슬라이드 1

Transcription

1 제 2 회건양대학교 물리치료학과학술제 사회자 : 김민석 일시 : :00 장소 : 건양대학교메디컬캠퍼스명곡홀

2 INDEX 개회식 사회자국민의례내 외빈소개격려사축사개회사논문발표 발표자폐회식 사회자

3 1 개회식

4 개회식 국민의례

5 개회식 국민의례

6 개회식 내 외빈소개

7 개회식 격려사

8 개회식 축 사

9 개회식 개회사

10 2 논문발표

11 논문발표 닫힌사슬에서의자세별체중지지와우세측과비우세측의체중지지시체간 근육활성화의변화 20 대여성에서굽높이와 Wedge 위치에따른안쪽빗넓은근과가쪽넓은근의 근활성도비교 짐볼을이용한쪼그려앉기와벽을이용한쪼그려앉기운동시무릎의각도 변화가안쪽빗넓은근과가쪽넓은근의근활성도에미치는영향 물리치료사의직무환경과직무스트레스가이직의도에미치는영향

12 닫힌사슬에서의자세별체중지지와 우세측과비우세측의체중지지시체간근육활성화의변화 The Change of Muscle Activation in Dominant and Non-dominant Side during Weight Shifting Konyang University Dept. of Physical Therapy Kim M.H. Kang N.Y. Kwon Y.R. Gil M.N, Shin H.Y. Park D.S. PhD. PT

13 CONTENTS Introduction Method Result Discussion Conclusion Abstract Reference

14 Introduction

15 Introduction 뇌졸중 기능장애 치료목표 치료방법 뇌의출혈, 또는경색으로인해신체움직임과의식의장애를일으키는질병 (Sharp와 Brouwer, 1997) 편마비와더불어자세조절능력및동적균형능력저하 (Bruce와 Dobkin, 2003) 기능적활동및독립적인일상생활동작수행을어렵게하고, 보행시낙상을초래할수있으므로이를회복하는것이중요함 (Geurts 등, 2005) 편마비환자의동적균형능력을증가시키기위해, 환측으로체중이동능력을증진시키는것이가장널리쓰이는방법 (Lane, 1978)

16 Introduction 대근육 전반적인체간안정화에관여 협응작용 증진 소근육 분절적인체간안정화에관여

17 Method 연구목표 정상성인을대상으로닫힌사슬에서의자세별체중지지와 우세측과비우세측의체중지지를시행한후, 각각체간근육들의 활성화에어떻게영향을미치는지알아보고자함

18 Method

19 Method 연구대상 선정기준 제외기준 최근 6 개월간근골격계와 신경학적질환이없는자 정상관절가동범위에제한이 없는자 EMG 부착이어려운자 심혈관질환을진단받은자 과제수행이가능한자 D 시소재 K 대학교재학생 20 대성인 10 명 ( 남자 5 명, 여자 5 명 )

20 Method 연구도구 표면근전도분석기 (Noraxon EMG, USA) 측정근육및부착부위 Muscle Upper trapezius Pectoralis major External oblique Rectus abdominis Erector spinae Multifidus Attachment Site line from C7 to end of acromion lateral side upper ⅓ between acromion anterior side and xiphoid process Approximatly 15 cm lateral to the umbilicus 2 cm lateral to the abdominal mid line, 3 cm upper umbilicus 3 cm lateral to the L3 3 cm lateral to the L5

21 Method 연구절차연구절차 Prone on elbow Quadruped position Sitting position (dominant side) Sitting position (Non-dominant side) Standing position

22 Result

23 Result

24 Discussion

25 Discussion

26 Discussion 열린사슬에서의체중지지와닫힌사슬에서의체중지지의차이점 Jeong 과 Jeong(2013) 본연구 손을짚지않고앉은상태에서 안정한면, 불안정한면에서체중이동 후체간근육활성도비교 불안정한면에서무게중심이둔부쪽으로이동함으로써체중이동시균형유지를위해체간근육이더활성화됨 팔꿈치지지자세보다무게중심 이동의양이더많은네발기기자세에 서체간근육에대한의존도가낮았음

