• Title/Summary/Keyword: therapy protocol

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The Development of Exercise Therapy Protocol Applied to an Efficacy Expectation Promoting Program in Type 2 Diabetes Mellitus Patients (효능기대증진 프로그램을 적용한 운동요법 프로토콜 개발 - 제 2 형 당뇨병 환자를 중심으로 -)

  • Hwang Ae-Ran;Kim Chun-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.3
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    • pp.366-378
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    • 2000
  • Type 2 Diabetes Mellitus patients have chronic metabolic disorder and they need self care for their lifetime. But most Diabetes Mellitus patients don't know how to do a self care due to the lack of adequate support from health care professionals. It has been reported that lack of exercise therapy compliance guide is very important one. This study was conducted to develop an exercise therapy protocol applied to an efficacy expectation promoting program based on Bandura's self efficacy model for type 2 Diabetes Mellitus patients. Firstly, a conceptual framework was developed through efficacy expectation promoting Program based on Bandura's self efficacy model. In order to identify the contents of program and to design a preliminary protocol, a with the consultation experts was made. A clinical validity was tested using twenty type 2 Diabetes Mellitus patients who received follow-up care regularly through the diabetic out-patient clinic from October, 1998 to May, 2000. After this process, the final protocol was developed. The results of this study are summarized as bellows : The final exercise therapy protocol applied to an efficacy expectation promoting program for type 2 Diabetes Mellitus Patients consists of individualized exercise test and prescription, a small booklet relating personal experience with Diabetes Mellitus and a telephone coaching program for 12 weeks on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. It is concluded that the exercise therapy protocol applied to an efficacy expectation promoting program is applicable to type 2 diabetes mellitus. And this exercise therapy protocol could show a positive effect on the exercise compliance of Diabetes Mellitus patients.

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PROPOSAL FOR PRETREATMENT OF PATIENTS IN ANTIPLATELET THERAPY REQUIRING MINOR ORAL SURGERY (항혈소판제 복용 환자의 구강 내 소수술 전 처치에 대한 제안)

  • Choi, Ji-Wook;Choi, Se-Kyung;Kim, Nam-Kyun;Choi, Eui-Young;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.426-430
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    • 2009
  • Purpose: Many patients in anti-platelet therapy have been consulted for bleeding risks before minor oral surgery. However, there has not been an established pretreatment protocol for treating these patients. The purpose of this study is to make a protocol for the preoperative management for patients in anti-platelet therapy. Patients and Methods: The existed consultation pattern of patients was examined in the Department of Oral and Maxillofacial Surgery, Yonsei Dental Hospital. Based on the observation, a protocol including classification of medical status of patients and the type of oral surgery in need was introduced. This protocol had been performed for 6 months. Result: Following this protocol, the frequency of consultation for bleeding risk was decreased. The number of minor oral surgeries with concurrent anti-platelet therapy was increased. There was no severe bleeding event observed among minor oral surgeries that were performed while maintaining anti-platelet therapy. Conclusion: This protocol can be used as a guideline for clinical practice of patients in anti-platelet therapy requiring minor oral surgery.

Assessment of Clinical Outcome in Dogs with Naturally Infected with Dirofilaria immitis after American Heartworm Society Protocol vs Slow Kill Method

