KJC Korea
Journal Central

Objective : The purpose of this study is to compare the effectiveness of combined therapy (traditional therapy plus electrical stimulation) and traditional therapy only in three dysphagic stroke patients using a nasogastric tube. Methods : A single-subject, alternating-treatment design with multiple-baseline design across individuals was employed in this study. Each subject alternately participated in daily traditional rehabilitation therapy including tongue exercise, swallowing control, postural control of the head and neck, sensory stimulation, and control of food only viscosity and traditional therapy plus electrical stimulation sessions. The outcomes were measured using MASA (Mann Assessment of Swallowing Ability), which were collected during all sessions of the study, and DOSS (Dysphagia Outcome and Severity Scale), which were performed before and after the treatment phase. 14 session measurements were made during the baseline and treatment phases. Results : The mean scores of the MASA for the two methods were increased in the treatment phase over the baseline. However, there was no difference between the two methods. The score of the DOSS was increased after the treatment phase. Conclusion : The findings suggest that electrical stimulation and traditional rehabilitation therapy are beneficial in improving the swallowing function of stroke patients using a nasogastric tube. The results of this study failed to determine clearly which treatment method was more effective. More case-control studies with greater sample sizes and longer interventions are required in the future in order to determine the clinical benefits of various treatment methods for stroke patients using a nasogastric tube.

Objective : To investigate the relationship of Allen Cognitive Level with the cognitive abilities and psychosocial factors of people with schizophrenia. Methods : Thirty patients with schizophrenia were evaluated using the following tests: an Allen Cognitive Level Screen (ACLS), Verbal Learning Test, Word-Color Test, Wisconsin Card Sorting Test, Self-Esteem Scale, Relationship Change Scale, Beck Depression Inventory, Social Problem Solving Inventory, and PANSS. Results : The ACLS showed a strong relationship with age, education, and duration of illness. However, the ACLS did not show a strong relationship with psychosocial characteristics with the exception of cognitive scale, which is a measurement of Social Problem Solving Inventory. With respect to the other tests, the Verbal Learning Test, Word-Color Test, and Wisconsin Card Sorting Test showed a strong relationship with the ACLS, but PANSS did not. Conclusion : From an analysis of this study, demographic variables such as age, education, and duration of illness should be considered when administering an ACLS to patients with schizophrenia. However, the ACLS does not appear to have a relationship with the symptoms and psychosocial characteristics of schizophrenia. In addition, the usefulness of the ACLS as a valid measure of the cognitive inabilities of schizophrenia is further supported by its relationship with neurocognitive function tests including the Verbal Learning Test, Word-Color Test, and Wisconsin Card Sorting Test.

Objective : Motor learning can be processed to acquire the two main factor - explicit and implicit knowledge which differ fundamentally in the information storage and learning process. We investigated the effect of the mental practice through target aiming task and serial reaction time task, which required the acquisition of explicit and implicit information respectively. Methods : Total of fifty normal subjects were participated in the experimental with written informed consent, who did not have no history of neurologic or visual deficits. Subjects were randomly divided to each of groups respectively(mental training, physical training, and control group). The target aiming task required to move and click the mouse with the 0.5㎝-circles(10㎝ apart), to travel from leaving 1 target to the second target as quickly and accurately possible. The serial reaction time task required to press the matched button as quickly and accurately as possible, when one of four colored lights was displayed on computer screen. For data analysis, Movement time and reaction time was collected before and after training for three days respectively. Results : In the target aiming task and the serial reaction time task, there were a significant change of movement time in both the mental training and physical training groups, compared to the control group. Also, in comparison of the standard Z-score, the mental training group showed more higher scores than the physical training group in the target aiming task. However, there was no significance between both groups in the serial reaction time task. Conclusion : Our results revealed that mental practice using motor imagery was effective on learning the task to be require to acquire implicit and explicit knowledge. In additionally, we founded that mental practice might be more effective on performing a task that have explicit information, and that was as much as useful as the physical training. It is possible that mental practice using motor imagery is considered as one of therapeutic intervention for patients with brain injury, who had a difficulty on performing the actual movement in the field of rehabilitation.

