Earticle

Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down in-jury among older adults compared with walking training or other exer-cises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome measures of functional reach, perceived health status, fear of fall were included. Quality of the included articles was rated us-ing Physiotherapy Evidence Database (PEDro) scale and the pooled ef-fect of SSE was obtained by Review Manager (RevMan5) software. Significant effect of SSE was detected over walking or no treatment to improve balance as well to prevent fear of fall and improve perceived health status. The results of this systematic review proposed that SSE significantly better than walking or no treatment to prevent fall, prevent fear of fall and improve perceived health status.

본 연구목적은 일지역 중소 재활병원 입원환자의 낙상실태 및 위험요인을 규명하고, 낙상예방 간호중재 연구 트랜 드를 문헌고찰하여 실제적인 낙상예방 간호중재프로그램을 구상하기 위함이다. 연구방법으로는 낙상실태 및 위험요인을 규명하기 위한 서술적 연구와 실제적 낙상예방 간호중재프로그램 구상을 위한 통합적 문헌고찰을 병행하였다. 연구결과 해당병원의 임상현장 특징이 반영된 낙상실태와 낙상위험요인을 확인하였으며, 문헌고찰을 통해 노년 인구에 민감도가 높은 낙상위험사정도구의 활용과 보다 효과적인 방식의 낙상예방 간호중재를 제안하였다. 결론적으로, 본 연구는 낙상예 방 간호중재의 실무근거를 마련하기 위해 통합적 문헌고찰 결과를 기반으로 실제에 맞는 낙상사정도구와 낙상예방 중재프 로그램의 선택을 제안하고 이들의 활용 전망을 비춰주었다. 이는 병원낙상 간호에서 비판적사고를 통한 근거기반 간호실 무 향상에 기여할 것이다.

This study is to design an effective fall-prevention nursing program. Researchers investigated the current condition and risk factors for falls in the small-medium sized rehabilitation hospital with descriptive research. We conducted integrative literature review to reflect the current approach of fall-prevention nursing program. We found that the risk factors for falls are related to the characteristics of clinical setting of the hospital. We suggested the nursing intervention with applying fall risk assessment scale that is sensitive to the elderly population and the intervention that shows maximum effect. In conclusion, this study proposed the way of selecting an effective fall-prevention nursing program based on a clinical setting and prospective of its application. This will contribute to the improvement in nursing practice with the critical view in hospital fall.

본 연구는 지역사회 노인의 일반적 특성 및 건강관련 특성을 조사하여, 낙상두려움 요인을 규명하고, 낙상두 려움, 낙상태도 및 낙상효능감과의 관계를 파악하기 위한 서술적 조사연구이다. 연구대상자는 D시의 복지관을 이용하는 노인 140명이었다. SPSS 21.0 프로그램을 이용하여 분석하였다. 연구결과 성별, 동거인, 주관적 건강상태, 통증, 불안전 한 걸음걸이에서 낙상두려움의 차이가 있었다. 낙상두려움과 낙상태도(r=-.396, p〈.001), 낙상두려움과 낙상효능감 (r=-.184, p=.030)은 유의한 음의 상관관계를 보였고, 낙상태도와 낙상효능감(r=.411,〈,001)은 양의 상관관계를 보였다. 본 연구결과에 기초하여 낙상두려움, 낙상태도 및 낙상효능감을 향상시킬 수 있는 낙상예방프로그램 개발 및 적용이 필요하다.

This study is a descriptive research study for examining the general characteristics and health-related characteristics of the elderly in a local community, investigating factors for the fear of fall and identifying the relationship between the fear of fall, attitude to fall and fall efficacy. The subject of this study was 140 senior citizens who are using a community center in D city. The collected data was analyzed with the SPSS/WIN 21.0 program. The result of the study showed there was a significant difference in the fear of fall according to gender, person living together, subjective health condition, pain and unsafe gait. There was a significant negative correlation between the fear of fall and fall fear and fall efficacy. However, fall fear and fall efficacy were positive correlated. This study aims to provide necessary preliminary data for developing fall prevention program that can improve the fear of fall, attitude to fall and fall efficay based on the results of this study.

Objectives: This study aimed to identify the level of confidence among care workers in patients’ fall prevention, fall-related knowledge, fall burden, and factors influencing fall burden. Methods: A descriptive correlational study was conducted with 158 care workers in metropolitan city B. Data were collected using self-reported questionnaires and analyzed using SPSS win 27.0 program. Results: The mean scores for confidence in fall prevention, fall-related knowledge, and fall burden were 7.22±1.87, 18.18±3.15, and 2.98±0.37, respectively. Factors influencing fall burden among care workers were working place (β=.28, p<.001) and confidence in fall prevention (β=-.23, p=.003). Conclusions: The results indicated that the higher the confidence in fall prevention among care workers, the lower the fall burden. The fall burden of care workers in long-term care hospitals was heavier than that in general hospitals. Therefore, the findings suggest the needs to develop a program and verify its effectiveness in reducing the burden of falls among care workers in long-term care hospitals.

