The purpose of this study was to investigate the changes of the activities of daily living (ADL) by the motor learning program for upper extremity in stroke patients. The subjects were sixty-two members who were treated at the department of occupational therapy. The ADL were measured with Functional Independence Measure (FIM). The result's were as fol1ows; 1. The ability to perform daily activities after treatment was significantly increased independent of age, gender, cause, affected side and speech disability (p<.01). The differences between the pre-treatment and the post-treatment was no significant correlation to sex, cause, affected side and duration of treatment, but the speech disability was significant. Therefore the pre-treatment scores and post-treatment scores were significantly different. 2. The variation of the pre-treatment and the post-treatment in the detail item to the performance of daily life of the stroke patients through the upper extremity motor learning program was significantly increased in self-care, sphincter control, locomotion, mobility, communication and social cognition (p<.01) Consequently, The motor learning program for upper extremity significantly improved the performance level of all ADL areas in stroke patients.

Objective: The purpose of this case study was to describe the treatment of a stoke patient with dysphagia. Method: The subject was an adult stroke patient with dysphagia. She was evaluated on the Functional Dysphagia Scale employing videofluoroscopic method. Swallowing task was swallowing of a thick fluid (5 cc) on oral intake. The treatments in this case study included active postural control activities, strengthening of facial muscles, facial and oral cavity massage, jaw and tongue mobilization, respiratory activities, icing and feeding training once a day. Results: A total score of functional dysphagia scale decreased from 95 to 60 and 23 consecutively. Conclusion: In this particular case study, the swallowing function in the stroke patient with dysphagia improved through occupational therapy intervention.

Objective: To explore the effect of a eye patching technique in order to decrease patients’ unilateral neglect. For this study, eye patching is easy to get and a simple method that most patients find acceptable. Method: This study used the ABA design. The subject was a male patient at the age of 66 who had the left hemiplegia and left unilateral neglect caused by right cerebral vascular accident. He was required to wear the eye patching on the right eye during all the period of ADL because unilateral neglect causes many problems in the majority of ADL. The assessments for the unilateral neglect had been performed by the Line bisection and the Albert test once a session (day). Results: Regarding the Means of the errors to the Line bisection and the Albert test, the Means of the errors was decreased during the period of the intervention (B) and was decreased after the withdrawal (A'). Conclusions: Right monocular patching was effective to release the unilateral neglect. Further study is necessary to increase the sample size and the duration of experiments.

Objective: The purpose of this study was to investigate the effects of cognitive function and Activities of Daily Living (ADL) improvement with Traumatic Brain Injury(TBI) and Stroke patient through Computer Assisted Cognitive Rehabilitation (CACR) program within specific approach and hierarchial approach training program. For this investigation CACR training was administered to 14 patients diagnosed of TBI and Stroke. Method: The CACR was given to the subject patient for 1months, 5times a week and each stimulation lasted 30 minutes. Cognitive function and activities of daily living were compared pre-CACR program with post-CACR program by MMSE and FIM . Results: Summarizing the results of this investigation; 1. Statistically significant improvement in 8 items of MMSE and 11 items of FIM was found after the application of CACR program training. 2. Cognitive function showed the spastically significant improvement after CACR program within specific approach and hierarchial approach training program 3. Activities of daily living showed the statistically significant improvement after CACR program within specific approach and hierarchial approach especially hierarchial approach more statistically significant increased than specific approach.

Objective: The purpose of this paper was to study the effect of typing speed and accuracy according to 4 different typing aids on computer keyboard and mouse use. Method: The subjects of this study were 11 of C6∼C7 complete injury patients who had been over six months after injury, and four style of the typing aids, finger, slip-on, band, and modified finger, were used in this study. Each data of typing aid was collected by measuring typing speed and accuracy and analysed with SPSS 10.0. Results: The measured result according to 4 typing aids in typing speed showed that a modified finger typing aid was 41.09 as the highest performance and a bend typing aid was 33.27 as the lowest performance. The typing speed through styles was statistically significant(p<0.05). The measured result according to typing aid style in typing accuracy showed that a bend typing aid was 96.45% as the highest performance and a finger typing aid was 95.45% as the lowest performance. The typing accuracy through styles was not statistically significant(p>0.05). Conclusion: The results of this study showed that modified typing aid seems to be the most efficient among four style of typing aids. Thus, modified typing aid can be an available typing aid having both functional and cosmetic factor for C6∼C7 complete injured patients. In the future use of the modified typing aid should be needed much more as well as its reevaluation should be performed.