27 Discussion

28 Discussion 최대체중이동거리를이용한체중이동보다는체중부하율을통한 체중이동이더높은근활성도를나타냄 Jeong과 Jeong(2013) 안정한면에서앉은자세로최대체중이동거리에도달하여 10초동안배바깥빗근의활성도를측정 5.46±2.74 % 본연구앉은자세에서의우세측체중지지시배바깥빗근의활성도를측정 16.38±6.34 %

29 Discussion

30 Discussion 무게의비율이비교적적은앉은자세에서의체중지지가일어선 자세에서보다더체간근육에의존됨 앉은자세 일어선자세 근력과상체의무게만이 체중지지를함 근력과몸전체의무게가 체중지지에영향을줌

31 Discussion 제한점 본연구는대상자수가적고건강한성인남녀인대상자들로만 한정되어있어뇌졸중환자를대상으로한추가적인연구가필요함 체중지지시등의각도에따라힘의부하률이달라질수있으므로 후행연구에서는보다더고정적인자세를설정할필요가있음

32 Conclusion

33 Conclusion 한가지의특정한자세에서의체중이동만이체간근육의활성도에큰영향을 미치는것이아니라, 각각의자세에서모두체간근육이활성화되었다. 하지만그중에서도자세에따라특정근육이유의하게근활성도증가가나타났다. 닫힌사슬에서의자세별체중지지가체간근육들의활성화와증진에 영향을미친다고볼수있다.

34 Abstract

35 Abstract In this study, when a weight bearing chain is closed in the upper extremities, and are then investigated for what effect the muscle activity of the trunk will be in accordance with the posture of each. Ten healthy young subjects (5 males, 5 females) were enrolled in this study. The muscle activity of the External Oblique and Rectus Abdominis were significantly increased in prone on elbows than quadruped(p<0.05). The muscle activity of Pectoralis Major, Erector Spinae and Multifidus were significantly increased in the dominate side of a sitting position than the nondominate side of the sitting side(p<0.05). The muscle activity of the External Oblique and Rectus Abdominis were significantly increased in the dominate side of the sitting position as opposed to the standing position(p<0.05). It is possible to see the weight-bearing position for each of the chains that are closed have an effect on strengthening the activity of the muscles of the trunk. Key Words : Electromyograph; Muscle activity; Prone on elbow; Quadruped; Stroke; Sitting Standing; Weight bearing.

36 Reference

37 Reference Bergmark. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand Suppl. 1989;230:1-54. Bruce, Dobkin. The clinical science of neurologic rehabilitation. neuroscientific foundations for rehabilitation. 2rd edition, Geurts ACH, Haart Md, Nes IJWv, Duysens J. A review of standing balance recovery from stroke. Gait & Posture. 2005;22(3): Hodges, Moseley. Pain and motor control of the lumbo-pelvic region : effect and possible mechanisms. J Electromyogr Kinesiol. 2003;13: Lane. Facilitation of weight transference in the stroke patient. Physiotherapy. 1978;64: Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Arch Phys Med Rehabil. 1997;78(11): Jihwan Park. Active daily life. Hyeonmunsa. 2010;63-65 Kyungsim Jeong, Ijeong Jeong. Effect of the support surface condition on muscle activity of trunk muscles during weight shifting exercise. J Korean Soc phys Ther. 2012;24(5): Ara Jo. Effect of standing position with stroke patient on affected side and lower muscle activation. Master Thesis. 2013;25(12): Cram JR. Introduction to surface electromyography. Aspen. 1998;

38

39 20 대여성에서굽높이와 Wedge 위치에따른안쪽빗넓은근과 가쪽넓은근의근활성도비교 Comparison of Muscle Activity on Vastus Medialis Oblique and Vastus Lateralis According to the Heel Height and Wedge in Twenties Female Konyang University Dept. of Physical Therapy Kim S.J. Kim S.J. Kim H.J. Park B.R. Park S.Y. Yu J.H. LEE H.J. PT

40 CONTENTS Introduction Method Result Discussion Conclusion Reference Abstract

41 용어정리 VMO 안쪽빗넓은근 (Vastus medialis oblique) VL 가쪽넓은근 (Vastus lateralis)

