The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI≤74 and MBI≥75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI≤74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI≥75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.

목적 : 문항반응이론에 기초한 Rasch모형을 적용하여 뇌졸중 입원환자의 일상생활수행 평가도구를 개발하는 것이다． 연구방법 : 2002년 8월 5일부터 2005년 4월 20일까지 전국 18개 재활기관에서 뇌졸중 입원환자 308명을 대상으로，작업치료사가 평가한 6개 영역의 23개 항목으로 구성된 설문지 결과를 수집하여 Winsteps 프로그램으로 라쉬분석하였다． 결과 : 3개 항목이 부적합한 항목으로 판정되었으며，남은 20개 항목의 난이도 순서를 배열하였다．뇌졸중 입원환자의 일상생활 수행능력은 -6.77~6.73 로짓으로 표시할 수 있으며，표준화점수로 표시하기 위한 변환식은 "점수 =（로짓점＋6.77)/ (6.77+6.73) 100" 이었다．평가항목의 난이도는 가장 어려운 항목은 보행영역의 ‘계단 오르내리기’ 항목이었으며，가장 쉬운 항목은 식사하기 영역의 ‘음료 마시기’ 항목 이었다． 결론 : 라쉬분석을 이용한 뇌졸중 입원환자의 일상생활수행 항목의 적합도와 난이도에 관한 결과제시로 개발되었으며，신뢰도와 타당도가 입증된 객관적인 평가도구이다．

목적 : 본 연구는 김해지역 노인들의 가정내 일상생활활동 중 어려운 활동과 중요한 활동을 알아보고 성별, 연령별 차이를 알아보고자 하였다. 연구방법 : 연구 대상은 김해시에 거주하는 65세 이상의 재가 노인 49명을 대상으로 하였다. 연구도구는 구조화된 설문지를 사용하였다. 가정내 일상생활활동 중 어려운 활동과 중요한 활동에 대한 설문내용은 Occupational therapy practice framework domain and process(2002)와 일상생활활동평가도구를 기초로 하여 개발하였다. 설문조사 방법은 개별 면접으로 실시하였다. 결과 : 김해 지역 노인들의 일상생활활동 중 어려운 활동은 청소하기, 건강관리, 식사준비하기, 목욕하기 및 샤워하기, 기능적 이동과 세탁하기 순으로 나타났다. 중요한 활동은 건강관리, 식사하기, 개인위생, 대소변 조절, 목욕하기 및 샤워하기의 순으로 나타났다. 어려운 활동에서 성별에 따라 유의한 차이를 보인 활동은 식사준비하기, 대소변 조절 그리고 청소하기였으며, 연령에 따라 유의한 차이를 보인 활동은 개인위생이었다. 중요한 활동에서 성별에 따라 유의한 차이를 보인 활동은 식사준비하기였으며, 연령에 따라 유의한 차이를 보인 활동은 개인위생과 세탁하기이었다. 결론 : 본 연구결과를 통해 김해지역 노인들의 일상생활에서 어려운 활동과 중요 활동을 알 수 있었으며, 성별과 연령에 따라 활동에 차이가 있음을 알 수 있었다. 앞으로 노인을 대상으로 작업치료를 적용하거나 노인을 위한 생활기기 개발시 노인의 관점에서 남․여 또는 연령에 따라 어려운 활동과 중요한 활동을 고려하여 접근하여야 할 것이다.

