Earticle

신제도주의의 한 유형인 역사적 제도주의 시각에서 접근하면 세월호 참사는 충격적인 사회문제로서 해양경찰조직의 진화과정에 커다란 영향을 미친 대표적 사례이다. 정부는 이 우연한 사건에 의해 발생한 위기상황을 극복하기 위하여 해양경찰조직을개편하였고 그 진화과정에서 지속성보다 단절을 선택했다. 그러나 정부는 절박한 고비와 혼란을 피하기 위해 짧은 기간에 조직개편을 단행함으로서 해양경찰의 자기강화에 초점을 두기보다는 정권의 정치적 위기를 돌파할 기회로 삼거나 비난회피의 수단으로 활용하였다. 따라서 이 연구에서는 해양경찰조직의 개편과 관련하여 중대한 전환점인 세월호참사를 기점으로 2013년과 2016년의 조직구조와 기능의 특징을 비교하는데 목적을두었다. 이러한 연구방법은 정태적인 면이 있음에도 불구하고 향후 해양경찰조직의합리적인 개혁과 제도의 발전경로를 탐색하기 위해서 필요하기 때문이다. 그 분석결과와 정책적 함의를 검토하면 다음과 같다. 첫째, 조직구조에 영향을 미치는 변수와 연계하면 해양경찰조직과 해양경비안전본부조직은 모두 정형적 모델에가깝다. 둘째, 2014년 이후의 조직개편에서는 해양경찰 기능을 충분히 회복하지 못했다. 정부는 국민안전에 중점을 두고 분산된 관련기관을 통합하면서 새로운 부서를신설했다. 이 과정에서 조직규모는 확대되어 가외성(加外性) 현상이 나타났고 그 기능은 지나치게 포괄적으로 통합되었다. 반면에 최근 해양경찰 기능에서 강조되는 분야는 조직개편에 적극적으로 반영되지 않았다. 이 사례는 조직개편 방법 중에서 해양경찰 기능을 재중앙집권화 하기위해 독립적외청에서 정부 내의 부처로 내부화(incorporating)시킨 전형적 속성을 보여준다. 그러나 만약 조직개편의 궁극적인 목적이 국민에 대한 서비스의 질을 향상시키는데 있다면 앞으로 조직개혁을 더 효율적으로 촉진하기 위해 새로운 접근을 시도하는 것이중요하다.

In the historical institutionalism view, as a type of the new institutionalism, the tragic Sewol ferry disaster is a great example of a shocking social issue influencing on evolutionary process of the Korea Coast Guard(KCG). The KCG newly organized its departments in order to overcome the crisis due to a chance event by government. and during evolution, the government selected a break, not the stable continuity. But In a relatively short period, The government reorganized the KCG to avoid crucial moment and confusion. As a result, The government has not strengthened self-reinforcement of the KCG. Rather, the KCG was taken this reorganization as political opportunity to get over difficulties, or was using it as a way to dodge criticism. The purpose of this study is to compare the features of structural and functional reorganization in the KCG, in particular before and after the 2014 Sewol ferry disaster was a crucial turning point. Despite having static aspect, this study method need to search for rational reform and path dependence of the system. A review on analysis and its policy implications is as follows. First, Based on the factors related to organizational structure, the KCG in 2013 and 2016 are closer to more formal model. Second, system of the KCG after the reform of 2014 had never fully recovered from the KCG functions than before. Government created new departments to consolidate many distributed agencies relates to public safety. Within this process, this massive reorganization was characterized by redundancy, and its functionality were consolidated too inclusive. On the other hand, significant area of the Coast Guard interest was not reflected aggressively in the reorganization of the KCG. Among the many methods for reorganization, this case connotes an typical attribute that was changed from external agency to incorporating in recentralization of the KCG. But most important of all, if the ultimate purpose improve the quality of services for the people, government should try again a new approach to promote a more effective organizational reform.

본 연구는 경증 뇌졸중 환자를 대상으로 KEPAD 손기능 작업표본검사와 뇌졸중 상지기능 평가(Manual Function Test : MFT)의 상관성을 알아보고, 경증 뇌졸중 환자의 손기능을 평가하는데 KEPAD 검사가 효용성이 있는지 보고자 하였다. 브런스트롬 손의 회복단계(Brunnstrom recovery stage)가 5단계 이상인 경증 뇌졸중 환자 62명을 대상으로 KEPAD 손기능 작업표본검사와 뇌졸중 상지기능평가(MFT)를 실시한 결과, 경증 뇌졸중 환자 전체 및 환측의 브런스트롬 손의 회복단계별 KEPAD 손기능 작업표본검사와 뇌졸중 상지기능검사(MFT)는 모든 영역에서 상관성을 나타내었다. 또한 경증 뇌졸중 환자 전체 및 환측의 브런스트롬 손의 회복단계별 KEPAD 손기능 작업표본검사의 하위 영역 간(대, 중, 소, 양손) 상관관계에서 높은 상관성을 보였다. 본 연구 결과는 KEPAD 손기능 작업표본검사가 뇌병변장애 중 하나인 뇌졸중 환자의 손기능을 평가하는데 유용하며, 이를 통해 환자의 초기 직업재활 계획을 세우는데 도움이 될 수 있음을 시사하고 있다.

