목적 : 뇌성마비가 아닌 발달장애로 진단된 아동을 대상으로 GMFM과 BSID-Ⅱ 평가를 각각 실시한 후 GMFM이 BSID-Ⅱ의 하위 항목들과 상관관계가 있는지 알아봄으로써 발달장애 아동의 평가도구로써 활용가능성을 검증하고자 한다. 연구방법 : 연구의 대상은 인하대학부속병원 재활의학과에서 뇌성마비 이외의 발달장애로 진단받은 만 3세 이하의 아동 26명을 대상으로 GMFM과 BSID-Ⅱ를 평가하였다. 대상자들의 특성에 따라 조산의 유무, 출생시 체중, 역연령에 따라 구분한 후 각 집단간 차이 및 두 평가도구의 상관관계를 알아보았다. 결과 : 발달장애 아동 26명 중 조산의 유무와 출생시 체중에 따라 각 집단간 GMFM, BSID-Ⅱ 정신척도, BSID-Ⅱ 운동척도의 점수를 비교한 결과 유의한 차이가 없었으며, 교정연령에 따른 집단에서만 유의한 차이가 있었다(p<0.05). 또한 집단간 GMFM과 BSID-Ⅱ 정신척도는 조산아(r=0.68), 만숙아(r=0.67), 저체중아(r=0.63), 평균체중아(r=0.72)에서 모두 상관관계가 있었으며, GMFM과 BSID-Ⅱ 운동척도도 조산아(r=0.57), 만숙아(r=0.89), 저체중아(r=0.65), 평균체중아(r=0.90)에서 모두 상관관계가 있었다. 전체 아동의 GMFM과 BSID-Ⅱ 정신척도의 상관계수는 0.71, GMFM과 BSID-Ⅱ 운동척도의 상관계수는 0.84로 관계가 있었으며, 교정연령 상 하위집단에서 0.56-0.85로 상관관계가 있었다. 결론 : 본 연구의 결과를 볼 때 발달장애 아동의 GMFM과 BSID-Ⅱ의 평가 결과는 모두 뚜렷한 상관관계를 나타내었으며, 발달장애 아동의 운동기능을 평가하는데 있어 GMFM의 적용가능성을 보여주는 기초 자료가 될 것으로 사료된다.

We assessed whether the use of a symmetrical upper limb motion trainer in daily repetitive training for a 6-week period reduced spasticity and improved motor function in three chronic hemiparetic patients. Upper limb motor impairment and disability were measured by the Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS) and Manual Muscle Test (MMT), respectively. The electromyography (EMG) of the affected hand was recorded during isometric wrist flexion and extension. In all patients, FMA and MMT scores were significantly improved after the 6-week training. However, MAS scores of the affected wrist spasticity did not change considerably. Onset and Offset delays in muscle contraction significantly decreased in the affected wrist. The co-contraction ratio of flexor and extensor muscles significantly increased after the 6-week training. Onset and offset delays of the muscle contraction and co-contraction ratio correlated significantly with the patients' FMA. This study showed that repetitive, symmetric movement training can improve upper limb motor functions and abilities in chronic hemiparetic patients. Also, the EMG assessment of motor response is likely to provide insights into mechanisms and treatment strategies for motor recovery in chronic hemiparetic patients.

