Earticle

목적 : 본 연구는 뇌졸중 환자의 상지기능과 일상생활동작 향상을 위해 적용된 과제 지향적 접근 연구들을 체계적 고찰과 메타분석으로 연구결과들을 비교 분석하였다. 이 결과들을 통해 앞으로의 과제 지향적 접 근의 방향을 제시하고자 하였다. 연구방법 : 분석 자료는 2000년 1월부터 2018년 8월까지 MEDLINE, CINAHL, Pubmed 데이터베이스를 사용하여 선정기준에 적합한 17편의 무작위 실험 연구를 수집하였다. 선정된 연구들은 질적 평가(Pedro score)와 Patient, Intervention, Comparison, Outcome(PICO)를 사용하여 체계적으로 정리하였다. 그 후 각 연구들의 중재 형식을 참고하여 평균, 표준편차, 표본수를 사용하여 메타분석을 실시하였다. 결과 : 선정된 17편의 연구는 Pedro score 5점 이상의 연구로 다양한 과제 지향적 접근을 통하여 상지기 능과 일상생활동작을 증진시키고자 하였다. 과제 지향적 접근의 중재 형식은 횟수 강도 등을 통제하는 반복강화형, 기계적 장치나 보조기 등을 사용하는 조합형, 환자별 특성 및 목표 등을 참고한 환자맞춤형 의 3가지로 분류하였다. 과제 지향적 접근이 상지기능에 미치는 영향은 큰 효과크기를 보였으며, 중재 형식에 따른 분석에서는 환자맞춤형은 큰 효과크기, 조합형과 반복강화형은 중간 효과크기를 보였다. 과 제 지향적 접근의 일상생활활동에 대한 영향은 중간 효과크기를 나타내었다. 결론 : 환자의 기능 향상을 위한 과제 지향적 접근은 일관되고 정형화된 과제 보다 다양한 자극과 환자 중 심의 목표, 환경, 피드백을 활용하여 과제의 다양성을 강화할수록 보다 높은 치료적 효과를 기대할 수 있다.

Objective: In this study, a task-oriented approach (TOA) applied to improve the upper limb function and daily life activities of stroke patients is systematically reviewed and meta-analyzed. Next, the direction of task-oriented research is presented. Methods: Data from 17 RCT studies from January 2000 to August 2018 were collected using the MEDLINE, CINAHL, and PubMed databases. Then, after a systematic analysis using the Pedro score and PICO, data from each study were used to conduct a meta-analysis. Results: The 17 studies showed improvements in upper limb functions and daily living activities using various TOAs. We found three types of TOA, namely, a repeat reinforcement type, a combination type, and a patient-tailored type. The influence of a TOA on the upper limb functions had a large effect size. In our analysis of the intervention type, the patient-tailored type had a large effect size, whereas the combination and reinforcement types showed moderate effect sizes. The influence of the TOA on the activities of daily living showed a moderate effect size. Conclusion: When applying a TOA, the effectiveness of treatment can increase as the diversity is enhanced by utilizing various stimuli, goals, environments, and feedback.

목적 : 로봇을 이용한 과제 지향적인 치료가 뇌졸중 환자의 상지 운동기능과 ADL 수행능력에 어떤 효과가 있는지 체계적 고찰과 메타분석을 실시하여 검증하고자 하였다. 연구방법 : 1980년부터 2015년 12월까지 발표된 국외 RCT연구들 중에서 과제와 함께 이루어지는 상지 로봇 재활치료를 대상으로 분석을 실시했다. EMBASE, Ovid-Medline, PubMed, CINAHL, Cochran CENTRAL을 통해 문헌검색과 선별을 실시했고, SIGN으로 질평가를, GRADE로 근거의 수준을 마련했다. Cochrane collaboration’s tool for assessing risk of bias로 편향을 측정하고, RevMan 5.3 으로 메타분석을 실시했다. 개별 연구들의 대상자 수, 중재 전-후 평균값, 표준편차 등을 자료합성에 사용하였다. 결과 : 12편의 연구가 최종 선정되었고 실험군의 대상자수는 총 341명(남성 235명, 여성 106명), 연령은 60.50±5.51세의 분포를 보였다. 대조군의 경우 대상자수가 모두 301명(남성 207명, 여성 94명)이었고 58.55±17.1의 연령대를 보였다. 운동기능 전체의 효과크기는 2.63, FMA가 2.98, BB 2.25로 기능증진에 효과가 있었고, ADL 수행능력에서는 FIM(3.04)을 제외하고 효과가 없었다. 결론 : 과제기반의 로봇상지재활치료는 뇌졸중 환자의 상지 운동기능과 ADL 수행능력에 전반적인 효과를 줄 수 있다. 장기적인 관점에서 효과가 있는지 결과변수에 대한 추가적인 연구가 필요하다.

