PURPOSE: This study was conducted to examine the effects of exercise on physiological, physical and psychological functions of the frail elderly. METHODS: The research design was a nonequivalent control group pretest-posttest design. Data were collected from September 9 to October 10, 2009. The subjects were 56 frail elders who agreed to participate in this study and each subject was randomly assigned to either the experimental group (n=28) or the control group (n=28). The exercise program was provided to each subject in the experimental group twice in a week for 6 weeks. Data were analyzed with frequency, chi2-test, Kolmogorov-Smirnor test and independent t-test using SPSS/WIN 12.0. RESULTS: There was a significant improvement in psychological functions in the experimental group compared to the control group (t=1.726, p=.045). CONCLUSION: The exercise program showed the effects to improve the psychological functions of the frail elderly with chronic disease. In recommendation, this exercise program could be utilized as a health promoting program for the frail elderly.
Aged ; Chronic Disease ; Depression ; Frail Elderly ; Humans ; Quality of Life ; Research Design

PURPOSE: The purpose of this study was to analyse researches on nursing intervention for elderly health promotion. METHOD: A literature review of 38 researches was carried out using guidelines developed by the present researchers. RESULT: The research papers studied in this research were theses written for doctoral or master's degree and published between 1994 to 2004. These researches applied nursing intervention for health promotion of elders and used experimental study design. The average period of nursing intervention was about 9 weeks and the average frequency was three times per week. As for major characteristics of subject groups, most of them were over 65 years old (76.3%) and resided in community (65.8%), and each group consisted of 10 to 29 elders. The dependent variables used in these studies included physiological variables (blood pressure, blood cholesterol level, pulmonary function, fasting blood sugar, blood cortisol level, body mass etc.), psychologic variables (depression, quality of life, life satisfaction, loneliness, anxiety etc.), cognitive variables (perceived benefits, perceived barriers, self-efficacy, self-concept, subjective health status etc.), activities of daily livings, health promotion behavior, pain, risks of fall, and variables related to Trans Theoretical Model. The majority of these studies (78.9%) applied exercise programs for health promotion including exercise motivating programs (15.8%). CONCLUSION: We suggest that more various nursing interventions must be applied to promote elders' health and to take care of their chronic diseases.
Aged* ; Anxiety ; Blood Glucose ; Blood Pressure ; Cholesterol ; Chronic Disease ; Fasting ; Health Promotion* ; Humans ; Hydrocortisone ; Loneliness ; Models, Theoretical ; Nursing* ; Quality of Life

OBJECTIVE: To investigate the dose-related effect of trunk control training (TCT) using Trunk Stability Rehabilitation Robot Balance Trainer (TSRRBT) in chronic stroke patients with poor sitting balance. METHODS: This was a retrospective study of 38 chronic stroke patients with poor sitting balance that underwent TCT with TSRRBT. The participants were assigned either to the low-dose training (LDT) group (n=18) or to the highdose training (HDT) group (n=20). In addition to the conventional rehabilitation therapy, the LDT group received 5 sessions of TSRRBT intervention per week, whereas the HDT group received 10 sessions of TSRRBT intervention per week. The outcome measures were the scores on the Trunk Impairment Scale (TIS) and its subscales, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC), and the Korean version of Modified Barthel Index (K-MBI). All outcome measures were assessed before the training and at the end of the 4-week training. RESULTS: After the 4-week intervention, TIS, BBS, FAC, and K-MBI scores showed improvement in both LDT and HDT groups. Furthermore, the improvements in TIS scores and its subscales were significantly greater in the HDT group than in the LDT group (p < 0.05). CONCLUSION: TCT using TSRRBT could be an additional treatment for the conventional rehabilitation therapy of chronic stroke patients with poor sitting balance. HDT may provide more beneficial effects on improving patients’ sitting balance than LDT.
Biofeedback, Psychology ; Classification ; Humans ; Outcome Assessment (Health Care) ; Rehabilitation ; Retrospective Studies ; Stroke* ; Video Games* ; Walking