본 연구는 우리나라 국립공원의 대표적 자연해설시설인 탐방안내소 중 계획에 의해 조성ㆍ운영중인 내장산국립공원 내장사지구 탐방안내소와 북한산국립공원 정릉지구 탐방안내소를 대상으로 기능평가를 통한 이용활성화 방안제시를 목적으로 하였다. 국내외의 문헌연구를 통해 탐방안내소의 개념 및 기능, 유형 등을 파악하고 McManus의 커뮤니케이션 이론을 중심으로 탐방객에 의한 이용 후 평가를 실시하였다. 총 5단계에 걸친 평가 결과 탐방안내소 이용자들은 탐방안내소를 이해하기 위한 충분한 관람시간을 갖지 못하였으며 편의시설과 안내시스템의 부족으로 올바른 이용이 이루어지지 않았다. 전시내용에 대한 관람성향과 전시 내용의 이해도 부문 역시 전시물과 탐방객과의 원활한 커뮤니케이션이 이루어지고 있지 않음을 알 수 있었다. 이런 문제점들의 개선방안으로는 첫째, 탐방안내소 홍보 및 안내사인 보완 둘째, 다양한 계층을 고려한 전시관별 특성화와 차별화 된 전시연출 셋째, 각 전시내용들이 각 탐방객들의 사회적 경험과 연관되도록 하며 넷째, 전시주제에 맞는 전시매체의 적극적 활용이 필요함을 제안하였다.

These were two main purposes of this study. The first was to research the relevance between gross motor function measurement (GMFM) and the spatiotemporal parameters of gait in children with cerebral palsy. The second was to research the relevance between gross motor performance measure (GMPM) and the spatiotemporal gait parameters. Twelve children ( years) with cerebral palsy participated in this study. GMFM and GMPM were performed and the spatiotemporal parameters of gait were measured by using WalkWay MG-1000. There were no significant correlations between the GMFM score and the stride length, step length, step width, cadence, and velocity (p>.05). The GMPM score also had no significant correlation with the spatiotemporal gait parameter (p>.05).

The purpose of this study was to validate the Korean version of the Gross Motor Function Measure (GMFM) using Rasch analysis. The data was obtained from the assessments of 59 children with cerebral palsy in Korea and were applied to Rasch's rating scale model to estimate the difficulty and goodness-of-fit of each item. Rasch modeling helped us to identify 76 items from the original 88-item GMFM that form an unidimensional hierarchical scale to rearrange 76 items in order of difficulty. Reliability coefficients of the 88-item and 76-item GMFM were .99 and .99, respectively. In this preliminary report, the Korean version of GMFM seems to have significant validity and reliability. These results may be useful in assessment of gross motor functions in children with cerebral palsy.

This study aims to compare the relationship between the Berg Balance Scale (BBS) scores, Timed Up & Go (TUG), Functional Independent Measure (FIM), and subject characteristics. All of the 18 subjects were women between the ages of 68 and 91 (mean=80.2, SD=5.43), and they all lived at the nursing home in Wonju. Balance was measured using BBS, and functional mobility was measured using TUG. FIM was used to evaluate functional independence. Data were analyzed using Spearman correlation. Statistically significant differences were noted between BBS and TUG (r=-.486, p<.05). There were no significant statistical differences between total FIM and BBS, TUG. The FIM items "locomotion" and "communication" showed significant statistical differences between BBS and TUG. The results suggest that FIM may be able to predict dangerous falls in elderly people.

Objective : The purpose of the present study was to compare the Spinal Cord Independence MeasureⅡ (SCIMⅡ) and the Modified Barthel Index (MBI) to determine the evaluation tool in order to use the tool as an effective index for following these patients for functional changes and determining treatment and rehabilitation outcomes.Method : The present study was conducted with 20 patients who underwent there first time rehabilitation care at A hospital from December 2002 to April 2003. The patients were evaluated at a 2-week interval using the SCIMⅡ and the MBI.Collected data analysis were completed by using Total agreement and Kappa coefficient of agreement, McNemar test, t-test, Correlation analysis, and Wilcoxon rank sum test. Results : The following results were obtained from this study.1.A high correlation was seen in the results of evaluation made by two raters in the SCIMⅡ, showing high interrater reliability(r=0.99, p<0.01).2.When functional changes were compared, more changes in the common items including management in bladder sphincter muscle(p<0.01), toileting(p<0.05), and bathing(p<0.05) were seen in the SCIMⅡ compared with the MBI. Furthermore, among the non-common items in the SCIMⅡ, significant changes were estimated in breathing, prevention of bed sores and bed mobility, and outdoor movement, the SCIMⅡ well reflecting major func-tional changes in patients with spinal cord lesion.3.When the scores of the SCIMⅡ and the MBI were compared at the time of admission and discharge, significant correlation was revealed between the two evaluation tools. However, the SCIMⅡ admission scores were significantly higher than the MBI admission scores in patients with quadriplegia (p<0.05), due to the effects of non-common items such as breathing, prevention of bed sores, and bed mobility.4.When these tools were compared according to muscle strength change, the SCIMⅡ com-pared with the MBI well reflected upper extremity motor score and the ASIA motor score in patients with complete and incomplete quadriplegia(p<0.05), and lower extremity motor score in patients with incomplete spinal cord lesion(p<0.05).Conclusions : These results indicated that the SCIMⅡ is more sensitive compared with the MBI as a tool for functional evaluation in patients with spinal cord lesion, suggesting that the SCIMⅡ would be used to examine functional changes in patients with spinal cord lesion and to effectively follow-up patients for rehabilitation treatment outcome.