42 Introduction

43 Introduction patellofemoral pain syndrome VMO 의약화 VL 의강화 VMO 의선택적인강화필요

44 Introduction 선행연구 류마티스관절염환자에게깔창 (insole) 적용시, 입각기동안발의 가쪽번짐 (eversion) 과안쪽돌림 (internal rotation) 이감소 (Woodburn et al, 1999) 정상인을대상으로웨지깔창 (wedged in-sole) 적용후각도에따른 근전도 (%MVC) 는유의한차이가없음 (Jung, Do-young et al, 2003) 정상인을대상으로 wedge 를적용하지않았을때와 medial wedge 를 적용하였을때, VMO/VL 근활성도의비가유의하게증가 (Yoo, Won-gyu et al, 2005)

45 Introduction VMO 넙다리뼈회전의고정작용 손상의예방과치료에중요 (Earl et al, 2001; Loudon et al, 2002; Owings&Grabiner, 2002) Squat VMO 와 VL 의비율이가장이상적인 1:1 의비율로나타남 정상인대상 (Coquerio et al, 2005) Heel 하이힐은발목관절의안정성을유지하는근육에불균형을야기 (Gefen et al, 2002)

46 Introduction 연구목적 Heel 5cm Flated VMO VL 근활성도변화 Wedge 힐착용시선택적강화 Medial lateral

47 Method

48 Method 연구대상 Survey group (n=61) Exclusion (n=31) Sample group (n=30) Control group (n=15) Flated heel experimental group (n=15) 5cm heel Medial wedge lateral wedge Medial wedge lateral wedge Figure 4. Research design

49 Method 연구대상 선정기준 배제기준 건강한 20 대여성 KNEE ROM 정상 하이힐습관화 발사이즈 mm 발의기형이없는자 무릎에통증

50 Method 연구대상 - 특성 Table 1. The general characteristics of subjects (N=30) flated heel 5 cm heel Age(yr) 21 ± ± 1.09 Height( cm ) ± ± 2.84 Weight( kg ) ± ± 4.75 Size of foot( mm ) ± ± 2.57

51 Method 실험도구 EMG(Noraxon,USA) Wedge - 표본주파수 1500 Hz - 대역통과필터 Hz - 높이 : 대상자의발허리뼈 - 너비 : 발바닥절반

52 Method 부착위치 Table 2. Attachment point of muscles Muscle Attachment Site VMO 4 cm upper, 3 cm medial to the medial patella VL 10 cm upper, 6-8 cm lateral to the lateral patella base (Cowan SM, Bennell KL, Hodges PW, 2001)

53 Method 연구설계 MVC Rest MVC (5sec) 3min MVC (5sec) 3min MVC (5sec) Squat (sec) 30sec

54 Method 실험방법 무릎굽힘각도는최대로근활성이일어나는 60 도함 (Tang et al, 2001) 60 ( 스쿼트자세에서무릎의각도는각도계 (goniometer) 를 사용하여고정 분석방법 유의수준 α=.05 SPSS ver 프로그램

55 Result

56 Result Table 3. Comparison of the VMO and VL activity due to wedge position and heel height Group Wedge Muscle Mean±SD Flated heel 5 cm heel Lateral Medial Lateral Medial VMO a 48.68±12.26* VL b 50.49±15.21* VMO a 48.66±13.10* VL b 51.00±16.14* VMO a 62.43±30.70* VL b 46.01±18.45* VMO a 59.89±30.27* VL b 47.07±17.99* a VMO: Vastus medialis Oblique, b VL: Vastus lateralis *p<.01 Table 4. Comparison of VMO/VL ratio due to heel height Ratio Wedge Group Mean±SD Lateral VMO a /VL b (%) Medial a VMO: Vastus medialis Oblique, b VL: Vastus lateralis *p<.05 Flated heel 1.02±0.29* 5 cm heel 1.40±0.49* Flated heel 0.99±0.24* 5 cm heel 1.32±0.53*

