본문 바로가기
KERD
논문KCI 등재

원격재활 기반 작업치료가 뇌졸중 환자의 실행기능, 일상생활수행, 작업수행에 미치는 영향

The Effects of Telerehabilitation Based Occupational Therapy on Executive Function, Activities of Daily Living, and Occupation Performance of People With Stroke

김수경|유두한|박성순|김희
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2021.02|재활치료과학 (Therapeutic Science for Rehabilitation)|제10권 제1호|pp. 115-127|DOI https://doi.org/10.22683/tsnr.2021.10.1.115

0

조회

0

다운로드

8

인용

0

참고문헌

키워드

실행기능원격재활Telerehabilitation수단적 일상생활수행일상생활수행작업수행클라이언트 중심Activity daily of livingExecution functionInstrumental activities daily of livingOccupation performance

초록

목적 : 본 연구는 원격재활에 기반 한 작업치료가 뇌졸중 환자의 실행기능, 일상생활수행, 작업수행에영향을 미치는지 알아보고자 한다. 연구방법 : 지역사회에 거주하며, 재활병원에 외래로 통원하는 환자 30명을 실험군과 대조군에 각각 15명씩무작위 할당하여 연구를 진행하였다. 실험군 집단과 실험군의 중재는 모두 주 3회 18회기로 실시하였다. 실험군 15명에게는 전통적 작업치료와 함께 더불어 가정에서의 원격재활 기반 프로토콜을 적용하였다. 대조군 15명은 전통적 작업치료만 실시하였다. 실험 참가자의 실행기능과 수단적 일상생활수행은 실행기능 수행평가 한국판(Executive Function Performance Test Korean version; EFPT-K)으로 측정하였고, 기본적 일상생활활동은 수정된 바델 지수(Modified Barthel Index; MBI), 작업수행은 클라이언트 중심의과제수행을 측정하기 위해서 캐나다 작업수행 측정(Canadian Occupational Performance Measure; COPM)을 이용하였다. 결과 : 중재 후 실험군과 대조군은 모두 실행기능, 수단적 일상생활활동, 작업수행에서 유의한 변화가있었으나(p<.05), 기본적 일상생활수행에서는 유의한 변화가 없었다. 집단 간 비교에서는 작업수행에서만실험군이 대조군보다 유의하게 더 많은 증진이 나타났다. 결론 : 원격재활과 작업치료는 뇌졸중 환자의 실행기능, 수단적 일상생활수행, 작업수행의 향상에 긍정적인영향을 미친다. 작업치료에 병행된 원격재활은 뇌졸중 환자의 작업수행에 추가적인 효과가 있음을 근거로써 제시한다.

Abstract

Objective : The purpose of this study was to investigate the effect of telerehabilitation on executive function, activities of daily living, instrumental activities of daily living, and occupational performance in stroke patients. Methods : The participants of this study were 30 outpatients with stroke residing in community. Both groups underwent the intervention 3 times a week for a total of 18 sessions. For the experimental group telerehabilitation was administered at home to only fifteen participants in the experimental group schedule, and it was supervised by the caregiver. Fifteen people in the control group underwent only the traditional occupational therapy. Executive function and instrumental activities of daily living were evaluated using the Korean version of the Executive Function Performance Test (EFPT-K). The basic daily activities of living were assessed using the Modified Barthel Index (MBI). The Canadian Occupational Performance Measure (COPM) was used to evaluate the client-centered occupational performance. Results : After the intervention, the experimental and control groups showed improvements in executive function, instrumental activities of daily living and occupational performance. Occupational performance improved more significantly in the experimental group than in the control group. Conclusion : Telerehabilitation and occupational therapy positively affect executive function, instrumental activities of daily living and occupational performance of patients with stroke. We suggest that telerehabilitation combined with occupational therapy is more effective in improving the occupational performance of stroke patients.

참고문헌 (46)

