Earticle

The purpose of this study was to describe the intervention strategy using hypothesis testing applied International Classification of Functioning, Disability and Health (ICF) Tool about sit-to-standing of patient with stroke. The data was collected by patient with stroke. The patient was a 49-year-old male diagnosed with left hemiplegia with hemorrhage. I applied the intervention strategy applied ICF Tool to patient with stroke. Parameters of result were collected for self-confidence, sit-to-standing ability and balance ability using Sit-to-stand test and timed up and go test (TUG), Berg balance scale (BBS), Tetrax, respectively. Clinical benefits were observed the patient with stroke for self-confidence, sit-to-standing ability and balance ability. The patient with stroke improved sit-to-standing ability and balance ability. Patient reported improved sit-to-standing ability and balance ability after intervention.

목적 : 본 연구에서는 참여 향상을 위한 중재를 방법과 내용을 분석하여 작업치료 임상현장에 적용할 수 있는 근거를 정립하는 것을 목적으로 실시하였다. 연구방법 : 전자 데이터 베이스인 Scopus, Pubmed와 Google scholar를 사용하여 2005년부터 2015년까지의 논문을 검색하였다. 주요검색 용어로 “Participation AND Occupation therapy AND Intervention”을 사용하였다. 2차 분류를 통하여 최종적으로 12개의 연구를 분석대상으로 선정하였다. 결과 : 결과는 연구의 질적 수준 및 동향, 중재 방법의 종류, 중재가 적용된 환경, 중재의 대상 클라이언트, 참여 평가도구, 동시에 측정된 종속변인을 중심으로 정리하였다. 연구의 질적 수준과 논문의 편수는 증가하고 있는 양상이며, 중재는 만성질환 환자를 중심으로 지역사회 내에서의 자기관리 프로그램을 가장 많이 시행하였다. 평가도구는 연구자의 연구 의도에 따라 다양하게 사용하는 양상을 보였으며, 연구자들은 ‘삶의 질’을 참여와 동시에 가장 많이 측정하였다. 결론 : 이번 연구를 통하여 참여 향상을 위한 작업치료 서비스에 대하여 이해하고 그 현황을 종합적으로 알아봄으로써 임상적 근거를 제공하고자 하였다. 추후에는 본 연구 결과를 바탕으로 참여 증진을 위한 작업치료 서비스에 대한 연구가 더욱 활발하게 이루어져야 할 것이다.

Objective: The purpose of this study was to examine the trend of interventions improving participation of occupational therapies’ clients and to provide evidence and implications regarding occupational therapy practice for client participation. Methods: For the main keywords of a database search, “Participation AND Occupational therapy AND Intervention” were used. Using Scopus, PubMed, and Google Scholar, we systematically examined papers published in journals from January 2005 to April 2015. A total of 12 studies were included in the analysis. Results: The results revealed the level of quality and trend of each study, the types of intervention, the environments provided during the intervention, the diseases of the participants, the applied tools, and dependent variables measured through participation. The quality and quantity of the studies were shown to be improving. In addition, the interventions were mostly provided for chronic conditions in the form of a self-management program in a community setting. The tools were used by the researchers following their research intention. Quality of Life (QoL) through participation was the most frequently measured condition. Conclusion: Through this systematic review, we were able to determine and understand the trends in occupational therapy service for improving participation. In the future, based on this study, research on intervention for improving participation may be further developed.

