This study was conducted to examine the effect of joint mobilization on forward head posture and to propose an effective method to improve correct body posture and balance. A total of eight patients from a Maitland-applied group (n=8) received mobilization therapy to increase the mobility of the cervical joint, with Maitland's movement grade III intensity for 30 seconds of treatment and 30 seconds of rest, for ten intervals, three times a week for four weeks. The craniovertebral angle (CVA) changes before and after the intervention with the Maitland technique were measured as 56.85 ± 2.31° before, 63.23 ± 2.23° two weeks after, and 64.98 ± 1.27° four weeks after joint intervention. There were significant CVA changes before and after the Maitland technique (P <.05). The results of this study suggest that the Maitland technique is useful for improving the head vertebral angle in patients with forward head posture

목적 : 본 연구는 뇌졸중 환자가 퇴원 후 가정에서 필요한 작업치료가 무엇인지 가족을 대상으로 가정작업치료에 대한 요구도를 알아보았다. 앞으로 가정작업치료사 제도를 보건․의료정책 제안의 기초자료로 활용하고자 시도하였다.연구방법 : 연구의 대상은 2004년 7월부터 8월까지 뇌졸중을 경험한 환자의 가족 168명에게 가정에서 필요한 작업치료가 무엇인지 직접 면접을 통해 자료를 수집하였다. 수집된 자료는 SAS를 이용하여 분석하였다. 측정도구는 본 연구자가 개발한 가정작업치료 요구도로서 37문항의 4점 척도였다.결과 : 대상자 168명 중 가정작업치료가 필요하다고 응답한 가족은 149명(88.6%)이었다. 대상자의 직업이 있는 경우, 가정경제가 보통인 경우 가정작업치료 요구도가 높았다. 뇌졸중 환자의 질병 특성에 따른 요구도를 보면 언어장애, 시각장애, 배뇨문제, 연하곤란이 있는 경우 가정작업치료 요구도가 유의하게 높았으며, 장애등급 1급이 2, 3급에 비하여 가정작업치료 요구도가 유의하게 높았다(p=0.0001). 범주별 가정작업치료 요구도 순위는 운동성 요구도가 가장 높았으며, 다음은 이동성 요구도, 수단적 ADL 요구도, 자조활동 요구도, 사회성훈련하기 요구도 등의 순위였다.결론 : 이상의 연구결과에서 뇌졸중 환자의 가족은 가정작업치료를 매우 필요로 하는 것을 보았을 때, 앞으로 가정작업치료는 우리에게 수행되어야 할 많은 연구의 전망을 가져다주고 있다.

This study was done to research the general information, causes of stroke, risk factors, complications during admission of geriatric CVA inpatients. We retrospectively studied 208 above 65 years old geriatric CVA inpatients treated in Ajou university hospital from 1994 to 2003 by medical record. These were divided into two groups by following years. We were gathered information about sex, onset age, cause of stroke, number of stroke, complications, housing, family, insurance, smoking, alcohol. Most of incidence of the stroke was noted in the group of young old age (65~74 years old) and old age (75~84 years old). The occurrence rate of male stroke (38.5%) was less than of female stroke (61.5%) and the ratio of male to female was 1:1.6. The occurrence rate of ischemic stroke (72.6%) was higher than of hemorrhagic stroke. The occurrence rate of ischemic stroke increased more and more at the late stage. The most common risk factors for stroke was hypertension and complications during hospitalization were neurogenic bowl and bladder. These results of epidemiologic study may help above 65 years old geriatric CVA early treatment and prevention, rehabilitation and use basic data for multiple prospective study using stroke registry.

This longitudinal study of CVA patients has two parts: the first with 50 subjects and the second with 24 subjects. The first part of study shows that in making a prognosis of the early stage of CVA, the factor of visual neglect is most critical. The second part suggested that I-ADL is a better criteria than ADL for long-term CVA patients. 1) In the first study, the 50 subjects, hospitalized in the Department of Rehabilitation Medicine, Korea University Hospital from January 1998 to December 1999, were divided by the result of their MVPT (Motor Free Visual Perception Test) into two groups: one with visual neglect and the other with no visual neglect. In terms of ADL (Activities of Daily Living), the group with visual neglect significantly scored less that the group with no visual neglect. This result strongly supports the hypothesis that the factor of visual neglect is closely related with the CVA patients’ progress of ADL. 2) After two years, the follow-up study on remaining 24 clients (4 deceased, 22 unreachable) has been conducted in an attempt to identify any significant differences of the progress of ADL and I-ADL (Instrumental Activities of Daily Living) between two groups: neglect and neglect-free group. At this time, the ADL of both groups have remarkably improved with no significant difference between groups. However, both groups still scored significantly low in I-ADL. 3) These results lead us to the conclusion that only in the early rehabilitation period, the factor of visual neglect is very useful to predict a prognosis of the CVA patients. In addition, it is reasonable to suppose that rehabilitation for the chronic CVA patients should be guided by I-ADL rather than ADL.

CVA(Cerebro-Vascular Accidant) and HLD(Herniated Lumbar Disc) induces psychiatric disorders as well as neural disorders. In oriental medical treatment and management of CVA patients(group A) and HLD patients(group B), these psychiatric disorders are as major and important as neural disorders. For investigating the rate and difference of psychiatric disorders between two groups, We examined them with SCL-90-R(Symptoms Check List-90-R), Beck Depression Inventory(BDI), State-trait Anxiety Inventory(STAI) among psychological test. then the results are as follows; 1. In group A, phobic Anxiety was most high, and somatization, psychoticism, depression, anxiety, hostility, interpersonal sensitivity, obsessive-compulsive and paranoid ideation were located by score. 2. In group B, somatization was most high, and phobic anxiety, hostility, depression, psychoticism, anxiety, obsessive-compulsive, interpersonal sensitivity and paranoid ideation were located by score 3. According to SCR-90-R test, group A were significantly increased compared to group B in phobic anxiety 4. According to STAI test, group A were significantly increased compared to group B in state anxiety and trait anxiety 5. According to BDI test, group A were significantly increased compared to group B in depression we might be suggested that CVA patients had more serious psychiatric disorders than HLD patients. therefore, CVA patients must be treated and managed more actively than HLD patients

The purpose of this study is to validate of 5 scale-MBI as ADL asessment instrument for stroke patients. The subject was 34 patients following CVA on rehabilitation ther- apy in the rehabilitation hospital, Yonsei medical center. They were assessed with FIM, and 5 scale-MBI in a day. There scores were taken statistics through SAS package, so that we have Pearson's R score. The results is following. 1) FIM and 5 scale-MBI scores averaged 86. 21, 62. 32. 2) On Pearson's R score between FIM and 5 scale MBI was 0. 9345(p(0.001). Therefore there was a very high correlation. 3) On Pearson's R score between motorFIM and MBI was 0.8565(p(0.001), between cog- nitive FIM and MBI was 0.4641(p(0.01). There was significant. 4) On Pearson's R score between same category of FIM and MBI - self care, sphincter control, mobility, locomotion - each others was 0.8960, 0.6974, 0.8585, 0.8540 (p(0.001 ) . In conclusion, 5 scale MBI was found to be useful scale to assess the stroke patients.