57 Discussion

58 Discussion Lateral wedge VMO Medial wedge VL 두근육의선택적인강화가가능

59 Discussion 제한점 연구에사용된구두의높이가두가지종류로국한됨 본연구의결과를다른연령층 다른성별에게까지일반화하기엔 어려움이있음 다른불안정한상태에서의 VMO 측정이이루어지지않았음

60 Conclusion

61 Conclusion wedge 종류에상관없이 flated heel 그룹은가쪽넓은근의근활성도값이높았고, 5 cm heel 그룹에서는안쪽빗넓은근의근활성도의값이높았으며, 유의함 heel 종류에상관없이안쪽빗넓은근는 lateral wedge 를착용할때더활성화되고, 가쪽넓은 근에서는 medial wedge 를착용할때더활성화되었으며, 유의함 lateral wedge 나 medial wedge 를착용하는것에상관없이안쪽빗넓은근 / 가쪽넓은근의근활 성비는 5 cm heel 그룹에서더높았고통계적으로도유의함 (p<0.05) lateral wedge 착용시 VMO 가, medial wedge 착용시 VL 이선택적으로강화 flated heel 보다 5 cm heel 을착용함으로써안쪽빗넓은근이선택적으로강화

62 Reference

63 Reference Caylor et al, 1993; Milgrom et al, 1991; Fulkerson, 2002; Sanchis-Alfonso et al, 1999; Witvrouw et al, Coqueriro KR, Bevilaqua-Grossi D, Berzin F, Soares AB, Candolo C, and Monteiro-Pedro V. Analysis on the Activation of the VMO and VL Muscles During Semisquat Exercises With and Without Hip Adduction in Individuals With Patellofemoral Pain Syndrome. Journal of electromyography and kinesiology. 2005;15: Earl JE, Schmitz RJ, Arnold BL. Activation of the VMO and VL During Dynamic Mini-squat Exercises With and Without Isometric Hip Adduction. J Electromyogr Kinesiol. 2001;11: Gefen A, Megido-Ravid M, Itzchak Y et al. Analysis of Muscular Fatigue and Foot Stability During High-heeled Gait. Gait posture. 2002;15(1): Kwon, Oh-yun, Jung, Do-young, Park, Kyoung-hee. The Effect of Rear Foot Wedge Angle on Peak Plantar Pressures on the Forefoot During Walking. Phys Ther Korea. 2002;9(3): Won-gyu Yoo, Hyun-ju Lee, Chung-hwi Yi. Effects of Medial, Lateral Wedge and Difference of Quadriceps Angle on Vastus Medialis Oblique/Vastus Lateralis Muscle Activity Ratios. Phys Ther Korea. 2005;12(2): Woodburn J, Turner DE, Helliwell PS, et al. A Re-liminary Study Determining The Feasibility of Electromagnetic Tracking for Kinematics at the Ankle Joint Complex. Rheumatology(Oxford). 1999;38(12):

64 Abstract

65 Abstract Patellofemoral pain syndrome (PFPS) is often attributed to abnormal musculoskeletal structure such as imbalance of vastrus medialis and vastus lateralis oblique to people having many physical activities. The purpose of this study was to investigate the change of the electromyographic (EMG) activity in vastus medialis oblique (VMO) and vastus lateralis (VL), also vastus medialis oblique/vastus lateralis ratios after wearing wedged flated or 5 cm heel shoes. The subjects were 30 healthy women in twenties who randomly assigned to two group, divided by flated or 5 cm heel group. They were asked to perform squat exercise in two postures using medial and lateral wedged shoes. In two groups, EMG activity of VMO and VL was significant difference between the flated heel and 5 cm heel (p<.01). This study showed that 5 cm heel could selectively strengthen VMO than flated heel. Key Words : Electromyography; Heeled shoes; Vastus lateralis; Vastus medialis oblique; VMO/VL ratio; Wedge

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67 짐볼을이용한쪼그려앉기와벽을이용한쪼그려앉기운동시무릎의 각도변화가안쪽빗넓은근과가쪽넓은근의근활성도에미치는영향 The Effects of Wall Squat and Gym Ball Squat Exercises on Vastus Medialis Obliques and Vastus Lateralis Muscle Activation According to Changing Knee Flexion Angles Konyang University Dept. of Physical Therapy Kim Y.H. Jeon S. Jeong Y.J. Jeong H.W. Ji C.H. Jin S.J. Cha H.R Chon S.C. PhD. PT