This study was designed to find out the effectiveness of KEPAD test on hand function assessment for mild Cerebrovascular Accident patients, by looking into the correlation between MFT and KEPAD hand function work sample test. When MFT and KEPAD hand function work sample test were conducted on 62 patients from Cerebrovascular Accident, who were taking hospital treatment for Cerebrovascular Accident and came under Stage 5 or higher of Brunnstrom recovery stage, significant correlation was shown in all areas of MFT and KEPAD hand function work sample test. Moreover, for each of the Brunnstrom recovery stage, significantly high correlation was shown in all areas(large, middle, small, both) of KEPAD hand function work sample test. As seen from the results of this study, it is found that KEPAD hand function work sample test was useful in hand function assessment for mild Cerebrovascular Accident patients as well as in establishment of initial vocational rehabilitation for patients by estimating hand function.

본 연구의 목적은 병적 도박군에서 관리기능 결손이 있다는 가설을 검증하는 것이었다. 연구 참여자는 병적 도박자 32명과 일반인 20명이었다. 관련 선행 연구들의 제한점 중 하나는 병적 도박군과 통제군의 차이가 관리기능 때문인지 다른 인지기능 때문인지가 불분명한 연구 설계를 사용한 점이다. 이러한 제한점을 개선하고자 병적 도박군과 통제군을 관리기능 의존도가 높고 낮음에 따라 구성한 6개의 짝과제에서 종합적으로 비교하였다. 결과를 보면 6개의 짝과제 중 5개의 결과가 병적 도박군에서 관리기능 결손이 있음을 제시하였다. 예를 들어, Wechsler IQ-Executive IQ의 짝과제에서 병적 도박군과 통제군의 차이는 Wechsler IQ보다 Executive IQ에서 유의하게 더 심하였다. 이러한 결과는 관리기능 이외의 다른 인지기능의 결손으로는 설명하기 힘든 점에서 관리기능결손의 가설을 강력히 지지한다. 관리기능결손은 도박 중독 이전에도 존재하며 병적 도박에 빠지게 만드는 인지적 취약성 중의 하나인 것으로추정된다.

The goal of the current study was to test the hypothesis that pathological gamblers have executive function (EF) deficits. Participants included 32 pathological gamblers and 20 normal subjects. A common limitation in previous relevant studies was use of an experimental design that could not clearly distinguish EF deficits from other cognitive deficits. To overcome this limitation, the current study employed a paired-task method, in which one task strongly demanded executive function and the other task did not. Evidence from five out of six paired tasks indicated that the pathological gambling group had a greater deficit in the task that strongly demanded EF than the task that weakly demanded EF. For example, difference between the pathological gambling and control groups was significantly greater in Executive IQ compared to Wechsler IQ. This pattern of results, which are not easily attributable to deficits in cognitive functions other than EF, provides stronger evidence for the ‘executive dysfunction’ hypothesis for pathological gambling compared with that offered by previous related studies. EF deficits in pathological gamblers may exist even before they become involved in gambling and may likely be one of the cognitive factors that make them vulnerable to addiction to gambling.

본 연구의 목적은 아스퍼거 장애에서 관리기능(executive function)의 결손이 있다는 가설을 검증하는 것이었다. 대부분의 관련 선행 연구들은 관리기능과 다른 인지기능의 결손을 잘 구별할 수 없는 과제의 결손만을 검증한 제한점이 있었다. 본 연구는 이러한 제한점을 극복하기 위하여 관리기능 의존도가 높고 낮음에 따라 구성한 짝과제를 이용한 연구 설계를 도입하였다. 구체적으로 아스퍼거 아동 15명과 통제 아동 15명을 Wechsler IQ-Executive IQ, Verbal IQ-Performance IQ, 단순시행-간섭시행, 상식-단어유창성, 빠진곳찾기-도안유창성, 재인시행-회상시행의 6개 짝과제에서 비교하였다. 6개의 짝과제 중 5개에서 집단(아스퍼거, 통제)과 관리기능 의존도(낮음, 높음)의 상호작용이 유의하였다. 이 상호작용은 통제군에 비교한 아스퍼거군의 결손이 관리기능 의존도가 낮은 과제에 비해 높은 과제에서 보다 심함을 반영하였다. 이 결과는 선행 연구들의 관련 결과에 비해 아스퍼거 장애의 관리기능 가설을 보다 분명히 지지하는 증거라는 점에서 의의가 있다. 관리기능 의존도가 낮은 6과제들 중 5개에서 유의한 집단간 차이가 없었다. 이는 아스퍼거 장애에서 관리기능을 제외한 다른 인지기능은 거의 정상 수준임을 제시한다.

