• 한국의료질향상학회지
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• 제8권2호
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• pp.146-159
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• 2001

Background : To propose effective strategies for successful implementation of QI in health care institutions, by identifying facilitating factors and barriers to conducting QI programs. Methods : In order to examine empirical evidence on the success factors or barriers to QI implementation in hospitals, a literature study was performed on the basis of MEDLINE search. Among the identified literature. 13 provided reliable findings and basis comprehensive discussion on this issue and thus were selected for in-depth analysis. A mailed questionnaire survey was conducted for hospital CEOs and QI directors of hospitals with 400 beds or greater to investigate what attributes of their organizations they perceived as success factors or obstacles to QI implementation. Result : The analysis of selected literature and survey results presented that the primary factors considered to be most important as successful implementation of QI were: strong support from hospital CEOs, setting higher priority for QI activities, continuous and persistent efforts in QI activities, and active participation of clinical staffs. The barriers identified in this study were : the lack of orientation and understanding of QI concepts, low level of interest and participation of physician in QI programs, the lack of evaluation and rewarding system for QI activities. Conclusion : By identifying factors that affect facilitation of QI, the study results will be of great use for either institutions being in the early stage of evolving QI or those looking for better strategies to achieve more active and persistent QI implementation in their institutions.

• 중소기업융합학회논문지
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• 제6권2호
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• pp.25-30
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• 2016

"개인정보 보호법"은 공공기관이 "통계법"에 따라 수집하고 있는 개인정보에 대해 그 수집 이용 등의 개인정보 처리 및 안전한 관리와 열람청구 등의 정보주체 권리보장을 적용하지 않고 있다. 이러한 "개인정보 보호법"의 적용 제외는 개인정보처리자의 개인정보 처리 오 남용과 안전관리 소홀 및 정보주체의 개인정보 자기결정권을 침해할 수 있는 문제가 있다. 본 연구에서는 "통계법"에 따라 수집되는 개인정보에 대해 통계 작성의 공익적 성격과 통계자료 수집 및 이용의 원활화를 고려하여 위 문제를 해소할 수 있는 방안을 연구하였다. 이에 "개인정보 보호법"의 개선방안으로 수집된 개인정보의 안전한 관리와 개인정보의 열람 및 정정 청구권 등 정보주체의 권리를 보장할 수 있는 방안을 제시하고자 한다.

• PNF and Movement
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• 제15권2호
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• pp.149-157
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• 2017

Purpose: The purpose of this study was to assess the effect of using smartphones for tele-rehabilitation on head position and neck dysfunction in workers with visual display terminal (VDT) syndromes over a four-week period. Methods: Sixteen VDT workers volunteered to participate in stretch exercise and posture education sessions. The subjects were divided into three groups as follows: five subjects in the visit group (VSG), six subjects in the video group (VEG), and five subjects in tele-rehabilitation group (TG). The subjects in all the groups performed the exercises three days per week for four weeks. Cranial rotation angle (CRA), craniovertebral angle (CVA) measurement, and neck disability index (NDI) tests were performed before and four weeks after the intervention. Results: No significant difference in the CRA and CVA variables was found among groups. No significant difference in the CRA variable was found within each group. A significant difference in the CRA variable was found in the VSG after the four-week intervention. No significant difference in NDI was found among the groups. The NDIs among all the groups were significantly decreased after the intervention when compared with the NDIs measured before the intervention. Conclusion: The use of smartphones in the tele-rehabilitation of VDT workers with neck pain was found to be as effective on neck function as the conventional intervention method. The tele-rehabilitation of VDT workers with neck dysfunctions may be presented as an alternative way.

