Earticle

This study was to identify the effects of task oriented training of trunk stability on a swiss ball in sitting position on trunk stability and balance in children with spastic diplegic cerebral palsy. 20 subjects were participated in this study and allocated into the experimental group (EG) trained with task oriented training on a swiss ball and the control group (CG) trained with it on a mat. Pediatric reaching test (PRT) and Touching-to-the-ground in Trunk control measurement scale (tTCMS) for trunk stability and Sitting, Quadruped and Kneeling in Gross motor function measure (sGMFM, qGMFM and kGMFM) and Static and Dynamic stability in TCMS (sTCMS and dTCMS) for balance were used as assessment tools conducted before and after 8-week training. In results, there were significant differences in PRT, tTCMS, sGMFM, qGMFM, kGMFM, sTCMS and dTCMS in both EG and CG (p<.05). And there were more significant differences in PRT, tTCMS, sTCMS and dTCMS of EG than those in CG (p<.05). Therefore, this study showed that task oriented training of trunk stability on a swiss ball in sitting position gave beneficial effects on trunk stability and balance in children with spastic diplegic cerebral palsy.

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.

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.

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.

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.

Motor imagery is the mental representation of movement without any body movement. It has been reported that showing positive results to improve balance and walking in neural rehabilitation. This study aimed to prove the effects of motor imagery with functional training on fall efficacy in elderly people as well as balance and gait, and to investigate whether motor imagery training can be used as a possible intervention for fall prevention. Three subjects who were over 65 years old participated for this study. Outcome measures were Berg Balance Scale (BBS) to evaluate the subjects’ balance ability, Timed Up and Go Test (TUG) for dynamic balance ability, and Fall Efficacy(FES) to assess fear of falling in the elderly. Also GAITRite System was used to measure gait parameters. Motor imagery training was performed for 1 hour per day, three times per week for six weeks (a total of 18 sessions). The findings suggest that all variables improved after the intervention. Overall, a motor imagery training might be used to enhance balance and gait, fall efficacy in the elderly people.

본 연구는 만성 뇌졸중환자의 상지 기능과 일상생활동작에 대한 동작관찰훈련과 과제지향훈련의 효과를 비교하기 위하여 시행되었다. 연구대상자들은 총 12 명으로 1 집단과 2 집단에 6 명씩 무작위로 할당되었으며, 각 집단의 대상자들에게 동작관찰훈련(A)과 과제지향훈련(B)을 순차적으로 적용하였다. 본 연구는 교차연구 설계를 사용하여 1 집단은 A-B, 2 집단은 B-A의 순서로 중재가 적용되었다. 각 훈련은 2 주 동안 주 5회, 매일 30 분씩 시행되었으며, 총 실험기간은 4 주였다. 측정은 울프 운동 기능검사(Wolf motor function test, WMFT)와 수정된 바델 지수(modified Barthel index, MBI)를 사용하여 기초선, 2 주후, 4 주후에 시행되었다. 본 연구의 결과는 과제지향훈련과 동작관찰훈련 모두 만성 뇌졸중환자의 WMFT와 MBI 점수를 유의하게 향상시키는 것으로 나타났으나(p<.05), 두 훈련 방법의 차이는 없었다(p>.05). 훈련 전후의 효과크기는 두 집단 모두 동작관찰훈련을 시행하였을 때 더 높은 것으로 나타났다. 이러한 결과는 동작관찰훈련과 과제지향훈련 모두 뇌졸중 환자의 상지기능과 일상생활동작을 향상시키는데 도움이 된다는 것을 의미하는 것이며, 동작관찰훈련의 임상적용 가능성을 지지하는 것이다.