목적 : 본 연구는 척수손상 환자를 대상으로 RPS Form을 적용하여 작업치료에서의 임상적 평가의 효용성을 알아보고, 적용 사례를 단계적으로 설명하여 실제 사용 방안을 제시하고자 하였다. 연구방법 : 31세의 척수손상 남성 환자를 대상으로 RPS Form을 적용한 평가와 중재를 제공하였다. 또한 임상전문 가 6인과 RPS Form의 효용적 측면에 대하여 논의하였다. 결과 : RPS Form은 척수손상 환자의 신체구조 및 기능, 활동 및 참여 이외의 환경적 요소까지 효율적으로 평가할수 있었고, 논리적인 결정을 내릴 수 있어 임상에서 적용하기 유용하였다. 환자의 중재에 대한 반응, 또한 긍정적이었다. 결론 : RPS Form은 건강에 대한 ICF의 재활관리 서비스를 한 장의 평가지로 시각화하여 사용이 간편하고, 그 내용 이 분명하여 임상적 추론을 주도하기에 용이하였다. 또한 타 재활 전문영역과의 원활한 팀 접근과 함께 근거기반의 작업치료를 제공할 수 있었다. 따라서 RPS Form의 폭넓은 적용을 위해서는 임상의 각 질환별 특징을 반영한 ICF Core sets의 첨부가 필요할 것으로 사료된다.

Objective : This study was performed to verify the comprehensive perspective based on the ICF-model and logical clinical thinking of Rehabilitation Problem Solving(RPS) Form. Methods : The patient was a 31-year-old man who injured spinal cord. A plan of care was to address impairment, activity limitation and participation restrictions by using RPS Form. And we discussed about clinical utilities of RPS Form with 6 clinical experts. Results : After the intervention, subject participated in computer lecture more often and for longer duration. And he expressed positive attitude about intervention. Experts mentioned agreeable opinion about using RPS Form in clinic. Conclusions : RPS provides a visual simpleness and clearness and it also guides logical thinking in clinical practice. Therefore RPS Form can be used to enhance multidisciplinary patient management and assists in clarifying clinical roles as part of a multidisciplinary team. The case report demonstrates that the RPS Form can be a viable strategy for occupational therapy.

목적 : 본 연구의 목적은 ICF(International Classification of Functioning, Disability and Health)의 능력(capacity)과 수행(performance) 평가치의 신뢰도와 FIM(Functional Independence Measure)과 MBI(Modified Barthel Index)와의 기준관련타당도를 알아보고자 하였다. 연구 방법 : 국립재활원에 입원한 아급성기 뇌졸중 환자 55명을 대상으로 실시하였다. ICF에 경험이 있는 2명의 의사가 FIM과 MBI에 해당하는 항목을 ICF 항목과 연결시켜 10개 항목 중 3개의 범주인 이동, 보행, 자기 관리 항목을 추출하였으며, 모든 평가는 물리치료사, 작업치료사에 의해 수행되었다. ICF의 수행과 능력 평가치의 측정자간 신뢰도(Inter-rater reliability)는 급간내상관계수인 ICC(2.1)을 절대적 신뢰도는 SEM(Standard Error Measurement)과 SRD(Small Reference Difference)를 FIM과 MBI, ICF와의 상관관계는 Pearson 상관계수를 이용하여 분석하였다. 결과 : ICF 능력과 수행 평가치의 측정자간 신뢰도는 각각 .92(.95, .97), .98(.97, .99), SEM은 1.03, 1.09이었으며, SRD는 2.85, 3.02로 매우 높은 신뢰도를 보였다. ICF 능력 평가치는 FIM(r=-.97), MBI(r=-.90)와 높은 음의 상관관계가 있었고, ICF 수행 평가치는 FIM(r=-.73), MBI(r=-.69)와 중간 정도의 음의 상관관계가 있었다. 결론 : ICF는 FIM과 MBI의 기준 관련 타당도에서 음의 상관관계가 있었으며, 신뢰할만한 기능 평가 도구로서 뇌졸중 환자의 기능적 상태를 평가하는데 임상 연구나 실험에서 유용한 평가 도구가 될 수 있을 것이다.

