목적 : 본 연구는 뇌졸중 클라이언트의 운동기술 평가방법으로서 Korean Assessment of Motor and Process Skills(K-AMPS) 의 유용성을 알아보고자 하였다. 연구방법 : K-AMPS로 분석한 클라이언트의 일상생활활동 과제수행 상의 효율성을 확인하였고, K-AMPS의 내용타당도 및 과제 간 신뢰도를 스피어만 상관관계 분석을 이용하여 통계학적으로 검증하였다. 결과 : 연구 결과에서 뇌졸중 클라이언트 2명의 일상생활동작 과제수행은 효율적이었으나 18명은 비효율적이었다. K-AMPS 와 MFT의 상관관계는 두 검사의 총점에서 통계학적으로 유의하였으나, K-AMPS의 총점과 MFT의 일부 하위 검사의 점수는 통계학적으로 유의하지 않았다. K-AMPS의 과제 간 신뢰도는 통계학적으로 유의하였다. 결론 : K-AMPS에서 제시되는 결과 리포트의 장점, K-AMPS와 MFT 간의 낮은 상관관계, K-AMPS의 높은 과제 간 신뢰도를 고려할 때 뇌졸중 클라이언트의 운동 기술 평가에 있어서 K-AMPS가 유용할 것이다.

목적 : 본 연구의 목적은 시각되먹임 제공 및 차단으로 시행된 자세수직훈련의 효과를 비교함으로써, 시각되먹임을 차단한 자세수직훈련이 뇌졸중 밀기증후군 환자의 기능회복 및 일상생활동작에 어떠한 영향을 미치는지 알아보고 자 하였다. 연구방법 : 본 연구는 개별사례 교차중재 연구설계 중 대상자간 다중기초선을 이용하였으며, 밀기증후군 환자 3명 을 대상으로 하였다. 기초선 측정은 대상자 1이 4회, 대상자 2가 7회 그리고 대상자 3이 10회였으며, 치료회기는 대상자 1이 14회, 대상자 2가 11회 그리고 대상자 3이 8회였다. 치료중재는 대상자 1이 14회, 대상자 2가 11회 그 리고 대상자 3이 8회였다. 밀기증상의 기능회복 평가는 밀기 증후 척도, 일상생활동작을 평가하기 위하여 바델지 수 및 실험 전∙후 대칭적인 서기자세를 평가하기 위하여 근전도기로 양측 중둔근에서 근활성도를 측정하였다. 결과 : 시각되먹임을 차단한 자세수직훈련이 적용되었을 때 대상자 1, 2, 3의 밀기 증후 척도는 각각 기초선과 비교 하여 52.4%(5.3점에서 2.8점), 36.4%(4.4점에서 1.6점) 및 23.6%(3.6점에서 0.9점) 향상되었다. 시각되먹임을 제공한 자세수직훈련은 42.9%(5.3점에서 2.3점), 26.1%(4.4점에서 1.2점) 및 13.2%(3.6점에서 0.5점) 향상되었다. 대상자 1, 2, 3의 바델지수는 각각 기초선과 비교하여 22.4%(44.3점에서 54.1점), 15.5%(44.7점에서 51.6 점) 및 15.8%(51.5점에서 59.6점) 향상되었다. 시각되먹임을 제공한 자세수직훈련은 17.0%(44.3점에서 51.8점), 11.4%(44.7점에서 49.8점) 및 14.8%(51.5점에서 59.1점) 향상되었다. 또한 실험 전과 비교하여 실험 후 환측의 중둔근 근활성도가 더 크게 향상되었다. 결론 : 교대로 적용된 치료중재 결과를 통하여 시각되먹임을 차단한 자세수직훈련이 시각되먹임을 제공한 자세수직훈련보다 밀기증후군 환자의 기능회복 및 일상생활동작능력에 더 효과적인 것으로 나타났다. 향후에는 많은 대상자를 포함시키고 오랜 기간 동안 적용한 연구들이 계속 이어져야 할 것이다.

