Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke.
Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients.
Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group (n1=7) and conventional postural vertical training (CPVT) group (n2=7). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject’s postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured preand post-intervention.
Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.
In a sheet metal forming process, fracture and wrinkle are the most difficult task in new parts launching. The variation in process condition generates the fracture and wrinkle fluctuation. The fracture and wrinkle are very sensitive to the process conditions, then the main effects of the design variables cannot be obtained from the standard mean analysis. Therefore, in order to minimize the fracture and wrinkle in parts of automobile, a special method to counterpart is required. In this study, a new design method to achieve the optimal in the sheet metal forming process is proposed. The effectiveness of the proposed methods is shown with an example of the parts of fracture and wrinkle.
The most time consuming job in the sheet metal forming process is compensating for springback. Factors such as uneven material properties and process conditions generate noise, which in turn create springback. The springback is very sensitive to the process and noise conditions, and the main effects of the design variables cannot be obtained from mean analysis. Therefore, to achieve minimal springback, an effective design countermeasure must be put in place to reduce noise effects. In this study, two robust design methods to achieve minimal springback in U-channel forming, including compensation process, are proposed. The effectiveness of the proposed methods is shown with an example of the sidewall curl springback. The proposed methods consistently outperform our previous work, indicating that the complex method is more preferable to the mean analysis, if there is no evidence of additivity of effects.
Background: The process of language translation, adaptation, and cross-cultural validation of tools for use in multiple countries requires the adoption of well-established, comprehensive, and rigorous methodological approaches. Back translation, which is the most recommended method, permits the detection of errors in the translation and the identification of words or phrases that cannot be accurately or literally translated.
Objects: The aim of this study was to verify the content validity of a Korean version of a Balance Evaluation Systems test (BESTest) by using a back-translation method.
Methods: This research was conducted in six steps: 1) translation of the BESTest into Korean, 2) evaluation of the translation conformity of Korean-translated BESTest, 3) evaluation of the degree of translation comprehension, 4) back translation of Korean BESTest, 5) evaluation of the technical and conceptual equivalence, and 6) completion of the Korean version of BESTest by the translation verification committee.
Results: In this study, Korean version of the BESTest achieved a rating of more than 3 (moderate) for translation comprehension, and technical equivalence and conceptual equivalence of back translation were evaluated as 3 (moderate) or more.
Conclusion: The Korean version of the BESTest has proven content validity and is an appropriate tool to measure balance function.
Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls.
Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis.
Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve.
Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale.
Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but tho
Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the ‘transfer’, and ‘turning to look behind left and right shoulders while standing still’ item showed misfit statistics. in total 40 children with CP. Also, ‘transfer’, ‘standing unsupported with feet together’ and ‘standing with one foot in front’ items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was ‘standing on one foot’, whereas the easiest item was ‘sitting with back unsupported and feet supported on the floor’. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.
Background: The assessment tool developed in other countries should be translated into Korean language using rigorous methodological approaches in order to be used in Korea. Because these procedures are insufficient for establishing the cross-cultural and linguistic equivalence, the need for statistical methods is raised. The Fullerton Advanced Balance Scale was translated into Korean and the content validity was verified through the back translation method, but the reliability and validity have not yet been proven by statistical methods. Objects: The purpose of this study was to investigate the reliability and validity of the Korean version of the Fullerton Advanced Balance Scale (KFAB) by statistical methods in elderly people. Methods: A total of 97 elderly adults (39 males and 58 females) participated in this study. Internal consistency of the KFAB was measured using Cronbach’s alpha and an intraclass correlation coefficient (ICC) was used to assess test-retest reliability between the two measurement sessions. Concurrent validity was measured by comparing the KFAB responses with the Korean version of the Berg Balance Scale (KBBS) using the Spearman correlation coefficient. Construct validity of the KFAB was measured using the exploratory factor analysis to evaluate the unidimensionality of the questionnaire. The significance level was set at α=.05. Results: The internal consistency of the KFAB was found be adequate with Cronbach’s alpha (.96), and test-retest reliability was excellent as evidenced by the high ICC (r=.996). Concurrent validity showed high correlation between the KFAB and KBBS (r=.89, p<.001). Construct validity was evaluated using exploratory factor analysis. The result from Bartlett test of sphericity was statistically significant (p<.001), and the value of Kaiser-Meyer-Olkin measure of sampling adequacy was .93. Exploratory factor analysis revealed the existence of only one dominant factor that explained 76.43% of the variance. Conclusion: The KFAB is a reliable, valid and appropriate tool for measuring the balance functions in elderly people.