Objective : This paper evaluates the clinical application of ICF(International Classification of Functioning,Disability and Health) through correlation among existing functional evaluation tools and examines ICF Inter-rater & absolute reliabilities. Methods : The subjects consisted of 55 sub-stroke patients from the Korea National Rehabilitation Center inSeoul. Two doctors with experience in the ICF code was extracted the 10 items. We linked the ICF codebetween corresponding entry in the FIM-subscale and MBI-total scale to the most appropriate ICFcategories(3 category: transfer, locomotion, self-care). The FIM(Functional Independent Measure),MBI(Modified Barthel Index), and ICF were examined and subjects were interviewed by trained physical &occupational therapist. To assess inter-rater reliability for capacity & performance, the ICF value wasmeasured using the ICC2.1. The absolute reliability was determined using the SEM(Standard Error ofMeasurement), SRD(Small Reference Difference), and the ICF, FIM, MBI were analyzed using a Pearsonproduct correlation. Results : Inter-rater reliability of ICF(Capacity & Performance) were very high(ICC2.1: .92, .98,respectively), also the absolute reliability were high(SEM: 1.03, 1.09, & SRD: 2.85, 3.02, respectively). TheICF capacity was highly negatively correlated between FIM(r=-.97) and MBI(r=-.90), the ICFPerformance was moderately negatively correlated between FIM(r=-.73) and MBI(r=-.69). Conclusion : The ICF tool is a reliable functional assessment tool that correlates inversely with FIM and MBI,showing its criteria-related validity. It can be a useful tool in the clinical setting and research for assessingfunctional status in stroke patients.

Purpose: The purpose was to link items of questionnaires that measure functioning and disability of persons with Low Back Pain (LBP) into the International Classification of Functioning, Disability and Health (ICF). Methods: The Oswestry Disability Index (ODI), Roland and Morris Disability Questionnaire (RM), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short Form-36 health survey (SF-36) were evaluated to map items of those questionnaires into the ICF categories. The linking rule was employed and linking was performed independently by 10 health professionals. One-hundred and two patients with LBP were recruited from 19 medical institutes to this study for a field test to examine relations between the scale and its linked ICF category set. Pearson correlation coefficient was used to analyze their relationships. Results: Walking was only found to be one-to-one linking between the scale and the ICF. Sixty questions in FABQ were to be linked to 9 of ICF categories. Ten and 14 ICF categories were able to be linked to RM and ODI respectively. It was found that majority of items from ODI and RM scale had similar concept and linked to the same ICF category. SF-36 had only 15 categories of the ICF linked. Strong relationship was observed between measurement scales and linked ICF code sets (r=0.79, r=0.65, r=0.47, and r=-0.31 for ODI, RM, FABQ and SF-36 respectively). Conclusion: It was found that commonly used clinical tools for LBP may be linked to ICF. The study results may suggest that clinical data can be standardized to communicate between related professionals.

Purpose: The aim of the study was to investigate items of commonly used questionnaires that measure functioning status of persons with stroke and map to the International Classification of Functioning, Disability and Health (ICF). Methods: Eighty-six patients with stroke were recruited from 12 medical institutes for the study. Each item of the Modified Bathel Index (MBI), Stroke Impact Scale (SIS), Mini Mental Status Evaluation (MMSE) and SF-36 were examined and compared its concept with the ICF. Concept linking was performed by 10 health professionals independently. A field test was performed to assess its correlation between those of scales and their linked ICF category sets. Results: It was found that 11 items in MBI was linked to 14 ICF categories, whereas 27 items of MMSE had 10 categories of ICF linked. 60 items of SIS were to be linked with 35 ICF categories. Agreement between professionals in linking was found to be high: 97.5% for MBI items, 78.0%, 78.0%, and 74.8% for MMSE, SIS, and SF-36 respectively. Strong relationship was observed between measurement scales and linked ICF code sets (r=-0.76 for SIS, r=-0.78 for MBI, r=-0.47 for MMSE) whereas there was no relationship was found between SF-36 and its ICF code set (r=-0.06) from the field test. Conclusion: It was found that items of SIS, MMSE and MBI may be linked to ICF categories. Those of linking concept between clinical tools and the ICF could be helpful for clinical data standardization.