  • Choi, Miru;Yoon, Won-Kyoung;Suh, Sang-IL;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.1-6
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    • 2017
  • Heartworm disease (HWD) in dogs is a life-threatening mosquito-borne disease resulting in right-sided congestive heart failure and inflammatory pulmonary disease. Due to complications from adulticidal therapy with melarsomine, slow kill protocol either with preventive dose of ivermectin or combined with doxycycline has been proposed for an alternative adultcidal therapy in dogs with HWD. Therefore, this study evaluated the clinical outcome of adultcidal therapy in dogs with class II stage of HWD after treating either American Heartworm Society (AHS) or slow kill protocol for 10 months. Clinical outcome after therapy was evaluated by clinical, radiographic and echocardiographic examination along with hematology before (D0) and after therapy (D300). Although clinical signs associated with HWD were all resolved after therapy in both groups, the infection was not cleared out 67% of dogs treated by slow kill protocol at the end of therapy. Furthermore, pulmonary arterial flow of acceleration time to ejection time ratio (AT/ET) and the right pulmonary artery distensibility index (RPADI) have been firstly used for detecting pulmonary hypertension in this study group. The pulmonary hypertension was more common in dogs with mild clinical signs, although tricuspid and pulmonary regurgitation were not detectable in most dogs in this study. Our study findings suggested that the slow kill protocol might not be efficacious enough to clear out HWD in dogs and more attention on the presence of pulmonary hypertension might be necessary for effective management of HWD in dogs.

The effects of knee joint position sense following local and general load protocols (국소적 부하와 전신적 부하가 슬관절 위치 감각에 미치는 영향)

  • Hwang, Yoon-Tae;Park, Rae-Joon;Choi, Jin-Ho
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.429-440
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    • 2005
  • The purpose of this study was to compare the effects of knee joint position sense following local and general load protocols in 25 healthy male subjects. Proprioception of the knee joint was evaluated by measuring absolute angular errors at matching angles before, after and between 2 different types of load protocols. Proprioception tests(on the dominant knee) were performed in which proprioception of the passivepassive reproduced and active-active reproduced knee position was measured. Local load was provided with maximum isokinetic knee extension-flexion on the isokinetic dynamometer(Cybex), and general load was 10 minutes running on a treadmill. Peak torque(knee extension and flexion) and heart rate(beats per minute) was evaluated as an indicator of local and general fatigue during load protocols. The results were as follows: 1. For pasive-pasive reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol(P<.05). However, no significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol (P>.05), no significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P>.05). 2. For active-active reproduced knee position test, significant difference in absolute angular errors after general load protocol was detected compared with that before general load protocol(P<.05), significant difference in absolute angular errors after local load protocol was detected compared with that before local load protocol (P<.05). Also, significant difference in absolute angular errors of general load protocol was detected compared with that of local load protocol(P<.05), significant difference in absolute angular errors of local load protocol was detected compared with that of general load protocol(P<.05). 3. A significant decrease of peak torque of knee extensors and flexors was seen after local load, although heart rate was significantly increased(P<.05). No significant change of peak torque of knee extensors and flexors was seen after general load(P>.05), although heart rate was also significantly increased(P<.05). The previous study revealed that knee proprioception is significantly altered when the muscle mechanoreceptors are dysfunctional due to muscle fatigue, although the joint mechanoreceptors have no significantly effect on knee proprioception when the presence of knee muscle fatigue. However, the results of this study are different from those of the previous study in that muscle weakness of the knee could not be seen after general load. This study shows that general load may diminish motor control by the central nervous system. Proprioceptional decline without muscle weakness of knee after general load suggests a change in the proprioceptional pathway without influence from muscle mechanoreceptors.

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Preliminary Study on Developing Protocol for Music Therapy Assessment for Cognitive and Emotional-Behavioral Domain using Rhythm (MACED-Rhythm) (인지 및 정서행동 영역에서의 음악치료 사정을 위한 리듬 프로토콜(MACED-Rhythm) 개발 예비 연구)

