The purpose of this study were to investigate the independent ADL (Activities of Daily Living) level of elderly people using a questionnaire made up of a mobility scale, two basic ADL measurement tools, and an instrumental ADL measurement tool, and to differentiate between the levels according to various performance environments. The subjects were elderly people (over 60 years) who live in Wonju City (pop.240,000). A survey tool made up of 110 items was used for this study and the quiestionnaire was completed by 7 investigators who interviewed the respondents at gatherings for the elderly. The results were analyzed according to gender, 3 age groups (60-69, 70-75, and over 76), comfortable position preference (floor sitting or chair sitting), and housing type (detached house or apartment) by non parametric statistics, Kruskal-Wallis and Mann-Whitney U tests. The results were as follows: 1. According to age group, basic ADL dependence level was not significantly different in ‘cleaning house’, ‘travelling’, ‘street crossing’, ‘hospital visiting’, and ‘walking around’. Women were more significantly dependent than men in instrumental ADL: ‘going to the post office’, ‘driving’, and ‘street crossing’, but without significant difference of dependence level in basic ADL. 2. According to position pattern, dependence level was not significantly different for ‘face washing’, ‘hair washing’ or ‘foot washing’. At rest, people sitting on the floor were more dependent in instrumental ADL items only for ‘shopping’ and ‘attending religious services’. People living in detached houses reported significantly more difficulty using the toilet than those in apratments. 3. The most sensitive items for evaluating functional independence of the elderly were: ‘using the telephone’, ‘face washing’, ‘hair washing’, ‘foot washing’, and ‘bottle opening’ in basic ADL, and ‘hospital visiting’, ‘travelling’, and ‘street crossing’ in instrumental ADL. The Cronbach α value of mobility, basic ADL, instrumental ADL were 0.87, 0.86, and 0.91, respectively. To evaluate the ADL of old age, we have to use evaluation tools suitable to the Korean culture. The most useful items were ‘telephone use’, ‘face washing’, ‘hair washing’, ‘foot washing’, ‘bottle opening’ in basic ADL, and ‘hospital visiting’, ‘travelling’, and ‘street crossing’ in instrumental ADL. Especially, instrumental ADL is more valuable than basic ADL in evaluating old age. It is more important in evaluating the practical aspects of life in old age to consider housing and living patterns because there are some ADL items which are affected by comfortable sitting preference and housing style.

The purpose of this study was to investigate the effect of ‘knowledge of results’ on wrist proprioceptive training in three persons with poststroke hemiplegia who had no unilateral spatial neglect on MVPT and had adequate cognition on MMSE-K. A single subject design with multiple baseline across individuals was employed. Each subject participated daily in the 10-15 minutes' wrist proprioceptive training for the affected wrist with ‘knowledge of results’ which informed the subjects of their wrist position verbally or visually as feedback. The proprioception was measured as average frequency and percentage of the correct responses on the wrist proprioceptive test in the affected side using apparatus of researcher’s own design and SoloSystem. The measurements were repeated three times; baseline, immediately, and 30 minutes after the training. The results were as follow: 1.　During the baseline period, the number of average correct responses in three subjects were: S1 7.20(36.00%), S2 7.25(36.25%), and S3 10.58(52.92%) respectively. 2.　Immediately after the training, the number of average correct responses in three subjects were: S1 14.07(69.67%), S2 12.83(64.17%), and S3 15.63 (78.13%) respectively. 3. Thirty minutes after the training, the number of average correct responses in three subjects were: S1 15.53(77.67%), S2 14.25(71.25%), S3 6.38(81.88%) respectively. 4. All the three subjects showed more correct responses in wrist proprioceptive tests at wrist flexion 60°and extension 60°during both the baseline and the training period. They also showed the highest improvement of correct response at neutral wrist position. These results indicated that ‘knowledge of results’ had positive effects on improving and maintaining the wrist proprioception of affected wrists in persons with poststroke hemiplegia. Effect of such improvement on the functional aspect of stroke-affected upper extremity remains to be evaluated in the later study.