PURPOSE: This study was conducted as a literature review to analyze the research trends related to the International Classification of Functioning, Disability and Health (ICF) in Korea from 2015 to 2020. METHODS: Precedent studies were searched with the search term "ICF" or "international classification of functioning, disability and health" from the databases of RISS, KISS, DBpia, and Pubmed. The inclusion criteria are that the studies have been carried out in Korea from 2015 to 2020 using ICF by researchers consisting of one or more Koreans and have been peer-reviewed. RESULTS: Of the total 269 studies, 107 that met the inclusion criteria were analyzed. It was found that these studies were published at a similar frequency each year. The most common area of expertise was identified as the clinical area (n = 67), followed by special education (n = 21) and social welfare (n = 13). The study subject groups were mostly patients (n = 39), disabled people (n = 25), and related experts (n = 13). The most common research topic was functioning evaluation (n = 49) and followed by a literature review (n = 29), and the most frequently used components in all the areas of expertise were activity and participation (n = 98), body function and structure (n = 73), and environmental factors (n = 61). CONCLUSION: For the past six years, domestic ICF-related research has been conducted in a wider range of expertise areas on more subdivised subject groups. Continuous research, development of standardized curricula and contents, and development of coding tools are considered to be important in vitalizing the use of the ICF.

Purpose: This study was to identify international classification of functioning, disability and health (ICF) categories that could be linked conceptually to disability of arm, shoulder and hand (DASH) items and short form of health survey 36 (SF-36) items for persons with shoulder pain. Methods: Linkage between each item in DASH and SF-36 and the categories in the ICF were assessed. The linking process was performed by ten health professionals following the linking rule. One hundred four patients with shoulder pain were enrolled from 12 private clinic outpatient departments and participated in this study. Pearson correlation coefficients were used to assess the relationships between each scale item and the linked ICF code. Results: Thirty DASH items were able to be linked to 30 ICF codes, whereas the 36 items in SF-36 were only linked to 17 ICF codes. General health items included in SF-36 could not be linked to a relevant ICF concept. There was a high correlation between the two measurement tools and the linked ICF codes, DASH and its ICF code list (r =0.91), SF-36-Physical Health and its code list (r =-0.62), and SF-36-Mental Health and its code list (r =-0.72). Conclusion: The results suggest that concepts within each item in DASH can be linked to ICF codes for patients with shoulder pain, however, the concepts in the SF-36 items had limited linkage to ICF codes. The shoulder-specific functional tool, DASH can be expressed with ICF codes and, therefore, its use can promote data standardization and improve communication between professionals.

Purpose: This study aimed to identify factors influencing subjective health status among individuals with spinal cord injury (SCI) usingthe International Classification of Functioning, Disability and Health (ICF) model. Methods: This study analyzed secondary data from the 2021 Survey on the Status and Needs of Individuals with SCI conducted by theKorea Spinal Cord Injury Association. A hierarchical multiple regression analysis was conducted in four steps. Independent variablesincluded sociodemographic factors, satisfaction with medical services (environmental factor), the need for weight control, the need fornutritional education, the need for dietary management, and disability acceptance (personal factors) along with exercise and activity ofdaily living (activity and participation factors). These factors were added sequentially at each step based on the ICF model. Results: A total of 513 participants were analyzed in this study, with an average subjective health status of 5.51±2.39. Higher satisfactionwith medical services (β=.27, p<.001), frequent exercise (β=.19, p=.008), and a greater level of activities of daily living (β=.02, p<.001)were significantly associated with improved subjective health status. Conversely, a lower need for nutritional education (β=-.25, p=.042)was negatively associated. Conclusion: This study highlighted satisfaction with medical services, nutrition education needs, exercise frequency, and activities ofdaily living as important factors. These findings provide insight into how the health status of individuals with SCI can be enhancedthrough targeted interventions and support from healthcare providers.

Background: The International Classification of Functioning, Disability, and Health-Child and Youth version (ICF-CY) is designed to record the characteristics of developing children and examine the influence of a child's environment on their health. Objects: This study was designed to determine the relationship between the clinically extracted ICF-CY items and The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Measure (GMFM) items. Methods: Thirty patients (17 males and 13 females) who were hospitalized in a pediatric and youth patient unit of a rehabilitation hospital were included in the study. Four health professionals (two physical therapists and two occupational therapists) working independently linked the PEDI and GMFM-66 items to the activity and participation domains of the ICF-CY. Results: There were strong negative correlations between the ICF-CY subdomains and the PEDI subdomains (r = 0.76-0.95; p < 0.05). There were positive strong correlations between the ICF-CY subdomains and the GMFM-66 (r = 0.76-0.95; p < 0.05). Conclusion: The extracted ICF codes were a valid tool for evaluating the mobility and selfcare conditions of cerebral palsy in the pediatric rehabilitation area.