The goal of the present study was to test the hypothesis that Asperger disorder is associated with executive function (EF) deficits. A common limitation in prior related studies was an experimental design that could not clearly distinguish EF deficits from other cognitive deficits. To overcome this limitation, the present study employed a paired-task method, in which one task strongly demanded executive function and the other task did not. Fifteen Asperger disorder and fifteen control children were compared on six paired-tasks: Wechsler IQ-Executive IQ, Verbal IQ-Performance IQ, simple trial-interference trial, common sense-verbal fluency, picture completion-design fluency and recognition-recall. The results indicated a significant interaction between group (Asperger, control) and executive function (low, high) on all paired-tasks except recognition-recall. Each significant interaction reflected the fact that Asperger children had a greater deficit in the tasks that strongly demanded EF than the tasks that did not strongly demand EF. These results provide stronger evidence for the ‘executive dysfunction’ hypothesis than prior related studies have offered. Other findings indicated that cognitive functions other than executive function are normal in Asperger disorder.

본 연구의 목적은 ICD-10에 의해서 진단된 아동과 청소년 정신병리 집단간에 나타나는 다양한 실행능력(Executive Function)의 차이를 분석하는 것이었다. 11세에서 18세까지의 연구대상자는 총 49명으로 섭식장애, 신경증장애, 품행장애, 과잉행동장애, 정신분열병의 5개 진단군으로 분류됐다. 이들 집단을 비교하기 위해서 협의의 실행능력 정의에 따라 선택된 총 4개의 신경심리학적 검사가 사용되었다. 4개의 검사는 Wisconsin Card Sorting Test (WCST), Tower of Hanoi (TOH), Trail Making Test (TMT) 및 Continuous Performance Test (CPT)이다. 이 검사를 통해서 사고전환의 어려움, 목적과 미래지향적 의도행동, 인지적 융통성 그리고 수동적 회피가 측정되었다. 정신분열병 아동과 청소년은 사고전환의 어려움과 인지적 융통성에서 4개의 나머지 대조군과 유의한 차이를 보이면서 실행능력의 저하를 나타냈고, 과잉행동장애 아동과 청소년은 행동억제를 반영하는 수동적 회피가 대조군에 비해 낮은 것으로 나타났다. 섭식장애 아동과 청소년은 사고전환의 어려움에서 정신분열병 진단군 다음으로 나머지 진단군과 구별되는 실행능력의 저하를 나타냈으나 이 차이는 통계적 유의수준에 달하지는 못했다. 이 연구결과는 아동과 청소년 정신병리 집단들 간에 실행능력의 질적 차이가 존재함을 보여준다. 5개 진단군에서 얻은 연구결과가 기존의 연구결과들과 비교되며 논의되었다.

The present study aimed to examine the different deficits of executive functions in children and adolescents with a diverse range of diagnoses of ICD-10. The subject(n= 49) aged 11 to 18 years belonged to 5 diagnosis groups which were as follows: eating disorder (ED), neurotic disorder, conduct disorder (CD), hyperkinetic disorder (HKD), and schizophrenia. The subjects were compared on a neuropsychiatric test battery consisted of the following 4 executive function tasks according to the narrow definition of EF: WCST perseverative error, TOH move, TMT Part B, and CPT nogo. The 5 diagnostic groups were distinguished significantly on the variables, perseveration(set-shifting), cognitive flexibility, passive avoidance (inhibition), but they didn't be on behavior planning. The schizophrenic patients performed significantly worse than 4 other psychiatric groups on the perseveration(set-shifting) and cognitive flexibility. The patients with HKD showed the significant worse performance than the rest 4 groups in regards to passive avoidance (inhibition). The patients with ED presented with a perseveration(set-shifting) more deficit than the rest groups without schizophrenia, but it did not reach statistical significance. These findings suggest that the specificity of EF for specific diagnosis groups exists, i. e. there are quality differences of EF between diagnosis groups.