파킨슨병 노인은 낙상의 신체적, 정신적 위험요인을 가진 비율이 비 파킨슨병 노인에 비해 높아, 파킨슨병 노인의 낙상 경험 유무에 따라 낙상에 영향을 주는 신체적, 정신적 위험요인을 한국 노인 전체를 모집단으로 하는 국가 데이터를 이용하여 규명하였다. 2017년 보건복지부의 노인실태 자료조사를 이용한 2차 분석연구로, 파킨슨 병 노인은 총 103명이었으며 결측값을 제외하고 총 96명의 대상자를 분석하였다. 파킨슨병 노인에게서 낙상에 가장 큰 영향을 미치는 요인은 IADL로 나타났으며, IADL은 운동 조절기능과 관련이 있다. 운동 조절기능의 저하 는 일상생활에 필수적으로 요구되는 신체 움직임에 제약을 가하며 위급상황에서의 자기 보호적 행동까지도 영향 을 미쳐 낙상에 영향을 미친다. IADL이 낙상에 영향을 줄 수 있다는 본 연구결과를 바탕으로 파킨슨병 노인의 낙상 예방 중재를 위한 다양한 운동요법을 제안할 수 있을 것이다.

Elderly people with Parkinson's disease have higher rates of physical and mental risk factors for falls than non-Parkinson's disease elderly. The purpose of this study is to investigate this by using national data that includes the entire population of the elderly in Korea. As a secondary analysis study using data survey on the elderly by the Ministry of Health and Welfare in 2017, there were a total of 103 elderly people with Parkinson's disease, and a total of 96 subjects were analyzed excluding missing values. In the elderly with Parkinson's disease, the factor most influencing the fall was IADL, and IADL is related to motor control function. Decreased motor control limits physical movements essential for daily life, and even affects self-protective behavior in emergency situations, affecting falls. Based on the research results that IADL can affect falls, various exercise therapies for fall prevention interventions in the elderly with Parkinson's disease can be suggested.

Purpose: The purpose of this study was to investigate factors influencing severity of occupational fall injury. Methods: A self-reported questionnaire was completed by 105 patients sustaining occupational fall injury between July 2010 and January 2013. The study instruments were developed by the National Traumatic Occupational Fatalities and National Electronic Injury Surveillance System. The questionnaire consisted of general characteristics of the subjects (30 items), workplace characteristics (12 items) and disaster characteristic (13 items). Results: Demographic factors, except age, did not affect the severity of injury. Injured patients aged 50-59 years tended to have more severe injuries than those aged 39 years. Type of transport vehicles, conditions, and the circumstances of the fall influenced injury severity. Patients transported by 119 ambulance suffered more severe fall injuries than those who were not. Electrical workers did not receive safety education wihin a year. Critical height in severe injuries was > 6 meters. Conclusion: Occupational fall injuries were influenced by patient age, types of transport vehicles, fall height, size of workplace, and safety education experience.

이 연구의 목적은 우리나라 지역거주 노인의 낙상 리스크를 평가하는 문항을 선정하고 유효성을 검토하는데 있다. 낙상위험 평가는 선행연구를 참고로 '낙상잠재성', '신체기능', '질병과 신체증상', '환경', '행동과 성격'의 5가지 요인으로 구분하였으며 내용타당성 검증, 교차분석 및 요인분석 결과에 따라 총 44개 문항으로 구성하였다. 한국형 낙상위험 평가척도 는 심각한 사회문제로 인식되고 있는 노인의 낙상문제를 개선하고 개인의 낙상예방에 중요한 정보를 제공하는데 유용한 도구로 사용될 수 있을 것이다.

The aim of this study was to select useful items for assessing fall risk in community-dwelling elderly. This study assumed five fall risk factors: Symptoms of falling, physical function, disease and physical symptoms, environment, and behavior and character based on previous studies. The questionnaire consisted of 44 items according to the contents validation, crossover analysis and factor analysis. The Korean version of the Fall Risk Assessment Scale (FRA-K) will be used as a useful tool to improve the fall problems perceived to be serious social problems and to provide important information for prevention of falls.

목적 : 상호작용식 메트로놈(Interactive Metronome; IM)을 이용한 반복적인 움직임 과제 훈련이 지역사회 거주 노인의 균형기능과 낙상효능감, 인지기능에 미치는 영향을 알아보고자 하였다. 연구방법 : D시에 거주하는 60세 이상 노인 3명에게 회당 31분씩 11회기 동안 IM훈련을 적용하며 균형기능, 낙상효능감, 주의력의 변화 추이를 살펴본 단일대상연구로, 평가도구로는 IM Short Form Test(IM SFT), Four Step Square Test(FSST), Fullerton Advanced Balance(FAB) Scale, 한국어판 낙상효능감 척도, 한국어판 활동특이적 균형 자신감 척도와 100에서 연속으로 다섯 번 7 빼기 과제를 사용하였다. 결과 : 3명의 대상자 모두 초기기초선 기간에 비해 중재 기간의 IM SFT SRO% 평균값이 증가하였고, 중재 전에 비해 중재 후의 균형기능 평가 점수가 향상되었다. 3명의 대상자 모두 초기기초선 기간에 비하여 중재 기간 동안 주의력 평가 평균 점수가 향상되었다. 결론 : IM을 이용한 훈련이 노인의 균형기능과 인지기능을 향상시키기 위한 중재로 적용 가능함을 확인하였다.

