Background: Mobilization with movement (MWM) is an effective intervention for increasing range of motion (ROM) and function without pain. Objectives: The purpose of this study is to comprehensively characterize the functional effects of MWM applied to the ankle joint in patients with stroke. Design: Systematic Review and Meta-analysis. Methods: International electronic databases, CINAHL, Embase, MEDLINE, PubMed, and Google scholar were included and identified after review by two investigators in July 2023 according to PRISMA guidelines. Data were synthesized using software provided by Cochran and analyzed using a random effects model with reweighting to account for heterogeneity between participants. Results: After excluding duplicate studies, 14 of the 19 articles screened through the abstracts were excluded, resulting in a total of five studies involving 109 participants with stroke. MWM showed significant differences in ankle ROM [overall effect (Z=3.27, P=0.00)], gait speed [overall effect (Z=3.33, P=0.00)], and cadence [overall effect (Z=2.49, P=0.01)]. Conclusion: The results of the meta-analysis confirmed that MWM is effective in improving ankle ROM and gait parameters in patients with stroke.

Background: The forward head posture acts as a factor that can cause various neurovascular and musculoskeletal dysfunctions. But searching for a study on quality of life for patient with forward head posture was challenging. Therefore, this study aims to find the factors that most affect the quality of life in patients with forward head posture. Objectives: The purpose of this study was to investigate the correlations between the cranio-vertebral angle (CVA), neck disability index (NDI), pain, and sternocleidomastoid (SCM) thickness of patients with forward head posture and the quality of life of the patients and to figure out important factors that affect the quality of life of the patients with forward head posture. Design: Cress-sectional study. Methods: To measure the CVA, the angle at which the visible protrusion of C7 and the ear bead were connected was measured, and the neck disorder index was evaluated using the Korean version of NDI. The degree of pain of the subject was measured using a visual-analog scale (VAS). The SCM thickness was measured using an ultrasound imaging device, and the quality of life was evaluated using the Korean version of the World Health Organization quality of life questionnaire (WHOQL-BREF). Results: A significant predictive model showing 88% explanatory power for the dependent variable was confirmed, with an appropriate regression equation being found. The factor that most affected patients' quality of life in the forward head posture was confirmed by the SCM thickness. Conclusion: When applying an intervention to improve a patient's quality of life for patient with forward head posture, an intervention method that improves the SCM thickness should be recommended.

Background: Among the various rehabilitation methods for stroke patients, one method involves the use of vibration. Recently, vibration foam rollers, combining vibration with foam rolling, have been developed and are widely used. Objectives: The purpose of this study was to investigate the effects of vibration foam rolling on ankle range of motion (ROM), and gait speed in patients with stroke. Design: A randomized controlled trial. Methods: Thirty stroke patients volunteered to participate and were randomly assigned to the vibrating foam roller group (n=15) and the non-vibrating foam roller group (n=15). Active dorsiflexion ROM, and 10-meter walk (10MW) were used to evaluate ankle ROM, and gait speed before and after each exercise. The two groups performed a 30-minute foam roller exercise program. The non-vibrating foam roller group performed the same exercise program as the vibrating foam roller group, but without vibration. Results: The within-group change in active dorsiflexion ROM after the exercise was significant for both the vibrating foam roller group and the non-vibrating foam roller group (P<.05). The within-group change in 10MW after the exercise was significant for the vibrating foam roller group (P<.05), while it was not significant for the non-vibrating foam roller group (P>.05). Additionally, there was no significant difference in active dorsiflexion ROM and 10MW between the vibrating foam roller group and the non-vibrating foam roller group (P>.05). Conclusion: This study confirmed that a vibrating foam roller exercise program immediately improves ankle ROM and gait speed in stroke patients.

Background: Interventions for acute low back pain include exercise therapy such as stretching, aerobic exercise, and sling exercise. Another treatment method for back pain is soft tissue release. Soft tissue release is a relaxation method that improves balance while allowing tension tissues to relax as much as possible. Objectives: To investigated the effect of acute low back pain on the massage ball exercise. Design: Randomized controlled trial. Methods: The twenty-eight subjects were randomly allocated to the Massage ball exercise with TENS group (MBETG, n=14) and the transcutaneous electrical nerve stimulation group (TG, n=14). For MBETG, massage ball exercise (BALLance Dr. Tanja Kühne method) was applied for 25 minutes followed by TENS for 15 minutes. The TG group applied TENS for 40 minutes. Each group conducted the intervention three sessions. The results were analyzed by measuring the numeric pain rating scale (NPRS), surface electromyography (%MVIC), and Oswestry disability index (ODI) before and after the intervention in each group. Results: Significant reduction was observed for NPRS and ODI in the MBETG (P<.05). And Significant higher was observed for %MVIC of the Erector spinae in the MBETG (P<.05). The NPRS and ODI in the MBETG were decreaed than the TG (P<.05). Conclusion: Massage ball exercise to patients with acute back pain will be effective in reducing pain, increasing muscle activity, and improving functional disability.