The purpose of this review article were to suggest ways for practitioners to determine the presence of sensory integrative dysfunction and something about its characteristics in the absence of the Sensory Integration and Praxis Tests (SIPT) and to suggest to need the use of a top-down assessment approach in the sensory integration approach. The review constructed in two major ways: sensory modulation disorders and disorders of praxis in sensory integration dysfunctions. The methods of test for sensory modulation disorders included a interview, take a sensory history in all sensory system and informal or/and formal observation of children in general and specific environment. Tests for sensory modulation were Sensory Profile (Dunn, 1999), Touch Inventory for Elementary School Children (TIE) and Evaluation of Sensory Processing etc.. The methods of test for disorders for praxis included direct clinical observation, performance of tasks, interview, sensory history, sequencing and balance in occupational performance. The test tools were Bruininks Oseretsky Test of Motor Proficiency (BOTMP), Motor Assessment Battery for Children (MABC), DeGangi-Berk Test of Sensory Integration, Clinical Observation of Motor and Postural Skills (COMPS), Clinical Test of Sensory Interaction with Balance (CTSIB) and Clinical Observations of Neuromotor Performance etc.. This article reviewed assessments of sensory modulation disorders and disorders of praxis within the context of a top-down approach to evaluation. It also presented formal and informal assessments and proposed a mean of assessing sensory integration in the absence of the SIPT.

Objectives: This study was conducted to evaluate the validity of the Korean Computerized Neuro-psychological Test in measurement of cognitive functioning in patients with brain damage. Methods: Eight tests of Korean Computerized Neuro-psychological Test, (1) Simple Reaction time, (2) Choice Reaction time, (3) Color Word Vigilance, (4) Digit Classification, (5) Digit Addition, (6) Symbol Digit Substitution, (7) Digit Span, (8)Finger Tapping Speed, were administered to the 30 patients who had impairments in cognitive function. Mini Mental State Examination-K (MMSE-K), and Purdue Pegboard Test were also administered compare with the computerized tests. Results: It was found that Choice Reaction time, Color Word Vigilance, Digit Classification, Digit Addition, Symbol digit Substitution, and Digit Span of computerized tests were acceptable in the patients who had MMSE-K score of 20 and more than 20. And Simple Reaction Time was found to be a useful test in the patients with MMSE-K score of less than 20. MMSE-K scores were highly correlated with Choice Reaction time, Color Word Vigilance, Digit Classification, Digit Span of computerized test. The scores of Purdue Pegboard were also highly correlated with the scores of Finger Tapping Speed, In computerized tests, Choice Reaction time, Color Word Vigilance, Digit Classification, and Digit Span were correlated with each other. Conclusions: The results suggested that Korean Computerized Neuro-psychological Test was found to be a useful test in measurement and rehabilitation of patients with cognitive impairments.