  1. American Occupational Therapy Association, "Occup ational therapy practice framework: Domain and process", American Journal of Occupational Therapy, 74, pp.1~87 (2014)[DOI]
  2. Angeleri, F., "The influence of depression, social activity, and family stress on functional outcome after stroke", Stroke, 24(10), pp.1478~1483 (1993)[DOI]
  3. Baum, C. M., "Reliability, validity, and clinical utility of the executive function performance test : A measure of executive function in a sample of people with str oke", American Journal of Occupational Therapy, 62(4), pp.446~455 (2008)[DOI]
  4. "Test manual: Executive function performance test" (2003)[URL]
  5. Blundon, G., "Cognitive rehabilitation : A pilot survey of therapeutic modalities used by Canadian occu pational therapists with survivors of traumatic brain injury", The Canadian Journal of Occupational Therapy, 67(3), pp.184~196 (2000)
  6. Boehm, N., "Managing poststroke fatigue using telehealth : A case report", America n Journal of Occupational Therapy, 69(6), pp.1~7 (2015)[DOI]
  7. Burns, R. B., "Using telerehabilit ation to support assistive technology", Assistive Technology, 10(2), pp.126~133 (1998)[DOI]
  8. Carpenter, L., "The use of the canadian occupational performance measure as an outcome of a pain management program", Canadian Journa l of Occupational Therapy, 68(1), pp.16~22 (2001)[DOI]
  9. Chen, J., "Effects of home-based telesupervisi ng rehabilitation on physical function for stroke survivors with hemiplegia : A randomized controlled trial", American Journal of Physical Medicine & Rehabilitation, 96(3), pp.152~160 (2017)[DOI]
  10. 최진호, "사지 실행증의 평가 및 신경생리학적 고찰", 대한물리치료학회지, 18(2), pp.7~16 (2006), 대한물리치료학회
  11. Cub, E. H., "Reliability and validity of th e canadian occupational performance measure in stroke p atients", Clinical Rehabilitation, 17(4), pp.402~409 (2003)[DOI]
  12. "Telerehabilitation‘Alarmy’application" (2016)[URL]
  13. Elliott, R., "Executive functions and their disorders : Im aging in clinical neuroscience", British Medical Bulletin, 65(1), pp.49~59 (2003)[DOI]
  14. European Commission, "Green paper on mobile health (“mHealth”)", 10(4), pp.1~20 (2014)
  15. Hayes, S., "Associations b etween executive function and physical function poststrok e : A pilot study", Physiotherapy, 99(2), pp.165~171 (2013)[DOI]
  16. Henneman, E. A., "Su rveillance : A strategy for improving patient safety in acute and critical care units", Critical Care Nurse, 32(2), pp.9~18 (2012)[DOI]
  17. Hsieh, C. L., "The diverse constructs use of activities of daily living measures in stroke randomized controlled trials in the year s 2005–2009", Journal of Rehabilitation Medicine, 44(9), pp.720~726 (2012)[DOI]
  18. 정한영, "한글판 수정바델지수(K-MBI)의 개발: 뇌졸중 환자 대상의 다기관 연구", Annals of Rehabilitation Medicine, 31(3), pp.283~297 (2007), 대한재활의학회
  19. 강대혁, "캐나다작업치료측정(COPM)과 운동처리기술평가(AMPS)의 상관관계: 준비연구", 대한작업치료학회지, 13(1), pp.25~35 (2005), 대한작업치료학회
  20. Kang, S. J., "A study on burden and well -being of primary caregivers of patients with a stroke", The Journal of Basic Nursing Science, 12(2), pp.09~21 (2000)
  21. Kegel, J., "Executive function and coping in stroke survivors", Neurorehabilitation, 34(1), pp.55~63 (2014)[DOI]
  22. Kim, H., "Reliability and validity of culturally-adapted Executive Function Perfo rmance Test for Koreans(EFPT-K)with Stroke", Journal of Stroke and Cerebrovascular Disease, 26(5), pp.1033~1040 (2016)[DOI]
  23. 김원호, "발병 후 3개월이 경과한 뇌졸중 환자의 일상생활동작에물리치료와 작업치료가 미치는 영향", 한국전문물리치료학회지, 14(1), pp.74~81 (2007), 한국전문물리치료학회
  24. Kunawararak, P., "Tuberculosis treatment with mobile-phone medication reminders in northern Thailand", Southeast Asian Journal of Tropical Medicineand Public Health, 42(6), pp.1444~1451 (2011)
  25. Lai, J. C., "Telerehabil itation—a new model for community-based stroke rehabilit ation", Journal of Telemedicine and Telecare, 10(4), pp.199~205 (2004)[DOI]
  26. Langhorne, P., "Does the organization of postacute stroke care really matter", Stroke, 32(1), pp.268~274 (2001)[DOI]
  27. Laver, K. E., "Telerehabilitation services for stroke", Cochrane Database of Systematic Reviews 2013, 12, pp.1~42 (2013)[DOI]
  28. Lin, K. H., "Bidirectional and multi-user telerehabilitation system : Clinical effect on balance, functional activity, and satisfaction in patients with chroni c stroke living in long-term care facilities", Sensors, 14(7), pp.12451~12466 (2014)[DOI]
  29. Mahoney, F. I., "Functional evaluation : The Barthel Index : A simple index of independence usef ul in scoring improvement in the rehabilitation of the chro nically ill", Maryland State Medical Journal, 14, pp.61~65 (1965)
  30. Maskill, L., "Neuropsychology for occupational therapists: Cognition in occupational perfor mance" (2017), John Wiley & Sons
  31. Miller, J. F., "Coping with chronic illnes s: Overcoming powerlessness" (2000), F A Davis
  32. Motta, K., "Post-stroke driving : Examining the effect of executive dysfunction", Journal of Safety Research, 49, pp.1~38 (2014)[DOI]
  33. Ownsworth, T., "Relationship between ex ecutive functions and productivity outcomes following stro ke", Disability and Rehabilitation, 30(7), pp.531~540 (2008)[DOI]
  34. Pan, A. W., "Reliability and validity of the canadian occupational performance me asure for clients with psychiatric disorders in Taiwan", Occ upational Therapy International, 10(4), pp.269~277 (2003)[DOI]
  35. Park, S. W, "The relationship between activities of daily living and cognitive function, anxiety, stress, depression in stroke patients", Journal of the Korean Academy of Rehabilitation Medicine, 23(1), pp.1~8 (1999)
  36. Postolache, G., "Rehabilitative telehealthcare for post-stroke outcome assessment", 2011 5th International Conferenceon, pp.408~413 (2011)
  37. Poulin, V., "Efficacy of executive function interventions after str oke : A systematic review", Topics in Stroke Rehabilitation, 19(2), pp.158~171 (2012)[DOI]
  38. Putrino, D., "Telerehabilitation and emerging virtual re ality approaches to stroke rehabilitation", Current Opinion in Neurology, 27(6), pp.631~636 (2014)[DOI]
  39. Rand, D., "Feasibility of a 6-month exercise and recreation progra m to improve executive functioning and memory in individ uals with chronic stroke", Neurorehabilitation and Neural R epair, 24(8), pp.722~729 (2010)[DOI]
  40. Redzuan, N. S., "Effectiveness of a video-based therapy progra m at home after acute stroke : A randomized controlled tria l", Archives of Physical Medicine and Rehabilitation, 93(12), pp.2177~2183 (2012)[DOI]
  41. Russell, T. G., "Physical rehabilitation using telemedici ne", Journal of Telemedicine and Telecare, 13(5), pp.217~220 (2007)[DOI]
  42. Sarfo, F. S., "Tele-rehabilitation after stroke : An updated syste matic review of the literature", Journal of Stroke and Cerebr ovascular Diseases, 27(9), pp.2306~2318 (2018)[DOI]
  43. Shah S., "Improving the sens itivity of the barhel index for stroke rehabilitation", Journal of Clinical Epidemiology, 42(8), pp.703~709 (1989)[DOI]
  44. 심윤복, "병원 간호사의 스마트 폰 의료관련 앱(APP) 사용의도 영향 요인", 보건행정학회지, 22(2), pp.249~262 (2012), 한국보건행정학회[DOI]
  45. Tchero, H., "Telerehabilitation for stroke survivors : Systematic revie w and meta-analysis", Journal of Medical Internet Research, 20(10), pp.1~10 (2018)[DOI]
  46. Van Den Berg, M., "Early supported discharge by caregiver-mediated exercises and e-health support after stroke : A proof-of-concept trial", Stroke, 47(7), pp.1885~1892 (2016)[DOI]