Background: Kinesio taping is being applied to improve ankle dorsiflexion in stroke patients. Currently, the elasticity of kinesio taping is applied in various ways. Objectives: To investigated the effect of tibialis anterior kinesio taping elasticity level on gait speed in stroke patients. Design: A randomized cross-over pilot study. Methods: A total of 12 study subjects were allowed to experience three conditions within a single group. The three conditions are strong elastic taping condition, weak elastic taping condition, and non-elastic taping condition. Study subjects were randomly assigned to each condition sequentially. For the evaluation, gait variables (cadence, gait speed, stride length) were measured 24 hours after applying the taping appropriate for each condition. Results: The strong elastic taping condition significantly increased gait variables compared to the weak elastic taping and non-elastic taping conditions (P<.05). Weak elastic taping significantly increased gait variables compared to non-elastic taping (P<.05). Conclusion: As tibialis anterior kinesio taping elasticity increased, gait variables significantly improved in stroke patients.

Background: Most studies targeting stroke patients have confirmed improvements in balance and walking using immersive and non-immersive virtual reality training programs. However, to date, there are not many studies targeting brain activation enhancement for the two training programs. Objectives: The purpose of this study is to investigate the effect of a virtual reality training program on the EEG of stroke patients according to differences in immersion. Design: A randomized controlled trial. Methods: A total of 20 stroke patients, with 10 in an immersive virtual reality training programs group (IVRG) and 10 in a non-virtual reality training programs group (NVRG) were randomly assigned to exercise three times a week for 6 weeks. EEG was measured for 2 minutes using DSI-24. Results: The intra-group difference in relative alpha waves of brain waves was not significant for both groups, and the between-group difference was not significant. Differences in EEG relative beta waves in the experiment group were significant in the Fp1, Fp2, Cz, C3, C4, P3, and O2 in the experiment group, and significant in the Cz and O2 in the control group. As a result of comparing the differences between each group before and after, there was a significant difference in the Fp1 area. Conclusion: Virtual reality training programs based on differences in immersion were found to have a positive effect on EEG. Therefore, it is believed that a virtual reality training program based on differences in immersion can be provided as a clinical intervention method for EEG.

Background: Hemiparesis not only affects the affected side but also exerts an impact on the unaffected side. Stroke patients endure muscular weakness attributable to hemiparesis, resulting in asymmetry of muscular strength between the paralyzed and non-paralyzed sides. Objectives: To investigate the correlation between lower limb muscle strength asymmetry and functional factors in patients with stroke. Design: A cross-sectional study. Methods: A total of 58 stroke patients participated in this study. After measuring the muscle strength of both lower limbs using manual muscle testing, the asymmetry was calculated. Functional factors such as berg balance scale (BBS), timed up and go (TUG), 10-metre walk (10MW), and modified barthel index (MBI) were measured. Results: The BBS showed positive correlations with hip, knee, and ankle strength asymmetry (P<.05). The TUG showed negative correlations with hip, knee, and ankle strength asymmetry (P<.05). The 10MW showed negative correlations with hip, knee, and ankle strength asymmetry (P<.05). The MBI showed positive correlations only with hip strength asymmetry (P<.05). Conclusion: We were found that there is a more pronounced lower limb muscle strength asymmetry in the lower extremity of stroke patients, which is associated with BBS, TUG, and 10MW.