The purposes of this study were to identify the influence of visual perception disorder to brain demaged patients and to found out the interrelationship between the lesion of brains and MVPT items. The subjects were 50 brain demaged patients and 29 normal people. Motor-free Visual Perception Test(MVPT) and Mini-Mental Status Examination (MMSE) were used to evaluate the visual perceptions of the both. The data were collected from January 1998 to March 1999. Compare the results of raw scores the among MVPT items of normal group & the brain demaged patients groups, significant differences were found in all level of age group. The difference of raw score in the third age group (70∼80) most significant. The results also indicated that there were some differences in the scores of Korean normal grops and the standard of MVPT suggested by AJOT. The result suggest , There is a need to develope MVPT that is suitable for Korean sujects.

Physiological Cost Index (PCI) of walking has been widely used to predict oxygen consumption in healthy subjects or patients. The purposes of this study were to evaluate the predictability of physiological cost index of upper extremity exercise with a sander for the amount of exercise and cardiac function and to find out most efficient speed of exercise. Upper extremity exercise was conducted in 67 healthy children (age 4 -12) for 2 minutes with a sander in two different speeds, such as self selected comfortable and self selected fast speeds. Speed of sander was calculated, and heart rate were measured before and immediately after the exercise. Physiological Cost Index (PCI) of upper extremity exercise was calculated for statistical analysis. The result were as follows; 1.　Comfortable and fast speeds of the sander went up according to the increase of age, sander PCI during exercise by it, decreased as the age increased with significant difference in each group (p=0.00). The heart rate change during exercising by it, there was no significant difference. 2.　The heart rate change during the exercise by sander increased as the speed of sander increased. Linear regression equation between the heart rate change during the exercise by sander and the speed of sander were 'Y (the heart rate change by sander) = 0.332X (the speed of sander) + 12.731' (R²= 0.154). Stepwise regression showed the speed of sander affected the change of heart rate positively, and the age affected negatively (R²= 0.242, p = 0.00). 3.　The PCI during the exercise by sander decreased as the speed of sander increased. Linear regression equation between the PCI during the exercise by the sander and the speed of sander were 'Y (the PCI by sander) = -0.00495X (the speed of sander) + 2.091'(R²= 0.267), and statistic significant was recognized (p = 0.00). 4.　The speed of exercise by sander it increased as the age increased. Linear regression equation between the speed of the sander and the age were 'Y (the speed of sander) = 2.481X (the age) -0.893(R²= 0.452), and statistic significant was recognized(p = 0.00). 5.　The reliability analysis for the method of examining each PCI, showed high reliability coefficients and the value of alpha was 0.9337. In conclusion, PCI of the upper extremity exercise with a sander could be thought to predict the energy consumption from the speed of sander as there was a linear relationship between the speed of sander exercise and heart rate change with exercise. PCI of the upper extremity exercise with the self selected fast speed was most efficient. Further study with oxygen consumption analysis is recommended to apply PCI in upper extremities in patients with different pathologies in motion.

