목적 : 본 연구는 감염병으로 인해 면회가 통제된 상황에서 재활요양병원에 입원한 환자의 면회가 기능회복 영역 및 정신 사회적 영역의 미치는 영향에 대해 알아보고자 하였다. 연구방법 : 본 연구는 재활요양병원에 입원 중인 환자 52명의 기능회복 영역에 대하여 Mini Mental State Ezamination-K(MMSE-K), Global Deterioration Scale(GDS), K-Modified Barthel Index(K-MBI), Grooved Pegboard Test를 평가하였고, 정신 사회적 영역에 대하여 Quality of Life(QoL), Emotional aspects of Loneliness and Isolation(ESLI), General Self-Efficacy Scale(GSE), Geriatric Depression Scale(GDS)를 평가하였다. 연구 대상자는 면회집단과 비면회집단으로 구분되었고, 초기와 재평가 자료를 분석하였다. 수집된 자료 분석은 기술통계, 대응표본 t-test, Spearman's 상관관계 분석, 단순 회귀분석을 사용하였다. 결과 : 면회집단 20명, 비면회집단 32명이었으며, 면회집단의 K-Modified Barthel Index(K-MBI)에서 유의한 향상을 보였으며, General Self-Efficacy scale(GSE) 점수는 유의한 감소를 나타냈다(p < .05). 비면회집 단의 Mini Mental State Ezamination-K(MMSE-K), K-Modified Barthel Index(K-MBI) 점수에 유의한 향상이 있었으며, 정서평가의 Emotional aspects of Loneliness and Isolation(ESLI), Geriatric Depression Scale(GDS) 점수는 유의한 증가가 있었다(p < .05). 면회와 Global Deterioration Scale(GDS) 는 유의한 양의 상관관계를 나타냈고, Quality of Life(QoL)과 유의한 음의 상관관계를 보였다(p < .05). 결론 : 본 연구를 통해 감염병으로 인해 면회가 제한된 재활요양병원 입원환자를 위한 정서지지 프로그램과 면회 제한에 대한 작업치료 프로그램 개발의 기초자료가 되기를 기대한다.

본 연구의 목적은 파킨슨병 환자를 대상으로 16주간 복합운동을 수행하였을 때 혈중 도파민 농도, 기능적 체력 및 삶의 질에 어떠한 영향을 미치는지를 규명하는데 있다. 이를 위해 본 연구에 참여한 60 대 이상의 파킨슨병 환자 24명을 운동군(n=12)과 통제군(n=12)으로 분류한 후 운동군을 대상으로 16주 동안 주 2회, 회기 당 70분의 복합운동을 실시하였다. 복합운동 실시 전·후 항목별 차의 비교를 위해 그룹 내 차이는 대응 t 검정, 그룹 간 차이는 독립 t 검정, 상호작용 검증을 위해 이원 반복측정 분산분석을 사용 하였으며, 각 항목별 통계적 유의수준은 .05로 설정하였다. 그 결과 첫째, 도파민 농도는 운동군(p<.01)이 16주간 운동 전보다 운동 후 유의하게 증가하였고, 통제군의 경우 유의한 차이가 나타나지 않았다. 둘째, 기능적 체력에서 악력은 운동군(p<.001)과 통제군(p<.05) 모두 16주간 운동 전보다 운동 후 유의하게 증가 하였고, 덤벨들기(p<.001), 의자 일었다 앉기(p<.001), 3m 걸어갔다 돌아오기(p<.01)가 16주간 운동 전보다 운동 후 운동군에서 유의한 차이를 보였고, 통제군은 유의한 차이가 나타나지 않았다. 셋째, 삶의 질은 운동군(p<.001)이 16주간 운동 전보다 운동 후 유의하게 증가하였다. 이상의 결과를 종합해 볼 때 16주간 의 복합운동은 파킨슨병 환자에게 매우 효과적임을 알 수 있었으며, 도파민 농도를 증가시키고 근력, 근지 구력, 평형성 및 보행능력 등 기능적 체력과 삶의 질을 향상시키는데 도움을 줄 수 있다고 사료된다.