목적 : 본 연구에서는 국제기능장애 건강분류: 아동 청소년 버전(International Classification of Functioning, Disability and Health-Children and Youth version, ICF-CY) 프레임워크를 활용하여 개별화교육계획(individualized education plan, IEP) 협력적 팀 중재에 대해 체계적으로 고찰하고자 한다. 이를 통해 국내에서 IEP 협력적 팀 중재 속 작업치료사의 전문적인 영역을 마련하는 데 근거를 만들고, 개별화교육 계획에서 협력적 팀 접근 중재의 목표를 통해 전문가로서 작업치료사의 역할에 대한 기반을 마련하고자 한다. 연구방법 : EBSCOhost, ProQuest, Web of Science를 통하여 2013년 1월부터 2023년 2월까지의 국외 논문을 검색하였다. 국외 검색어에는 “Special education”, “Individualized education plan (IEP)”, “IEP process”, “IEP implementation”, “Occupational therapy”를 사용하였다. 2차 분류를 통해 최종 10편의 연구를 분석하였다. 결과 : 분석 대상 연구의 근거 수준은 무작위 실험설계 연구가 가장 많았고, 중재 대상은 자폐성 장애가 가장 많았으며, 중재 방법은 환경 개선이 가장 많이 적용되었다. ICF-CY를 이용한 IEP 협력적 팀 중재의 목표 분석을 통해 활동에 관하여 5편, 참여와 관련하여 4편, 신체 구조 및 신체 기능과 관련하여 1편인 것으로 확인되었다. 결론 : IEP에서 협력적 팀 접근 중재 속 작업치료사의 역할은 중재의 목표에서 중요한 역할임을 확인할 수 있었다. 이를 기반으로 국내의 IEP에서 협력적 팀 접근의 전문가 중 하나로 작업치료사의 전문성을 설명할 수 있는 근거가 될 것으로 보인다.

Objective : This study systematically reviewed the collaborative team interventions of the Individualized Education Plan (IEP) using the International Classification of Functioning, Disability, and Health-Children and Youth (ICF-CY) framework to establish the professional domain of occupational therapists in Korea and their role as experts in IEP cooperative team interventions in special education. Methods : Articles were collected from the EBSCOhost, ProQuest, and PubMed databases. International search terms included “Special education,” “Individualized education plan (IEP),” “IEP process,” “IEP implementation,” and “Occupational therapy.” The study period was limited from January 2013 to February 2023, and the final 10 studies were analyzed using secondary classification. Results : Most studies were randomized experiments targeting individuals with autism, and often employed environmental improvements. The IEP collaborative team interventions using the ICF-CY framework emphasized goals related to activity (five studies), participation (four studies), and body structure/function (one study). Conclusion : Occupational therapists play a crucial role in collaborative IEP team interventions. This study established expertise in the context of special education in South Korea.

PURPOSE: This study was conducted to determine the effect of dual-task training (based on the International Classification of Functioning, Disability, and Health; ICF) on walking ability and self-efficacy in individuals with chronic stroke. METHODS: 22 chronic stroke patients participated in this study. Participants were randomly allocated into either the single-task group (n=11) or the dual-task group (n=11). Both groups had physical training three a week for 4 weeks, and at a three-week follow-up. Outcome measures included the 10m walking test (10MWT), figure of 8 walk test (F8WT), dynamic gait index (DGI), and Self-efficacy scale. All data were analyzed using SPSS 18.0 for Windows. Between-group and within-group comparison were analyzed by using the Mann-Whitney U test and Wilcoxon singed-rank test respectively. RESULTS: In the dual-task group, the 10MWT, time and steps of F8WT, DGI, and self-efficacy showed significant differences between pre- and post-test (p<.05). The Changes between the pre- and post-test values of 10MWT (p<.05), DGI (p<.05), and self-efficacy scale (p<.05) showed significant differences between the dual-task group and single-task group. CONCLUSION: Participants reported improved walking ability and self-efficacy, suggesting that dual-task training holds promise in the rehabilitation of walking in chronic stroke patients. This study showed that ICF-based on a dual-task protocol contiributes to motor learning after chronic stroke.