본 연구의 목적은 관리기능(executive function)이 다른 인지기능보다 빨리 노화한다는 가설을 검증하는 것이었다. 이를 위해 연령이 16-69세인 736명의 건강한 일반인에게 관리기능 의존도의 강약에 따라 구성한 세 개의 짝과제를 실시하였다. 세 짝과제는 스트룹간섭시행과 단순시행, 단어유창성과 상식, 도안유창성과 빠진곳찾기였다. 분석으로는 연령이 독립변인이고 교육년수와 성별이 공변인인 반복측정 공변량분석을 짝과제별로 시행하였다. 결과를 보면, 세 짝과제 모두에서 짝과제와 연령 간의 상호작용이 통계적으로 유의하였다. 이 상호작용은 연령에 따른 저하가 관리기능 의존도가 높은 과제에서 더 빠름을 나타내었다. 그러므로 스트룹단순시행보다는 간섭시행, 상식보다는 단어유창성, 빠진곳찾기보다는 도안유창성에서 연령에 따른 저하가 더 빨랐다. 오류반응을 보면 스트룹검사의 간섭오류, 단어유창성의 반복반응, 도안유창성의 반복반응이 연령에 따라 유의하게 증가하였다. 이 결과들은 관리기능이 차별적으로 빨리 노화한다는 가설을 지지한다. 선행 연구들은 관리기능의 성숙이 다른 인지기능에 비해 늦은 연령까지 계속됨을 보고하였다. 이런 보고와 본 연구의 결과를 종합하면, “Last in, first out”, 즉 가장 늦게 성숙한 인지기능이 가장 먼저 쇠퇴한다고 결론할 수 있다.

This study is conducted to verify the hypothesis stating the executive function of a human brain loses its efficiency relatively faster than other cognitive functions in accordance with the body age. In this analysis, 736 healthy participants between age 16 to 69 were recruited and three paired tasks were performed depending the subjects' independency level of their executive functions. The three paired tasks were Stroop Interference Trial vs. Stroop Simple Trial, Verbal Fluency vs. Information, and Design Fluency vs. Picture Completion. The data for each paired task were subject to analysis of covariance in which “age” was the independent variable and “years of education” and “gender” were two covariants. The result shows that there is a statistically significant relationship between the paired tasks and the age of participants. In this interaction, the decreasing rate of participant age-considered performance is greater in the tasks demanding a higher level of executive function. Thus, the age-related performance decline was faster in Stroop Interference Trial relative to Stroop Simple Trial, Verbal Fluency relative to Information, and Design Fluency relative to Picture Completion. In terms of erroneous responses, it showed age-related increases in errors on Stroop Interference Trial and perseverative responses in Verbal and Design Fluency. These results are consistent with the executive decline hypothesis of cognitive aging. The previous studies have provided the evidence that the executive function matures more slowly than nonexecutive cognitive functions. Considering this evidence, this study results lead to a conclusion that the cognitive functions that mature slowly are also age faster, or more succinctly expressed, it is a “Last in, first out”.

본 연구는 초등학교 고학년 아동이 자기-보고식으로 평정할 수 있는 아동용 실행 기능 결함 질문지를 개발하고 신뢰도와 타당도를 검증하는 것을 목적으로 수행되었다. 연구 1에서는, 기존의 관련 척도 및 이론적 내용에 근거하여 아동용 실행 기능 결함 질문지의 기초 예비 문항을 제작하고, 내용 타당도와 안면 타당도의 확인을 거쳐서 최종 예비 문항을 선정하였다. 이후 서울 및 경기 지역의 4개 초등학교에 재학 중인 4～6학년 아동 1022명을 대상으로 예비 문항 질문지를 실시했으며, 이 중 931명의 자료로 탐색적 및 확인적 요인분석을 시행하여 최종 문항을 선정하고 문항 구조의 타당도를 검증하였다. 연구 2에서는 이러한 과정을 거쳐 개발된 질문지의 신뢰도를 확인하였으며, 공존 타당도를 검증하기 위해 기존 관련 검사들과의 상관 분석을 실시하였다. 이러한 타당도 검증을 위해, 아동용 자기-보고 질문지인 ‘자기 조절 능력 척도, Barratt 충동성 척도-Ⅱ, ADHD 아동용 자기 보고 척도’ 및 실행 기능 관련 개별 신경 심리 검사인 ‘하노이 탑 검사, 스트룹 아동 색상-단어 검사, 아동 색-선로 검사, 숫자 따라하기’를 실시하였다. 연구 2의 대상은 서울 소재 초등학교에 재학 중인 4～6학년 아동 159명으로 하였다. 연구 결과, 본 질문지는 두 개의 상위 요인과 각 두 개의 하위 요인으로 나누어진 총 29문항으로 구성되었으며, 이를 통해 아동의 실행 기능 결함을 신뢰롭고 타당하게 평가할 수 있음이 시사되었다.