This study is a descriptive correlation study to explore the intention of nursing for patients with COVID-19 among nurses in a tertiary hospital in Seoul, and to identify factors influencing the nursing intention. Data were collected from 239 nurses with more than 6 months of working experience from December 1, 2020 to December 31, 2020. Data were analyzed by t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and Hierarchical multiple regression using the SPSS WIN 24.0 program. According to a result of this study, the score of participant's nursing intention for patients with COVID-19 was an average of 4.48 points out of 7 points. Factors influencing the nursing intention were control beliefs, position, positive behavior beliefs, negative behavior beliefs, and normative beliefs: Among the factors influencing nursing intentions, control beliefs have been shown to have the greatest influence. These variables accounted for 65.2% of the variance in the nursing intention. Therefore, to increase the nursing intention for patients with COVID-19, it is necessary to educate and train nurses to strengthen their confidence in caring the patients. In addition, repeated studies were suggested with extended sample in other settings and to find other factors influencing the nursing intention.

Background: Masticating is an activity that is free from temporal or spatial constraints, with an advantage that it can be combined easily with other treatment methods. While several studies have reported a positive effect of the intervention of chewing using the jaw on postural stability, only a few studies were conducted on stroke patients. Objectives: To investigated the effects of masticating chewing gum on the static and dynamic balancing of stroke patients. Design: Randomized cross-over study design. Methods: Nineteen stroke patients were randomly assigned to the chewing group or control group. BT4 was used to measure the static and dynamic balancing abilities. Pre-test measurements were taken before mastication of chewing gum, and post-test measurements were taken after 2 days. The stroke patients in the chewing group were guided to sit on a chair and chew gum for 3 min, and their balancing abilities were simultaneously measured. The balancing abilities of the control group patients were measured while they sat at rest without masticating chewing gum. Results: The chewing group showed significant increases in the measures of static balance (i.e., C90 area, trace length, X mean, and Y mean). In the between-group comparison, the measures of static balance were significantly higher in the chewing group than in the control group. Conclusion: These findings suggest that masticating chewing gum enhanced the static balancing ability of stroke patients. Thus, gum chewing should be considered a viable clinical intervention to control posture in stroke patients.

Background: Stroke is a neurological disorder characterized by an impaired static balance. A change in poor posture after stroke may worsen static balance. The balance control through an upright posture may include kinesiology taping of the middle back. Objectives: To investigated the effect of kinesiology taping of middle back on static balance in patients with stroke. Design: A randomized controlled trial. Methods: A total of 10 patients with stroke were divided into two groups. The experimental and control groups received kinesiology taping and placebo taping of the middle back, respectively. After 24 h, static balance (i.e., sway area and path length) was measured in closed eyes condition. Results: The experimental group (kinesiology taping group) showed a significant decrease in sway area and path length after the intervention. In addition, kinesiology taping group showed a significant decrease in sway area and path length compared to the control group. Conclusion: Kinesiology taping of the middle back can improve static balance in stroke patients.

Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupⅡ. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn’t show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

Background: Back pain is associated with a high risk of recurrence. Various physical therapy techniques for back pain have been studied, including reprogramming the central nervous system by integrating sensation and motion with sensory exercise training. Objectives: To aimed verify the effectiveness of sensorimotor training in improving postural stability and pain levels. Design: A randomized controlled trial. Methods: The study population was randomized into a sensory exercise training group and trunk stabilization training group and treated three times a week for 4 weeks. Each group took part in sensorimotor training for 15 minutes or lumbar stabilization exercise for 15 minutes. Results: After the intervention both groups showed Improvements in the variables. There was a significant difference in the dynamic postural stability, limit of stability, and modified visual analog scale scores in the sensorimotor training group compared to the lumbar stabilization exercise group (P<.05). Conclusion: Sensorimotor training appears to be an effective physical therapy exercise program that can be applied in patients with low back pain to improve muscle control ability.

