Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
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Analysis of Occupational Therapy Intervention Research for Improving Memory: Focus on Single-Subject Research Design in Korean Academic Journals

기억력 향상을 위한 작업치료 중재 연구 분석: 국내 단일대상연구 중심으로

  • Jung, Yu-Jin (Dept. of Occupational Therapy, Wonkwang University Hospital / Dept. of Occupational Therapy, Graduate School, Wonkwang University) ;
  • Choi, Yoo-Im (Dept. of Occupational Therapy, Wonkwang University)
  • 정유진 (원광대학교병원 재활의학과 작업치료사, 원광대학교 일반대학원 작업치료학과) ;
  • 최유임 (원광대학교 환경과학연구소, 의과대학 작업치료학과)
  • Received : 2021.05.10
  • Accepted : 2021.08.05
  • Published : 2021.11.30
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Abstract

Objective : This study aimed to identify the characteristics and analyze the quality of studies on memory improvement using a single-subject research design. Methods : Six studies were selected through the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and National Digital Science Library (NDSL). Keywords were memory training, stroke, early dementia, mild cognitive impairment, and single-subject research design. The characteristics and quality levels were analyzed between January 2011 and October 2020. Results : Regarding the quality level, the middle level (7-10 points) was 66.7% of the four articles, and the high level (11-14 points) was 33.3% of the two articles. Reversal designs were used in all studies. Independent variables were errorless learning, smartphone application, cognitive training system (CoTras), spaced retrieval training (SRT) with errorless learning, spaced retrieval training, and iPad applications. The dependent variables included memory, attention, electroencephalogram, instrumental activities of daily living, depression etc., which increased after the intervention. The total session, study period, and intervention time were varied. Conclusion : In single-subject research design related to memory training, occupational therapy intervention was confirmed as an effective method for improving memory and attention. The quality level of single-subject research design was moderate or higher, and high-quality level of studies should be conducted by additional design to increase the validity in the future.

목적 : 본 연구의 목적은 기억력 장애를 가진 성인 환자를 대상으로 기억력 향상을 위한 작업치료 중재를 수행한 단일대상연구의 특성을 확인하고 질적 수준을 알아보는 것이다. 연구방법 : 본 연구는 2011년부터 2020년까지 기억력 향상 작업치료 중재 연구 중 단일대상연구 설계를 적용한 총 6편의 논문을 분석한 문헌연구로, 연구내용에 대한 일반적 특성 및 연구방법의 질적 수준을 분석하였다. 결과 : 분석대상의 질적 수준은 66.7%(4편)가 중간 수준이었고 33.3%(2편)는 높은 수준이었으며, 낮은 수준의 연구는 없었다. 단일대상연구 설계 유형은 모두 반전설계로 ABA가 가장 많았다. 대상자는 뇌졸중, 치매, 경도인지장애 환자였으며, 대상자 수는 1~3명이었다. 독립변수는 오차배제훈련, 어플리케이션 활용 중재, 전산화인지훈련, 시간차회상훈련이었다. 종속변수는 공통변수인 기억력과 함께 집중력, 뇌파변화, 수단적 일상생활활동 및 우울이었다. 중재시간은 30~40분, 중재회기는 6~15회기였으며, 총 연구기간은 3~8주로 다양하였다. 중재 결과 모든 연구에서 중재 후 종속변수가 향상된 것으로 보고되었다. 결론 : 기억력훈련에 대한 단일대상연구 적용 작업치료 중재 연구들은 모두 중간 이상의 질적 수준을 보여 임상에서 적용 시 근거기반자료로 의의가 있으며, 기억력 향상에 효과적인 연구들이라는 것을 확인하였다.

