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원종임(Jong-im Won) 한국전문물리치료학회 2020 한국전문물리치료학회지 Vol.27 No.1
Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients’ high motivation and committed participation. Patients’ motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients’ participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients’ level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients’ participation at early intervention were important determinants of functional outcome. These findings suggest that patients’ participation should be encouraged in order to achieve successful stroke recovery.
원종임(Jong-im Won),이미영(Mi-young Lee) 한국전문물리치료학회 2010 한국전문물리치료학회지 Vol.17 No.3
Mortality rates from stroke have been declining. Because of this, more people are living with residual disability. Rehabilitation plays an important role in functional recovery of stroke survivors. In stroke rehabilitation, early prediction of the obtainable level of functional recovery is desirable to deliver efficient care, set realistic goals, and provide appropriate discharge planning. The purpose of this study was to identify predictors of functional outcome after stroke using inpatient rehabilitation as measured by Functional Independence Measure (FIM) total scores. Correlation and stepwise multiple regression analyses were performed on data collected retrospectively from two-hundred thirty-five patients. More than moderate correlation was found between FIM total scores at the time of hospital admission and FIM total scores at the time of discharge from the hospital. Significant predictors of FIM at the time of discharge were FIM total scores at the time of hospital admission, age, and onset-admission interval. The equation was as follows: expected discharge FIM total score = 76.12+.62x(admission FIM total score)-.38x(age)-.15x(on set-admission interval). These findings suggest that FIM total scores at the time of hospital admission, age, and onset-admission interval are important determinants of functional outcome.
비급성기 요통환자에 있어 장애를 예측하는 요인으로서의 통증관련 두려움과 우울
원종임(Jong-im Won) 한국전문물리치료학회 2009 한국전문물리치료학회지 Vol.16 No.3
Psychsocial factors appear to play an important role in the maintenance and development of chronic disability from low back pain. Fear of pain may be more disabling than the pain itself in patients with nonacute low back pain. The purpose of this study was to identify the contribution of gender, age, depression and pain-related fear to pain intensity and disability in nonacute low back pain patients. This was a cross-sectional survey study of eighty four patients who had low back pain for at least 4 weeks. More than moderate correlations were found between pain intensity, disability, fear-avoidance beliefs and depression. Regression analyses revealed that disability ratings and fear-avoidance beliefs for work activities significantly contributed to the prediction of pain intensity, even when controlling for age, gender and pain duration. Also, fear-avoidance beliefs for physical activity, pain intensity, age and depression, significantly contributed to the prediction of disability, even when controlling for gender and pain duration. These findings suggest that disability scores and fear-avoidance beliefs for work activities are important determinants of pain intensity. They also suggest that fear-avoidance beliefs for physical activity, pain intensity, age and depression are important determinants of disability.
만성 뇌졸중 환자의 보행속도와 보행 비대칭에 영향을 미치는 무릎근력과 발목 관절가동범위
원종임 ( Jong Im Won ),안창만 ( Chang Man An ) 한국전문물리치료학회 2015 한국전문물리치료학회지 Vol.22 No.2
The common features of walking in patients with stroke include decreased gait velocity and increased asymmetrical gait pattern. The purpose of this study was to identify important factors related to impairments in gait velocity and asymmetry in chronic stroke patients. The subjects were 30 independently ambulating subjects with chronic stroke. The subjects’ impairments were examined, including the isokinetic peak torque of knee extensors, knee flexors, ankle plantarflexors, and ankle dorsiflexors. Passive and active ranges of motion (ROM) of the ankle joint, ankle plantarflexor spasticity, joint position senses of the knee and ankle joint, and balance were examined together. In addition, gait velocity and temporal and spatial asymmetry were evaluated with subjects walking at their comfortable speed. Pearson correlations and multiple regressions were used to measure the relationships between impairments and gait speed and impairments and asymmetry. Regression analyses revealed that ankle passive ROM and peak torque of knee flexors were important factors for gait velocity (R2=.41), while ankle passive ROM was the most important determinant for temporal asymmetry (R2=.35). In addition, knee extensor peak torque was the most significant factor for gait spatial asymmetry (R2=.17). Limitation in ankle passive ROM and weakness of the knee flexor were major contributors to slow gait velocity. Moreover, limited passive ROM in the ankle influenced the level of temporal gait asymmetry in chronic stroke patients. Our findings suggest that stroke rehabilitation programs aiming to improve gait velocity and temporal asymmetry should include stretching exercise for the ankle joint.
요통기간에 따른 손상, 장애, 심리적 요인들의 상관성 비교
원종임 ( Jong Im Won ) 한국전문물리치료학회 2011 한국전문물리치료학회지 Vol.18 No.3
The purpose of this study was to investigate the correlations between pain intensity, physical impair-ments, dlisability, and psychological factors according to the dlifference in duration of low back pain. This study was a cross-sectional survey of 102 participants with low back pain, divided into two groups equal in number The first group consisted of patients with acute and subacute low back pain, while the second group consisted of patients suffering from chronic low back pain. The results showed that gender, age, pain intensity, physical impairment, disability and Fear-Avoidance Beliefs (FABs) for work activities were not significantly different between two groups. FABs for physical activities of the first group were sigpain intensity, physical impairment, and disability in the first group. Less than moderate correlations were found between pain intensity, physical impairment, disability, FABs, and depression in the second group. These findings suggest that we must consider psychological factors in the treatment of patients with chronic low back pain. Regression analyses revealed that pain intensity and FABs for work activities significantly contributed to the prediction of disability in the first group. Also, pain intensity and FABs for physical activities significantly contributed to the prediction of disability in the second group. Pain in-tensity was most important predictor of disability in two groups.