This study was carried out survey to compare using status of physical therapy for elderly persons between urban and rural area in Honam. There were 16 places consisting of general clinics, departments of family medicine, pain medicine, and orthopedics that run outpatient physical therapy. This study distributed 636 questionnaires in total and collected 400 responses. Regionally, 200 responses out of 311 questionnaires from Gwangju and 200 responses out of 325 questionnaires from Jeollanam-do and Jeollabuk-do were collected. Regionally speaking, Gwangju was 62% while Jeollanam-do and Jeollabuk-do regions were 88%, indicating patients in rural areas employed more public transportation, which was statistically significantly different. There was a difference between urban and rural areas with regard to questions regarding improvement with physical therapy. Factors related to the number of physical therapy visits per week that showed a significant difference between urban and rural areas found by the linear regression analysis result were working hours, whether the patient exercised or not, and pain stress. This result suggest that it is necessary to reduce working hours and pain stress experienced by rural elderlies as well as to encourage regular exercise via national polices.

Pediatric home-based physical therapy (PHBPT) provides professional rehabilitation programs at the patient’s home, where the activities of daily life are actually performed. PHBPT also allows to avoid the difficulties of transporting children with disabilities to the clinic. Despite these advantages, PHBPT is not yet widely practiced in Korea. There is little objective information regarding the opinions of the main stakeholders on PHBPT. To investigate the awareness and demand of PHBPT among the main stakeholders, 41 pediatric physical therapists (PT) (of 60 contacted) were recruited from different regions of Korea on the basis of the regional population distribution. The recruited PTs completed their questionnaires and also participated in collecting questionnaires from 35 medical doctors (MD) with whom they worked and from randomly selected 201 parents of children with disabilities recruited. The overall response rate was 85.5%. The awareness of PHBPT differed between PTs (95.1%) and parents (67.2%) (p<.001). The survey showed that 82.9% of MDs had at least heard about PHBPT. Significantly more parents (83.5%) than MDs (57.1%), and 70.0% of PTs, wanted to start PHBPT service immediately (p<.001). Significantly more parents (90.0%) than PTs (73.2%) were willing to participate in PHBPT (p<.001). Opinions on the details of policies and procedures (i.e., necessity for prescription, treatment cost, and treatment frequency) differed among the respondent groups, but all favored a minimal qualification of 6∼10 years of pediatric experience and a treatment session duration of 1 hour. These findings provide objective information to support health service administrators to understand the current demand and develop feasible policies and procedures of PHBPT in Korea.

연구목적은 방문재활 물리치료 도입을 위한 정책적 자료를 제시하여 방문재활 물리치료의 제도적 도입과 방문건강관리사업에서 방문물리치료의 활성화를 위한 정책적 기초자료를 마련하고자 한다. 연구방법은 전국 의료기관 51곳의 조사 자료와 가정간호 수가체계를 토대로 뇌혈관환자의 방문재활 물리치료의 비용-편익 분석을 직접비용 조사와 지불용의 접근법으로 1회 건당 물리치료의 순편익과 비용-편익 비를 산출한 후, 민감도분석을 통해 연간 사회적 순편익을 계산하여 경제적 이익을 조사하였다. 연구결과 첫째, 뇌혈관환자의 방문재활 물리치료 비용-편익 분석의 직접비용 조사에서 방문재활 물리치료 방식이 의료기관 내원방식보다 2.04배 경제적 이익이 높았고, 사회적 순편익은 19,255,406천원으로 분석되었다. 둘째, 지불용의접근법에서 1.84배 경제적 이익이 높았고, 사회적 순편익은 15,546,120천원으로 분석되어 의료기관 내원방식보다는 방문재활 물리치료방식이 더 저렴하며 경제적 이익으로 사업성에 따른 경제적인 효과가 있었다. 병원을 내원하여 물리치료를 받는 것보다 방문재활 물리치료의 도입으로 가정에서 물리치료를 받는 것이 경제적인 이익이 있는 것으로 조사되었다.