목적 : 초기 녹내장 환자를 대상으로 시기능이 일상생활에서의 시력의 질에 미치는 영향을 알아보고자 하였다. 방법 : 서울시 KU 대학교 병원 안과에서 본 연구에 참여 의사를 밝힌 초기 녹내장 환자 20명을 대상으로 하였다. 녹내장 환자의 시기능을 측정하기 위해 대비시력, 대비감도, 시야결손, 입체시력을 측정하였고, NEI VFQ-25 설문지를 이용하여 시기능을 평가하였다. 모든 측정값은 SPSS 26.0 프로그램을 이용하여 분석하였다. 결과 : 초기 녹내장 환자의 경우 저대비 시력이 정상안보다 저하되었고, 시력저하와 시야결손은 일상생활의 시각적 ‘활동의존성’과 상관성이 있었다(p<0.050). Better eye의 3 cpd 및 12 cpd 대비감도는 ‘원거리 시생활’의 불 편함과, worse eye의 18 cpd 대비감도는 ‘근거리 시력’, ‘주변 시생활’ 및 ‘전반적인 시기능’과, 양안의 12 cpd 대 비감도는 전반적인 시기능저하와 관련이 있었다(p<0.050). 근거리 입체시력은 ‘역할의 제한’과 관련이 있어 취미나 직업 등의 활동에 제한이 있는 것으로 나타났다. 결론 : 시야결손이 적은 초기 녹내장 환자에서 시력, 대비감도 및 입체시력의 저하와 시야감소는 시생활의 질을 저하시키는 것으로 나타났다.

본 연구는 자가간호프로그램이 요추간판제거술 환자의 운동이행 자기효능감, 자가간호지식, 자가간호이행에 미치는 효과를 확인하기 위한 실험연구이다. 대상자는 D광역시 소재 일개 척추전문병원 입원환자 중 미세현미경 요추간판제거술을 받은 환자로 실험군 26명, 대조군 27명이다. 수집된 자료는 SPSS 25프로그램을 이용하여 평균, 백분율, 표준편차, t-test, χ2-test, t-test, repeated measures ANOVA로 분석하였다. 연구결과 자가간호프로그램 중재를 받은 실험군은 제공받지 않은 대조군에 비해 시간이 경과함에 따라 보조기 관리지식(p=.001)과 일상생활관리지식점수(p=.005)가 더 높아 지지되었다. 또한 자가간호 프로그램을 제공받은 실험군은 제공받지 않는 대조군보다 보조기 관리이행도(p=.011), 일상생활 이행도 (p=.007), 유해생활 습관관리 이행도(p=.011)가 높아 지지되었다. 따라서 자가간호프로그램은 요추간판제 거술 환자의 수술 전후 적용을 통해 운동이행 자기효능감, 자가간호지식 및 자가간호이행도를 향상시켜 보다 빠른 회복을 도울 수 있는 프로그램이라고 할 수 있다.

이 연구는 강직성 척추염 환자를 대상으로 12주간의 가정기반운동(home-based exercise) 프로그램을 수행하여 환자 특성별 염증관련 혈액지표, 관절가동범위, 통증척도 및 심리적인 지표 세부적이고 종합적으로 제공하고자 수행되었다. 연구의 목적을 위해 강직성 척추염을 진단받은 환자 10명을 선정하여 연령별(30대 vs. 40대 vs. 50대), 성별(남성 vs. 여성) 및 유병기간(5년 미만 vs. 5년 이상)으로 구분하였다. 가정기반 운동 프로그램은 유산소운동과 필라테스 기반 저항성 운동의 복합운동 형태로 최대심박수 (maximal heart rate, MHR)의 50-70% 강도에서 주 4회, 12주 동안 수행되었다. 연구결과, 12주간의 가 정기반운동 중재 후 강직성 척추염 환자의 혈중 CRP (C-reactive protein) 농도가 감소됨으로써 (-35.6%, p=.017) 혈중 염증 수치가 개선되었으며, 각 관절(고관절, 허리, 경추)의 가동성이 향상되었다(p<.05). 또한 질병활성도(Bath ankylosing spondylitis disease activity index, BASDAI)는 -67%(p=.005), 시각통증지표 (Visual analogue scale, VAS)는 -64.8%(p=.005) 감소됨으로써 강직 및 통증이 전반적으로 완화되었다. 특히, 우울 정도가 -65.5%(p=.005), 불안 정도는 -55.2%(p=.008) 감소됨으로써 12주간의 가정기반운동은 신체적 변화 뿐 아니라 심리적인 요인도 개선 시켜주는 것으로 나타났다. 반면, 강직성 척추염 환자의 연령, 성별, 유병기간에 따른 운동 효과 차이는 나타나지 않았다(p>.05). 따라서 이 연구에서 적용된 12주 간의 가정기반운동이 환자 특성과 상관없이 강직성 척추염 환자에게 보편적으로 사용될 수 있는 효과적인 운동프로그램이 될 수 있을 것으로 사료된다.

