Background: Most patients with chronic stroke have difficulty walking, and various exercise methods are used clinically to improve the disability. Among them, various methods are being applied to improve walking through torso movement. Objectives: This study was conducted to determine the effect of Maitland vertebra joint mobilization exercise and Evjenth trunk muscle stretching exercise on the walking ability of patients with hemiparesis due to chronic stroke. Design: A randomized controlled trial. Methods: In this study, 30 chronic stroke patients with hemiplegia were divided into 15 patients in the Maitland vertebra joint mobilization group (MVJMG) and 15 in the Evjenth trunk muscle stretching exercise group (ETMSEG), and the intervention was conducted for 3 weeks, 5 times a week, 30 minutes a day. After the intervention, walking ability was measured using a gait analyzer. Results: In terms of walking ability, there was a significant increase in walking rate, walking speed, and stride length following the intervention in both the MVJMG and ETMSEG groups (P<.05). When comparing the difference in walking ability between the two groups, there was no significant difference in walking rate. Conclusion: The study found that both Maitland vertebra joint mobilization and Evjenth trunk muscle stretching exercises were effective for improving walking function in chronic stroke patients. However, there was no significant difference in effectiveness between the two interventions.

현대사회에서 스트레스와 긴장감은 피할 수 없는 요인이다. 다양한 피부질환은 스트레스를 일 으키는 중요한 요인으로 언급되고 있다. 피부질환을 가진 환자들은 수면상태가 원활하지 않아 전반적으로 수면 효율이 낮다. 또한 피부질환으로 인해 심리적 스트레스 수치가 높아지고, 이와 같은 과정은 반복적으 로 발생하고 있다. 피부질환과 스트레스는 상호적으로 연관되어 있으며, psychodematology에 대한 연구가 증가하고 있다. 이에 본 연구에서는 피부질환을 저하 시킬 수 있는 호박, 작약, 타트체리 복합물을 활용하 여 피부 각질 형성 세포에서 스트레스로 인한 만성 피부질환을 개선할 수 있는 소재를 개발하고 효능을 입 증하고자 하였다. HaCaT 각질형성세포에 복합 추출물은 12.5, 25, 50, 100 μg/mL 농도 의존적으로 TNF-α, IL-1β, IL-6, MDC, TARC 발현량이 저해되었으며 특히 IL-1β의 경우, 100 μg/mL의 농도 에서 40% 이상 저해하는 우수한 효능을 확인하였다. 또한 AQP-3, HA, filaggrin의 생성량 농도 의존적으 로 유의미한 증가를 보이며 TNF-α/IFN-γ로 증가된 p-ERK, p-JNK, p-p38의 단백질 발현은 복합 추 출물의 처리로 유의하게 감소시 키는 것으로 나타났다. 이를 통하여 해당 복합 추출물은 피부질환을 치료 및 예방할 수 있는 소재로서 활용가치가 있는 것으로 판단되며, 이는 피부질환과 스트레스 간의 상호 관계 의 악영향을 낮춰 줄 것으로 판단된다.

만성췌장염은 췌장암 발생의 위험인자 중 하나로, 췌장암 감시가 주목을 받고 있다. 유전자 변이 여부에 따라 유전성 만성췌장염과 산발성 만성췌장염으로 분류할 수 있다. PRSS1 변이 유전성 만성췌장염의 경우 췌장암 발생 위험이 매우 높아 40세 이후 선별 검사 및 추적 감시가 필요하다. 그 외의 유전성 만성췌장염 및 산발성 만성췌장염에서 췌장암의 발생률은 상대적으로 낮아 선별 검사 및 추적 감시를 권고하지 않는다. 췌장암 선별검사의 방법으로 복부컴퓨터단층촬영 또는 췌장자기공명영상이 적합하다. 내시경초음파는 췌장실질의 염증, 섬유화 및 석회화로 인하여 권유하지 않는다. 산발성 만성췌장염에서도 다양한 췌장암 위험인자가 동반되는 경우 췌장암의 발생 빈도가 상당히 증가하고 만성췌장염 진단 후 5년 동안은 췌장암 발생률이 지속적으로 높아 환자의 증상 및 개별적 상황에 따른 췌장암 선별 검사 시행 및 추적 감시를 고려할 수 있다. 만성췌장염은 영양실조 발생이 높으므로 관심, 영양상태 평가 및 적극적인 영양요법이 필요하다. 필수 영양소 공급뿐만 아니라 미량영양소 공급을 놓치지 않도록 한다. 그리고 만성췌장염 환자에서 골다공증 또는 골감소증의 위험이 높음을 인지하고 이의 진단, 예방 및 치료에 관심을 둘 필요가 있다. 각 기관의 영양지원팀에 의뢰하여 적극적으로 영양요법을 시행하는 것도 도움이 되겠다.