This study aimed to compare the effectiveness of action-observational training and task-oriented training on upper limb function and activities of daily living in patients with post-stroke hemiparesis. This study included 12 voluntary participants with post-stroke hemiparesis. Subjects were randomly assigned to either group 1 or group 2, with 6 in each group. Each subject completed the crossover experiment that comprised of action-observational training (A) and task-oriented training (B). The intervention sequence was A-B for the group 1 and B-A for the group 2. Each training was performed for 30 min a day, 5 times a week for 2 weeks (total experimental period of 4 weeks). Assessments were made using the Wolf Motor Function Test (WMFT) and Modified Barthel Index (MBI) thrice: at baseline, after 2 weeks of intervention, and after 4 weeks of intervention. The results showed that the WMFT and MBI scores significantly improved after the completion of each training (p<.05). Therefore, a determination of the superior training method was difficult. The effect sizes of both groups were greater when performed the action-observational training. The findings suggest that both the action-observational training and task-oriented training may be helpful in improving the upper limb function and activities of daily living for patients with post-stroke hemiparesis, and support the clinical feasibility of the action-observational training.

목적 : 본 연구는 치매모델 쥐에게 과제지향 훈련을 반복적으로 실시하고 그 결과로 인지기능과 중추신경계 가소성의 한 지표 물질인 아세틸콜린의 함량 변화를 관찰하여 치매의 개선 효과를 확인하는데 그 목적이 있다. 연구방법 : 스코폴라민을 투여한 치매모델 쥐에게 과제지향 훈련을 수행하지 않은 실험군Ⅰ과 과제지향 훈련을 수행한 실험군Ⅱ으로 구성하였다. 과제지향 훈련은 앞발의 뻗기, 잡기, 옮기기를 적용하였고 장애물 보행을 실시하였다. 인 지기능은 기억력의 측정에 정량화된 수동회피검사를 실시하였고 중추신경계 가소성의 변화는 아세틸콜린의 함량의 변화를 비교하였다. 결과 : 연구의 결과는 다음과 같다. 첫째, 스코폴라민을 투여한 치매모델 쥐의 과제지향 훈련을 실시한 후 4일부터 인지 기능의 유의미한 향상이 있었다(.00). 둘째, 스코폴라민을 투여한 치매모델 쥐에 적용한 과제지향 훈련은 아세틸콜린 함량의 유의미한 증가를 보였다(.00). 결론 : 본 연구에서는 작업치료 중재 중 임상에서 노인성 치매환자에게 많이 수행하고 있는 과제지향 훈련을 치매모델 쥐에게 수행함으로서 기억력 개선을 통한 인지기능 향상과 중추신경계 가소성을 확인할 수 있는 아세틸콜린의 함량 증가를 과학적으로 입증하였다.

Objective : The purpose of this study is to repeatedly conduct task-oriented training in scopolamine-induced dementia rats and as a result observe changes in the content of acetylcholine, a marker of cognitive function and central nervous system plasticity, to identify the improvement effect of dementia. Methods : It consisted of two groups. One group I was that did not perform task-oriented training in scopolamine-induced dementia rats and the other group II was that performed task-oriented training. Task-oriented training involved stretching, grasping and moving arms and walking obstacles on the legs. We performed a quantified passive avoidance test in the measurement of memory for cognitive function and compared the change in the content of acetylcholine for the plasticity of the central nervous system. Results : The results of the study are as follows: First, there was a significant improvement in cognitive function since the 4th days after task-oriented training of scopolamine-induced dementia rats(.00). Second, task-oriented training applied to scopolamine-induced dementia rats showed a significant increase in acetylcholine content. Conclusion : In this study, task-oriented training, which is often performed on senile dementia patients during occupational therapy intervention, was scientifically demonstrated in scopolamine-induced dementia rats by enhancement of cognitive function through memory improvement and increase in the content of acetylcholine confirming central nervous system plasticity.

