하수관거시스템 개량 우선순위 결정 모형

이정호,박무종,김중훈 한국방재학회 2008 한국방재학회논문집 Vol.08 No.06

The main objective of sewer rehabilitation is to improve its function while eliminating inflow/infiltration (I/I). If we can identify the amount of I/I for an individual pipe, it is possible to estimate the I/Is of sub-areas clearly. However, in real, the amount of I/I for an individual pipe is almost impossible to be obtained due to the limitation of cost and time. In this study, I/I occurrence of each sewer pipe is estimated using AHP (Analytic Hierarch Process) and RPDM (Rehabilitation Priority Decision Model for sewer system) was developed using the estimated I/I of each pipe to perform the efficient sewer rehabilitation. Based on the determined amount of I/I for an individual pipe, the RPDM determines the optimal rehabilitation priority (ORP) using a genetic algorithm for sub-areas in term of minimizing the amount of I/I occurring while the rehabilitation process is performed. The benefit obtained by implementing the ORP for rehabilitation of sub-areas is estimated by the only waste water treatment cost (WWTC) of I/I which occurs during the sewer rehabilitation period. The results of the ORP were compared with those of a numerical weighting method (NWM) which is the decision method for the rehabilitation priority in the general sewer rehabilitation practices and the worst order which are other methods to determine the rehabilitation order of sub-areas in field. The ORP reduced the WWTC by 22% compared to the NWM and by 40% compared to the worst order. 하수관거시스템 개량의 주된 목적은 불명수(Inflow/Infiltration, I/I)를 제거함으로써 그 성능을 향상시키는데 있다. 이때 전체 하수관거시스템 내에서 개개 관거별 I/I 발생량을 정량화할 수 있다면, 전체 하수관거시스템 내에서 소유역별 해당 정보의 추출이 보다 명확해질 수 있다. 그러나 실제 현장에서는 예산 및 시간의 제약 때문에 개개 관거의 I/I 발생 정보의 획득은 거의 불가능하다. 본 연구에서는 하수 관거별 I/I 발생량을 AHP(Analytic Hierarch Process)를 이용하여 정량화하였으며, 산정된 관거별 I/I 발생량을 이용하여 효율적인 하수과거 개량 사업 시행을 위한 개량 우선순위 결정 모형(Rehabiliation Priority Decision Model for sewer system, RPDM)을 개발하였다. 개개 관거별 I/I 발생량 산정 결과에 기반하여 RPDM은 개량이 시행되는 기간 동안 발생하는 I/I 발생량을 최소화하는 소유역별 최적 개량 우선순위(Optimal Rehabilitation Priority, ORP)를 유전자 알고리즘을 이용하여 결정한다. 이때 최적 개량 우선순위에 따른 소유역별 개량 시행 시 발생하는 이익은 개량 기간 동안 하수처리장으로 들어가는 I/I의 하수처리비용(Waste Water Treatment Cost, WWTC)에 대한 절감을 의미한다. 본 연구에서는 개발된 RPDM에 의한 최적 개량 우선순위의 결과는 일반적인 하수관거개량사업의 우선순위 결정 방법인 점수가중평가법(Numerical Weighting Method, NWM)과 최악의 개량순서에 따른 결과들과 비교되었으며, 개량 기간 동안의 I/I 처리비용이 점수가중평가법에 비하여 22%, 최악의 개량순서에 비하여 40% 감소하는 것으로 나타났다.

한국의 재활의료 전달체계

권혁철,정영일,남은우 高神大學校 保健科學硏究所 1993 보건과학연구소보 Vol.3 No.-

This study was carried out for reorientation of Rehabilitation Service Delivery System (RSDS) through reviewing reference and observing field practice. The most important results are as follows: 1. The current rehabilitation facility for handicapped persons can be classified into four categories : (a) those for physically disabled persons, (b) those for mentally disturbed persons, (c) those for visually disturbed persons, and (d) those for acoustic and speech disturbed persons. The nationwide number of rehabilitation facilities is 101 of those, 43.5% is for physically disabled persons and 32.9% is for mentally disturbed persons. 2. A small number of circulating rehabilitation centers for physically disability are being run by comprehensive rehabilitation centers since 1992. 3. The hospitals are self-supporting only 20% of their operational costs, and the rest of the operational costs comes from federal tax(40%) and local tax(40%). 4. The number of handicapped persons in Taegu and Kyungpook province is estimated to be about 50,000, but only 20 percent out of them ws registered. The rehabilitation facilities located in this area receives 69% of their operational costs from central government. This figure is higher than the national average of 64.6%. 5. Although RSDS is different from other medical delivery system, nonetheless, it should be developed as a sub-system of national health care delivery system. Its development should also be in accordance with the need of local community. Therefore we suggest the development policy for the development of RMDS must consider the following points.; First, all rehabilitation-related medical systems should be integrated unde ra single comprehensive system so that handicapped persons may easily obtain better service available. Second, rehabilitation programs based on local community should be rejuvenated. In addition to in-patient service, development of intermediate facilities and programs connecting home and society should be encouraged. Third, rehabilitation medical services should be more specialized. Also, more emphasis should be given to team approach to rehabilitation medical services. Fourth, a comprehensive rehabilitation information system should be developed so that handicapped persons may have easy access to public welfare facilities, and the central government should formulate a comprehensive long-term plan for the rehabilitation system.