  • Duerksen, George;Chong, Hyun Ju
    • Journal of Music and Human Behavior
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    • v.10 no.1
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    • pp.67-83
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    • 2013
  • Assessment in music therapy is a vital part for both the therapist and client in the process of therapy. Based on what is assessed, objectives are identified to formulate specific action procedures and strategies. The existing assessment tools involve lists of skills and behaviors in developmental domains without the music assessment protocol. In this study, the authors attempted to develop an assessment protocol using rhythm production for assessing skills in cognitive and emotional-behavior domain, namely Music Therapy Assessment for Cognitive and Emotional Behaviors (MACEB). The test items of the MACEB-Rhythm were developed using rhythmic patterns varying in terms of item difficulty, which are based on the various degree of clarity in the grouping/gestalt, saliency in part-whole relationship, and complexity in repetition vs. variability. Also the developed tool purported to examine one's level of emotional behavior trait by analyzing performance of musical parameters such as tempo, pacing, and loudness in the reproduced output. In order to verify the logical sequencing of test items, firstly 61 subjects participated in verifying the item difficulty for the selected 15 pilot items. The test items were revised and re-sequenced based on the gathered scores of item difficulty. In the second procedure, seven experts in the fields of music education, music therapy and music psychology whose research interest lie in music cognition revised the developed rhythm protocol items focusing on learning sequence, cognitive process and feasibility for skills assessment. The study attempted to provide foundations for using rhythm as an assessment protocol prior to its verification of assessment validity and reliability.

Proton Beam Dosimetry Intercomparison

  • Fukumura, Akifumi;Kanai, Tatsuaki;Kanematsu, Nobuyuki;Yusa, Ken;Maruhashi, Akira;Nohtomi, Akihiro;Nishio, Teiji;Shimbo, Munefumi;Akagi, Takashi;Yanou, Toshihiro;Fukuda, Shigekazu;Hasegawa, Takashi;Kusano, Yohsuke;Masuda, Yasutaka
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.252-254
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    • 2002
  • A new protocol for dosimetry in external beam radiotherapy is published by the Japan Society of Medical Physics (JSMP) in 2002. The protocol deals with proton and heavy ion beams as well as photon and electron beams, in accordance with IAEA Technical Report Series No. 398. To establish inter-institutional uniformity in proton beam dosimetry, an intercomparison program was carried out with the new protocol. The absorbed doses are measured with different cylindrical ionization chambers in a water phantom at a position of 30-mm residual range for a proton beam, that had range of 155 mm and a spread out Bragg peak (SOBP) of 60-mm width. As a result, the intercomparison showed that the use of the new protocol would improve the +/- 1.0 % (one standard deviation) and 2.7 % (maximum discrepancy) differences in absorbed doses stated by the participating institutions to +/- 0.3% and 0.9 %, respectively. The new protocol will be adopted by all of the participants.

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The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome (일차성 및 이차성 신증후군에서 Mendoza Protocol에 의한 Intravenous Methylprednisolone Pulse Therapy의 효과)

  • Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.117-124
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    • 2001
  • Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

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The effect of interventions in implementation of nutrition therapy for malnourished inpatients (영양 위험군 입원환자에 대한 영양치료 수행 중재 효과)

  • Bae, Eun-Joo;Park, So-Hee;Kim, Jung-Eun;Shim, Jin-Joo;Lee, Yun-Jung;Kim, Ji-Yoon;Jang, Young-Eun
    • Quality Improvement in Health Care
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    • v.19 no.1
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    • pp.44-52
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    • 2013
  • Objectives: Several studies on hospital malnutrition have reported that malnutrition among patients is highly prevalent and that more than 40% of hospitalized patients have nutritional risk factors. The purpose of this study was to assess the implementation of physicians' prescribed nutrition therapy before and after a protocol on nutrition therapy for malnourished inpatients was instituted. Methods: Data regarding the rates of physician implementation of nutritional therapy and the duration of therapy were collected and analyzed using SPSS version 20. Results: The percentages of physicians who prescribed nutrition therapy before and after the protocol was initiated were 47.5% and 74.6%, respectively, which statistically significant with 95% confidence. The rates of therapy lasting less than 24 hours before and after the protocol was in place were 100% and 86.4%, respectively, which was not statistically significant. This result suggests that the improvement activity was not effective. Conclusion : The percentage of physicians who prescribed nutritional therapy based on improved nutritional program was significantly increased. Nutrition therapy for malnourished inpatients can be advanced through this new model.

