OBJECTIVES: In order to obtain information useful in setting up occupational rehabilitation programs, an evaluation was conducted to determine predictive factors of workers' return to work after an occupational injury. METHODS: 13, 903 records of registered occupationally injured cases identified to have received disability compensation in 1998 were collected from the 36 branch of Korean Labor Welfare Corporation(KLWC). Through simple systematic sampling, a total of 3, 658 cases were selected as final subjects. Status of return to work, general characteristics, workplace characteristics, disability characteristics and disability outcome characteristics were collected from the KLWC and National Health Insurance Corporation records(NHIC). For statistical analyses, chi-square test and stepwise multiple logistic regression analysis were applied using the SAS software package program. RESULTS: Negatively affecting significant predictive factors for return to work were included the female gender, age of 50 years or older, 6 month or less of work duration, 1 or less family dependents, workplace with 200 or less employees, electric, gas, waterwork companies, foot injuries compared to finger injuries, fall from elevation, high degree of disability claims(1~4 grade), and period of medical care more than 181 days. CONCLUSIONS: The results suggest that the poor rate return to work in occupationally injured workers' is particularly affected by female gender, older-aged employees, and workers employed by electric, gas, waterwork companies. Also, it was more difficult to return to work for workers who received injuries from a fall from elevation and who had longer period of medical care(more than 181days). It is strongly recommended that more efficient and systematic occupational rehabilitation programs be set up, taking into consideration the above mentioned factors.
Compensation and Redress ; Female ; Finger Injuries ; Foot Injuries ; Humans ; Logistic Models ; National Health Programs ; Occupational Injuries ; Occupations ; Rehabilitation ; Return to Work*

OBJECTIVE: To evaluate the effect of Korean Computer-Assisted Cognitive Rehabilitation Program (CogRehabK ) on cognitive function of the patients with brain injury. METHOD: Fifty subjects with brain injury were enrolled and classified into two groups, experimental (n=25) and control group (n=25). Control group received conventional rehabilitation therapy including physical and occupational therapy. Experimental group received additional computer-assisted cognitive training using CogRehabK software consisted of 10 level-completing programs, 3 times per week, 30 minutes per session, for 4 to 6 weeks. All patients were assessed their cognitive functions using Seoul Computerized Neuropsychological Test (SCNT , Maxmedica, 2001), minimental status examination (MMSE), digit span, and Wechslermemory scale before and after treatment. Functional independence measure and geriatric depression scale were also applied for evaluation of functional and mood status. RESULTS: Before the treatment, two groups showed no difference in their cognitive functions. After 4 to 6 weeks of treatment, the experimental group showed significantly higher performance in forward digit span, forward visual span, auditory continuous performance test, and visual continuous performance test in CNT and MMSE than control group (p<0.05). CONCLUSION: We conclude that the CogRehabK may be useful as an additional tool for the cognitive rehabilitation in patients with brain injury.
Brain Injuries* ; Brain* ; Depression ; Humans ; Neuropsychological Tests ; Occupational Therapy ; Rehabilitation* ; Seoul

OBJECTIVE: To evaluate the effect of computer-assisted cognitive rehabilitation program on cognitive function of the patients with brain injury. METHOD: Twenty seven subjects with brain injury (23males, 4 females) were enrolled and classified into two groups, experimental and control group. There was no significant difference between two groups in age and postonset duration. Control group received conventional rehabiliation therapy including physical and occupational therapy. Experimental group received additional computer-assisted cognitive training using PSS CogRehab software (USA, 1995), 3 times per a week, 30 minutes per session, for 4 weeks. The PSS CogRehab software consisted of foundation, memory, visual spatial and problem solving categories with 45 indivisualized training programs. These 45 programs are arranged according to the degree of difficulty. All patients were assessed their cognitive function using Computerized Neuropsychological Test (Mirae engineering, 1999) before treatment and at 1 month after treatment. RESULTS: Before the treatment, two groups showed no difference in their cognitive function. After 1 month treatment, the experimental group showed significantly higher performance in forward digit span, forward visual span, auditory continuous performance test and visual controlled continuous performance test than control group (p<0.05). CONCLUSION: Computer-assisted cognitive training would be useful as a additional tool of cognitive rehabilitation in patients with brain injury.
Brain Injuries* ; Brain* ; Education ; Humans ; Memory ; Neuropsychological Tests ; Occupational Therapy ; Problem Solving ; Rehabilitation*