중등도 족관절 외측 인대 염좌 후 재활치료

김진영,임길병,김정민,이홍재,신용일 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.4

Objective: To evaluate the effect of comprehensive rehabilitation treatment in patients with moderate lateral ankle ligament sprain. Method: We reviewed the medical records of 22 patients who had been in rehabilitation program after moderate lateral ankle ligament sprain. We measured the range of motion of ankle joint, pain intensity by visual analogue scale (VAS) score, the difference of ankle circumference between normal and affected side, and strength of dorsiflexor, plantarflexor, invertor and evertor of ankle before and after rehabilitation. Results: The range of motion, VAS score, ankle circumference, strength of dorsiflexor, invertor and evertor of the affected ankle significantly improved after rehabilitation exercise (p<0.05). Eighteen out of 22 patients returned to the sports activities successfully after systemic rehabilitation. Conclusion: Systemic and appropriate rehabilitation is inevitably necessary after acute ankle sprain for the successful return to the sports activities. Objective: To evaluate the effect of comprehensive rehabilitation treatment in patients with moderate lateral ankle ligament sprain. Method: We reviewed the medical records of 22 patients who had been in rehabilitation program after moderate lateral ankle ligament sprain. We measured the range of motion of ankle joint, pain intensity by visual analogue scale (VAS) score, the difference of ankle circumference between normal and affected side, and strength of dorsiflexor, plantarflexor, invertor and evertor of ankle before and after rehabilitation. Results: The range of motion, VAS score, ankle circumference, strength of dorsiflexor, invertor and evertor of the affected ankle significantly improved after rehabilitation exercise (p<0.05). Eighteen out of 22 patients returned to the sports activities successfully after systemic rehabilitation. Conclusion: Systemic and appropriate rehabilitation is inevitably necessary after acute ankle sprain for the successful return to the sports activities.

재활의료서비스의 이상적인 전달체계

조강희 대한의사협회 2017 대한의사협회지 Vol.60 No.11

Rehabilitation care requires an organized health care delivery system, stroke, brain injury, spinal cord injury, amputation, severe multiple musculoskeletal injury, and congenital damage to the nervous system frequently result in permanent disability or a temporary serious reduction of bodily function. These diseases or injuries require acute medical treatment at general and tertiary hospitals, but then also require a long period of intensive and comprehensive rehabilitation treatment. Currently, a 3-stage rehabilitation care delivery system, involving acute, subacute (recovery), and chronic (maintenance) rehabilitation, is being considered. Although the concepts underlying this delivery system have not yet been clearly defined, acute rehabilitation should be provided at general and tertiary hospitals for patients with permanent disabilities, an unstable medical condition, and/or a severe temporary reduction of bodily function simultaneously with or immediately after acute medical treatment. Cardiac rehabilitation, respiratory rehabilitation, pressure ulcer management, rehabilitation of severe cerebral palsy, rare diseases, and cancer, for which the cooperation of internal, surgical, and critical care staff is essential, are included in acute rehabilitation. Additionally, intensive and comprehensive inpatient subacute (recovery) rehabilitation should be provided for patients with severely impaired bodily function who are medically stable. Subsequently, chronic rehabilitation may be required for patients who need postural changes throughout the day, those who require rehabilitation treatment intended to prevent long-term complications and to ensure the maintenance of body function, those who show shortness of breath or dysphagia, and those who show little improvements of bodily function, making discharge into the home difficult. These services can be categorized as outpatient, visiting, or long-term rehabilitation services.

Stroke Rehabilitation Fact Sheet in Korea

Se Hee Jung 대한재활의학회 2022 Annals of Rehabilitation Medicine Vol.46 No.1

With rapid aging, the number of stroke survivors with disabilities in Korea is increasing even if mortality is declining. Despite coordinated efforts for quality improvement of stroke rehabilitation in Korea, the statistics of stroke rehabilitation were not well reported. This review aimed to provide contemporary and comprehensive statistics and recent changes in stroke rehabilitation in Korea. The Clinical Practice Guideline for Stroke Rehabilitation in Korea was developed in 2009 and updated in 2012 and 2016. Additionally, the representative databases for stroke rehabilitation include the Korean Brain Rehabilitation Database and the Korean Stroke Cohort for functioning and rehabilitation. These nationwide databases provided current information on stroke rehabilitation. Among Korean stroke survivors, one in three had motor impairment, one in four had cognitive impairment, one in three had speech impairment, one in four was dependent in ambulation, one in six had swallowing difficulty, and one in four was dependent in activities in daily living at 5 years after stroke. Comprehensive inpatient rehabilitation following transfer to the department of rehabilitation medicine significantly decreased stroke-related mortality and long-term disability. This review provides an improved understanding of stroke rehabilitation and guidance to implement timely, coordinated, evidence-based stroke rehabilitation services to relieve the socioeconomic burden of stroke.