The purpose of this study was to develop a Children's Executive Function Deficits Inventory(CEFDI), and examine its reliability and validity. In the first part of the study, the factors of CEFDI were categorized based on a review of both the literature and a number of existing inventories, and then CEFDI was developed through content and face validity. The CEFDI was then conducted for 1022 students in fourth, fifth, and sixth grades at four elementary schools in Seoul and Gyeonggi-do, Republic of Korea, the inventories of 931 of these children were subsequently analyzed. The item validity of CEFDI was proved by exploratory and confirmatory factor analyses. In the second part of the study, the internal consistency reliability and concurrent validity were analyzed. In order to verify convergent validity, self-report scales, such as ‘Self Regulation Scale, Barratt Impulsiveness Scale Ⅱ, and ADHD Children's Scale’, and neuropsychological tests, such as ‘Tower of Hanoi Test, Stroop Color and Word Test, Children's Color Trails Test, and Digit Span’, were executed. Subjects for the second part of the study included 159 students in fourth, fifth, and sixth grades in elementary school in Seoul. The CEFDI consisted of 29 questions and was confirmed to be a reliable and valid assessment tool to measure executive function deficits in children.

목적 : 본 연구는 연하장애 환자를 대상으로 구강안면기능을 평가할 수 있는 포괄적 구강안면기능척도(Comprehensive Oro-Facial Function Scale; COFFS)를 개발하고자 실시되었다. 연구방법 : COFFS의 문항 구성과 신뢰도를 검증하는 연구로 4개의 선행 연구를 선택 분석하여 예비문항을수집하였고, 전문가를 대상으로 2차의 설문조사를 통해 내용타당도(Content Validity Ratio; CVR)를도출하였다. 평가 항목의 내적 타당도를 위해 Cronbach’s α값을 산출하였으며, 급간 내 상관계수(Internal Classification Coefficients; ICC)를 이용하여 검사-재검사 신뢰도 및 검사자간 신뢰도를 구하였다. 결과 : 전체 문항의 내용타당도는 0.67로 나타났으며, 영역별 Cronbach’s α값의 경우 의사소통 영역 0.849, 구강안면 구조 및 형태 –0.224, 구강안면 움직임 수행능력 0.831, 저작 및 삼킴 기능은 0.946으로 도출되었으며, 검사-재검사 신뢰도는 0.974, 검사자간 신뢰도는 0.937로 높은 신뢰도를 보였다. 결론 : 본 연구에서 COFFS의 평가도구는 4개의 영역에서 34개의 문항을 최종적으로 선정하였고, 평가항목에 따라 3~5점 척도로 개발되었다. 추후 연구에서는 구강안면기능을 측정하는 다른 평가도구와의 상관관계를 통해 타당도를 입증할 추가연구가 필요할 것으로 사료된다.

Objective : This study aimed to develop a Comprehensive Oro-Facial Function Scale (COFFS) that can evaluate oro-facial function in patients with dysphagia. Methods : To verify the item composition and reliability of the COFFS, preliminary items were collected by selecting and analyzing four previous studies, and the Content Validity Ratio (CVR) was derived through a second survey of experts. Cronbach’s α was calculated for the internal validity of the evaluation items, and the test-retest reliability and inter-rater reliability were calculated using the internal classification coefficients (ICC). Results : The content validity ratio of all items was 0.67; in the case of Cronbach’s α value for each domain, 0.849 for communication domain, ?0.224 for the oro-facial structure and shape, 0.831 for the ability to perform orofacial movements, and 0.946 for mastication and swallowing function. The test-retest reliability was 0.974 and the inter-rater reliability was 0.937, showing high reliability. Conclusion : In this study, the evaluation tool of COFFS was finally selected from 34 items in four areas and developed on a 3-5 point scale according to the evaluation items. In future studies, additional research is needed to prove its validity through correlation with other evaluation tools that measure oro-facial function.

울프운동기능검사(Wolf Motor Function Test)는 상지와 손 기능 검사를 위해 개발된 평가 도구로 국내에서 타당도와 신뢰도의 검증이 이루어진 도구이다. 본 연구는 울프운동기능검사의 비장애인 표준치를 수집하여 연령별, 성별, 각 항목간의 상지와 손의 기능을 객관적으로 비교할 수 있는 자료를 마련하는데 그 목적이 있다. 2010년 3월부터 2010년 5월까지 상지 및 손 기능에 장애를 초래하는 질병이 없으며, 신체 기능 중 상지 및 손의 해부학적 구조, 가동성, 근력, 감각 및 조절 능력에 이상이 없는 비장애 성인 200명을 대상으로 울프운동기능 검사를 시행하였다. 수집된 자료는 SPSS 12.0을 이용하여 통계처리 하였으며, 우세손과 비우세손, 성별에 따른 평균 수행시간을 산출하고, Pearson 적률 상관 계수를 활용하여 우세손과 비우세손 및 연령과의 항목별 상관관계를 알아보았다. 한글판 울프운동기능검사의 비장애인 표준치를 수집한 결과 우세손, 비우세손 모두에서 연령과 수행시간과의 높은 상관관계를 보였으며, 총 수행시간 및 개별 항목의 수행시간에서 성별에 따른 수행시간의 차이는 없었다. 또한 남성의 경우 연령이 증가할수록 우세손과 비우세손 모두에서 장악력이 감소하는 것을 알 수 있었다. 본 연구를 통해 울프운동기능검사의 비장애인 표준치를 알아보았으며, 향후 상지와 손 기능 장애를 가진 장애인들의 수행 수준 비교에 유용하게 사용될 수 있을 것이다.

