목적 : 본 연구는 삼킴장애를 동반한 뇌졸중 환자에게 동영상 동작모방이 삼킴기능에 미치는 영향을 알아 보고자 하였다. 연구방법 : 2013년 5월부터 12월까지 부산광역시 소재의 P병원에 뇌졸중으로 내원한 환자 중 삼킴장애를 동반 한 뇌졸중 환자 16명을 동영상 동작모방군과 대조군으로 무작위 할당 하였다. 동영상 동작모방군은 동작관찰 과 함께 동영상에서 제공되는 동작을 모방하였고, 반면 대조군은 풍경으로만 구성된 동영상을 5분간 관찰하 였다. 중재에 사용된 동영상은 정상인이 음식을 먹는 장면으로 구성 되었으며, 총 시간은 5분이다. 1일 1회, 주 3회, 4주간 치료시작 전 실시하였으며, 중재이외의 모든 치료는 두 군에게 동일하게 제공되었다. 중재의 효과를 검증하기 위해 중재 전, 후에 연식, 고형식, 액상식에 대한 비디오 투시 조영검사(Videofluoroscopic Swallowing Study; VFSS)를 실시한 후 기능적 삼킴장애척도(Functional Dysphagia Scale; FDS), 삼킴장 애 임상척도(Clinical Dysphagia Scale; CDS), 구강이동시간(Oral Transit Time; OTT)을 조사하였다. 결과 : 집단 내 분석 결과 동영상 동작모방군은 모든 척도에서 중재 전에 비해 중재 후 모든 식이유형에서 유의한 차이를 보였다(p<.05). 또한 집단 간 분석 결과 FDS가 모든 식이유형에서 대조군보다 동영상 동작모방군이 통계학적으로 향상됨을 알 수 있었다. 결론 : 삼킴장애 재활치료에 동영상 동작모방을 적용하는 것이 뇌졸중 환자의 삼킴기능을 향상시키는데 효 과적임을 확인하였다.

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (＞;24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) (n1=7) and control (FES) (n2=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p＜.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

The purpose of this study was to examine the effects of dual-task training (cognitive and exercise tasks) on the balance and gait performance of chronic stroke patients. Eighteen subjects with chronic stroke were divided equally into two groups, an experimental group and a control group. Subjects in both groups participated in an exercise program, performing the same tasks, for 45 minutes per day, three times per week for four weeks. The experimental group also performed additional cognitive task. The experimental group showed a more significant improvement than the control group on the Berg Balance Scale, the Timed Up and Go Test, the Korean Activities-Specific Balance Confidence Scale, and the Functional Gait Assessment (p<.05). The cognitive task error rates in the final week were significantly less than in the first week in the experimental group (p<.01). These results suggest that dual-task training for chronic stroke patients is effective in improving balance, gait, and cognitive abilities.

The objective of this study was to examine the effects of auditory biofeedback training and kicking training on walking times in patients with hemiplegia to determine if the effects of such training would be maintained even after stopping the intervention. Thirty hemiplegia patients were selected and randomly assigned to a control group of 10 patients to receive general exercise treatment; an auditory biofeedback training group of 10 patients to receive auditory biofeedback training, along with general exercise; and a kicking training group to receive kicking training, along with general exercise. All the patients received their respective training 12 times in total, three times per week for four weeks. In addition, all those in the control and experimental groups received the same general exercise treatment 12 times in total, three times per week for four weeks, and underwent follow-up tests thereafter. The patients’10m walking times were measured using a stopwatch. The significance was analyzed using repeated-ANOVAs. In cases where there were interactions between measuring times and groups, in each group were examined using repeated-ANOVAs. In cases where there were differences, post-hoc tests were conducted using repeated of contrast test. The 10m walking times of the control and experimental groups were significant differences in 10m walking times were shown between measurement times(p<.05), and significant differences in the interactions between measuring times and groups were shown between the groups(p <.05). However, no significant differences in 10m walking times were shown between the groups(p>.05). The auditory biofeedback training group showed significant decreases in walking times four weeks after the beginning of the intervention(p<.05) and significant increases eight weeks after the beginning of the intervention(p<.05). The kicking training group showed significant decreases in walking time four weeks after the beginning of the intervention(p<.05) and maintained the walking times without showing any significant differences eight weeks after the beginning of the intervention(p>.05). The walking speeds of only the kicking training group were maintained until eight weeks after the beginning of the intervention.