Objective: To evaluate the clinical usefulness of ICF (International Classification of Functioning, Disability and Health) through correlation among existing functional evaluation tools and examined environmental factors affecting its function. Method: One hundred eight persons with disabilities living in Seoul were randomly selected according to disability severity categories. Functional Independence Measure (FIM), modified Barthel index (MBI) and ICF were examined and subjects were interviewed by trained rehabilitation doctors and occupational therapists. We compared correlation between these three functional measurements. We coded environmental factors affecting function. That was used in second level of 74 ICF items. Results: The average of FIM, modified Barthel index, capacity and performance scores of ICF was 112.76, 92.97, 5.74 and 3.19. There was a statistical correlation among FIM, Barthel index, and ICF. The facilitator chapters among ICF's environmental factors were support and relationships (51.9%), attitudes (45.8%) in order. Most facilitated second level domains among the 68 items were immediate family (66.77%) and health professionals (52.8%). The most barrier chapters in ICF were product and a technology (19.5%), environment changes (15.5%) in order. Most barrier second level domains were design, construction and technology of buildings for public use (37%) and assets (37.0%). Conclusion: ICF correlates with the existing functional evaluation tool and can facilitate management of activity and participation by linking the result with the environmental factors, which may exacerbate or minimize them.

목적 : 본 연구는 국제기능장애 건강분류에 따른 한국 아동작업치료의 연구실태 및 동향을 파악하고자 하였다. 연구방법 : 본 연구는 대한작업치료학회지에 게재된 아동작업치료 분야 연구 115편을 선별하여 연구형태분류 및 근거 수준을 분석하고 이에 대한 동향을 파악하였다. 또한 대상 논문의 연구 대상자 수와 그에 대한 연령, 진단명과 평가도구 사용률을 분석하였고 연구 분야는 ICF-CY(International Classification of Functioning, Disability and Health-Children & Youth Version)에 따른 기준을 적용하여 분류하였다. 결과 : 대한작업치료학회지에 게재된 아동작업치료 관련논문을 분석한 결과 연구형태는 그룹 비교 및 상관관계연구가 24.3%로 가장 높았고 근거 수준은 4단계가 44.3%로 가장 높은 비율을 차지하였다. 또한 학령기 아동을 대상으로 한 논문이 41.5%로 가장 높았고 대상자 수에서는 101명 이상을 대상으로 한 논문이 가장 많은 것으로 집계되었다. 연구 대상자의 진단명에서는 뇌성마비가 26.0%로 가장 높은 비율을 차지하였으며 평가도구에서는 Sensory Profile이 11.6%로 아동연구에서 가장 많이 사용된 것으로 집계되었다. ICF-CY를 기준으로 분류한 연구 분야에서는 신체 구조와 기능적 요소가 51.2%로 가장 높은 비율을 차지하였다. 결론 : 본 연구는 대한작업치료학회지에 실린 아동작업치료 관련논문을 분석하여 연구 동향을 살피고 ICF-CY분류체계를 사용하여 주제를 분석하였다. 이를 통해 아동작업치료 분야에서 참여와 개인적 요소에 대한 연구가 부족한 것을 확인하였고 연구 주제 선정에 있어 다양성이 필요함을 알 수 있었다.

