• 대한감각통합치료학회지
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• 제17권3호
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• pp.46-60
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• 2019

목적 : 본 연구에서는 일상생활활동 향상을 위해 아동·청소년 작업치료를 적용한 국내 논문을 체계적으로 분석하여 참여자의 진단명, 사용한 평가도구, 중재방법과 그 효과에 대해 알아보고자 하였다. 연구방법 : 2010년부터 2019년 9월 30일까지 게재된 국내 학술지를 대상으로 하였다. 검색엔진은 학술연구정보서비스와 한국학술정보를 사용하였다. 사용한 검색어는 '아동작업치료 & 일상생활', '아동작업치료 & 자조', '아동작업치료 & 자기관리', '아동작업치료 & 작업', '작업치료 & 식사하기', '작업치료 & AMPS(Assessment of Motor and Process Skills)', '작업치료 & WeeFIM(Functional Independence Measure for children)'이었다. 결과 : 총 14편을 분석하였고 연구의 질적 수준은 IV, V가 각각 36%로 총 연구의 72%를 차지하였다. 참여자의 진단명은 지적장애가 50%를 차지하였고 뇌성마비를 포함한 뇌병변이 20%이었다. 일상생활활동을 평가하기 위해 가장 많이 사용하는 평가도구는 COPM(Canadian Occupational Performance Measure)으로 36%를 보였고, WeeFIM이 22%, 관찰이 13%이었다. 중재방법으로 가장 많이 사용하는 것은 감각통합치료로 36%이었고, 인지프로그램이 22%이었다. 지적장애 아동에게 자조활동 그룹치료를 적용한 한편의 연구를 제외하고, 모두 중재효과가 긍정적인 것으로 나타났다. 결론 : 체계적 고찰방법을 통해 일상생활활동에 대해 작업치료 적용을 알아본 국내의 연구는 없었다. 따라서 본 연구는 임상에서 작업치료 적용을 위한 근거자료로 사용될 것이다.

• 한국산학기술학회논문지
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• 제20권8호
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• pp.431-440
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• 2019

이 연구는 경직성 뇌성마비 아동을 대상으로 1년간 물리 및 작업치료 후 대동작 기능분류체계에 따라 일상생활동작 변화정도가 차이가 있는지 그리고 소아장애척도지수와 아동용 일상생활 기능독립 측정 중 어떤 평가도구가 일상생활 동작의 변화에 민감하게 반응하는지를 알아보기 위해 시행되었다. 48명의 경직성 뇌성마비 아동이 참여하였고, 대동작 기능분류체계, 아동용 일상생활 기능독립 측정, 그리고 소아장애척도지수를 측정하였다. 연구결과, 대동작 기능분류체계는 소아장애척도지수와 유의한 상관을 보였지만(p<0.05) 아동용 일상생활 기능독립 측정과 유의한 상관을 보이지 않았다. 또한 중재 전과 후 일상생활동작의 변화는 아동용 일상생활 독립측정인 경우 유의한 차이를 보이지 않았지만, 소아장애척도지수인 경우 유의한 차이를 보였다(p<0.05). 대동작 기능분류체계에 따라 일상생활동작의 변화는 유의하게 차이가 있었으며, 기능수준이 높은 경우 일상생활동작이 변화가 유의하게 컸었다(p<0.05). 물리 및 작업치료 후 대동작 기능 분류체계에 따라 일상생활동작의 향상정도는 다르지만 임상적으로 의미 있게 향상되는 것으로 보이며, 소아장애척도지수는 일상생활동작의 변화에 민감하게 반응하므로 임상에서 폭 넓게 활용하는 것이 필요한 것으로 여겨진다.

• The Journal of Korean Physical Therapy
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• 제24권6호
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• pp.398-404
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• 2012

Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.