The present study examined the effects of functional electrical stimulus( group 1), proprioceptive neuromuscular facilitation(group 2) and combined training of functional electrical stimulus and proprioceptive neuromuscular facilitation(group 3) with scapula adductor muscles on scapula movement, upper limb function and gait in fifteen subjects stroke patients. The training was thirty minutes a day, five times a week for six weeks, obtained result as follow, upper limb function was significant difference in the group 2(p<.05) but no significant difference in other groups. The change of weight bearing were significant difference in all the groups(p<.05), and increase of gait velocity were significant difference in all the group(p<.05). In conclusion, when applied with functional electrical stimulus, proprioceptive neuromuscular facilitation and combined training to the scapular adductor muscles, it was oberved in the course of the experiment that proprioceptive neuromuscular facilitation was the most effective treatment among the three methods applied to the scapula adductors.

The purpose of this study was to compare the effects of treadmill walking in underwater and overground which affects gait and physical function of people who have had a stroke. Twenty people after a stroke who have become hemiplegic over 6 months were participated. Participants were divided into two groups: underwater treadmill group(UTG) and overground treadmill group(OTG). The intervention was done 4 times per weeks for 6 weeks and 1 session lasted for 30 minutes. Gait and physical function elements were measured at baseline, at the middle(3 weeks) and at the end of the intervention(6 weeks). For the elements of gait, walking velocity, affected stance phase, affected weight bearing were assessed. For the elements of physical function, Short Form 8(SF-8) health survey was used. The result of this study showed that both groups improved similarly in walking velocity. However participants in UTG improved more than those in OTG in affected stance phase(p<.05), affected weight bearing( p<.05) and emotional aspect(p<.001). Based on the results of this study, it can be suggested that treadmill walking both in underwater and on the ground can be effective in improving hemiplegic gait and physical function of people who have had a stroke. The result also suggest that the underwater treadmill exercise can be more effective than overground treadmill in restoration of gait in people after stroke.

The majority of strokes are caused by ischemia and result in brain tissue damage, leading to problems of the central nervous system including hemiparesis, dysfunction of language and consciousness, and dysfunction of perception. The purpose of this study was to investigate the effects of Poly(ADP-ribose) polymerase(PARP) on necrosis in neuronal cells that have undergone needle electrode electrical stimulation(NEES) prior to induction of ischemia. Ischemia was induced in male SD rats(body weight 300g) by occlusion of the common carotid artery for 5 min, after which the blood was reperfused. After induction of brain ischemia, NEES was applied to Zusanli(ST 36), at 12, 24 and 48 hours. Protein expression was investigated using immuno-reactive cells, which react to PARP antibodies in cerebral nerve cells, and Western blotting. The results were as follows: In the cerebral cortex, the number of PARP reactive cells after 24 hours significantly decreased(p<.05) in the NEES group compared to the GI group. PARP expression after 24 hours significantly decreased(p<.05) in the NEES group compared to the GI group. As a result, NEES showed the greatest effect on necrosis- related PARP immuno-reactive cells 24 hours after ischemia, indicating necrosis inhibition, blocking of neural cell death, and protection of neural cells. Based on the results of this study, NEES can be an effective method of treating dysfunction and improving function of neuronal cells in brain damage caused by ischemia.

The aim of this study was performed to determine the inter-rater reliability of the Stroke Rehabilitation Assessment of Movement (STREAM) translated in Korean. This was a new clinical measurement tool for evaluating the recovery of voluntary movement and basic mobility following stroke. A direct-observation reliability study was conducted on 20 patients who had strokes and were in a rehabilitation setting. Subjects were assessed by two physical therapists. The reliability of the STREAM scores was demonstrated by weighted kappa statistics for inter-rater agreement on scores for individual items ranged from .83 to 1.0, intraclass correlation coefficients for total score was .99, and for subscale scores was ranged from .96 to .99. The internal consistency of the STREAM scores was demonstrated by Cronbach alphas of greater than .99 on the subscales and overall. These high levels of reliability support the use of the STREAM translated in Korean instrument for the measurement of motor recovery following stroke.