목적 : 본 연구의 목적은 최근 10년간 뇌졸중 환자의 상지기능 회복을 위해 사용된 가상현실 중재들에 대해 알아보고 체계적으로 고찰을 실시하고자 한다. 연구방법 : 2010년 1월부터 2020년 12월까지 Research Information Sharing Service(RISS), Koreanstudies Informatin Service System(KISS), DBpia, PubMed, ScienceDirect, Scopus의 온라 인 데이터 베이스에 등록된 논문을 검색하였다. 최종적으로 18개의 Randomized Controlled Trials(RCT) 논문을 대상으로 PICO 방법을 사용하여 분석하였다. 결과 : 뇌졸중 환자의 상지기능 회복을 위해 사용된 가상현실 중재방법은 9개였고, 총 18회 사용되었다. 그중 Nintendo Wii가 4회(22.22%), 가상현실 프로그램이 4회(22.22%)로 가장 많았다. 연구 분석 결과 뇌졸중 환자의 상지기능 향상에 Nintendo Wii와 가상현실 프로그램이 효과적인 것으로 나타났다. 결론 : 뇌졸중 환자의 상지기능 향상을 위한 가상현실 중재방법의 종류와 빈도를 제시하였고 가장 많이 사용되는 Nintendo Wii와 가상현실 프로그램의 중재 방법에 대한 근거 논문들을 중재 방법, 중재 기간 및 횟수, 중재효과를 표로 만들어 제시하였다. 결과는 임상 치료사들이 치료방법 및 기간, 평가도구를 선택하는데 근거 자료로 사용할 수 있을 것이다.

목적 : 뇌졸중 환자들의 재활의료 서비스 이용현황을 분석하여 미국과 일본의 재활의료 서비스와의 비교를 통해 우리나라 재활서비스 수가체계의 개정 필요성과 정책 개선 방안을 제안 하고자 한다. 연구방법 : 재활의료 이용현황 분석을 위해 심평원 DB를 활용하였다. 2016년 1월 1일부터 12월 31일까 지 주 상병코드가 I60, I61, I62, I63, I64인 입원 환자 중 18세 이상 100세 이하인 환자 78,719명을 대상으로 전문재활 청구율, 항목별 전문재활 청구율, 입원기간 중 의료기관 이동 횟수, 이동한 의료기관에서의 전문재활 청구율을 분석하였다. 또한 회복기 의료기관의 지역사회 복귀에 대한 효과를 알아보기 위해 2018년 1월부터 12월 까지 재입원율을 분석하였다. 우리나라 재활의료 이용현황을 통해 문제점을 미국과 일본의 재활의료 체계와 비교하여 재활의료 서비스 개선방안을 제시 하였다. 결과 : 급성기 치료가 주로 이루어져야하는 상급종합병원에서부터 만성기 환자 기능 유지를 담당해야하는 요양병원에 이르기까지 종별 구분 없이 모든 재활치료가 이루어지고 있었다. 또한, 회복기 의료기관의 평균 재입원율이 61.9%로 초기 집중치료를 위한 비용대비 지역사회 복귀율은 낮은 것으로 나타났다. 결론 : 선진국의 재활의료 체계를 조사, 비교하여 우리나라 재활서비스 전달체계 확립, 재활의료 서비스 제공 범위확대와 수가 비용 현실화, 퇴원 후 지역사회 연계수가 확립 등을 제시하였다.