The purpose of this study is to find the standard value of hand width, of grip strength and of pinch strength by age, sex, and by left hand and right hand and also to find how the general characteristics influences grip strength and pinch strength. Martin Vigorimeter (List No. 17-27-01) was used for measuring grip strength, and the pinch gauge (0∼30 lbs) of B&L engineering for measuring pinch strength. The subjects of this study are the children at the age of three to seven years, who attending the babies' play room, kindergarten and the primary school in Seoul and the Kyungki province area. They all were normally developed without any significant neurology problem. wo hundred girls and two hundred boys were partifipated in this study. They were divided into ten subgroups according to the age of six month interval. Each group consisted of forty children of twenty boys and twenty girls. Analysis of data presents the technical statistics upon the hand width of right and left hand and the grip strength and pinch strength according to the age and sex. Multiple regression analysis using mixed liner model was operated in order to find how the general characteristics (of the age, sex, and side of hand) influence hand width, grip strength, and pinch strength individually. Also, we calculated the correlation among hand width, grip strength and pinch strength under the condition of controlling general characteristics; and to find correlation between the right hand and the left hand of the age and sex, we carried out paired t-test and came to the conclusion as follows: 1.　Hand width is significantly increased with the increase of age (p<0.01). The increase of hand width according to age, boy is wider than that of girl significantly (p<0.01), and the right hand is wider than that of the left hand significantly (p<0.01). 2.　Grip strength is significantly increased as the age and hand width increased (p<0.01). The increase of grip strength according to the age, boy is stronger than that of girl significantly (p<0.01), and grip strength of the right hand is stronger than that of the left hand(p<0.01). 3.　Three-jaw pinch strength is increased as the age, hand width and grip strength are increased(p<0.01). But there is no significant difference of three-jaw pinch strength according to sex and the side of hand(p>0.05). 4.　Tip pinch strength is significantly increased as the age and grip strength are increased(p<0.05). The increase of tip pinch strength according to the age, boy is stronger than that of girl significantly (p<0.05), but there is no significant difference between the right hand and the left hand(p>0.05). 5.　Lateral pinch strength is significantly increased as the age and grip strength are increased(p<0.01). But the increase of lateral pinch strength, there is no significant difference according to the hand width, sex and the side of hand(p>0.05). 6.　The test of correlation among hand width, grip strength and pinch strength showed the correlation between grip strength and pinch strength was stronger than the correlation between hand width and pinch strength(0.3<r<0.7). There was strong correlation between each pinch strength(0.3<r<0.7). Above all, the correlation of three-jaw pinch strength and tip pinch strength was strongest(0.7<r<1.0). 7.　The test of hand width according to the age and sex, and the difference between the right hand and the left hand in grip strength and pinch strength showed that there was significant difference against all the test of hand width, of grip strength, and of pinch strength in the age group from seven years and six months to seven years and eleven months than the age group under six years, specially in girls group(p<0.05).

The purpose of this study was to investigate the relation between components of population, maternal health, need for health care, maternal lifestyle and environment from a conceptual model for cerebral palsy, and the occurrence of cerebral palsy with spastic quadriplegic. This study was a case-control design. The subjects consisted of 53 children with quadriplegic cerebral palsy as a case who were receiving treatment after a diagnosis for cerebral palsy at 3 university hospitals and 3 rehabilitation facilities, and 186 children as a control who were visiting well baby clinics and pediatric departments after screening at the same hospitals in Seoul. The data were collected by a structured questionnaire survey from October, 1998 to February, 1999. The odds ratios of risk factor was produced by χ2 and simple logistic analysiss. The unconditional logistic analysis was done by modeling the data, after adjusting for gestational age. Statistically associated with an increase the risks for spastic quadriplegia were asphyxia(OR=221.89, 95% CI 15.8-999.0) and maternal history of admission during the pregnancy (OR=10.55, 95% CI 2.2-50.4). The result suggested that the improvement of obstetric and neonatal care is necessary to prevent cerebral palsy with spastic quadriplegia.

The purpose of this study was to obtain normative data and comparing cognitive abilities of patients with stroke and normal population by administering Lowenstein Occupational Therapy Cognitive Assessment (LOTCA). The subjects were 31 patients with stroke and 19 adults in a good health. The results were as follows: 1.　The experimental group received statistically lower scores than the control group in all items except for object identification, shape identification and copying geometric forms. 2.　There was no significant difference in analysis of items based on affected side. 3.　There was a significant difference in the relationship between educational background and visuomotor organization and thinking operation. 4.　There was a significant difference in the relationship between treatment period and visuomotor organization. 5.　There was no significant difference in the relationship between LOTCA scores and age and onset of the disease. The result shows that there was a significant difference in LOTCA scores between the experimental group and control group. These data are expected to be used as a baseline.