Objective : The aims of this study were to investigate the effects of a sensory integration centered occupational therapy program on occupational performance in children with developmental disabilities utilizing the DeGangi-Berk Test of Sensory Integration(TSI), the Assessment of Motor and Process Skills(AMPS) and the Canadian Occupational Performance Measure(COPM) and to provide clinical guideline of evaluation and treatment by exploring relationships between occupational performance components and occupational performance skills. Methods : Thirty children with developmental disabilities between 3 and 13 years of age from community programs in Seosan, Hongseong, Dangjin participated in this study. Each child participated in 20 to 24 sessions of a sensory integration centered occupational therapy program. The TSI was used to measure the changes in sensory integration abilities. The AMPS and the COPM were used to measure the changes in occupational performance. One group pretest-posttest design was used to verify the effect of sensory integration centered occupational therapy and Pearson product-moment correlation coefficients were used to investigate the relationships between occupational performance components and occupational performance skills. Results : The results of TSI, AMPS, and COPM scores demonstrated statistically significant improvement in all areas of occupational performance components and occupational performance skills (p＜.05) after sensory integration centered occupational therapy. There were no statistically significant relationships between occupational performance components and occupational performance skills except for COPM-Performance and COPM-Satisfaction(r=.840). Conclusion : The results of this study suggest that, first, the sensory integration centered occupational therapy worked positively on occupational performance in children with developmental disabilities, and second, in order to fortify the evidence that a sensory integration approach is effective, it is essential to evaluate changes in both occupational performance components and occupational performance skills.

Objective : The purpose of this study was, by a comparison of child-rearing attitudes and sensory processing between general mothers and mothers with disabled children, to study the problems faced by mothers with disabled children and relativities in terms of child-rearing attitudes and sensory processing. Methods : Adolescent/Adult Sensory Profile (ASP) for general mothers(20) and mothers with disabled children(20) and a Maternal Behavior Research Instrument (MBRI) were used. It took 25 minutes to complete the two research forms, and was conducted in September 2007, over two month. Child-rearing attitudes and sensory processing mean scores were analyzed and a Pearson's correlation analysis was used to conduct the statistical calculations. Results : As a comparison of child-rearing attitudes, general mothers were, on average, more positive than mothers with disabled children (p<.05). Most mothers of disabled children were found to have less affectionate, self-regulating, and rejecting attitudes. Mothers with disabled children were found to have low grades of sensory processing, especially in terms of active behavior of the 'Sensation Seeking' area. Both affectionate and self-regulating qualities were correlated with the four area of sensory processing: 'Low Registration', 'Sensation Seeking', 'Sensory Sensitivity', and 'Sensation Avoiding' (p<.05). Conclusion : Many problems relating to attitude in mothers with disabled children were examined in this study. In addition, mothers with registration, sensitiveness, and active responses to stimulation expressed more affectionate and self-regulating attitudes toward their children. In the following study, numerous factors affecting child-rearing attitudes are outlined in detail.

Objective : The purpose of this study is to suggest the general and physiological health features of rural elderly persons, and to use the results toward the basic data of community-based occupational therapy (CBOT) for the elderly. Methods : 166 elderly persons who use a center for the elderly in the Nonsan region were conveniently sampled from Sep. 14th, 2006 to Nov. 23th, 2006. Measurements of the lower extremity strength and functional movement, balance, and degree of obesity were analyzed using an InBody 720. A data analysis was conducted using SPSS win 12.0. Results : For muscle strength and balance, the elderly males were better than females, while the obesity degree of the females was higher than that of the males. Significantly, as age growsolder, the muscle strength, balance, and functional movement were lower. The body mass index (BMI) showed a significant difference in the degree of obesity. The correlation between functional reach while standing on one leg and the waist hip ratio (WHR) was significant, while the correlation between functional movement and obesity was insignificant. Conclusion : Community-based occupational therapy is needed for the rural elderly, as is a preventive falling program considering the degree of obesity according to the sex and age of the elderly.

Objective : The purpose of the study is to determine the effect of a submerged symmetrical exercise (SSE) on the functionality of the affected upper limb in a subject with hemiplegic cerebral palsy. Methods : An 8-year old female subject suffering from a left hemiplegia was selected, and a single-subject A-B-A design was used. 8 session-measurements were made in the baseline (A), intervention (B) and follow-up (A) phases. During the intervention period, the SSE was additionally performed after regular rehabilitation therapy, and in the follow-up phases, the SSE was withdrawn in order to investigate the carry-over effects of treatment. The outcome measures used were a Bruininks-Oseretsky motor proficiency test and a grooved pegboard test, which were collected during all phases of the study. Also, a motion analysis for a seated forward reach task was performed before and after the intervention phase. Results : During the intervention phase, there were visible improvements in the function of the upper extremity, and these improvements were maintained with a general trend of reduction during the follow-up phase. In reach task analysis, the findings revealed that trunk compensation was reduced, while shoulder and elbow mobilities were increased after the intervention period, and the reaching motion pattern became relatively stable. Conclusion : This study shows the therapeutic possibility and clinical advantage of SSE as a long-term rehabilitation method for children with hemiplegic CP.

