목적 : 본 연구는 한국표준산업분류에 따라 산재환자의 작업능력평가 세부항목 실시 데이터를 분석하여 업종별 직장복귀프로그램의 기초자료를 제시하는데 있다. 연구방법 : 후향적 코호트 조사 연구로 근로복지공단 소속병원의 전자의무기록을 활용하여 2018년 1월부터 2020년 12월까지 작업능력평가를 실시한 2,145명의 산재환자의 기초분석과 한국표준산업분류에 따라 건설업, 제조업, 전문ㆍ기술업, 시설 관리 및 서비스업, 운송업, 보건업 및 사회복지 서비스업으로 분류한 후 대상자들에게 시행된 작업능력평가 세부항목의 수행 빈도 차이를 분석하였다. 결과 : 작업능력평가에 참여한 대상자는 남성 1,798명(83.8%), 여성 347명(16.2%)이었으며, 연령대는 50-59세가 790명(36.8%)으로 가장 많았다. 산재 요양시작 이후 평균8.83 ± 5.32개월 시점에 평가가 이루어졌다. 제조업 692명(32.3%), 건설업 642명(29.9%), 전문ㆍ기술업 308명(14.4%)이 대부분이었고 손상 부위는 하지 손상이 736명(34.3%)으로 가장 많았다. 작업능력평가 시 포함된 세부 평가항목 중 어깨높이에서 밀기ㆍ당기기, 작업장 이동에서 걷기, 기어가기, 자세유지평가에서 무릎 꿇기 작업을 제외한 모든 항목에서 직업에 따라 유의한 차이가 있었다. 특히, 건설업에서 들기와 옮기기의 수행 빈도가 높았고, 가장 무거운 무게까지 평가를 했으며, 제조업에서는 자세유지평가 빈도가 높았다. 결론 : 본 연구에서 작업능력평가에 참여한 산재환자의 동향과 한국표준산업분류에 따라 실시되는 작업능력평가 세부항목 차이를 확인하여 임상에서 참고할 수 있는 기초자료를 제시하였다.

Background: The continuous co-contraction of the trunk muscles through trunk stabilization exercises is important to patients with lumbar spinal stenosis (LSS). However, intentional abdominal muscle contraction (IAMC) for trunk stabilization has been used only for specific training in the treatment room. Objects: The purpose of this study was to provide feedback to adults with LSS to enable IAMC during activities of daily living (ADLs). Methods: The participants with spinal stenosis were divided into an experimental group of 15 adults and a control group of 16 adults. Electromyographic signals were measured while the subjects kept their both hands held up at 90°. The measured muscles were the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES). Pelvic tilt was measured using a digital pelvic inclinometer. The degree of pain was measured using the visual analogue scale (VAS) and functional capacity was measured using the Korean version of the Oswestry disability index (KODI). Results: While the experimental group showed statistically significantly higher activities in the RA, EO, and IO after the intervention compared with the control group. Pelvic tilt was significantly decreased only in the experimental group. Both the experimental and control groups exhibited statistically significant declines in the VAS and KODI (p<.01). In terms of the levels of changes, the experimental group exhibited a statistically significant larger decline only in the VAS and the pelvic tilt when compared with the control group (p<.05). Conclusions: The subjects could stabilize their trunks, and relieve their pain and dysfunctions and reduce pelvic tilt by learning abdominal muscle contraction during ADLs.

The estrogen-mediated effect of mesenchymal stem cells (MSCs) is a highly critical factor for the clinical application of MSCs. However, the present study is conducted on MSCs derived from adult donors, which have different physiological status with steroid hormonal changes. Therefore, we explores the important role of 17β-estradiol (E2) in MSCs derived from female and male newborn piglets (NF- and NM-pBMSCs), which are non-sexually matured donors with steroid hormones. The results revealed that in vitro treatment of MSCs with E2 improved cell proliferation, but the rates varied according to the gender of the newborn donors. Following in vitro treatment of newborn MSCs with E2, mRNA levels of Oct3/4 and Sox2 increased in both genders of MSCs and they may be correlated with both estrogen receptor α (ERα) and ERβ in NF-pBMSCs, but NM-pBMSCs were only correlated with ERα. Moreover, E2-treated NF-pBMSCs decreased in β-galactosidase activity but no influence on NM-pBMSCs. In E2-mediated differentiation capacity, E2 induced an increase in the osteogenic and chondrogenic abilities of both pBMSCs, but adipogenic ability may increased only in NF-pBMSCs. These results demonstrate that E2 could affect both genders of newborn donor-derived MSCs, but the regulatory role of E2 varies depending on gender-dependent characteristics even though the original newborn donors had not been affected by functional steroid hormones.