Objective : The purpose of this study was to examine the effects of IM training on the balance, fall efficacy, and cognitive function of community-dwelling older adults. Methods : Three older adults participated in a total of 11 31-minute sessions of IM training during this single-subject design research study. An IM Short Form Test(IM SFT), a Four Step Square Test(FSST), and the Fullerton Advanced Balance(FAB) Scale were used to evaluate the subjects' balance. The Korean versions of the Fall Efficacy and Activities-specific Balance Confidence Scale were used to evaluate the fall efficacy. A serial 7 subtraction task was used to evaluate the cognitive function of the participants. Results : All participants showed a higher than average IM SFT SRO% during the intervention period compared to the pre-interventional baseline period. All of them achieved higher scores on their post-interventional balance function test than on their pre-interventional test. All three demonstrated a higher than average attention test score during the intervention period than pre-intervention. Conclusion : It was confirmed that IM training is applicable for community-dwelling older adults to improve their balance and cognitive function.

목적 : 상상연습(mental practice)이 노인의 균형 능력에 미치는 효과를 규명하고 노인 낙상 예방을 위한 효과적인 중재 방법으로써 적용 가능성에 대해 알아보는 것이었다. 연구방법 : 본 연구는 2013년 7월부터 10월 까지 인지에 문제가 없고 낙상에 경험이 있지만 보조 도구 없이 자립보행이 가능한 65세 이상 노인 3명에게 상상연습을 제공하였다. 개별 사례 실험 연구 중 ABA' 설계를 사용하여 기초선 과정 4회기, 중재 과정 5회기, 재 기초선 과정 4회, 총 13회기로 진행되었다. 독립변수는 노인의 균형 능력 및 낙상 효능감 증진을 위해 상상연습을 사용하였고, 종속변수로는 전반적 균형능력의 변화를 알아보기 위해 버그 균형 척 도(Berg Blance Scale; BBS), 낙상효능감에 변화를 알아보기 위해 낙상효능감척도(Fall Efficacy Scale: FES), 정적, 동적 균형에 변화를 측정하기 위해 각각 외다리기립검사(One-Leg Standing test; OLS), 일어나 걸어가기 검사 (Timed Up & Go test : TUG)를 실시하였다. 결과 분석은 평균값과 시각적 그래프를 통해 제시하였다. 결과 : 상상연습 기법 적용 후 모든 대상자의 낙상효능감이 기초선 과정에서 측정된 수치 보다 증가된 결과를 보였으며 또한 전반적 균형 능력과 정적·동적 균형 능력 또한 증진 또는 유지 되었다. 결론 : 본 연구는 상상연습이 노인의 낙상효능감과 균형능력의 향상과 유지에 효과가 있는 것으로 나타났음으로 노인의 낙상 예방 활동으로 상상연습의 적용을 추천한다.

Objective : The aim of this study is to prove the effects of mental practice in balance ability of elderly population, and to investigate the possibility of application as an effective intervention method for fall prevention. Methods : This study provided mental practice to 3 subjects over 65 years old who have experienced fall, but do not have cognitive dysfunctions and independent in gait without any use of assistive devices from July to October, 2013. Within the individual case study, 4 sessions of initial baseline process (A), 5 sessions of mental practice (B), 4 sessions of re-initial baseline process (A’) were proceeded using ABA design. Independent variable used mental practice for enhancing balance ability and fall efficacy in elderly population, and dependent variable were Berg Balance Scale (BBS) to find out the change in overall balance ability, Fall Efficacy Scale (FES) to see the change in fall efficacy, One-Leg Standing test(OLS), and Timed Up and Go Test (TUG) to determine the changes in both static and dynamic balance. Analysis of the results were provided via mean value and graph. Results : After the application of mental practice method, all of the subjects have shown increase in fall efficacy baseline values, and in addition, overall balance ability and both static and dynamic balances either increased or maintained. Conclusion : This study demonstrated that mental practice has positive effects on fall efficacy improvement and maintenance in elderly, thereby suggesting mental practice for fall prevention in elderly populations.

