Earticle

목적 : 본 연구는 경도 알츠하이머병 치매환자에게 인지활동을 중심으로 신체활동, 정서활동을 병행한 복합 중재 프로그램을 적용하였을 시 대상자의 인지기능 및 도구적 일상생활수행능력에 미치는 영향을 알아 보고자 하였다. 연구방법 : 약물치료 중인 경도 알츠하이머병 치매환자 59명을 실험군 39명, 대조군 20명으로 무작위 배정 하였다. 실험군에는 복합중재 프로그램, 대조군은 비 중재를 적용하였다. 중재는 실험군에 8주 동안 주 2회, 회기 당 110분씩 총 16회기의 중재를 실시하였다. 중재 전·후 비교를 위하여 치매선별용 간이정 신상태 검사(Mini-Mental State Examination for Dementia Screening; MMSE-DS), 노인용 전산화 인지평가도구(Computer Cognitive Senior Assessment System for Elderly; COSAS), 한국형 도구 적 일상생활활동 측정도구(Korean Instrumental Activities of Daily Living; K-IADL)를 사용하였다. 결과 : 약물을 복용 중인 경도 알츠하이머병 치매환자 59명 중 복합중재 프로그램을 실시한 집단은 비 중 재를 실시한 집단과 비교하여 인지기능과 도구적 일상생활수행능력이 통계적으로 유의미하게 향상되었 다(p<.01). 결론 : 복합중재 프로그램은 경도 알츠하이머병 치매환자의 인지기능, 도구적 일상생활수행능력의 유지 및 향상에 효과적인 중재 프로그램임을 제시하였다.

Objective: This purpose of this study was to investigate the effects of a multimodal interventional program(MIP) that combined physical activity and emotional activities centering on cognitive activities on cognitive function, instrumental activities of daily living(IADL) in patients with mild Alzheimer's Disease. Methods: A total of 59 patients with mild Alzheimer's disease were randomly assigned to a study group of 39 patients and a control group of 20 patients. For the experimental group, the multimodal intervention program and the control group were applied for the non-intervention. MIP was conducted twice a week for 8 weeks and for 110 minutes per session. In order to evaluate the cognitive function of the subjects, MMSE-DS, COSAS were used, and K-IADL was used to measure IADL. Results: Among the 59 patients with mild Alzheimer's disease who were taking medication, the group with MIP showed a statistically significant improvement in cognitive function and instrumental activities of daily living compared with the group without non-intervention(p<.01). Conclusion: The multimodal intervention program is the effective intervention program for the maintenance and improvement of cognitive function and IADL in patient with mild Alzheimer's disease.

This study aimed to investigate the effects of the multimodal group intervention that combined animal-assisted therapy (AAT) and integrated play therapy (IPT) on depression and self-esteem in undergraduate university students. The subjects were 40 students attending animal-related and social welfare departments of universities located in a metropolitan city. The multimodal intervention program was conducted for eight sessions (twice a week, 60 min each) in the experimental group. Data analysis was conducted using the independent sample t-test, ANCOVA, and paired sample t-test for pre- and post-test. Therefore, the multimodal intervention program applying AAT and IPT showed positive effects on depression and self-esteem in university students. Based on these results, this study proposed the operation of multidisciplinary education and practical and policy utilization methods to reduce depression among university students and help improve their self-esteem.

목적: 신체활동, 인지활동, 사회적 상호작용, 놀이 및 수공예 등의 목적있는 활동 및 사회적 상호작용을 포함한 집단 복합 중재가 초기치매 노인의 인지기능과 우울에 미치는 효과를 알아보고자 하였다. 연구방법: 유사 실험연구로써 단일 집단 사전-사후 디자인(One group pretest-posttest design)으로 설계하였고, 중재는 회당 90분, 주 1회, 8회기 동안 실시하였다. 중재 전과 후의 인지기능과 우울 수준의 변화를 비교하기 위해 치매 선별용 간이정신상태검사(Mini-Mental State Examination-Dementia Screening; MMSE-DS)와 단축형 한국어판 노인우울척도(Korean Version of Short Form Geriatric Depression Scale; SGDS-K)를 사용하였다. 결과: 초기치매 노인에게 집단 복합중재 후의 인지기능은 통계적으로 유의미한 향상이 있었고(p<0.01), 우울 수준은 통계적으로 유의미한 감소가 있었다(p<0.05). 우울증 의심에 해당되는 대상자 6명은 모두 정상범주로 분류되었다. 결론: 신체활동, 인지활동, 사회적 상호작용, 놀이 및 수공예 등의 목적있는 활동을 포함한 집단 복합 중재는 초기 치매 노인의 인지기능의 퇴행을 늦추고, 우울수준을 감소시키는데 유의한 효과가 있다. 향후 연구결과의 확증이 필요하며, 치료사의 태도나 역량 등 중재의 정확한 전달에 필요한 질적인 내용을 포함하는 연구가 이루어져야 할 것이다.