OBJECTIVES: The most common occupational disease that is compensated by Industrial Accident Compensation Insurance (IACI) in Korea is musculoskeletal disease (MSD). Although complaints about the workers' compensation system have been raised by injured workers with MSD, studies that examine workers' experiences with the Korean system are rare. This paper is a qualitative study designed to examine injured workers' experiences with the workers' compensation system in Korea. The aim of this study is to explore the drawbacks of the workers' compensation system and to suggest ways to improve this system. METHODS: All workers from an automobile parts factory in Anseong, GyeongGi province who were compensated for MSD by IACI from January 2003 to August 2013 were invited to participate. Among these 153 workers, 142 workers completed the study. Semi-structured open-ended interviews and questionnaires were administered by occupational physicians. The responses of 131 workers were analyzed after excluding 11 workers, 7 of whom provided incomplete answers and 4 of whom were compensated by accidental injury. Based on their age, disease, department of employment, and compensation time, 16 of these 131 workers were invited to participate in an individual in-depth interview. In-depth interviews were conducted by one of 3 occupational physicians until the interview contents were saturated. RESULTS: Injured workers with MSD reported that the workers' compensation system was intimidating. These workers suffered more emotional distress than physical illness due to the workers' compensation system. Injured workers reported that they were treated inadequately and remained isolated for most of the recuperation period. The compensation period was terminated without ample guidance or a plan for an appropriate rehabilitation process. CONCLUSIONS: Interventions to alleviate the negative experiences of injured workers, including quality control of the medical care institutions and provisions for mental and psychological care for injured workers, are needed to help injured workers return to work earlier and more healthy.
Accidents, Occupational ; Automobiles ; Compensation and Redress ; Employment ; Gyeonggi-do ; Insurance ; Korea ; Musculoskeletal Diseases ; Occupational Diseases ; Occupational Injuries ; Qualitative Research ; Quality Control ; Rehabilitation ; Return to Work ; Sick Leave* ; Workers' Compensation

Although occupational low back pain accounts for 20~40% of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and functional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. we estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson(1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of 30~45%, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.
Budgets ; Compensation and Redress ; Cost-Benefit Analysis* ; Health Care Costs ; Humans ; Low Back Pain* ; Occupational Injuries ; Pain Clinics ; Rehabilitation ; Return to Work

OBJECTIVE: To confirm the effects of combined upper limb robotic therapy (RT) as compared to conventional occupational therapy (OT) in tetraplegic spinal cord injury (SCI) patients and to suggest the optimized treatment guidelines of combined upper limb RT. METHODS: After subject recruitment and screening for eligibility, the baseline evaluation for outcome measures were performed. We evaluated the Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), the American Spinal Injury Association upper extremity motor score, grip and pinch strength, and the Spinal Cord Independence Measurement III (SCIM-III). In this study, the pre-tested participants were divided randomly into the RT and OT group. The utilized interventions included combined upper limb RT using ArmeoPower and Amadeo (RT group), or conventional OT (OT group) in addition to daily inpatient rehabilitation program. The participants underwent 40 minutes×3 sessions×5 weeks of interventions. RESULTS: A total of 30 tetraplegic SCI patients completed entire study program. After 5 weeks of intervention, both groups demonstrated increases in GRASSP-strength and SCIM-III. The manual muscle test scores of elbow flexion, elbow extension, 2-5th metacarpophalangeal extension, and SCIM-III subscores of bathing-upper, dressing-upper, and grooming as well as the GRASSP-qualitative prehension score were noted to have been significantly increased in the RT group as evaluated. The OT group showed improvements in the GRASSP-quantitative prehension score and some items in grip and pinch strength. There was no significant difference between the two groups in almost all measurements except for the SCIM-III bathing-upper subscore. CONCLUSION: Combined upper limb RT demonstrated beneficial effects on the upper limb motor function in patients with tetraplegic SCI, which were comparable with conventional OT.
Animals ; Elbow ; Grooming ; Hand Strength ; Humans ; Inpatients ; Mass Screening ; Occupational Therapy ; Outcome Assessment (Health Care) ; Pinch Strength ; Rehabilitation ; Robotics ; Spinal Cord Injuries ; Spinal Cord ; Spinal Injuries ; Upper Extremity

This study examined the association between return-to-work and impairment type. Database of the Korea Workers' Compensation and Welfare Service was used to identify disabled persons; and return-to-work information was obtained from the Korea Employment Information Services database. The study participants were 79,328 persons who received Workers' compensation and who were confirmed as disabled during 2009-2011. Logistic regression was used to analyze the association between return-to-work and impairment type, adjusted by age, sex, impairment severity, pre-injury businesses size, and pre-injury occupational category. Compared to injuries of the upper limbs, the odds ratio of return-to-work was 0.63 (95% CI, 0.60-0.65) for injuries involving the lower limbs, 0.62 (95% CI, 0.59-0.66) for the spine, 0.75 (95% CI, 0.66-0.86) for the eyes, 0.98 (95% CI, 0.77-1.25) for the oral cavity, 0.44 (95% CI, 0.37-0.53) for the ears, 1.02 (95% CI, 0.83-1.25) for the figure, 0.75 (95% CI, 0.72-0.79) for pain, and 0.36 (95% CI, 0.32-0.41) for neuropsychiatric impairment. These findings indicate that impairment type influences return-to-work rates.
Adult ; Disability Evaluation ; Disabled Persons/*rehabilitation ; Employment ; Female ; Humans ; Male ; Middle Aged ; Occupational Injuries/*rehabilitation ; Occupations ; Rehabilitation, Vocational ; Republic of Korea ; Return to Work/*statistics & numerical data ; Workers' Compensation/statistics & numerical data