This study examined the effects of a physical therapy program on quality of life (QOL), and neck and shoulder disability in head and neck cancer patients. The program included neck and shoulder range of motion (ROM) exercises, massage, progressive strengthening exercises, and stretching exercises. Sixteen patients who were assigned to an experimental group performed physical therapy for 40 minutes three times a week for eight weeks. Fifteen other patients were assigned to a control group who did not performed the physical therapy program. The European organization for research and treatment of cancer (EORTC QLQ-C30) and head and neck (EORTC QLQ-H&N) instruments, and the Neck Disability Index (NDI) were assessed before and after the rehabilitation program. The 40-minute program consisted of a 10-minute ROM exercise for the neck and shoulder, a 10-minute massage and 15-minute of progressive resistance exercises, followed by a five-minute stretching exercises. Statistically significant differences were noted for changes in global health, physical function in the EORTC QLQ-C30 and cancer related symptoms in the EORTC QLQ-H&N35 (p<.05). The NDI also showed significant differences (p<.05). Physical therapy may therefore benefit the physical aspects and QOL and improve neck and shoulder disability in patients with head and neck cancer.

The purpose of this study is to examine the changes in bone mineral density in long-stay patients of a geriatric hospital in relation to physical therapy, thereby providing basic data for preventing the onset or deterioration of osteoporosis in inpatients of geriatric hospitals or relevant facilities. The subjects of this study were 133 elderly patients who had been in H geriatric hospital in Yongin-si for more than four years. Their bone mineral density T-scores at admission and those after four years were measured to compare and analyze the changes in bone mineral density in relation to physical therapy. According to the results, the decrease in T-score for the group without physical therapy was greater by .40 than that for the group with physical therapy, indicating a statistically significant difference between the two groups(p<.01). Accordingly, physical therapy proved to be effective in preventing bone mineral density loss and maintaining the current density.

목적 : 뇌병변 환자에게 집단 작업치료프로그램을 실시하여 개별 작업치료만 받는 환자와 집단 작업치료프로그램을 병행하여 받는 환자들의 상지기능, 인지∙지각기능 및 일상생활동작에 미치는 영향을 비교, 분석하여 집단 작업치료프로그램 적용 효과를 규명하고 효과적인 프로그램을 위한 기초자료를 제공하기 위함이다. 연구방법 : 2008년 5월부터 10월까지 전통적 치료방법인 개별작업치료만 받는 뇌병변 환자 70명을 대상으로 8주 동안 주 5회 60분씩 총 40회의 치료를 실시하였으며, 치료적 활동프로그램이 포함된 집단작업치료프로그램에 참여하기를 동의한 환자 30명을 대상으로 8주동안 주4회 개별치료와 주1회 60분씩 집단치료를 실시하였다. 결과 : 개별작업치료만 받는 환자군에 비하여 집단작업치료프로그램을 병행하여 받은 환자군이 상지기능, 인지∙지각기능과 일상생활 수행기능이 통계적으로 유의하게 높아졌다. 결론 : 전통적 치료방법인 개별작업치료만 받는 환자군에 비하여 치료적 활동프로그램이 포함된 집단작업치료프로그램을 병행하여 받은 환자들의 치료 효과가 더 높았음을 나타내고 있다. 앞으로 보다 많은 대상으로 집단 작업치료프로그램 개발 및 치료효과를 입증할 수 있는 연구가 이루어지기를 바란다.

Since physical therapy was first introduced in Korea, it has been 50 years past and Korean physical therapy has made rapid progress. However, history or educational system of Korean physical therapy is still not known worldwide. Now, for Korean physical therapy to go beyond Asia and leap toward the world, endless studies, efforts and publicity are required. Korean physical therapy first began by missionaries dispatched from other countries like America and Canada with Korean War, which occurred in 1950. After the War, Korean Physical Therapy is devel˗ oped very fast. Korean Physical Therapy Association was founded in October 1, 1965 and many physical therapist were discharged. Korea became a full member of World Confederation of Physical Therapy(WCPT) in 1974, and held the 2nd Asia Pacific Confederation of Physical Therapy assembly in 1984 and WCPT assembly in 2005. Today, in 2010, licensed physical therapists are about 35,000 and there are physical therapy departments in 74 universities, and 17 uni˗ versities have master's or doctor's degree courses. And there are many academic journals(more than 10) related to physical therapy that are published. Many Korean physical therapists are working at various countries like America or Australia, and are acknowledged with excellent treatment technology and academic studies. This thesis aims to shed new light to the history and educational system reorganization of Korean phys˗ ical therapy and introduce it to the world, and establish the historical foundation to develop Korean physical therapy into the international level.