목적 : 본 연구는 기능적 전기자극 동안의 과제훈련이 뇌졸중 환자의 상지기능에 미치는 영향을 평가하고, 회귀분석 을 통해 인과관계에 따른 설명력을 확인하고자 한다. 연구방법 : 뇌졸중으로 인한 편마비 환자 39명을 대상으로 중재방법에 따라 세 그룹으로 나누어 비교하였다. 15명 의 실험군은 기능적 전기자극 동안에 과제훈련을 실시하였고, 13명의 대조군Ⅰ은 기능적 전기자극만을 실시하였으며, 11명의 대조군Ⅱ는 과제훈련만을 실시하였다. 6주 후에 분산분석을 통해 세 그룹 간에 손의 근력과 상지의 기능, 운동 활동 지표와 일상생활활동에서 평균변화량의 차이를 각각 비교하였다. 그리고 영역별 결과에서 상지기능의 향상에 대한 잠재적인 변인들과의 상관관계를 분석하고, 회귀분석을 통해 상지기능에 영향을 주는 요소의 인과관계를 분석하였다. 결과 : 연구 결과 손의 근력과 상지 기능, 운동 활동 지표에서 세 그룹 간에 유의한 차이를 확인하였고, 기능적 전기자극 동안에 과제훈련을 실시한 실험군에서 통계적으로 유의한 향상을 보였다(p<.05). 이러한 긍정적인 결과에서 나타난 각 요소들은 상호간에 높은 상관관계를 보였으며, 변수간의 인과성을 확인하기 위한 위계적 중다회귀분석 결과, 모형 1에서는 근력(R2 = .17), 모형 2에서는 움직임의 질(R2 = .28), 모형 3에서는 움직임의 질과 실험군 중재법(R2 = .37)이 유의한 설명력을 보였다. 운동 활동 지표 중 움직임의 질과 실험군에서 실시한 중재 방법이 상지 기능에 가장 영향력 있는 변수로 나타났고, 상지기능의 회복을 위해 기능적 전기자극 동안의 과제훈련에 대한 중요성을 입증하였다. 결론 : 기능적 전기자극 동안에 과제훈련을 실시한 실험군은 대조군Ⅰ,Ⅱ보다 손의 근력과 상지기능, 운동 활동 지표에서 더 긍정적인 효과를 보였다. 또한 움직임의 질과 기능적 전기자극 동안의 과제훈련이 상지기능 향상을 위한 높은 설명력을 보였다. 따라서 뇌졸중 환자의 상지기능 향상을 위하여 기능적 전기자극 동안에 능동적이고 반복적인 과제훈련 적용이 작업치료사에 의해서 활발하게 이루어져야 할 것이다.

Objective : The purpose of this study is to assess effects of task-oriented training on upper extremity during functional electrical stimulation, and to confirm a causal relationship among the factors in stroke patients. Methods : Thirty-nine hemiplegia with stroke participated in this study. Experimental group conducted taskoriented training during functional electrical stimulation for fifteen patients. Control groupⅠ conducted functional electrical stimulation for thirteen patients and Control groupⅡ conducted task-oriented training on non-sounded upper extremity for eleven patients. Mean differences among the groups were analyzed by One-way ANOVA in six weeks. Hierarchical multiple regression analysis was performed to determine the factors effect function of upper extremity. Results : Hand muscle strength, hand function, motor activity log were compared in three groups, the experimental group showed a statistically significant improvement(p<0.05). These factors were highly correlated with each other. In particular, Hand strength and MAL, interventions were 37% of the variance for upper extremity functional recovery. QOM of MAL test and task-oriented training interventions during functional electrical stimulation in upper extremity function were the most influential variables. Conclusion : The experimental group that conducted task-oriented training during functional electrical stimulation showed positive effects more than the those of control groupⅠ & Ⅱ. Voluntary and repetitive training during functional electrical stimulation will be clinically useful in the field of 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.

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.

The purpose of this study is to investigate the effect of task-oriented voluntary trunk rotation among stroke patients with unilateral neglect; the focus was to detect any reduction of unilateral neglect or increase in balancing ability. This study used a single subject experimental design with multiple baselines. Participant 1, 2 and 3 performed 4, 8 and 12 sessions each during the baseline phase, and 16, 12 and 8 sessions at the intervention, respectively. The results were assessed by using the line bisection test, Berg Balance Scale(BBS), which were separately implemented. The Line bisection scores of participant 1, 2 and 3 were improved by 38.9%, 44% and 35.9%, trunk rotation in task-oriented voluntary trunk rotation. The BBS scores of participant 1, 2 and 3 were improved by 39.6%, 31.6% and 7.7% each, compared to the baseline. The findings suggest that task-oriented voluntary trunk rotation is adaptable to clinical applications to reduce unilateral neglect and to enhance balancing ability to the target patients. Future studies with wider range of participants and longer experiment span, are required in order to strengthen the result of the research.