Objective : This study aimed to understand the current study conditions and trends of Korean occupational therapy for children regarding the International Classification of Functioning(ICF) of disability and health. Methods : This research selected 115 studies in the field of occupational therapy for children reported in the Journal of Korean Society of Occupational Therapy, and conducted an analysis on the classification of study type and evidence level to understand the trends. In addition, the number, age, diagnoses, and evaluation tools of the study subjects were analyzed. Moreover, this research categorized the studies based on the ICF-CY standard. Results : The analysis outcomes of the articles published in the Journal of Korean Society of Occupational Therapy were as follows: (1) Correlation studies and group comparisons were the largest study type at 24.3%. (2) Level Ⅳ was the largest evidence level at 44.3%. (3) The articles using school-age children as the subjects was the largest at 41.5%, and articles with more than 101 subjects made up the greatest number. Among the diagnoses, cerebral palsy was the largest at 26.0%, and a sensory profile was the most common evaluation tool at 11.6%. As for the study field categorized by ICF, the physical structure and functional factor were the largest at 51.2%. Conclusion : This study reviewed articles on occupational therapy for children published in the Journal of Korean Society of Occupational Therapy to understand the trends in Korean occupational therapy for children. It verified the lack of themes regarding individual factors, and the participation factors of the occupational therapy field for children, and the results indicate a need for diversity in the selection of study themes.

목적 : 본 연구는 뇌졸중 환자를 대상으로 ICF tools를 적용한 작업치료 중재 사례를 살펴보고, 실증적 차원에서 논의하고자 한다. 연구방법 : 2010년 4월부터 5월까지 광주광역시 C병원에 의뢰된 뇌졸중 환자를 대상으로 ICF tools(categorical profile, assessment sheet, assignment maps, intervention table, evaluation display)를 적용하였다. 연구결과를 기반으로 임상전문가 5인과 실증적 차원에서 ICF의 임상적 적용을 논의하였다. 연구결과 : Stroke core sets를 사용하여 카테고리를 선정하였다. 선정한 카테고리를 기반으로 Categorical profile을 정리하였고, Assessment sheet로 평가하였다. Assignment maps를 사용하여 각 전문분야의 역할을 규명하였고, Intervention table로 중재 목표와 방법을 선정하였다. Evaluation display로 중재 결과를 제시하였다. 논의에서 임상전문가들은 ICF의 임상적 적용에 동의하였으나 작업치료적의 특성을 고려할 것과 보건관련 전문가를 대상으로 한 ICF 교육 및 경제성에 대한 연구의 필요성을 언급하였다. 결론 : Stroke core sets는 뇌졸중 환자의 특성을 효율적으로 반영하였고, ICF tools는 보건전문분야의 효율적인 평가, 중재목표 설정, 역할분담, 환자중심의 문제해결에 효과적이므로 임상에서 사용을 추진해야 할 것이다. 또한 ICF의 원활한 작업치료 적용을 위해서는 용어 및 작업수행 분석의 전문성에 대한 임상적 합의와 다양한 후속연구 들이 요구되는 바이다.

Objective: The purpose of this study was to present the clinical use of ICF tools and discuss their usefulness in occupational therapy. Methods:The subject was a male stroke patient, and the study was conducted from April to March of 2010. First, stroke core sets were used to detect the categories. Next, ICF tools (categorical profile & assessment sheet, assignment maps, an intervention table, and an evaluation display) were performed step by step. Finally, 5 experts discussed the results. Results: Stroke core sets were used to select the categories under study. In clinical practice, ICF tools allow the description of a functioning state, an illustration of the patient's functioning experience, the relation between rehabilitation goals and appropriate intervention targets, an overview of the resources required to improve specific aspects of human functioning, and finally, changes in stated functionality following rehabilitative intervention. Experts expressed the positive aspects of ICF, but pointed out their consideration of the characteristics of occupational therapy. They also suggested the need for ICF education and cost effective analysis. Conclusion: Stroke core sets were used to select the categories corresponding to a patient's health status. ICF tools are definitely effective for evaluations, setting goals, role-sharing of professionals, and applying clientcentered problem-solving tasks. Therefore, clinical agreement regarding the terms and professionalism in a performance analysis will need to apply ICF tools for use in occupational therapy.