The purpose of this article was to explore the potential for the use of mental practice for the rehabilitation in persons with stroke. Clinical application of mental practice in physical medicine and rehabilitation have not flourished to the same extent as application of mental practice to sports psychology. Studies from the disciplines of kinesiology, neurophysioloy and psychology support the use of mental practice in the post-stroke population. A model is included to demonstrate how mental practice can work through motivation, cognition and neural reorganization to facilitate motor relearning and functional independence. Recent evidence using modern brain-imaging techniques suggest that motor planning during both imagined and actual movements use very similar brain centers. Influencing factors such as imaging ability, task, and method of instructions are discussed. The advantage and disadvantage of using mental practice are included. The potentials of mental practice as a method of promoting and acquiring the exercise functions of stroke patients are being recognized, and is expected to have high effectiveness as a method of improving the functions of the patients in the field of occupational therapy.

Activities of daily living (ADL) and instrumental activities of daily living (I-ADL) are tasks of self-care, functional mobility, functional communication, home management, and community living that enable an individual to achieve personal independence. The purpose of this study were to investigate the effect of factors on ADL in stroke patients and to identify the relationship between the function of upper extremities and ability of ADL. Thirty-one stroke patients participated in this study. The results of this study were as follows: 1) There were significant functional gains between admission and discharge on the MFT score, dexterity, and the motor FIM(p<0.01). 2) There were moderate correlation between MFT score of the non-affected side and motor FIM score at discharge(r=0.499, p<0.01) and high negative correlation between dexterity of non-affected hand and motor FIM score at discharge(r=-0.704, p<0.01). 3) There was a significant difference on motor FIM score among academic background groups (p<0.01). 4) There was no significant difference on motor FIM score among caregiver groups (p<0.01). 5) Four factors were found. one factor comprised dexterity of non-affected hand at admission and discharge and duration of treatment. Two factor comprised MFT of non-affected side at admission and discharge and academic background. Three factor comprised MFT of affected side at admission and discharge and caregiver. Four factor comprised sex and affected side.

The purpose of this study is to examine the effect of transfer of training approach on cognitive function and functional recovery and the difference in the stroke patterns of adult stroke patients with affected cognitive function. Twenty stroke patients were participated ; 8 males and 12 females, the age ranged from 34 to 73. By the classification of diagnosis, 10 subjects were cerebral infarction and 10 subjects were cerebral hemorrhage, by the classification of affected side, 11 Rt hemiplegic patients, 9 Lt hemiplegic patients who were above at least post onset 2 month to a year. It was evaluated and analyzed pre and post treatment with MMSE and FIM, and the method of transfer of training approach was practiced every 30 min a day for a month. The data were analyzed by t-test and one way ANOVA. The results of this study were as follows: 1. There was significant in the effect of transfer of training approach on cognitive function of stroke patinets. 2. There was significant in the effect of transfer of training approach on functional recovery of stroke patients. 3. There was a significant difference in the effect of treatment in the group of cerebral infarction.

The purpose of this study was to examine the effect of the upper limb nerve mobilization (ULNM) on functional recovery of upper extremity in hemiplegic patients following stroke. Twenty patients who had functional impairment on upper extremity were participated. Subjects were randomly divided into two groups: Control group (n=10) received traditional physical therapy only for 4 weeks; Experimental group (n=10) received ULNM treatment along with traditional physical therapy for the same period. Upper extremity functions were assessed by manual muscle test (MMT), modified Ashworth scale (MAS), and Fugl-Meyer assessment (FMA) before and after the treatment. In both experimental and control group, upper extremity functions were significantly improved in MMT (p<.01) and FMA (p<.01), however only experimental group showed significant improvement in FMA after the treatment (p<.05). Moreover, experimental group showed significantly greater improvement than control group in MMT (p<.05), MAS (p<.05), and FMA (p<.05). We conclude that the upper extremity functions is a useful additional therapeutic technique for the effective treatment of upper extremity deficits in hemiplegic patients.

This study is on the concept of contralateral needling through considering some document. Contralateral needling is the way of selecting points located opposite side of the diseased area(puncturing the left to treat the right in body). Its aim is to regulatethe qi and Blood and make run down the merdian well. So it can be used to treat the pain with blocking of qi and the motor paralysis. There is the principle that the injury part is weak while the opposite healthy part is strong. So if we take the acupuncture in healthy part-opposite side of lesion, it would be effective because of invigoration motor functional disorder with reduction of excess. It is indicated that contralateral needling is superior to non-contralateral needling in elevating care rates and improving the blood circulation of brain lesion. In brief, contralateral needling is effective to treat motor paralysis in stroke and it takes an important role to promote the blood flow of brain, specially acute stage in stroke.

