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2008, Vol.16, No.4

  • 1.

    Effects of a Group Cognitive Rehabilitation Therapy on Mild Dementia Patients in a Community - Focused Occupational Therapy Intervention Process Model -

    JEONG, WON-MEE | Lee, Dong-Young | Ryu, Seung-Ho and 4other persons | 2008, 16(4) | pp.1~17 | number of Cited : 31
    Abstract
    Objective : This study aims to understand the effects of Group Cognitive Rehabilitation Therapy (GCRT) based on Occupational Therapy Intervention Process Models (OTIPM) on the Activities of Daily Living (ADL), cognitive function, and depression of mild dementia patients, and to suggest the basic data for GCRT for dementia patients. Methods : GCRT was applied two times a week for eight weeks to 14 mild dementia patients who visited the Gwanak Center for Managing Dementia and the Seongbuk Center for Dementia in Seoul between August 2007 and July 2008. The research was conducted for a total of 12 weeks including a tracking evaluation conducted four weeks later. Based on OTIPM, the GCRT was applied by selecting a compensation model, an education teaching model, a restorative model, and an acquisitional model. Moreover, a one-group pretest-post test design, which is a quasi-experiment and research tool, was also applied in order to verify the effects of the rehabilitation therapy on the subjects' ability toward ADL, cognitive function, and depression. Results : A significant effect was confirmed (p<.05) from the GCRT, which was comprised of a verbal fluency test, MMSE-KC, ACL, and AMPS. In contrast, there was no significant effect in MMSE-KC, which was comprised of Boston naming, word list memory, constructional praxis, and word list recall tests. No significant effect on improving the depression syndromes from GDS was found either. Conclusion : It seems that GCRT based on OTIPM has an effect on the improvement of the ability toward ADL and on the cognitive function of mild dementia patients living in a community.
  • 2.

    The Effects of Functional Electrical Stimulation on Arm Motor Function in Patients With Chronic Hemiplegia

    김정화 | 윤용순 | BokHee Chong | 2008, 16(4) | pp.19~29 | number of Cited : 9
    Abstract
    Objective : The purpose of this study was to determine the effects of functional electrical stimulation(FES) on arm motor function in patients with chronic hemiplegia. Methods : Eighteen consecutive patients who had chronic hemiplegia over 12 months after a stroke attack were included. They received conventional rehabilitation treatment without FES for 4 weeks, and then undertook FES on a hemiplegic arm daily for 20 minutes a session, five days a week, for an additional 4 subsequent weeks. Four channels of FES worked sequentially for such motions as eating. The outcome was assessed using a manual muscle test for arm strength, dynamometer, and pinch gauge for grip and pinch power; the upper extremity subset of the Fugl-Meyer motor Assessment (FMA) for hand function; and CMS10 measuring system for motion analysis at baseline, after 4 weeks and then again after an additional 4 weeks of post-treatment. Results : In a conventional rehabilitation treatment session without FES, there were no significant changes on finger or arm strength, and FMA (p>.05). In the FES session, there was significant increasement of arm strength, finger strength, and motor function by FMA after 4 weeks of treatment (p<.05). Furthermore, motion analysis showed significantly improved movement qualities on most parameters of pronation-supination movement, hand tapping, and finger tapping motions after 4 weeks (p<.05). Conclusion : FES is an effective treatment method for arm motor function in patients with chronic hemiplegia over 12 months after a stroke attack.
  • 3.