향후 임도사업(林道事業)과 임도배치망(林道配置網) 계획(計劃)에 기초자료(基礎資料)를 제공코자 현재 개설(開設)되어 있는 임도(林道)를 중심으로 임도개설비(林道開設費)에 대한 투자효과(投資效果)를 최대로 하는 최적임도배치(最適林道配置) 및 집재기능(集材機能)을 고려한 임도배치망(林道配置網)을 평가(評價)하였다. 1. 적정(適定) 임도밀도(林道密度) 및 임도연장거리(林道延長距離)를 계산(計算) 비교(比較)한 결과(結果), 각(各) 조사지(調査地)의 유성별(流城別) 기설(旣設) 임도밀도(林道密度)가 이론적으로 계산(計算)한 임도밀도(林道密度)보다 작았으며 앞으로 좀더 많은 임도개설(林道開設)이 필요하였다. 2. 투자효과(投資效果)를 최대(最大)로 하는 임도로선배치법(林道路線配置法)에 의해 계산(計算)한 임도배치망(林道配置網)과 기설(旣設)의 임도배치망(林道配置網)을 비교분석(比較分析)한 결과(結果), 각(各) 조사지(調査地)에서 기설(旣設)의 임도망(林道網)은 공도적(公道的) 기능(機能)을 높이기 위한 임도망(林道網)으로서 우회률(迂回率)이 큰 임도로선망(林道路線網)인 반면, 투자효과(投資效果)를 최대(最大)로 하는 임도배치망(林道配置網)은 공도적(公道的) 기능(機能)이 고려(考慮)되면서 임업적(林業的) 기능(機能)이 고려된 집재기능(集材機能)이 높은 수기형상(樹技形狀)의 임도망(林道網)으로 배치(配置)되어 계획구역(計劃區域)에 골고루 배치(配置)되어 있는 것을 알 수 있었다. 따라서 기설(旣設)의 임도배치망(林道配置網)이 다소 집재기능적(集材機能的)인 면(面)과 임업적(林業的) 기능(機能)이 결여(缺如)된 임도배치망(林道配置網)이라고 하겠으며 앞으로 좀더 투자효과(投資效果)와 집재기능(集材機能)을 고려(考慮)한 임도배치망계획(林道配置網計劃) 필요(必要)하겠다. 3. 각(各) 조사지(調査地)에 대한 평균(平均) 최대집재거리(最大集材距離)와 평균(平均) 집재가능면적(集材可能面積)이 기설(旣設) 임도망(林道網)과 계산(計算)에 의한 임도배치망(林道配置網)에 대한 수평거리(水平距離)와 사거리별(斜距離別) 평균(平均) 최대집재거리(最大集材距離)와 평균(平均) 집재가능면적(集材可能面積)이 다르다는 것을 알 수 있었다. 또한 최대집재수평거리(最大集材水平距離)를 동일하게 적용(適用)했을 경우, 기설(旣設) 임도망(林道網)과 계산결과(計算結果) 임도망(林道網)의 평균(平均) 최대집재거리(最大集材距離)와 평균(平均) 집재가능면적(集材可能面積)이 다르다는 것을 알 수 있었으며, 기설(旣設) 임도망(林道網)을 기준으로 최대집재거리(最大集材距離)를 동일하게 적용(遭用)했을 경우도 최대집재거리(最大集材距離)를 수평거리(水平距離)와 사거리(斜距離)로 구별했을 때에 평균(平均) 최대집재거리(最大集材距離)와 평균(平均) 집재가능면적(集材可能面積)이 다르다는 것을 알 수 있었다. 따라서 임도배치(林道配置)를 가능하면 산능선(山陵線)이나 산복(山腹)을 중심으로 배치(配置)하는 것이 효과적(效果的)이라는 것을 알 수 있었다. 그리고 기설(旣設)의 임도(林道)와 계산(計算)하여 배치(配置)한 임도(林道)의 집재거리별(集材距離別) 평균(平均) 집재가능면적(集材可能面積), 집재면적률(集材面積率)의 수평거리(水平距離)와 사거리(斜距離)의 총 평균값도 차이가 있는 것을 알 수 있다. 이를 볼 때, 기설(旣設)의 임도(林道)보다는 투자효과(投資效果)를 최대(最大)로 하는 임도배치망(林道配置網)이 임업적(林業的) 기능(機能)과 집재기능적(集材機能的)인 면(面)에서 더욱 효과적(效果的)이고 최대집재거리(最大集材距離)를 수평거리(水平距離)보다 사거리(斜距離)로 계산(計算)했을 경우가 집재가능면적(集材可能面積)이 작으므로 임도배치망(林道配置網)을 가능하면 산복(山腹)과 산능선(山陵線)을 중심으로 배치(配置)하는 것이 집재기능(集材機能)을 더욱 높일 수 있다는 것을 알 수 있었다. 따라서 앞으로 임도로선배치계획시(林道路線配置計劃時)에 가능하면 집재기능(集材機能)을 고려(考慮)하여 집재가능면적(集材可能面積)을 크게 할 수 있도록 임도배치망(林道配置網)을 구축(構築)할 필요가 있겠다. 4. 현재(現在) 개설(開設)되어 있는 임도로선(林道路線)이 산능선부(山稜線部), 산복부(山腹部), 계곡부중(溪谷部中) 어느 구역을 중심으로 개설(開設)되어 있는지를 평가(評價)하기 위해 임도로선(林道路線)의 위치(位置)를 조사(調査)한 결과(結果), 기설(旣設)의 임도로선(林道路線)이 대부분 산복부(山腹部)와 계곡부(溪谷部) 중심으로 배치(配置)되어 있었으며, 기설(旣設)의 임도망(林道網)이 집재기능(集材機能)이 다소 결여된 임도배치망(林道配置網)이므로 향후 좀더 집재작업(集材作業)시스템을 고려(考慮)한 임도로선배치(林道路線配置)가 요망(要望)된다.

