목적 :본 연구는 재활 보조기기서비스에 대한 옹호중재의 관점에서 개인의 특성에 따른 지원절차 및 품목 을 통합한 매뉴얼을 개발하여 서비스 수요자뿐만 아니라 제공자에게도 보조기기서비스의 세부절차와 내 용에 대한 이해를 돕고 재활서비스 현장에서 활용할 수 있도록 하기 위하여 설계되었다.연구방법 :국내 11개 지역별 보조기기센터와 관련 행정기관 4개소를 대상으로 방문, 전화, 홈페이지검색 등을 통하여 매뉴얼, 제공절차, 관련법령 등에 관한 자료를 수집하였다. 수집된 자료를 토대로 기관과 지 원분야에 따라 대분류, 중분류, 소분류로 구분한 후 각 분류에 맞추어 보조기기서비스 통합 지원절차 매 뉴얼을 개발하였다. 개발된 매뉴얼은 개인의 특성에 따른 서비스 흐름도와 제품정보로 구성하였다.결과 :개발된 재활 보조기기서비스 통합 매뉴얼은 먼저 지역별 보조기기센터 및 관련 행정기관의 지원제도 로부터 서비스를 제공받을 수 있는 모든 과정을 하나로 통합한 통합지원절차 흐름도와 공공기관별(전국 보조기기센터, 보건복지부, 국가보훈처, 고용노동부, 미래창조과학부) 지원절차 흐름도로 구분하여 개발 하였다. 또한 제품정보는 지역별 보조기기센터의 보조기기목록과 행정기관별 지급 가능한 보조기기목록 으로 분류하여 제공하였다.결론 :본 매뉴얼은 국내 재활 보조기기서비스 지원절차와 제품정보를 통합하였기 때문에 재활 보조기기서 비스 수요자나 제공자들에게 신속하고 정확한 서비스 제공이 가능하며 향후 작업치료 관점에서 보조기 기서비스에 대한 독립적 옹호중재의 역할을 기대한다.

The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) Ⅱ·Ⅲ·Ⅳ of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTⅡ·Ⅳ·Ⅰ. 3) In case of thoracic-lumbar scoliosis and head rotation·facial asymmetric· cervical scoliosis·ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTⅢ·Ⅰ, ribcage forward and thoracic scoliosis GBTⅡ·Ⅳ. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation·patella high·umbilicus tilt and hallux valgus·foot longitudinal arch: FLA·patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTⅢ·Ⅰand patella high-direction GBTⅣ·Ⅱ·Ⅰ. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.