Mortality rates from stroke have been declining. Because of this, more people are living with residual disability. Rehabilitation plays an important role in functional recovery of stroke survivors. In stroke rehabilitation, early prediction of the obtainable level of functional recovery is desirable to deliver efficient care, set realistic goals, and provide appropriate discharge planning. The purpose of this study was to identify predictors of functional outcome after stroke using inpatient rehabilitation as measured by Functional Independence Measure (FIM) total scores. Correlation and stepwise multiple regression analyses were performed on data collected retrospectively from two-hundred thirty-five patients. More than moderate correlation was found between FIM total scores at the time of hospital admission and FIM total scores at the time of discharge from the hospital. Significant predictors of FIM at the time of discharge were FIM total scores at the time of hospital admission, age, and onset-admission interval. The equation was as follows: expected discharge FIM total score = 76.12+.62×(admission FIM total score)-.38×(age)-.15×(onset-admission interval). These findings suggest that FIM total scores at the time of hospital admission, age, and onset-admission interval are important determinants of functional outcome.

This study examined whether any changes by mental task types on postural control in chronic stroke persons. Sixteen chronic stroke persons (mean age=53.75 yr) and sixteen age-and gender-matched healthy controls (mean age=54.44 yr) took part in this study. Participants randomly performed three different tasks on the stable and unstable surfaces. The no mental task was to stand while holding a 100 g weight in each hand, the arithmetic task (mental task) was to perform a silent 1-backwards counting while standing and holding a 100 g weight in each hand, and the simple task (mental task) was to stand and hold with both hands a tray (200 g) on which a glass filled with water has been placed. Sway path and sway velocity of the center of pressure (COP) were measured to assess standing postural control by task performance using the force platform. According to the results, in stroke group, total sway path and total sway velocity of COP was significantly decreased during arithmetic and simple task compared to no mental task on the stable surface (p<.05), and sway path (anteroposterior AP, mediolateral ML) of COP, total and sway velocity (AP, ML, total) of COP was significantly decreased during arithmetic and simple task compared to no mental task on the unstable surface (p<.05). Especially, sway path (AP, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased under the simple task when compared to the arithmetic task on the unstable surface (p<.05). In healthy control group, sway path (AP, ML, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased during arithmetic and simple task compared to no mental task on the stable and unstable surface (p<.05), and sway path (AP, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased under the simple task when compared to the arithmetic task on the unstable surface (p<.05). In conclusion, the findings of this study showed that arithmetic and simple task improved standing postural control for chronic stroke patients and the type of arithmetic and simple tasks were critical factor that reduced standing postural sway in dual-task conditions. Future research should determine whether dual-task conditions, including simple task, would be effective as a training program for standing postural control of stroke patients.

The purpose of the study was to determine the effects of balance training with 'TETRAX' system, a balance training and assessment tool, on balance and mobility in acute hemiplegic patients. Nineteen matched subjects were assigned randomly into either an experimental group or a control group. An experimental group with 10 subjects received balance training with 'TETRAX' exercise program and conventional physical therapy interventions 5 times per week during 4 weeks. A control group with 9 subjects received conventional physical therapy interventions 5 times per week during 4 weeks. Outcome measures were taken before and after 4 weeks of interventions using the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), gait speed, and the fall down index. Results indicated that both exercise groups improved significantly in STREAM, BBS, and gait speed (p<.05). The experimental group had a little improvement than the control group. Both exercise groups did not show statistical significance in fall down index (p<.05). Following 4 weeks of intervention, except gait speed there was no statistically significant difference between two groups. However, these findings suggest that conventional physical therapy interventions with visual feedback training could be effective on improving balance and mobility than conventional physical therapy alone in acute hemiplegic patients.