• PNF and Movement
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• 제15권3호
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• pp.253-257
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• 2017

Purpose: This study was conducted to predict the risks that arise while standing on mediolateral ramps at various ramp angles by identifying the ratio of medial to lateral gastrocnemius muscle activities. Methods: The subjects were 20 healthy adult men. Seven mediolateral ramp angles ($0^{\circ}$, $2^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, and $25^{\circ}$) were applied for the experiment. The ratio of medial to lateral gastrocnemius muscle activities in each condition was measured using electromyography, and the measured data were converted to root mean square values to calculate the activity ratios. Results: The study results showed statistically significant differences in the ratio of mediolateral gastrocnemius muscle activities according to the selected mediolateral ramp angles. The results of a post hoc test confirmed that the multifidus muscles were asymmetrically used on the two sides at mediolateral ramp angles of $5^{\circ}$ or higher. Conclusion: This study found that an asymmetric use of the multifidus muscles began at a mediolateral ramp angle of $5^{\circ}$, and the provision of propulsion using the ankle joints on mediolateral ramps at $5^{\circ}$ or steeper was maneuvered differently from that on flat ground. This suggests that individuals with balance control disorder have the risk of falling due to ankle sprains and unstable balance control. Therefore, patients and elderly people are required to exercise caution when crossing $5^{\circ}$ or steeper ramps.

• 대한정형도수물리치료학회지
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• 제14권2호
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• pp.50-59
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• 2008

Taping techniques have been usually used by physical therapists long time ago, which have been considered a useful adjunct to treatment programs for a variety of musculoskeletal disorders. Also, taping techniques may be employed as effective prophylactic methods in clinical setting because of ease application and cost effectiveness. The aims of this study were to describe background information for the management of some chronic low back pain patients with/without leg pain that don't respond to conservative treatment, to demonstrate McConnell taping as successful therapeutic strategies for treating these patients, and to provide detailed application methods of McConnell taping in order that physical therapists can readily use the taping in clinical setting. This study emphasized to illustrate biomechanical benefits of McConnell taping in controlling undesirable muscle activation by decreasing mechanical loads on specific muscles. McConnell taping may be helpful for the inhibition of overactive synergist or antagonists, the facilitation of inactive synergists, the promotion of proprioception, the optimization of joint alignment, pain reduction, and unloading of irritable neural tissue. This study provides taping examples of low back pain, sacroiliac joint dysfunction and lower extremity symptoms associated with these conditions, and discusses the possible mechanisms for their successful application.

• 한국실내디자인학회논문집
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• 제22권5호
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• pp.188-198
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• 2013

Advancement toward aging society has presented the importance of house planning in consideration of the elderly, increasing the necessity of such planning. Therefore the importance of indoor design guideline for elderly houses has been stressed and the understanding of the aging in regard to this trend will create more mature spaces. In line with this trend the purpose of this study is to study the medical factors related with bathroom interior design guidelines of the existing elderly houses from the viewpoint of deteriorating physical functions due to aging process. In order to research the deterioration of physical functions due to aging literatures of medical and exercise physiology were used and concerning the existing bathroom design guidelines for the aged people, the guideline items of behavior facilitation, physiological maintenance and perceptual maintenance aspects out of Murtha & Lee's user benefit criteria(1976) related with physical functions were selected to research in relation with the knowledge about the deterioration phenomena of physical functions. Physical aging and deterioration aspects were classified from the viewpoint of musculoskeletal disorder, cardiovascular disorder, respiratory disorder, gastronomy disorder, urology disorder, somatosensory disorder, endocrine disorder, immune disorder, nervous disorder and skin diseases and these were utilized in interpreting total 100 items of bathroom design guideline. Because bathroom is the space where many physical movements are done, it had the closest relationship with the deterioration of musculoskeletal health in general and as bathroom is the space where people use water and feel the difference in temperature and moisture more than other spaces, deterioration of skin and somatosensory health had the next closest relationship. The result of this study revealed that regarding the deterioration of physical functions of the elderly people in aspect of their perceptibility as designers will design creatively and sincerely based on its relationship with nervous system in future, the result of this study will be used to develop better spatial designs efficiently to meet for the aging society.