Background: Rasch analysis estimates the probability that a respondent will endorse an item and select a particular rating for that item. It has the advantage of placing both the items and the person along a single ration scale and calibrates person ability and item difficulty onto an interval scale by logits. In addition, Rasch analysis is a useful tool for exploring the validity of questionnaires that have been developed using traditional methods. Therefore, it has been recommended as a method for developing and evaluating functional outcome measures. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of the Fullerton Advanced Balance Scale (KFAB) using Rasch analysis. Methods: Total 97 subjects (39 males and 58 females) with dwelling elderly adults were participated, but 3 people were excluded for misfit persons. Rasch analysis was then done by means of the Winsteps program to determine the item fit, item difficulty, rating scale, and reliability of the KFAB. Results: In this study, the ‘standing with feet together and eyes closed’, ‘two-footed jump’, ‘walk with head turns’, and ‘stand on foam, eyes closed’ items shown misfit statistics. The most difficult item was ‘stand on one leg’, whereas the easiest item was ‘turn in full circle’. The rating scale was acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. This would indicated that each domain covers a useful range of item difficulty that is appropriate for measuring a person with a wide range of functional ability. Conclusion: The KFAB has been proven reliable, valid and an appropriate tool with which to evaluate the balance of the elderly people.
The purpose of this study was to review existing assessment tools for patients with low back pain and improve them through combination. A total of 314 patients with low back pain participated. Their condition was assessed using the Oswestry Disability Questionnaire (ODQ), the Quebec Back Pain Disability Scale (QBPD), and the Back Pain Functional Scale (BPFS). Rasch analysis was applied to identify inappropriate items, item difficulties, and the separation index. In this study, the 'sex life' item of the ODQ (10 items) and the 'sleeping' item of the BPFS (12 items) showed misfit statistics, whereas all items of the QBPD (20 items) were appropriate. After combining the ODQ, QBPD and BPFS, Rasch analysis was applied. The 'pain intensity', and the 'sex life' item of the ODQ and the 'throw a ball' item of QBPD showed misfit statistics. These 3 items were retained for further analysis. The remaining 42 combined ODQ-QBPD-BPFS items were arranged according to difficulty. For all subjects, the most difficult item was 'pain intensity', whereas the easiest was 'take food out of the refrigerator'. As the separation index of 42 combined ODQ-QBPD-BPFS was higher than that of the three questionnaires separately, difficulty of items varied with some need for rearrangement. The results of this study confirmed the possibility and need for a new back pain disability assessment tool, and produced one. Further study is needed to refine the questionnaire in consideration of psychosocial and occupational factors.
Three hundred and fourteen low back pain patients completed the Korean version of the Oswestry Disability Questionnaire (KODQ) and the Rasch analysis was then applied to identify the inappropriate items and to determine ODQ item difficulties according to a subject's characteristics. For women and youths, the 'sex life' item showed misfit statistics, whereas for older subjects it was the 'pain intensity' and 'standing' items. Also, in the acute low back group the 'pain intensity', 'standing' and 'sex life' items showed misfit statistics. For all subjects, the most difficult item was 'pain intensity', whereas the easiest item was 'walking'. But for the older and acute groups 'lifting' was the most difficult item and for those who have a visual analogue scale score of 3 or less 'sitting' was the most difficult item. These results show that differential item functioning is present in several items according to sex, age, acute and chronic pain, and VAS score. This study may be useful for adjusting the KODQ item difficulties for low back pain patients with different characteristics
This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.
