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2009, Vol.17, No.4

  • 1.

    The Relevant Factors and Effect of Swallowing Function on Oropharyngeal Stimulation Program in Stroke Patients With Swallowing Disorder

    우지희 | JEONG, WON-MEE | Kim, Yong-Gyu and 1other persons | 2009, 17(4) | pp.1~12 | number of Cited : 12
    Abstract
    Objective : The aim of this study was to investigate the related factors and effects of an oropharyngeal stimulation program on the swallowing function of dysphagia patients after suffering a stroke. Methods : We applied an oropharyngeal stimulation program for 3 weeks to 40 patients (20 were under 6 months since suffering a stroke, and the other 20 were over 6 months, as of November 2008). We investigated the general features of dysphagia patients, cognitive function, duration after onset, and functional dyspahgia scale scores according to PO/NPO feeding type. Results : The results are as follows: 1. According to the onset duration, cognitive function, and PO/NPO feeding type, the functional dyspahgia scale showed a difference between before and after the program. In particular, the normal cognitive group under 6 months since suffering a stroke showed a statistically significant difference (p<.05). 2. The subjects were stratified according to the duration after onset (under or over 6 months), cognitive function, and feed type and applied oropharyngeal stimulation program. We found that the subjects under 6 months since their onset, with normal cognitive function and PO feeding type, showed a significant difference with functional dysphagia scale (p<.05). 3. The results of multiple regression analyses before and after the oropharyngeal stimulation program proves that the duration after onset, cognitive function, and PO/NPO feeding type have an influence on the functional dysphagia scale. Conclusion : Our findings suggest that an oropharyngeal stimulation program is beneficial to dysphagia patients under 6 months since suffering a stroke, with normal cognitive function and PO feeding type. It is necessary that more comparative studies on the related factors of an oropharyngeal stimulation program with functional electric stimulation be conducted.
  • 2.

    Effects of EMG Biofeedback Training on the Hand Functions of Stroke Patients

    한승협 | 최용원 | 감경윤 | 2009, 17(4) | pp.13~24 | number of Cited : 6
    Abstract
    Objective : The aim of this study is to investigate the effects of EMG biofeedback training on the hand functions of stroke patients. Methods : Ten patients who had suffered from the effects of a stroke for at least six months participated in this study. Five of the subjects were randomly given EMG biofeedback training, while the others were assigned as a control group. One session of EMG biofeedback tracking tasks consists of resting and activity stages. During the activity stage, the subjects performed tracking tasks forty times. The experimental group performed one session of tracking tasks per day and received the training five days per week for six consecutive weeks. Their hand functions were measured before and after training using Modified Ashworth Scale, Fugl-Mayer assessment scale, Box & Block test, and Manual Function Test. Results : Except for the Modified Ashworth Scale, all other post-test scores for hand functionality after six weeks of training showed a statistically significant difference compared with the pre-test scores before training (p<.05). However, the control group failed to show a significant difference between the pre- and post-test scores in all tests. The experimental group showed a significant improvement in hand functionality measured by all tests, compared with the control group (p<.05). Conclusion : This study suggests that EMG biofeedback training can be an effective therapeutic tool in the improvement of hand functions of stroke patients.
  • 3.

    The Study on the Necessity of Occupational Therapy for Social Cognition

    Kim,Young-geun | 2009, 17(4) | pp.25~35 | number of Cited : 5
    Abstract
    Objective : The purpose of study was to clear the existence of social cognition disorder in CVA and dementia patients and to suggest the necessity of evaluating and treating social cognition problems. Methods : For this purpose, 18 normal, 10 CVA, 10 dementia subjects were administered‘Social Skills Scales’, the‘independent Living Skill Survey’and the‘Cartoon Task’. The average grades from the three evaluation tools were compared for the three groups at the cognition level. Results : The average grades of each evaluation tool among three groups showed significant differences(p<.01). The correlation exists between MMSE-K and SSS(r=.40, p<.05) and the‘Cartoon Task’(r=.57, p<.01) was existed. Conclusion : These results indicate that CVA and dementia patients may have a social cognition disorder and suggest that occupational therapists specialize in cognitive rehabilitation should study the evaluation and treatment methods for social cognition disorders.
  • 4.