Objective: This study is aimed at finding the effects of task-oriented robot-assisted therapy for stroke patients in terms of the motor function of the upper extremities and ADL performance based on a systematic review and meta-analysis. Methods: RCTs were identified through a database search of MBASE, Ovid-Medline, PubMed, CINAHL, and Cochran CENTRAL from 1980 to December 2015, and through additional manual searches. Meta-analyses were separately conducted in terms of the motor function of the subjects' upper extremities and ADL performance. A quality assessment was conducted using SIGN, the level of evidence was reviewed based on GRADE, and the risk of bias was assessed using the Cochrane collaboration tool. The statistical heterogeneities were also investigated, and RevMan 5.3 was used for a Meta analysis covering the averages and standard deviations. Results: Twelve studies were selected and reviewed. The overall task-oriented robot-assisted therapy group was made up of 341 participants (235 male, 106 female) with an average age of 60.50±5.51. The control subjects totaled 301 (207 male, 94 female, with an average age of 58.55±17.1). The improvement in the entire motor function of their upper extremities showed a statistical significance (mean difference, 0.34; 95% CI, -0.30 to 4.38; p<.05; I2=65.0%) with an FMA of 2.98 (mean difference, 2.10; 95% CI, 0.72 to 3.48; p<.05; I2=52.0%), BB of 2.25 (mean difference, 2.34; 95% CI, 0,30 to 4.38; p<.05; I2=28.0%), and FIM of 3.04 (mean difference, 4.14; 95% CI, -1.47 to 6.80; p<.05; I2=73.0%). However, their WMFT, overall ADL performance, ABILHAN, and MAL did not reach a level of statistical significance. Conclusion: Task-oriented robot-assisted therapy was shown to have a positive possibility for the recovery of stroke survivors, particularly in the motor function of their upper extremities and ADL performance. Further research will be needed to ground the evidence and support the clinical use of task-oriented robot-assisted therapy.

Wearable hip exoskeletons have been developed and applied to improve walking function in individuals with walking disabilities. For stroke patients, gait function ability is crucial for their quality of life. However, research on the effects of training with wearable hip exoskeletons in stroke patients is limited. This study aimed to investigate the effects of task-oriented training using wearable hip exoskeletons(Bot Fit, Samsung Electronics Co, Korea) on walking, balance ability, muscle thickness and strength in chronic stroke patients. The study employed a single-subject experimental research design (ABA'). Four chronic stroke patients participated, and the experimental process was divided into three phases: (1) baseline phase (8 sessions), (2) intervention phase (12 sessions), and (3) return-to-baseline phase (8 sessions). Outcome measures included the timed up and go, 10 meter walking test, and berg balance scale to assess functional performance. And muscle thickness was measured using sonography while strength was evaluated using a dynamometer. Each session involved 30 minutes of task-oriented training, with the wearable hip exoskeletons intervention applied during the intervention phase. The results showed significant improvements in timed up and go, 10 meter walking test, and berg balance scale scores during the intervention phase, and these gains were maintained in the return-to-baseline phase. Although no significant changes were observed in muscle strength and thickness, they were maintained without decline. The findings suggest that task-oriented training using a wearable hip exoskeletons may effectively improve balance and gait abilities while maintaining muscle strength and thickness in chronic stroke patients. Future studies should focus on further enhancing and sustaining these effects and exploring the long-term benefits and potential applications of wearable hip exoskeletons-assisted training in a larger population of chronic stroke patients.

목적 : 가상현실 프로그램과 현실화된 과제 지향 프로그램이 노인의 균형에 어떠한 영향을 미치는지 그 효 과를 비교해 보고자 한다. 연구방법 : 12명의 건강한 노인을 대상으로 가상현실 프로그램과 현실화된 과제 지향 프로그램을 각각 6 주 간 주 2회씩 실시하였다. 균형 능력 변화를 위해 버그 균형 척도(Berg Balance Scale: BBS), 이동 능력 검사(Timed Up and Go: TUG), 한 발 서기 검사(One-Legged Stance Test: OLST), 5회 반복 앉았다 일 어서기 검사(5-Repetition Sit-To-Stand Test: 5R-STS Test)를 사용하였다. 결과 : 분석결과 프로그램 전․후에서는 통계적으로 유의한 결과를 얻지 못하였다. 하지만 세 집단 간 비교 에서는 버그 균형 척도, 한 발 서기 검사 중 눈 뜨고 좌, 우에서 통계적으로 유의한 결과를 얻었으며 사 후 검정결과 눈 뜨고 검사 - 좌에서 가상현실 프로그램과 현실화된 과제 지향 프로그램 간에 유의한 결 과를 얻었다. 결론 : 현실화된 과제 지향 프로그램은 노인의 균형 능력 향상에 좀 더 긍정적이었으며 임상 및 지역사회 에 서 좀 더 쉽게 수행할 수 있는 프로그램으로 유용하게 사용될 수 있을 것이라 생각된다.

Objective : The purpose of this research is to discuss on comparative assessments between virtual reality and task-oriented programs of balance for elderly. Method : 12 healthy elderly for each program are received twice a week for 6 week period. Changes in balance ability were assessed using Berg Balance Scale (BBS), Timed Up and Go(TUG), One-Legged Stance Test(OLST) and 5 - Repetition Sit-To-Stand test(5R-STS test). Result : All groups were not statistically meaningful differences between pre- and post-program. However, comparative outcomes among three groups were statistically significant in opening the eyes of One-Legged Stance Test(OLST) from the left and right side, and Berg Balance Scale(BBS). In post hoc, shows a statistically significant in both programs with opening the eyes of One-Legged Stance Test(OLST) from left side. Conclusion : Task-oriented programs is more useful and effective clinical methodology for balance excise programs for elderly. In addition, this clinical trial may be easily implemented by elder care facilities.