The objective of this study was to examine the effects of auditory biofeedback training and kicking training on walking times in patients with hemiplegia to determine if the effects of such training would be maintained even after stopping the intervention. Thirty hemiplegia patients were selected and randomly assigned to a control group of 10 patients to receive general exercise treatment; an auditory biofeedback training group of 10 patients to receive auditory biofeedback training, along with general exercise; and a kicking training group to receive kicking training, along with general exercise. All the patients received their respective training 12 times in total, three times per week for four weeks. In addition, all those in the control and experimental groups received the same general exercise treatment 12 times in total, three times per week for four weeks, and underwent follow-up tests thereafter. The patients’10m walking times were measured using a stopwatch. The significance was analyzed using repeated-ANOVAs. In cases where there were interactions between measuring times and groups, in each group were examined using repeated-ANOVAs. In cases where there were differences, post-hoc tests were conducted using repeated of contrast test. The 10m walking times of the control and experimental groups were significant differences in 10m walking times were shown between measurement times(p<.05), and significant differences in the interactions between measuring times and groups were shown between the groups(p <.05). However, no significant differences in 10m walking times were shown between the groups(p>.05). The auditory biofeedback training group showed significant decreases in walking times four weeks after the beginning of the intervention(p<.05) and significant increases eight weeks after the beginning of the intervention(p<.05). The kicking training group showed significant decreases in walking time four weeks after the beginning of the intervention(p<.05) and maintained the walking times without showing any significant differences eight weeks after the beginning of the intervention(p>.05). The walking speeds of only the kicking training group were maintained until eight weeks after the beginning of the intervention.

The purpose of this study was to analysis of the effect of proprioceptor training and vestibular organ training for balance ability. The subjects was consist of two different subjects group, proprioceptor training group and vestibular organ training group. Proprioceptor training group consisted of 10 subjects and vestibular organ training group consisted of 10 subjects. Training was performed 3 times per week, 30 minutes per day, for 3 weeks. Balance ability analysis was performed using Romberg's one leg standing test and BT4 when opened eyes and closed eyes. The analysis results were as follows. There was no significant differences in balance after the training in both groups when they opened their eyes(p<.05). But there was significant differences in balance after the training in both groups when they closed their eyes(p<.05). And there was no significant difference in balance after the training between the proprioceptor training group and the vestibular organ training group when they closed their eyes(p<.05). Given the above results, proprioceptor training and vestibular organ training enhanced balance but there was no significant difference between the two methods.

The purpose of this study was to investigate the effects of visual cue deprivation during sideways treadmill training in individuals with stroke. Twenty-eight stroke patients were divided into two groups, and each group participated in a sideways treadmill training session for 20 minutes, three times per week for 4 weeks. The eyes close group (15 subjects) performed this treadmill training with visual cue deprivation, while the eyes open group (13 subjects) performed it without visual cue deprivation. Gait function was measured in both groups before and after the training sessions with the Biodex Gait Trainer 2, which determined walking speed, distance, step length, and time on each foot. Balance was measured before and after each training period in both groups using the Five-Times Sit-to-Stand Test (FTSST), the Timed Up and Go test (TUG), and the seven-item Berg Balance Scale-3P (7-item BBS-3P). The eyes close group showed significantly improved gait function, walking speed, distance, step length, and time on each foot after training (p<.05). The eyes close group showed improved balance ability, FTSST, TUG, and 7-item BBS-3P test after training (p<.05). The findings indicated that sideways treadmill training with visual cue deprivation positively affects gait ability of stroke patients. Therefore, sideways treadmill training with visual cue deprivation may be useful for the recovery of gait ability of stroke patients.