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Effect of Aerobic Exercise using Bruce Protocol on Heart Rate, Oxygen Saturation, and Blood Pressure after Recovery from COVID-19 Infection (COVID-19 이환자의 브루스 프로토콜을 이용한 유산소 운동이 심박수, 산소포화도, 혈압에 미치는 영향)

  • Yeon-Seop Lee;Seung-Soo Yang;Seul-Gi Jang;Ji-Hee Seol;Ji-Eun Lee;Dong-Jin Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.141-147
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    • 2023
  • Purpose : This study aimed to find out the effect of aerobic exercise using Bruce protocol on heart rate, oxygen saturation, and blood pressure after recovery from COVID-19 infection. Methods : In this study, 34 students from D University located in J city were targeted, COVID-19 infected group (17 people) and non-COVID-19 non-infected group (17 people). The Bruce protocol using a treadmill was applied to the aerobic exercise of this study. The Bruce protocol has in the first stage of METs 4 (slope 10 %, speed 2.7 km/h). The second stage was METs 5 (slope 12 %, speed 4 km/h), and the third stage was METs 6 (slope 14 %, speed 5.4 km/h). All measurements were measured 3 times and the average value was used. Results : As a result of this study, as a result of comparing heart rate changes according to aerobic exercise using the Bruce protocol. EG group and the CG group increased significantly according to the progressive exercise load (METs 4~5), and in the third stage of the Bruce protocol between groups, The EG group showed a significantly lower heart rate. As a result of comparing changes in oxygen saturation and blood pressure, there was no significant difference between the EG and C groups according to the gradual exercise load. Conclusion : In conclusion, there was no difference between normal and pressure when MET of moderate intensity exercise (4 to 6) was applied to the effect on heart rate, oxygen saturation, and blood pressure in healthy adults who were fully recovered from COVID-19. Secondary side effects may occur when high intensity exercise with a MET of 6 or higher, so it is strongly recommended that hospitals or specialized institutions measure exercise and physical ability according to individual exercise intensity.

Research for Developing Medical Nutrition Therapy on Korean Medicine : Literature Study and a Survey (한의학적 임상영양치료법 개발을 위한 연구)

  • Han, Eun Kyung;Hwang, Sang Moon;Seo, Soo Youn;Jung, Yun Im;Bae, Go Eun;Kim, Byung Joo;Lee, Sang Jae;Chae, Han;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.4
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    • pp.350-361
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    • 2013
  • aksun(藥饍), or 'Traditional oriental medicine nutrition therapy', is expected to be an effective nutritional intervention for the patients suffering from chronic diseases. However, there are no systemized protocol that utilize Yaksun as an effective nutrition therapy for Asian patients even though they are accustomed to traditional oriental diet. We investigated the possibility of using Yaksun for developing an effective Medical Nutrition Therapy for Asian patients and proposed factors that have to be considered. Articles published between 1995-2012 about MNT (Medical Nutrition Therapy) and Yaksun were reviewed. Male and female patients of two Korean Medicine Hospitals (n=93) and one Korean Medicine Clinic (n=20) answered a questionnaire asking about their thoughts on the effectiveness of nutritional intervention for their disease management and about their expectations toward Medical Nutrition Therapy on Korean Medicine. 92.9% of the patients have perceived that nutritional intervention is important in disease management. 79.6% of the patients have positively responded that they are willing to use the Medical Nutrition Therapy on Korean Medicine as a clinical nutrition therapy if developed. Female patients, aged in their forties and fifties, educated equivalent to high school graduates and more, and who visited Korean medicine clinic were most interested in the Medical Nutritional Therapy on Korean Medicine. The factors considered in developing the protocol are 1. effectiveness 2. safety 3. expense, in order of importance. Nutritional intervention protocol using Yacksun is necessary for the patients. Medical Nutrition Therapy on Korean Medicine is in need of development. Accumulated case-control studies, cost effectiveness studies, and studies about programming and systemizing the protocol are needed.