Earticle

목적 : 본 연구에서는 뇌졸중 환자들에게 RECK MOTOmed viva2를 이용한 반복적 단일 운동 치료와 과제 수행을 통한 과제 지향적 운동 치료의 적용이 상지 기능 향상에 미치는 효과를 비교해보고자 하였다. 연구방법 : 대상자는 2010년 3월부터 동년 9월까지 A병원에서 뇌졸중으로 진단받고 재활치료가 의뢰된 입원환자 들 중 선정 기준에 적합한 46명을 각각 23명씩 반복적 단일 운동 치료군과 과제 지향적 운동 치료군으로 나누어 중재 전, 후의 변화를 비교해 보았다. 대상자들은 3주간 30분씩 주 5회 작업치료를 받았고, 추가적으로 RECK MOTOmed viva2를 이용한 반복적 단일 운동 치료 혹은 과제 수행을 통한 과제 지향적 운동 치료를 3주간 30분씩 주 5회 동안 받았다. 상기 기능 향상을 알아보기 위하여 중재 전, 후에 Fugl-Meyer Assessment(FMA), Manual Function Test(MFT)를 실시하였다. 결과 : 반복적 단일 운동 치료군의 상지 기능은 FMA의 총점이 21.22±12.35에서 25.26±11.88로, MFT의 총점이 33.17±22.83에서 41.52±23.69로 향상되었고(p<.05), 과제 지향적 운동 치료군의 상지 기능은 FMA의 총점이 22.22±12.48에서 26.39±10.84로, MFT의 총점이 33.52±21.83에서 42.22±21.67로 향상되었다(p<.05). 결론 : 반복적 단일 운동 치료군과 과제 지향적 운동 치료군의 상지 기능 향상을 비교해 본 결과, 두 군 사이에 유의한 차이가 없다는 것을 알 수 있었다. 또한 반복적 단일 운동 치료와 과제 지향적 운동 치료가 대근육 기능 또는 소근육 기능과 같은 상지의 특정 기능 향상에 유의한 영향을 미치기 보다는 전반적인 상지의 기능 향상을 유도한다는 것을 알 수 있었다.

Objective : The purpose of this study was a comparison of effects on repetitive singular exercise using RECK MOTOmed viva2 and task oriented exercise on upper extremity function in patients with stroke. Methods : The subject were hospitalized in A Medical Center from March to September in 2010 for rehabilitation. 46 patients who were diagnosed with stroke and included in selection criteria were divided into two groups: 23 patients involved in repetitive singular exercise group, 23 patients involved in task oriented exercise group. The traditional occupational therapies with repetitive singular exercise or task oriented exercise were given five times a week for three weeks. An assessment of their upper extremity function was made using a Fugl-Meyer Assessment(FMA) and Manual Function Test(MFT). Results : The improvement of upper extremity function of repetitive singular exercise group was 21.22± 12.35 to 25.26±11.88 in FMA, and 21.22±12.35 to 25.26±11.88 in MFT(p<.05). The improvement of upper extremity function of task oriented exercise group was 22.22±12.48 to 26.39±10.84 in FMA, and 33.52±21.83 to 42.22±21.67 in MFT(p<.05). Conclusion : There are no significantly difference between repetitive singular exercise group and task oriented exercise group. Also, both the repetitive singular exercise and the task oriented exercise lead improvement of general upper extremity function rather than specific function as gross motor and fine motor function.

