[논문]CO-OP 중재 적용이 뇌졸중 환자의 상지 기능과 실행기능 및 작업 수행 증진에 미치는 영향

김경실; 김희

doi:10.22683/tsnr.2021.10.2.141

CO-OP 중재 적용이 뇌졸중 환자의 상지 기능과 실행기능 및 작업 수행 증진에 미치는 영향
Effects of CO-OP Interventions on Affected Upper Extremity Use, Execution Function and Occupational Performance in Patients With Stroke 원문보기

Therapeutic science for rehabilitation = 재활치료과학, v.10 no.2, 2021년, pp.141 - 150

김경실 (건양대학교 일반대학원 작업치료학과) , 김희 (건양대학교 의과학대학 작업치료학과)

초록
AI-Helper

목적 : 본 연구는 뇌졸중 환자에게 Cognitive Orientation to daily Occupational Performance(CO-OP) 중재법을 적용하여 작업수행의 질, 상지기능 및 실행기능에 영향을 주는지 확인하고자 하였다. 연구방법 : 연구대상은 재활치료를 받고 있는 입원, 외래 환자 중 발병한지 3개월 이상된 뇌졸중 환자 5명이었다. 연구는 단일집단 사전-사후 평가로 설계되었다. 중재는 1일 1회 30분간 주 5회로 총 20회기를 적용하였다. 중재활동은 환자가 선정한 중요도는 높지만 만족도와 수행도는 낮은 활동을 선정하여 진행하였다. 평가도구로는 수행의 질을 평가하는 Performance Quality Rating Scale(PQRS)과 Canadian Occupational Performance Measure(COPM), 실행기능을 알아보기 위한 Executive Function Performance Test for Koreans(EFPT-K), 상지기능을 알아보기 위한 Motor Activity Log(MAL)를 사용하였다. 중재 전·후를 비교할 수 있는 통계방법으로는 비모수 검정인 Wilcoxon's signed rank test를 사용하였다. 통계학적 유의수준은 p<0.05로 하였다. 결과 : 상지기능은 모든 항목에서 유의미한 변화를 나타냈으며 실행기능은 시작하기 항목을 제외한 준비하기, 순서정하기, 판단과 안전, 종결하기 전 항목에서 유의미한 변화를 나타냈다. 또한, 작업수행도 유의미한 차이를 보였다. 결론 : 만성 뇌졸중 환자를 중심으로 20회기의 CO-OP 중재를 통해 상지기능, 실행기능, 작업수행을 향상시켰다. 뇌졸중 환자의 작업수행뿐 아니라 세부적인 작업 요소 향상에 긍정적인 영향을 도출하였다.

Abstract ▼ AI-Helper

Objective : In this study, the upper extremity use, executive function, and occupational performance effects of cognitive orientation to daily occupational performance (CO-OP) interventions for patients with stroke were assessed. Methods : The study was designed as a single-group pre-post test with 20 sessions. The participants were five hospitalized patients with stroke who were present in a rehabilitation setting, and their onsets were more than 3 months previously. Outcomes were measured using the Canadian Occupation Performance Measure (COPM), Performance Quality Rating Scale (PQRS), Executive Function performance Test - Korean version (EFPT-K), and Motor Activity Log (MAL). The Wilcoxon signed-rank test was conducted to determine the difference between the pre-and-post of CO-OP interventions. The statistical significance level was p<.05. Results : The upper extremity function showed significant changes and the execution function showed significant changes in preparation, sequencing, judgment and safety, and closing, except for items to be started. The performance of the task also showed significant changes. Conclusion : Through 20 sessions of CO-OP interventions, especially in patients with chronic stroke, the upper extremity function, execution function, and task performance were improved. We found that CO-OP intervention had a positive effect on the improvement of detailed task elements as well as the performance of tasks overall, in patients with stroke.