본 연구는 성취목표지향성과 삶의 만족도의 관계를 알아보기 위한 것이다. 고교, 대학, 실업팀 선수 450명을 대상으로 조사하였다. 수집된 자료는 각 검사지의 신뢰도와 타당도 확인과정을 거쳐 성별에 따른 분산분석, 상관분석, 그리고 다중회귀분석을 실시하였다. 분석결과 성취동기의 4요인 중 숙달과 수행접근에서 남성이 더 높은 점수로 성별간 유의한 차이가 나타났다. 삶의 만족도 역시 남성이 더 높은 점수를 보이며 성별간 유의한 차이를 보였다. 마지막으로 운동 성취목표성향과 삶의 만족간의 중다회귀분석 결과 숙달접근이 정적으로, 숙달회피가 부적으로 운동선수의 삶의 만족도에 영향을 미치고 있다. 성별에 따른 성취목표성향과 삶의 만족도의 관계는 남녀 선수 모두 숙달접근은 삶의 만족에 정적으로 영향을 미치고 있다. 숙달회피 또한 남녀 모두 삶의 만족에 부적인 영향을 미치고 있다.

This study aims to verify the relationship between achievement goal orientation and life satisfaction. It consists of 450 athletes from high school, university, and professional teams as an object. After examining reliability and validity on questionnaires, the data, based on gender, was evaluated by analysis of variance, correlation analysis, and multiple regression analysis. The result says that male athletes have higher scores in Mastery approach and Performance approach - two of the four achievement motivation factors - which means a meaningful difference between gender. Life satisfaction also shows that male players have more satisfaction and indicates a big difference between gender. Finally, according to the multiple regression analysis on the Athlete's achievement goal orientation and life satisfaction, Mastery approach affects statically but Mastery avoidance does negatively on athlete's life satisfaction. The gender-based relationship between Athlete's achievement goal orientation and life satisfaction reveals that mastery approach gives positive effects on life satisfaction for both genders, but mastery avoidance influences negatively on male and female life satisfaction.

Objective To explore the amount of practice and progression during task-oriented circuit training (TOCT) in chronic stroke survivors; to test the use of pedometers and observation-based measures in detecting step activity; to verify the possible correlation between step activity and locomotor function improvements.Methods Six community-dwelling chronic stroke survivors underwent 10 TOCT sessions (2 hours/each) over 2 weeks in which they were trained both on a treadmill and on six task-oriented workstations (W1?W6). During the sessions, they wore a piezoelectric pedometer and step activities were recorded. Outcome measures were as follows: % of activities during which pedometers worked properly; pedometer-based measures (total step counts, treadmill steps, workstation steps? total and W2,W3,W5,W6); observation-based measures (number of repetitions in task W1 and W4); walking speed changes measured by the 10-m walking test (10MWT) and walking endurance changes (6-minute walking test) after TOCT.Results During TOCT sessions (n=57), activities were recorded through pedometer-based measures in 4 out of the 6 patients. The total amount of step activity was 5,980.05±1,968.39 steps (54.29% in task-oriented workstations, 37.67% on treadmill, and 8.03% during breaks). Exercise progression was highlighted significantly by observational measures (W1, W4). A positive correlation was observed between increased gait speed and observational stair step repetitions progression (W1) (r=0.91, p=0.01) or pedometer-based tandem exercise step progression (W3) (r=0.98, p=0.01).Conclusion TOCT can be considered a high-intensity, progressive intervention to restore locomotor function in chronic stroke survivors. Pedometer-based measures might help in quantifying TOCT’s volume of practice; however, further investigations are required.

Objective : This study aimed to investigate the effect of simultaneous application of peripheral nerve sensory stimulation and task-oriented training on the improvement of upper extremity motor function after stroke. Methods : This study included 29 patients with hemiplegia. The 14 subjects were in the peripheral nerve sensory stimulation and task-oriented training group for 4 weeks (30 min/d, 5 d/wk), while the 15 control group subjects underwent only task-oriented training for the same duration. The outcome measures were the percentage of voluntary baseline muscle contractions of the wrist and shoulder and Box and Block Test, grip and pinch strength, and Action Research Arm Test. Results : After 4 weeks, muscle activity of extensor carpi radialis, flexor carpi radialis and grip strength and Action Research Arm Test were significantly higher in the experimental group. Conclusion : Simultaneous application of the peripheral nerve sensory stimulation and task-oriented training was found to be superior to task-oriented training for improving upper extremity motor function of adults with stroke.

목적 : 본 연구에서는 발달성협응장애와 발달성협응장애 아동을 대상으로 한 과제-중심 접근법을 문헌 고 찰을 통하여 알아보고자 하였다. 본론 : 본 연구는 발달성협응장애의 정의, 진단, 원인, 평가에 대한 전반적인 개요를 제시한다. 또한 신경 운동과제훈련(Neuromotor Task Training; NTT)과 인지기반작업수행(Cognitive Orientation to daily Occupational Performance; CO-OP)의 중재 전략에 대해 알아보기 위해 2000년 1월부터 2023년 9 월까지 게재된 국외 문헌 18편을 분석하였다. 선정된 문헌에서 언급된 중재의 목적은 작업치료 실행체계 4판(Occupational Therapy Practice Framework-4; OTPF-4)의 기준에 따라 분류하였다. 분류 결 과, NTT는 클라이언트 요인(client factor) 영역에 대한 목표 설정의 빈도가 높았고, CO-OP는 작업 (occupation) 영역에 대한 목표만을 설정하였다. 이러한 목표 설정의 차이는 두 중재 간 전략의 차이로 설명된다. 결론 : 발달성협응장애에 대한 전반적인 개요와 과제-중심 접근법의 중재에 대한 전략의 이해는 질환에 대한 인식도를 높이고 근거 기반 임상을 위한 기초 자료가 될 것이다.