Background: Chronic back pain not only causes physical discomfort and decreased functionality but also affects emotional well-being, resulting in feelings of anxiety, depression, and other psychological issues. Studies have indicated that cognitive functional therapy and motor control exercises can alleviate chronic low back pain and associated psychological issues. Objectives: To investigated the effect of chronic low back pain on the cognitive functional therapy (CFT) and motor control exercises (MCE). Design: Quaxi-experimental study. Methods: Forty patients with chronic low back pain were randomly assigned and divided into 20 cognitive functional therapy group with motor control exercises group (CFTMG) and 20 patients in motor control exercises group (MCEG). After applying CFT with motor control exercises and motor control exercises for 8 weeks, changes in numeric pain rating scale (NPRS), Oswestry disability index (ODI) and Fear-avoidance beliefs questionnaire (FABQ) were observed. Results: In the CFTMG, statistically significant changes were observed in NPRS, ODI, and FABQ before and after the intervention. In the MCEG, statistically significant changes were observed in VAS and ODI before and after the intervention. Conclusion: The application of CFTM and MCE in patients suffering from chronic low back pain has demonstrated effectiveness in alleviating pain, enhancing back function, and reducing kinesiophobia associated with the condition.

Background: The compression therapy, which is the standard treatment for lymphedema patients, may be difficult to implement and contraindicated to some patients depending on their health condition. Objects: The purpose of this study is to investigate whether kinesiology taping (KT) can be used effectively and safely in the management of lymphedema as an alternative treatment through systematic review and meta-analysis. Methods: In February 2023, the literature was systematically collected through eight search engines with a combination of terms, ‘lymphedema’ and ‘kinesiology taping.’ We qualitatively analyzed the differences and safety of KT methods, and quantitatively meta-analyzed the effects of volume reduction in edema, range of motion (ROM), and pain improvement using Review Manager ver. 5. 4. To assess the risk of bias in the randomized controlled trial (RCT) studies, Risk of Bias was used. Results: A total of 616 articles searched and 20 studies were selected, including 12 RCTs and eight case studies. KT intervention could not replace multilayer compression bandage (MLB), but it demonstrated similar or better results compared to compression garment (CG), with reduced pain and improved intervention comfort. Studies reported skin adverse events ranging from 2.5% to 20.68%, with a total adverse event incidence of 7.7%. There was no significant difference in the application method of KT. As a result of the meta-analysis from the 8 RCTs, the KT intervention showed a mean difference (MD) of –7.18 with a 95% confidence interval (CI) [–12.64 to –1.72] in the volume change of lymphedema, while the pain difference was MD 0.82 with CI 95% [0.50 to 1.15], in comparison to the MLB and CG intervention. Conclusion: KT therapy led to a reduction in edema size, volume, pain, and improved ROM and quality of life. KT may be a viable option for lymphedema patients who have trouble applying traditional compression therapies.

본 연구는 만성질환으로 외래서비스를 이용하는 환자를 대상으로 의 료기관 유형별 의료서비스 이용 경험을 조사하고, 만성질환자의 건강 결과를 실증적으로 비교 분석하여, 만성질환 관리의 효과적인 중재방안 마련에 기초자료를 제공하고자 시도되었다. 본 연구의 자료수집은 2023년 7월 1일부터 7월 31일까지 고혈압과 당뇨병 진단으로 보건소 와 의원, 종합병원의 외래서비스를 이용하고 있는 대상자 167명에게 면담을 통한 구조화된 설문지를 작성하여 자료를 수집하였고, 수집된 자료는 SPSS 통계프로그램을 이용하여 분석하였다. 연구 결과 고령의 취약계층은 의료기관 중 의원을 가장 많이 이용하고 있었고, 의료기관 유형별 이용경험의 결과는 의원이 가장 부정적이었다. 그러나 만성질환 관련 건강 결과는 의료기관 유형별로 유의한 차이가 없었다. 그러므로 보건소는 특히 취약계층 환자들의 보건의료 요구를 중시하고 공공보건 서비스를 효율적으로 제공해야 하며, 의원의 만성질환 관리 역량의 강 화를 위한 다양한 중재 방안 마련과 함께 국가 시범사업의 적극적 참 여를 유도할 수 있는 정책이 수립되어야 할 것이다.

