KJC Korea
Journal Central

Objective : The main focus of this study was to provide evidence of improvements in the executive function and balance for stroke patients using virtual reality therapy. Methods : A total of 64 participants diagnosed as having a stroke were randomly assigned to a virtual reality therapy group or a video observation group. Intervention for the VRT(Virtual Reality Therapy) group used a NintendoⓇ Wii FitTM for 20 minutes, three days a week, for five weeks. The VO(Video Observation) group watched a demo clip for the same number of times and duration. Both groups were treated with additional conventional occupational and physical therapy for 20 minutes during the same session. To investigate the clinical features, the Korean versions of the Behavioral Dyscontrol Scale(BDS-K), Functional Reaching Test(FRT), and Timed Up And Go test(TUG) were used. Results : The BDS-K score after intervention was increased more for the VRT group than for the VO group, the difference of which was significant (p<.05). For the changes after intervention, the VRT participants showed significant improvements in BDS-K, FRT, and TUG (p<.05). Conclusion : The clinical features of virtual reality therapy include repetitions of whole-body movements, and provide positive effects in terms of executive functions and balance for stroke patients. This study suggests an evidence-based clinical use of virtual reality application for therapists.

Objective: The purpose of this study was to develop a Korean version of the manual Wheelchair Skills Training Program for hemiplegia (K-WSTP), and evaluate its effectiveness for improving the wheelchair mobility of hemiplegic patients. Methods: Twenty-four subjects were selected to evaluate the effectiveness of the K-WSTP. Of them, six hemiplegic patients requiring assistance when using a manual wheelchair participated as the training group. The other 18 subjects were selected into comparison groups, i.e., independent hemiplegic patients, college students, and occupational therapists, each consisting of 6 persons. All subjects were evaluated based on WST(Wheelchair Skills Test), COPM(Canadian Occupational Perfomance Measure), K-MBI(Korean version of Modified Barthel Index and their subjective opinions before and after implementing the K-WSTP. Results: The results show that the training group was significantly improved (p<.05) in terms of the WST and K-MBI after training. The performance score and degree of satisfaction after training did not show a statistical significance (p>.05) between the training and comparison groups. Of the total subjects, 18.2% expressed their opinion regarding the difficulties in wheelchair movements such as ‘turn in place’ and ‘maneuver sideways’, whereas the training group expressed an opinion regarding the difficulties in a ‘level transfer’ and ‘relieving weight from the buttocks.’ (note from editor, please check the red sentence carefully to make sure it matches your original intention.) Conclusion: The developed K-WSTP showed improvements in wheelchair skills, independence, individual performance, and satisfaction. It is expected that this study will enhance the motivation toward rehabilitation, improving one's mobility in daily life, and contribute to the quality of life of hemiplegic patients.

Objective : This study aims to suggest the basis for the development of evaluation items used to measure the community participation of stroke patients. Methods : Opinions were collected from 32 community and stroke-related expert panels using the Delphi method. The first survey gathered opinions through items reconstructed using closed-ended·open-ended questions for community participation, while the second survey determined the goodness of fit and its importance. The third survey was a final check of the opinions by providing a response and results to the second survey. Results : A total of 38 items were selected from the first Delphi results. For the second Delphi results, five items showing a value of .33 or lower for the content validity ratio were removed to make a total of 33 items. For the third Delphi results, the 33 items were deemed to be fit, and were therefore selected. Finally, the average content validity ratio of the Delphi results was .93, the stability was .11, the convergence was .40, and the consensus was .83, which are regarded as high scores. Conclusion : Through this study, items for measuring the degree of participation of stroke patients in their community were developed. In is expected that these results can be used as a basic set of data to promote more participation by stroke patients in their communities.

Objective : The purpose of this study was to analyze the swallowing function evaluation tools for stroke patients with dysphagia, and to help choose appropriate evaluation tools considering the patients and their clinical conditions. Methods : A systematic review was conducted according to the PRISMA checklist. We accessed databases including PubMed, Medline, EBSCO host, and the National Assembly Library of Korea. The PEDro scale was used to evaluate the quality of the articles. Evaluation tools were divided into whether each tool requires an instrument or not. They were also classified according to the swallowing phase. Results : Thirty-two articles were included and analyzed in total. A total of 45 evaluation tools were found. Twenty of these tools were instrumental tools or evaluation tools based on an instrument. Thirteen of them essentially require a VFSS to evaluate the swallowing function. We found that most of the tools not depending on an instrument were for observing the oral preparatory or oral phase; however, some tools including GUSS(Gugging Swallowing Screen), EAT-10(Eating Assessment Tool), SSQ(Sydney Swallow Questionnaire), and a clinical assessment were used to detect problems in the pharyngeal or esophageal phases. Finally, ASHA(American Speech-language Hearing Association), DD(Degree of Dysphagia), DOSS(DOSS: Dysphagia Outcome and Severity Scale), DSR scale(Dysphagia Severity Rating), and FOIS(Functional Oral Intake Scale) were found useful for evaluating the nutritional condition, diet type, and degree of swallowing, although they could not be matched to the specific swallowing phase. Conclusion : This systematic review provides guidelines for choosing proper swallowing evaluation tools leading to customized treatment for stroke patients with dysphagia in the clinical field.