    The Clinical Application of ICF(International Classification of Functioning, Disability and Health) for Functional Ability Analysis of Stroke Patients

    Seung Heon An | Dae-Sung Park | 이석민 | 2009, 17(4) | pp.37~44 | number of Cited : 16
    Abstract
    Objective : This paper evaluates the clinical application of ICF(International Classification of Functioning, Disability and Health) through correlation among existing functional evaluation tools and examines ICF Interrater & absolute reliabilities. Methods : The subjects consisted of 55 sub-stroke patients from the Korea National Rehabilitation Center in Seoul. Two doctors with experience in the ICF code was extracted the 10 items. We linked the ICF code between corresponding entry in the FIM-subscale and MBI-total scale to the most appropriate ICF categories(3 category: transfer, locomotion, self-care). The FIM(Functional Independent Measure), MBI(Modified Barthel Index), and ICF were examined and subjects were interviewed by trained physical & occupational therapist. To assess inter-rater reliability for capacity & performance, the ICF value was measured using the ICC2.1. The absolute reliability was determined using the SEM(Standard Error of Measurement), SRD(Small Reference Difference), and the ICF, FIM, MBI were analyzed using a Pearson product correlation. Results : Inter-rater reliability of ICF(Capacity & Performance) were very high(ICC2.1: .92, .98, respectively), also the absolute reliability were high(SEM: 1.03, 1.09, & SRD: 2.85, 3.02, respectively). The ICF capacity was highly negatively correlated between FIM(r=-.97) and MBI(r=-.90), the ICF Performance was moderately negatively correlated between FIM(r=-.73) and MBI(r=-.69). Conclusion : The ICF tool is a reliable functional assessment tool that correlates inversely with FIM and MBI, showing its criteria-related validity. It can be a useful tool in the clinical setting and research for assessing functional status in stroke patients.
  • 5.

    Effects of EMG Biofeedback Training on the Hand Functions of Stroke Patients

    심영헌 | 정진화 | Yu, Jae-Ho | 2009, 17(4) | pp.45~56 | number of Cited : 2
    Abstract
    Objective : The purpose of this study was to identify the difference of peak torque, total work, and average power according to grip size(small, midium and maximal size) on forearm pronation and supination, and thereby provide research materials regarding grip, pronation, and supination strengths, and offer guidelines about optimal grip size of tools. Methods : Twenty one healthy males who have right dominant hand were recruited for this study. Grip size was divided into three categories(13, 16 & 19cm), and the subjects were measured twice using Biodex System 3 Pro dynamometer isokinetic test. The data were analyzed suing an SPSS 12.0 program for oneway repeated ANOVA and Bonferoni's correction. Results : There was a significant difference in peak torque, total work, and average power according to grip size(small, midium & maximal size)(p<.01). Especially middle size of grip showed relatively high numerical value in the peak torque, total work, and average power. For peak torque, the total work , and average power were analyzed comparatively on forearm supination, and showed significant difference in midium vs. maximal and small vs. midium(p<.05), while for forearm pronation, they showed significant difference in midium vs. maximal, small vs. midium & small vs. maximal size(p<.05). Conclusion : This study shows that there are significant differences in the peak torque, total work & average power according to grip size. Further study is needed to examine impacts of grip size and the sex on forearm torque, and to identify appropriate grip size for each hand.
  • 6.

    Effects of EMG Biofeedback Training on the Hand Functions of Stroke Patients

    Hwang, Sang-hui | 이기업 | 최경림 | 2009, 17(4) | pp.57~70 | number of Cited : 0
    Abstract
    Objective : The aim of this study is to investigate the effects of EMG biofeedback training on the hand functions of stroke patients. Methods : Ten patients who had suffered from the effects of a stroke for at least six months participated in this study. Five of the subjects were randomly given EMG biofeedback training, while the others were assigned as a control group. One session of EMG biofeedback tracking tasks consists of resting and activity stages. During the activity stage, the subjects performed tracking tasks forty times. The experimental group performed one session of tracking tasks per day and received the training five days per week for six consecutive weeks. Their hand functions were measured before and after training using Modified Ashworth Scale, Fugl-Mayer assessment scale, Box & Block test, and Manual Function Test. Results : Except for the Modified Ashworth Scale, all other post-test scores for hand functionality after six weeks of training showed a statistically significant difference compared with the pre-test scores before training (p<.05). However, the control group failed to show a significant difference between the pre- and post-test scores in all tests. The experimental group showed a significant improvement in hand functionality measured by all tests, compared with the control groub (p<.05). Conclusion : This study suggests that EMG biofeedback training can be an effective therapeutic tool in the improvement of hand functions of stroke patients.
  • 7.