The purpose of this study was to investigate the effect of combined exercise training during 12weeks on physical fitness, body composition and bone mineral density in university students. Nineteen male university students who were enrolled of 1st grade at department of physical education in Korea National University of Education were participated in this experiment. Subjects were performed combined exercise training - running, physical training using plyometrics and resistance training - of 5days per week, 70min per 1 time, during 12weeks. The measurement items were health related fitness(muscle strength, muscular endurance, cardiovascular endurance, flexibility), motor skill fitness(power, balance), body composition(% body fat, muscle mass) and bone mineral density(T-score). On the basis of the results analyzed in this study and consideration of many pre studies related it, the result were as follows. First, data analysis of 12 week combined exercise training on health related fitness, post level was revealed more significant increase than pre level at muscle strength(p<.05), muscular endurance(p<.05), cardiovascular endurance(p<.001) and flexibility(p<.05). Second, data analysis of 12 week combined exercise training on motor skill fitness, It was not revealed significant differences between the pre and the post level of the power and balance). Third, data analysis of 12 week combined exercise training on body composition, post level revealed more significant improvement than pre level at muscle mass(p<.05), but It was not revealed significant differences between the pre and the post level of the % body fat. Fourth, data analysis of 12 week combined exercise training on bone mineral density, post level revealed more significant improvement than pre level at T-score(p<.05). In conclusion, It was revealed that 12 week combined exercise training increased physical fitness, and improved body composition and bone mineral density. I hope that more studies will be followed on physical fitness, body composition and bone mineral density on various exercise types, exercise intensity, time and frequency in university students in the future.

목적 : 본 연구는 만성 뇌졸중 환자를 대상으로 상상훈련과 근전도 유발 신경근전기자극의 결합된 치료가 마비측 상지 기 능과 일상생활활동에 미치는 영향을 알아보고자 하였다. 연구방법 : 2012년 8월부터 2013년 2월까지 K의료원에 외래 치료 중인 44명의 만성 뇌졸중 환자를 대상으로 무작위 대 조 실험을 하였다. 두 집단은 전통적 재활치료와 함께 실험군은 상상 훈련과 근전도 유발 전기자극의 결합된 치료를, 대조군은 일반적인 전기자극치료를 회당 30분간, 주 5회, 6주간 실시하였다. 상지기능평가로 Fugl-Meyer Assessment (FMA)와 Manual Function Test (MFT)를 사용 하였으며 일상생활활동 평가로 수정바델지수(Modified Barthel Index; MBI)를 사용하여 중재 전·후 평가를 실시하였다. 결과 : 1) 6주간의 중재 후 실험군의 FMA, MFT 점수의 비교 결과 통계학적 유의한 변화를 보였다(p<.01). 2) 실험군의 MBI 점수의 비교 결과 통계학적 유의한 변화는 없었다. 하지만 개인위생과 옷 입기 항목에서 통계학적 유의한 변화를 보였다(p<.05). 반면 대조군의 경우 약간의 점수 향상은 있었지만 모든 평가에서 통계학적 유의한 변화는 없었다. 결론 : 만성 뇌졸중 환자를 대상으로 상상훈련과 근전도 유발 전기자극의 결합된 치료가 기능적 전기자극치료에 비해 뇌 졸중 환자의 마비측 상지기능을 향상 시킨다는 것을 확인하였으며, 손의 움직임과 관련된 일상생활활동 수행능력에도 영향을 미친다는 것을 알 수 있었다.