목적 : 본 연구는 신체장애인들이 사용하는 보조기기가 일상생활활동 수행 능력과 삶의 만족도에 미치는 영향을 알아보기 위한 것이다. 연구방법 : 본 연구는 경상남도 김해시에 거주하는 신체장애인 40명을 대상으로 2004년 8월 1일부터 동년 8월 31일까지 각 가정을 방문하여 일상생활활동 능력 평가 및 설문조사를 실시하였다. 자료 수집을 위해 사전 지도와 FIM 평가에 대한 훈련을 받은 6명의 연구원들이 장애인과 개별적 면접을 통해 시행하였다. 설문지는 장애인의 일반적인 특성 9문항과 보조기기관련 7문항, 5점 척도의 재활의료서비스, 가족 지지정도, 지역사회참여 정도에 대한 만족도 항목 3문항으로 구성되었다. 결과 : 보조기기 사용 유무에 따른 신체장애인의 일상생활활동 수행 능력은 차이가 없었다. 재활의료서비스 만족도는 보조기기 사용집단과 미사용집단 간에는 통계학적으로 유의한 차이가 없었다. 가족지지 만족도와 지역사회참여 만족도는 보조기기 미사용집단보다 사용집단에서 모두 높은 만족도를 보였다(p<0.05). 결론 : 신체장애인들이 보조기기를 사용한 경우 가족지지와 지역사회참여 만족도에서 보다 높은 만족도를 보였다(p<0.05). 보조기기 사용유무에 따른 일상생활활동 수행 능력과 재활의료서비스 만족도에서는 통계학적으로 유의한 차이가 나타나지 않았다. 앞으로의 연구에서는 지역별 특성을 고려하여 여러 지역의 많은 장애인을 대상으로 보조기기 사용 특성에 대한 연구가 이루어져야 할 것이다.

목적 : 본 연구는 대전지역 노인들의 일상생활동작 수행수준과 삶의 질에 관련된 요소를 측정하여 노인들의 일상생활동작 수준 및 삶의 질에 따른 일상생활동작 수행의 차이에 대해 알아보고자 시도되었다. 연구방법 : 연구 대상은 대전광역시에 거주하는 65세 이상의 재가 노인 500명으로 하였다. 본 연구에서 사용된 설문지는 일반적인 특성 및 일상생활동작 능력 평가도구인 Barthel Index, Frenchy Activities Index와 SF-12에서 발췌한 삶의 질 관련 요소들로 구성되었으며, 일대일 면접조사를 통해 수집되었다. 결과 : 대전 지역 노인들의 일상생활동작 수행점수는 평균 96.05(표준편차 11.04)이었으며, 노인의 결혼 상태, 가족구성, 자녀유무, 직업유무에 따라 기본적 일상생활동작수행의 차이가 있었다(p<0.05). 수단적 일상생활동작 수행점수는 평균 18.41(표준편차 10.28)로 노인의 성별, 연령, 교육 수준, 가족구성, 자녀유무, 직업유무에 따라 수단적 일상생활동작 수행의 차이가 있었다(p<0.05). 노인의 주관적 건강상태 및 생활전반에 대한 만족도에 따른 기본적 일상생활동작 수행수준과 수단적 일상생활동작 수행은 그룹 간 유의한 차이가 있는 것으로 나타났다(p<0.05). 결론 : 본 연구결과를 통해 대전 지역노인들의 기본적인 일상생활동작 수행의 수준과 수단적 일상생활동작 수행의 수준을 알 수 있었고, 주관적 건강상태나, 생활만족도와 같은 삶의 질에 관련된 요소와 일상생활동작 수행수준 간에 관련이 있음을 알 수 있었다. 앞으로 노인들이 건강하게 살 수 있도록 삶의 질을 높이기 위해서는 일상생활동작 수행수준을 높일 수 있는 작업치료사의 역할이 요구되며, 노인들의 의존적인 문제를 보완하고 능동적이며 긍정적인 삶을 유지할 수 있는 중재 방안이 마련되어야 할 것이다.

Objective : The purpose of this paper was to study the effect of involved upper extremity’s motor function recovery on Activities of Daily Living in subject with hemiplegia by using Fugl-Meyer Assessment (FMA) as a motor recovery test and Functional Independence Measure (FIM) as a functional test.Method : The subjects of the study were 20 stroke patients who were admitted in KeiMyung University Dongsan Medical Center from November, 2002 to April, 2003. Data were analyzed for wilcoxon signed-rank test, mann-Whitney U test, spearman’s rho using SPSS/PC+ program. Result : The results of the study was as follow;1. Involved upper extremity’s motor function and independence of ADL is significantly differ-ence after occupational therapy(p<.05).2. Involved upper extremity’s motor function recovery is not significantly correlated in-dependence of ADL. but, motor FIM and FMA is significantly correlated after occupational therapy(r=.461).3. Involved upper extremity’s motor function recovery is significantly difference in lesion site and not significant difference in sex, involved side (p<.05).4. Independence of ADL is not significant difference in lesion site, sex, involved side(p>.05).Conclusion : The results suggest that lesion site maybe a factor to predict involved upper extremity’s motor recovery and require various occupational therapy program according to lesion site.