목적 : 수정된 강제유도운동치료와 양손 움직임을 위한 활동으로 구성한 과제 지향적 치료 프로그램이 뇌졸중 환자 의 상지기능과 일상생활활동에 미치는 효과를 알아보는 것이다. 연구방법 : 5명의 뇌졸중 편마비 환자들을 대상으로 수정된 강제유도운동치료를 적용하였다. 수정된 강제유도운동 치료는 3주 동안 매일 가장 활동적인 5시간 동안 건측 상지의 움직임을 제한하는 장갑을 착용하였고 제한시간 동 안 환측의 움직임을 위한 과제들을 수행하였다. 양손 움직임을 위한 활동은 건측을 제한하지 않고 일상생활활동과 밀접한 과제들을 1주 동안 수행하였다. 상지기능 변화는 뇌졸중상지기능평가(MFT)를 사용하였고 일상생활활동 의 변화는 운동처리기술평가(AMPS)를 사용하였다. 결과분석은 3번의 반복 측정된 자료의 차이를 검증하기 위해 비모수 방법인 프리드맨 검정을 사용하였고 사후 검정은 윌콕슨 쌍대비교 분석을 이용하였다. 통계적 유의수준은 .05로 하였다. 결과 : 대상자의 상지기능과 일상생활활동 수행능력은 수정된 강제유도운동치료 후와 양손 움직임을 위한 활동 후 유의하게 향상되었다. 수정된 강제유도운동치료를 실시한 후에 편마비 환자의 환측 상지기능과 일상생활활동 수 행 능력이 유의하게 향상되었고 양손움직임을 위한 과제 지향적 치료 이후에도 유의한 수준은 아니지만 긍정적인 효과가 나타났다. 결론 : 연구 결과를 통해 과제 지향적 방법이 적용된 수정된 강제유도운동치료를 실시하고 이를 통해 향상된 환측 을 기능적으로 활용하도록 양손 활동 과제를 이용하여 훈련하는 본 연구의 치료 프로그램이 뇌졸중 환자의 환측 상지 기능과 일상생활활동의 증진에 효과적임을 확인할 수 있었다.

목적 : 본 연구를 통해 뇌졸중 편마비 성인에게 일상생활보조도구를 적용했을 때 작업수행 및 만족도에 어떤 영향을 미치는지 알아보고자 한다. 연구방법 : 대상자는 뇌졸중으로 인해 왼쪽 편마비 장애를 가진 60세 여성이다. 상담 및 평가를 통해 한 손 사용자를 위한 도마와 손잡이가 긴 목욕도구(바디샤워)를 3개월 동안 적용하였다. 보조기구의 효율성을 확인하기 위해 Modified Bathel Index(M BI)와 캐나다작업수행측정(Canadian Occupational Performance Measurement, COPM)을 사용하였다. 결과 : MBI에서는 목욕하기 영역에서 점수 향상이 있었고, COPM에서는 작업수행의 문제로 설정한 목욕하기 및 식사준비하기 의 두 영역 모두에서 작업 수행도 및 만족도 점수가 증가하였다. 결론 : 적절한 보조기구의 적용은 장애인이 장애 발생 전에 수행하던 역할을 다시 수행하도록 하는데 긍정적인 영향을 미치며 일상생활활동의 수행과 만족도를 증진시켜 준다. 따라서 작업치료사는 뇌졸중 편마비 성인의 작업 수행 증진을 위해 적절한 일상생활보조기구 평가 및 훈련에 대한 다양한 접근을 해야 할 것이다.

The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.

The Functional Independence Measure (FIM) is widely used to determine the dependency of activity of daily living in rehabilitation patients. The purposes of this study were to evaluate the unidimentionality of the FIM physical items and to analyze the validity of cross-functional levels in stroke survivors in Korea. Thirteen physical items of FIM were rated according to an ordinal scale of a 7-level classification. Two hundred and seventy-nine patients participated in the study (age range 18~92 years and 57% male). Six items-eating, bladder control, bowel control, transfer to and from the bed/wheelchair, transfer to and from the toilet, and bathing-showed misfits with the Rasch model. The most difficult item was 'bathing', the easiest item was 'bowel control'. Although there were several differences within functional levels, the hierarchical order of item measures was rather similar. 'Bathing' was the most difficult in high level patients (above 60), however 'stairs' was most difficult in the middle level (41~60) group. In the low level group (below 40), 'toileting' was the most difficult. In conclusion, the present study has shown several differences of item difficulty among functional levels. This result will be useful in planning interventions, and developing rehabilitation programs for stroke survivors.