The use of herbs for medical benefit has played an important role in nearly every culture on earth. Herbal medicine was practiced by ancient cultures in Asia. Herbal drugs should be processed before using or making into various forms. We study on the formulae and administration of herbal drugs used for stroke in the Poong(風) section of DongYiBoGam(東醫寶鑑) and the conclusion is said that;. Besides decoction of herbal drug, there are pill, powder, soft extract, powder to be taken after infused in warm boiled-water or liquor. The most commom way to take a medicine is a decoction boiled with the water(pills comes next, powder follows it), and bamboo juice or ginger juice was usually added when it needs. Pills are mostly taken with honey and being done with flour comes as the 2nd common way. In 11 cases, pills are wrapped by cinnabar or gold foil(sometimes both come together). Pills and powder are commonly taken with the warm water or herb(most of them are ginger juice or warm liquor). Warm liqour is the most common material taken with the powder but warm water or ginger juice is used, too. In chui-che(取嚔) method, powder is simply used. Their characteristics and administrations are shown in detail in Pharmacology of Traditional Korean Medical Formulae. It is neccessary to research and develope various administrations of drug in order to take the best effects on oriental(Koran traditional) medicine.

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 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.

This study was to investigate the effects of a functional electrical stimulation (FES) on temporal parameters (stride length, step width and cadence) of gait patterns in a patient with right hemiparesis. A single-subject reversal (ABAB) design was used. The subject was a 25-year-old male who had foot drop and circumduction gait pattern. An ink foot-print method was used to assess the temporal parameters of gait between the baseline phase and the intervention phase. FES was applied at 8 m walkway, three times a week for 5 weeks. The results showed that stride length was increased by 4.04 cm and that step width was decreased by 3.93 cm in the intervention phase. There was no difference in cadence between the baseline phase and intervention phase.

The purpose of this study is to first to evaluate the function of the involved upper extremity of adult hemiplegia in relation to the hand dexterity with the uninvolved hand by using Manual Function Test(MFT) to measure the function of the involved upper extremity and Grooved Peg Board Test to assessment the hand dexterity with the uninvolved hand. Second to evaluate the hand dexterity with the uninvolved hand of adult hemiplegia in relation to activities of daily living(ADL) by using Functional Independence Measure(FIM) to measure the ADL. The subjects in this study were 21 stroke patients who were admitted for intensive treatment at Department of Rehabilitation in Asan Medical Center from September to November, 1998. Data were analyze for wilcoxon signed ranks test and Spearman correlation coefficients using SPSS/PC+ program. The results of this study are : 1) Statistically MFT score at admission showed significant correlation with MFT score at discharge (p < 0.01). 2) Statistically the hand dexterity with the uninvolved hand at admission showed si-gnificant correlation with the hand dexterity with the uninvolved hand at discharge(p< 0.01). 3) The function of the involved upper extremity and the hand dexterity with the un-involved hand are poorly related variables in stroke patients(p < 0.01). 4) The function of the involved upper extremity and independence in ADL are poorly related variables in stroke patients(p < 0.01). 5) The hand dexterity with the uninvolved hand and independence in ADL are poorly related variables in stroke patients(p < 0.01). 6) In the relationships between FIM score at admission and FIM score at discharge; there were no significant differences(p < 0.01). It was difficult to compare the measured hand dexterity with the uninvolved hand in stroke patients as well as to assess the hand dexterity with the same side hand in normal, for it is in the variation between the current data used for this study and the standard data obtained from Lafayatte Instrument Company. The activities of daily liv-ing of the hemiplegic patient are largely dependent on their uninvolved hand which is thought to be vital for the rehabilitation of the hemiplegic patients. Therefore, occupa- tional therapy program in stroke patients should include improving skills of uninvolved hand.

