과제지향적순환훈련이 만성 뇌졸중 환자의 운동기능, 일상생활동작 및 삶의 질에 미치는 영향 : 사례연구 Effects of Group Task-Oriented Circuit Training on Motor Function, ADLs and Quality of Life in Individuals with Chronic Stroke: A Case Study원문보기
본 연구의 목적은 만성뇌졸중 환자에게 운동학습이론을 기초한 물리치료와 작업치료를 병행한 집단 과제지향적 순환훈련 프로그램을 실시하여 운동기능, 일상생활동작과 삶의 질적인 변화를 알아보고자 하였다. 6명의 만성 뇌졸중 환자에게 31주간 실시하였다. Chedoke-McMaster 뇌졸중평가, 균형검사, 일상생활활동 운동 처리기술 평가(Assessment of Motor and Process Skills: AMPS)와 뇌졸중 영향척도 측정을 치료 전과 후에 수집하였다. 연구결과, 운동기능 손상영역, 균형과 뇌졸중 영향척도의 기분과 정서영역에서 통계적으로 유의하게 향상되었다. 일상생활활동 운동 처리기술 평가는 운동(motor)영역에서 6명 중 3명에게 처리(process)영역은 4명에서 훈련 후 향상되었다. 본 연구결과를 바탕으로 집단 과제지향적 순환훈련은 지역사회 만성 뇌졸중 환자의 신체적 기능 향상에 이점이 있다고 제언하는 바이다.
본 연구의 목적은 만성뇌졸중 환자에게 운동학습이론을 기초한 물리치료와 작업치료를 병행한 집단 과제지향적 순환훈련 프로그램을 실시하여 운동기능, 일상생활동작과 삶의 질적인 변화를 알아보고자 하였다. 6명의 만성 뇌졸중 환자에게 31주간 실시하였다. Chedoke-McMaster 뇌졸중평가, 균형검사, 일상생활활동 운동 처리기술 평가(Assessment of Motor and Process Skills: AMPS)와 뇌졸중 영향척도 측정을 치료 전과 후에 수집하였다. 연구결과, 운동기능 손상영역, 균형과 뇌졸중 영향척도의 기분과 정서영역에서 통계적으로 유의하게 향상되었다. 일상생활활동 운동 처리기술 평가는 운동(motor)영역에서 6명 중 3명에게 처리(process)영역은 4명에서 훈련 후 향상되었다. 본 연구결과를 바탕으로 집단 과제지향적 순환훈련은 지역사회 만성 뇌졸중 환자의 신체적 기능 향상에 이점이 있다고 제언하는 바이다.
The purpose of this study was to examine the effects of group task-oriented circuit training (TOCT) based on motor learning applied in conjunction with physical and occupational therapy on functional activity, activities of daily living (ADLs), and quality of life in individuals with chronic stroke....
The purpose of this study was to examine the effects of group task-oriented circuit training (TOCT) based on motor learning applied in conjunction with physical and occupational therapy on functional activity, activities of daily living (ADLs), and quality of life in individuals with chronic stroke. Six chronic stroke patients participated for a duration of 31 weeks. Treatment outcomes were assessed via Chedoke-McMaster Stroke Assessment, the Berg Balance Scale, the Assessment of Motor and Process Skill (AMPS), and the Stroke Impact Scale pre- and post-intervention. The participants exhibited significant improvements in impairment, static and dynamic balance, and mood and emotion after group TOCT. The results of AMPS indicated an improvement in the motor area in 3 of the subjects. In the process area, 4 of the subjects exhibited improvement. The results of this study suggest that TOCT is beneficial to physical functions for chronic hemiparetic stroke patients in community-dwelling.
The purpose of this study was to examine the effects of group task-oriented circuit training (TOCT) based on motor learning applied in conjunction with physical and occupational therapy on functional activity, activities of daily living (ADLs), and quality of life in individuals with chronic stroke. Six chronic stroke patients participated for a duration of 31 weeks. Treatment outcomes were assessed via Chedoke-McMaster Stroke Assessment, the Berg Balance Scale, the Assessment of Motor and Process Skill (AMPS), and the Stroke Impact Scale pre- and post-intervention. The participants exhibited significant improvements in impairment, static and dynamic balance, and mood and emotion after group TOCT. The results of AMPS indicated an improvement in the motor area in 3 of the subjects. In the process area, 4 of the subjects exhibited improvement. The results of this study suggest that TOCT is beneficial to physical functions for chronic hemiparetic stroke patients in community-dwelling.
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문제 정의
The purpose of this study was improvement of gait and ADLs using a group circuit exercise program led by physical and occupational therapists. A total of 6 research team members comprising physical therapists, occupational therapists and physical therapy student assistants were assigned to 2 groups of 6 stroke patients, led by 2 therapists.