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity (FM-U․L/E). The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (β=.420～.862) had slightly more power in predicting trunk control than the . TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study clearly indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

The aim of this study was to determine the effect of action observational physical training (AOPT) on manual dexterity and corticomotor facilitation in stroke patients. Ten hemiparetic patients participated in this study. Each subject was asked to participate the three conditions; base condition (Base), physical training (PT), AOPT. Participants were asked to observe the action in the video that a therapist moved the blocks during the AOPT conditions. Corticomotor facilitation was determined in three conditions by monitoring changes in the amplitude of motor-evoked potentials (MEPs) elicited in hand muscles by transcranial magnetic stimulation. MEP responses were measured from the first dorsal interosseous after participants attended to three conditions. For the manual dexterity, Box and Block test (BBT) was used. The results of present study were summarized as follows: MEPs amplitude significantly tended to be larger than PT and Base condition. The scores of BBT in the AOPT condition were also significantly larger than other conditions. In conclusion, this finding of present study indicates that physical training for observation of an action is beneficial for enhancing a dexterity of paretic arm in stroke patients.

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were 0˚, 45˚, and 90˚. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was 0˚, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was 90˚, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.

목적 : 뇌졸중 환자를 대상으로 4점 척도인 뇌졸중 자세 평가 척도(Postural Assessment Scale for Stroke: PASS) 와 5점 척도인 버그 균형 척도(Berg Balance Scale, BBS)를 3점 척도로 단순화시켜 원본 PASS, BBS와 특성을 비교하고 신뢰도 및 타당도를 알아보고자 하였다. 연구방법 : 만성뇌졸중 환자 62명을 대상으로 PASS(0-1-2-3)는 PASS-3Level(0-1.5-3)로 BBS( 0-1-2- 3-4)는 BBS-3Level(0-2-4)로 기록하여 비교하였다. PASS-3L과 BBS-3L 평가의 측정자내·측정자간 신 뢰도는 급간내 상관계수를(ICC3,1), 절대적 신뢰도는 표준 오차 측정(Standard Error Measurement: SEM)과 최 저 실제 차이(Small Reference Differences: SRD)를 이용하였고, 내적 일치도를 알아보기 위하여 Cronbach’s α 계수를 구하였다. PASS(PASS-3L), BBS(BBS-3L)의 동시 타당도와 수정된 바델 지수(Modified Barthel Index, MBI)와 퓨글 마이어 운동(Fugl Meyer-Motor: FM-M)과의 수렴 타당도를 알아보기 위하여 피어슨 상관 분석을 하였다. 결과 : PASS-3L과 BBS-3L의 검사 재검사 신뢰도는 각각 ICC = .96, .96, 측정자간 신뢰도는 각각 ICC = .95, .94이었다. PASS-3L과 BBS-3L의 SEM은 각각 .99, 1.55, SRD는 1.74, 4.30, Cronbach's α계수는 .77, .85로 신뢰도가 높게 나타났다. PASS-3L의 동시 타당도는 PASS(r=.93), BBS(r=.75), BBS-3L(r=.80)과 유의한 관 련이 있었고, BBS-3L은 PASS(r=.80)와 BBS(r=.93)와 유의한 상관관계가 있었다(p<.01). PASS-3L의 수렴 타당도는 MBI(r=.60), FM-M(r=.42)과 유의한 관련이 있었고, BBS-3L은 MBI(r=.79), FM-M(r=.48)와 유 의한 상관관계가 있었다(p<.01). 결론 : 2개의 단순화된 PASS-3L과 BBS-3L은 PASS, BBS와 비교하여 매우 높은 신뢰도와 타당도를 보여 뇌졸 중 환자의 균형을 평가하는데 적합하다고 할 수 있다.

목적 : 본 연구는 뇌졸중으로 인한 연하장애 환자를 대상으로 흑후추 기름(Black Pepper Oil: BPO)을 이용한 후각 자극이 연하기능 회복에 미치는 영향을 알아보고자 하였다. 연구 방법 : 뇌졸중 후 연하장애를 가진 환자 20명을 대상으로 BPO 후각자극을 이용한 연하장애 치료 중재를 적용하 는 실험군과 증류수 후각자극을 이용한 연하장애 치료 중재를 적용하는 대조군으로 각각 10명씩 나누었다. 6주에 걸친 치료 중재 전·후의 연하기능을 비교하기 위해 기능적 연하장애 척도를 이용하였다. 결과 : BPO 후각자극을 이용한 연하장애 치료 후 유의한 연하기능의 향상을 보였고(p<.05), 항목별 변화는 삼킴반 사 지연, 후두상승과 후두덮개 폐쇄, 후두계곡의 잔여물, 인두 통과 시간 항목에서 유의한 연하기능의 향상을 보였 다(p<.05). 결론 : BPO 후각자극을 이용한 연하장애 치료가 뇌졸중으로 인한 연하장애 환자의 연하기능을 호전시킨다는 것을 알 수 있었다. 따라서 BPO 후각자극을 이용한 연하장애 치료는 연하장애 치료의 새로운 방법으로 사용이 간단하 고 비용이 저렴하여 작업치료 임상에서 유용하게 적용될 수 있을 것이라 생각된다.