68 CONTENTS 1 Introduction Method Result Discussion Conclusion Abstract Reference

69 Introduction

70 Introduction 짐볼 스쿼트 스쿼트 선행연구 무릎굽힘각도 선행연구 짐볼 (Gymnastic-Ball) 은레크레이션훈련환경내에서코어근육안정성강화를위한훈련장치로서 다양하게보고되고있다 (Paul et al, 2005). 최근짐볼을이용한운동프로그램이상당히증가하는경향을보이며, 이를통해재활이나부상예방, 특히허리통증경감효과가있다고보고된바있다 (Merritt & Merritt, 2007).

71 Introduction 짐볼 스쿼트 스쿼트 선행연구 무릎굽힘각도 선행연구 쪼그려앉기는대표적인닫힌사슬하지근력강화운동 (Lee et al, 2013) 안쪽넓은근, 가쪽넓은근, 넙다리두갈래근, 장딴지근강화에많은영향 (Consitt et al, 2002) 관련운동학적변인 : 바벨의위치, 지지발의형태, 몸통과넙다리가이루는각도및넙다리와정강이의각도

72 Introduction 짐볼 스쿼트 스쿼트 선행연구 무릎굽힘각도 선행연구 Christian et al(2014) 짐볼을허리와엉덩이사이에위치하여벽면에대항하여양다리쪼그려앉기를실시하였을 때와, 한쪽무릎과벽사이에짐볼을넣은자세에서의한다리쪼그려앉기시행을통해큰볼 기근과중간볼기근의근활성도를비교 Michelle et al(2006) 짐볼을사용한쪼그려앉기과제수행동안의안쪽빗넓은근과가쪽넓은근의근활성도를비교

73 Introduction 짐볼 스쿼트 스쿼트 선행연구 무릎굽힘각도 선행연구 Irish et al(2010) 열린사슬운동, 엉덩관절모음을동반한 45 쪼그려앉기운동, 런지운동 (lunge) 의세가지운 동방법에서안쪽빗넓은근과가쪽넓은근의근활성도를비교 Yoo et al(2004) 쪼그려앉기운동시 5 개의하지복합자세에따라안쪽빗넓은근과가쪽넓은근의근활성도에 미치는영향을연구한보고에서무릎관절의굽힘자세를 45 로설정

74 Introduction 짐볼 스쿼트 스쿼트 선행연구 무릎굽힘각도 선행연구 본연구에서는벽과짐볼을이용한쪼그려앉기자세에서무릎관절의굽힘각도의변화가 안쪽빗넓은근과가쪽넓은근의근활성도변화및비율을알아보고자한다.

75 Method

76 Method 연구대상자 Table 1. Physical characteristics of subjects (Mean±SD) Variable Mean+SD Range Age(yr) 20± Weight(kg) 64.34± Height(cm) ± 제외조건무릎에손상이있는자하지와관련된관절가동범위에제한이나통증이있는자하지의근육힘이비정상적으로비대칭을이루는자

77 Method 연구대상자 가쪽넓은근 안쪽빗넓은근

78 Method 연구대상자 일직선으로붙인테이프위에두번째발가락을위치

79 Method 연구대상자 A : Wall squat with knee flexion 45 B : Wall squat with knee flexion 90 C : Ball squat with knee flexion 45 D : Ball squat with knee flexion 90

80 Method 연구대상자 A : Knee flexion 45 B : Knee flexion 90 무릎관절의굽힘각도는정강이뼈에대한넙다리뼈의상대각

81 Method 실험방법 분석방법 1. 최대수의적근수축 (MVC) 을 이용하여정량화 (Normalization) 2. 5초간 3세트실시 3. 각세트사이 30초의휴식시간 분석방법 : paired t-test 유의수준 α=.05 SPSS ver 프로그램 4. 처음 1 초와마지막 1 초를제외한 3 초동안측정된근전도값을 평균내어자료분석에사용

82 Result

83 Result Table 2. vastus medialis oblique muscle and vastus lateralis muscle activation during wall-squat, ball-squat (unit : %MVIC) wall-squat ball-squat t p 90 VMO 34.72± ± >0.05 VL 34.66± ± < VMO 16.31± ± >0.05 VL 18.46± ± >0.05