This work was performed to investigate the distribution of the fuel droplet size around the bluff-body and the combustion characteristics. The geometry of the bluff-body influenced the spray shape and the combustion characteristics. Diameters of the bluff-body in this experiment are 6, 8, and 10mm and the impingement angles( θ) are 30°, 60°, and 90°. The measurement points were at the distances of 20 and 30mm axially from the nozzle. The SMD and Rosin-Rammler distribution was acquired by image processing technique(PMAS), and the mean temperatures were measured by thermocouple. The results obtained are as follows; In the condition of θ=60°, the values of SMD are not greatly varied compared to the other conditions. As the impingement angle of bluff-body was increased, the high temperature region was wider along radial direction. When the air-fuel ratio was increased, the CO concentration was decreased.
This study was conducted to identify the effects of high-heel shoes on EMG activities of rectus femoris and biceps femoris in 28 healthy women. Subjects were composed of experimental group (wearing high-heel shoes) and control group (wearing low-heel shoes). Two groups participated in three conditions standing (bare foot wearing athletic shoes and 7.5 cm height shoes). In high-heel shoes condition, EMG activities of rectus femoris of control group were significantly lower than that of biceps femoris of experimental group, but EMG activities of both muscles of experimental group did not should significant difference. In bare foot standing condition, EMG activities of rectus femoris of experimental group were significantly lower than that of biceps femoris but EMG activities of both muscles of control group had no significant difference. These results showed that hamstring lengthening effects was produced when wearing high-heel shoes because the external knee extension moment was increased. In the short term, high-heel shoes effect on the increase of the biceps femoris activities by spindle reflex, but in the long term, the normal amplitude of the same muscle activities by Golgi tendon organ reflex.
가압 경수로형 원전에 사용되는 Alloy 600 증기발생기 전열관재료의 입계응력부식균열 거동에 미치는 냉간변형의 영향을 1차 냉각수 모사조건에서 정속인장시험방법으로 조사하였다. 인장 냉간변형은 응력부식균열을 크게 가속화 시키지는 않았으며 변형량이 25%이상인 경우에는 응력부식균열이 발생하지 않았다. 이 현상은 냉간 변형량 및 형태에 따른 미소변형 및 응력의 불균질성에 영향을 받는 것으로 사려되며 응력의 크기는 직접적인 영향을 주지 않는 것으로 보인다. 국부적인 큰 응력구배가 존재하는 경우 균열의생성 및 성장이 현저히 가속화되었는데 이는 원전 1차측 응력부식균열 기구가 응력구배에 의존하는 과정과 연관되어 있다는 증거이다. Hump 시편을 이용한 정속인장시험방법은 짧은 실험기간내에 원전 1차측 응력부식균열 특성을 평가할 수 있는 방법이었다.
Genetic factors are increasingly found as potential causes of children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). Representative genes include cationic trypsinogen, serine protease 1 (PRSS1), serine protease inhibitor Kazal type 1 (SPINK1), cystic fibrosis transmembrane conductance regulator (CFTR), chymotrypsin C (CTRC) and calcium sensing receptor (CASR) genes, etc. In Korean children, PRSS1 and SPINK1 genes have been most commonly studied, while CFTR mutations were reported in one patient to date. We report a case of a 13-year-old male adolescent with CP with CFTR mutations. Since he was first diagnosed with idiopathic acute pancreatitis (IAP) based on laboratory and computed tomographic findings, he was admitted with ARP and CP over four times in a year at the secondary and tertiary hospital. No etiology was detected by several examinations including magnetic resonance cholangiopancreatography (MRCP), endosco-pic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS) with fine needle aspiration (FNA) biopsy and genetic test including PRSS1 and SPINK1. Although he had no typical symptoms associated with cystic fibrosis (CF), CFTR mutations were detected with additional gene examination. Testing for CFTR mutations should be concerned in pediatric patients with APR and CP without other identified causes.