목적 : 본 연구의 목적은 ICF(International Classification of Functioning, Disability and Health)의 능력(capacity)과 수행(performance) 평가치의 신뢰도와 FIM(Functional Independence Measure)과 MBI(Modified Barthel Index)와의 기준관련타당도를 알아보고자 하였다. 연구 방법 : 국립재활원에 입원한 아급성기 뇌졸중 환자 55명을 대상으로 실시하였다. ICF에 경험이 있는 2명의 의사가 FIM과 MBI에 해당하는 항목을 ICF 항목과 연결시켜 10개 항목 중 3개의 범주인 이동, 보행, 자기 관리 항목을 추출하였으며, 모든 평가는 물리치료사, 작업치료사에 의해 수행되었다. ICF의 수행과 능력 평가치의 측정자간 신뢰도(Inter-rater reliability)는 급간내상관계수인 ICC(2.1)을 절대적 신뢰도는 SEM(Standard Error Measurement)과 SRD(Small Reference Difference)를 FIM과 MBI, ICF와의 상관관계는 Pearson 상관계수를 이용하여 분석하였다. 결과 : ICF 능력과 수행 평가치의 측정자간 신뢰도는 각각 .92(.95, .97), .98(.97, .99), SEM은 1.03, 1.09이었으며, SRD는 2.85, 3.02로 매우 높은 신뢰도를 보였다. ICF 능력 평가치는 FIM(r=-.97), MBI(r=-.90)와 높은 음의 상관관계가 있었고, ICF 수행 평가치는 FIM(r=-.73), MBI(r=-.69)와 중간 정도의 음의 상관관계가 있었다. 결론 : ICF는 FIM과 MBI의 기준 관련 타당도에서 음의 상관관계가 있었으며, 신뢰할만한 기능 평가 도구로서 뇌졸중 환자의 기능적 상태를 평가하는데 임상 연구나 실험에서 유용한 평가 도구가 될 수 있을 것이다.

목적 : 본 연구의 목적은 뇌졸중 환자의 손기능에 대한 근전도 바이오피드백 훈련의 효과를 조사하는 것이다. 연구 방법 : 발병 6개월 이상인 뇌졸중 환자 10명을 무작위로 실험군과 대조군으로 각각 5명씩 배정하였다. 실험군은 근전도 바이오피드백 훈련을 1일 1회, 주 5일, 6주 동안 수행하도록 하였다. 훈련의 1회기는 15초의 휴식기와 5초간의 추적과제를 수행하는 활동기로 구성되며 1회 훈련동안 추적과제를 총 40번 시행하였다. 반면, 대조군의 모든 치료 상황은 바이오피드백 훈련을 제외하고는 실험군과 같았다. 손기능을 검사하기 위하여 훈련 전·후에 개정된 Ashworth 척도, Fugl-Meyer 평가, 상자와 나무토막 검사, 뇌졸중 상지기능 검사를 실험군과 대조군 모두에게 실시하였다. 결과 : 실험군은 개정된 Ashworth 척도를 제외한 모든 검사에서 훈련 후의 결과가 훈련 전의 결과와 비교하여 통계적으로 유의한 차이를 보였다(p<.05). 대조군은 모든 검사에서 유의한 차이를 보이지 않았다(p>.05). 또한 집단간 비교에서 실험군의 훈련 후 손기능 향상이 모든 검사에서 대조군에 비하여 통계적으로 유의하게 높았다(p<.05). 결론 : 본 연구는 실시된 근전도 바이오피드백 훈련이 뇌졸중 환자의 손기능 향상에 효과적임을 지지한다.