• 대한한방내과학회지
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• 제41권5호
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• pp.777-786
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• 2020

Background: This study is a report on a case of a Wernicke's encephalopathy with quadriplegia, ataxia, and impaired cognition, whose condition was improved by Korean medicine treatment. Case report: A 51-year-old man diagnosed with Wernicke's encephalopathy was treated with acupuncture, Banhabakchulchunma-tang mixed with Ondam-tang-gami (半夏白朮天麻湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Berg Balance Scale (BBS), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and a numeric rating scale (NRS). After 22 days of treatment, his clinical symptoms showed improvement. The motor function improved (MMT Rt. side Gr. 4+G/4+G, Lt. side Gr. 4G/4+G → Rt. side Gr. 5-N/4+G, Lt. side Gr. 5-N/4+G), Ataxia was relieved (BBS 3→33), cognition improved (K-MMSE 15→27), ADL scores showed improvement (FIM 58→90, MBI 40→75), and the NRS score decreased for headache (3→0). Conclusion: Korean medicine treatment could be effective in the treatment of patients with Wernicke's encephalopathy.

• 대한한방내과학회지
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• 제42권5호
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• pp.904-915
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• 2021

This study is a case report of Korean medicine treatment for a patient with quadriplegia and impaired cognition as neurological sequelae after ingestion of herbicides. A 59-year-old man with toxic encephalopathy and hypoxic encephalopathy after the ingestion of herbicides was treated with acupuncture, Hyulbuchuko-tang mixed with Ondam-tang-gami (血府逐瘀湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After three months of treatment, clinical symptoms improved. The motor function improved (MMT on both sides, Gr. 3+F/4G→Gr. 4-G~4G/4+G), cognition improved (K-MMSE, 13→21), and ADL (Activities of Daily Living) scores also improved (FIM 41→74; MBI 20→63). Korean medical treatment could effectively treat neurological sequelae after ingestion of herbicides in this case.

• 대한지역사회작업치료학회지
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• 제4권1호
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• pp.33-45
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• 2014

목적 : 본 연구에서는 뇌졸중 환자 중에서 편측무시가 있는 군과 없는 군 각각에 대해 4주간의 거울치료를 적용하여 그 효과를 알아보고자 하였다. 또한 거울치료를 통하여 상지의 기능 향상과 일상생활동작에 어떠한 효과가 있는지에 대해서도 알아보고자 한다. 연구방법 : 창원시 C병원에 입원하여 작업치료를 받는 성인 편마비 환자로써 편측무시가 있는 환자 10명, 편측무시가 없는 환자 10명, 총20명을 대상으로 실시하였고 치료사와 1:1로 30분씩 주5회 총 4주간 걸쳐 거울치료 프로그램을 실시하였다. 편측무시 유무를 확인하고 거울치료 중재 전, 후 비교를 위해 알버트 검사를 사용하였다. 상지기능평가로써 Fugl-Meyer motor function Assessment(FMA), Box & Block Test(BBT)을 사용하였으며 일상생활활동평가는 Functional Independence Measure(FIM)를 사용하였다. 결과 : 거울치료는 편측무시를 가진 뇌졸중 환자에게 효과가 있었다(p<.05). 또한 뇌졸중환자의 편측무시 유무에 관계없이 상지기능과 일상생활활동에 효과가 있었다(p<.05). 결론 : 거울치료가 뇌졸중 환자의 마비측 상지기능과 일상생활활동 능력을 향상시킬 뿐만 아니라 편측무시 증상을 가지고 있는 뇌졸중 환자에게서도 편측무시 감소를 보였다. 결론적으로 거울치료는 편측무시 감소를 보일 뿐만 아니라 뇌졸중 환자의 기능적인 회복과 일상생활활동 수행능력 향상을 위한 치료방법으로써 임상에서 유용하게 적용될 수 있을 것이라 사료된다.

• 대한한의학회지
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• 제36권4호
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• pp.8-18
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• 2015