The aim of the study was to evaluate the effectiveness of exercise therapy on physical function of patients with anklyosing spondylitis (AS) through the systemic review and meta-analysis. The 54 studies were identified from computerized search of published researches on PubMed, Embase, CINAHL, PEDro, KISS, KERIS database until February, 2008 and review of reference lists. The main search terms were the combination "ankylosing spondylitis", "exercise", "spondyloarthropathy and exercise", "ankylosing spondylitis and physical therapy". The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention, method of intervention, intervention period and the point of outcome measured. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The result was as follows: The 10 trials were eligible for inclusion criteria, then the systematic review and meta-analysis was assessed on effectiveness of exercise therapy. The meta-analysis of 10 studies based on the random effect model showed that the exercise therapy was beneficial in treating the diseases (effect size .55; 95% confidence interval -.3.75~.61). The findings suggest that the exercise therapy would be appropriate to manage the physical function of AS with evidence based on Meta-analysis. Therefore, the exercise therapy supervised by physical therapist should be recognized as the essential approach to manage the AS and necessarily recommended to improve physical function.

The objective of this study was to discover the effects of the short-term home visiting physical therapy program involving patients with some chronic brain disorders at Gimhae City, Kyongnam. Recovery of activities of daily living (ADL) is a very important factor of rehabilitative procedures, and Functional Independence Measure (FIM) is a useful standard of evaluation for it. The FIM is widely used in brain disorder research because it measures real functional activities of daily living. We applied the physical therapy exercise program twice per week (10~15 times repeatedly); a warm-up and cool down exercise performed every ten minutes by active & active-assistive ROM and stretching exercises. Main exercises were composed of getting up & laying down in bed, standing training, walking exercise in the room, and window or wall sliding exercise using affected upper limbs for a total duration of 30 minutes. We collected the data from 20 patients with chronic brain disorders at his/her home and analyzed by means of SPSS/PC+ program (Ver. 10.0). After the six week long physical therapy exercise program, the average was 56.10±22.59 point compared with initial 50.55±19.12 point by FIM, improved functional ADL ability about 5.55 point, and these changed scores were statistically significant (p=.000). We also studied another factor regarding patient's satisfaction. The majority of subjects (10 people) rated the program with the maximum score of ten points (50.0%), and three people rated it a seven point program (15.0%), the other two subjects gave a rating of nine and eight points (10.0%). Because the program was effective at improving the physical ADL ability and satisfaction of each subject, we suggest continual development and implementation of a home visiting physical therapy program. Further study should involve a longer period of observation with a larger population that is involved in an individually designed home physical therapy program.

The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI≤74 and MBI≥75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI≤74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI≥75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.

Patient education is one of the most important roles of a physical therapist. Physical therapists have to teach and provide information about illness, instruct for home exercise, and give advice relating to correct posture and daily activities et al. For an efficient education some strategies are required. The purpose of this article is to review general learning methods, to introduce elements that influence the procedure of patient education and learning, and to plan an education strategy.

It is not common in rehabilitation situation to encounter patients exhibiting paralysis or other disabilities which have no apparent organic basis. Even without organic causes for their signs and symptoms these patients often require comprehensive treatment and management. Patients with conversion disorder often pose particular difficulties because of diagnostic confusion and the lack of therapeutic strategies for rehabilitation management. We feel that systematic functional rehabilitation is helpful in resolving symptom and recovering normal function in the patient suffering from conversion disorder since it provides motivation and reduces reinforcements which contribute to sustained disabled state. This report describes the patient with hysterical motor paralysis who is successfully treated with structured physical therapy. The objectives of this report are to provide therapeutic guidelines for physical therapy and to emphasize the role of physical therapist in the assessment and treatment of hysterical paralysis.