Background: Various treatments are being tried for lumbar neuropathy. Among them, neural mobilization aims to reduce peripheral nerve sensitivity by stimulating them directly. Similarly, applying kinesiotape stimulates skin and joint receptors around the nerves, thereby affecting nerve function and movement. Objectives: To investigated the effect of low back pain on the neural mobilization and kinesiotaping. Design: Randomized controlled trial. Methods: Thirty patients with chronic low back pain were randomly allocated to three groups: the neural mobilization exercise with kinesiotaping group (NEKTG, n=10), the neural mobilization exercise group (NEG, n=10), and the kinesiotaping group (KTG, n=10). Each group performed six intervention sessions over two weeks. The results were analyzed by measuring the numeric pain rating scale (NPRS) and straight leg raise (SLR) before and after the intervention in each group. Results: NEKTG, NEG, and KTG all indicated a significant decrease in the back pain index before and after the intervention. However, there were no differences observed between the three groups. The SLR angles before the experiment were identical across the three groups. The SLR angles before and after the intervention were as follows: the SLR angle significantly increased in NEKTG. Furthermore, there was a significant increase in the SLR angle in NEKTG compared to both NEG and KTG. Conclusion: Neural mobilization combined with kinesiotaping provided better therapeutic effects regarding pain reduction and neurodynamic improvement compared to alone kinesiotaping and mobilization with chronic low back pain.

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: Ankle sprains occur frequently among humans who undertake various body movements. Diverse walking environments and dual tasks, that can affect ankle sprains, have been studied. However, there is a lack of research on inter-trial variability according to the changes in gait speed. Objects: The purpose of this study was to compare the adaptive ability of walking between the subjects with chronic ankle instability and healthy adults while performing a walking task with different walking speeds. Methods: In this study, 24 people in the chronic ankle instability group and 24 people in the healthy ankle group were selected as subjects. The length of the pre-measurement and the actual walking measurement were both set to 4.6 m. Once the subjects entered the measurement section, they changed their gait speed according to the randomly assigned speed change. Gait was measured twice and the average value was used for the analysis. Results: The coefficient of variation (CV) of cycle time in subjects with chronic ankle instability showed a significant difference in all cases except when the subjects changed their speed from preferred to slow and from slow to preferred. The CV of step length demonstrated a significant difference in all cases except for the change from slow to preferred and from preferred to fast. The cycle time and step length differential showed a significant difference only when the subjects changed the speed from slow to fast. Conclusion: The subjects with chronic ankle instability were found to have significantly reduced walking adaptability while performing inter-trial variability tasks with different gait speeds compared to healthy subjects.

Potentillae Chinensis Herba 추출물의 항산화 효능 평가를 위해 DPPH 자유라디칼 소거 활성 과 ABTS 양이온 라디칼 활성 평가를 시행하였다. 세포 실험에서 항염증 평가를 위해 호흡기 점막 상피세 포 NCI,H292와 RAW264.7 세포 대상으로 항염증 효능을 평가하였다. 그 결과, DPPH 자유라디칼 소거 활성과 ABTS 양이온 라디칼 활성 모두 농도 의존적으로 항산화 활성이 증가하는 것으로 나타났다. 세포 MTT 분석 결과, 각 농도 100 μg/ml로 처리한 경우 NCI-H292 세포의 생존율이 70% 미만으로 감소하 였고, 이후 실험은 50 μg/ml로 진행하였다. 항염증 효능 평가에서는 NO생성, TNF-α, IL-1β, PGE2가 감소하였고, COX-2도 50 μg/ml에서 유의하게 감소하였다. Potentillae Chinensis Herba 추출물과 생물 전환 추출물의 뮤신 단백질 발현은 MUC5AC 발현이 유의하게 감소하는 것으로 관찰되었다. 이상의 결과 는 Potentillae Chinensis Herba의 호흡기 점액 단백질 발현을 도와 염증을 억제하는 기능성 소재로 활용하 는데 가치가 있음을 알 수 있다.