The purpose of this study were to evaluate the effect of program in visual perception on eye-hand coordination in a child with cerebral palsy. The results were as follows. 1)　Eye-hand coordination were increased significantly compared to doing without pretreatment with the program in visual perception with time-dependent fashion with a cerebral palsy child 2)　A most increased part of eye-hand coordination activities was a large heavy objects and a least increased part of those was a writing. From the above results, it is suggested that program in visual perception is a most useful therapy for a child with cerebral palsy having incomplete eye-hand coordination activity functionally.

It is expected that the demands of medical services in terms of health medical and social welfare will be increased rapidly due to the development of old-aged society and medical technologies. Accordingly the roles and tasks of the occupational therapist become more important, and the demands for the occupational therapist will be also increased. Therefore more systematic and effective manpower management on the occupational therapists is required. When the occupational therapists are classified by their job sites - clinic, health, and other, this study shows that the proportion of occupational therapist in clinic is the biggest. It is also expected that the proportion will be kept in the future. On this point of view, the demand and supply for the occupational therapists in clinics are discussed in this study. The number of occupational therapists demanded are usually depended upon the factors such as health care needs from public, system of medical fee payment and medical insurance, medical policy, share and coordination system of the role of medical service suppliers, and usage of medical facilities by public. This study shows that even the occupational therapists including the students in college in 2000 itself are over-estimated and over-supplied already under the current system of legislation, even though the estimation on manpower needed in this field shows lack of. In this point of view, this study proposes the measures against the problems expected as follow. 1. Legislative specification In spite of the varieties of the occupational therapy, only 4 categories of therapy -simple therapy, complex therapy, special therapy, activities of daily living adjustment training method - are specified in the insurance category of the law. Moreover, the law stipulates that special therapy and ADL adjustment training method shall be prescribed by the rehabilitation medicine. Thus the occupational therapy could not be requested from neurosurgery and orthopedic surgery at all. Nevertheless, it is strongly requested that patients from pediatrics, psychiatric, geriatrics, neurology, orthopedics as well as rehabilitation medicine shall be regarded as the subjects of the special therapy in the law. 2. Certification of psychiatric health care supplier According to the clause 7 of the psychiatric health law, only 3 groups of psychiatric health specialists including clinical psychologist, nurse, and social welfare specialist can supply a psychiatric health care. Anyhow the job descriptions on the clause 2 of the PH law implementation regulation such as ADL adjustment training, occupational and recreational therapy, etc should be classified as the job of occupational therapist. The psychiatric health care courses including the practices are established for the curriculum of the department of occupational therapy in college. And considering that the development of independent ADL ability for the patients is one of the most critical areas of the occupation therapy discipline, the occupational therapist shall supply the psychiatric health care services, 3. Short of facilities and the alternatives The number of occupational therapy clinics in Korea, 98, is not sufficient. Moreover many of the clinics are at big hospitals in big cities, and only 32 clinics are in regional areas. It is required to inform the government agencies and public opinion leaders that occupational therapy clinics shall not be limited to the big hospitals, rather than health offices managed by government should accept the clinics at first. The ultimate purpose of health services, promoting personal health status and help him to return to the society, is likely accorded with that of occupational therapy. Therefore it is requested that the occupational therapy clinics shall be opened in psychiatric resorts, health offices, special institute for disabled, rehabilitation institutes, and the facilities for old aged persons as well as in hospitals.

Occupational science, stemmed from occupational therapy, is a new basic social science defined as the systematic study of the human as an occupational being. Mary Reilly argued that occupational therapy profession should reorganize its academic structure of knowledge by embracing traditional emphasis on occupation. Supporting Reilly’s view, Elizabeth J. Yerxa and her colleagues developed a doctoral program in occupational science with suggestions that the basic science (occupational science) of occupation should focus on the explanation of occupation, whereas the applied science (occupational therapy) should emphasize advancing knowledge on the use of occupation in treatment. The priority of occupational science is to promote theories about the form, function, and meaning as well as the sociocultural context of occupation so that the profession of occupational therapy can be nourished. The major contribution of occupational science to occupational therapy will be providing a body of knowledge sharply focused on the concept of occupation which will help in justification and enhancement of occupational therapy practice.