Objective : The aim of this study was to develop a Home-based Activities (AHA) assesment that can determine the performance of daily at-home activities of the elderly in three areas: Independence, difficulty, and safety.
Methods : Certain steps were followed: Collection and selection of the activities, finalizing the activities, and determination of the scale level and scoring method. A total of 38 daily activities were collected, which were narrowed down to 26 through the three rounds of selection. In the selection rounds, 10 experts and 145 elderly people participated in a survey or panel meeting on the conformance and/or importance of the activities. The degree of independence was determined on a 3-point scale, whereas the difficulty and safety levels were determined on a 4-point scale. The scoring method was determined using a Likert method for the rating summation.
Results : The AHA is composed of 3 measurement areas and 26 activities for each area. The activities include 14 BADL, 11 IADL, and 1 leisure activities.
Conclusion : The AHA is the first instrument in Korea for assessing elderly people’s performance of daily at-home activities, and is expected to be useful in the planning and implementation of interventions in the field of rehabilitation through occupational therapy.
Objective : This study aims to investigate the effect of an 8-weak tongue pressure resistance training protocol onthe tongue strength, overall swallowing function, and dietary stage in chronic stroke patients with dysphagia.
Methods : The subjects of this study were seventy-five dysphagia patients who were divided into an experimentalgroup and a control group from August 2013 to February 2014. Both groups received traditional dysphagiarehabilitation therapy and the experimental group received an additional tongue pressure resistance exercise usingthe Iowa Oral Performance Instrument (IOPI). IOPI was used for a change in muscle strength of the tongue, andVDS & ASHA NOMS based on VFSS were used for changes in the overall swallowing function and dietary stage.
Results : The experimental group, which underwent tongue pressure resistance training, did not have a cleardifference in tongue strength, swallowing function, and dietary stage effect compared to the control group. Theresults were as follows. 1) There were significant differences between the experimental and control groups in themuscle strength change at the anterior and posterior of the tongue (p<.05). 2) There were also significantdifferences between both group sin terms of change sin their swallowing function and dietary stage (p<.05). 3) Inaddition, variations before and after intervention showed no statistically significant difference for either group.
Conclusion : This study was unable to verify the effect of tongue pressure resistance training on the musclestrength of tongue, swallowing function, or dietary stage of chronic stroke patients with dysphagia when comparedwith the results of the control group. Future studies should verify the effect using a protocol with a modificationin the intervention period and amount of training.
Objective : The purpose of this study was to verify the predictive validity of the aspiration capability in strokepatients with dysphagia based on a Swallowing Function Test (SFT).
Methods : The subjects of this study included 90 stroke patients with problems of dysphagia. The data collectedusing Videofluoroscopy Swallowing Studies (VFSS), Swallowing Function Test (SFT), Penetration-AspirationScale (PAS), and American Speech-Language-Hearing Association National Outcome Measurement System(ASHA NOMS) for the 90 stroke patients were analyzed based on a Receiver Operating Characteristic curve (ROCcurve) to determine the cutoff score of the aspiration Area Under the Curve (AUC), and the sensitivity andspecificity of the SFT. In addition, the data were analysed based on the positive and negative predictive values fora prediction of the aspiration capability. The items used for the validity of the SFT were analyzed based on theAUC value. In addition, The SFT was analyzed using a Pearson’s correlation analysis with ASHA NOMS andPAS.
Results : The cutoff score of the SFT was 36 points, and that of the AUC was .94. In addition, the sensitivity andspecificity of the SFT were 94.3% and 90.9%, respectively. The five best items of the SFT for predicting theaspiration capability were ‘voluntary cough,’ ‘laryngeal elevation,’ ‘swallowing before/during/after coughing,’ ‘voicechanges,’ and ‘the appearance of throat clearing.’ In addition, ASHA NOMS and PAS were significantly correlatedusing the SFT.
Conclusion : The SFT for stroke patients with dysphagia has been proven to be a useful test. It is expected thatthe SFT will be used as a predictive tool of aspiration capability and will offer intervention guidelines fordysphagia rehabilitation.