이 연구는 마음챙김을 기반으로 한 명상 프로그램을 말기 암 환자에게 실시하여 마음챙김의 주의 자각이 환자들의 죽음에 대한 불안감 감소에 미치는 효과를 검증하고자 하였다. 연구방법은 단일집단 사전-사후검사 설계를 바탕으로, 부산 소재 D병원에서 항암과 방사선 치료를 받고 있는 말기 암 환자들에게 마음챙김 명상 프로그램을 주 1회 1시간 30분씩 5 회기를 실시하였으며, 효과성에 대한 검증을 살펴보기 위해 비모수 검정 인 Wilcoxon Signed-Test로 분석하였다. 연구의 결과 마음챙김 명상 프로그램이 연구 참여자들의 주의 자각을 향상시킴으로써 참여자들의 죽 음에 대한 불안감을 감소시키는데 효과가 있음이 입증되었다. 결론 및 제언으로 마음챙김 명상 훈련을 통해 말기 암 환자들의 죽음에 대한 불 안감을 감소시킬 수 있다는 본 연구의 결과를 바탕으로 말기 암 환자들 의 불안감 감소가 지속적으로 유지될 수 있는 시스템의 구축과 꾸준히 마음챙김 명상 프로그램을 활용한 연구가 진행되기를 제언하였다.

The study aim was to develop and test the effects of integrated simulation pertaining to patients with schizophrenia using a hypertensive crisis module for nursing students. Methods: This pilot study with seven undergraduate nursing students used a single group, pre-post test design. Integrated simulation pertaining to patients with schizophrenia using a hypertensive crisis module was developed based on the ADDIE model (i.e., Analysis, Design, Development, Implementation, and Evaluation), expert meetings with subject professors, a literature review, a preliminary survey, and focus group interviews. Data were collected and measured for general characteristics of the study participants, critical thinking disposition, problem-solving, clinical judgment, self-efficacy, simulation design, and simulation effectiveness. Qualitative contents were analyzed through focus group interviews. Results: No statistically significant differences were found in class design, critical thinking disposition, problem-solving, clinical judgment, and self-efficacy after applying the integrated simulation module. Based on the data obtained from the focus group interviews of study participants, the following four categories were established: “Integrating knowledge and applying it to practice,” “Nursing in unexpected situations,” “Challenged to be an expert,” and “Ensuring receptive and psychological safety in simulation practice.” Conclusion: An integrated simulation module was developed to integrate the nursing problems associated with individual subjects beyond the scope of one subject, and the effect was verified by applying it

목적: 본 연구는 남성 척수손상 환자들을 대상으로 사회연결망 분석을 활용하여 작업연결망의 구조를 분석하는 데 목적이 있다. 연구방법: 연구대상은 남성 척수손상 환자 12명이다. 대상자들의 작업연결망 구조는 사회연결망 분석을 활용하였 으며, 연결망 분포에 대한 지표와 중심성에 대한 지표로 구분하여 분석하였다. 연결망 분포에 대한 지표는 밀도, 평균 연결정도, 평균 거리, 포괄성, 고립노드를 분석하였다. 중심성에 대한 지표는 연결정도 중심성과 매개 중심성을 분석하였다. 일상생활 활동의 항목은 지역사회 건강조사 활동항목을 활용하여 조사하였으며, 활동에 대한 강도는 만족도로 설정하였고, 10점 척도로 조사하여 적용하였다. 결과: 연결망 특성에서 밀도는 60%, 평균 연결정도는 8.40, 평균 거리 1.40, 포괄성 100%, 고립노드 0으로 나타났다. 중심성 분석 결과 내향 연결정도 중심성과 외향 연결정도 중심성 모두 참여활동, 개인건강관리, 교제활동의 순으로 높게 나타났다. 매개 중심성 분석 결과 개인건강관리, 교제활동, 여가활동 순으로 높게 나타났다. 결론: 본 연구에서는 사회연결망 분석을 활용하여 척수손상 환자들의 작업수행에 대한 구조와 그 특성을 파악하였다. 본 연구에서 분석한 결과는 척수손상 환자들의 일상 속에서 만족감을 지니며 수행하고 있는 작업수행의 구조를 의미한다. 이에, 본 연구결과는 척수손상 환자들이 자신의 일상을 더욱 의미 있게 구성하고, 작업수행에 적극적으로 참여할 수 있는 근거로서 활용할 수 있는 중요한 의미와 가치를 지니며, 임상적으로 의미를 지닌다. 이에, 본 연구 결과는 척수손상 환자들의 재활과정에서 작업수행에 대한 참여를 확대하고, 영역별 확장을 유도할 수 있는 기초자료로서 활용할 수 있을 것으로 판단된다.