본 연구는 일회성 발목가동성 운동프로그램이 만성적인 발목불안정성(CAI)에 나타나는 발목가 동범위와 통증 수준에 미치는 영향을 확인하는데 목적이 있다. 연구 대상자는 발목불안정성 설문지 검사에 서 좌, 우측 평균 점수가 24점 이하인 성인여성 20명을 선정 하였으며 집단은 일회성 발목 가동성 운동프 로그램 집단(Ankle mobility exercise program, AE, n=10)과 대조군(CON, n=10)으로 구분하였다. AE 처 치는 일회성 운동에 대한 반응을 확인하기 위해 좌·우측 발목을 각각 1회(20분) 실시하였으며 처치 전후 발목불안정성 검사, 통증 및 발목가동범위를 확인하였다. 먼저 AE 프로그램을 실시한 AE 집단의 통증 수 준은 사전과 비교하여 사후 유의하게 감소하는 것으로 나타났다(p<.01). 또한 AE 프로그램 처치한 AE 집 단에서 배측굴곡이 사전과 비교하여 증가하는 것으로 나타났다(p<.05). 이러한 결과를 종합해 보면 일회성 발목 가동성 운동 프로그램은 CAI에서 나타나는 발목 통증과 발목의 가동범위를 개선시켜 결과적으로 발 목 불안정성을 완화시킬 수 있는 효과적인 운동 중재 방법이라고 생각된다.

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.

Background: Pain neuroscience education (PNE) combined with exercise and mobilisation with cognitive goals presented decreases in pain and disability and an increase in spinal function compared to physiotherapy intervention in patients with chronic low back pain (CLBP). Objectives: To investigated the effect of forward head posture (FHP) with chronic neck pain on the PNE combined with cervical and thoracic mobilization. Design: A randomized controlled trial. Methods: The subjects were randomly allocated to the MDT with PNE group (MPNEG, n=15) and the PNE group (PNEG, n=15). Pain neuroscience education was provided to both groups, and MDT exercise was additionally performed in the experimental group. Training was conducted 3 times a week for 8 weeks, and the Oswestry Disability Index (ODI) and numeric rating scale (NRS) were used to measure the level of back pain dysfunction, and each was evaluated before and after the experiment. Results: Results from the study indicated that statistically significant decrease in NRS and ODI in MPNEG. In PNEG, there was statistically significant decrease in NRS. And in MPMES, there was a statistically significant decrease in ODI than in PNEG. Conclusion: The MDT combined with PNE is more effective than PNE alone as a treatment method for improving lumbar dysfunction and reducing pain in chronic low back pain.

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.

Background: ErigoPro enables acute stroke patients to carry out stable weight-bearing training with gradual verticalization. Study on the effectiveness of robotic assisted treatment equipment for chronic patients is insufficient. Objectives: This study aims to investigate the effect of dynamic vertical posture training using ErigoPro on trunk alignment and balance in chronic stroke patients. Design: Randomized controlled trial. Methods: The subjects of this study were 30 patients were randomly assigned to a study group of 15 patients and a control group of 15 patients. The study intervention was carried out for 50 minutes per day consisting of 30 minutes of general neuro-physiotherapy and 20 minutes of ErogoPro training, 3 times a week for 8 weeks. Results: The study group showed difference in trunk inclination (P<.05), kyphotic angle (P<.05), lateral deviation of the spine (P<.05), thoracic angle (P<.01), timed up and go test (P<.01), Berg balance score (P<.01). There was a significant difference between the groups in the trunk inclination (P<.05), timed up and go test (P<.01), Berg balance score (P<.05). Conclusion: It could be seen that the treatment combined with ErigoPro training for 8 weeks was effective in restoring trunk alignment and improving balance ability in chronic stroke patients.

목적 : 본 연구는 몰입형 가상현실과 비몰입형 가상현실 두 가지 형태의 가상현실 기기를 이용한 중재가 만성 뇌졸중 환자의 상지기능 향상에 미치는 효과를 알아보고자 하였다. 연구방법 : 연구 대상은 뇌졸중 발병 후 6개월 이상인 편마비 환자 3명이었다. 연구설계는 단일대상실험연 구(single-subject research design)인 AB 디자인과 교차 연구설계(alternating design)를 사용하였 다. 중재효과를 측정하기 위한 상지기능 평가는 Box and Block Test와 Fugl-Myer Assessment를 사 용하였고, 연구진행은 기초선 4회, 중재 기간 16회를 포함하여 총 20회기를 진행하였다. 연구결과는 시 각적 그래프와 2SD 구간을 설정하여 분석하였다. 결과 : 연구결과는 비몰입형과 몰입형 가상현실 중재법 모두 기초선과 비교하여 Box and Block Test, Fugl-Myer Assessment 점수가 확연히 증가하였다. 그러나 비몰입형 가상현실 중재와 몰입형 가상현 실 중재 간의 의미있는 차이는 발견할 수 없었다. 결론 : 본 연구는 몰입형 가상현실을 이용한 중재가 비몰입형 가상현실을 이용한 중재와 같이 만성 뇌졸중 대상자의 상지기능 향상에 긍정적인 효과를 줄 수 있다는 것을 확인하였다. 이러한 결과는 만성 뇌졸중 대상자들의 상지기능 향상을 목표로 하는 임상현장에서 가상현실 중재와 연구에 유용한 자료가 될 것이 라 사료된다.