In particular, there has not been a study that examined ADLs after training through an objective assessment measure. Therefore, the purpose of this study was to examine changes in motor function, ADL, and quality of life in chronic stroke patients after physical and occupational therapy through a group TOCT program.
This study enrolled chronic stroke patients in physical and occupational therapy to examine the effects on ADLs and quality of life. It is difficult to provide a comprehensive service that compiles information and opinions from various health care professionals because different professionals assess and treat patients independently.
It is difficult to provide a comprehensive service that compiles information and opinions from various health care professionals because different professionals assess and treat patients independently. This study had the advantage of compiling recommendations from both physical and occupational therapists during assessment and with regard to program strategy development to create a more comprehensive intervention plan. According to the most recent clinical practice guidelines published by the American Heart Association, a multidisciplinary approach to stroke patient rehabilitation coordinated and carried out in an organized manner is recommended[29].
This study sought to evaluate changes in motor function, ADLs, and quality of life in stroke patients after TOCT in conjunction with physical and occupational therapy with the goal of improving motor performance and ADL performance. When hemiparetic patients complete their rehabilitation, the functional gains attributable to their therapy are often reduced or lost because of a reduced level of physical activity[1].
제안 방법
Each exercise session included brief (5-10 min) warm-up and cool-down periods in which the participants performed extremity stretches and active or self-assisted range of motion exercises. The 12 workstations incorporated into the circuit were: (1) physical therapy (6 workstations) and (2) occupational therapy (6 workstations).
In this study, improvements in shoulder pain, postural control, and arm and leg ROM were observed via CMSA. This agrees with the study by Murie-Fernández (2012),where upper extremity physical therapy improved shoulder pain and ROM in stroke patients[21].
There are four categories for assessing the capacity for stroke recovery: "impairment" describes the symptoms of pathological conditions "disability" represents limitations in functional activities; "handicap" indicates limitations in a functional role; and "quality of life" refers to a patient’s physical, psychological, and social wellness[20]. In this study, the CMSA and BBS were used to assess motor function, the AMPS was used to assess impairments in ADLs, and the SIS was used to assess changes in impairment, disability, and quality of life. In response to TOCT, participants exhibited statistically significant improvement in motor function (as assessed by the CMSA), but significant changes did not occur in disability (as assessed by the SIS).
When hemiparetic patients complete their rehabilitation, the functional gains attributable to their therapy are often reduced or lost because of a reduced level of physical activity[1]. The participants exhibited significant improvement in impairment, static and dynamic balance, and mood and emotion after group TOCT intervention. However, there were no significant improvements in disability, strength, memory and thinking, communication, ADLs, mobility, hand function or social participation after group TOCT intervention in this study.
A total of 6 research team members comprising physical therapists, occupational therapists and physical therapy student assistants were assigned to 2 groups of 6 stroke patients, led by 2 therapists. The students that participated were well educated in TOCT, functional ability of the subjects, and the applied therapy methods prior to the study. The exercise program was conducted for 31 weeks, once a week, for 100 minutes.
대상 데이터
The purpose of this study was improvement of gait and ADLs using a group circuit exercise program led by physical and occupational therapists. A total of 6 research team members comprising physical therapists, occupational therapists and physical therapy student assistants were assigned to 2 groups of 6 stroke patients, led by 2 therapists. The students that participated were well educated in TOCT, functional ability of the subjects, and the applied therapy methods prior to the study.
Six hemiplegic participants who had experienced stroke (9 males, 3 females) were included in this study. Information regarding the purpose and method of this study was provided and consent was obtained.
데이터처리
In this study, Wilcoxon’s signed rank test was used to verify changes in the factors assessed (CMSA, BBS, SIS) pre and post-intervention and SPSS version 12.0 (SPSS Inc., Chicago, IL, USA) was used for analysis with a significance level of 0.05.
성능/효과
There are 13 major groups, such as meal preparation, table setting, and laundry, among others. During the task, 16 motor and 20 process skills are scored on a 4-point scale from 1 (an unacceptable amount of effort or inefficiency, imminent safety risk, or need for assistance was noted) to 4 (no problems observed with this skill in this task). The validity and reliability of this tool have been previously documented[16].
There were no notable changes in the other three subjects. In the process skills areas of AMPS in ADLs, two subjects showed a statistically significant increase greater than 0.5 logits, while there was a greater than 0.3 logit increase in the other two subjects, and no changes in the remaining two subjects [Table 3].
The eight different functional workstations used in this trial were goal-oriented, challenging, feasible, meaningful and relevant to patients' needs (i.e., not too easy, yet not too difficult).
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