본 연구는 65세 이상의 경상북도 거주 여성노인 137명을 대상으로 근감소증요인, 대사증후군, 노인체력, 인지기 능 및 낙상효능감을 조사하여 연관성을 분석하고, 노화로 인한 복합적인 요인을 규명하는데 목적이 있다. 대사증후군지표 와 근감소증 요인의 상관관계 분석결과, 근감소지표인 ASM/m2는 체질량지수(p<.01), 허리둘레(p<.01)와 정적상관관 계가 나타났으며, 체지방률(p<.01)은 부적상관관계가 나타났다. 왼쪽상대악력은 체질량지수(p<.01)와 허리둘레 (p<.01)에서는 부적상관관계, 오른쪽상대악력은 허리둘레(p<.05)와 부적상관관계가 나타났다. 보행속도는 허리엉덩 이둘레비(p<.05)와 부적상관관계가 나타났으며, 종아리둘레는 체질량지수(p<.01), 허리둘레(p<.01)와 정적상관관계 가 나타났다. ASM/m2는 공복혈당(p<.05)에서 부적상관관계가 나타났으며, 종아리둘레는 안정시심박수(p<.05), 공복 혈당(p<.05)에서 부적상관관계가 나타났다. 인지기능은 왼쪽상대악력(p<.05), 오른쪽상대악력(p<.05)과 정적상관관 계가 나타났으며, 낙상효능감은 보행속도(p<.01)와 정적상관관계가 나타났다. 65세 이상 여성의 노화로 인한 근감소지 표 요인과 대사질환, 체력, 인지기능 및 낙상과 밀접한 관련이 있으며, 본 연구 결과를 통해 노화의 복합적인 요인으로 발생하는 노쇠를 예방 할 수 있을 것이다.

The purpose of this study was to investigate the correlation between sarcopenia factors, metabolic syndrome, physical fitness in the elderly, cognitive function, and fall efficacy in 137 women aged 65 years in Gyeongsangbuk-Do. As a result of the correlation analysis between the obesity index and the sarcopenia factor, GS showed negative correlation with WHR(p<.05), and positive correlation with Calf and BMI(p<.01) and Waist(p<.01). There was a negative correlation between the sarcopenia factor ASM/m2 and GLU(p<.05), and the calf circumference was negatively correlated with RHR(p<.05) and GLU(p<.05). For the sarcopenia factor, ASM/m, GLU showed a negative correlation, and for calf circumference, RHR(p<.05) and GLU(p<.05) showed a negative correlation. Cognitive function was positively correlated with Lt. HG(p<.05) and Rt. HG(p<.05), and Fall efficacy and GS(p<.01) were positively correlated. It is closely related to muscle loss index factors due to aging in women over 65 years of age, metabolic diseases, physical strength, cognitive function, and falls. Through the results of this study, it will be possible to prevent senescence caused by complex factors of aging.

This study is to investigates all the responsibilities and forgiveness and reconciliation among human relations. For Miller, the Holocaust is one of the most central events of twentieth century, and one from which everyone can learn much about human nature. A number of Miller's plays have a close connection to the Holocaust, some like After the Fall using the Holocaust as an important symbol. By the dominating symbol of the “blasted stone tower of a German concentration camp” on the stage Miller wishes to convey the continuing, dark presence of the Holocaust in the minds of the cast and audience. In the play, the concentration camp is not only a metaphor for other peoples's betrayals, but Quentin's own sense of separateness, his own guilt about betraying others who depend on him. Louise was Quentin's first wife. He first begins to take her for granted and then, when she becomes more independent, he realizes how little they have left in common. Although through Quentin's eyes she is regarded as cold and self-centered, She is also shown to be an intelligent woman who comes realize she no longer has any place in her husband's list of priorities. She sensibly decides to take charge of her life, no longer waiting for Quentin to fix everything. Since he believes in the sanctity of marriage and because they have a daughter together, he tries to resuscitate their marriage, but his efforts are neither consistent nor totally sincere. Her second wife, Maggie offers him the chance to be needed, which Louise has long since refused, and an active sex life. But Maggie offers something of the “tyranny of innocence.” Her dependency on others and their opinions is so extreme that she has no real concept of self. Quentin tries to teach her self-respect, but it is a lesson she is incapable of learning. She made a number of suicide attempts to gain attention, but finally Quentin refuses to help her, insisting she take responsibility for her own life. But She refused and ended by killing herself, leaving Quentin with the burden of guilt that this is something he may have prevented had he been a more careful man. Quentin is still unsure how much blame he should shoulder for this, but accepts that he was partly at fault. Quentin's final discovery is that no one can be totally innocent, as we are all willing to betray others to save ourselves when placed in such a position. Quentin sees that blame for an event like the Holocaust needs to be accepted by everyone, for we are all capable of acting as the Nazis did. In the face of such knowledge, the only remedy is not to give up hope, and it is this aspect of Holga's personality that draws Quentin. Her greatest strength is that of self-knowledge. He decides to take a chance and allow himself to love again. After the Holocaust, Miller realized that everyone is capable of evil, and so demands that everyone be partly responsible for any evil that is performed in the world. Miller emphasizes the moral responsibility of the human being as an evil creature. He asks people to accept guilt for the world's atrocities through After the Fall. Quentin confesses his sins and conquers denial, reconstructing his life based upon love and responsibility and finds a self-identity with which he can continue to live. He learns what Miller sees as the lessons of the Holocaust: Self-acceptance, forgiveness and reconciliation.