Objective : To evaluate the cognitive perceptual performance in relation to the instrumental activities of daily living in Korean elderly women living in Seoul, Pundang, and Kwang-ju county.Method : To evaluate the cognitive perceptual performance, LOTCA-G battery was employed while IADL by Lawton and Brody was used to evaluate the instrumental activities of daily living. T-test, ANOVA, correlation analysis, and multiple regression analysis were used to ana-lyze the accumulated data.Results : The total cognitive perceptual performance score (LOTCA-G) and the total instrumental activities of daily living score (IADL) generally demonstrated a high correlation : (1) From observing the correlation of each items, the ability to use the telephone demonstrated a positive correlation with orientation, concentration, visuomotor organization, perception, memory, thinking operation and praxis (2) While shopping demonstrated a positive correlation with think-ing operation, visuomotor organization, orientation and memory (3) Food preparation demon-strated a positive correlation with orientation, thinking operation, visuomotor organization, con-centration, memory and praxis (4) While house keeping had a positive correlation with ori-entation, memory, visuomotor organization, thinking operation, concentration and perception (5) Laundry demonstrated a positive correlation with all of the items except visuomotor organization (6) While the mode of transportation demonstrated a positive correlation with all of the items including orientation and memory (7) Responsibility for one’s own medication demonstrated a positive correlation with orientation and thinking operation (8) The ability to handle finances demonstrated a positive correlation with orientation and all of the items.Conclusion : Cognitive perceptual performance was found to be significantly correlated with the instrumental activities of daily living skills. In particular, orientation and thinking operation, which are the items of cognitive perceptual performance affected the instrumental activities of daily living the most. Thus, orientation, perception, visuomotor organization, thinking operation, memory, praxis, concentration and cognitive perceptual performance need to improve not only so elderly women may live independently in the community but so as to offer them a high stand-ard of livin.

Objective : To compare the value of basic activities of daily living between occupational therapists and patients with stroke. Methods : A questionnaire survey was conducted to investigate the relative importance of basic ADL (Activities of Daily Living) with a total of thirty-four item cards. The survey was completed by 36 occupational therapists that have clinical experience of more than three years in a hospital or rehabilitation settings and by 38 inpatients/outpatients with stroke. The relative importance of each activity of daily living was measured by the Q sorting technique. A Mann-Whitney U test was used to test the statistical significance of the mean difference in the Q score between the occupational therapists and the patients with stroke. Results : Among the 34 items, 11 items (‘obtaining and using supplies’, ‘selecting clothing’ etc.) selected by inpatients, showed that the Q score was significantly higher in its importance than that of occupational therapists. The survey showed that ‘caring for nails’ was more im-portant to outpatients than it was to occupational therapists. Several items (18 items for in-patients, 3 items for outpatients) of the total 34 items were statistically significantly different on the value of the basic ADL between occupational therapists and patients with stroke. Conclusion : The relative value of each activity of daily living could serve as a guide for sequencing learning steps during the ADL training in a hostpital or rehabilitation setting.

The purpose of this study was to examine the effects of stroke patients' cognitive score on their the activities of daily living. The subjects of this study were 30 stroke patients who were admitted to Te-Bong hospital from November, 2002 to March, 2003. The subjects were administerd an MMSE as a cognitive assessment and an MBI as a functional assessment upon referral to physical therapy initially. The results were as follows: 1. The MMSE scores for the stroke patients were related to the patients' abilities to perform their activities of daily living. The changes of MBl scores significantly correlated with the changes of MMSE scores (p<.05). 2. The subjects with left hemispheric lesion scored higher in MMSE than those with right hemispheric lesions (p<.05). 3. The hemispheric lesions did not significantly affect the activities of daily living score (p>.05).

The purpose of this case is to find effectiveness of improvement of cognitive function with head injury patients through Computer-Assisted Cognitive Rehabilitation(CACR) program within various training programs. The subjects were three inpatient persons with head injury on Rehabilitation Hospital in Yonsei University and aged 28 and 14 and 2 woman and another man. It was used PSS CogRehab program during 15 days. Cognition, perception and activities of daily living(ADL) were compared pre-CACR with post-CACR by LOTCA, MVPT and MBI. According to this case study, in spite of short-term period, the subjects had changed of performance skills of cognition, perception and activities of daily living. Results were as follows : 1. LOTCA score of 3 cases showed increasing change after CACR performance, especially perception and visuoperception organization were increased. 2. Raw score was increased and processing time was controlled adjustable of MVPT within 3 cases. 3. MBI score of 3 cases were improved, especially dressing, feeding and toileting were improved each one step.