Purpose: The purpose of this study was to understand the meaning and nature of the experiences of adult patients infected with HIV (Human Immunodeficiency Virus) when they were teens. Methods: To this end, we analyzed how the experience was interpreted in their daily lives and what its meaning was through the Interpretative Phenomenological Analysis (IPA), a new method of extensive qualitative research in the UK. Among the confirmed HIV infections in teenagers, three people who agreed to participate in the study were men in their 20s and 30s. Participants were interviewed in-depth to collect data and the data was analyzed and interpreted using IPA. Results: As the results, eight themes and 18 sub-themes were derived from meaningful statements through in-depth analysis, and these were categorized into 4 categories. The four categories included ‘shock and despair’, ‘realistic difficulties’, ‘barriers in relationships’, and ‘life transitions’. Conclusion: Adolescent infected persons had support from their families or surroundings, and this positively influenced on the recovery of infected persons. We discussed the implications of the understanding of HIV infection, changes in social perception, the need for correct sex education, and the experiences of teenagers infected with HIV, and suggested follow-up studies.

Management of malignant diseases in elderly patients has been a global clinical issue because of increased life expectancy worldwide. Currently, pancreatic adenocarcinoma mainly occurs after 60 years of age, and its prognosis remains poor despite modest improvements in recent decades. Surgical resection is the only potentially curative treatment for pancreatic cancer. Resection of the pancreas, either by pancreaticoduodenectomy (PD) or laparoscopic pancreaticoduodenectomy (LPD) is a complex surgical procedure with a high rate of morbidity and mortality. However, mortality rates after pancreatic surgery have dropped to less than 2-5% at experienced centers. Whereas, complication rates are high, reaching at least 30% in many centers. Mortality also increases proportionally with age viz. 6.7% of patients aged 65-69 years, 9.3% of patients aged 70-79 years, and 15.5% of patients aged 80 years or older. The present review article delineates clinical outcomes along with safety, morbidity and mortality after PD or LPD in elderly, especially in octogenarian patients.

Worldwide, oral cancer accounts for 2%–4% of all cancer cases. It is estimated that more of 90% of all oral neoplasms are oral squamous cell carcinoma (OSCC). The aims of this study were to evaluate follow-up outcomes in patients with OSCC invading the mandibular body bone who underwent primary radical resection and reconstructive surgery by fibular free flap or CAD-CAM T-mesh with pathological study on two cases. In this article, two cases of mandibular reconstruction in patients with OSCC invading the mandibular body bone are reported. A 68-year-old male patient visited the authors’ clinic with pain on the left mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, a enterocutaneous fibular free flap from right leg was used to cover the intraoral mucosal defect. The other 51-year-old female patient visited the authors’ clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, reconstruction was done with a reconstruction plate and a fibula free flap from right leg. Unfortunately, fibular free flap was lost due to infection of the flap at post-operative 1month, secondary reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair on the mandibular defect after four years postoperatively. The customized CAD-CAM T-mesh was made prior to the operation according to mirror image of remained jaw. Patients with OSCC invading the mandibular body bone are required an accurate segmental mandibulectomy immediate reconstructive surgery with various methods and followed by adjuvant radiation with or without chemotherapy in order to improve the quality of life through the restoration of the oral function and esthetics after surgery. Postoperative CCRT was determined according to the final pathologic findings such as lymph node metastasis and main lesion free margin safety, and this has an essential relationship in the prognosis of postoperative recurrence. We reviewed reliable treatment options on two patients of OSCC in mandible with pathologic findings.Worldwide, oral cancer accounts for 2%–4% of all cancer cases. It is estimated that more of 90% of all oral neoplasms are oral squamous cell carcinoma (OSCC). The aims of this study were to evaluate follow-up outcomes in patients with OSCC invading the mandibular body bone who underwent primary radical resection and reconstructive surgery by fibular free flap or CAD-CAM T-mesh with pathological study on two cases. In this article, two cases of mandibular reconstruction in patients with OSCC invading the mandibular body bone are reported. A 68-year-old male patient visited the authors’ clinic with pain on the left mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, a enterocutaneous fibular free flap from right leg was used to cover the intraoral mucosal defect. The other 51-year-old female patient visited the authors’ clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, reconstruction was done with a reconstruction plate and a fibula free flap from right leg. Unfortunately, fibular free flap was lost due to infection of the flap at post-operative 1month, secondary reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair on the mandibular defect after four years postoperatively. The customized CAD-CAM T-mesh was made prior to the operation according to mirror image of remained jaw. Patients with OSCC invading the mandibular body bone are required an accurate segmental mandibulectomy immediate reconstructive surgery with various methods and followed by adjuvant radiation with or without chemotherapy in order to improve the quality of life through the restoration of the oral function and esthetics after surgery. Postoperative CCRT was determined according to the final pathologic findings such as lymph node metastasis and main lesion free margin safety, and this has an essential relationship in the prognosis of postoperative recurrence. We reviewed reliable treatment options on two patients of OSCC in mandible with pathologic findings.