Objective : The purpose of this study is to create the basic standards for clinical training guidelines to receive aproper quality level of on-site clinical training education by investigating a system of clinical training for anationwide department of occupational therapy and clinical occupational therapists.
Methods : A survey regarding a system of clinical training was conducted in a nationwide department ofoccupational therapy and at an institution of clinical occupational therapy from August 2013 to April 2014. Basedon the job analysis data from the occupational therapists, we investigated and analyzed the preparation technique,and its importance, required for novice occupational therapists.
Results : Thirty-eight colleges and universities participated in this clinical training system survey. The averagetime of the clinical training is 517.2 hours in colleges and 983.5 hours in universities. University hospitals havethe largest number of clinical training institutions, followed by rehabilitation hospitals. In addition, disabled adultinstitutions make up 66.8% of the total number of clinical training institutions. The results of the importance in theuse of a preparation technique show that the number of items scoring higher than 4.5 points (on a 5-point scale)are 14 for the evaluation items and 2 for the intervention items based on the responses of the professorssurveyed, and 3 for the evaluation items and 2 for the intervention items based on the responses from theclinicians. In the two groups, there are significant differences in 19 of the evaluation items and 1 of theintervention items. The results of the preparation techniques of newly appointed occupational therapists show thatthe items scoring higher than 4.5 points (on a 5-point scale) are 23 for the evaluation items and 30 for theintervention items based on the responses of the professors, and 14 for the evaluation items and 25 for theintervention items based on the responses of the clinicians. In the two groups, there are significant differences in20 of the evaluation items and 8 of the intervention items.
Conclusion : This study showed significant differences in interdisciplinary training times when implementing aclinical training program. There is large difference between professors and clinicians in terms of which techniquesare important in the area of occupation therapy. The development of clinical training guidelines reflecting theopinions of both sides is needed. In addition, the development of clinical practice guidelines according to each fieldis needed because there is big difference in the important techniques used in the areas of occupational therapy.
Objective : The purpose of this study was to develop a Korean version of the Safe Driving Behavior Measure(K-SDBM) and verify its reliability.
Methods : To develop the K-SDBM, a series of steps were followed: First, the SDBM was adapted to the Koreancircumstances. Second, driving behaviors fitting Korean culture were collected. Drivers and a therapist verified thevalidity of the content.
Results : A total of 37 out of 40 items remained after verifying the content validity. A total of 211 elderly driversover 65 years in age, having a valid driver’s license and driving at least once during a 3-month period,participated in this study. The internal consistency and test-retest reliability of the K-SDBM were examined. Theinternal consistency (Cronbach’s α) for the elderly drivers was .97, and the test-retest reliability (intraclasscorrelation coefficient) was .75.
Conclusion : This study contributed to the base of evidence and knowledge regarding the reliability of theK-SDBM, and is expected to be useful in planning and implementing intervention for elderly people in the area ofdriving rehabilitation.
Objective : The purpose of this study was to determine through a meta-analysis the effect of Constraint-InducedMovement Therapy for the upper-extremity function in children with cerebral palsy suffering from hemiplegia.
Methods : The data were collected using domestic and foreign search engines. The fourteen studies selected werepublished from 2006 to 2013. The studies that meet the selection criteria were conducted through a qualitativeassessment using the PEDro score. The average and standard deviations and the sample size of the pre-test andpost-test, depending on the topic, were determined through a meta-analysis.
Results : The fourteen studies that meet the selection criteria were 6 points over the PEDro score and involved527 study participants. The effect size of the affected upper-extremity function, amount of use, and quality asindicated by a “large effect size,” was statistically significant (p<.001). The effect size of the dissociatedmovement, visual motor integration, and bilateral hand use as indicated by a “medium effect size,” was alsostatistically significant (p<.05).
Conclusion : Constraint-Induced Movement Therapy is more effective than conventional therapy for improving theupper-extremity function of children with cerebral palsy suffering from hemiplegia. This evidence can be used toimprove the upper-extremity function of such children in a clinical setting.