관련 논문AI추천

CO-OP 중재 적용이 뇌졸중 환자의 상지 기능과 실행기능 및 작업 수행 증진에 미치는 영향김희, 김경실대한신경계작업치료학회 · 재활치료과학2021 · 제10권 제2호뇌졸중 환자 집행 기능 향상을 위한 중재에 대한 체계적 고찰고석범, 김문영, 오윤택대한신경계작업치료학회 · 재활치료과학2015 · 제4권 제2호뇌졸중 환자의 운동기능에 원격재활이 미치는 효과: 체계적 문헌고찰박지혁, 신윤찬대한신경계작업치료학회 · 재활치료과학2018 · 제7권 제4호지역사회 거주 뇌졸중 환자의 가정방문 작업치료 효과: 사례 연구정은화대한신경계작업치료학회 · 재활치료과학2020 · 제9권 제2호뇌졸중 환자의 인지적 전략개발 중심 중재가 수행기술에 미치는 효과 비교 : 무작위 비교연구안시내보건의료산업학회 · 보건의료산업학회지2016 · 제10권 제3호뇌졸중 환자에게 적용한 과제 지향적 중재의 효과: 체계적 문헌 고찰강민혜, 고혜영, 권희연, 김혜경, 이유나, 차현진한국노인작업치료학회 · 한국노인작업치료학회지2025 · 제7권 제1호

이 간행물의 다른 논문 (9건)

텍스트마이닝을 활용한 국외 노인작업치료의 연구동향 분석김아람, 이태권, 정인재, 박혜연pp. 7-17지역사회 거주 노인 대상의 생활공간 이동성(Life-space mobility) 연구 동향정은화pp. 19-35구강운동촉진기술: 1 부-이론적 배경과 기초 요소서상민, 우희순, 민경철pp. 37-52구강운동촉진기술: 2 부-개념적 위계 및 핵심 기법민경철, 우희순, 서상민pp. 53-61보건소 작업치료사의 지역사회 재활 및 보건서비스 제공에 대한 업무 경험에 관한 현상학적 연구박강현, 전병진, 정민예pp. 63-75
원문 보기