지금까지 교육훈련 연구는 크게 두 가지 흐름이 있다. 하나는 교육훈련을 실시하는 기업의 관점에서 교육훈련 성과를 높이기 위해 교육과정, 방법, 강사, 내용과 같은 시스템적 접근이 있고, 또 하나는 피훈련자의 관점에서 교육훈련 성공을 위한 연구의 흐름이 있다. 후자는 주로 피훈련자의 교육훈련 동기가 교육 훈련 성과를 좌우 할 수 있다는 가정 하에 이를 잘 설명할 수 있는 다양한 변수들에 대한 연구가 있다. 본 연구는 후자의 관점에서의 연구이고 지금까지 연구된 바로는 교육훈련 동기를 설명하는 변수를 크게 나누면 인적특성변수와 상황특성 변수로 구분할 수 있다. 그 가운데 교육훈련 동기를 설명하는 인적특성 변수의 연구의 중요성이 강조되고 특히 이 가운데 목표지향의 개념이 학습에 매우 중요한 개념이므로 교육훈련에 적용 연구할 필요성이 특히 강조된다. 그러나 우리나라에서는 이와 관련한 연구가 매우 적다. 또한 사회적 지원이 교육훈련 동기에 미치는 영향에 대한 연구는 상이한 관점이 존재하고 규명되어야 할 부분이 존재한다. 이와 같은 관점에서 본 연구는 피훈련자의 인적특성인 목표지향과 조직의 상황적 특성인 사회적 지원이 교육훈련 동기에 미치는 영향과 교육훈련 동기가 교육훈련 성과변수인 교육훈련 전이와의 관계를 연구하였다. 그리고 목표지향 및 사회적 지원과 교육훈련 전이와의 관계에서 교육훈련 동기의 매개효과를 연구 하였다. 나아가 교육훈련 연구는 조사방법의 한계가 항상 존재한다. 본 연구는 독립변수와 매개효과가 종속변수에 미치는 효과를 보다 엄격하게 검증하고 설문지법의 한계인 동일방법편의를 줄이기 위해, 준실험설계 방식으로 설계하여 교육훈련 전과 교육훈련 후로 나누어 2번에 걸쳐 자료를 수집하였다. 이와 같은 방법으로 622명을 대상으로 자료를 수집하여 분석한 결과 다음과 같은 결과를 얻었다. 첫째 학습목표 지향과 과시성과목표 지향은 교육훈련 동기와 정의 관계, 동료지원은 교육훈련 동기와 정의 관계를 얻었다. 그러나 회피성과목표 지향과 상사지원은 교육훈련 동기와 관계가 없었다. 교육훈련 동기는 교육훈련 성과변수인 교육훈련 전이를 잘 설명해주고 있다. 그리고 학습목표지향과 과시성과목표 지향 및 동료지원과 교육훈련 전이와의 관계를 교육훈련 동기가 유의하게 매개역할을 하였다. 이러한 결과는 교육훈련 동기의 선행변수로서 학습목표 지향, 동료지원이 매우 중요할 뿐만 아니라 교육훈련 동기가 교육훈련 성과를 위해 매우 중요하다는 것을 의미한다. 상사지원이 교육훈련 동기를 설명하지 못하는 것은 매우 주목되는 결과다. 본 연구는 이러한 결과의 의미를 논의할 것이다. 그리고 본 연구 결과는 교육훈련 동기 연구의 중요성을 다시한번 확인해 주는 결과라고 할 수 있다.

목적 : 본 연구는 발달장애 아동을 위한 작업치료에서 정적 강화를 통한 3단계 지시 따르기 훈련법이 작업참여도 증진에 미치는 영향을 알아보고자 한다. 또한, 3단계 지시따르기 훈련 후 실시한 작업치료에서 정적 강화물의 사용 유무에 따 른 작업참여도의 변화를 비교하고자 한다. 연구방법 : 연구 대상자는 발달장애 아동 2명이었으며, 개별실험 연구방법 중 중다기초선(multiple baseline across tasks)설계를 사용하였다. 연구의 진행은 1단계 기초선에서 대상 아동들에게 기존의 작업치료 방법(작업치료Ⅰ)을 시 행하여 작업참여도를 측정하였다. 2단계에서는 정적 강화를 통한 3단계 지시따르기 훈련법을 사용하여 지시따르기 훈 련을 실시하였다. 지시따르기 훈련 후 작업치료(작업치료Ⅱ)를 시행하여 작업참여도를 측정하였다. 3단계에서는 작업 치료를 실시할 때 아동에게 강화물을 제공하면서(작업치료Ⅲ) 작업참여도를 측정하였다. 결과 : 대상자 1은 작업치료Ⅰ에 비해 지시따르기 훈련 후 실시한 작업치료Ⅱ에서 작업참여도가 증가하였고, 강화물을 적용한 작업치료Ⅲ에서는 작업치료Ⅱ에 비해 작업참여도가 다소 감소하였다. 대상자 2는 작업치료Ⅰ에서와 지시따르 기 훈련 후 실시한 작업치료Ⅱ에서 작업 참여도의 변화는 거의 나타나지 않았으나, 강화물을 적용한 작업치료 Ⅲ에서 는 작업참여도가 증가하였다. 결론 : 작업치료 중재에 있어 치료 전에 지시따르기 훈련을 적용하거나 치료시 직접적인 강화물을 적용하는 것은 작업참 여도를 향상 시키는데 긍정적인 영향을 주었다.