Background: Functional capacity evaluations (FCEs) are designed to systematically assess the capacity to perform work-related tasks and to determine worker’s ability to return to the previous job following work-related injuries. These evaluations may be rated either by clinician or worker. There has been a lack of consensus between the two scoring methods. Objects: This study aimed: 1) to confirm if the data are fit to the Rasch rating scale model and 2) to investigate the item-level concordance rate between the ratings of clinician and injured worker of the FCE. Methods: A cross-sectional study was conducted with a sample (n=124) of a rehabilitation program with the Occupational Rehabilitation Data Base for workers with low back pain. The functional capacity evaluation at admission and discharge was administered to clinicians and workers. The data were analyzed using both classical test theory-based Pearson’s r and intra-class coefficient followed by item-level analysis with Rasch rating scale model. Results: All items of the FCE, except sitting items rated by clinician at admission and handling items rated by both clinician and worker throughout admission and discharge, were acceptable fit statistics with minor out of ranges for a misfit criterion. This may indicate that the items of the FCE overall fit to the Rasch rating scale model. Few problematic items responding differently to clinician and worker both at admission and discharge were detected with the differential item functioning analysis despite the excellent concordance rate using the two conventional statistics-sitting and handling items at admission and handling item at discharge. Conclusion: The item-level speculations using Rasch analysis of the FCE demonstrate that the ratings of clinician and self ratings of worker were psychometrically acceptable though there was an apparent discrepancy between the raters both at admission and discharge.

The primary aim of this study was to compare responsiveness of self-report by worker and therapist-scored functional capacity instrument. Self-report and therapist-scored interval-level person measures and item difficulties were compared at admission and discharge. Therapist and worker ratings were collected on 230 clients from 27 rehabilitation sites using the newly developed Occupational Rehabilitation Data Base (ORDB) functional capacity instrument. ORDB comprises several subscales measuring relevant variables of "a return-to-work model" in work-related rehabilitation clinics. The functional capacity scale deals with 10 DOT job factors. The rating scale categories were 1-severely impaired, 2-moderately impaired, 3-mildly impaired, and 4-not impaired. Only data from clients with low back pain (n=98) with complete data (both admission and discharge scores) were used for the present study. Therapists and workers completed the functional capacity instrument at admission and discharge. Rasch analysis [1-parameter item response theory model (IRT)] was applied to calibrate item difficulty and person ability measure of therapist and workers ratings. Effect sizes for therapist and self-report ratings were slightly different, .69 and .30, respectively. Therapist and worker ratings were more consistent at discharge (r=.54) than at admission (r=.32). Workers have a tendency to be more severe in their ratings (show higher item difficulties) than therapists at admission and discharge. Therapists and workers report similar magnitudes of improvement following treatment program. These findings challenge the belief that injured workers may unreliable source for monitoring therapeutic outcomes. Self-report measures have the advantage of conserving therapist time for treatment (versus evaluation). While the therapist and self-report ratings are comparable at discharge, there is less consistency at admission. Comparable therapist-worker ratings may be achieved by controlling for rating severity using IRT methodologies.

The purpose of this study is to see the effect of functional electrical stimulation on forced vital capacity and alternating motion rate in children with spastic cerebral palsy. This study divided 20 children with spastic cerebral palsy into two groups; functional electrical stimulation treatment group and control group. Functional electrical stimulation treatment group had 20min per day treatment three times a week for four weeks and the control group did not have any treatment. Before and after intervention, this study measured forced vital capacity and alternate motion rate(/peo/,/teo/) for all children. Forced vital capacity showed statistically significant increase for the group with functional electrical stimulation(p<.05) while the control group did not show any significant increase(p>.05). Alternate motion rate showed statistically significant increase for the group with functional electrical stimulation(p<.05) while the control group did not show any significant increase(p>.05). This result shows that functional electrical stimulation affected the ability of the children with spastic cerebral palsy who have decreased breathing and phonation capability.

The purpose of this study was to assess the effect of rehabilitation exercise and neuromuscular electrical stimulation on a visual analysis scale and functional visual analysis scale regarding functional capacity. A total of 7 consecutive patients with the complaint of patellofemoral pain syndrome who received this diagnosis from a sports medicine physician were recruited to assess the effect of rehabilitation exercise and neuromuscular electrical stimulation (NMES) on Visual Analog Scale (VAS) and Functional Visual Analog Scale (FVAS), functional capacity patients with patellofemoral pain syndrome. The exercise rehabilitation consisted of a complex training program requiring five treatments a week for eight weeks. The training program consisted of four phases, and each lasted for two weeks. Statistical analyses were one-way ANOVA with repeated measures. The results were as follows: (1) There were significant differences in the VAS and FVAS during 8-weeks of rehabilitation exercise and neuromuscular electrical stimulation (p<.01). (2) There were no significant differences in the functional capacity during 8-weeks of rehabilitation exercise and neuromuscular electrical stimulation (p<.05). In conclusion, at the end of the eight weeks of this rehabilitation program and neuromuscular electrical stimulation, a significant reduction was found in VAS and FVAS, but there was no significant difference in functional capacity at the end of the treatment.