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 : 본 연구는 뇌성마비 아동의 신체기능과 일상생활 향상을 위해 적용된 과제 중심 훈련 방법에 대해 정리하고 효과를 제시하고자 하였다. 연구방법 : 검색 기간은 2008년 1월부터 2020년 8월까지로 하였으며, 자료 검색을 위해 CINAHL, MEDLINE, PubMed의 데이터베이스를 이용하였다. 총 18편이 선정되었으며, PICO(Patient, Intervention, Comparison, Outcome) 방법을 적용하여 체계적으로 정리하였다. 과제 중심 훈련은 선행연구를 참고하여 운동학습 및 운동조절 이론의 전략인 과제(Task), 실행(Practice), 피드백(Feedback)으로 분류하여 제시하였다. 결과 : 그 결과 13편의 연구가 운동기술 영역에서 유의한 결과를 보였으며, 그 중 2편의 연구에서 일상생활 영역에서 유의한 결과를 보였다. 과제는 개별 과제(discrete task)와 닫힌 과제(closed task) 형태가 가 장 많이 사용되었다. 실행은 전체 실행(whole practice) 유형이 가장 많이 사용되었으며, 부분 실행 (part practice), 차단 실행(blocked practice) 순으로 사용되었다. 마지막으로 피드백은 구체적으로 제 시하지 않은 경우가 가장 많았으며, 외재적 피드백(extrinsic feedback)이 사용되었다. 결론 : 본 연구를 바탕으로 향후에는 뇌성마비 아동의 운동조절을 촉진하는 기술의 체계적인 선택과 구체적 인 방법의 제시를 통하여 과제 중심 훈련이 임상에서 더욱 효과적으로 사용될 수 있을 것이라 기대한다.

Objective : This study aimed to analyze and classify the task-oriented training methods used to improve the daily lives of children with cerebral palsy. Methods : The search period from January 2008 to August 2020, and the CINAHL, MEDLINE and PubMed was databases were used. A total of 18 studies was selected, and the PICO method was applied to conduct the systematic review. The training methods were then classified according to task, practice, and feedback as strategies to learn or to exercise control based on prior research. Results : Of the selected studies, 13 reported significant results in the area of motor skills, two of which related to Activities of Daily Living. Discrete and closed were the most common forms of task, and the most used types of practice were whole, part, and blocked, in that order. Finally, feedback was not specifically provided in most studies, followed by extrinsic feedback. Conclusion : Based on this review, task-oriented training for children with cerebral palsy can be made more effective in clinical practice in the future through the systematic selection of techniques that promote exercise control and the presentation of specific methods.

본 연구는 뇌졸중 환자에게 과제 지향적 훈련과 진동 자극을 결합한 중재에 경두개 직류 전류 자극을 융합했을 때 상지 기능의 회복에 미치는 영향을 알아보고자 하였다. 총 20명을 대상으로 총 4주간, 주 5회, 30분씩 실시했으며, 경 두개 직류 전류 자극을 융합한 과제 지향적 훈련과 진동자극의 결합 중재의 실험군과 과제 지향적 훈련과 진동자극 의 결합 중재의 대조군으로 나누었다. 측정은 손의 기민성과 상지기능의 회복을 측정하였다. 실험군과 대조군은 손의 기민성과 잡기, 쥐기, 큰 동작 움직임에서 유의한 개선을 보였으며(p<.05), 실험군은 손의 기민성과 잡기, 쥐기 동작에서 대조군 보다 유의한 개선을 보였다(p<.05). 중재 전후 효과 크기는 모든 평가 항목에서 작은 효과이상을 보였다. 본 연구 결과를 근거로 하여 임상 환경에서 보다 효과적이고 효율적인 재활 치료를 할 수 있을 것으로 사료된다.