Background: Patients with lumbar spinal stenosis show abnormal changes in muscle activity due to pain and limited range of motion of the lumbar spine. Excessive increased muscle tone and decreased muscle activity patterns threaten the patients’ quality of life. However, there have been a few studies showing how to improve muscle performance in patients with lumbar spinal stenosis. Among these, joint mobilization is one way of improving muscle performance through pain relief and increasing the range of motion. Objectives: To investigate the effect of lumbar mobilization by orthopedic manual physical therapy on paravertebral muscle activity and tone in patients with lumbar spinal stenosis. Design: A randomized controlled trial. Methods: In this study, 24 patients with lumbar spinal stenosis were randomized (1:1 ratio) into two groups. The experimental group underwent lumbar posteroanterior mobilization, and the control group underwent conventional physical therapy (conventional transcutaneous electrical nerve stimulation) for 15 minutes each. For outcome measures, MyotonⓇPRO was used to evaluate muscle tone when resting of the paravertebral muscle in the pain area. For muscle activity evaluation, the reference voluntary contraction of the paravertebral muscle was evaluated using surface electromyography. Results: Muscle tone and activity were significantly improved after intervention in both the experimental and control groups. In addition, the experimental group showed more significant decrease in muscle tone and activity than the control group. Conclusion: These results suggest that lumbar mobilization improving muscle performance in patients with lumbar spinal stenosis.

Background: Physical therapy applied to stroke patients is recognized as a treatment that promotes function recovery, and it is a widely known fact that constant exercise should be performed. However, there are insufficient studies on exercise intensity and exercise time that can minimize side effects and maximize function recovery for exercise therapy. Objectives: To determine the effect of exercise variables on CPK generation during aerobic exercise in stroke patients and to discover how to use appropriate exercise intensity and time when conducting an exercise for function recovery in stroke patients. Design: Quasi-experimental research. Methods: This study classified subjects into three groups (low-intensity exercise group: LIE, moderate-intensity exercise group: MIE and high-intensity exercise group: HIE) according to exercise intensity, and was further classified into two groups (10-minute exercise group: 10MG and 20-minute exercise group: 20MG) according to exercise time variables within each exercise intensity group. After, the change in CPK according to exercise intensity and time was confirmed through hematological analysis. Results: In LIE and MIE, the CPK blood concentrations before and after exercise were increased in 10MG and 20MG, which was not statistically significant (P>.05). In HIE, the CPK blood concentrations before and after exercise were increased in 10MG, and it was statistically significant (P<.05). In HIE, the CPK blood concentrations before and after exercise were increased in 20MG, and it was statistically significant (P<.01). In 10MG and 20MG, the CPK blood concentrations before and after exercises were increased in all intensity group, and there was a statistically significant difference only in HIE. Conclusion: From the results of this study, considering CPK, it will be helpful to recover and improve function if the exercise intensity setting is applied in the type of moderate intensity exercise during physical therapy interventions in stroke patients.