연구목적: 본 연구는 지하공동구 내 다수 작업자의 낙상을 자동으로 판별하기 위한 Top-down 방식의 딥러닝 자세 추정 모델 기반 낙상 검출 모델을 제안하고, 제안 모델의 성능을 평가한다. 연구방법: Top-down 방식의 자세 추정모델 중 하나인 YOLOv8-pose로부터 추론된 결과와 낙상 판별 규칙을 결합 한 모델을 제시하고, 지하공동구 내 2인 이하 작업자가 출현한 기립 및 낙상 이미지에 대해 모델 성능지 표를 평가하였다. 또한 동일한 방법으로 Bottom-up 방식 자세추정모델(OpenPose)을 적용한 결과를 함 께 분석하였다. 두 모델의 낙상 검출 결과는 각 딥러닝 모델의 작업자 인식 성능에 의존적이므로, 작업 자 쓰러짐과 함께 작업자 존재 여부에 대한 성능지표도 함께 조사하였다. 연구결과: YOLOv8-pose와 OpenPose의 모델의 작업자 인식 성능은 F1-score 기준으로 각각 0.88, 0.71로 두 모델이 유사한 수준이 었으나, 낙상 규칙을 적용함에 따라 0.71, 0.23로 저하되었다. 작업자의 신체 일부만 검출되거나 작업자 간 구분을 실패하여, OpenPose 기반 낙상 추론 모델의 성능 저하를 야기한 것으로 분석된다. 결론: Top-down 방식의 딥러닝 자세 추정 모델을 사용하는 것이 신체 관절점 인식 및 개별 작업자 구분 측면 에서 지하공동구 내 작업자 낙상 검출에 효과적이라 판단된다.

Purpose: This study proposes a fall detection model based on a top-down deep learning pose estimation model to automatically determine falls of multiple workers in an underground utility tunnel, and evaluates the performance of the proposed model. Method: A model is presented that combines fall discrimination rules with the results inferred from YOLOv8-pose, one of the top-down pose estimation models, and metrics of the model are evaluated for images of standing and falling two or fewer workers in the tunnel. The same process is also conducted for a bottom-up type of pose estimation model (OpenPose). In addition, due to dependency of the falling interference of the models on worker detection by YOLOv8-pose and OpenPose, metrics of the models for fall was not only investigated, but also for person. Result: For worker detection, both YOLOv8-pose and OpenPose models have F1-score of 0.88 and 0.71, respectively. However, for fall detection, the metrics were deteriorated to 0.71 and 0.23. The results of the OpenPose based model were due to partially detected worker body, and detected workers but fail to part them correctly. Conclusion: Use of top-down type of pose estimation models would be more effective way to detect fall of workers in the underground utility tunnel, with respect to joint recognition and partition between workers.

본 연구는 여성노인에게 적용한 복합하지근력운동프로그램이 노인의 낙상위험도에 미치는 영향을 알아 보기위하여 W시 소재 복지관을 이용하는 여성노인 20명을 대상으로 운동그룹(EG :Exercise Group, n=10명, 평균나이:69.6±2.2), 운동프로그램에 참여하지 않은 통제군(CG :Control Group, n=10명, 평균나이:71.3±4.6)으로 나누어 배정 하여 12주간 복합하지 근력운동프로그램을 실시하고 낙상위험도 검사를 위하여 BBS(Berg Balance Scale)와 OLST(One -Leg Stance Test)를 이용하여 적용한 결과 다음과 같은 결론을 얻었다. BBS 변화 결과 EG와 CG그룹간의 유의한 차이가 나타났고 OLST의 변화 결과 EG와 CG그룹간의 유의한 차이가 나타났다. 따라서 낙상의 위험도가 높은 노인을 대상으로 복합하지근력운동프로그램의 적용만으로도 낙상위험도에 긍정적인 영향을 미치는 것을 확인 할 수 있다.

The purpose of this study was to investigate the effects of 12weeks complexed lower body muscle-strengthening exercise program on fall risk in elderly women. Twenty subjects volunteered to participate who use a welfare center in W city For the study we divided into two groups: exercise group (EC, n=10, mean age:69.6±2.2), comparative group(CG, n=10, mean age:71.3±4.6). In order to investigate the effect of lower body muscle-strengthening program on the degree of risk of fall. It reached a conclusion as follows after having applied BBS (Berg Balance Scale) and OLST (One -Leg Stance Test) to examine the degree of risk of fall. As a result of changes in BBS and OLST, there were significant differences between EG and CG for each test(p<.00). Therefore, it confirmed that the application of complexed lower body muscle-strengthening program to the elderly who have a high risk of fall influences the risk of fall positively.

