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이충휘,원종혁,옥준영 한국전문물리치료학회 2000 한국전문물리치료학회지 Vol.7 No.1
As in house care is develops and becomes part of the health care delivery system in Korea, it is necessary to quantify the viewpoints of in-patients and outpatients. The purposes of this study are to analyze the utilization of house visits by physical therapist and to investigate the viewpoint of in- and out-patients who had rehabilitation treatment at 3 general hospitals in Wonju, Korea. Two hundred and fifty-eight questionnaires were analyzed and the major findings are as follows: 1. Sixty-five point seven percentage of respondents showed their willingness to utilize house visits by physical therapist if an in house physical therapy program were established. 2. The questionnaire used a Likert-type scale to ask the respondents their viewpoints on in house physical therapy services. Most respondents showed a positive attitude, answering 'I agree'. The findings show that house visits by physical therapists should be introduced as an integral system for the delivery of health care in Korea.
발달지연 아동 및 뇌성마비 아동의 평가실태와 물리치료사들의 평가에 대한 인식도 조사
박혜정,이충휘,조상현,권혁철 한국전문물리치료학회 2000 한국전문물리치료학회지 Vol.7 No.1
The purpose of this study were to research the current stat of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists's knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained form August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. the current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%) 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDST-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation. 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate rage and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used with a large number of therapists depending on subjective description. Possible reasons for the low rate of objective assessment tool use: 1) Poor clinical environment: Too many clients and limited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based(3 year) or university-based(4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.
이규완,이충휘,조상현,박정미 한국전문물리치료학회 2001 한국전문물리치료학회지 Vol.8 No.1
The purposes of this study were to investigate the therapeutic effects of an early exercise program after mastectomy and to provide the early exercise program protocol for patients who had undergone mastectomy. The subjects were seventy women who were diagnosed with breast cancer. They were randomly assigned either to a experimental group (n=35) that received early postoperative exercise program or to a control group (n=35) that received only education by nurses. Data were obtained for each patient from goniometric measurements of shoulder flexion, abduction, external rotation, 10 elements of functional performance, and subjective pain evaluation using visual analogue scale (VAS). All variables were measured preoperatively, three days postoperatively, and one month postoperatively. Data were compared by groups using independent t-test and Mann-Whitey U test for parametric or non-parametric data, respectively. There were no significant differences between the groups for all variables preoperatively and at three days postoperatively. But there were significant differences at one month postoperatively. The experimental group showed a statisti-cally significant increases in shoulder flexion, abduction, and external rotation and in the pain VAS at one month Postoperatively (p〈,05). Also, at one month prostoperatively, the experimental group had less difficulty with three elements of functional performance-doing up a 'back' zippered article of clothing, reaching the ipsilateral scaula, and contralateral scapula with the fingers on the operated side- than the control group (p〈.05). The results of this study suggest that after mastectomy, the early exercise program conducted by a well-trained physical therapist can make a significant contribution to the return of more normal shoulder function and activities of daily living and to an increased quality of life.
골반 자세 변화에 따른 일어서기의 기능적 연결분석의 접근
최종덕,권오윤,이충휘,김종만,김진경 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.2
The purpose of this study was to analyze the effects of three different pelvic tilts on a sit-to-stand (STS) and to suggest a new assessment approach based on biomechanical analysis. The three difrent pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To determine the onset time of muscle contraction surface electrodes were applied to the rectus femoris muscle (RF), vastus lateralis muscle (VL), biceps femoris muscle (BF), tibialis anterior muscle (TA), gastrocnemius muscle (GCM), and soleus muscle (SOL). The ICC was used for functional linkage analysis. The findings of this study were as follows. First, significant differences were found in kinematic variables and in muscle activation pattern among the three activities. Second, the results of functional integrated analysis revealed that recruited muscle activation patterns changed when the thigh-off was viewed as a reference point. Third, there were independent functional units between the thigh-off and the VL and between the thigh-off and the RF in the functional linkage analysis. The VL and RF acted as prime mover muscles, and more postural adjustment muscle recruitment was required as the demand of postural muscle control increased (PPT STS, APT STS, and CPT STS in order). In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity. APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated. However, excessive APT would change the muscle activation patterns of BF and SOL and require additional postural muscle control to cause abnormal control patterns.