Objective : The purpose of this study was to investigate the effects of a multimodal intervention program organized with purposeful activities, including physical activity, cognitive activity, social interaction, play, and craft making on the cognitive function and depression of older adults with early dementia. Methods : This study was executed using a single group pretest-posttest design. The participants joined eight weekly sessions of group intervention, and every session took 90 min to complete. A Mini-Mental State Examination-Dementia Screening (MMSE-DS) and the Korean Version of the Short form Geriatric Depression Scale (SGDS-K) were used to evaluate the cognitive function and depression of the participants. Results : After a multimodal intervention, the participants showed a significant increase in their average score of cognitive function, and a significant decrease in their average score of depression. The six participants with a suspicious depression were shown to be within the normal range after intervention. Conclusion : Multimodal intervention has the effect of delaying the progress of cognitive impairment and decreasing the depression level of older adults with early dementia. Further research is recommended to prove the results of this study more concretely. Research on the quality of intervention regarding therapists’ attitude or abilities in terms of the way they provide intervention for their clients is suggested

목적: 신체활동과 인지운동, 사회적 상호작용을 혼합한 단기 집단 복합중재가 75세 이상의 고령 정상노인의 인지기능과 우울 수준에 미치는 영향을 알아보고자 하였다. 연구방법: 본 연구 설계는 단일 집단 사전-사후 설계(one group pretest-posttest design)로 중재는 회당70분, 주 1회, 총 4회기 동안 실시하였다. 중재 전과 후의 인지기능과 우울 수준, 신체기능의 변화를비교하기 위해서 치매 선별용 간이 정신상태검사(Mini-Mental State Examination-Dementia Screening; MMSE-DS)와 단축형 노인우울척도(Short Form for Geriatric Depression Scale; SGDS), 버그균형척도(Berg Balance Scale; BBS)를 사용하였다. 결과: 75세 이상의 고령 정상노인에게 집단 복합중재를 적용한 후 인지기능은 통계적으로 유의미한 향상이있었고(p＜.01), 우울 수준은 통계적으로 유의미한 감소가 있었다(p＜.05). 균형수준도 중재 전46.83±9.11점에서 중재 후 48.08±7.00점으로 평가점수의 증가는 있었으나, 통계적으로 유의미하지는않았다(p＞.05). 결론: 신체활동과 인지운동, 사회적 상호작용을 혼합한 단기 집단 복합중재는 75세 이상의 고령 정상노인의인지기능의 저하를 늦추고 우울수준을 감소시키는데 유의한 효과가 있었다. 본 연구는 정상노인들의치매, 우울 예방을 위한 중재에 있어서 보다 체계적인 중재를 제공하기 위한 근거를 제시한다는 점에의의가 있다. 향후 연구에서는 작업치료사에 의한 전문적인 치료에 대한 효과연구와 실험군-대조군연구를 통해 효과입증이 이루어져야 할 것이다.

Purpose: This study aimed to investigate the effects of a short-term group multimodal intervention program that mixes physical activity, cognitive motion, and social interaction, on the cognitive function and depression level of healthy over 75-year-old individuals. Method: This study used a one group pre-test-post-test design, and intervention was made for 70 minutes per session, once a week, for four sessions in total. To compare changes in cognitive function, depression level and physical function before and after intervention, this study used the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Depression Scale-Short Form (GDS-SF), and Berg Balance Scale (BBS). Result: After applying group multimodal interventions to healthy over 75-year-old individuals, there was a statistically significant improvement in their cognitive function (p ＜ 0.01), and there was a statistically significant decrease in their depression level (p ＜ 0.05). Also, there was an increase in the rating score of the degree of balance from 46.83 ± 9.11 points before the intervention, to 48.08 ± 7.00 points after the intervention; however, it was not statistically significant (p ＞ 0.05). Conclusion: Short-term group multimodal intervention that mixes physical activity, cognitive motion, and social interaction had a significant effect on slowing down the deterioration of cognitive function in healthy over 75 year-old individuals, and decreased their depression level. This study is significant in that it presents a foundation for providing more systematic intervention for the prevention of dementia and depression in the healthy older individuals. Follow-up studies should verify the result through research on the effects of an occupational therapist’s professional treatment, and experimental group-control research.