Keywords

References

  1. Aben, L., Heijenbrok-Kal, M. H., van Loon, E. M., Groet, E., Ponds, R. W., Busschbach, J. J., & Ribbers, G. M. (2013). Training memory self-efficacy in the chronic stage after stroke: A randomized controlled trial. Neurorehabilitation and Neural Repair, 27(2), 110-117. doi:10.1177/1545968312455222
  2. Anderson, J. R. (2005). Cognitive psychology and its implications. American Journal of Psychotherapy, 41(1), 146. doi:10.1176/appi.psychotherapy.1987.41.1.146
  3. Backman, C. L., Harris, S. R., Chisholm, J. A. M., & Monette, A. D. (1997). Single-subject research in rehabilitation: A review of studies using AB, withdrawal, multiple baseline, and alternating treatments designs. Archives of Physical Medicine and Rehabilitation, 78(10), 1145-1153. doi:10.1016/s0003-9993(97)90142-8
  4. Byiers, B. J., Reichle, J., & Symons, F. J. (2012). Single-subject experimental design for evidence-based practice. American Journal of Speech-Language Pathology, 21(4), 397-414. doi:10.1044/1058-0360(2012/11-0036)
  5. Choi, Y. I., Kim, E. J., & Park, E. Y. (2012). Review the level of quality of single subject research design in the field of Korean occupational therapy by using the Journal of Korean Society of Occupational Therapy. The Journal of Korean Society of Occupational Therapy, 20(4), 111-124.
  6. Cicerone, K. D., Goldin, Y., Ganci, K., Rosenbaum, A., Wethe, J. V., Langenbahn, D. M., ... & Harley, J. P. (2019). Evidence-based cognitive rehabilitation: Systematic review of the literature from 2009 through 2014. Archives of Physical Medicine and Rehabilitation, 100(8), 1515-1533. doi:10.1016/j.apmr.2019.02.011
  7. Cumming, T. B., Marshall, R. S., & Lazar, R. M. (2013). Stroke, cognitive deficits, and rehabilitation: Still an incomplete picture. International Journal of Stroke, 8(1), 38-45. doi:10.1111/j.1747-4949.2012.00972.x
  8. das Nair, R., Cogger, H., Worthington, E., & Lincoln, N. B. (2016). Cognitive rehabilitation for memory deficits after stroke. Cochrane Database of Systematic Reviews, 2016(9), 1-62. doi:10.1002/14651858.cd002293.pub3
  9. Donovan, N. J., Kendall, D. L., Heaton, S. C., Kwon, S., Velozo, C. A., & Duncan, P. W. (2008). Conceptualizing functional cognition in stroke. Neurorehabilitation and Neural Repair, 22(2), 122-135. doi:10.1177/1545968307306239
  10. Elliott, M., & Parente, F. (2014). Efficacy of memory rehabilitation therapy: A meta-analysis of TBI and stroke cognitive rehabilitation literature. Brain Injury, 28(12), 1610-1616. doi:10.3109/02699052.2014.934921
  11. Ertel, K. A., Glymour, M. M., & Berkman, L. F. (2008). Effects of social integration on preserving memory function in a nationally representative US elderly population. American Journal of Public Health, 98(7), 1215-1220. doi:10.2105/ajph.2007.113654
  12. Grandmaison, E., & Simard, M. (2003). A critical review of memory stimulation programs in Alzheimer's disease. The Journal of Neuropsychiatry and Clinical Neurosciences, 15(2), 130-144. doi:10.1176/jnp.15.2.130
  13. Gross, A. L., Parisi, J. M., Spira, A. P., Kueider, A. M., Ko, J. Y., Saczynski, J. S., ... Rebok, G. W. (2012). Memory training interventions for older adults: A meta-analysis. Aging & Mental Health, 16(6), 722-734. doi:10.1080/13607863.2012.667783
  14. Guerra, Z. F., Lucchetti, A. L., & Lucchetti, G. (2017). Motor imagery training after stroke: A systematic review and meta-analysis of randomized controlled trials. Journal of Neurologic Physical Therapy, 41(4), 205-214. doi:10.1097/NPT.0000000000000200
  15. Hwangbo, S. W., Kim, M. Y., Kim, J., & Park, H. Y. (2018). Improvement of attention and short-term memory of mild dementia using iPad applications: A single case study. Therapeutic Science for Rehabilitation, 7(3), 47-58. doi:10.22683/tsnr.2018.7.3.047
  16. Kim, J. M., Jo, A. Y., Jang, J. Y., & Song, C. S. (2014). Effect of Korean computer-based cognitive rehabilitation program (CoTras) for the memory and EEG activity in stroke. The Journal of Korean Society of Occupational Therapy, 22(4), 61-75. doi:10.14519/jksot.2014.22.4.06
  17. Kim, J, N., & Jung, M, Y. (2015). Review on effect of spaced-retrieval training combined with errorless learning on dementia patients. The Journal of Occupational Therapy for the Aged and Dementia, 9(1), 25-33.
  18. Kim, S. E., Koo, S. G., & Yoo, E. Y. (2016). Effects of spaced retrieval training on memory for the elderly with early dementia: A single-subject research design. The Journal of Korean Society of Occupational Therapy, 24(4), 109-119. doi:10.14519/jksot.2016.24.4.08