    Trunk Control After Stroke and the Relationship With Balance, Activity Daily Living ; PASS, TCT, BBS, FM-B, MBI

    An, Seung-Heon | lee suk-min | 2008, 16(4) | pp.31~44 | number of Cited : 8
    Abstract
    Objective : The purpose of this study was to find the correlations among Postural Assessment Scale for Stroke(PASS), Trunk Control Test(TCT), Berg Balance Scale(BBS), Fugl-Meyer Balance(FMB) Assessment, and Modified Barthel Index(MBI). Methods : The subjects were 43 chronic stoke patients of the Korea National Rehabilitation Center in Seoul. All patients were assessed on trunk control measured using PASS and TCT, on ADL using MBI, and on balance using BBS and FM-B. The data were analyzed using a pearson product correlation. MBI & PASS scale among other clinical and instrumental indexes, and multiple stepwise regression analysis, were peformed to identify the prognostic factors for PASS-subscale, FM-B, TCT, BBS, and ADL incline. Results : The results of this study were as follows: There were significant correlations between PASS and TCT (r=.79~.96), PASS & TCT, BBS, FM-B (r=.65~.82), and MBI (r=.75~.79). There were also significant correlations between BBS & FM-B (r=.77~.78) and FM-B & BBS (r=.84)(p<.01). The walking item in the MBI subscale showed the strongest variance in PASS-Maintaining Posture, Changing Posture, Total, FM-B (p<.001), TCT, and BBS (p<.01). The unsupported standing item in the PASS subscale showed the strongest variance in ADL, FM-B, TCT, and BBS(p<.001). The PASS Total score was the strongest variance of the ADL (p<.01). The unsupported standing item of the PASS subscale showed the strongest variance in personal hygiene, bathing one's self, toilet, stair climbing, ambulation, and chair․bed transfer (p<.001), while supine to the affected side lateral and supine to sitting up on the edge of the table items showed the strongest variance in dressing(p<.001) and feeding (p<.01). Conclusion : The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of stroke patients. Further study on PASS, TCT, BBS, FM-B, MBI is needed using a longitudinal study design.
  • 4.

    The Study on Physical Predictors Which Affect Performance of Acute and Post-acute Stroke Patients

    Song, Young-Jin | Kwon Jae Sung | 2008, 16(4) | pp.45~54 | number of Cited : 1
    Abstract
    Objective : The purpose of this study is to discover the significance in upper-and lower-extremities and trunk function in terms of physical predictors that affect acute and post-acute stroke patients' performance of ADL, and then to compare the differences of physical influence in both groups. Methods : The subjects were 30 persons with acute strokes onset within the past six months, and 22 persons with post-acute stokes onset over six months ago. The evaluation tools used were an Arm and Leg Brunnstrom Recovery Stage, Trunk Impairment Scale (TIS), and MBI. We made an analysis Pearson correlation to discover the relativity of each score, and conducted a multiple regression analysis to discover the relative efficiency affecting the MBI scores. Results : In acute subjects, the physical and MBI scores showed a positive correlation. To check as physical predictors affecting MBI operated multiple regression analysis as a result TIS was founded statistically significant predictors of ADL. Conclusion : As a result of the study, we acknowledged that the influence of a stoke patient's physical function to ADL is different according to the period of time from the initial attack. It is understood that an especially acute stroke patient's trunk function is a physical predictor for ADL performance.
  • 5.

    The Effects of Weighted Vest on EEG in Child With Attention Deficit Hyperactivity

    이지연 | 2008, 16(4) | pp.55~64 | number of Cited : 2
    Abstract
    Objective : This study examined the effects of a weighted vest on EEG in children with attention deficit hyperactivity. Methods : The subjects were two boys with attention deficit hyperactivity and sensory process problems. The EEG was used to determine the effects of the weighted vest. The EEG for each subject was measured before and after wearing the weighted vest, before and after activity with the weighted vest, and before and after activity without the weighted vest. Results : Both subjects showed an increase of relative alpha power in Fp1 and Fp2 with the weighted vest. After activity, the total relative alpha power and relative alpha power in each part of the brain increased in ADHD when the weighted vest was used. Conclusion : These findings provide evidence of the neurophysiologic aspects identified in previous research that showed that weighted vests have a relaxation effect in subjects with ADHD.
  • 6.