Objective : This study aimed to provide an overview of task-oriented approaches for children with developmental coordination disorder, including its definition, diagnosis, causes, and assessment, through a literature review. Subject : Eighteen international articles published between January 2000 and September 2023 were analyzed to explore the intervention strategies of Neuromotor Task Training (NTT) and Cognitive Orientation to daily Occupational Performance (CO-OP). The objectives of the interventions mentioned in the reviewed articles were categorized according to the criteria of the Occupational Therapy Practice Framework-4 (OTPF-4). The results showed that NTT more frequently set goals in the area of client factors, while CO-OP set goals only in the area of occupation. This difference in goal setting can be explained by the strategy differences between the two interventions. Conclusion : A broader and deeper understanding of strategies for interventions with task-oriented approaches to developmental coordination disorder can increase awareness of the disorder and provide a more solid basis for evidence-based practice.

목적 : 본 연구는 발달지연의 아동을 대상으로 과제지향의 중재를 사용하여 시-운동 협응과 소운동 협응 기능의 변화를 알아보고자 하였다. 연구방법 : 연구대상은 6세의 여아 1명이었다. 아동은 진단은 받지 않았으나 전반적인 기능에 발달지연을 보였다. 연구기간은 2021년 2월 5일부터 6월 4일까지이었고, 연구 설계는 단일대상연구 A-B를 사용하 였다. 기초선 A는 초기 3회기로 아동의 기능 파악을 위해 초기평가를 하였다. 중재기 B는 12회기로 과 제지향의 중재(task-oriented intervention)를 사용하였다. 기초선과 중재기에 동일하게 아동의 시-운 동 협응 기능을 측정하기 위해 한국판 시지각발달검사 3판의 타원그리기를 실시하였고, 소운동 협응 기 능을 측정하기 위해 Clinical Observation of Motor and Postural Skills(COMPS)의 손가락-코 짚기 를 실시하였다. 회기별 변화도는 그림으로 제시하였다. 결과 : 한국판 시지각발달검사 3판의 타원그리기의 기초선 평균은 23점이었고, 중재기 평균은 39.66점으로 기초선에 비해 중재기의 평균이 16점 이상 향상되었다. COMPS의 손가락-코 짚기의 기초선 평균은 0 점이었고, 중재기 평균은 5.08점으로 기초선에 비해 중재기의 평균이 5점 이상 향상되었다. 결론 : 취학 전의 발달지연아동에게 과제지향의 중재는 아동의 학습에 바탕이 되는 시-운동 협응과 소운동 협응 기능에 긍정적인 영향을 미치는 것으로 보인다.

Purpose : This study aims to identify changes in the visuomotor coordination and fine motor coordination functions caused by the use of a task-oriented intervention in a child with developmental delay. Methods : The participant, who was a 6-year-old girl, was not diagnosed but showed a developmental delay in overall function. The study period was February 5, 2021, to June 4, 2021, and a single-subject A-B study design was used. The baseline (A) was initially evaluated in the first three sessions to identify the child’s functions. In the intervention period, 12 session (B), task-oriented intervention was applied; the child engaged in many of the activities in kindergarten, such as painting, writing, making, and cutting with scissors. Visuomotor coordination and fine motor coordination were equally measured during the baseline and intervention periods. Visuomotor coordination was measured via drawing of an oval according to the Korean Developmental Test of Visual Perception 3 (K-DTVP-3), and fine motor coordination was assessed using the finger-nose touching item of the Clinical Observation of Motor and Postural Skills (COMPS). Results : The mean of the baseline of the K-DTVP-3 oval drawing was 23, and the mean of the intervention period was 39.66. The mean of the baseline of the COMPS finger-nose touching was 0, and the mean of the intervention period was 5.08. Conclusion : Task-oriented intervention seems to have a positive effect on the visuomotor coordination and fine motor coordination abilities of children with developmental delay.

목적 : 본 연구의 목적은 발달성협응장애 아동에게 과제중심접근 치료가 효과적인지 알아보기 위하여 문헌 분석을 통하여 중재결과를 ICF 모델로 제시하고자 하였다. 연구방법 : 대상자는 DSM-Ⅳ 진단 기준에 따라 발달성협응장애에 해당하는 0∼12세 아동으로 과제중심 중재방법인 신경운동 과제훈련과 일상 작업수행의 인지중심 접근 두 가지에 관하여 1995년 1월∼2007년 11월까지 게재된 논문을 Pubmed와 Medline을 통해 체계적 고찰(systematic review)을 하였다. 결과 : 중재 효과는 과제중심 중재결과 자료 중 17개(62.96%)가 중재효과가 있는 것으로 분석되었다. 이중 신경운동과제 훈련 접근법에서 5개(18.52%), 일상작업수행의 인지 중심 접근법에서 12개(44.44%)가 중재효과가 있는 것으로 분석되었다. ICF 모델로 제시한 결과 신체 기능 및 구조 영역을 평가한 자료가 14개(51.85%), 활동 및 참여 영역을 평가한 자료가 13개(48.15%)로 나타났다. 그러나 중재효과는 신체 기능 및 구조 영역에서 6개(22.22%)이었던 반면 활동 및 참여 영역에서 11개(40.74%)로 분석되었다. 결론 : 과제중심접근 치료가 발달성협응장애 아동에게 효과가 있는지 알아보기 위해 체계적 고찰을 하였다. 고찰 결과 과제중심접근이 ICF model의 활동 및 참여 영역에서 더 효과가 있는 것으로 나타났다. 분석 논문 수가 8개라는 제한점이 있으나, 국내작업치료분야에서 체계적 고찰을 통해 이러한 지식을 활용하고, 임상적 사용에 대한 근거를 제시할 수 있다.

