OBJECTIVE: To identify the effects of isokinetic strengthening of trunk muscles on balance in hemiplegic patients after stroke. METHOD: All participants were ambulatory hemiplegic patients, injured at least 6 months prior to study. The patients (n=16) were randomly divided into two groups. The control group received neurodevelopmental treatments and gait training 3 times a week. In addition to the same treatments provided for the control group, the experimental group received trunk isokinetic strengthening exercises using isokinetic dynamometer 3 times a week. Trunk muscle peak torque and balance in the experimental group were compared with those in control group at baseline and 4 weeks after treatments. RESULTS: There were no significant differences in age, lesion of hemiplegia, time after stroke onset, trunk muscle strength and Berg balance score before treatments between two groups. In the experimental group, peak torques of trunk extensor increased significantly at 60degrees/sec and 90degrees/sec at 4 weeks (p<0.05), but there were no significant improvements in peak torques of trunk flexor at all degree and extensor peak torques at 120degrees/sec. Both the extensor and flexors showed no significant changes in the control groups. In the experimental group, a mean percent change in peak torque involving the trunk extensor was significantly increased at 60degrees/sec. In the experimental group, Berg balance scores, 10 m gait velocity, sit to stand and gait 3 m and return, and 10 seconds stair up and down were improved (p<0.05). No significant improvements were noted in the control group. CONCLUSION: Isokinetic strengthening of trunk muscles can improve balance in hemiplegic patients.
Exercise ; Gait ; Hemiplegia ; Humans ; Muscle Strength ; Muscles ; Stroke ; Torque

PURPOSE: To describe nursing students' experience of sexual harassment during clinical practicum. METHODS: An interpretive phenomenological qualitative approach was used to understand contextual experiences of participants. Individual in-depth interviews were conducted to collect data from thirteen nursing students who experienced sexual harassment during clinical practice in general hospitals at D metropolitan city. All interviews were recorded and transcribed into Korean and English. Transcripts were analyzed using the data analysis method described by Diekelmann, Allen, and Tanner. RESULTS: The following 12 themes emerged from the data: ‘unprepared to respond’, ‘lack of education’, ‘unsure about when behavior crosses the line’, ‘power differential for nursing students’, ‘balancing self-preservation with obligations to patients’, ‘shame’, ‘feeling responsible for not being able to prevent the harassment’, ‘impact on patient care’, ‘fear of what might have happened’, ‘fear of repercussions’, ‘long term impact’, and ‘peer support’. CONCLUSION: Participants in this study described feeling an obligation to care for their patients. However, they seemed to be unable to balance this while feeling vulnerable to sexual harassment with strong negative feelings. Helping students recognize and effectively deal with sexual harassment is a critical element to assure quality learning for participants and maintain quality of care during clinical practice.
Hospitals, General ; Humans ; Learning ; Methods ; Nursing* ; Preceptorship* ; Qualitative Research ; Sexual Harassment* ; Statistics as Topic ; Students, Nursing

OBJECTIVE: To investigate and compare the effect of low-dye taping (LDT) and figure-8 modification of LDT (MLDT) on peak plantar pressure and heel pain in patients with heel pad atrophy. METHODS: There were reviewed 32 feet of 19 patients who have been diagnosed with heel pad atrophy who were enrolled in this study. The patients were diagnosed with heel pad atrophy with clinical findings, and loaded heel pad thickness measured by ultrasonography. At the first visit, patients were taught how to do LDT and MLDT. They were instructed to do daily living with barefoot, LDT and MLDT at least one time per day. Patients performed pedobarography with barefoot, LDT and MLDT within 2 weeks. The severity of heel pain was also checked with the visual analogue scale (VAS) during daily living with barefoot, LDT and MLDT. RESULTS: VAS of hindfoot were significantly decreased after LDT and MLDT (p < 0.01). Peak plantar pressure under hindfoot were also decreased after LDT and MLDT (p < 0.01). The effect of MLDT in decreasing peak plantar pressure of hindfoot (p < 0.01) and pain relief (p=0.001) was better than the effect of LDT. CONCLUSION: The LDT technique is clinically useful for pain management and reducing peak plantar pressure of hindfoot in patients with heel pad atrophy. MLDT is more effective than LDT in reducing peak plantar pressure and heel pain in patients with heel pad atrophy.
Atrophy* ; Foot ; Gait ; Heel* ; Humans ; Pain Management ; Ultrasonography