본 연구는 소뇌성 운동 실조증 환자들에게 지면에 기울기에 따른 후방낙상에 대한 균형 회복에 대한 동작들을 연구하였다. 연구 참여자는 소뇌 위축증을 진단 받은 환자 8명과 대조군 8명을 대상으로 피험자의 체중 1%를 기울임 놓기 방법(lean-and-release method)으로 낙상 상황을 재현하고 걸음을 통해 독립적으로 균형을 회복하는 능력을 평가하였다. 실험 조건에서는 지면 기울기에 따른 후방 낙상 시 균형을 회복하기 위한 걸음 반응과 전략을 첫발의 움직임과 체간의 움직임을 평가 하였다. 연구결과, 지면 경사도에 따른 후방 낙상 시 경사도가 높아질수록 소뇌 질환 환자가 대조군 에 비해 움직임에 거리가 크게 증가하였으며, 경사도가 높아질수록 대조군과에 차이가 나타났다. 특히, 발과 신체무게중 심(COM)의 거리는 대조군에 비해 짧았으며, 첫발 착지 시 COM 움직임 속도는 경사도가 증가할수록 빠르게 나타났다. 마지막으로 체간 움직임 각도는 대조군에 비해 적은 움직임이 나타났다. 결론적으로, 소뇌 질환 환자는 지면 경사가 높아 질수록 심리적 두려움을 느끼며, 비 환자들과 같은 빠른 시간의 반응을 보였지만 짧은 거리의 기저면 전략을 사용하였고, 체간의 각도를 회복하지 못하는 비효율적인 움직임 전략을 사용하는 것으로 보였다. 이러한 비효율적인 움직임 전략을 확인한 본 연구의 자료는 소뇌성 운동 실조증 환자들의 재활 현장에서 의미 있는 정보를 제공하여 적용 가능한 운동 프로그 램을 개발 하는데 기초 자료로 도움이 될 것이라 판단한다.

The purpose of this study is the behavior of the balance recovery strategy for posterior falls according to the slope of the ground in patients with cerebellar ataxia. Participants in the study evaluated eight patients diagnosed with cerebellar atrophy and eight controls' ability to reproduce the fall situation using the lean-and-release method of 1% of the subject's body weight and restore balance independently through walking. In the experimental conditions, the step response and strategy to restore balance in the event of a rear fall according to the slope of the ground were evaluated for the movement of the first step and the movement between the bodies. As a result of the study, the higher the slope in the rear fall according to the ground slope, the greater the distance in movement of patients with cerebellum disease compared to the control group, and the higher the slope, the difference from the control group. In particular, the distance between the foot and the Center of Mass(COM) was shorter than that of the control group, and the COM movement speed at the first landing appeared faster as the slope increased. Finally, the interbody motion angle showed less movement than the control group. In conclusion, patients with cerebellum disease felt psychological fear as the ground slope increased, had the same short-term response as non-patients, but used a short-distance basal plane strategy, and seemed to use an inefficient movement strategy that did not restore the angle between the bodies.

본 연구는 노인의 낙상지식, 태도와 예방행위 정도를 확인하고, 이들 간의 관계와 낙상예방행위에 미치는 영향을 분석하는 것이다. 대상자는 복지관 이용 노인 167명이고, 일대일 면담을 통해 자료를 수집하였다. 수집된 자료는 SPSS 18.0 을 이용하여 분석하였다. 분석결과 낙상지식과 낙상태도(r=0.28, p<.001), 낙상태도와 낙상예방행위(r=0.45, p<.001)간에 유 의한 정적 상관관계가 있었다. 낙상예방행위에 유의한 영향을 미치는 요인으로 성별(β=-0.17, p=.019)과 낙상태도(β=0.41, p<.001)가 확인되었고, 설명력은 21.1%이었다(F=8.41, p<.001). 본 연구결과에 기초하여 노인 낙상예방행위 향상을 위해 낙 상태도 개선에 초점을 둔 낙상예방중재 프로그램 개발 및 적용이 필요하다.

This study identified the knowledge, attitude and degree of prevention behaviors on falls of the elderly and analyzed the relationship among them as well as their effects on fall prevention behaviors. This study was targeted at 167 elderly attending senior welfare centers and data collected by interview was analyzed using SPSS 18.0 program. As a result of correlation analysis, positive relations were identified between knowledge and attitude on falls, as well as attitude and prevention behaviors on falls. Factors that had significant effect on fall prevention behaviors were gender and attitude and showed 21.1% of explanatory power (F=8.41, p<.001). The study further suggests intervention programs on fall prevention focusing on the improvement of attitude on falls for enhancing fall prevention behaviors of the elderly to be developed and applied based on the results of this study.

본 연구의 목적은 입원환자가 낙상사고 전후에 따라 건강상태 관련 특성의 차이를 확인하기 위함이며, 2016년 1월 1일부터 2020년 12월 31일까지 입원 후 낙상사고가 발생하여 환자안전보고시스템에 보고된 환자 328명의 데이터를 활용 한 후향적 연구이다. 연구대상자의 연령은 평균 68.57±14.13세로서 70대가 30.49%로 가장 많았고, 입원 이후 평균 13.86±25.03일이 경과 시에 낙상사건이 발생하였고, 발생 시간대는 야간(22:30- 06:59)이 42.99%로 가장 많았다. 입원 후 낙상 전후에 배변문제(x2=314.0, p<.001), 배뇨문제(x2=284.0, p<.001 ), 정맥수액요법(x2=85.16, p<.001 ), 걸음걸이의 허약감(x2=69.77. p<.001 ), 와상(x2=51.60, p<.001 ), 의식이 불명하거나 자신의 기능을 과대평가한 경우(x2=17.52, p<.001 ) 비협조적 태도(x2=220.17, p<.00 1)에서 통계적으로 유의한 차이가 있었다. 낙상 전후 환자의 건강상태 관련 특성의 차이를 파악하여 환자의 특성에 맞는 적절한 낙상예방 및 개별적인 교육중재활동을 모색할 필요가 있다.