OBJECTIVE: To investigate employment status after spinal cord injury (SCI) and identify personal, family, and injury characteristics those affect their employment in South Korea. METHODS: Participants were 334 community-dwelling persons 20-64 years of age who had sustained SCI for more than one year. Investigators visited each participant's home to carry out the survey. Bivariate and binary logistic regression analyses were performed to identify personal, family, and injury characteristics that influenced employment after SCI. RESULTS: Employment rate decreased significantly from 82.5% to 27.5% after SCI. Logistic regression showed that the probability of employment was higher in men than women, and in individuals older than 45 years at the time of injury than those aged 31-45 years of age. Moreover, employment was higher in individuals injured for longer than 20 years than those injured for 1-5 years and in individuals with incomplete tetraplegia than those with complete paraplegia. Employment was lower in individuals with SCI caused by industrial accidents than those injured in non-industrial accidents. CONCLUSION: Injury characteristics are the most important predictors of employment in persons with SCI. For persons with lower employment rate, individualized vocational rehabilitation and employment-support systems are required.
Accidents, Occupational ; Employment* ; Female ; Humans ; Logistic Models ; Male ; Paraplegia ; Quadriplegia ; Rehabilitation, Vocational ; Republic of Korea* ; Research Personnel ; Spinal Cord Injuries* ; Spinal Cord*

STUDY DESIGN: Pilot randomized controlled trial. PURPOSE: To compare the efficacy between virtual reality intervention (using Nintendo Wii) along with conventional occupational therapy and conventional occupational therapy alone in improving upper limb function in patients with spinal cord injury (SCI). OVERVIEW OF LITERATURE: The use of virtual reality has gained importance in the rehabilitation sector over the last few years. Nintendo Wii has the potential to encourage upper limb function while engaging in an interesting activity, which is important in long-term interventions, such as the treatment of SCI. METHODS: Overall, 22 patients with SCI participated in the study. They were randomly assigned to two groups. Group I received 30 minutes of virtual reality intervention (using Nintendo Wii) and 30 minutes of conventional therapy, whereas group II received conventional therapy only for 30 minutes. Both groups received therapy 3 days a week for 4 weeks. One hand of each patient was identified as the target hand based on the inclusion criteria. All patients were assessed at baseline, 2 weeks and 4 weeks (post-intervention), and 6 weeks (follow-up). The functional ability of the target hand was assessed using the Capabilities of Upper Extremity (CUE) questionnaire. Gross motor dexterity was assessed using the Box and Block Test (BBT). The level of independence in activities of daily living was assessed by the Spinal Cord Independence Measure-Self Report and quality of life by the World Health Organization Quality of Life-BREF. RESULTS: After 4 weeks of intervention, there was no significant difference in improved hand function between the groups. Mean scores were higher for group I than for group II, with a higher percent change (31.5% in CUE questionnaire and 51.7% in BBT) in group I. CONCLUSIONS: Virtual reality along with conventional therapy produces similar results in upper limb function as does conventional therapy alone.
Activities of Daily Living ; Cues ; Hand ; Humans ; Occupational Therapy ; Quadriplegia ; Quality of Life ; Rehabilitation ; Spinal Cord Injuries ; Spinal Cord ; Upper Extremity ; World Health Organization

PURPOSE: Complaints from spinal cord injury (SCI) patients are typically related to physical disability affecting activities of daily life. However, difficulties with voiding and defecation and/or sexual function can also be major concerns. The general population and even physicians are generally unaware of these complaints; therefore, this study focuses on surveying SCI patients regarding challenges that are faced in daily life. METHODS: A questionnaire was administered randomly and anonymously to SCI patients who visited the Korea Spinal Cord Injury Association and several rehabilitation hospitals in the Republic of Korea in 2013. All participants gave their consent prior to filling out the questionnaire. RESULTS: A total of 299 patients answered the questionnaire; the male to female ratio was 5.8:1 and common vectors for injury were motor vehicle accidents, industrial accidents, and falling down. Of the 169 patients who answered the ‘most troublesome’ and ‘wish would improve’ complaints questionnaire properly, urinary problems were most common, specifically incontinence and urinary tract infection. Among all patients, 67% were using clean intermittent catheterization, 63% were taking voiding-related medications, 83% had sexual desires, and among the 122 patients who did not have offspring, 27% had future plans for children. CONCLUSIONS: From this questionnaire, we discovered that SCI patients in the South Korea suffer not only from physical disability but also many other quality-of-life-related problems. When managing SCI patients, physicians should show greater concern and educate patients about problems related to voiding and sexual activity, rather than just physical disability.
Accidental Falls ; Accidents, Occupational ; Anonyms and Pseudonyms ; Child ; Defecation ; Female ; Humans ; Intermittent Urethral Catheterization ; Korea* ; Male ; Motor Vehicles ; Quality of Life* ; Rehabilitation ; Republic of Korea ; Sexual Behavior ; Spinal Cord Injuries* ; Spinal Cord* ; Surveys and Questionnaires ; Urinary Tract Infections ; Urination Disorders