This study analyzes the factors involving clinical practice which have an influence on the satisfaction of students majoring in physical therapy at colleges or universities located in the Pusan and Kyungnam area. We investigated using a self-reporting method 305 students receiving a grade point average between 2.0 and 4.0 and who had finished their clinical practice. We also investigated the characteristics of clinical settings which make up the clinical practice, the general characteristics of the students involved and the characteristics of a clinical teaching method performed by physical therapists versus a teaching method by a professor of a university. The number of students divided according to educational background are as follows: 149 people (48.9% of the total group) were 4 year students, 156 people were 3 year students (51.1% of the total group). Sixty-nine students' or 22.6% of the group were men while women consisted of 236 persons or 77.4% of the group. Four year students had a longer clinical practice period than that of the 3 year students (p<.05). An average satisfaction score of students with their clinical practice was 3.84. The satisfaction scores showed no significant difference between genders, educational backgrounds, and grades. (p>.05). There were no significant differences in the satisfaction score of students with their clinical practice was 3.84. The satisfaction scores showed no significant difference between genders, educational backgrounds, and grades. (p>.05). There were no significant differences in the satisfaction scores regarding the student management system among varying gender or educational backgrounds between the 3 year and 4 year programs. The average satisfaction score with the environment of the physical therapy room was 3.35. And there were no significant differences in the physical therapy room satisfaction score based on sex or educational system (p>.05). The most influential factor of determining clinical practice satisfaction was a student management system of the clinical practice (p<.01). The next most influential factors were the clinical practice period (p<.05), size of facilities (p<.01) and relationship with physical therapists (p<.01) (=.554).

Objective : This paper presents an empirical study on the bias toward the disabled by the students studying occupational therapy, who will make an expert group to take care of them in the future. It was investigated how much sense of distance the students had according to the physical characteristics of the disabled. Method : Total 128 students majoring in occupational therapy were asked to fill out a self-administered questionnaire. The physical characteristics of the disabled and the sense of distance toward the disabled were measured as follows: The visible physical characteristics of the disabled were restricted to the disorders of external physical functions based on the Article 29 ‘Classification of the Disabled’ of the Disabled Welfare Act. The functional characteristics of the disabled were measured by using the FIM (Functional Independence Measure) method. Meanwhile, Westie (1952)’s inventory of the sense of distance was adopted for the inventory for the sense of distance toward the disabled in the study. Results : The subjects showed the biggest sense of distance toward the disabled in the order of the disabled with encephalopathy, physical handicap, language disorder, visual disturbances and acoustic disturbances. As for the functional characteristics, the sense of distance was the greatest in the order of the completely dependent disabled, partially dependent disabled, and completely independent disabled. The average sense of the distance was compared in terms of the subjects’ school and year, and the results revealed there were statistically significant differences in all the areas except for the sense of distance toward the completely dependent disabled. Conclusions : The sample needs to be expanded in number, and random sampling is required to secure diverse social and cultural backgrounds. In addition, the causality verification should be done in order to understand the nature of sense of distance in a study on it according to the physical characteristics of the disabled. Finally, an evaluation tool needs to be developed that can be used to measure the sense of distance toward the disabled.

The purposes of this study were to investigate the patient satisfaction with physical therapy services and find the related factors to patient satisfaction. In this study, three hospitals were selected at large, middle, small city. Ninety subjects (53 males, 37 females) who had received physical therapy service were participated in this survey. Survey data were collected by a written questionnaire. The patient satisfaction scale had a good reliability (Cronbachs alpha=.9134). The collected data were analyzed by t-test, ANOVA, and Kruskal-Wallis. The scores of patient satisfaction with physical therapy services at large, middle, and small city were 79.67, 76.23, and 86.33 respectively. The score of patient satisfaction at small city was significantly higher than middle and large city (p<.01). There was no significant difference in patient satisfaction with physical therapy services according to gender, age, education years, occupation, marital status, religion and average monthly income. Further studies are needed to identify which specific factors are related to patient satisfaction with physical services. This information will be useful in improving the patient satisfaction.