  19. Kim, Y. J., & Park, H. Y. (2015). The effects of spaced retrieval training with errorless learning on memory, IADL, depression in mild cognitive impairment: Single-subject design. Therapeutic Science for Rehabilitation, 4(2), 73-83. https://doi.org/10.14474/ptrs.2015.4.2.73
  20. Kwag, S. W., Sim, J. M., & Roh, H. L. (2014). Study on the characteristics and quality level of single subject researches in the sensory integration therapy field of Korean occupational therapy. The Journal of Korean Academy of Sensory Integration, 12(2), 25-36. doi:10.18064/JKASI.2014.12.2.025
  21. Lee, I. S. (2014). Improvement of attention and memory of stroke patient using smart phone applications: Single case study. Therapeutic Science for Rehabilitation, 3(1), 57-65.
  22. Lee, N. R., Park, Y. J., & Jang, J. S. (2021). Analysis of effect of non-drug intervention on the elderly with dementia in Korea: Meta-analysis. Journal of the Korea Academia-Industrial Cooperation Society, 22(4), 466-472. https://doi.org/10.5762/KAIS.2021.22.4.466
  23. Lee, Y. N., & Yoo, E. Y. (2013). The effects of errorless learning on mild demented old adult's memory - A single subject research design. The Journal of Occupational Therapy for the Aged and Dementia, 7(1), 15-22.
  24. Lockwood, C. (2017). Cognitive rehabilitation for memory deficits after stroke: A Cochrane review summary. International Journal of Nursing Studies, 76, 131-132. doi:10.1016/j.ijnurstu.2017.02.011
  25. Logan, L. R., Hickman, R. R., Harris, S. R., & Heriza, C. B. (2008). Single-subject research design: Recommendations for levels of evidence and quality rating. Developmental Medicine & Child Neurology, 50(2), 99-103. doi:10.1111/j.1469-8749.2007.02005.x
  26. McDonald, M. W., Black, S. E., Copland, D. A., Corbett, D., Dijkhuizen, R. M., Farr, T. D., ... Nithianantharajah, J. (2019). Cognition in stroke rehabilitation and recovery research: Consensus-based core recommendations from the second stroke recovery and rehabilitation roundtable. International Journal of Stroke, 14(8), 774-782. doi:10.1177/1747493019873600
  27. Norris, D. (2017). Short-term memory and long-term memory are still different. Psychological Bulletin, 143(9), 992-1009. doi:10.1037/bul0000108
  28. Odom, S. L., Brown, W. H., Frey, T., Karasu, N., Lee Smith-Canter, L., & Strain, P. S. (2003). Evidence-based practices for young children with autism: Contributions for single-subject design research. Focus on Autism and Other Developmental Disabilities, 18(3), 166-175. doi:10.1177/10883576030180030401
  29. Ottenbacher, K. J. (1986). Reliability and accuracy of visually analyzing graphed data from single-subject designs. American Journal of Occupational Therapy, 40(7), 464-469. doi:10.5014/ajot.40.7.464
  30. Rostami, H. R., Khayatzadeh, M. M., & Yarmohammadi, N. (2015). Feasibility of the modified constraint-induced movement therapy in patients with median and ulnar nerve injuries: A single-subject ABA design. Clinical Rehabilitation, 29(3), 277-284. doi:10.1177/0269215514542357
  31. Sim, K. B. (2018). Study on the characteristics and quality level of single subject researches in the stroke patients: The field of health care. The Journal of Korean Society of Community Based Occupational Therapy, 8(2), 15-28. doi:10.18598/kcbot.2018.08.02.02
  32. Spaan, P. E., Raaijmakers, J. G., & Jonker, C. (2003). Alzheimer's disease versus normal ageing: A review of the efficiency of clinical and experimental memory measures. Journal of Clinical and Experimental Neuropsychology, 25(2), 216-233. doi:10.1076/jcen.25.2.216.13638
  33. Weissman-Miller, D., Shotwell, M. P., & Miller, R. J. (2012). New single-subject and small-n design in occupational therapy: Application to weight loss in obesity. American Journal of Occupational Therapy, 66(4), 455-462. doi:10.5014/ajot.2012.004788
  34. Westerberg, H., Jacobaeus, H., Hirvikoski, T., Clevberger, P., Ostensson, M. L., Bartfai, A., & Klingberg, T. (2007). Computerized working memory training after stroke - A pilot study. Brain Injury, 21(1), 21-29. doi:10.1080/02699050601148726
  35. Yoo, E. Y., Lee, J. S., Lee, J. Y., Park, H. Y., & Yoo, J. E. (2011). Research literature in Korean occupational therapy by using a Journal of Korean Society of Occupational Therapy. Journal of Korean Society of Occupational Therapy, 19(1), 29-41.