Objective : The present study was conducted to compare the real ability of stroke patients with the awareness of their caregiver in terms of the patients’ ADL ability. Methods : For the present study, the Korean Modified Barthel Index(K-MBI) was used. It was executed for 95 stroke patients and caregivers. The researchers observed the ADL of the patients, and caregivers filled out a document. An independent t-test was used to analyze the data. Results : When the real ADL ability of a patient is better than the awareness of the caregiver, a statistically significant difference (p<.05) was shown. For the real ADL ability of the patient, the mean and standard deviations are 78.65±14.55, and for the awareness of the caregiver, the mean and standard deviations are 70.89±15.35. When the awareness of the caregiver is better than the real ADL ability of the patient, a statistically significant difference (p<.05) was shown. In this case, for the real ADL ability of the patient, the mean and standard deviations are 69.63±9.82, and for the awareness of the caregiver, the mean and standard deviations are 76.11±10.72. Conclusion : The results show that the real ADL ability of a patient and the awareness of their caregiver are different. We suggest that a further study is needed to come up with detailed measures for improving the independence of the patients.

Objective : The aim of this study is to investigate the effect of Computer-Assisted Cognitive Training(CACT) applied for improving cognitive function among older adults. Methods : Previous studies were found in an electronic database(e.g., Medline, EMbase, Cochrane, CINAHL, PsycINFO, KISS, KMbase, NDSL) between 2006 and 2016 for 10 years. The following key terms were used: ‘Therapy, Computer-Assisted (Mesh term)’, ‘Aged (Mesh term)’, ‘Cognitive Therapy (Mesh term)’, ‘Randomized Controlled Trial (Publication Type)’. Finally, 8 RCT articles met the inclusion criteria. Results : PEDro score in all the articles reviewed was from 6 to 8 points in the‘Good’ range. Types of client group in older adult included 45.5% Mild Cognitive Impairment(MCI), 27.3% healthy older adult. Dependent valuables included 31.6% Memory, 21.0% Global cognitive function, 15.8% Attention and Executive function each. In MCI, Memory showed a positive effect in 4 out of 5 articles, and Attention was significantly improved in 3 articles measured attention as the dependent variable. 3 articles for healthy older adult showed a significant improvement on Memory. Conclusion : Through this systematic review, we were able to understand effect of CACT for cognitive function in older adults. It was to provide clinical evidence to the occupational therapist and research on long-term intervention may be further developed for aging population to make clinical evidence based on these research results.

Objective : The purpose of this study was to examine the effects of IM training on the balance, fall efficacy, and cognitive function of community-dwelling older adults. Methods : Three older adults participated in a total of 11 31-minute sessions of IM training during this single-subject design research study. An IM Short Form Test(IM SFT), a Four Step Square Test(FSST), and the Fullerton Advanced Balance(FAB) Scale were used to evaluate the subjects' balance. The Korean versions of the Fall Efficacy and Activities-specific Balance Confidence Scale were used to evaluate the fall efficacy. A serial 7 subtraction task was used to evaluate the cognitive function of the participants. Results : All participants showed a higher than average IM SFT SRO% during the intervention period compared to the pre-interventional baseline period. All of them achieved higher scores on their post-interventional balance function test than on their pre-interventional test. All three demonstrated a higher than average attention test score during the intervention period than pre-intervention. Conclusion : It was confirmed that IM training is applicable for community-dwelling older adults to improve their balance and cognitive function.

Objective : The aim of this study was to investigate the effects of spaced retrieval training with errorless learning to improve the verbal memory and memory related to Activities of Daily Living(ADL) for the elderly with early dementia. Methods : To memorize the tasks related to ADL, spaced retrieval with errorless learning was executed for two elderly persons with dementia. The experiment used a BA design and a total of nine sessions, which were composed of six intervention sessions (B) and three generalization sessions (A). The Korean version of the Memory Assessment Scale (K-MAS) was used pre- and post-experiments to evaluate their verbal memory, and the recall success rate was used every session to measure their memory related to ADL. To investigate the generation effect of the training, the researchers also asked the caregiver to check the answers of the subjects on that day for a two-week period. Results : The amount of recall was significantly increased during the intervention sessions, and the effects continued during the generalization sessions. In addition, the training effects transferred into real life. However, their general verbal memory showed no changes. Conclusion : Spaced retrieval training with errorless learning is effective for the elderly with early dementia to memorize and maintain the trained contents. However, a statistically meaningful effect on verbal memory was not observed.