The purpose of this study is to provide developmental data of the performance of children between the age of 6 to 12 to verify the hierarchical order of acquiring the cognitive competencies and to identify whether differences in the performance between male and female tested in revised Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). The test consists of six subtests designed to be representative of various cognitive abilities. The subjects were 60 normal children from age 6 to 12 were assigned to a group 1 from 6.0∼7.11, a group 2 from 8.0∼9.11 and a group 3 age 10.0∼12.0. We measured their cognitive-perceptual ability with LOTCA. The results were a progress with from 6 to 12 years in both and speed of performance. Male group showed better score than females in Shape Identification of Visual Perception, Logic Question of Thinking Operation, Attention And Concentration. The Females are better than males in Motor Imitation of Motor Praxis, Pegboard Construction and the performance duration, Colored Block-Design and the performance duration, Plain Block-Design and the performance duration, and The length of time taken. Several subtests except Visual Perception, Direction on Cs’ Body, Spatial Relation of Spatial perception, Motor Praxis, Two-Dimensional Model of Visuomotor Organization, ROC Unstructured, ROC Structured, Pictorial Sequence A, and Pictorial Sequence B of Thinking Operation, which are showed significant differences between age groups. With the above results, we conclude that LOTCA is an appropriate tool for occupational therapists to use in assessing cognitive-perceptual abilities.

In this paper, the QFD(quality function deployment) technique is used to acquire the quality requirements of package software which is sold in a commercial software shop. To select the principal quality characteristics of package software, an user survey was conducted for a quality model developed based on the international standards and the previous research. The software user is divided into three groups：the general user, the expert, and the developer. The method of QFD is applied to choose the software quality attributes which have strong correlation with the selected quality characteristics.