Objective : The aim of this study is to suggest evidence to evaluate the effectiveness of a task-oriented approach developed for the treatment of children with developmental coordination disorder. Treatment outcomes are presented using the International Classifications of Functioning, Disability and Health (ICF). Methods : Participants had to be children diagnosed with DCD according to DSM-Ⅳ and aged 0 to 12 years old. Their intervention could be neuromotor task training and cognitive orientation to daily occupational performance. The literature search included the following electronic databases: Medline, Pubmed (January 1997 to November 2007). Results : There were 17 (62.96%) papers on the effectiveness of neuromotor task training, and 12 (44.44%) papers on the effectiveness of cognitive orientation to daily occupational performance. The results of the ICF model presented 14 (51.85%) papers on body structure & function and 13 (48.15%) papers on activity and participation. And there were 6 (22.22%) papers on the effectiveness of body structure & function and 11 (40.74%) papers on the effectiveness of activity and participation. Conclusion : This paper conducted a systematic review of the research literature that reports on the effectiveness of a task-oriented approach developed for the treatment of children with developmental coordination disorder. The results of the review presented greater effect on the activity and participation of the ICF model. There was limit of 8 journals used. But this knowledge is utilized in occupational therapy, and therefore presents evidence of practice.

Mind-wandering consists of the process of thinking task-unrelated thoughts (TUT) during task performance. In a task-oriented group, the subject and the subject matter of team members’ mindwandering episodes are of critical interest to the team's performance. However, many writers suggested that mind-wandering may be more common in some circumstances than others. Understanding the social-psychological factors that precipitate mind-wandering in a technological setting is necessary because mind-wandering influences numerous outcomes connected with taskoriented groups. Therefore, this paper aims to explore whether certain social-psychological factors predict self-reported engagement behavior in a number of TUT in the assessment of attitudes. Specifically, our objectives are to put in place behavioral experience sampling methodologies and probe-caught methodologies for measuring online mind-wandering. We intend to design a set of virtual teams using laboratory experiments followed by survey. Our study aims to add to the body of research on virtual teams and mind-wandering by determining the relation between attitude, social factors, and emotions of team members and self-reported engagement in TUT.

Purpose: This study aimed to evaluate the effect of task-oriented training on trunk stabilization, coordination of the lower extremities, and dynamic balance of patients with stroke. Methods: Ten patients with stroke were randomly divided into two groups of five patients each who met the selection criteria. The training was conducted five times a week for 60 minutes. The experimental group received task-oriented training and general physical therapy, while the control group received only general physical therapy. The Mann-Whitney U test was used to compare differences between the groups, and the Wilcoxon signed-rank test was used to compare differences between pre- and post-intervention within each group. Results: Trunk stabilization was measured using the trunk impairment scale. Only the coordination assessment on the trunk impairment scale was statistically significant after intervention in the experimental group (p = 0.046) and between the experimental and control groups (p = 0.029). The LEMOCT, figure-of-8 walk test (F8WT), timed up-and-go (TUG) test results were not statistically significantly different in the group after intervention. However, the F8WT and TUG test results showed a statistically significant difference between the experimental and control groups (p = 0.029). Conclusion: The task-oriented training showed positive effects on the trunk stabilization, coordination of the lower extremities, and dynamic balance of the patients with stroke.

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.

Constraint-induced movement therapy (CIMT/mCIMT) and task-oriented training (TOT) represent prominent interventions for upper-limb rehabilitation following stroke; however, their relative efficacy and consistency across outcome measures remain subjects of ongoing debate. This study aimed to synthesize evidence from randomized controlled trials (RCTs) comparing CIMT and TOT for upper-extremity recovery post-stroke and to quantify pooled effects on validated impairment and activity assessments. Fourteen peer-reviewed RCTs published between 1990 and 2025 (seven investigating CIMT/mCIMT and seven investigating TOT) involving adult stroke survivors and providing sufficient data for meta-analysis were included. Adhering to a pre-specified protocol consistent with PRISMA 2020 guidelines, two independent reviewers conducted study screening, data extraction, and risk of bias assessment using the RoB 2 tool. Random-effects meta-analyses were performed to estimate pooled effect sizes; heterogeneity was evaluated using the I² statistic, and funnel plots were examined when the number of studies per outcome permitted. Primary outcomes synthesized included the MAL–Quality of Movement (MAL-QOM; mean difference [MD]), Action Research Arm Test (ARAT; standardized mean difference [SMD], Hedges’ g, based on change scores), and Fugl-Meyer Assessment for Upper Extremity (FMA-UE; SMD, Hedges’ g). Across four studies, MAL-QOM scores favored experimental interventions, predominantly CIMT variants, with a pooled MD of 0.68 (95% CI, 0.39 to 0.97; I² = 71%), indicating moderate but variable improvements in perceived real-world arm use. For ARAT (k = 3), pooled effects favored experimental treatments with an SMD of 0.95 (95% CI, 0.58 to 1.31; I² = 0%), and for FMA-UE (k = 2), the pooled SMD was 1.47 (95% CI, 0.98 to 1.97; I² = 0%), demonstrating robust enhancements in activity and impairment, respectively. The overall risk of bias was low to moderate, with masked outcome assessment commonly employed. Tests for publication bias were underpowered due to the limited number of studies (k < 10). These findings support the efficacy of intensive, task-specific upper-limb rehabilitation post-stroke. CIMT/mCIMT exhibited the most consistent benefits across impairment and activity outcomes, whereas TOT demonstrated advantages that appeared contingent upon intervention dose, fidelity of implementation, and task relevance. Clinically, rehabilitation programs that provide sufficient, progressive, and meaningful practice (utilizing CIMT when feasible and dose-matched TOT when restraint is impractical) are most likely to yield clinically significant improvements.