The purpose of this study was to know whether the performance of activities of daily living(ADL) affect the depression level of disable people or not. In this study, the ADL item was divided into two category as basic ADL and instrumental ADL. The particip- ants were 67 persons with cerebral palsy(aged 16 to 49). Over 80% of the subjects had independent ability to perform the basic ADL, but, in instrumental ADL items, 50% of them needed assistance. Each of basic and instrument ADL item were signific- antly correlated to the depression level(p<0.01). The Spearman correlation coefficients of basic and instrumental ADL item were 0.336 and 0.416 respectively. As before, ins-trumental ADL item score was more correlated to depression level than basic ADL item score.

The purpose of this study was to evaluate the cognitive perceptual performance in relation to activities of daily living in stroke patients who were treated at department of rehabilitation medicine of the Samsung Medical Center from December 5. 1996 to April 10, 1997. The cognitive perceptual performance was measured by the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and by the Modified Barthel Index (MBI) to evaluate activities of daily living(ADL). Sixty-seven stroke patients were the subjects in this study. Collected data analysis were completed by using t-test. ANOVA, correlation analysis, and multiple regression analysis. The following were as follow: 1. Among the subtest of the LOTCA, orientation to time, plain block design, reproduction of puzzle showed significant difference depending on patient's affected side. Orientation to time score was higher with left hemiplegic patients. Plain block design and reproduction puzzle score were higher with right hemiplegic patients. 2. Among the subtests of the MBI, dressing, ambulation, and self-care were significantly correlated with the subtests of the LOTCA in order of thinking operation, visuomotor organization, perception and orientation. 3. The result of the cognitive perceptual function affecting the MBI performance using multiple regression analysis, thinking operation was the most influential factor. The cognitive perceptual perfomance have significant correlation with activities of daily living skills. Also, it is an important factor to functional recovery after stroke. Therefore, accurate evaluation of cognitive perceptual performance after stroke with treatment of each patient's appropriate level should be done simultaneously with rehabilitation treatment to improve patient's activities of daily living skills.

본 연구는 원예치료프로그램이 시설에 거주하는 치매노인의 일상생활수행능력과 손기능에 미치는 효과를 알아보고자 하였다. 2008년 3월 13일부터 5월 24일까지 3개월간 실험군을 대상으로 원예치료프로그램을 회당 2시간씩 주 2회, 총 22회 실시하였다. 원예치료프로그램은 치매노인의 일상생활수행능력과 손기능 향상을 위해 친근하고 쉬우며 다양한 손동작을 필요로 하는 작업으로 구성하였다. 일상생활수행능력 경우 대조군은 원예치료 실시 전 14.7점에서 실시 후 13.7점으로 감소하였으나 유의성은 없었다(p=0.294).실험군은 실시 전 14.1점에서 실시 후 15.7점으로 1.6점 높아졌으며 p=0.05 수준에서 유의하게 향상되었다. 악력은 대조군의 경우 원예치료실시 전 5.75kg에서 실시 후 5.43kg으로 감소하였으나 유의차는 없었다(p=0.657).실험군의 경우 실시 전 4.83kg에서 실시 후 8.38kg으로 고도로 유의하게 (p<0.01)증가하였다. 손가락 근력은 대조군의 경우 원예치료실시 전 4.01kg에서 실시 후 4.11kg으로 0.1kg 증가하였으니 유의한 차이는 없었다(p=0.811).실험군은 원예치료 실시 전 4.83kg에서 실시 후 8.38kg으로 3.55kg 증가하였으며 고도로 유의한 차이(p<0.01)를 나타내었다. 이상의 결과로부터 치매노인에게 친숙하고 쉬우며 손기능에 적절한 원예치료의 적용은 시설에 거주하는 치매노인의 일상생활수행능력의 향상뿐만 아니라 손기능의 유지와 강화에 효과적인 것으로 나타났다.