    The Effect of a Work-Hardening Program for Workers Returning to Work With low Back Pain

    박소연 | Kim, Hyun-Wook | 2008, 16(4) | pp.65~76 | number of Cited : 5
    Abstract
    Objective : This study was performed to examine the effects of a work-hardening program on workers who returned to their jobs after medical treatment for work-related low back pain. Methods : This study was conducted in a domestic car manufacturing company from August through November, 2005, and all participants returned to their jobs after over 6 months of medical treatment for work-related low back pain. Experimental (N=18) and control groups (N=20) were selected for the study. For the experimental group, an individualized education and exercise program built on a fear-avoidance beliefs model was provided for 2 hours a day, 5 days a week for approximately eight weeks. For the control group, workers who returned to their normal jobs through a long adaptation period after returning to work were selected. The characteristics of the two groups were compared by the scores of fear-avoidance beliefs, disability of activities of daily living, pain intensity, depression, and the safe maximum weights in pre- and post-tests. Results : Statistically significant decreases in the scores of fear-avoidance work beliefs (FABQ1-work), disability of activities of daily living due to low back pain (RDQ), pain intensity (VAS), and depression (K-BDI), and the safe maximum weights assessed at three different heights were found after intervention in the experimental group (p<.05). The mean working period after returning to work in the experimental group was 6.1 (±3.2) months, while that of the control group was 22.4 (±14.9) months, which were statistically and significantly different (p<.05). The results showed that, in adapting to their job, the functional status of the experimental group improved up to the level of the control group in about 8 weeks. Conclusion : This study confirmed that an individualized work-hardening program in the workplace is an effective means for improving workers' functional capacity and for decreasing the duration of a period of adaptation to work. We expect that in the future, the study of work-hardening programs to support an early return of workers with low back pain will be vitalized.
  • 7.

    Analysis of the Risk Level of Musculoskeletal Disorders for Workers at Automative Component Factory Using Work Sampling

    Jang, Young-Sook | 이택영 | 박소연 | 2008, 16(4) | pp.77~88 | number of Cited : 6
    Abstract
    Objective : Using a work sampling technique and cross-section analysis, this study was performed in order to analyze the risk level of musculoskeletal disorders for workers engaged in the manufacturing industry. Methods : Using a self-entering mode questionnaire, the study was conducted to survey the musculoskeletal disorders of 29 workers at an automative component factory. The extent of the musculoskeletal disorders of the workers was classified into basis 1(KOSHA), basis 2(NIOSH), and basis 3 (labor scientific research institute of Incheon university). And the risk levels of the musculoskeletal disorders were evaluated using OWAS, RULA, and REBA for each work posture, extracting 1 cut per 1 sec, based on the work sampling technique, after having photographed the work processes of the individual workers with a high performance camera. Results : The number of workers who complained of pain in one or more parts of their body were 24 persons (82.8%) in basis 1, 22 persons (75.9%) in basis 2, and 19 persons (65.5%) in basis 3. As a result of having analyzed the musculoskeletal disorders, OWAS was in risk level 4 in a cross-section analysis (inflicted with severe musculoskeletal disorders), and as for the work sampling technique, the workers in risk level 2 (inflicted with milder musculoskeletal disorders) were 3 persons. Also, the workers whose work sampling of risk level had been 3 (continuous observation and fast work improvement were required) while their cross-section analysis for RULA was at risk level 4 (precision survey and immediate improvement were required) were 2 persons, while in REBA, the workers whose work sampling risk level was 2 (risk was normal) while their cross-section analysis risk levels were 3 (risk was high) were analyzed as 3 persons. The consistencies of the work sampling and cross-section analysis in the high-risk group and the low-risk group are as follows; OWAS (Kappa=.4423), RULA (Kappa=.4938), and REBA (Kappa=.5193). Conclusion : The results showed that this study may be used to analyze the exposure risk level to the musculoskeletal disorders of workers using a work sampling technique, and it has been confirmed as a trusted method in selecting the workers who require a preferential improvement of their work environment.
  • 8.