84 Result Table 3. vastusmedialis oblique muscle and vastuslateralis muscle activation during wall-squat, ball-squat (unit : %MVIC) t p wall-squat VMO 34.72± ± <0.05 VL 34.66± ± <0.05 ball-squat VMO 49.83± ± <0.05 VL 48.39± ± <0.05

85 Discussion

86 Discussion 엉덩관절모음을동반한쪼그려앉기운동이안쪽빗넓은근과가쪽넓은근의근활성도가 유의하게증가한다 (Goh et al, 2011). 무릎굽힘 45 에서실시한쪼그려앉기운동이 90 쪼그려앉기운동보다근활성비를증가 시켰다 (Nam, 2008). 60 각도의쪼그려앉기운동시근활성도가가장높다 (Simon et al, 2001). 무릎넙다리관절의압력과부하정도를고려해 45 이하의각도에서쪼그려앉기운동을 해야한다 (Steinkamp et al, 1993). 무릎각도 45~60 사이의쪼그려앉기가안쪽빗넓은근의선택적인강화에효과적이다 (Tang et al, 2001).

87 Discussion 무릎굽힘을 60 로벽면쪼그려앉기와짐볼쪼그려앉기를실시하였을때벽면쪼그려 앉기군에서가쪽넓은근, 짐볼쪼그려앉기군에서안쪽빗넓은근이가장높은근활성도를 보인다 (Oh,2013). 안쪽빗넓은근 / 가쪽넓은근의근활성비는무릎넙다리통증증후군을예견할수있는요인으로받아들 여진다 (Ficat and Hungerford, 1977). 본연구에서는관절각도에따른안쪽빗넓은근 / 가쪽넓은근의근활성비는벽면쪼그려앉기와짐볼쪼 그려앉기를실시하였을때 90 에서각 1, 1.03 의수치를보였다. 45 에서벽면쪼그려앉기와짐볼쪼그 려앉기를실시하였을때나온 0.88 과 0.86 에비교하여높은근활성비를나타내었다.

88 Discussion 소수의대상자 단일군설정 제한점 정상성인대상연구 전후실험설계

89 Conclusion

90 Conclusion 향후하지근력강화를위한쪼그려앉기운동시 짐볼쪼그려앉기운동을벽쪼그려앉기운동보다권장 보다다양한쪼그려앉기운동방법에따른연구가진행되어 목적에맞는쪼그려앉기운동을선택적으로적용할수있는 근거를마련

91 Abstract

92 Abstract 본연구는벽스쿼트와짐볼스쿼트자세에서무릎관절의굴곡각도의변화가대퇴사두근의안쪽빗넓은근과가쪽넓은근의근육활동에미치는영향을알아보고자하였다. 이러한연구목적에따라정상성인남녀 16명을대상으로다리를내전시킨상태에서벽스쿼트와짐볼스쿼트를 45 와 90 굽힌상태에서실시하게하였다. 데이터는운동자세를 5초간유지하도록하고 3회측정하여앞뒤 1초씩을제외한 3초평균값을이용하였다. 분석결과무릎굽힘을 90 로실시하였을때벽스쿼트와짐볼스쿼트시안쪽빗넓은근과가쪽넓은근의근활성도는통계적으로유의한차이를나타내었다 (p<0.05). 또한무릎굽힘을 90 로실시하였을때, 짐볼스쿼트와벽스쿼트에서안쪽빗넓은근의근활성도가가장높게나타났다. 이결론은종합해보면하지근력강화를목적으로스쿼트운동을하는경우, 무릎굽힘을 90 로한다면벽스쿼트보다짐볼스쿼트를권장할수있으며무릎굽힘을 45 로유지하는경우에는벽스쿼트나짐볼스쿼트사이에운동효과의차이는적다고결론지을수있다. Key Words : Squat, Gym ball, VMO, VL, EMG

93 Reference

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96 Impact of Work Environment and Work Related Stress On the Turnover Intention in physical Therapists Konyang University Dept. of Physical Therapy Lee J.T. Lee A.R Jeon H.N. Park S.Y. Ryu T.S. Lee B.K. PhD. PT Seo D.G. PhD. PT