    The Effects of Different Head Angles on Suprahyoid Muscle Activation

    Woo, Hee-Soon | Kiyeon Chang | Chon Seung Chul | 2009, 17(4) | pp.71~79 | number of Cited : 4
    Abstract
    Objective : This research was carried out for the purpose of creating clinical applications for improving the swallowing function by comparing suprahyoid muscle activation at different head angles. Methods : Volunteers were collected among students attending OO university in Daejeon, Gwangyeok-si, and 39 subjects 394 males and 15 females) participated in the experiment. The neutral position (a head flexion of 0°) was set with a base angle of the Frankfort horizontal plane parallel to the Earth's sus 394; after confiering a 15°inferior and superior head angle through an X-ray scty ie39h anguas position (head flexion 0°, head flexion 15°and head extension 15°) was tested for 3 dry swallowing and wet swallowing attempts (a 10 second break after 1 swallow). Results : In both dry and wet swallowing, a 15°flexion of the head angle activates the suprahyoid muscles more than in the neutral position, while a 15°stretching of the head angle did not have a statistically significant effect on swallowing. Conclusion : Swallowing induced at a flexed head angle position can more greatly activate the suprahyoid muscles and mobilize the hyoid bone; therefore, this is suggested as a safe way of eating.
  • 8.

    A Study on the Prevalence of Attention Deficit Hyperactivity Disorder in Normal Children and Their Self-Efficacy and Self-Control

    김진영 | 김진경 | 이택영 | 2009, 17(4) | pp.81~87 | number of Cited : 4
    Abstract
    Objective : This study aims to determine the prevalence of attention deficit hyperactivity disorder (ADHD) in children in the general ivpulation; in additiin tit aims to evaluate the self-efficacy and self-control in these children on the basis of the ACRS. Methods : From December 2007 to May 2008, we used the ACRS to survey the self-efficacy and selfcontrol in normal children aged 7-13. Attending their kindergartens and schools, we distributed questionnaires to the parents of 420 such children. The questionnaire was only administered to participants who provided their informed consent when the purpose of the study was explained to them. Of the 420 questionnaires that were distributed, 229 completed copies were returned (a collection rate of 54.5%). In order to determine the prevalence of ADHD in children in the general population, frequency was utilized using an independent t test, and we evaluated the self-control and self-efficacy in normal children and those with ADHD. Results : Using the results of the ACRS in normal children, we observed that 33 (15.7%) of the 210 subjects showed characteristics of ADHD. In addition, children with ADHD exhibited lower self-efficacy and selfcontrol (p< 0.05). Conclusion : Through this study, we revealed that a considerable number of children exhibit ADHD characteristics; in addition, it was found that these children exhibit lower self-efficacy and self-control than normal children. The methods for the systematic treatment and follow-up of such children should be studied in order to solve this problem, and it is essential to have professionally trained personnel who can quickly grasp the problems faced by children with ADHD and treat them at school.
  • 9.

    A Study on the Readability and Content Validity of Korean-translated Version of the Sensory Profile

    Park Kyoungyoung | 유은영 | 2009, 17(4) | pp.89~98 | number of Cited : 13
    Abstract
    Objective : The purpose of this study was to evaluate readability and to establish the content validity of the Sensory Profile (Korean version). Methods : For review of a Sensory Profile, the committee was comprised of one professor of Dept. occupational therapy and two occupational therapist with over 5 years’clinical experience in using the Sensory Profile. The committee compared Korean version of the Sensory Profile with original version and reviewed grammar, sentence structure and meaning of items. For readability, 33 parents with children and 42 occupational therapists with over 1 years clinical experience rated their degree of understanding of the Korean-translated items using 5 point Likert scale. We selected and corrected the others except for items attained at least 3-points above 80% of the respondents for readability. Results : The committee selected 37 items with inappropriate word or poor grammar, and the selected items were corrected. Then, in the second review the committee recommended correcting 13 items and in the last review 3 items. 87.9~100% of the parents responded with 3 point or above for readability of the final version of Sensory Profile so any items weren't corrected. And above 83.3% of 42 occupational therapists responded with 3 point or above for readability of all items except for 75 item and 101 item. Finally, two items were corrected by review of the committee. Conclusion : We concluded that the Sensory Profile was translated into Korean to be easily read and the content validity of the instrument was established through a review by the committee.
  • 10.