The purpose of this study was to investigate the Effect of transcranial direct current stimulation convergence task-oriented training combined with vibration stimulation on hand dexterity and upper limb function in stroke patients. One time 30 minutes 5 times a week for 4 weeks. experimental group of transcranial direct current stimulation convergence task-oriented training combined with vibration stimulation and control group of the task-oriented training combined with vibration stimulation were divided into 10 members. Hand dexterity and upper limb recovery were measured. The experimental group and the control group showed significant improvement in hand dexterity and grasping(p<.05), grasping, and gross movement(p<.05). The experimental group showed a significant improvement in hand dexterity and grasp and grip than the control group. Effect size showed more than small effect in all evaluation items. Based on the results of this study, it is considered that more effective and efficient rehabilitation treatment can be performed in the clinic.

목적 : 본 연구는 경직형 양마비 아동에게 과제지향훈련을 시행할 때 무게조끼 적용이 대동작 수행력과 균형 능력에 미치는 영향을 알아보며 뇌성마비 아동을 치료하기 위한 중재방법으로 임상적으로 유용한지 제안하고자 시도되었다. 연구방법 : 연구 대상자를 단순 무작위 표본추출법으로 실험군(남자 : 9명, 여자 : 8명, 평균연령 : 8.12세)과 위약군(남자 : 9명, 여자 : 8명, 평균연령 : 7.53세) 각각 18명씩 배분한 후 두 중재군 모두에게 1회 40분, 주 2회 과제지향훈련을 12주 동안 실시하였다. 실험군은 무게저항을 제공하는 무게조끼를 착용하고, 위약군은 무게저항 없이 무게조끼만 착용 하였다. 두 중재군 모두에게 닫힌 운동사슬과 다관절의 기능적인 움직임 패턴을 촉진하는 과제지향훈련을 각각 8~10회 실시하며 과제 사이에 약 3분간 휴식 하였다. 두 중재군의 대동작 수행력, 균형 능력에 대한 사전검사는 중재 전에 측정하였고, 사후검사는 중재 6주후와 12주후 총 2회 시행하였으며 마지막으로 추적검사는 실험종료 12주후에 실시한 후 두 중재군 사이의 시간경과에 따른 변화량을 분석하였다. 결과 : 대동작 수행평가는 중재 6주후와 12주후에는 실험군이 위약군보다 평균 점수가 더 증가하였으며 유의한 차이가 나타났다(p<.05). 아동용 균형척도는 중재 6주후와 12주후에는 실험군이 위약군보다 평균 점수가 더 증가하였으며 유의 한 차이가 있었다(p<.05). 결론 : 그러므로 닫힌 운동사슬과 다관절의 기능적인 움직임을 촉진시키는 과제지향훈련 시 무게조끼 적용은 경직형 양마 비 아동의 대동작 수행력과 균형 능력을 향상시키는 유용한 중재 방법으로 고려될 수 있다.

Objective : The purpose of this research is to find clinical effects of application of weighted vest during task-oriented training focused on gross motor performance and balance abilities of children with spastic diplegia. Methods : 34 subjects were divided by simple random sampling into two groups; experimental group (male : 9, female : 8, average age : 8.12) and placebo group (male : 9, female : 9, average age : 7.53). Both two groups underwent to 40 minute intervention, twice a week for 12 weeks. The intervention was task-oriented training focused on facilitating closed kinematic chain and multi-joint functional movement pattern. During the training, the experimental group received loaded-resistance weighted vest and placebo group also received weighted vest but without loaded-resistance. Participants in both groups underwent 8 to 10 reps of the task-oriented training and there were 3 minutes break time between tasks. There were pre-test of gross motor performance and balance abilities, and two times of post-tests were performed upon 6 weeks and 12 weeks after the intervention completed. And in final, an additional follow-up test was performed 12 weeks after the evaluation was finished in order to find any difference between the two groups over time. Results : There was significant difference in Gross Motor Performance Measure (GMPM) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). There was significant difference in Pediatric Berg’s Balance Scale (PBS) between two groups. It is found that average score of the experimental group increased more than the placebo group after 6 weeks and 12 weeks intervention (p<.05). Conclusion : Based on the results in this study, it is proposed that application of weighted vest into task-oriented training to facilitating closed kinematic chain and multi-joint movement can improve gross motor performance and balance abilities of children with cerebral palsy.