Purpose: The purpose of this study was to evaluate the effect of task-oriented exercise and abdominal muscle contraction using functional electrical stimulation (FES) on abdominal muscle thickness and balance of stroke patients. Methods: Ten stroke patients who met the selection criteria were assigned randomly into two groups of five. One group received FES therapy before task-oriented training (experimental group), while the other group received a FES placebo before task-oriented training (control group). The Mann-Whitney U test was used to compare the groups, and the Wilcoxon Signed-ranks test was used to compare differences between the groups before and after intervention. The Mann-Whitney U test was used to compare the rate changes of each item before and after intervention, between the two groups. Results: In the rectus abdominalis and external oblique muscle thickness tests that used ultrasound, there was a statistically significant difference in the experimental group (p<.05),but no significant difference in the control group (p>.05). There was also a significant difference between the groups (p<.05). In the Balance test that used the Berg Balance Scale (BBS) and timed up and go test (TUG), there was a statistically significant difference in the experimental and control groups (p<.05), but there was no significant difference between the groups (p>.05). Conclusions: FES therapy before task-oriented training increases the thickness of abdominal muscles and improves balance abilities.

The purpose of this study is to examine how the task-oriented sling exercise based on rhythm affects patients with chronic stroke. We used a study with a single-subject design (A-B-A'). Two patients with chronic stroke participated in this study. Stretching/strengthening and task-oriented function exercises based on music using the sling were performed one hours per day for 8 times during intervention phase(B). Outcome measure included grip strength, range of motion(ROM), modified bathel index(MBI), berg balance scale(BBS), 10meter walk test(10MWT) and 6minute walk test(6MWT). After the intervention, the strength of grip strength, ROM, activities of daily living, balance and walking function of all patients was remarkably increased after the training, and these gains were positively maintained at 2-weeks follow-up phase. This result have shown that the task-oriented sling exercise basced on music might improve muscle performance, activities of daily living and gait function for patients with chronic stroke.

Purpose: This study investigated the effects of progressive resistance task-oriented strengthening exercises (PRTSE) on the strength of the lower extremities, balance, and activities of daily living (ADL) of patients following a stroke. The purpose of the study was to provide fundamental data regarding the use of PRTSE with stroke patients. Methods: Twenty stroke patients were randomly divided into an experimental group (n = 10) who took part in PRTSE and a control group (n = 10) who performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes five times a week for four weeks. The strength of their lower extremities was measured using a hand-held dynamometer. The balance of the participants was assessed using a Berg balance scale. The modified Barthel index was conducted to measure ADL. A paired t-test was performed to compare within-group changes before and after the PRTSE. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: After the exercises, there was a significant within-group change in the strength of lower extremities, balance, and ADL in the experimental group and the control group (p < 0.05). There was also a significant between-group difference in the strength of lower extremities after the intervention (p < 0.05). Conclusion: General rehabilitation is commonly applied as a treatment for stroke patients and is relatively effective. The application of PRTSE may be useful in such patients, considering its effects on the strength of lower extremities, balance, and ADL.

PURPOSE: The purpose of this study was to investigate the effects of task oriented circuit exercise(TOCE) on the balance and cognition in mild dementia patients. METHODS: The subjects of the study were 30 patients with mild dementia and assigned to the TOCE(task oriented circuit exercise) group(n=15) and aerobic exercise(AE) group(n=15). TOCE group performed six task three times weekly for 12 weeks. AE group underwent the cycle ergometer and treadmill exercise three times a week during the experimental period respectively. Timed up and go test(TUG), Berg balance scale(BBS) and AP1153 Biorescue were used to assess the parameters for the balance. Korean-mini mental state examination and Global deterioration scale(GDS) were used to assess the parameters for the cognition. For the statistical analysis, paired t-test and independent t-test were used to compare the differences among two groups. RESULTS: Each group showed improvement in balance and possibility for improving cognitive function. TOCE group especially, there were significant improvements in limit of stability. CONCLUSION: The results of the study suggest that TOCE is a more diverse exercise programs introduced in the study. Furthermore, TOCE can be a helpful to improve the balance and cognition in mild dementia patients.