• PNF and Movement
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• 제16권1호
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• pp.67-73
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• 2018

Purpose: Smartphones, which are widely used worldwide to detect acceleration and position, have been used in the area of rehabilitation medicine in recent clinical research studies and tests. The aim of the present study was to determine the feasibility of using a smartphone application based on center of movement (COM) displacement to measure gait parameters in stroke patients in the clinical field of rehabilitation medicine. Methods: The study consisted of 30 stroke patients. The COM was measured using a smartphone application, Gait Analysis Pro, during a 6-m walk. Each patient performed three 6-m walking trials, and the smartphone application measured gait duration, gait speed, step length, cadence, and vertical and lateral displacement of the COM. The Kolmogorov-Smirnov test was conducted to determine the normality in gait parameters, and a repeated one-way analysis of variance (ANOVA) was performed to determine the consistency among the three trials. A p value of 0.05 was considered statistically significant in all the tests. Results: In all the measured parameters, the smartphone application showed a normal distribution, as shown by the results of the Kolmogorov-Smirnov test. There were no significant differences among the three repetitive walking trials. Conclusion: These results suggest that the smartphone application can be used for evaluating gait in stroke patients, as well as in healthy adults. However, prior to using the smartphone application in the clinical field, further research involving three-dimensional gait analysis is needed to enhance the confidence level of the findings.

• PNF and Movement
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• 제18권1호
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• pp.23-34
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• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.

• PNF and Movement
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• 제18권1호
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• pp.77-86
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• 2020

Purpose: This study investigated the effects of progressive resistance task-oriented strengthening exercises (PRTSE) on the strength of the lower extremities, balance, and activities of daily living (ADL) of patients following a stroke. The purpose of the study was to provide fundamental data regarding the use of PRTSE with stroke patients. Methods: Twenty stroke patients were randomly divided into an experimental group (n = 10) who took part in PRTSE and a control group (n = 10) who performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes five times a week for four weeks. The strength of their lower extremities was measured using a hand-held dynamometer. The balance of the participants was assessed using a Berg balance scale. The modified Barthel index was conducted to measure ADL. A paired t-test was performed to compare within-group changes before and after the PRTSE. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: After the exercises, there was a significant within-group change in the strength of lower extremities, balance, and ADL in the experimental group and the control group (p < 0.05). There was also a significant between-group difference in the strength of lower extremities after the intervention (p < 0.05). Conclusion: General rehabilitation is commonly applied as a treatment for stroke patients and is relatively effective. The application of PRTSE may be useful in such patients, considering its effects on the strength of lower extremities, balance, and ADL.

• PNF and Movement
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• 제13권2호
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• pp.89-93
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• 2015

Purpose: This study aimed to verify the effect of integrated patterns (IPs) of PNF on individuals with malalignment using upper extremity and lower extremity patterns simultaneously. This information was then compared to the effect of bowling exercises on malalignment. The study population included individuals in their twenties with malalignment in their posture. Methods: Individuals with malalignment (40 participants in total) were divided into 2 groups based on trunk inclination and side deviation. In one group, IPs of PNF were used as interventions, while the other group used bowling exercises. This process was completed over the course of four weeks. The IP group used two patterns simultaneously: flexion-adduction-external rotation and extension-abduction-internal rotation. These patterns were used in the upper and lower extremities and were crossed diagonally. Results: The trunk inclination decreased in the IP and the bowling group. In the IP group, the degree of inclination decreased from 0.94 to 0.33. The side deviation also decreased to 1.53 (p < 0.05). In the bowling group, the two measured values decreased significantly (p < 0.05). Conclusion: Compared to the bowling exercises used in the bowling group, the results of this study indicate that the use of IPs had a significant effect on trunk inclination and side deviation for malalignment posture patients. Individuals can easily improve malalignment using IPs of PNF (for example, at home or at their office), which suggests that they are not required to seek assistance from a fitness or bowling center, which may save them time.