The Purpose of this study is to provide normative data which is able to compare objectively by age, sex and subitem of wolf motor function test in non-disabled korean adult. Data were obtained from 200 adult who have no disability in upper extremity and hand function result from disease and no deficit of anatomical structure, range of motion, strength, sensation and coordination in upper extremity and hand function from Mar, 2010 to May, 2010. To statistical analysis of collected data was used SPSS 12.0 program. Mean scores were calculated according to sex, dominant hand and nondominant hand. Pearson product moment correlation coefficients was also used to investigate interrelation of dominant hand, non-dominant hand and age. The results of collected normative data in non-disabled korean adult showed significant correlation in both dominant hand and non-dominant hand and no difference by age. These finding suggest that normative data of wolf motor function test will be able to make good use to compare performance level in people with disability of upper extremity and hand function.

목적 : 본 연구의 목적은 종합 신경인지기능 평가인 Comprehensive Neurocognitive Function Test(CNFT)의 표준화 자료를 얻고 신뢰도와 공인타당도를 검증하기 위함이다. 연구방법 : CNFT는 기억력, 집중력, 감각,운동협응, 전두엽 및 고위인지기능을 평가하는 것으로 결과는 전산화되어일관성 있고 자동으로 처리된다. 연구대상은 표준화 자료를 얻고 신뢰도를 검증하기 위한 조사에서 20대부터 80 대 이상까지 서울특별시와 대구시에 거주하는 정상 성인 140명이 참여하였다. Computerized Neurocognitive Function Test(CNT)와의 상관관계를 통하여 타당도를 검증하기 위한 조사에는 정상 성인 40명이 참여하였다. 결과 : 정확도는 연령이 증가할수록 낮아지며, 반응속도는 늦어졌다. 또한 영역별 점수 분석결과 기억력, 전두엽 및고위인지기능 점수가 낮은 편으로 나타났다. 2주 간격의 검사-재검사 신뢰도는 r=.48~.85로 나타났고 두 검사사이의 유의한 차이는 없었다(p>.05). CNT와의 세부 영역과의 상관계수는 r=.67~.79이다(p<.05). 결론 : 종합 신경인지기능 평가인 CNFT의 표준자료와 해석기준이 마련되었다. CNFT는 인지기능에 문제를 평가할수 있는 신뢰도와 타당도를 갖춘 평가도구이다.

Objective : The purpose of this study was to investigate the reliability and concurrent validity of the computerized cognitive function test system (called CNFT) for evaluating the cognitive function and to provide its normative data. Methods : For this purpose, 140 normal adults participated in a investigation to provide the normative data of CNFT. 40 normal adults participated in an evaluating experiment to verify the reliability and validity. CNFT consists of attention, memory, sensori-motor coordination, and frontal lobe & higher cognitive function domains. Because CNFT is a computerized evaluation tool, all results and operations are processed consistently and automatically. Results : In the results, as the age of subjects increased, the average accuracy decreased and response time increased. Additionally, memory and frontal lobe & higher cognitive function was lower than other domains. Test-retest reliability of 2 weeks interval was highly correlated (r=.48~.85) and there is no significant difference between test and retest scores. CNFT was highly correlated with computerized neurocognitive function test (r=.67~.79; p<.05). Conclusion : Normative data of CNFT were obtained, and the guidelines for the interpretation were provided. A reliable and valid clinically applicable computerized cognitive function test was developed.