본 연구에서는 건조 후 20여년 운항한 군산대학교 실습선 해림호의 발전기를 대상으로 직접 선박현장에서 실험하여 최적 연료분사시기를 규명해서 선박의 경제적이고 친환경적인 운항에 도움을 주고자 연구하였다. 실험은 기관회전속도 1,200 rpm으로 일정히 유지하고, 기관부하를 0 kW에서 90 kW까지 30 kW간격으로 변화시켰으며, 연료분사시기는 BTDC 19o에서 23o까지 2o 간격으로 변화시키면서 실험하였다. 실험결과 연료분사시기를 BTDC 21°에서 BTDC 23°로 앞당길 경우, 연료소비율은 1.37 % 감소하였고, 질소산화물은 11.59 % 증가하였으며, 매연은 23.5 % 감소하였고, 아황산가스는 2.8 % 감소하였다. 따라서 노후 발전기 엔진에 있어서 연료분사시기가 연소특성 및 배기배출물특성에 미치는 영향을 종합적으로 분석․고찰한 결과, 최적 연료분사시기는 원래의 분사시기보다 2° 앞당겨진 BTDC 23°로 확인되었다.

The purpose of this study was to determine the effectiveness of sit-to-stand training on unstable surfaces in individuals with stroke. Nineteen subjects with chronic stroke were divided into two groups: an experimental group (10 subjects) and a control group (9 subjects). They received 30 minutes of Neuro-developmental therapy (NDT) treatment, and sit-to-stand exercise for 15 minutes three times a week for four weeks. During the sit-to-stand training, the experimental group performed on an unstable AIREX balance pad, but the control group performed on a stable surface. Balance ability and weight-bearing distribution during quiet standing were measured before and after training period using the 7-item Berg balance scale-3P (BBS-3P) and the Five-times-sit-to-stand test (FTSST). In addition, the muscle strength of the knee extensor was evaluated before and after the training period. The results were as follows: 1) The weight-bearing distribution forward of the affected leg, increased significantly in the experimental group after the four-week intervention (p<.05), 2) The 7-item BBS-3P and FTSST increased significantly in the experimental group after the four-week intervention (p<.05), 3) The knee extensor muscle strength in both groups increased significantly after the four-week intervention (p<.05). In conclusion, the results of this study did not show that the sit-to-stand training on an unstable surface was more effective than on a stable surface. However, the results suggested that sit-to-stand training is effective in the balance training of stroke patients.

This study is intended to examine the tDCS and Morris Water maze training in Alzheimer’s disease(AD) rats on Tau protein expression. Experiment groups were divided into four groups and assigned 16 rats to each group. Group Ⅰ was a control group(AD induced by scopolamine); Group Ⅱ was a experimental control group(AD injured by scopolamine and treatment tacrine); Group Ⅲ was a group of tDCS application after AD injured by scopolamine; Group Ⅳ was a group of morris water maze training after AD injured by scopolamine. In cognition test, the outcome of group Ⅱ was significantly lower than the groups(p<.001). and group Ⅲ, Ⅳ were significantly low result at 14 days(p<.05). In histological finding, the experimental groups were destroy of micro vessels and finding of cell atropy and swelling. Group Ⅲ, Ⅳ were decreased in degeneration of liver and kidney cells. In immuno- histochemistric response of BDNF and tau protein in hippocampus, BDNF expression of Group Ⅱ was more increase than the other groups. and increase of BDNF expression was Ⅲ, Ⅳ were higher than group Ⅰ at 21 days. Tau protein expression of Group Ⅱ was more decrease than the other groups. and decrease of Tau protein expression was Ⅲ, Ⅳ were lower than group Ⅰ at 21 days. These result suggest that improved tDCS and morris water maze training after scopolamine induced is associated with dynamically altered expression of BDNF and Tau protein in hippocampus and that is related with cognitive function.