    A Study on the Factors Affecting Falls of the Elderly in Rural Areas

    Byoungjin Jeon | Jaeshin Lee | 이옥자 and 3other persons | 2009, 17(4) | pp.99~112 | number of Cited : 19
    Abstract
    Objective : To confirm the variables in the falling efficacy of the elderly in rural areas, this paper deals with the causal relationship between variables that is related to the physical and psychological factors and effects through functional mobility as a parameter. Methods : Data were collected from 290 elderly subjects in 15 senior centers in the Nonsan area from September 3rd, 2008 to May 30th, 2009. For the physical factor, measurements of lower extremity (LE) strength and obesity index were carried out with an InBody 720, which measures the impedance for body parts. For the psychological factor, pain and depression tests were carried out. For functional mobility, tests for Timed Up and Go (TUG) and walking a line were carried out. Data on falls used the Fall Efficacy Scale (FES). Physical and psychological factors were used as exogenous variables for analysis, and the ML (maximum likelihood) estimation procedure of Amos 7.0 was used to analyze functional mobility as a mediating variable, and causal effect of falls as a final endogenous variable. Results : The results of the analysis for correlation between variables that affect fall efficacy showed a negative affect of functional mobility, abdominal obesity, visceral fat, pain, depression, and age; and a positive affect for strength of LE and sex. Significant factors affecting TUG as a mediating variable were LE strength (β=-.352), obesity index (β=.159), and psychological variable (β=.240); and age (β=.424) was a significant factor affecting TUG as a control variable. Significant factors affecting TUG as a final endogenous variable were functional mobility (β=-.524) and psychological variable (β=-.152). The order of absolute influence in total effect included direct effects, and indirect effects were functional mobility (-.524), psychological variables (-.236), and age (-.164) Conclusion : The factors that affected the fall efficacy of seniors in rural areas were functional mobility, LE strength, psychological variables, obesity index, and age. An occupational therapy mediation program that is related with the above factors should be developed to improve the performance ability in daily life, which can increase the fall efficacy of seniors.
  • 11.

    An Analysis on the Status and Supply-Demand of Occupational Therapists in Korea

    MINYE JUNG | 차유진 | 2009, 17(4) | pp.113~127 | number of Cited : 43
    Abstract
    Objective : The purpose of this study is to analyze the supply and status of occupational therapists and grasp the demand accurately, to estimate the appropriate supply-demand of occupational therapists in the future and to contribute to accomplishment of appropriate occupational therapists. For this purpose, I will examine the training and increase status of occupational therapists, the professional activities and employment status of occupational therapists, and appropriate supply estimation of occupational therapists. Methods : I utilized secondary data for all materials used for manpower estimation and found the sum total and average through a technical statistical analysis for the collected data. Results : As a result of the analysis of the status of supply and manpower of occupational therapists in Korea, it is seen that occupational therapists have been trained at 19 4-year colleges and 27 3-year technical colleges. The average passing rate of applicants for the national examination for occupational therapists is 78%, with currently 4395 occupational therapists having been produced. The employment ratio in 2008 was 79%, while in 2009 it was 83%. 54.9% of occupational therapists are members of the Korean Association of Occupational Therapists. Occupational therapists are mainly employed in rehabilitation hospitals, followed by general hospitals and other hospitals and clinics. Compared to other countries, the level of supply of occupational therapists is very lacking; however, it is expected that the number of trained occupational therapists will be equal to that of advanced countries by 2020. Conclusion : 57.9% of occupational therapists are employed in medical institutions. The number of occupational therapists per 100,000 persons after 2020 will be 37 persons, which is the similar to the quantitative growth of advanced countries. It is urgent to change the Korean legal systems to an advanced state so that occupational therapists can provide occupational treatment services to the chronically disabled and aged in communities, other than at medical institutions in the future.