Earticle

Objective To investigate disparities in the fear of falling between urban and rural communities in relation to socio-demographics, health status, and functional level.Methods A total of 974 subjects aged 40 years or older participated in this study (335 urban residents and 639 rural). They completed a questionnaire about socio-demographics, health-related variables, and experience with falls. We employed both direct questioning and the Korean version of Falls Efficacy Scale-International (KFES-I) to investigate fear of falling in terms of perceptive fear and higher level of concern over falling during daily activities. The Korean version of Instrumental Activities of Daily Living was used to assess functional independency.Results Aging, female gender, fall history, and the presence of chronic medical problems were independently associated with higher prevalence for the fear of falling. Both perceptive fear of falling and a higher level of concern over falling were more prevalent in the rural senior population compared with those in the urban population when they had the following characteristics: lower income or educational background, physical laborer or unemployed, no chronic medical morbidity, or functional independency in daily activities.Conclusion The disparity in the fear of falling between the two areas is thought to be related to age structure, and it may also exist in healthy or functionally independent senior populations under the influence of socio-environmental factors. A senior population with lower socio-economic status residing in a rural area might be related with a greater vulnerability to the fear of falling. We should consider regional characteristics when we design fall-related studies or develop fall-prevention programs at the community level.

[방법] 연구대상자는 경직성 뇌성마비 중 양마비 아동 20명이었으며, 수중과 지상복합 집단 10명(5.1±0.87yr, 93.50±3.56cm, 13.55±1.49kg)과 지상운동 집단 10명(5.5±1.17yr, 95.10±2.92cm, 14.90±1.46kg)으로 구분하였다. 운동기능의 측정은 대근육 운동기능 평가(GMFM; gross motor function measure)를 실시하였으며, 기능적 독립성은 장애아동의 기능적 일상생활동작 평가도구인 WeeFIM(functional independence measure for children)을 사용하였다. 운동 프로그램은 두 집단 모두 24주간 주 4회 회당 약 30분간 1대 1 형태로 프로그램을 실시하였다. 지상에서의 운동만 실시한 집단은 주 4회 지상운동만 실시하였고, 수중과 지상 복합운동 집단은 주 4회 중 2회는 수중운동, 2회는 지상운동을 실시하였다. 처치에 따른 두 집단 간 비교를 위해 사전검사를 기준으로 12주 후, 24주 후의 운동기능 및 기능적 독립성의 변화율(%)을 비교·분석하였다. [결과] 앉기 영역, 기기와 무릎서기 영역 그리고 GMFM 총점에서 집단 간 유의한 차이가 있었으며(p< .05), 기능적 독립성에서는 두 집단 간 유의한 차이가 나타나지 않았다. [결론] 경직성 뇌성마비 아동의 운동처방에 있어 수중운동과 지상운동을 복합하는 것이 지상운동만 실시하는 것보다 대근육 운동기능 개선에 효과적인 것으로 사료된다.

[INTRODUCTION] A combined water and land exercise programs may be a beneficial form of therapy for children with spastic cerebral palsy, particularly for those with significant movement limitations. We investigated the effects of a combined water and land exercise programs on exercise function and functional independency in children with spastic cerebral palsy. [METHOD] The groups of this study were the water and land combined exercise group(n = 10, 5.1±.87 years, 93.50±3.56 cm, 13.55±1.49 kg) and the land exercise group(n = 10, 5.5±1.17yr, 95.10±2.92 cm, 14.90±1.46 kg). We measured sitting, crawling & kneeling, and total points as indices of exercise function. Functional independency was assessed using WeeFIM(Functional Independence Measure for Children). The water and land combined exercise group performed a water and land combined exercise program for twenty four weeks and the land exercise group only performed a land exercise therapy program for twenty four weeks. [RESULTS] The water and land combined exercise group demonstrated significantly greater(p< .05) gains in exercise function than the land exercise group, but there was no significant different between the water and land combined exercise and land exercise group in functional independency. [CONCLUSION] These findings suggest that combined water and land exercise may improves exercise function than land exercise in children with spastic cerebral palsy. Further studies utilizing other population and more subjects may confirm these results.