목적 : 본 연구는 국내 65세 이상 노인의 웰빙 수준을 측정하기 위하여 웰빙 수준에 대한 사회적 생산 기능 도구(Social Production Function Instrument for the Level of well being; SPF-IL)를 한국어로 번역하고 신뢰성과 타당성을 검증하는 것을 목적으로 하였다. 연구방법 : 본 연구 대상자는 온라인 설문조사로 모집한 65세 이상의 국내 노인이었으며, 척도의 타당성을 검증하기 위하여 내용타당도와 구성타당도를 평가하였다. 척도의 신뢰도를 검증하기 위하여 내적 일관성 검증과 검사-재검사 신뢰도를 평가하였다. 결과 : 총 350명의 대상자가 설문을 완료하였다. 내용타당도는 작업치료학과 교수 및 연구자들에 의하여 평가되었으며, 내용타당성 평가 과정에서 삭제된 문항은 없었다. 확인적 요인분석 결과 적절한 모형 적합도(X2 = 91.164 (p = .002), df = 55, RMSEA = .43, CFI = .977, TLI = .967, SRMR = .039)를 보였다. Cronbach’s alpha 값은 .62~.88로, 원본 평가도구와 다른 언어로 번안된 같은 척도와 함께 비교하였을 때 양호한 내적 일관성을 나타내었다. 검사-재검사 신뢰도 검증에서 초기검사와 재검사 사이의 유의미한 차이가 없는 것이 확인되었다. 결론 : 한국판 SPF-IL 척도는 국내 노인의 웰빙 수준을 평가하는데 있어 한국 인구에 대한 신뢰성과 타당 성을 확보하였다.

Objective : This study translated the Social Productive Functioning Instrument for the Elderly(SPF-IL) into Korean, and evaluated its reliability and validity for assessing the well-being of older adults aged 65 years and above in South Korea. Methods : The participants included Korean older adults aged 65 years and above, who were recruited through an online survey. The validity of the scale was assessed using content and construct validity. Reliability was determined by evaluating the internal consistency and test-retest reliability. Results : A total of 350 participants completed the survey. Content validity was evaluated by professors and researchers of occupational therapy, and no items were removed during the assessment process. The confirmatory factor analysis demonstrated an adequate model fit. Cronbach’s alpha values ranged from .62 to .88, indicating good internal consistency when compared to the original and other translated versions of the scale. The test-retest reliability analysis confirmed no significant differences between the initial and retest scores. Conclusion : The Korean version of the SPF-IL scale demonstrated reliability and validity in assessing the well-being of older adults in the Korean population. This makes it a suitable tool for future research and practice.

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Objective: To identify the relationship between dysphagia, dietary level, and pulmonary function in post-stroke patients.Methods: Thirty-six post-stroke patients with dysphagia, who were hospitalized from June 2017 to October 2017 in the Department of Rehabilitation Medicine at a tertiary hospital, were analyzed retrospectively. The video-fluoroscopic swallowing study (VFSS) and videofluoroscopic dysphagia scale (VDS) were used to assess dysphagia. The vital capacity (VC) and peak cough flow (PCF) were used to assess the pulmonary function. Upon admission, the patients were divided into three groups according to their dietary level (tube feeding, dysphagia diet, and general diet). The correlation between dysphagia and pulmonary function was analyzed using an independent t-test test with the optimal points, and the relationship between the diet level and pulmonary function was evaluated using a one-way analysis of the variance.Results: Significant correlations between the pulmonary function and sub-items of VDS were found in “oral transit time” with VC, “vallecullar residue” and “aspiration” with PCF, and “triggering of pharyngeal swallow”, “VDS total score” with VC and PCF. The dietary levels upon admission had a significant correlation with VC and PCF. The VC among groups divided according to three diet levels showed statistically significant differences. Conclusion: This study revealed the relationship between the pulmonary function and dysphagia in post-stroke patients. Moreover, the pulmonary function correlated with dietary level, even though it was not confirmed that it affected dietary levels. The clinical importance of the pulmonary function in post-stroke patients with dysphagia should be emphasized. In addition, a large-scale study is needed to determine the correlation between the pulmonary function and swallowing difficulty.

Objective To analyze the respiratory function of high cervical cord injury according to ventilator dependence and to examine the correlations between diaphragm movement found on fluoroscopy and sensory and motor functions.Methods A total of 67 patients with high cervical spinal cord injury (SCI), admitted to our hospital were enrolled in the study. One rehabilitation physician performed sensory and motor examinations on all patients while each patient was in the supine position on the American Spinal Injury Association (ASIA) standard. In addition, fluoroscopic diaphragm movement studies and bedside spirometry were performed.Results Bedside spirometry and diaphragm fluoroscopic tests were analyzed according to ventilator dependence. Forced vital capacity and maximal inspiratory pressure were significantly higher in the ventilator weaned group. Natural breathing during the fluoroscopic diaphragm examinations and ventilator weaning showed statistical significance with the movement on the right, while deep breathing showed statistical significance with the movement on both sides. Deep breathing movement has correlation with the C5 key muscle. Diaphragm movement has correlation with right C3 and bilateral C4 sensory functions.Conclusion The present expansion study showed that, through simple bedside physical examinations, rehabilitation physicians could relatively easily predict diaphragm movement and respiratory function recovery, which showed significance with ventilator weaning in patients with high cervical SCI.