This study examined the effectiveness of combining remote physical therapy with task-oriented training to improve hand grip strength, and respiratory function in a patient with duchenne muscular dystrophy (DMD). An 18-year-old male with DMD participated in a 4-week program consisting of weekly clinic-based task-oriented respiratory therapy (balloon-blowing and inspiratory muscle training) and home-based exercises (diaphragmatic pursed-lip breathing, and upper extremity stretching) performed under parental supervision, with daily monitoring of exercise adherence. After the intervention, hand grip strength increased from 1 kg to 2 kg bilaterally, peak cough flow rose from 90 L/min to 96 L/min, and chest circumference showed slight increases at the axilla, xiphoid process, and the midpoint between the xiphoid and navel during both maximal expiration and inspiration, while forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) remained at similar, markedly reduced predicted levels without evidence of obstructive ventilatory impairment. Forearm supinator and pronator strength improved from trace to poor on manual muscle testing, and the visual analog scale score for dyspnea decreased from 5 to 2, with high exercise adherence and no adverse events reported. These findings suggest that combined remote physical therapy and task-oriented training is a feasible, safe, and practical home-based rehabilitation approach for a DMD patient, with potential benefits for maintaining functional status and quality of life.

The aim of this study was to determine effect of a task-oriented circuit training for functional performance after stroke. Subject was 20 outpatients and randomly divided into two group: 10 subjects were experimental group who executed the task-oriented circuit training (3 times/wk) and general physical-occupational therapy(5 times/wk) for 4 week. 10 subjects were control group who executed only general physical-occupational therapy(5 times/wk) for 4 week. All subject were evaluated about 10m walking test, 6 minutes walking test, physical activity scale for individuals with physical disability(PASIPD). Subject have conducted the measurement variable, 10MW, 6MW, PASIPD ,before and after 4week of exercise, respectively. An independent t-test was used to determine the between the experimental group and the control group after 4 week of exercise. While a paired t-test was used to examine the differences in the experimental group before and after the task-oriented circuit training. Results are as follows : There was statistically significant increase of 10m walking test of experimental group after 4 weeks of task-oriented circuit training(p<.05). There was statistically significant increase of 6 min walking test of experimental group after 4 weeks of task-oriented circuit training(p<.05). There was statistically significant increase of PASIPD of experimental group after 4 weeks of task-oriented circuit training(p<.05). There were statistically difference of 10MW, 6MW, PASIPD between experimental group and control group(p<.05). This study proved that task-oriented circuit training after stroke can improve functional performance. Thus, this study suggest that task-oriented circuit training for functional performance be effective on the stroke rehabilitation.

The purpose of this study was to investigate the effect of task-oriented functional training on a musscle strength , balance and gait ability of chronic hemiplegia patients. Ten who were able to walk independently were evaluated in this study. Subjects exercised three, 60min times a week for 12 weeks. Functional Exercises consist of sit to stand, reaching, pick up, transfer and gait on various environments. We measured strength of lower extremity by manual muscle test, static balance by forceplate, dynamic balance through TUG and BBS. 10m walking time reflects gait ability. The paired t-test was performed to analyze differences between pre-and post-tests and α＝.05 set up with the significant level. The major findings of this study were that task-oriented functional exercises brought about increases in strengths of knee extensor(p<.001) and ankle dorsiflexor(p<.05), decrease in a averge sway path(p<.05), decrease in TUG (p<.05), increase in BBS(p<.05) and decrease in a10m walking time(p<.05). The strength of knee extensor to be significantly correlated with balance, gait ability(p<.05). Dynamic balance has positive correlation with gait ability(p<.05). We suggest that task-oriented functional training enabled stroke patient to improve the muscle strength, balance and gait ability, which is contribute to plan to rehabilitation exercise.