Objective : The purpose of this study was to identify the needs and experiences of severely disabled people in using a powered wheelchair through a focus group interview. Methods : Five severely disabled people using a powered wheelchair were recruited. The interview employed a question-asking method modified from the question-asking method presented by Krueger and Casey. The contents of the interview were recorded, transcribed, and analyzed using Krueger’s principle. Results : The subjects experienced defects of the wheelchair itself, problems regarding the components of the powered wheelchair, and wheelchair follow-up service. Accordingly, they want to enlarge the assistive technology service involving a wheelchair user assessment and proper prescription, and improvements in the supporting and propulsion structure of a powered wheelchair. Financial support concerning powered wheelchair payments and expenses for a follow-up service are also expected. Occupational therapist are considering a wheelchair user belong to the environment, the desired activity and user’s function when wheelchair prescriptions must be provided proper propulsion component and support structure such as power seat function. (note from editor, unfortunately, the red text is not clear. If you can revise itI can check your revision). Conclusions : This study presented a point to be considered who occupational therapist able to prescribe using powered wheelchair with severely disabled people. and will be used as basic data have led to institutional change for effective assistive technology services(note from editor, this part is also unclear).

Objective : This study examined the statistical changes in occupational therapy services (based on the National Health Insurance Service). In addition, it offers basic data for improvements in the National Health Insurance Service. Methods : Medical treatment statistics, such as “treatment action statistics” and “medical expenses statistics” from 2011 to 2015 were used in this research. Results : Most of the occupational therapy services were shown to improve. The NHIS income of occupational therapists (per therapist) has increased by 4.8%. The number of occupational therapists has increased by 65.9%. The NHIS income of occupational therapists as a whole has increased by 73.9%. Conclusion : The occupational therapy services in Korea have improved over the past five years. We suggest continuing research with a follow-up study for occupational therapy services development.

Objective : This study aimed to analyze published research papers in the Journal of Korean Society of Occupational Therapy from 2011 to 2015. Methods : Articles published from 2011 to 2015 were surveyed, and a descriptive analysis was used to determine the types of research, level of evidence, participants, research fields, and researchers. Results : The analysis outcomes of the this study were as follows. The most frequent type of research was experimental research, followed by evaluation tool research, and review articles. The most frequent level of evidence was level Ⅳ (56.8%), and the most frequent research designs were survey and evaluation tools, reliability, and validity research. The main subjects were adults (37.2%). The most common diagnoses of adults (elderly people) were strokes. In the case of children, the diagnoses were cerebral palsy, followed by pervasive developmental disorders, and intellectual disorders. The independent variables addressed were the largest frequency of cognitive intervention and occupation-based intervention. The dependent variables were mostly for the upper extremity functions, followed by psychosocial factors. Descriptive survey researches were mostly a policy of occupation therapy, followed by activities of daily living and cognition. Conclusion : This study showed the recent research trends of the Journal of Korean Society of Occupational Therapy, and analyzed the research types, level of evidence, participants, and research field. These results will help readers know the research trends in the field of occupational therapy, and will be able to contribute to the amount of evidence available

Objective : This study aimed to understand the current study conditions and trends of Korean occupational therapy for children regarding the International Classification of Functioning(ICF) of disability and health. Methods : This research selected 115 studies in the field of occupational therapy for children reported in the Journal of Korean Society of Occupational Therapy, and conducted an analysis on the classification of study type and evidence level to understand the trends. In addition, the number, age, diagnoses, and evaluation tools of the study subjects were analyzed. Moreover, this research categorized the studies based on the ICF-CY standard. Results : The analysis outcomes of the articles published in the Journal of Korean Society of Occupational Therapy were as follows: (1) Correlation studies and group comparisons were the largest study type at 24.3%. (2) Level Ⅳ was the largest evidence level at 44.3%. (3) The articles using school-age children as the subjects was the largest at 41.5%, and articles with more than 101 subjects made up the greatest number. Among the diagnoses, cerebral palsy was the largest at 26.0%, and a sensory profile was the most common evaluation tool at 11.6%. As for the study field categorized by ICF, the physical structure and functional factor were the largest at 51.2%. Conclusion : This study reviewed articles on occupational therapy for children published in the Journal of Korean Society of Occupational Therapy to understand the trends in Korean occupational therapy for children. It verified the lack of themes regarding individual factors, and the participation factors of the occupational therapy field for children, and the results indicate a need for diversity in the selection of study themes.