혁신적 행동은 조직의 장기적인 생존을 위해 점점 더 중요해지고 있으며, 변화 지향적 리더십은 특히 구성원 의 혁신적 행동을 촉진하는 데 효과적이라고 주장되고 있다. 하지만 이 관계에 대한 실증적 증거가 부족하기 때 문에, 본 연구는 변화 지향적 리더십이 구성원의 성과에 미치는 영향을 분석하는 것에 중점을 두었다. 구체적으 로, 본 연구는 변화 지향적 리더십과 과업 성과 간의 관계에서 혁신적 행동의 매개 효과와 변화 지향적 리더십 과 혁신적 행동 간의 관계에서 심리적 임파워먼트의 조절 효과를 분석하였다. 동일방법편의(common method bias)를 해결하기 위해 3차에 걸쳐 설문지를 수집하였고, 연구 결과 심리적 임파워먼트는 변화 지향적 리더십과 혁신적 행동 간의 관계를 조절하며, 혁신적 행동은 변화 지향적 리더십과 과업 성과 간의 관계를 매개하는 것으 로 나타났다. 또한, 심리적 임파워먼트를 느끼는 개인이 변화 지향적 리더십을 인식할 때 혁신적 행동에 더 많이 참여할 가능성이 있다는 매개된 조절 효과가 발견되었다.

Innovative behavior is increasingly important for an organization’s long-term survival and change-oriented leadership has been argued to be particularly effective in engendering follower innovative behavior. Due to the lack of empirical evidence for this relationship, this study focuses on linking change-oriented leadership to follower performance outcomes. Specifically, the study explored how innovative behavior mediates the relationship between change-oriented leadership and task performance, as well as how psychological empowerment moderates the relationship between change-oriented leadership and innovative behavior. Data were gathered through a three-wave self-reported questionnaire conducted in South Korea. The study found psychological empowerment to moderate the relationship between change-oriented leadership and innovative behavior while innovative behavior mediated the relationship between change-oriented leadership and task performance. Moreover, the study found mediated moderation suggesting that individuals that feel empowered are more likely to engage in innovative behaviors when they perceive change-oriented leadership.

목적: 본 연구는 국내외에서 과제지향 중재를 통해 뇌졸중 환자의 독립성 및 일상생활 수행에 미치는 영향을 분석한 연구들을 체계적으로 고찰하였으며, 특히 작업치료사의 중재 과정을 중심으로 학문적 근거를마련하고자 하였다. 연구방법: 과제지향 중재가 뇌졸중 환자의 독립성 및 일상생활수행에 미치는 영향에 대해 알아보았다. 2013년 8월부터 2023년 2월까지 RISS, KISS, DBpia, Google Scholar, PubMed에서 10년간의 문헌을 검색하였다. 주요 검색용어로 “뇌졸중”, “독립성”, “일상생활”, “일상생활 중재”, “인지”, “Stroke”, “Independence”, “ADL”, “Cognitive”를 사용하였다. 선정기준과 배제기준을 사용하여 총 12편의 문헌을 분석 대상으로 선정하였다. 결과: 과제지향 중재의 효과를 측정하기 위해 독립적인 일상생활, 상지 기능, 인지기능, 삶의 질 등의 평가도구를 사용하였다. 선정된 12편의 모든 문헌에서 과제지향 일상생활 중재는 과업 수준 증진에 유의미한 효과를 보였다. 뿐만 아니라, 운동기능, 삶의 질, 인지기능, 일상생활활동, 심리 사회적인 부분에서도유의미한 효과를 보였다. 결론: 본 연구를 통해 뇌졸중 환자의 독립성과 일상생활 수행의 기능 향상을 확인하였고 뇌졸중 환자의 삶의 질 변화에 긍정적인 효과가 있음을 알 수 있었다. 이는 과제지향 중재가 임상에서 적절하게 활용될수 있는 학문적 근거 자료를 마련하였다는 의의가 있다.

Objective : This study systematically analyzed the impact of task-oriented interventions on the independence and daily living of people who have experienced stroke worldwide. Methods : The RISS, KISS, DBpia, Google Scholar, and PubMed databases were search for related studies from August 2013 to February 2023. The main search terms were “stroke”, “independence”, “daily life”, “daily life arbitration”, “recognition”, “ADL”, and “cognitive”. Twelve papers were selected for analysis based on the inclusion and exclusion criteria. Results : Tools evaluating independence in activity of daily living, upper limb function, cognitive function, and quality of life were used to measure the effectiveness of task- oriented interventions. Interventions in activity of daily living by occupational therapists substantially increased the task level of the individuals in all 12 studies. In addition, arbitration in daily life considerably affected the motor function, quality of life, cognitive function, activities of daily living, and psychosocial functioning of people with stroke. Conclusions : Occupational therapists systematically applied task-oriented interventions, with the results confirming the effectiveness of this method. Thus, clinical information and evidence can be appropriately used to guide evidence-oriented interventions in clinical practice.