PURPOSE: The purpose of this study was to investigate the effect of multimodal intervention through VR (virtual reality)-based immersion program on the cognitive function and brain activity of patients with mild cognitive impairment. METHODS: The subjects of the study were 10 people in the experimental group who applied a complex intervention that performed cognitive tasks using the movement of the upper extremities through the VR program, and 10 people in the control group who received traditional occupational therapy. After the study intervention was applied 5 times a week, 30 minutes a day for a total of 8 weeks, LOTCA-G(Lowenstein Occupational Therapy Cognitive Assessment for Geriatric Population) and NIRSIT LITE were used to compare. RESULTS: Significant differences in cognitive function and brain activity were noted between the pre- test and post-test in the experimental group. Brain activity showed statistically significant differences in four channels of the working memory domain and one channel of the metacognitive domain (p < . 05). Comparative analysis of the difference between the two groups revealed statistically significant differences in cognitive function and brain activity. The brain activity showed statistically significant differences in three channels of the working memory domain and one channel of the metacognitive domain (p < .05). CONCLUSION: Through the results of this study, it was found that the complex intervention of performing cognitive tasks using upper extremity movements through the VR program had a positive effect on the cognitive function of patients with mild cognitive.

This study aimed to investigate the effects of the multimodal group intervention that combined animal-assisted therapy (AAT) and integrated play therapy (IPT) on depression and self-esteem in undergraduate university students. The subjects were 40 students attending animal-related and social welfare departments of universities located in a metropolitan city. The multimodal intervention program was conducted for eight sessions (twice a week, 60 min each) in the experimental group. Data analysis was conducted using the independent sample t-test, ANCOVA, and paired sample t-test for pre- and post-test. Therefore, the multimodal intervention program applying AAT and IPT showed positive effects on depression and self-esteem in university students. Based on these results, this study proposed the operation of multidisciplinary education and practical and policy utilization methods to reduce depression among university students and help improve their self-esteem.

본 연구에서는 지역사회 노인성인지장애군에게 적 용한 워크북 기반의 복합중재 프로그램이 인지기능 및 일상생활수행, 우울, 삶의 질에 미치는 효과를 확 인하고자 하였다. 경도인지장애 및 경증치매 대상자 29명에게 단일집단 사전-사후 설계를 통해 중재를 적용하였다. 대상자들에게 12주 동안 워크북을 활용 한 집단 인지훈련 프로그램을 주 2회, 회기 당 60분 씩 적용하였으며, 이와 더불어 신체기능 및 일상생활 훈련을 바탕으로 한 홈 프로그램을 주 5회, 회기 당 30분씩 반복 제공하였다. 연구 결과, 경도인지장애군 은 기억력과 집행기능, 일상생활수행능력, 우울, 삶의 질에서 유의한 효과가 있었으며, 경증치매군은 기억 력과 일상생활수행능력, 우울, 삶의 질에서 효과가 있음이 확인되었다. 기억력과 언어능력, 우울, 삶의 질은 경도인지장애군의 변화량이 더 컸으나, 주의집 중력과 일상생활수행능력에서는 경증치매군의 변화 량이 더 큰 것으로 나타났다. 본 연구에서는 지역사 회 노인성인지장애군의 기능 유지 및 회복을 위해 워크북을 활용한 인지훈련과 더불어 동작훈련 중심 의 홈 프로그램을 복합 적용하여 중재 효과의 극대 화를 모색하였다. 추후, 진단 별 특성에 맞는 중재 설계를 통해 기능 일반화에 도움이 되기를 기대한다.

The purpose of this study was to compare the effects of a workbook-based multimodal intervention program applied to the geriatric cognitive impairment group on cognitive function, daily living ability, depression, and quality of life, and to compare them by diagnosis. The intervention was applied to 29 elderly people with MCI and MD through a one-group pretest-posttest design. The group cognitive training program using a workbook was applied to the subjects for a total of 24 times for 60 minutes per session. In addition, a home program was provided for 30 minutes every day. The MCI group had a significant effect on the intervention in memory, executive function, daily living ability, depression, and quality of life, and the MD group had an effect on memory, daily living ability, depression, and quality of life. When the score changes of the two groups were compared, the change in memory, language ability, depression, and quality of life was larger in the MCI group, but the change in attention and daily living ability was larger in the MD group. In this study, in order to maintain the function of elderly cognitive impairment in the local community, cognitive training using a workbook and a home program centered on motion training were combined to maximize the intervention effect. In the future, it is expected that it will be helpful for generalization of functions through an intervention design suitable for the characteristics of each diagnosis.