defined by the compensator, collimator and potal devices at the outside of the patient body. However the target such as lung or liver cancer moves along with respiration. This increases the irradiated volume of normal tissue. Prior discussions about organ motions along with respiration have been mainly focused on inferior-superior movement that was usually perpendicular to beam axis. On the other hand, the change of the target depth along the beam axis is very important especially in particle radiotherapy, because the range end of beam (Bragg peak) is so sharp as to be matched to distal edge of the target. In treatment planning, the range of the particle beam inside the body is calculated using a calibration curve relating CT number and water equivalent path length (WEL) to correct the inhomogeneities of tissues. The variation in CT number along the beam path would cause the uncertainties of range calculation at treatment planning for particle radiotherapy. To estimate the uncertainties of the range calculation associated with patient breathing, we proposed the method using sequential CT images with respiration waveform, and analyzed organ motions and WELs at patients that had lung or liver cancer. The variation of the depth along the beam path was presented in WEL rather than geometrical length. In analyzed cases, WELs around the diaphragm were remarkably changed depending on the respiration, and the magnitude of these WEL variations was almost comparable to inferior-superior movement of diaphragm. The variation of WEL around the lung was influenced by heartbeat.

• Investigative Magnetic Resonance Imaging
• /
• v.21 no.1
• /
• pp.28-33
• /
• 2017

Purpose: To investigate and compensate the effects of respiration-induced B0 variations on fat quantification of the bone marrow in the lumbar spine. Materials and Methods: Multi-echo gradient echo images with navigator echoes were obtained from eight healthy volunteers at 3T clinical scanner. Using navigator echo data, respiration-induced B0 variations were measured and compensated. Fat fraction maps were estimated using $T2^*$-IDEAL algorithm from the uncompensated and compensated images. For manually drawn bone marrow regions, the estimated B0 variations and the calculated fat fractions (before and after compensations) were analyzed. Results: An increase of temporal B0 variations from inferior level to superior levels was observed for all subjects. After compensation using navigator echo data, the effects of the B0 variations were reduced in gradient echo images. The calculated fat fractions show significant differences (P < 0.05) in L1 and L3 between the uncompensated and the compensated. Conclusion: The results of this study raise the need for considering respiration-induced B0 variations for accurate fat quantification using gradient echo images in the lumbar spine. The use of navigator echo data can be an effective way for the reduction of the effects of respiratory motion on the quantification.

• Advances in Traditional Medicine
• /
• v.4 no.1
• /
• pp.18-21
• /
• 2004

Six volunteers (mean $age=25.7{\pm}1.7$, $height=173{\pm}1.9$ and $weight=63.4{\pm}2.3{\;}kg$) participated in a graded exercise test and one hour of basic form of ChunDoSunBup (CDSB) Qi-training to investigate the cardiorespiratory responses and exercise intensity of Qi-training, a Korean traditional psychosomatic training. In the maximal exercise, the trainee showed $96.2{\pm}8.89{\;}l/min$ in ventilation (VE), $46.0{\pm}4.4$ in breath frequency (BF), $1.31{\pm}0.05$ in respiratory exchange ratio (RER), $180.7{\pm}3.0$ in heart rate (HR), and $2.6{\pm}1.1{\;}l/min$ or $40.7{\pm}2.3{\;}ml/kg/ml$ in oxygen consumption $(VO_2)$. Qi-training induced significant changes in BF, RER, HR, and $VO_2$. The exercise intensity of Qi-training were 42.3%, 46.9% and 38.7% of $HR_{max}$ during the sound exercise, slow motion (haeng-gong) and meditation respectively and the average was 46.2% of $HR_{max}$. We conclude that Qi-training is an aerobic exercise of a light (mild) intensity exercise, and it leads to decrease the metabolic rate in the trainee by breathing efficiently and relaxing them. In addition, Qi-training may affect cardiorespiratory function of BF, RER, HR and $VO_{2max}$ in trainees.