Objectives: There have been several studies evaluated effect of electroacupuncture (EA) on spasticity but most studies could not assess spasticity quantitatively because they used clinical rating scales for assessment spasticity. The objective of this study is to evaluate effect of EA on poststroke spasticity quantitatively using tendon reflex (T-reflex). Methods: 29 stroke patients with upper extremity spasticity were randomized to EA group and control group. The EA group received combined EA and rehabilitation therapy 5 times a week for 3 weeks. Acupuncture treatment was given at Jian Yu (LI 15), Qu Chi (LI 11), Shao Hai (HT 3), Wai Guan (TE 5), He Gu (LI 4), Lie Que (LU 7), Hou Xi (SI 3) of the affected side, 30 minutes of electrical stimulation with a frequency of 40/13 Hz was applied at Qu Chi (LI 11), He Gu (LI 4). The control group received only rehabilitation therapy. The efficacy of treatment was assessed using T-reflex latency and amplitude, modified Ashworth scale (MAS) of biceps brachii, brachioradialis and triceps brachii. Fugl-Meyer motor function assessment (FMA) and functional independence measure (FIM) were also measured to assess motor function and functional independence. All outcomes were measured before treatment, immediately after 3 weeks of treatment and 1 week after 3 weeks of treatment. Results: No statistically significant differences were found in outcomes including T-reflex between the study groups except for FIM values immediately after 3 weeks of treatment (p=0.037). Conclusions: These results suggest that 3 weeks of EA does not reduce poststroke upper extremity spasticity electrophysiologically and clinically. However, small sample sizes and contradictory tendency between results from T-reflex and those from MAS require cautious judgement on interpretation of the results. A larger, well-designed clinical trials for quantitative evaluation of effect of EA on poststroke spasticity will be needed.

• 대한통합의학회지
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• 제9권3호
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• pp.9-18
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• 2021

Purpose : In this study, we applied a computerized cognitive rehabilitation program (CoTras-C) for children with cerebral palsy. Research was conducted to investigate the impact of upper limb function, sensory function, and activities of daily living. Methods : The study period lasted 10 weeks from October 2019 to December 2019. The study subjects were 12 subjects according to the selection criteria, and a computerized cognitive rehabilitation program (CoTras-C) was conducted twice a week for 30 minutes before and after the application of basic occupational therapy. Results : As a result of the computerized cognitive rehabilitation program, scores of upper limb function (QUEST), sensory function (SSP-2), and daily life activity (WeeFIM) were significantly improved (p>.05). From the result of examining the motor area, improvement in fine-motor function and protective extension through touch pad or controller operation was found. It also showed improvement in activities of daily living including motor and activities of daily living including social cognition. In the sensory function evaluation, it was not significant in movement sensitivity. Significant differences were shown in the items excluding olfactory/taste sensitivity. Conclusion : The application of the computerized cognitive rehabilitation program (CoTras-C) showed significant results in upper limb function, sensory function, and daily life activities of children with brain lesions. Based on these results, future studies need to generalize the study by expanding the age or population of children with brain lesions, or by expanding the diversity of diseases and environments.

• 대한물리의학회지
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• 제4권3호
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• pp.183-192
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• 2009

Purpose：This study was conducted to investigate whether modified CIMT with Kinesio-Taping on paretic upper limb effects upper limb function in stroke patients in comparison to those receiving only modified CIMT. Methods：20 out-patients with hemiplegia were randomly assigned to either an experimental or a control group. Both groups received modified CIMT during a 10-week period. Additionally, an experimental group received modified CIMT with Kinesio-Taping on paretic upper limb and trunk. Results：In Manual function test, Grip strength, Jebsen-Taylor hand function test, MAL(Motor Activity Log) and Functional independence measure (FIM) were significantly different at all intervals of the study period(0, 3, 6, 10-week) in the experimental and control groups(p<.05). Exceptionally there was no significant difference in Jebsen-Taylor hand function test between the experimental and control groups. Conclusion：These results suggest that modified CIMT with Kinesio-taping improve the upper limb function. And also increase usage of affected upper limb and assist in daily living activity more than only modified CIMT.

• 대한한방내과학회지
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• 제39권2호
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• pp.130-138
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• 2018

Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder of the central nervous system characterized by optic neuritis and longitudinally extensive myelitis. Painful tonic spasm is a common complication of NMO, but there have been no reports about it in Korean medicine studies. In this case, we treated a 53-year-old woman diagnosed with NMO with paraplegia, painful tonic spasm, and decreased visual acuity using Korean medicine treatment, including acupuncture, herbal medicine, cupping, and moxibustion. We measured changes in clinical symptoms using the manual muscle testing (MMT), the numeric rating scale (NRS), the modified Barthel Index (MBI), and the Functional Independence Measure (FIM). After treatment, clinical symptoms were improved. The results indicate that Korean medicine treatment may be effective in the treatment of an NMO patient with paraplegia and painful tonic spasm.