Stroke patients often experience reduced respiratory muscle function, which leads to decreased cardiopulmonary capacity and negatively affects gait and trunk stability. This single- subject study aimed to examine the effects of respiratory muscle strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on respiratory function, trunk stability, gait speed, and endurance in a patient with right-sided hemiplegia. Based on the international classification of functioning, disability and health (ICF), a PNF-based respiratory muscle strengthening program was implemented three times per week for four weeks, with each session lasting 50 minutes. Respiratory function was assessed using forced vital capacity (FVC), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP). Gait function was evaluated using the 10 meter walking test (10MWT) and 6-minute walking test (6MWT), and trunk function was measured using the trunk impairment scale (TIS) and a pressure biofeedback device. After the intervention, respiratory function, gait performance, and trunk stability improved, suggesting that PNF-based respiratory muscle strengthening may enhance recovery in individuals with stroke.

Purpose: The objective of this study was to identify functional problems, including walking ability, of patients with strokes using the International Classification of Functioning, Disability, and Health (ICF) and to present a method that could solve functional problems, thereby determining the applicability of the ICF to increase the quality of evaluation and intervention in clinical fields in the future. Methods: Information on stroke patients who were admitted and treated in a hospital was collected. The authors conducted evaluations, interventions, and measurements of the results of the ICF tool in order to improve gait abilities of patients. The subjects were trained using proprioceptive neuromuscular facilitation (PNF) one hour a day and five times a week for four weeks. The result measurement variables were a six-minute gait test, 10 m velocity test, gait instability test, and measurements using the ICF sheet. Results: In the six-minute gait test, gait distance increased by 48 m, from 102 m to 150 m. The gait velocity test result showed an improvement from 0.36m/s to 0.44m/s. The subjects performed a gait instabilitytestwithacupfilledwith50mmwater. In the gait instability test, the amount of water was 38 mm before the intervention; however, it was 50 mm after the intervention. The gait velocity with a cup filled with water improved from 0.25m/s to 0.31m/s. Conclusion: An evaluation and intervention were designed with the ICF tool for stroke patients. Gait abilities improved when the PNF technique was used. The IFC method can be used for evaluation and intervention, and it could help improve gait abilities of stroke patients.

Background and Purpose：Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF- based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description：The client was 44-years-old man with hemiplegia who was in 1 month post- stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks ofintervention was carried out after proposing the short goal and detailed purpose. Outcome：The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion：The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.

Objectives: The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas. Methods: A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations. Results: Multiple linear regression analysis indicated that cardiovascular endurance was the strongest significant factor associated with QoL in rural areas (B=0.027, standard error [SE]=0.013, p=0.050). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.447, SE=2.360, p<0.001), followed by hemoglobin level (B=-1.842, SE=0.744, p=0.015), age (B=-0.822, SE=0.217, p<0.001), and cognitive function (B=0.396, SE=0.162, p=0.016). Conclusions: Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.

Objectives: This study aimed to analyze the outcomes of the Comprehensive Health and Social Need Assessment (CHSNA)system, which identifies community residents’ health and social needs, and to link these needs with the International Classificationof Functioning, Disability, and Health (ICF). Methods: Adult community residents in a metropolitan city in Koreawere recruited. They were asked to assess their health and social needs via the CHSNA system, which was integrated into anonline community-care platform. Three assessment steps (basic health assessment, needs for activities of daily living, andin-depth health assessment) associated with five ICF components were used to evaluate physical health impairment, difficultiesin activities and participation, and environmental problems. The final list of health and social needs was systematicallylinked to the domains and categories of the ICF. Only data from participants who completed all three assessment steps wereincluded. Results: Wide ranges of impairments and difficulties regarding the daily living activities, physical health, and environmentalstatus of the community were recorded from 190 people who completed assessments of their health and socialneeds by the CHSNA system. These participants reported various health and social needs for their community life; commonneeds corresponded to the ICF components of body functions and activities/participation. Conclusions: The ICF may besuitable for determining the health-related problems and needs of the general population. Possible improvements to the presentsystem include providing support for completing all assessment steps and developing an ICF core set for an enhancedunderstanding of health and social needs.