97 CONTENTS Introduction Method Result Discussion Conclusion Reference

98 Introduction

99 Background Increases the number of patients with chronic diseases Reducing turnovers Importance of physical therapy Increase workers' satisfaction Quality improvement of health services

100 Background Work Related Stress Work Environment Emotional labor

101 Background Previous Research Radiological Technologists A Comparative Study on The Job Satisfaction and Intentions of Quitting a Job of Radiological Technologists of Medium Sized Hospitals and University Hospitals. Park YT Occupational therapist Several Rehabilitation and Geriatric Hospital Occupational Therapist Factors Affecting Turnover Intention. Kwon YH Nurse Workplace stressors, coping, demographics and job satisfaction in Chinese intensive care nurses. Li J and Lambert VA. 2008

102 Purpose Hence, this study was conducted in order to provide the basic data for the solutions to reduce the turnover rate of physical therapists and help create efficient personnel management and organization management by exploring the impact of the work environment and work related stress on the turnover objective and analyzing the correlation between them.

103 Method

104 Subjects A survey was conducted on 241 physical therapists working at medical institutions in the Daejeon and Chungcheong area.

105 Experiments Procedure A total of 236 were treated statistically. (Except 5 questionnaires of 241) Period : 3month from January to March, 2014 Turnover intention measurement tool Work related stress measurement tool Work environment measurement tool turnover intention 7 qu estions and turnover fa ctor 4 questions total of 11 questions. Kang(2012) questionnaire consistin g of total 15 questions Byun(2009) questionnaire with a tot al of 26 questions. Lim(2011)

106 Data Analysis For the analysis on the collected data, correlation and linear regression analysis were conducted using the SPSS 18.0 program and Cronbach s alpha coefficient. Cronbach's alpha coefficient Pearson s Correlation Coefficient Linear Regression Analysis

107 Result

108 Characteristics 1. The general characteristics of study subjects. Characteristics classification n % Sex Male Female Age(years) < Marital status Single Married Educational level College University Graduate school Hope department Yes No First job Yes No Total career(years) < ~ ~ Current hospital career(years) < ~ Monthly income(10,000 won) < ~ ~

109 Co-relationship 2. Turnover intention, work related stress, work environment of survey subjects. Variables Question Number Mean±SD Cronbach s alpha Turnover intention ± Work related stress ± Work environment ±

110 Linear-regression 3. The correlation coefficients of turnover intention, work related stress and work environment. Turnover intention Work related stress Work environment Turnover objective 1 Work related stress 0.531** 1 Work environment ** ** 1 *P<0.05, **P<0.01

111 Linear-regression 4. Impact of work environment and work related stress of study subjects on the turnover Intention Variables ß t p-value Work related stress Work environment R²=0.419, Adjust R²=0.414, F= (p=0.000)

112 Discussion

113 Discussion provide the be st care services to patients physical therapists satisfaction increasing the treatment efficiency Interaction in the relationship with patients Cementing the relationship with patient

114 Discussion Co-relationship between turnover intention and work related stress Byun(2009) s study targeting 212 new nurses Co-relationship between turnover intention and work environment Sin(2013) s study targeting 290 nurses Regression analysis on turnover intention according to work related stress Lim(2011)'s study targeting 248 nursing teachers Heo(2011)'s study targeting 353 nurses Regression analysis on turnover intention according to work environment Lee(2010)'s study targeting 236 golf course employees Lim(2011)'s study targeting nursing teachers Sin(2013)'s study targeting local hospital nurses

115 Limitation Physical therapists in Daejeon(Chungcheong), physical therapists working in rehabilitation hospitals and young physical therapists were surveyed. The correlation between various factors of stress and work environment affecting turnover intention could not be clearly identified because survey questions were not segmented.

116 Conclusion

117 Conclusion Improvement of work environment work related stress reduction Reduction of Turnovers intention clinical efforts and systematic development

118 Conclusion all medical institutions subjects of various ages National physical therapists Research that can be used as objective data Analyzing turnover intentions of various occupations

119 Reference

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122 3 폐회식

123 Thank You