Here, upon acute (96 h) and chronic (14 days) exposure, ingestion of polystyrene NPs (100 nm) and physiological, biochemical, and cholinergic modulations were analyzed in the water flea Moina macrocopa exposed to different concentrations (0.001, 0.01, 0.1, 1, 5, 10, 50, 100, and 500 μg l-1). Exposed NPs were observed in the internal organs (e.g., digestive tract and foregut) of the water flea. Chronic exposure to the relatively high concentrations resulted in significant decreases in survival, body length, and the total number of molts, whereas reproduction parameter was not affected. Significant increase in oxidative stress biomarker (malondialdehyde) and decrease in the intracellular content of endogenous antioxidant (glutathione) and enzymatic activity of antioxidant enzymes (glutathione peroxidase, glutathione reductase, catalase, superoxide dismutase, and glutathione S-transferase) were detected in response to relatively high concentrations of NPs. Transcriptional expression of the hsp70 gene was increased in response to relatively high concentrations of NPs, whereas acetylcholinesterase activity was lowered by the same concentrations of NPs. Taken together, NPs exposure would be a significant modulator on physiological and biochemical metabolism of water flea.

Purpose: This study explored illness experiences and the demands for a health-related program tailored to individuals with chronic disease at one of the Korean Seon Centers. It also utilized this information as foundational data for developing a program tailored to their needs. Methods: The study utilized focus group interviews to collect data from members of one of the Korean Seon centers who have chronic disease, regarding their illness experiences and their expectations for disease management programs. The collected data was then analyzed using the qualitative content analysis method. Results: The analysis yielded five overarching themes and 14 subthemes. These themes included opposing responses to disease diagnosis, reflections on the causes of disease, efforts toward disease recovery, obstacles to disease recovery, and the need for a customized disease management program. Conclusion: The findings highlighted the challenges the participants faced in their disease recovery process. They expressed a strong desire for a comprehensive management program that incorporates in-depth information, experience sharing, and education. Such a program would empower individuals to take control of their physical and mental well-being.

Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis. Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed. Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased. Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.

Background: Technological developments have led to the creation of a mechanical device capable of providing a representative massage as a passive treatment. The use of mechanical massage offers the distinct advantage of being user-friendly and available for use at any given time. Objectives: To investigated present the outcomes of utilizing a massage bed on the range of motion (ROM) and pressure pain threshold (PPT) in patients diagnosed with chronic low back pain. Design: ABA design of a single case study. Methods: To measure the ROM of the subject's trunk flexion, extension, lateral flexion, and rotation, a tape measure and goniometer were utilized. Furthermore, PPT was measured using an electronic pressure pain meter. Baseline A and Baseline A’ periods were conducted for 5 consecutive days without intervention. Following the baseline periods, a massage bed intervention was administered for 1 hour daily for a total of 10 days during the Intervention B period. Daily assessments were performed, and the Intervention B period was conducted after the intervention. Results: The ROM effect was confirmed in trunk lateral flexion and rotation, while the PPT was effective in both L1, right L2, left L4, and left L5. Conclusion: The results of this study confirmed that the use of a massage bed improved the ROM and PPT in patients suffering from chronic back pain. Further randomized controlled trials involving a larger sample size are necessary to validate these findings.

본 연구에서는 만성요통을 가진 여성노인의 체형 및 요부안정화를 위해 12주간 필라테스 운동 프로그램을 적용한 후 체형에 미치는 영향을 알아보고, 통증의 변화를 규명함으로써 노화를 늦추고 신체활 동 영역을 높일 수 있는 노인에게 적합한 운동 프로그램 개발에 필요한 자료를 제공하고자 하였다. 이에 3~5cm 중증도 통증범위의 만성요통을 가진 16명여성노인을 대상으로 주관적 통증척도지를 통해 실험집단 8명, 통제집단 8명을 단순무선표집(Simple Random Sampling)으로 선정하였다. 요부안정화 필라테스 운동 프로그램은 주 2회씩 총 12주간 50~60분간 실시하였으며, 1세트 종료 시 1분 휴식을 주는 방식으로 실시 하였다. 그 결과 첫째, 체형 및 통증에서는 경추 기울기에서 요부안정화 운동그룹의 경우 운동 전에 비해 감소하였으나 통제집단은 증가하였다. 둘째, 요부 통증의 결과 운동집단의 경우 운동에 비해 감소하였으나 통제집단은 증가하였다. 결론적으로 요부안정화 필라테스 운동은 만성요통을 가진 여성노인에게 있어서 통 증을 감소시킬 수 있는 프로그램으로 적용될 수 있으며, 체형을 개선시키는데 도움을 줄 수 있는 것으로 확인되었다.