연구방법 : 서울지역 화상 특화병원에서 작업치료를 받은 수부 화상환자 30명을 대상으로 각 15명씩 과제 지향적 작업치료를 받은 실험군과 단순 운동치료를 받은 대조군으로 무작위 배분하였다. 중재는 주 3회, 1회 30분간, 6주간, 총 18회 실시하였다. 평가는 한국판 미시간 손 기능 평가 설문지(Korea version of Michigan Hand Outcomes Questionnaire; MHQ-K), 젭슨-테일러 손 기능 평가(Jebsen-Taylor Hand Function Test; JTT)를 시행하였으며, 중재 전, 후 평가를 실시하였다. 결과 : 첫째, 사전 사후 비교 시 실험군은 JTT의 모든 항목과 MHQ-K의 일과 통증을 제외한 6항목에서 통계학적으로 유의한 향상을 보였으며(p<.05), 대조군에서는 JTT의 모든 항목과 MHQ-K의 일, 통증, 모습을 제외한 5항목에서 통계학적으로 유의한 향상을 보였다(p<.05). 둘째, 중재 후 두 집단 간 비교는 JTT의 글씨쓰기와 먹는 흉내 내기, MHQ-K는 만족도와 통증에서 실험군이 대조군에 비해 유의한 차이 를 보였다(p<.05). 결론 : 수부 화상 환자에게 과제 지향적 작업치료와 단순 운동 치료 중재는 두 집단 모두에서 손 기능의 향 상을 보였지만 과제 지향적 작업치료는 단순 운동치료보다 글씨쓰기, 먹는 흉내 내기의 손 기능과 만족 도에 효과적임을 확인하였다. 따라서 향후 수부 화상 환자의 손 기능 향상을 위한 치료에 과제 지향적 작업치료가 긍정적인 영향을 줄 것으로 생각된다.

In the present study, to examine the effects of somatosensory stimulation of the hands on the hand functions and visuomotor coordination of children with developmental disabilities, a total of 24 sessions of experiments were conducted with three children with developmental disabilities for 60 minutes per session, three sessions per week from January 7, 2013 to March 11, 2013. To examine the effects of somatosensory stimulation of the hands on grasping and visuomotor coordination which are sub-areas of PDMS-2, the A-B study design was used which is a single case study method out of single-subject experimental research designs. Somatosensory stimulation of the hands was shown to be effective in improving the hand functions of children with developmental disabilities. Somatosensory stimulation of the hands showed positive effects on the raw scores and standardized scores of grasping and visuomotor coordination in all the three subject children. Visuomotor coordination functions showed higher scores in post-hoc tests in all three children. In particular, ring throws showed high scores at right 90°, right 45°, center, left 45°, and left 90°among visual directions. In the present study conducted with children with developmental disabilities, ring throws were performed to examine visuomotor coordination. In particular, the numbers of successes of ring throws on the front, left, and right were shown to be high. Therefore, somatosensory stimulation of the hands was effective on the hand functions and visuomotor coordination functions of children with developmental disabilities.

목적 : 본 연구의 목적은 뇌졸중 환자의 손기능에 대한 근전도 바이오피드백 훈련의 효과를 조사하는 것이다. 연구 방법 : 발병 6개월 이상인 뇌졸중 환자 10명을 무작위로 실험군과 대조군으로 각각 5명씩 배정하였다. 실험군은 근전도 바이오피드백 훈련을 1일 1회, 주 5일, 6주 동안 수행하도록 하였다. 훈련의 1회기는 15초의 휴식기와 5초간의 추적과제를 수행하는 활동기로 구성되며 1회 훈련동안 추적과제를 총 40번 시행하였다. 반면, 대조군의 모든 치료 상황은 바이오피드백 훈련을 제외하고는 실험군과 같았다. 손기능을 검사하기 위하여 훈련 전·후에 개정된 Ashworth 척도, Fugl-Meyer 평가, 상자와 나무토막 검사, 뇌졸중 상지기능 검사를 실험군과 대조군 모두에게 실시하였다. 결과 : 실험군은 개정된 Ashworth 척도를 제외한 모든 검사에서 훈련 후의 결과가 훈련 전의 결과와 비교하여 통계적으로 유의한 차이를 보였다(p<.05). 대조군은 모든 검사에서 유의한 차이를 보이지 않았다(p>.05). 또한 집단간 비교에서 실험군의 훈련 후 손기능 향상이 모든 검사에서 대조군에 비하여 통계적으로 유의하게 높았다(p<.05). 결론 : 본 연구는 실시된 근전도 바이오피드백 훈련이 뇌졸중 환자의 손기능 향상에 효과적임을 지지한다.

With the object of examining the effects of horticultural therapy based on structural recall by developmental stage on cognitive, emotional, and hand functions of institutionalized elderly, this study executed a horticultural therapy program once a week and through a total of 14 sessions during the period from May 2 to December 5, 2013. The subjects of this study were 34 elders admitted to S Geriatric hospital for geriatric diseases, and they were divided into a control group and an experimental group. Because the program was designed for institutionalized elders who were able to do only indoor activities, it provided various seasonal horticultural activities that could be done even in a limited space by giving materials and subjects that could be recalled by developmental stage. The results of this study are as follows. As to changes in cognitive functions (MSQ) after the horticultural therapy program, the control group showed a decrease as having more negative ranks, and the experimental group showed an increase as having more positive ranks, but such changes in the control and experimental groups were not significant. As to changes in emotional functions after the horticultural therapy program, the control group showed a decrease but without significance in ego integrity as having more negative ranks, and the experimental group showed an increase with significance as having more positive ranks (P=0.020). As to the experimental group’s changes in the sub factors of ego integrity, positive ranks increased in all the sub-factors and the increase was particularly significant in satisfaction with present life (P=0.038). As to changes in life satisfaction, the control group showed increased positive ranks but without significance, and the experimental group showed significantly increased positive ranks (P=0.022). As to the experimental group’s changes in the sub-factors of life satisfaction, changes in denial of the past (P=0.029) and denial of the future (P=0.016) were particularly significant. As to changes in hand functions, both the control and experimental groups showed some improvement in pinch after the horticultural therapy program but the changes were not significant. Grip strength did not change in the control group, and in the experimental group right-hand grip strength was improved slightly more than left-hand one, the difference was not significant. The results of this study suggest that horticultural therapy based on structural recall by developmental stage is effective in improving institutionalized elders’ emotional functions and, consequently, can contribute to higher quality of life, which is the ultimate goal of elders.

This study was conducted to investigate the effect of horticulture on hand function and cognitive ability of the old age with serious brain diseases. This study was intended for the inpatients in a geriatric ward, K hospital located in Gumi-si, Kyeongsangbuk-do, for dementia or cerebral apoplexy caused by brain diseases. Patients were divided to 7 of experimental group and 4 of control group. Horticulture program included flower arrangement in the first half and plant culture in the later half. As a result horticulture program test, Hand function showed significant development on both hands from 57.42 to 82.57 (p=.001) on the right hand, from 62.50 to 90.58 (p=.001) on the left hand. Change of cognitive ability show as follow. Communicational problem and senile infirmity of the patients with serious brain diseases made many difficulties. The numeral value, therefore, did not show significant development due to high individual deviation. As a result, horticulture program is effective for development of cognitive ability and hand function for the old age with serious brain diseases. Therefore, the more systematic horticulture program in the long view is expected to help the old age with serious brain diseases to raise the quality of life and give them effective affect.