본 연구는 순환식 과제지향 운동이 만성 뇌졸중 환자의 상지기능과 자기효능감에 미치는 영향을 알아보기 위하여 실시하였다. 선정 기준에 부합하는 28명을 순환식 과제지향 운동을 시행한 실험군 14명과 일반적 과제지향 운동을 시행한 대조군 14명으로 무작위 배정하였다. 중재는 주 5회 30분씩 4주간 실시하였으며 중재 전⋅후 상지기능과 자기효능감을 비교 분석하기 위해 뇌졸중 기능 회복 평가와 자기효능감 척도를 평가하였다. 순환식 과제지향 운동군은 중재 후 상지기능의 어깨/팔꿈치/아래팔, 손, 협응력과 속도 항목에서 유의하게 향상되었으며, 자기효능감 척도에서 유의하게 향상되었다. 그러나 일반적 과제지향 운동군은 중재 후 상지기능의 어깨/팔꿈치/아래팔 항목에서만 유의하게 향상되었다. 순환식 과제지향 운동군과 일반적 과제지향 운동군을 비교한 결과 상지기능의 어깨/팔꿈치/아래팔, 손 항목에서 그룹 간의 유의한 차이가 있었다. 그러나 자기효능감 척도에서는 그룹 간의 유의한 차이가 없었다. 본 연구의 결과를 통해 순환식 과제지향 운동이 일반적 과제지향 운동보다 상지기능을 증진시킨 것을 알 수 있다.

The purpose of this study was to investigate the effect of a task oriented circuit exercise in upper extremity function and self-efficacy in stroke patients. An experimental group of 14 patients was assigned to conduct a task oriented circuit exercise and the general task oriented exercise a control group of 14 patients was randomly assigned to exercise for 30 minutes 5 times every week during 4 weeks. Fugl-Meyer Assessment and Self-Efficacy Scale were evaluated to compare the upper extremity function and self-efficacy before and after the exercise. The result of this study were as follows : First, after the Task oriented circuit exercise, the upper extremity function and Self-Efficacy showed statistical significant difference between pre and post test. Second, after the general task oriented exercise, the upper extremity function showed statistical significant difference between pre and post test. But not much in Self-Efficacy. The comparison result between experimental group and control group in presented statistically significant differences where the upper extremity function. But, presented not statistically significant differences where Self-Efficacy Scale.

본 연구는 과제지향적 스위스볼 운동프로그램을적용하여 뇌졸중 환자의 상지기능, 균형, 기능적 자기 효능감에 미치는 영향을 알아보고자 하였다. 연구기간은 2015년 9월 15일부터 11월 10일까지 G광역시 건강생활지원센터에 통원하는 뇌졸중 환자에게, 연구의 취지를 설명하고 연구의 목적과 참여에 이해 및 동의한 20(실험군 10 대조군 10)명을 대상으로 하였다. 과제지향적 스위스볼 운동프로그램은 상지기능과정적 및 동적 균형을 향상시켰고, 기능적 자기 효능감을 증진시켰으며, 중재 후 집단 간의 차이는 균형과 기능적 자기효능감에서 효과가 있었다. 이에 뇌졸중 환자의 기능적 활동의 기반이 되는 체간의 안정성 및 자세조절을 향상시켜 상지기능과 균형을증진시키고, 기능적 자기 효능감에도 긍정적인 변화를 일으키는 과제지향적 스위스볼 운동프로그램을제안하는 바이다

This study was to investigate the effects of task-oriented swiss ball exercise program on upper-extre mity function, balance, and functional self-efficacy in stroke patients. The research period was september 15 through november 10, 2015, and the subjects were 20 persons (control group 10, intervention group 10), who understood the purpose of this study and agreed to par ticipate in the study, among the stroke patients attending health living support center in G. City. As a result, their upper extremity function and static, dynamic balance was improved and functional self-efficacy was enhanced by the task-oriented swiss ball exercise program. Also, after intervention, b alance and functional self-efficacy did differ between the two groups. Therefore, this study proposes use of task-oriented swiss ball exercise program, which is enhance up per extremity function and balance by improving trunk stability and postural control what based functi onal activity of stroke patient and make a positive change in functional self-efficacy.