Objective : The purpose of this study is to analyze the task of drinking a glass of water through three-dimensional motion analysis and electromyogram (EMG). Methods : Thirty healthy young adults were recruited for this study. The participants performed the task of drinking a glass of water in a sitting position. During the task, the time, range of motion, and velocity of upper extremity movement were measured using VICON MX SYSTEM, and the muscle activities were measured using MP-100. Results : The results show a maximal adduction of the shoulder and an extension of the elbow during the glass-holding phase. There were a maximal flexion, abduction of the shoulder, and maximal flexion of theelbow during the drinking phase. During the reaching phase, the shoulder angle was highly correlated with the elbow angle (r=-.904, p<.05), the shoulder angle moderately correlated with the wrist angle (r=.722, p<.05), and the elbow angle moderately correlated with the wrist angle (r=-.700, p<.05). During the forward transport phase, returning phase, drinking phase, and reaching phase, the upper trapezius (7.31%), biceps brachii (1.60%), triceps brachii (.43%), deltoid middle fiber (1.33%), and extensor carpi radialis longus (2.20%) showed the highest muscle activities. Conclusion : The results of this study can be applied to people with neurological conditions who experience upper extremity weakness for their most-efficient movement patterns during various activities of daily living. This may lead to an effective occupational therapy program, treatment plan, and better client satisfaction.

Objective : Ipsilateral mirror movements (MMs) are involuntary movements of one limb during voluntary unilateral movements of the opposite limb. MM decreases in the course of motor development, but may reappear in adults suffering from brain damage after a stroke. The purpose of this study is to measure MM and compare the relationship between ipsilateral MM and the motor function of the affected upper extremity in stroke patients. Methods : Fifteen stroke patients with MM and fifteen stroke patients without MM were selected for this study. Two dynamometers were used during a squeezing task in order to measure the intended movements from the active hand as well as MM from the opposite hand. The upper extremity's motor function was measured using Fugl-Meyer Assesment (FMA), Purdue Pegboard Test (Purdue), and grip strength. Results : There was a significant difference in the upper extremity's motor function according to FMA, Purdue, and grip strength, depending on the presence of MM. The motor deficit of patients with MM was significantly greater than that of patients without MM. Conclusion : The findings show that stroke patients with MM have a significant motor deficit. The observation of ipsilateral hand MMs with greater motor deficit may suggest that these MMs represent a clinical sign of the restorative processes after a stroke. Therefore, the evaluation of MM can be useful for the assessment and treatment of stroke patients. Further studies are needed to attempt temporal assessments and develop a treatment intervention of MM after a stroke

Objective : The purpose of this study was to research the practical degree of use of assistive technology in order to provide occupational therapists conveying an assistive technology service and devices to persons with disabilities for their health and rehabilitation with actual and present conditions concerning assistive technology services, and to discover improvement methods toward the present application of assistive technology. Methods : This study was conducted using 256 occupational therapists who have obtained their occupational therapist license in South Korea and have practiced in a clinical setting. The study period was from October 28, 2006 to November 4, 2006. Results : Eighty-two (32.0%) of the occupational therapists had experience with assistive technology, and the subject group with physical disabilities was the largest portion. Moreover, 165 (64.4%) answered that the application of the therapeutic environment was low or very low. And 127 (49.6%) of the occupational therapists answered positively to the question of whether they are planning to use an assistive technology appended to the current method. The practical degree of use of assistive technology among occupational therapists was indicated as relatively low; averaging a score of only 1.70 out of 12. To improve the application, they answered in the following order: offering educational opportunity, providing financial support, improving cognition, and supplying professionally trained manpower/labor. Individuals with higher educational background had a higher percentage of using an assistive technology. Conclusion : In conclusion, assistive technology has been widely acquired among occupational therapists. For the effectiveness of the application of assistive technology, there should be continuous support in terms of associative supplementary education, related workshops and seminars, and financial support.

Objective : This study investigates work-related stress and the factors affecting it in Korean occupational therapists. Methods : All of the subjects are current Korean occupational therapists with more than 6 months of work experience. Using an acceptable 138 survey responses, a factor analysis was conducted for work-related stress. Results : Through a factor analysis from 38 questions of the survey, the results show 9 main work-related stresses: heavy duties, conflicts regarding the therapist’s professional role, lack of professional knowledge and skills, problems in personal relationships, disagreements with doctors, limitations of the medical system, inappropriate treatment, inappropriate salary, and an inappropriate physical environment. Conclusion : This study demonstrates work-related stress and its factors in Korean occupational therapists. The results may contribute in developing an evaluation kit to measure their work-related stress. Further research is necessary to study more specific work-related stress in Korean occupational therapists.