목적 : 본 연구의 목적은 균형능력에 문제가 있는 만성 뇌졸중 환자를 대상으로 과제 지향적 활동의 실험군과 보존적 작업치료의 대조군과의 중재결과를 비교하여 일상생활동작의 수행 능력과 균형능력, 만족도에 미치는 영향을 알아보고자 하였다. 연구방법 : 본 연구는 2000년 7월부터 2008년 6월까지 뇌졸중 진단을 받고 서울 △병원에서 입원 치료를 받은 대상자 중 본 연구 목적에 맞는 실험군 18명 대조군 15명을 대상으로 실시하였다. 모든 중재는 훈련받은 2인의 작업치료사가 3개월 동안 주 5회, 1일 30분씩 시행하였고, 실험군은 과제 지향적 활동으로, 대조군은 신경발달치료를 기반으로 한 보존적 작업치료로 중재하였다. 중재 전·후 일상생활동작과 균형능력, 작업수행 만족도는 Berg Balance Scale(BBS), Canadian Occupational Performance Measure(COPM), Functional Independence Measure(FIM)으로 측정하였다. 결과 : 중재 후 과제 지향적 활동의 실험군(p<.001)과 보존적 작업치료를 받은 대조군(p<.01)의 균형능력과 일상생활동작 수행능력, 환자의 만족도 모두 중재 전보다 유의하게 향상되었다. 중재 후 집단 간 비교에서는 균형능력(p<.05)과 환자의 만족도(p<.01)에서 실험군이 대조군보다 유의하게 향상되었다. 일상생활동작 수행능력에서는 집단 간 차이를 보여주지 못했다(p>.05). 결론 : 본 연구 결과에 근거하여 과제 지향적 활동이 보존적 작업치료보다 만성 뇌졸중 환자의 일상생활동작 수행능력과 균형능력, 만족도를 향상하는데 도움이 될 것으로 보인다.

The aim of this study was to assess the effectiveness of group therapeutic exercise programs on the cognitive function, Activities of Daily Living (ADL), and balance-performing ability in older adults. Fifteen community-dwelling subjects (mean age 73.7 yrs, standard deviation 2.4) participated in this study. An 8-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-Korean (MMSE-K), Modified Barthel Index (MBI), Berg Balance Scale (BBS), Functional Reaching Test (FRT), and Timed Up & Go (TUG) test were measured during pre-exercise and post-exercise points. The results of this study were as follows: 1. After eight weeks, the MMSE-K and MBI total score was more significantly increased for post-exercise tests than pre-exercise tests (respectively, p<.05, p<.01). 2. Of the MBI contents, personal hygiene, dressing, ambulation, and chair/bed transfers scores were significant increased for post-exercise tests. 3. Post exercise BBS, FRT, and TUG scores were higher than the pre-exercise scores. The difference was statistically significant (respectively, p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise can be used to improve the cognitive function, ADL, and balance-performing ability in elderly persons.

Objective : The purpose of this study was to investigate the change of activity of daily liv-ing(ADL) on task-oriented Learning program in adult with cerebral palsy.Method : The subjects were forty members who were treated at dept. occupational therapy the H Rehabilitation Center in kwang ju from January 2003 to July 2003. The ADL were meas-ured with Functional Independence Measure(FIM) and collected data were statistically analysed by SPSS PC for Wilcoxon signed rank test using NPARIWAY.Results : 1. A age distribution of the subject was from 20 to 36, and the average age was 25.6. The number of the twenties are the most number of the subjects by 28 persons(70%). The men were 19 persons(47.5%) and the women were 21 persons(52.5%). The clinical types of adult with cerebral palsy were dyskinesia 4 persons(10%), spastic quadriplegia 10 persons(25%), spas-tic hemiplegia 12 persons(30%), spastic diplegia 14 persons(35.5%). In the dominated hand, the right’s was 27 persons(67.5%), and the left’s was 13 persons(32.5%) and the number of person with language disability was 26 persons(65%), without language disability was 14 persons (35.5%). The duration of medical treatment was 61 days at the shortest, 123 days at the lon-gest, and the average duration was 82 days. 2. The variation to the performance of daily life after pre-treatment and post-treatment through the general characteristics of the adult with cerebral palsy was significantly (p<.01) in-creased independent of age, gender, clinical types except dyskinesia, dominated hand, speech dis-ability and treatment duration of less than 2∼3month.3. The variation of the pre-treatment and the post-treatment in the detail item to the per-formance of daily life of the adult with cerebral palsy through task-oriented Learning program was significantly(p<.01) increased at the self-care, sphincter control, locomotion, mobility, com-munication and social cognition.Conclusion : Cerebral palsy cause disability on daily life with decrease of motor performance ability by adding marked growth of the adolescence, disease, treatment interruption, trauma etc, to past poor motor control function, impaired balance reaction, muscle spasticity etc. But if proper task-oriented Learning program has been performing to patients continuously, General ADL performance ability will be increasing in young adult with cerebral palsy patients.

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.

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.