This paper offers an approach to physical therapy and rehabilitation procedure for the temporomandibular joint dysfunction (TMD). Forms of physical therapy are used in the treatment of chronic musculoskeletal pain conditions that include TMD joint disorders. However, there still remains a void in the study as to the various rehabilitative protocols used on those patients with TMD. Recent evidence in clinical trials show that physical therapy is helpful for patients with TMD. Exercise programs designed to improve physical fitness had beneficial effects on TMD pain and dysfunction. This study establishes treatment procedures of physical therapy and provides a method of evaluation for patients with TMD disorders.

Developmental dysplasia or dislocation of the hip is the most pronounced form of a condition in which the femoral heads tends progressively to leave the acetabulum. In the young child the variability of findings and course suggest a spectrum of conditions in which there are a number of common features: restriction of movement, particularly of abduction in flexion; shortening; and abnormal radiology, including a sloping or dysplastic acetabulum and delay in the appearance of the upper femoral epiphysis. It is vital to make the diagnosis of a congenital dislocation as soon after birth as possible. Conservative treatment with an abduction brace before the child run begins to walk is completely adequate, but after the age of 4 even surgical repositioning is difficult and after the age of 7 it is almost impossible. The aim of the study was to gain insight into the value of physical therapy of developmental dysplasia or dislocation after operation.

The pain is common among individuals with physical disabilities. It can interfere with therapy since patients with pain can become uncooperative and reluctant to move. This paper reviews the natural physiological mechanisms that can reduce pain perception, and considers physiological mechanisms which contribute to clinical pain by describing how the pain system changes its sensitivity depending upon the body's needs. The peripheral and central mechanisms contributing to sensitised nociceptive system are described with reference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous 'on-going'-projected and referred pain. It is suggested that in some chronic pain the nociceptive system maintains a state of sensitivity despite the absence of on-going tissue damage and under such circumstances the nociceptive system itself may have become dysfunctional. Such situations are often initiated by damage to nervous tissue which results in changes in the activity and organization of neuronal circuits within the central nervous system. The ability of the nociceptive system to operate in a suppressed state is also discussed with reference to pain modulation. The physical therapist can help facilitate the activation of these mechanisms through a combination of noninvasive modalities, functional activities, and the therapeutic use of self.

Conversion disorder is defined as a specific and enduring sensorimotor dysfunction that contradicts known neurological or musculoskeletal pathology or physical findings. The patient with conversion symptoms unconsciously adopts these symptoms to convert their psychological stress to a physical phenomenon. Conversion disorder often involves the mimicry of organic symptoms similar to those experienced by a relative or an acquaintance. Because conversion symptoms are produced by psychological stress, specific treatment strategy and reinforcement program are needed for treatment. Treatment comprises avoiding unnecessary medical tests and removing symptoms by using graded exercises given by physical therapists. Clinical therapists must maintain a continuous and detailed follow-up to completely recover from conversion symptoms. The goal of treatment is to emphasize health rather than disease, to resolve physical symptoms, and to prevent recurrence. This study looks into the case reports of 4 patients diagnosed with conversion disorder.

Physical therapists use assumptions about motor control in every aspect of their work in treating stroke patients. An understanding of the recovery process after stroke, some neural mechanism of recovery and therapeutic model is critical factor for physical therapist to evaluate and obtain a higher final stage of recovery. The purpose of this article was to review the recovery process after stroke, some neural mechanism of recovery, the role of rehabilitation in the process of recovery, therapeutic model and its limitation. This article will help understanding of recovery process. evaluation, and treatment of the stroke patients. Each therapeutic method consists of a different set of assumptions and they are not completely independent of one another. Therefore specializing in any techniques of physical therapy will not be enough to treat stroke, so we are in need of integrated approach and objective measurement instrument to adequately evaluate and treat stroke patients.