Objective : The purpose of this study was to investigate the effect of multimodal intervention, consisting ofphysical activities, cognitive training, and social interaction activities, on the quality of life, depression level, andcognitive function in elderly people with dementia.
Methods : We used a single group pre- and post-test design. We executed a multimodal intervention for 10sessions The subjects included six elderly people with dementia who underwent eight 120 min. interventionsessions once a week. In the first and tenth sessions, the patients underwent pre- and post-tests. We usedGQOL, GDS-K, and MMSE-K as dependent measurements.
Results : The GQOL score of the subjects was significantly increased (p<.05). The GDS-K scores decreased butnot significantly. The MMSE-K scores increased but not at a statistically significant rate (p>.05). There were nosignificant differences between mild dementia and moderate dementia in terms of the GQOL, GDS-K, andMMSE-K score variations (p>.05).
Conclusion : Multimodal intervention is effective on the QoL of elderly people with dementia, and has positiveeffects on the depression level and cognitive function. Therefore, we provided evidence for occupational therapiststo provide professional and systemic intervention for elderly people with dementia.
Objective : The objective of this study was to determine the structure of suffering that patients with spinal cordinjury undergo.
Methods : Conversations conducted once or twice over a two-month period, from October 1 to November 30, 2013were set up with 9 patients diagnosed with a cervical spinal cord injury. Data regarding the level of suffering thatparticipants experienced, from simple experiences to repetitive experiences, were collected from the participants.
The data collection and analysis were conducted through a procedure based on Parse’s human becoming theory.
Results : The suffering level of patients with a spinal cord injury was shown to range between a sense ofhumiliation owing to their physical disability, frustration in being unable to recover their body functions, and ahope to return to society after a process of resignation and acceptance.
Conclusion : The purpose of this study is to understand the patients suffering from a spinal cord injury and to beused as a reference for occupational therapists to think about their role.
Objective : The aim of this study was to investigate the awareness and need for driving rehabilitation for strokepatients in Busan and Gimhae.
Methods : A questionnaire consisting of three parts was given: 13 items on the general characteristics, 7 items onthe current or previous state of driving ability, and 16 items on the awareness and need for driving rehabilitation.
The survey period was from December 2013 to January 2014. One-hundred and fourteen questionnaires wereanalyzed in total.
Results : More than 50.0% answered ‘I don’t know anything about that’ regarding the motor function fitnessassessment and the driving education institution for the disabled. Awareness regarding a supportive policy fordisabled drivers was higher for drivers than for non-drivers. More than 80.0% answered that a drivingrehabilitation institution for the disabled, a cognitive or perceptual assessment for driving fitness, car remodelingfor the disabled, and a prescription of driving assistive devices for the disabled are ‘necessary.’ The need for adriving rehabilitation program for non-drivers was higher than for drivers. The special field that the respondentsperceived as the most appropriate for driving rehabilitation was occupational therapy. They answered that anexpansion of education and training facilities is a top priority, with financial support and advertising being the nextmost important elements, for improvements in driving rehabilitation of the disabled.
Conclusion : To develop a driving rehabilitation system for people suffering a stroke, institutional support, such asfinancial aid and the installation of driving rehabilitation centers; professional responsibility, including a roleexpansion and reinforcement of occupational therapists; and active promotion are needed.
Objective : The purpose of this study was to investigate the time use and occupational balance of mothers withyoung children.
Methods : A researcher analyzed the time use of mothers with young children (n=2369). The data were collectedfrom a ‘2009 Time Use Survey’. The mean data of each area were used to analyze the occupational balance ofthe mothers.
Results : The areas of occupational balance based on time ranged from 370 to 550 minutes of sleep, 100 to 230minutes of daily life activities, 40 to 300 minutes of child care, 210 to 560 minutes of work, and 100 to 360minutes of leisure time. The occupationally balanced groups showed that the amount of time given to child carewas reduced, and the amounts of sleep and leisure time increased.
Conclusion : Occupational therapists working in partnership with families need to consider the time allocation ofmothers with young children.