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

OBJECTIVE: To develop the Korean version of the Kessler Foundation Neglect Assessment Process (KF-NAP), which enables a more functional assessment of unilateral spatial neglect, by first translating it into Korean and then statistically standardizing it. METHODS: Two rehabilitation specialists translated the KF-NAP into Korean. The entire process of administering the Korean KF-NAP to 30 patients with brain disease was video-recorded. Five occupational therapists from 4 university hospitals nationwide evaluated the 30 video-recorded examination cases. We analyzed inter- and intra-reliabilities of the Korean KF-NAP using the intraclass coefficient and Pearson correlation coefficient. Internal consistency reliability of the assessment categories was also examined using Cronbach's alpha coefficient. RESULTS: For the construct validation study, the Korean KF-NAP was strongly correlated with the Albert's test and letter cancellation test (r ≥ 0.8; p < 0.05). The intraclass correlation coefficients for the first and second assessments of the Korean KF-NAP were 0.973 and 0.982, respectively, showing high reliability (p < 0.05). The intra-rater reliabilities exceeded 0.9 (p < 0.05), and Cronbach's alpha coefficient exceeded 0.8, showing internal consistency reliability. CONCLUSION: The Korean KF-NAP is a reliable and valid instrument for assessing hemispatial neglect symptoms in patients with brain diseases.
Brain Diseases ; Hospitals, University ; Humans ; Perceptual Disorders ; Rehabilitation ; Reproducibility of Results* ; Specialization ; Translating ; Translations

OBJECTIVE: To compare the effects of spinal stabilization exercise against with lumbar extensor strengthening exercise. METHOD: Sixty patients with chronic low back pain were enrolled into the study and randomly classified into three groups. Groups were treated with spinal stabilization exercise (Group 1), lumbar extensor strengthening exercise using a MedX machine (Group 2), or with a combination program (Group 3) for 8 weeks. Patients were not given any other treatment modalities. Isometric peak torque of the lumbar extensors, pain rating score (PRS), Medical Outcomes Study Short Form-36 (SF-36) score, and the Oswestry low back pain disability questionnaire (OLBPD-Q) were assessed at 0, 4, and 8 weeks of exercise. RESULTS: 1) After 8 weeks, all groups showed incremental improvements in maximal isometric torque of the lumbar extensors and exhibited improvement in SF-36, PRS, and OLBD-Q scores (p<0.05). 2) There were no significant differences in the degree of improvement among the three groups after 8 weeks of exercise. 3) The percentage of patients with scores of good or excellent in Group 3 was higher than in Groups 1 and 2 according to all evaluation tools. CONCLUSION: In the treatment of chronic low back pain, all exercise groups showed decreased pain, improved quality of life, and increased lumbar extensor strength regardless of the exercise type employed. We suggest that exercise programs in general are effective for the treatment of chronic low back pain and a combination exercise program seems to be most beneficial.
Humans ; Low Back Pain ; Quality of Life ; Surveys and Questionnaires ; Torque

OBJECTIVE: The purpose of this study was to determine the effects of isokinetic eccentric knee extensor and flexor strengthening training on affected limbs of patients with chronic hemiplegia. METHOD: Twenty-one subjects with chronic stroke were participated in this study. All subjects were indoor ambula tors. The hemiplegic knee flexors and extensors of the experimental group (n=11) were trained eccentrically using Cybex 770 dynamometer 3 times a week for 6 weeks. Conventional rehabilitation treatment was administrated to the control group at the same duration and frequency as the experimental group. Total peak torque, total work and functional parameters were measured before and after training. RESULTS: Significantly higher mean percent changes of peak torque and total work were observed in the experimental group compared to the control group at all eccentric angular velocities tested. Functional parameters also showed significant improvements in the gait speed, a timed stair climb up and down, and sit-to-stand time compared to the control group (p<0.05). CONCLUSION: The isokinetic eccentric strengthening training of knee extensors and flexors in patients with chronic hemi plegia were useful in strengthening the affected leg and functional improvement.
Extremities ; Gait ; Hemiplegia* ; Humans ; Knee* ; Leg ; Paralysis ; Rehabilitation ; Stroke ; Torque