This study was designed to get normative data of normal subjects by MFT(Manua1 Func-tion Test). The subjects were 95 normal adults. The results are as follows: 1. Mean scores of left and right MFS(Manua1 Function Score) were respectively 97.43 and 98.13. 2. MFS was higher on right upper extremity function than on left upper extremity function. 3. MFS was not significantly different between male and female. 4. Both left and right MFS (Manual Function Score) was significantly negative correlation with age.

Objective To investigate the non-speech mechanism function in relation with functional status and find out the relationship between nutritional status and non-speech mechanism function in children with cerebral palsy (CP). Method Eighty four children with CP were participated in this study. Non-speech mechanism function was investigated with a simple scale of oral motor status (OMS) and a feeding-swallowing evaluaton protocol for children (FEP-C). Higher score represents more severe in dysfunction in both tests. As well, Gross motor function classification system (GMFCS), the nutritional status based on body mass index were assessed in these subjects. GMFCS level I to III were grouped into high functioning group while GMFCS level IV and V were grouped into low functioning group. Results Fifty seven (67.9%) individuals with CP showed dysphagia symptoms (OMS sore ≥1). The mean scores of non-speech mechanism function in low functioning group were higher than in high functioning group (p＜ 0.05). The mean scores of both OMS and FEP-C were higher in individuals with underweight (p＜0.05). Compared to high functioning individuals with CP, underweight was more prevalent along with higher scores in oral motor function in low functioning group. OMS scores were significantly correlated with the mean scores of non-speech mechanism in all subareas (p＜0.05). Conclusion Non-speech mechanism function was closely related with GMFCS level. As well, this study revealed that the oromotor function and nutritional status in these individuals with CP related with non-speech mechanism function

Objective To identify the potential predictors of ambulatory function in subacute stroke patients, and to determine the contributing factors according to gait severity. Methods Fifty-three subacute stroke patents were enrolled. Ambulatory function was assessed by gait speed and endurance. Balance function was evaluated by the Berg Balance Scale score (BBS) and the Timed Up and Go test (TUG). The isometric muscular strengths of bilateral knee extensors and flexors were measured using an isokinetic dynamometer. Cardiovascular fitness was evaluated using an expired gas analyzer. Participants were assigned into the household ambulator group (<0.4 m/s) or the community ambulator group (≥0.4 m/s) based on gait severity.Results In the linear regression analyses of all patients, paretic knee isometric extensor strength (p=0.007) and BBS (p<0.001) were independent predictors of gait endurance (R2=0.668). TUG (p<0.001) and BBS (p=0.037) were independent predictors of gait speed (R2=0.671). Paretic isometric extensor strength was a predictor of gait endurance (R2=0.340, p=0.008). TUG was a predictor of gait speed (R2=0.404, p<0.001) in the household ambulator group, whereas BBS was a predictive factor of gait endurance (R2=0.598, p= 0.008) and speed (R2=0.713, p=0.006). TUG was a predictor of gait speed (R2=0.713, p=0.004) in the community ambulator group.Conclusion Our results reveal that balance function and knee extensor isometric strength were strong predictors of ambulatory function in subacute stroke patients. However, they work differently according to gait severity. Therefore, a comprehensive functional assessment and a different therapeutic approach should be provided depending on gait severity in subacute stroke patients.

Objective: To determine whether adding extracorporeal shockwave therapy (ESWT) to conventional treatment enhances pain, function, and electrophysiological functionality in females with carpal tunnel syndrome (CTS).Methods: One hundred females (25?40 years) diagnosed with CTS were randomly allocated to a control group that received conventional therapy and an experimental group that received the same program augmented with ESWT. Outcome measures included the symptom severity scale (SSS), function severity scale (FSS), pain intensity assessed using the visual analog scale (VAS). In addition, distal sensory latency/distal motor latency (DSL/DML), and sensory nerve conduction velocity/motor nerve conduction velocity (SNCV/MNCV) were measured using a nerve conduction velocity study.Results: The experimental group exhibited significantly greater improvements in SSS, VAS, DSL, DML, SNCV, compared to controls (all p≤0.05). However, changes in MNCV and FSS were non-significant (p>0.05).Conclusion: Integrating ESWT into rehabilitation enhances function, pain, and electrophysiological recovery in females with CTS.

The Maa pee＾+Low-tone construction corresponds to a wide array of adverbial and complement clause notions, including temporal, conditional, purpose, result, motivation, utterance complements, and subjunctive mood. The pattern of senses found in discourse argues that the construction actually codes only that the dependent clause proposition is "temporally related" (in an extended sense) to its matrix proposition. Comprehenders must interpret more specific relations based on stored knowledge and textually-overt lexical items.