This study aims to investigate the changes in health status of inpatients before and after a fall accident, and it is a retrospective study using data from 328 inpatients who fell from January 1, 2016 to December 31, 2020, reported to the patient safety reporting system. The average age of the study subjects was 68.57(±14.13), and those in their 70s accounted for the most at 30.49%. Falls occurred on average 13.86(±25.03) days after hospitalization, and the time when the most falls occurred was between 22:30 and 06:59 with 42.99%. Before and after a fall during hospitalization, bowel problems (x2=314.0, p<.001 ), urination problems (x2=284.0, p<.001 ), intravenous fluid therapy (x2=85.16, p<.001 ), and walking (x2=69.77. p<.001 ), bedridden state (x2=51.60, p< .001 ), mental state and performance (x2=17.52, p<.001 ) patient's attitude (x2=220.17, p<.001 ), there was a statistically significant difference. It is necessary to develop an appropriate method and education program for fall prevention in hospital by considering the individual characteristics of inpatient.

이 연구의 목적은 지역에 거주하는 65세 이상 노인의 신체 활동(physical activity; PA) 수준과 활동 체력 (functional fitness; FF) 변인 사이의 관계를 조사하는 것이었다. 피검자(남성:1,645명; 여성:2,394명)의 PA 수준은 설문지를 이용하여 조사하였고, FF는 상·하지 근력, 민첩성 및 동적 평형성, 유연성, 유산소성 능력, 협응력, 그리고 신체 구성 등 체력 영역을 대표하는 6항목으로 측정, 평가하였다. 피검자는 신체 활동 권장기준에 따라 권장량보다 낮은 그룹 (low physical activity; LPA)과 권장량 기준을 충족하는 그룹(PA)으로 나누었고, PA 그룹은 다시 강도 수준에 따라 중강도 그룹(MIPA)과 고강도 그룹(HIPA)으로 분류하였다. 권장량 수준을 충족하는 피검자는 48%였고, 이들은 모든 항목에서 LPA보다 성적이 높았다(p<.001). HIPA 그룹은 MIPA 그룹보다 민첩성 및 동적 평형성, 협응력, 그리고 하지 근력(여성)이 유의하게 높았다(p<.001). 결론적으로 지역에 거주하고 있는 노인이 활동 체력을 유지하고 개선하기 위해 서는 건강을 위해 권장하고 있는 신체 활동량을 충족시켜야 하며, 특히 낙상 관련 체력을 개선하기 위해서는 강도가 높은 신체 활동을 할 필요가 있다.

The objective of this study was to examine the relationship between physical activity (PA) level and functional fitness (FF) parameters in community-dwelling older adults aged 65 or above in Korea. Subjects’ (M: 1,645; F: 2,394) PA level were assessed using a questionnaire. The subjects were divided into two groups: one below the recommended level of PA(LPA) and one above the recommended level (PA). PA was further classified by intensity level into medium- and high-intensity PA (MIPA and HIPA respectively) groups. FF was assessed based on six test items representing the following fitness areas: lower and upper body strength, agility and dynamic balance, flexibility, aerobic capacity, coordination, and body composition. Of the subjects, 36% met the recommended level of PA. Both MIPA and HIPA were superior to LPA in all FF items(p<.05). The HIPA group was significantly better in terms of agility and dynamic balance, coordination, and lower body strength (only in women) than was the MIPA group(p<.05). In conclusion, PA above the recommended level is needed to maintain functional fitness. In addition, HIPA seems to promote fall-related functional fitness and should be encouraged when safe and feasible.

연구목적: 건설현장 안전관리를 인적 역량 중심에서 첨단기술인 AIoT와 Mobile 기술을 활용한 시스템 중심의 관리체계로의 전환을 위한 건설현장 안전관리 활성화 방안을 마련하고자 한다. 연구방법: AIoT 와 Mobile 기술을 활용한 건설현장 안전관리 모니터링 시스템이 건설현장의 유효성에 대하여 공동주 택현장의 골조공종에 종사하고 있는 작업자를 대상으로 가상휀스, 화재감시, 안전모 미착용 인식 3개 의 알고리즘을 적용하여 실험을 실시 하였다. 연구결과: 실험대상 근로자는 215명, 가상휀스 침입은 7.61명으로 불안전 행동 발생율은 실험대상 인원 대비 3.5%, 화재감지는 0.16건으로 실험대상 대비 불 안전 행동 발생율이 0.07% 나타났으며, 안전모 미착용 인지는 월 평균 안전모 미착용은 8.79명으로 실 험대상 대비 불안전 행동 발생율 4.05% 나타났다. 결론: AIoT와 Mobile 기술을 활용한 건설현장 안전 관리 모니터링 시스템이 건설현장에 유효한 영향을 미치는 것으로 나타났다.