Stroke is a serious disease despite recent improvement in medical and surgical treatment. Hence, identification of modifiable risk factors for stroke is important. This case-control study was done to demonstrate that relationship between smoking, alcohol consumption, obesity, perception of saltness and the incidence of stroke and to identify that smoking, alcohol consumption, obesity and perception of saltness, after adjusting for age, hypertension. A structured interview was carried out from April 15, 1996 to May 3, 1996 in Yonsei Medical Center. The study group consisted of 59 neurologically confirmed stroke patients as the study group and 59 non-stroke patients as controls. Analysis of the data was done by means of -test and logistic regression analysis. The results were as follows. In the study group: 1) Hypertension in males had a 10.2 odds ratio (p<0.05), cardiovascular disease in females had a 11.3 odds ratio (p<0.05) and a farnily history of stroke in males had a 3.1 odds ratio (p<0.05). 2) Females smoking one or more cigarettes had a 8.3 odds ratio (p<0.1), but males had no direct relationship with odds ratio of 1.5 (non-significant). 3) Alcohol consumption in males had a 0.4 odds ratio, and in females had a 0.8 odds ratio. The odds ratio was decreased in alcohol consumption group (non-significant). 4) Males with more than 20 cigarettes pack-years history had a 2.5 odds ratio (p<0.05), more than 25 Body Mass Index had a 3.1 odds ratio (p<0.05) and more than 220 ml ethanol weekly consumption had a 1.5 odds ratio (non-significant). 5) Female smokers had a 8.3 odds ratio (p<0.1), drinkers a 0.8 odds ratio and more than 25 Body Mass Iidex, a 43.1 odds ratio (p<0.05). 6) Females without saltness perception from a 0.5% salt solution had a 6.8 odds ratio (non-significant). 7) By logistic regression analysis independent risk factors for stroke in males were found to be hypertention, age, and obesity. The study was limited because number of subjects was too small for practical implications. However, like as other results, this study suggest that people should be advised to control hypertension, and obesity since these carry a risk of stroke.

Stroke induces neuro-psychiatric symptoms as well as neural disorders. In oriental medical treatment of stroke, these neuro-psychiatric symptoms and motor․sensory nerve disorders are major and important points of differentiation of syndromes and major therapeutic aim for stroke patients. For looking at changes of neuro-psychiatric symptoms in stroke patients, we devided stroke patients into two groups by time after attack; group in 4 weeks (Group A) after attack, group more than 5 weeks (Group B). We examined them with SCL-90-R(Symptoms Check List-90-R), one of neuro-psy -chiatric examination tools, then the results as follows; In group A, phobic Anxiety was most high, and phobia anxiety, anxiety, psychoticism, hostility, depression, obsessive-compulsive, paranoid ideation and interpersonal sensitivity were located by score. In group B, phobic anxiety was most high, and depression, somatization, anxiety, psychoticism, interpersonal sensitivity, obsessive-compulsive, hostility, paranoid ideation were located by score. We recognized that all indexes of Group B including global severity index(GSI), positive symptom total(PST) and positive symptom distress index(PSDI) were higher than those of Group A. We suggest that the aim of treatment about stroke patients be made by considering changes of neuro-psychological symptoms.

The purpose of this study was to identify the relationship between motor and mental status and functional status, and to determine appropriate test times. Using the Modified Motor Assessment Scale(motor status) and the Modified Barthel Index(functiona1 status), the Glasgow Coma Scale(menta1 status), we tested 9 stroke patients. 1 week. 1 month after their stroke. Three measures are reliable and valid. We used the Sperman correlation coefficient(r) and Wilcoxon signed rank test to analyze the data. MMAS scores at 1 month correlated significantly with MBI scores at 1 month(r=0.89). But GCS scores at 1 month did not correlate significantly with MBI scores at 1 month. All data of MMAS at 1 month correlated significantly with MBI scores at 1 month. But only verbal response score among GCS scores at 1 month correlated significantly with MBI scores at 1 month(r=0.86). The difference of MMAS, GCS. MBI scores between 1 week and 1 month after stroke onset were statistically significant(p(0.05). This study suggested that the mental status had more impact on functional recovery than motor status at 1 week after their stroke. Also, the motor status had more impact on functional recovery than mental status at 1 month after their stroke. But the mental and motor status should be considered together in predicting the functional recovery status of stroke patients.

This Study was designed to provide the basic data of effective intervention for the promotion of coping and quality of life in family caregivers of stroke patients. The subjects of this study were a total of 113 caregivers of stroke patients under occupational therapy at university hospitals located in Seoul city and Kyeongki-do. Data were collected by means of a questionnaire during the period from March 4th to July 30th. 1997. The questionnaires consisted of questions regarding burden(21 item. 5 point scale). coping(29 item. 4 point scale) and quality of life(47 item. 5 point scale). Data were analyzed using SAS program for t-test. ANOVA. Scheffe test and Pearson correlation coefficients. The results were as follows: 1. In the relationships between burden and demographic characteristics of the family caregivers: there were no significant differences. 2. In the relationships between coping and demographic charactersistics of the family caregivers: monthly income and religious affilition had statistically significant differences. The level of coping was significantly higer in those who perceived their religion as helpful than in their counterparts. 3. In the relationships between quality of life and demographic characteristics of the family caregivers: supporters, education, occupation and monthly income had statistically significant differences. The level of the quality of life was significantly higher in those who received support for family chores than in those who didn't. 4. The relationship between burden and coping showed a significant negative correlation. The relationship between coping and quality of life, and current Barthel Index showed a significant positive correlation.