• The Transactions of The Korean Institute of Electrical Engineers
• /
• v.58 no.10
• /
• pp.2071-2078
• /
• 2009

In this paper, we proposed a non-contact respiration measurement system with ultrasonic proximity sensor. Ultrasonic proximity sensor approach of respiration measurement which respiration signatures and rates can be derived in real-time for long-term monitoring is presented. 240 kHz ultrasonic sensor has been applied for the proposed measurement system. The time of flight of sound wave between the transmitted signal and received signal have been used for a respiration measurement from abdominal area. Respiration rates measured with the ultrasonic proximity sensor were compared with those measured with standard techniques on 5 human subjects. Accurate measurement of respiration rate is shown from the 50 cm measurement distance. The data from the method comparison study is used to confirm the performance of the proposed measurement system. The current version of respiratory rate detection system using ultrasonic can successfully measure respiration rate. The proposed measurement method could be used for monitoring unconscious persons from a relatively close range, avoiding the need to apply electrodes or other sensors in the correct position and to wire the subject to the monitor. Monitoring respiration using ultrasonic sensor offers a promising possibility of non-contact measurement of respiration rates. Especially, this technology offers a potentially inexpensive implementation that could extend applications to consumer home-healthcare and mobile-healthcare products. Further advances in the sensor design, system design and signal processing can increase the range of the measurement and quality of the rate-finding for broadening the potential application areas of this technology.

• Clinics in Shoulder and Elbow
• /
• v.26 no.3
• /
• pp.296-301
• /
• 2023

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

• Progress in Medical Physics
• /
• v.26 no.2
• /
• pp.87-92
• /
• 2015

The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.

• Progress in Medical Physics
• /
• v.23 no.3
• /
• pp.138-144
• /
• 2012

Dose distribution throughout the clinical organ range of motion was analyzed using a respiratory-motion simulator that was equipped with a polymer gel dosimeter and EBT2 film. The normoxic polymer gel dosimeter was synthesized from gelatin, MAA, HQ, THPC and HPLC. The gel dosimeter and EBT2 film were irradiated with Co-60 gamma rays that were moved along the x-axis and y-axis in ${\pm}1.5cm$ steps at five-second intervals. The field size was $5{\times}5cm^2$. The SSD was 80 cm and set to 10 Gy at a depth of 2 cm. The PDD at a depth of 50 mm was 75.2% in the ion chamber, 82.3% in the static state and 86.1% in the dynamic state in the gel dosimeter. The penumbra for the dynamic state target, which was measured using the gel dosimeter, averaged 10.89 mm, this is a 40.5% increase over the penumbra of the static state target of 7.74 mm. In addition, when measuring with gel dosimetry, the value for the penumbra is 36.6% smaller in the static state and 29.4% smaller in the dynamic state compared to measuring with film. The aim of this study was to investigate the dosimetric properties of a normoxic polymethacrylic acid gel dosimeter in static and dynamic states and to evaluate the potentiality as a relative dosimeter for dynamic therapeutic radiation.

• The Journal of Korean Society for Radiation Therapy
• /
• v.24 no.1
• /
• pp.15-21
• /
• 2012

Purpose: Image Guided Radiation Therapy (IGRT) has been carried out using On-Board Imager system (OBI) in Asan Medical Center. For this reason, This study was to analyze and evaluate the impact on Cone-Beam CT according to variation of material and respiration. Materials and Methods: This study was to acquire and analyze Cone-Beam CT three times for two material: Cylider acryl (lung equvalent material, diameter 3 cm), Fiducial Marker (using clinic) under Motion Phantom able to adjust respiration pattern randomly was varying period, amplitude and baseline vis-a-vis reference respiration pattern. Results: First, According to a kind of material, when being showed 100% in the acryl and 120% in the Fiducial Marker under the condition of same movement of the motion phantom. Second, According to the respiratory alteration, when being showed 1.13 in the baseline shift 1.8 mm and 1.27 in the baseline shift 3.3 mm for acryl. when being showed 1.01 in 1 sec of period and 1.045 in 2.5 sec of period for acryl. When being showed 0.86 in 0.7 times the standard of amplitude and 1.43 in 1.7 times the standard of amplitude for acryl. when being showed 1.18 in the baseline shift 1.8 mm and 1.34 in the baseline shift 3.3 mm for Fiducial Marker. when being showed 1.0 in 1 sec of period and 1.0 in 2.5 sec of period for Fiducial Marker. When being showed 0.99 in 0.7 times the standard of amplitude and 1.66 in 1.7 times the standard of amplitude for Fiducial Marker. Conclusion: The effect of image size of CBCT was 20% in the case of Fiducial marker. The impact of changes in breathing pattern was minimum 13% - maximum 43% for Arcyl, min. 18% - max. 66% for Fiducial marker. This difference makes serious uncertainty. So, Must be stabilized breathing of patient before acquiring CBCT. also must be monitored breathing of patient in the middle of acquire. If you observe considerable change of breathing when acquiring CBCT. After Image Guided, must be need to check treatment site using fluoroscopy. If a change is too big, re-acquiring CBCT.