Purpose: The government intends to come up with measures to revitalize safety management at construction sites to shift safety management at construction sites from human capabilities to systemoriented management systems using advanced technologies AIoT and Mobile technologies. Method: The construction site safety management monitoring system using AIoT and Mobile technology conducted an experiment on the effectiveness of the construction site by applying three algorithms: virtual fence, fire monitoring, and recognition of not wearing a safety helmet. Result: The number of workers in the experiment was 215 and 7.61 virtual fence intrusion was 3.5% compared to the number of subjects and 0.16 fire detection were 0.07% compared to the subjects, and the average monthly rate of not wearing a safety helmet was 8.79, 4.05% compared to the subjects. Conclusion: It was found that the construction site safety management monitoring system using AIoT and Mobile technology has a valid effect on the construction site.

본 연구는 만 40세-64세의 중년 여성의 낙상에 영향을 주는 요인을 알아보고 낙상 예방 프로그램 개발에 기초자료로 활용하기 위하여 시도되었다. 연구방법은 2019년도 지역사회건강조사 자료를 이용하여 43,917명 중 년 여성을 연구대상으로 낙상, 신체 건강, 정신건강 및 건강행태를 조사하였다. 대상자의 낙상에 영향을 미치는 요인을 알아보기 위하여 descriptive statistics, chi-square test, multiple logistic regression을 하였다. 연구 결과 중년 여성의 낙상 경험은 11.9%로 보고되었고 연령이 증가할수록, 배우자가 없는 여성에서 낙상을 많이 경 험하였다. 높은 우울감과 지각된 스트레스, 당뇨병을 진단받은 경우, 폭음하는 여성에서 낙상 경험이 높게 나타났 다. 중년 여성의 낙상을 감소시키기 위해서 본 연구에서 밝혀진 변수를 고려하여 다양한 간호 중재의 근거자료로 적용될 수 있을 것이다.

This study aimed to find out the factors influencing the fall of middle-aged women aged 40 to 64 and to use it as basic data for the development of a fall prevention program. The study was based on raw data from the 2019 Korea Community Health Survey. To establish the impact of fall experience of middle-aged women, descriptive statistics, chi-square test, and multiple logistic regression were used. Of the 43,917 people surveyed, 11.9% of middle-aged women said that they had experienced a fall. Falls were more common among women with increasing age or without a spouse. Those who experienced a lot of depression and perceived stress and were diagnosed with diabetes also had a higher fall experience. In the case of drinking, women who drank more than non-drinkers were more likely to fall. The results of this study can lead to a better understanding middle-aged women who have experienced falls, and they can be used as basic data for the development of related health programs.

본 연구는 치매 노인의 치매 관련 요인 및 동반질환이 낙상 위험도에 미치는 영향을 파악하고자 실시한 자료분석 연구이다. 한국고용정보원에서 실시한 2018년 제7차 고령화연구패널조사를 이용하여 치매 노인 119명을 분석 대상으로 포함하였다. 치매 관련 요인은 치매 유병 기간 및 치매로 인한 일상생활 제한 여부에 대한 응답자료를 활용하였고, 동반질 환은 고혈압, 당뇨, 비만 자료를 사용하였다. 수집된 자료의 통계분석은 SPSS statistics 22.0을 사용하여 로지스틱 회귀 분석을 실시하였다. 분석대상자의 치매관련 요인 및 동반질환 모두 낙상 위험도 증가에 유의한 영향을 미쳤으며, 특히 비만, 당뇨, 고혈압, 치매로 인한 일상생활 제한, 치매 유병 기간 순으로 영향력이 큰 것으로 도출되었다. 본 연구는 치매 노인의 낙상 위험을 높이는 요인을 확인함으로써 낙상 예방 프로그램의 구성에 우선되어야 할 요인을 제시하였다. 본 연구의 결과를 바탕으로 치매노인 케어에 치매유병기간과 일상생활 제한에 따른 낙상예방 전략과 동반질환으로 인한 낙 상 고위험군의 집중 관리와 보행 보조도구 등 안전 보조도구 사용 훈련이 필요할 것이다.

This study is a data analysis study to identify the factors influencing the prevalence and risk factors for falls of older adults with dementia in Korea. Using the data of the 7th Aging Research Panel in 2018, 119 people were enrolled. We used response data on the dementia-related factors that is the duration of dementia and whether or not activity of daily living was restricted due to dementia. For comorbid diseases, data on hypertension, diabetes, and obesity were used. For statistical analysis of the collected data, logistic regression analysis was performed using SPSS statistics 22.0. Dementia-related factors and comorbidities of the analyzed subjects had a significant effect on the falling index. In particular, it was found that the influence was greatest in the order of obesity, diabetes, hypertension, daily life restrictions due to dementia, and the duration of dementia. This study is meant to identify factors that should be prioritized in the composition of a fall prevention program for the elderly with dementia. Based on the findings of this study, strategies for preventing falls due to the duration of dementia and limiting daily life, intensive management of high-risk groups for falls due to comorbid diseases, and training in the use of safety aids such as walking aids will be required in the care of the elderly with dementia.