국내 권역재활병원 내 어린이재활 치료부문의 평면분석 연구

이현일,이택기,조철호 한국실내디자인학회 2019 한국실내디자인학회논문집 Vol.28 No.6

Children’s rehabilitation patients should be provided with appropriate rehabilitation programs in accordance with the developmental stages, apart from adult rehabilitation treatments, and careful consideration should be given to emotional and educational aspects in connection with home and schools. As a result, children’s rehabilitation programs require a carefully planned out system of rehabilitation medical care that provides continuous medical support based on the region in which patients live. However, the current rehabilitation medical system in Korea lacks support and servies are only available in ‘national’ or ‘regional’ level rather than ‘local’ level. The regional rehabilitation hospitals, which were implemented in 2006 and first opened in 2008 under poor domestic conditions, have high expectations as regional base rehabilitation medical institutions, and within the facility, operating guidelines are set up to include the facilities sector for rehabilitation of children. However, the specific facility standards given for rehabilitation of children are almost nothing other than the 30-bed standard for each ward. As a result, the six regional rehabilitation hospitals currently in operation have different facilities and functions, and the children who need rehabilitation in the regional area are moving around between hospitals, looking for the facilities they need. Therefore, this study first summarizes the building facilities and scale standards of children’s rehabilitation facilities used by various institutions related to rehabilitation. In addition, by analyzing the architectural planes of the six regional rehabilitation hospitals and identifying the composition of each room in the children’s rehabilitation departments. The children’s rehabilitation departments of the regional rehabilitation hospitals are for children who need rehabilitation in the area. The purpose is to present architectural data to ensure proper rehabilitation. In conclusion, this study suggests each rehabilitation facilities to run all 6 types of units in order to provide appropriate services to children’s patients around the region.

국내 급성기 재활의료 공급체계

유승돈,정용설,김태우 대한의사협회 2017 대한의사협회지 Vol.60 No.11

Acute-phase rehabilitation hospitals focus on managing disabilities, reducing sequelae and symptoms, and enhancing social reintegration, to provide patients with the highest possible independence and the best quality of life. In order to achieve these goals, it is necessary to ensure the appropriate length of hospital stays based on a consideration of disease severity and patients’ potential for rehabilitation, as well as to provide multidisciplinary rehabilitation. Multidisciplinary rehabilitation has been shown to be effective in the management of complex or severe conditions. Hospitals should include rehabilitation centers (specialized rehabilitation units) for patients with complex or severe needs. Starting in acute settings, specialized rehabilitation wards provide intensive, highly specialized interventions to restore function to patients with complex rehabilitation needs. Financial resources should be allocated to rehabilitation services to implement recommendations for the delivery of medical services In Korea, the appropriate allocation of resources for rehabilitation could increase both the availability and the quality of rehabilitation services by facilitating the establishment of specialized rehabilitation units in acute settings.

Cancer Rehabilitation: Experience, Symptoms, and Needs

김용미,김대열,전민호,전재용,윤기정,이무송 대한의학회 2011 Journal of Korean medical science Vol.26 No.5

The aim of this study was to examine the experience of cancer patients undergoing rehabilitation, to identify symptoms associated with rehabilitation from cancer, and to assess the need for rehabilitation services for cancer patients. Cancer patients (n = 402)at the Asan Medical Center (Seoul, Korea) were enrolled from June to September 2008. A chart review was used to collect demographic and clinical data, including type of cancer,current treatment, time from initial diagnosis to screening, and cancer stage. Each participant provided informed consent and was then given a questionnaire that asked about experience with rehabilitation, symptoms associated with rehabilitation, and the need for different types of rehabilitation services. Clinicians recommended rehabilitation for 8.5% of patients, and 6.7% underwent rehabilitation. Among study patients, 83.8%had one or more symptoms associated with rehabilitation, and 71.6% of patients with symptoms wanted rehabilitation management. The need for rehabilitation was associated with the presence of metastasis, advanced cancer stage, time to diagnosis, and type of current treatment. Our results provide specific information about particular functional symptoms and the rehabilitative needs of subgroups of cancer patients. It is suggested to develope and implement rehabilitation programs for cancer patients.