목적 : 연구의 목적은 성인 뇌졸중 환자에게 과제 지향적 중재를 적용한 연구를 대상으로 체계적 문헌 고찰을실시하여 중재 내용과 결과, 사용된 작업치료 평가도구 및 효과를 분석하여 근거를 알아보기 위함이다. 연구방법 : 본 연구는 검색 엔진으로 국내와 국외 데이터베이스인 한국학술정보(Korean Studies Information Service System; KISS), 학술연구정보서비스(Research Information Sharing Service; RISS), 구글학술검색(Google Scholar), PubMed, ProQuest Central을 사용하여 2014년 1월부터 2023년 12월까지 출판된 문헌을 검색하였다. 주요 검색용어로는 국내 “뇌졸중” AND “과제 지향”, 국외 “stroke” AND “task oriented”를 사용하였다. 최종적으로 선정된 12편의 연구를 분석하였다. 결과 : 국내 논문 4편과 국외 논문 8편을 분석한 결과 대부분의 연구에서 2가지 이상의 활동을 결합한 구조의 과제 지향적 중재를 제공하였고, 12편의 논문 중 9편에서 상지기능과 심리사회적인 수준에 유의한향상이 나타났다. 또한 상지기능 개선 효과 확인을 위한 평가도구로는 JTHFT, MFT가 가장 많이 사용된 것으로 확인되었다. 결론 : 본 연구에서 뇌졸중 환자에게 적용한 과제 지향적 중재를 체계적으로 고찰하여 그 효과를 확인하였다. 이는 작업치료 현장에서 과제 지향적 중재가 효과적으로 이루어지기 위한 기초 자료로 활용될 수있을 것이다.

Objective : This study aimed to analyze the effects of task-oriented interventions for evidence of benefits in patients with stroke. To this end, we conducted a systematic review of Korean and international literature, compared intervention details and occupational assessment tools used, and analyzed the results and effects. Methods : PubMed, ProQuest Central, Google Scholar, KISS, and RISS were searched for Korean and international literature published between January 2014 and December 2023. Our search terms were "stroke" and "task oriented.” Twelve studies were selected for further analyses. Results : Analysis of relevant studies in 4 domestic journals and 8 international journals revealed that most studies providing task-oriented interventions structured them by combining two or more activities. Nine of 12 studies showed significant improvement in upper limb function. In addition, the JTHFT and MFT were the occupational assessment tools most commonly used to confirm efficacy in improving upper extremity function. Conclusion : In this analysis, efficacy was confirmed through a systematic examination of task-oriented interventions in studies involving patients with stroke. This information can be used as a basis for effective task-oriented interventions in occupational therapy.

목적 : 본 연구는 기능적 전기 자극을 병행한 과제 지향적 훈련이 불완전 경수 손상 환자의 손 기능에 미치는 영향을 알아보고자 하였다. 연구방법 : 대상자는 불완전 경수 손상 진단을 받은 성인 3명으로, ABA 설계를 사용하였으며, 연구기간 동안 기초선(A1) 5회기, 중재기(B) 20회기, 재기초선(A2) 5회기로 총 30회기 실시하였다. 중재기(B) 동안 기능적 전기 자극을 병행한 과제 지향적 훈련이 제공되었고, 모든 회기에는 손 기능을 평가하기 위해 상자와 나무토막 검사(Box and Block Test), 떨어지는 막대 잡기(Grip the falling bar)와 먹기 흉내 내기(Simulated feeding)를 측정하였으며, 기초선(A1) 전, 재기초선(A2) 후로 Canadian Occupational Performance Measure(COPM), Jebsen-Taylor Hand Function Test(JTHFT)와 Wolf Motor Function Test(WMFT)를 실시하여 중재 효과를 살펴보았다. 결과 : 모든 대상자는 상자와 나무토막 검사(Box and Block Test), 떨어지는 막대 잡기(Grip the falling bar)와 먹기 흉내 내기(Simulated feeding)를 통해 기초선(A1)보다 중재기(B)에서 우세 손 기능이 향상되었고, 재기초선(A2)에서 그 효과가 유지되었다. 재기초선(A2) 후 COPM, JTHFT와 WMFT의 결과, 우세 손 기능의 향상과 과제 수행도와 만족도의 향상을 보였다. 결론 : 기능적 전기 자극을 병행한 과제 지향적 훈련은 경수 손상 환자의 손 기능뿐만 아니라, 대상자가 선택한 훈련 과제의 과제 수행도와 만족도 향상에 효과적이다.

Objective : The purpose of this study was to investigate the effects of task-oriented training with functional electrical stimulation on hand function in incomplete cervical cord injury. Method : The subjects of the study were 3 adults diagnosed as incomplete cervical cord injury. The design of this study was ABA single-subject research design to compare dominant hand function of before and after intervention and detect individual effects. The experiment consisted of 30sessions, in which baseline process A1 and A2 were implemented 5 sessions each for 10sessions. Intervention B was implemented 20 sessions. The dependent variable was converted to the change of hand function every session, and Canadian Occupational Performance Measure(COPM), Jebsen-Taylor Hand Function Test(JTHFT), Wolf Motor Function Test(WMFT) were selected for outcome measurements. Result analysis was suggested through visual analysis using a graph and comparison of pre, post and follow-up intervention measurements. Results : As a result, the quality and quantity of dominant hand function increased during intervention B compared to the baseline A1 for all subjects. Baseline A2 was also maintained without training. Additionally, JTHFT, WMFT and COPM scores demonstrated improvement and maintain. The follow up JTHFT and WMFT showed increased required time on all subjects and decrease or maintain task performance and satisfaction in COPM. Conclusion : The task-oriented training with function electrical stimulation in this study has been positive effects on hand function and task performance and satisfaction.