선관측에 기초한 DOAS와 같은 광투과 분석방식의 계측능과 기상인자와의 관계를 평가하기 위해, 서울시의 반포지역을 중심으로 약 14개월(1999. 6∼2000. 8) 동안 확보된 3대 기준성 오염물질(SO2, NO2, O3)과 주변 환경변수와의 관계를 여러 가지 통계적 방식으로 분석하였다. 본 연구 결과에 의하면, DOAS의 계측능은 오염물질간 또는 기상인자간에서도 비교적 뚜렷한 경향성을 갖는 것이 확인되었다. 그리고 이러한 경향성은 계절과 같은 시간적 요인에 따라복잡하게 변화할 수 있는 것으로 나타났다. 특히 SO2나 NO2,와 같은 항목의 경우, 여러 가지 요인의 차이에도 불구하고 계측능이 일정한 수준을 유지할 수 있는 것으로 나타났다. 반면 O3의 경우, 기상조건의 변화에 상대적으로 민감한 변화를 보였다. 기상인자들간의 관계를 비교한 결과, 풍향, 풍속, 일사량과 같은 요인들이 성능에 민감한 영향력을 행사할 가능성이 큰 것으로 나타났다. 마지막으로 두 기기간의 농도차이를 조절하는 요인들을 상관분석을 통해 비교한 결과, 풍속, 일사량, 기온 등의 요인이 증가할수록 계측기간의 농도차가 줄어들었다. 반대로 오염물질의 농도가 증가하는 방향으로 흐를 경우, 계측기간의 오차는 상대적으로 증폭되는 방향으로 변화하였다. 따라서 DOAS로부터 계측된 자료를 해석하기 위해서는 기상인자를 포함하는 주변 환경인자의 변화에 대한 해석을 동시에 수행하는 것이 중요할 것으로 사료된다.

This paper presents the relevance between GMFM and the spatiotemporal parameters of gait in children with cerebral palsy. Twenty-one children ( months) with cerebral palsy participated in this study. GMFM was performed and spatiotemporal parameters of gait were measured by foot print gait analysis. A correlation analysis was used to investigate the correlation between GMFM scores and spatiotemporal parameters of gait. A linear regression analysis was employed to find how much each gait spatiotemporal parameters could be predicted from GMFM scores. The total GMFM scores was significantly correlated with walking speed, cadence, and stride length. Dimensions D (standing) and E (walking, running, and jumping) were more significantly correlated with gait spatiotemporal parameters than dimensions A (lying and rolling), B (sitting), and C (crawling and kneeling). The GMFM scores were useful for predicting spatiotemporal parameters. However, it is difficult to predict the status of gait development using GMFM scores because GMFM scores and gait spatiotemporal parameters are only measured as quantities not qualities. In the field, it is easily found that many children with cerebral palsy are unable to walk in any way. Consequently, gait analysis cannot be performed in many cases. Therefore, it is more reasonable to investigate the influence of GMFM on spatiotemporal parameters, rather than vice versa.

The purposes of this study were to determine the effect of different degrees of severity of diabetic neuropathy on balance function, and to evaluate dynamic balance and functional performance in diabetes patients. Twenty-four subjects with diabetes mellitus were divided into three groups according to results of sensory nerve conduction study. All subjects were evaluated for dynamic balance which was measured using computerized dynamic posturography, and functional performance which was measured using the Berg balance scale. One-way analysis of variance was used to determine whether there were any statistically differences of dynamic balance function and functional performance among the three groups. The Spearrnan's rank correlation was used to determine statistical significance between dynamic balance and age. The results were as follows: 1. Dynamic balance measured using computerized dynamic posturography was significantly lower in the no response group than in the normal amplitude group (p<0.05). 2. Functional performance tested by the Berg balance scale was not statistically different among the three groups (p>0.05). 3. an inverse relationship was found between dynamic balance measured using computerized dynamic posturography and age (r=-0.68, p<0.05). These results suggest that patients with severe diabetic neuropathy have loss of dynamic balance function. Therefore, patients with severe diabetic neuropathy need to have their balance evaluated and receive appropriate education.