Posturographic examination is commonly used by clinicians to evaluate standing balance. Because it is perfomed with double leg standing, it cannot sensitively detect the minor balance problem like functional ankle instability. This study aims to evaluate the test retest reliability of the single leg balance test using Tetrax posturography and its correlation with modified star excursion balance test (mSEBT). 30 healthy participants (16 male, 14 female, mean age 26.3+/-3.3) were volunteered for this study. We manufactured a specially designed wood plate to assess their single leg standing balance. It was set on each of the 4 force plates of Tetrax posturography (Sunlight Medical Ltd., Ramat Gan, Israel). Stability index were measured based on each single leg stance. Participants performed the single leg balance test on Tetrax posturography in three different times, and they also performed the mSEBT. The test retest reliability of stability index measured by Tetrax posturography was assessed by the intraclass correlation coefficient, and its correlation with the normalized composite distance of mSEBT was assessed by Pearson correlation coefficient. The single leg balance test using Tetrax posturography showed good test retest reliability. There was a negative correlation between the stability index of Tetrax posturography and the normalized composite distance of mSEBT, based on right and left leg stance, respectively. These findings suggest that Tetrax posturography is a useful and reliable tool for single leg balance assessment.
Ankle ; Ankle Injuries ; Female ; Humans ; Leg* ; Male ; Postural Balance ; Proprioception ; Wood

No abstract available.
Activities of Daily Living ; Aged* ; Depression ; Humans

Small cell lung cancer(SCLC) is frequently associated with paraneoplastic syndromes, which occur in approximately 20% of patients at presentation. Clinical Cushing's syndrome secondary to ectopic ACTH production is uncommon, occurring in approximately 5% of all SCLC patients. However, biochemical evidence of hypercortisolism can be detected in up to 50% of patients. Patients with Cushing's syndrome from ectopic ACTH production show hypertension, weakness, hyperglycemia, and hypokalemic metabolic alkalosis, but differ from patients with classic Cushing's disease in that symptoms develop more rapidly. Ectopic ACTH production is associated with a poor response to chemotherapy, short survival, and a high risk of treatment-related complications. We report a case of Cushing's syndrome associated with ectopic corticotropin production in 59-year-old male patient with extensive stage of SCLC.
Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hyperglycemia ; Hypertension ; Lung Neoplasms* ; Lung* ; Male ; Middle Aged ; Paraneoplastic Syndromes

OBJECTIVE: To investigate the relationship of the patient's criteria of successful treatment to emotional factors in patients with chronic musculoskeletal pain. METHODS: Patients who visited our outpatient hospital due to chronic musculoskeletal pain were evaluated using a questionnaire survey. Patients were evaluated with the Patient-Centered Outcomes Questionnaire (PCOQ) to investigate their expectation and criteria for success regarding treatment of chronic musculoskeletal pain. Beck Depression Inventory and State-Trait Anxiety Inventory were used to check for psychological variables. Correlations among each of the variables were evaluated statistically. RESULTS: Patients with higher levels of depression and anxiety needed larger improvements to consider the treatment as a success in the pain domain (depression, r=0.398, p=0.04; anxiety, r=0.447, p=0.02) and emotional distress domain (depression, r=0.617, p=0.001; anxiety, r=0.415, p=0.03), but had lower level of expectation of the treatment in the pain domain (depression, r=-0.427, p=0.01; anxiety, r=-0.441, p=0.004), emotional distress domain (depression, r=-0.454, p=0.01; anxiety, r=-0.395, p=0.04), and interference of daily activities domain (depression, r=-0.474, p=0.01; anxiety, r=-0.396, p=0.04). Patients were classified into 3 clusters based on the importance rating of each domain via a hierarchical analysis. The cluster of the patients with the higher rating of importance across all domains (importance of pain domain, 9.54; fatigue domain, 9.08; emotional distress domain, 9.23; interference of daily activities domain, 9.23) had the highest level of depression and anxiety. CONCLUSION: Consideration of psychological factors, especially in patients who require larger improvements in all treatment domains, may be helpful for the successful treatment of chronic musculoskeletal pain.
Anxiety ; Chronic Pain ; Depression ; Fatigue ; Humans ; Musculoskeletal Pain* ; Outpatients ; Psychology ; Surveys and Questionnaires

Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort.
Abscess ; Bacteria ; Diagnosis ; Fasciitis, Plantar ; Female ; Follow-Up Studies ; Gram-Positive Cocci ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Nontuberculous Mycobacteria ; Osteomyelitis* ; Polymerase Chain Reaction ; Rehabilitation

OBJECTIVE: To assess the intrarater and interrater reliability of the supraspinatus thickness measured by ultrasonography (US) in normal subjects and to identify the relationship between the supraspinatus thickness measured by US and cross sectional area (CSA) of the supraspinatus muscle by magnetic resonance imaging (MRI) in hemiplegic patients. METHOD: We examined 20 shoulders of normal subjects and 10 shoulders of hemiplegic patients. In normal subjects, one examiner measured the supraspinatus thickness twice by US at the scapular notch and another examiner measured the supraspinatus thickness several days later. The intrarater and interrater reliability of supraspinatus thickness measurements were then evaluated. In hemiplegic patients, the supraspinatus thickness at the scapular notch was measured by US in affected side and compared with CSA of the supraspinatus muscle at the scapular notch and the Y-view of MRI. RESULTS: One examiner's supraspinatus thickness measurement average was 1.72+/-0.21 cm and 1.74+/-0.24 cm, and the other examiner's supraspinatus thickness measurement average was 1.74+/-0.22 cm in normal subjects. Intraclass correlation coefficients of intrarater and interrater examination were 0.91 and 0.88, respectively. For hemiplegic patients, the supraspinatus thickness measured by US was 1.66+/-0.13 cm and CSA by MRI was 4.83+/-0.88 cm2 at the Y-view and 5.61+/-1.19 cm2 at the scapular notch. The Pearson Correlation Coefficient between the supraspinatus thickness at the scapular notch and the CSA at the Y-view was 0.72 and that between the supraspinatus thickness and CSA at the scapular notch was 0.76. CONCLUSION: The supraspinatus thickness measurement by US is a reliable method and is positively correlated with the CSA of the supraspinatus muscle in MRI in hemiplegic patients. Therefore, supraspinatus thickness measurement by US can be used in the evaluation of muscle atrophy and to determine therapeutic effects in hemiplegic patients.
Humans ; Magnetic Resonance Imaging ; Muscles ; Muscular Atrophy ; Shoulder

OBJECTIVE: To investigate the usefulness of ultrasonographic measurement of hyoid bone movement during swallowing. METHODS: Fifty-two patients who had swallowing dysfunction were enrolled in this study. When a patient swallowed 5 mL of water while maintaining an upright sitting position, hyoid bone movement during swallowing was measured with ultrasonography. Recorded images were analyzed to measure the maximum change in hyoid bone displacement. Mandible was used as reference point to calculate hyoid bone displacement. The farthest distance from resting position and the nearest distance during swallowing were measured and their differences were recorded. Participants also underwent videofluoroscopic swallowing study (VFSS). Based on penetration-aspiration scale (PAS), they were grouped to non-aspirators (PAS 1), penetrators (PAS 2-5), or aspirators (PAS 6-8). Measured hyoid bone displacements by submental ultrasonography were compared among groups. RESULTS: The mean hyoid bone displacement in non-aspirators group (n=21, 15.9±2.7 mm) was significantly (p<0.05) greater than that in penetrators group (n=20, 11.5±2.8 mm) or aspirators group (n=11, 8.0±1.0 mm). Hyoid bone displacement below 13.5 mm as a cutoff point for detecting penetration or aspiration had a sensitivity and specificity of 83.9% and 81.0%, respectively. CONCLUSION: Submental ultrasonographic evaluation was well correlated with PAS measured by VFSS. Therefore, submental ultrasonographic evaluation could be a useful screening tool for dysphagic patients.
Deglutition ; Deglutition Disorders* ; Humans ; Hyoid Bone ; Mandible ; Mass Screening ; Sensitivity and Specificity ; Ultrasonography ; Water