보는 하천의 대표적 횡단구조물로써 보 상·하류의 낙폭으로 인해 발생하는 유속을 적절히 감세하지 못할 경우 하류하상에 피해를 야기할 수 있다. 이에 보의 설치위치 및 규모에 따른 적절한 감세시설의 설치가 필수적이다. 본 연구에서는 다기능 보 하류의 세굴현상에 대한 해결책으로 ‘Hydraulic Design of Navigation Dams’(USACE, 1987)에서 감세시설로 권장하는 2차 감세지(Secondary Stilling Basin)를 보에 적용하여 하류의 감세효과를 검토하였다. 3차원 수치모의를 통해 2차 감세지의 효과를 판단하기 위해 하도, 다기능 보, 2차 감세지를 반영하여 지형을 구축하였다. 수치모의는 상·하류의 수위차가 최대로 발생하는 관리수위 조건에서 수행하였으며, 보 하류의 수위, 유속분포, 바닥전단응력, Froude 수 등의 수리특성 검토를 수행하였다. 모의결과를 바탕으로 보로부터의 거리에 따른 최대유속 등을 산출하고, 2차 감세지의 감세효과를 확인하였다. 또한 2차 감세지의 형상(상·하류 경사 및 폭)을 변화시키며 바닥보호공 끝단에서 작용하는 전단응력과 하상의 소류력을 비교하여 하상이 평형 상태에 도달할 수 있는 적정모델을 제시하였다. 2차 감세지를 활용한 감세효과의 검증을 통해 홍수기에 보 하류에 발생하는 세굴 피해의 저감이 가능하며, 2차 감세지의 현장적용 시 기존 세굴된 지형을 활용할 수 있어 보수 및 보강 비용의 절감이 기대된다.
기존 수행되는 제방붕괴관련 연구는 댐붕괴 형태로 가정하여 해석하기 때문에 하도 내의 흐름을 반영하지 못하였다. 이러한 단점을 보완하기 위해 하도 내의 흐름을 반영할 수 있는 수리모형실험이 진행되었다. 하지만 붕괴부 내의 흐름을 파악하기에는 붕괴부가 발달함에 따라 측점이 이동하기 때문에 계측장비를 이용한 측정이 어려웠기 때문에 수리모형실험에서는 붕괴부의 유량이나 폭에 대한 연구가 대부분이였다. 따라서 본 연구에서는 하도흐름과 붕괴부 형상을 수치모의를 통해 재현한 후 붕괴부의 흐름특성을 분석하고자 하였다. 수치모의는 기존에 수행된 수리모형실험과 동일한 조건으로 수행하였으며 제방의 제원은 제방고 0.3 m 제방경사 1:2(H:L) 마루폭 0.3 m이다. 수리모형실험 결과를 이용하여 시간에 따른 붕괴형상을 FLOW-3D의 GMO(General Moving Object)의 기능을 이용하여 구현하였다. 수치모의와 수리모형실험에 대해서 붕괴유량과 하도수위를 비교하여 수치모의가 수리모형실험을 유사하게 재현함을 확인하였고 수치모의를 통해 도출된 유속분포를 이용하여 제체에 가해지는 외력을 분석함으로써 제방 붕괴의 발달 매커니즘을 분석할 수 있었다. 본 연구에서 도출된 결과를 이용하여 제방붕괴를 발달시키는 주요변수를 파악하면 제방붕괴에 대한 이론을 확립하는데 중요한 자료로 활용될 수 있을 것으로 판단된다. 추후 붕괴부내 흐름뿐만 아니라 홍수터를 전파하는 흐름까지 재현하여 보다 정확한 침수면적을 예측하여 홍수 피해를 감소시키는 데 주요한 역할을 할 수 있을 것이다.