    The Analysis Study of Time Use and Occupational Performance Issues for Individuals With a Spinal Cord Injury in Rehabilitation Hospital

    Seung-Pyo Hong | Lee, Ji-Eun | Park, Sun-Hee | 2008, 16(4) | pp.89~98 | number of Cited : 11
    Abstract
    Objective : The purpose of this study is to describe the self-care, productivity, and leisure problems identified by individuals with a spinal cord injury, and to examine the relationships among time-use patterns, activities of daily living, and occupation performance and satisfaction. Methods : We analyzed time-use using a 'Time-table' that was divided into thirty minutes for each occupational area. Also, a Modified Barthel Index (MBI) and Canadian Occupational Performance Measure (COPM) were conducted on 19 SCI patients in a rehabilitation hospital. Results : A total of 84 occupational performance issues were identified, with self-care goals being identified the most frequently (71.4%). The higher the MBI score, the more time for self-care was needed (p<.05), while the SCI sample showed more time for passive leisure than active leisure. Conclusion : The results showed the occupational performance issues identified by individuals with a spinal cord injury, and that the balance among occupational areas was broken. Therefore, our study suggests that occupational therapists need to include such analysis and re-built time-use pattern, and consider the patients' priorities during goal-setting for individuals with a spinal cord injury.
  • 9.

    The Effects of Line Drawing on Object Recognition

    김영근 | HyunJung Shin | 2008, 16(4) | pp.99~112 | number of Cited : 0
    Abstract
    Objective : An experiment was performed to investigate the effects of a line-drawing on object recognition and to suggest the importance of an object's internal information on form constancy. Methods : In the experiment, the focus was on a comparison and analysis of whether stimulus types and rotation directions affect the decisions of physical shape sameness of two figures presented successively. Results : The results of the experiment showed that the line-drawing type affects object recognition. A line-drawing-type object was perceived more quickly and accurately than a silhouette-type, and was similar to a shade-type. The accuracy and response time were affected by the change of rotation direction. In particular, a line-drawing effect was seen better than a foreshortened view. Conclusion : These results suggest that the internal information(line-drawing) of an object positively affects object recognition and form constancy.
  • 10.

    A Review of the Application of Snoezelen on BPSD of older People With Dementia

    Han sang woo | Jaeshin Lee | 2008, 16(4) | pp.113~124 | number of Cited : 6
    Abstract
    Introduction : This research tries to provide the information needed for succeeding research through investigating the subjects, research designs, analysis methods and results, and limits of the existing literature in order to look at the applicational effects of a multisensory environment for the aged with dementia showing abnormal behavior. Body : The materials of the research were collected by retrieving research items in the areas of "dementia, multiple sensory, snoezelen, and Behavioural and Psychological Symptoms of Dementia (BPSD)" from the data base of PubMed. Among the collected materials, 12 research results are suggested regarding the application of a multisensory stimulation program to the aged with dementia showing abnormal behavior in terms of subject, research design, measurement tool, cure method and result, analysis method, and limit. All the researches that applied a multisensory stimulation program to the aged with dementia showing abnormal behavior show a positive effect, and 10 researches present a statistically meaningful result. According to the comparison, the group of multisensory stimulation programs shows more meaningful difference than a control group that was normally protected and managed, and a comparison group that was applied by activities in awareness level, defiant behavior, depression symptoms, apathetical behavior, aggressive behavior, and interaction ability. However, some of the results show a meaningful difference only during the mediation period or present the re-appearance of abnormal behavior during a follow-up survey. That is, these results do not show a meaningful outcome compared to the results before the mediation period. Conclusion : The multisensory stimulation program shows a positive effect toward the reduction of abnormal behavior of the aged with dementia, but follow-up research to maintain the positive effect is needed.