근로자를 위한 안전교육의 중요성에 대한 관심이 많지 않다. 이에 본 연구에서는, 가정봉사원들을 위한 안전교육이 어떻게 그들의 업무관련부상에 영향을 주는지 조사하였다. 이와 더불어, 안전교육이 직속상사의 인간 중심적 배려행동과 상호작용을 통해 가정봉사원들의 업무관련부상에 미치는 영향도 함께 살펴보았다. 이 연구를 위하여 노인들을 위해 일하는 282명의 가정봉사원을 대상으로 설문조사를 실시하였고, 이를 통하여 얻은 자료에 대하여 다중회귀분석을 실시하였다.

목적 : 본 연구의 목적은 컴퓨터 기반 전산화 인지 훈련이 정신분열증 환자의 인지기능과 수단적 일상생활 활동에 미치는 영향을 알아보는 것이었다. 연구방법 : 연구 설계는 사전사후(pre-test and post-test design)이며 종속변인으로 집중력, 기억력, 실행기능과 수단적 일상생활활동 수준을 독립변인으로 컴퓨터 기반 전산화 인지훈련(REHACOM)을 사용하였다. 연구 대상자는 12명이었으며, 인지훈련을 위한 중재 프로그램은 레하컴의 집중력, 기억력, 실행기능 훈련 프로그램을 주 2회씩 8주간 총 16회기 동안 실시하였다. 결과 : 연구결과 집중력, 기억력, 실행기능, 수단적 일상생활 수행능력에서 유의미한 향상을 보였고(p<.05), 기억력과 수단적 일상생활 활동이 유의한 상관관계를 나타냈다(p<.05). 결론 : 본 연구 결과 전산화 인지훈련은 정신분열증 환자의 인지기능과 수단적 일상생활 수행능력에 긍정적 영향을 미쳤다. 추후 연구에서는 대조군을 통한 비교 연구와 다양한 인지훈련 프로그램을 적용한 인지 영역별 연구가 이루어져야 할 것이다.

This study examines the effects of different environments on the application of hemiplegia patients circuit balance training. Group 1 performed circuit balance training without any auditory intervention Group 2 performed training in noiseless environments and Group 3 performed training in white noise environments. First, among lower extremity muscular strength evaluation items, maximum activity time(MAT) was not significantly different(p>.05). Maximum muscle strength(MMS) increased significantly in Group 3(p<.01), there was no significant difference in MMS among the groups. Average muscle strength(AMS) indexes also significantly increased in Group 3(p<.01), there was no significant difference in AMS among the groups. Second, among balancing ability evaluation items, Berg's balance scale(BBS) scores significantly increased in all groups(p<.05), BBS scores were significantly difference among the groups. Based on the results, Group 1, 2 and Group 1, 3 showed significant increases (p<.05). Functional reach test(FRT) values significantly increased in Group 2, 3(p<.05), and there was no significant difference in FRT values among the groups. Timed up and go(TUG) test values significantly decreased in Group 2, 3(p<.05), and there was no significant difference in TUG test values among the groups. Third, among walking speed evaluation items, the time required to walk 10m significantly decreased in all groups(p<.05), and there was no significant difference in the values among the groups. Average walking speeds showed significant increases in Group 1, 3(p<.05), and there was no significant difference in the values among the groups. Based on the results of this study, noise environments should be improved by either considering auditory interventions and noiseless environments, or by ensuring that white noise environments facilitate the enhancement of balancing ability.