Background: Vibration stimulation has emerged as a treatment tool to help reduce spasticity during physical therapy. Spasticity includes problems of reduced range of motion (ROM) and stiffness. However, the benefits of vibration rolling (VR) on interventions for stroke patients are unclear. Objectives: This study aimed to investigate the effect of VR intervention on the ankle ROM and ankle stiffness in stroke patients. Design: A randomized crossover study. Methods: Seven stroke patients completed two test sessions (one VR and one non-VR [NVR]) in a randomized order, with 48 hours of rest between each session. Participants completed intervention and its measurements on the same day. The measurements included ankle dorsiflexion and plantarflexion ROM and stiffness of ankle muscles, including the tibialis anterior, medial, and lateral gastrocnemius muscle. Results: After VR, ankle dorsiflexion ROM, lateral gastrocnemius stiffness, and medial gastrocnemius stiffness improved significantly (all P<.05). After NVR, only the lateral gastrocnemius stiffness improved significantly (P<.05). Furthermore, in the cases of changed values for ankle dorsiflexion ROM and lateral gastrocnemius stiffness were compared within groups, VR showed a more significant difference than NVR (P<.05) Conclusion: VR improved ankle ROM and muscle stiffness. Therefore, we suggest that practitioners need to consider VR as an intervention to improve dorsiflexion ROM and gastrocnemius stiffness in stroke patients.

Background: Recently, a new home-based dysphagia rehabilitation method using information and communications technology (ICT) has been reported, but clinical evidence is still lacking. Objectives: To investigate the effects of home-based dysphagia rehabilitation using ICT on tongue muscle strength and volume in patients with developed dysphagia after stroke. Design: Randomized controlled trial design. Methods: Twenty patients who developed dysphagia after stroke were enrolled. The experimental group received dysphagia rehabilitation in the form of ICT-based home care. In contrast, the control group received traditional rehabilitation based on swallowing under the supervision of occupational therapists. All interventions were conducted five times a week for four weeks. Results: Both groups showed statistically significant increases in tongue muscle strength and volume after the intervention (P<.05, both). However, there were no significant differences in tongue strength or volume between the two groups after the intervention (P>.05, both). Conclusion: Home-based dysphagia rehabilitation using ICT showed effects similar to those of conventional swallowing rehabilitation in patients who developed dysphagia after stroke. These findings suggest that dysphagia rehabilitation can be conducted at home without the help of a therapist.

목적 : 본 연구는 뇌졸중 환자의 상지기능과 일상생활동작 향상을 위해 적용된 과제 지향적 접근 연구들을 체계적 고찰과 메타분석으로 연구결과들을 비교 분석하였다. 이 결과들을 통해 앞으로의 과제 지향적 접근의 방향을 제시하고자 하였다. 연구방법 : 분석 자료는 2000년 1월부터 2018년 8월까지 MEDLINE, CINAHL, Pubmed 데이터베이스를 사용하여 선정기준에 적합한 17편의 무작위 실험 연구를 수집하였다. 선정된 연구들은 질적 평가(Pedro score)와 Patient, Intervention, Comparison, Outcome(PICO)를 사용하여 체계적으로 정리하였다. 그 후 각 연구들의 중재 형식을 참고하여 평균, 표준편차, 표본수를 사용하여 메타분석을 실시하였다. 결과 : 선정된 17편의 연구는 Pedro score 5점 이상의 연구로 다양한 과제 지향적 접근을 통하여 상지기 능과 일상생활동작을 증진시키고자 하였다. 과제 지향적 접근의 중재 형식은 횟수 강도 등을 통제하는 반복강화형, 기계적 장치나 보조기 등을 사용하는 조합형, 환자별 특성 및 목표 등을 참고한 환자맞춤형 의 3가지로 분류하였다. 과제 지향적 접근이 상지기능에 미치는 영향은 큰 효과크기를 보였으며, 중재 형식에 따른 분석에서는 환자맞춤형은 큰 효과크기, 조합형과 반복강화형은 중간 효과크기를 보였다. 과제 지향적 접근의 일상생활활동에 대한 영향은 중간 효과크기를 나타내었다. 결론 : 환자의 기능 향상을 위한 과제 지향적 접근은 일관되고 정형화된 과제 보다 다양한 자극과 환자 중심의 목표, 환경, 피드백을 활용하여 과제의 다양성을 강화할수록 보다 높은 치료적 효과를 기대할 수 있다.