Purpose: This study aimed to investigate the perception of visiting hospice services to end-of-life patients at home. Methods: Individual in-depth interviews and qualitative content analysis were used for data collection and analysis, respectively. The study’s participants were 15 end-of-life patients receiving visiting hospice services at home. Results: Four themes emerged from nine subthemes, which were categorized from 26 condensed meaning units by interpreting underlying meanings. The four themes were “service with value started by chance”, “service that fills the care gap”, “service that the vulnerable group can rely on”, and “service that is insufficient to medical support”. Conclusion: Based on these results, it is suggested that policy support is needed to develop and apply a community-based hospice service model that connects hospitals and homes.

Purpose: This study aims to not only understand the meaning and essence of patients’experiences visiting the Raphael Nanum Homeless Clinic but also explore what kind of healthcare programs they would like to have in the future by appraising patients’experiences in depth. Methods: This study employed a qualitative content analysis method. The data were collected from June 11, 2023, to June 25, 2023. A total of 17 patients who could provide detailed experiences of their visit to the Raphael Nanum homeless clinic participated in this study. We conducted a focus group interview with 6 patients and in-depth one-on-one interviews with the remaining 11 patients. Results: The qualitative content analysis result revealed five themes: “visiting a free clinic for various paths,” “positive experiences at the free clinic,” “negative experiences at the free clinic,” “dissatisfaction with the clinic site,” and “anticipation for the future of the free clinic.” Conclusion: To ensure the right to health and survival of marginalized populations in the future, it is necessary to establish comprehensive healthcare support measures, which include enhancing the facilities of the free clinic and expanding the range of available medical specialties.

Purpose: To determine whether artificial -intelligence quarantine robots can positively contribute to environmental management in medical institutions. We conducted in-depth interviews to understand the experiences of hospitalized patients receiving environmental management from such robots. Methods: Data were collected during March 20~May 20, 2023. individual in-depth interviews were conducted with 15 hospitalized patients, who could provide specific details of their experience of receiving environmental management from a quarantine robot. Results: Qualitative content analysis identified four themes, including “First encounter with an amazing and new quarantine robot,” “Efficiently performs non-face-to-face quarantine work in hospitals,” “Problems with quarantine robots,” and “Recommendations for improving the functionality of quarantine robots in medical institutions so quarantine robots and humans can coexist.” Conclusion: Currently, quarantine robots have limited functionality, and additional research is needed to identify various other functions in consideration of future infectious disease situations and the level of quarantine appropriate in a hospital.

목적 : 본 연구는 시뮬레이터 훈련이 척수손상 환자의 운전시뮬레이터 도로 주행시간과 주행조작 능력에 미치는 영향을 알아보고자 하였다. 연구방법 : 본 연구는 단일사례실험연구 AB설계로 진행되었으며, 기초선 3회기, 중재기 10회기를 적용하였다. 기초선 3회, 중재기 5회 도로주행코스(중급) 수행 시 운전시간, 주행조작 능력 자료가 수집되었으며, 연구결과 분석을 위하여 시각적 분석 방법과 평균 ±2*표준 편차를 사용한 양적 분석을 동시에 사용하였다. 결과 : 연구대상자 3명의 총 주행시간은 기초선 A보다 중재기 B에서 3분 내외의 감소하였고, 세 명 모두에서 통계학적으 로 의미있는 주행 능력의 향상이 확인되었다. 주행조작능력 또한 오류 점수가 감소하였고, 첫 번째 참여자와 세 번째 참 여자의 경우 그 변화가 통계학적으로 유의하였다. 결론 : 본 연구에서 연구대상자의 총 주행시간 및 수행 오류의 감소가 확인되어 운전시뮬레이터 훈련의 효과가 있었다. 이 와 같은 결과는 운전시뮬레이터 훈련의 적용 가능성을 뒷받침 한다.

Background: As ways to optimize the mobilization of postural stability muscles for sitting up motions, arm reaching motions and head raising motions have important effects. Objectives: This study was conducted to investigate the effects of reaching to sit-up training on the trunk muscle activity, postural ability, and balance ability of patients with hemiplegia due to stroke. Design: Randomized controlled trial. Methods: This study was conducted with 18 stroke patients who met the selection criteria divided into two groups: a study group of 9 patents and a control group of 9 patients. The study group carried out reaching to sit-up training, which can promote trunk muscles and improve control through trunk interactions. The control group received general physical therapy intervention Results: The activity of the trunk muscle was significantly different before and after intervention in study and control group. The functional reaching test showed significant changes in both the study group and the control group. The timed up and go test showed a significant change in the study group. Conclusion: Reaching to sit-up training for 4 weeks showed increases in trunk muscle activity in stroke patients and was effective in improving balance ability.