목적 : 본 연구는 기능적 전기자극 동안의 과제훈련이 뇌졸중 환자의 상지기능에 미치는 영향을 평가하고, 회귀분석 을 통해 인과관계에 따른 설명력을 확인하고자 한다. 연구방법 : 뇌졸중으로 인한 편마비 환자 39명을 대상으로 중재방법에 따라 세 그룹으로 나누어 비교하였다. 15명 의 실험군은 기능적 전기자극 동안에 과제훈련을 실시하였고, 13명의 대조군Ⅰ은 기능적 전기자극만을 실시하였으며, 11명의 대조군Ⅱ는 과제훈련만을 실시하였다. 6주 후에 분산분석을 통해 세 그룹 간에 손의 근력과 상지의 기능, 운동 활동 지표와 일상생활활동에서 평균변화량의 차이를 각각 비교하였다. 그리고 영역별 결과에서 상지기능의 향상에 대한 잠재적인 변인들과의 상관관계를 분석하고, 회귀분석을 통해 상지기능에 영향을 주는 요소의 인과관계를 분석하였다. 결과 : 연구 결과 손의 근력과 상지 기능, 운동 활동 지표에서 세 그룹 간에 유의한 차이를 확인하였고, 기능적 전기자극 동안에 과제훈련을 실시한 실험군에서 통계적으로 유의한 향상을 보였다(p<.05). 이러한 긍정적인 결과에서 나타난 각 요소들은 상호간에 높은 상관관계를 보였으며, 변수간의 인과성을 확인하기 위한 위계적 중다회귀분석 결과, 모형 1에서는 근력(R2 = .17), 모형 2에서는 움직임의 질(R2 = .28), 모형 3에서는 움직임의 질과 실험군 중재법(R2 = .37)이 유의한 설명력을 보였다. 운동 활동 지표 중 움직임의 질과 실험군에서 실시한 중재 방법이 상지 기능에 가장 영향력 있는 변수로 나타났고, 상지기능의 회복을 위해 기능적 전기자극 동안의 과제훈련에 대한 중요성을 입증하였다. 결론 : 기능적 전기자극 동안에 과제훈련을 실시한 실험군은 대조군Ⅰ,Ⅱ보다 손의 근력과 상지기능, 운동 활동 지표에서 더 긍정적인 효과를 보였다. 또한 움직임의 질과 기능적 전기자극 동안의 과제훈련이 상지기능 향상을 위한 높은 설명력을 보였다. 따라서 뇌졸중 환자의 상지기능 향상을 위하여 기능적 전기자극 동안에 능동적이고 반복적인 과제훈련 적용이 작업치료사에 의해서 활발하게 이루어져야 할 것이다.

The purpose of this study is to examine the effects of gait training using functional electrical stimulation on the improvement of hemiplegic patients' functions for balance and gait velocity. The subjects of the experiment were determined to be 10 each hemiplegic patients who had been diagnosed with stroke or brain damage six months or longer earlier assigned to an experimental group and a control group respectively. The subjects were evaluated before the experiment using Tetrax and 10M gait tests, received gait training five times a week for four weeks using functional electrical stimulation and were evaluated after the experiment in the same method as used in the evaluation before the experiment. In order to examine differences between the experimental group that received gait training using functional electrical stimulation and the control group that was treated by functional electrical stimulation and received gait training thereafter, differences between before and after the experiment were analyzed using paired sample t-tests and differences in changes after the experiment between the experimental group and the control group were analyzed using independent sample t-tests in order to compare the two groups with each other. Experimental results showed significant differences in weight bearing, balance and gait velocity between before and after the experiment in the experimental group(p<.05). In the control group, whereas weight bearing and gait velocity did not show any significant difference between before and after the experiment(p>.05), balance showed significant differences(p<.05). Weight bearing, balance and gait velocity change rates showed significant differences between the experimental group and the control group(p<.05). In conclusion, it was indicated that gait training using functional electrical stimulation is effective for enhancing stroke patients' weight bearing rates, balance abilities and gait velocity.