고등학교 야구투수의 12주간 견관절 내회전 결손 재활트레이닝이 운동수행능력에 미치는 영향

윤효원,이현정,조기정 세계태권도문화학회 2017 세계태권도문화학회지 Vol.8 No.4

The purpose of this study was to investigate the effect of glenohumeral internal rotation deficit rehabilitation training on exercise performance & body shape displacement in high-school baseball pitchers. Research subjects were composed of 27 high-school baseball pitchers in a rehabilitation training center and a hospital in a metropolitan area who have glenohumeral internal rotation deficit (GIRD) and are under rehabilitation or a control group without rehabilitation. They were divided into three types of groups: private trainer for impairment prevention (PIP) rehabilitation training group (n=9), hospital rehabilitation training group (n=8), and general(parallel to exercise without rehabilitation) group (n=10). Observation variables were pre (initial) and post (12weeks) tests (independent variables). The exercise performance tests conducted were isokinetic strength (peak torque, ratio), ROM & GIRD, back strength, grip strength. The body shape displacement test used was frontal plane, sagittal plane, on leg standing (dependent variables). Two-way mixed ANOVA with repeated measure and paired t-test were used for analyzing the data. Results found from such a comparative analysis study were as follows; First(exercise performance), The glenohumeral internal rotation throwing shoulder and glenohumeral external rotation throwing shoulder & non-throwing shoulder (PIP rehabilitation training group) along with the glenohumeral internal rotation non-throwing shoulder (hospital rehabilitation training group) showed a significant difference by the pre-post tests in the isokinetic peak torque (60°/sec). A significant interaction effect appeared in the isokinetic peak torque (60°/sec) of glenohumeral internal rotation throwing shoulder & non-throwing shoulder and glenohumeral external rotation throwing shoulder & non-throwing shoulder. Glenohumeral rotation throwing shoulder & non-throwing shoulder didn't show a significant difference among the group in isokinetic strength ratio (60°/sec). The PIP rehabilitation training group showed a significant difference by the pre-post tests in the isokinetic strength ratio (60°/sec). A significant interaction effect in isokinetic strength ratio (60°/sec)with glenohumeral rotation throwing shoulder & non-throwing shoulder. Glenohumeral internal rotation throwing shoulder and non-throwing shoulder and glenohumeral external rotation throwing shoulder & non-throwing shoulder didn't show a significant difference among the groups in ROM & GIRD. Glenohumeral internal rotation throwing shoulder(PIP rehabilitation training group & hospital rehabilitation training group) showed a significant difference by the pre-post tests in ROM & GIRD. An interaction effect appeared in the ROM & GIRD with glenohumeral internal rotation throwing shoulder. Back strength and grip strength didn't show a significant difference among the groups, while back strength showed a significant difference by the pre-post tests in the PIP rehabilitation training group & hospital rehabilitation training group. Grip strength showed a significant difference by the pre-post tests in the PIP rehabilitation training group. A significant interaction effect appeared in back strength and grip strength.

The Rehabilitation-Related Effects on the Fear, Pain, and Disability of Patients With Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis

Haiyan Cheng,Jing Liu,Lin Shi,Xiuxiu Hei 대한척추신경외과학회 2023 Neurospine Vol.20 No.1

Objective: The lumbar fusion is an important surgery for the orthopedic diseases. The rehabilitation might improve the outcome of patients with lumbar fusion surgery. The rehabilitation-related effects can be revealed by a systemic review and meta-analysis of randomized clinical trials (RCTs). The purpose of this study is to clarify the rehabilitation effects in the patients with lumbar fusion surgery. Methods: We performed a systematic search and a meta-analysis for the RCT of rehabilitation treatment on the patients with lumbar fusion surgery. The comparison between rehabilitation treatment (including psychological rehabilitation, exercise, and multimodal rehabilitation) and typical treatment was performed to find if the rehabilitation treatment can improve the outcome after the lumbar fusion surgery. Fifteen studies of lumbar fusion patients under rehabilitation treatment and typical treatment were enrolled in a variety of rehabilitation modalities. The focused outcome was the rehabilitation-related effects on the fear, disability, and pain of patients after the lumbar fusion surgery. Results: Five hundred twenty-eight rehabilitation subjects and 498 controls were enrolled. The psychological-related rehabilitation showed a significant decrease in pain-related fear when compared to usual treatment. The multimodal rehabilitation can improve the disability outcome to a greater extent when compared to usual treatment. The multimodal rehabilitation seemed to have a more significantly positive effect to decrease disability after lumbar fusion surgery. In addition, the exercise and multimodal rehabilitation can relieve the pain after lumbar fusion surgery. The exercise rehabilitation seemed to have a more significantly positive effect to relieve pain after lumbar fusion surgery. Conclusion: The rehabilitation might relieve the pain-related fear, disability, and pain after lumbar fusion surgery.