목적 : 본 사례연구는 보툴리눔 독소(Botulinum Toxin) 주사 후 과제 지향적 훈련이 뇌졸중 환자의 상지 기능 변화와 일상생활활동에 향상에 영향을 미치는지 알아보고자 하였다. 연구방법 : 실험 대상자는 뇌졸중으로 인해 편마비 진단을 받은 44세 남자 환자로 손상 측 상지에 보툴리눔 독소 주사 후 과제 지향적 훈련을 주 5회 30분씩 8주간 훈련을 받았다. 평가는 주사 전, 중재 4주 후와 8주 후의 상지기능변화와 일상생활활동 수행변화를 평가하였다. 상지기능 평가는 뇌졸중 상지기능 평가(Manual Function Test; MFT)와 상자와 나무토막 검사(Box and Block Test)로 평가하였고, 일상생활활동 수행평가는 수정된 바델지수(Modified barthel index; MBI)로 측정하였다. 결과 : 상지기능평가에서 손의 조작능력과 기민성이 향상되었고 또한, 일상생활활동 하위 영역 중 개인위생, 식사하기, 용변처리, 옷 입기 항목에서 향상을 보였다. 결론 : 본 연구 결과를 바탕으로, 보툴리눔 독소 주사 후 과제 지향적 훈련이 뇌졸중 환자의 상지기능 및 일상생활활동 수행능력 향상을 위한 치료에 효과적임을 알 수 있었다.

Objective : This study was examined the effects of task-oriented training therapy after botulinum toxin injection, upper extremity function and activities of daily living for stroke patient. Methods : The subject was a 44 year old male who suffered from hemiplegic patient received a task-oriented training therapy after botulinum toxin injection on involved upper extremity for 30-min sessions 5 times every week during 8 weeks. The scores were obtained before the injection, at 4 weeks, and 8 weeks after the injection. The upper extremity function was assessed using a Manual Function Test and Box and Block Test, and also Modified Barthel Index was applied for evaluation of Activities of Daily Living performance ability. Results : The results of this study show that the subject’s In-hand manipulation and dexterity function increase significantly. Also, In activities of daily living, personal hygiene area, feeding area, toilet area, dressing area scores are improved significantly. Conclusion : Through this study, task-oriented training after botulinum toxin injection can improve upper extremity function and Activities of Daily Living performance ability of patient with stroke.

목적 : 상지 협응 움직임을 기반으로 한 과제중심적 접근 훈련이 발달성 협응 장애아동의 한글 글씨쓰기 능력에 미치는 영향을 알아보며 각 접근이 한글 글씨 쓰기 수행의 질과 글씨쓰기 준비기술에 미치는 영향을 비교하고자 한다. 연구방법 : 본 연구는 5~10세의 발달성 협응장애 아동 40명을 대상으로 무작위 추출을 통해 두 집단으로 나뉘어 사전-사후 검사로 진행하였다. 두 집단은 과제중심접근 중재군과 과정중심접근 중재군으로 5주 동안 40분씩 주 2회중재를 받았다. 글씨쓰기 수행은 한글 자모 쓰기 검사로 측정하고, 글씨쓰기 준비요소인 상지 운동 기능, 시 지각기능과 시 운동기능은 각각 운동 유창성 평가(Bruininks-Oseretsky Test of Motor Proficiency-2: BOT-2)중미세운동조절의 하위검사 일부, 한국판 시 지각 발달 검사(Korean-Developmental Test of Visual Perception-2: K-DTVP-2), 개정된 시 운동기술 평가(Test of Visual Motor Skills-Revised: TVMS-R)로 평가하였다. 고찰 : 본 연구는 과제중심접근법을 적용하여 발달성 협응 장애아동의 글씨쓰기 수행도를 향상시킨다는 임상적 근거를 제공하는데 의의가 있다. 또한 과정중심접근법과 과제중심접근법이 글씨쓰기 준비기술의 향상에 어떠한 영향을 끼치는 지에 대한 결과를 확인하여 보다 효과적인 글씨쓰기 중재방법을 제시하는 초석이 될 수 있을 것이라생각한다.

Objective : The purpose of this study is to investigate the impact of task-oriented approach based on upper limb coordinated movement on the ability of the Korean handwriting in children with developmental coordination disorder(DCD). Methods/Design : This randomized controlled trial designed as a pre-/post- test will compare the effectiveness of task-oriented approach and process-oriented approach on handwriting performance for children with DCD aged 5 to 10. These interventions consist of 10 training sessions and 4 assessment sessions over 7weeks. Children will be measured regard to handwriting legibility, speed and pre-handwriting skills including upper limb movement skills, visual perception and visual motor coordination. Conclusion : This is the first attempt to investigate effects of a task-oriented approach in children with DCD. The significance of this study is to provide the clinical evidences to apply the task-oriented approach improves the children’s handwriting performance. Furthermore it will also present a more effective intervention for handwriting by figuring out each approach’s impact on the improvement of pre-handwriting skills.