주제어

표/그림 (7)

그림 Figure 1. Intervention of Process of CO-OP Approach
표 Table 1. Example of CO-OP Intervention (Toileting)
표 Table 2. Example for CO-OP Intervention (Dressing)
표 Table 3. Results of the Pre and Post Assessment on MAL (N=5)
표 Table 4. Result of the Pre and Post Assessment on EFPT-K (N=5)
표 Table 5. Results of the Pre and Post Assessment on PQRS (N=5)
표 Table 6. Results of the Pre and Post Assessment on COPM (N=5)

참고문헌 (27)

Ahn, S. N., Yoo, E. Y., Jung, M. Y., Park, H. Y., Lee, J. Y., & Choi, Y. I. (2017). Comparison of cognitive orientation to daily occupational performance and conventional occupational therapy on occupational performance in individuals with stroke: A randomized controlled trial. NeuroRehabilitation, 40(3), 285-292. doi:10.3233/NRE-161416

상세보기
Alvarez, J. A., & Emory, E. (2006). Executive function and the frontal lobes: A meta-analytic review. Neuropsychology Review, 16(1), 17-42. doi:10.1007/s11065-006-9002-x

상세보기
Carpenter, L., Baker, G. A., & Tyldesley, B. (2001). The use of the Canadian Occupational Performance Measure as an outcome of a pain management program. Canadian Journal of Occupational Therapy, 68(1), 16-22. doi:10.1177/000841740106800102

상세보기
Cooper, B. Y., Glendinning, D. S., & Vierck, C. J. (1993). Finger movement deficits in the stumptail macaque following lesions of the fasciculus cuneatus. Somatosensory & Motor Research, 10(1), 17-29. doi:10.3109/08990229309028820

상세보기
Crawford, S., & Channon, S. (2002). Dissociation between performance on abstract tests of executive function and problem solving in real-life-type situations in normal aging. Aging & Mental Health, 6(1), 12-21. doi:10.1080/13607860120101130

상세보기
Dawson, D. R., Binns, M. A., Hunt, A., Lemsky, C., & Polatajko, H. J. (2013). Occupation-based strategy training for adults with traumatic brain injury: A pilot study. Archives of Physical Medicine and Rehabilitation, 94(10), 1959-1963. doi:10.1016/j.apmr.2013.05.021

상세보기
Dawson, D. R., Gaya, A., Hunt, A., Levine, B., Lemsky, C., & Polatajko, H. J. (2009). Using the cognitive orientation to occupational performance (CO-OP) with adults with executive dysfunction following traumatic brain injury. Canadian Journal of Occupational Therapy, 76(2), 115-127. doi:10.1177/000841740907600209

상세보기
Erez, A. B. H., Rothschild, E., Katz, N., Tuchner, M., & Hartman-Maeir, A. (2009). Executive functioning, awareness, and participation in daily life after mild traumatic brain injury: A preliminary study. American Journal of Occupational Therapy, 63(5), 634-640. doi:doi.org/10.5014/ajot.63.5.634

상세보기
Eslinger, P. J., Moore, P., Anderson, C., & Grossman, M. (2011). Social cognition, executive functioning, and neuroimaging correlates of empathic deficits in frontotemporal dementia. The Journal of Neuropsychiatry and Clinical Neurosciences, 23(1), 74-82.

상세보기
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., & Stroke, S. S. (2013). Heart disease and stroke statistics-2013 update: A report from the American heart association. Circulation, 127(1), 143-152. doi:10.1161/CIR.0b013e31828124ad

상세보기
Goel, V., Grafman, J., Tajik, J., Gana, S., & Danto, D. (1997). A study of the performance of patients with frontal lobe lesions in a financial planning task. Brain: A Journal of Neurology, 120(10), 1805-1822. doi:10.1093/brain/120.10.1805

상세보기
Gracies, J. M., Marosszeky, J. E., Renton, R., Sandanam, J., Gandevia, S. C., & Burke, D. (2000). Short-term effects of dynamic lycra splints on upper limb in hemiplegic patients. Archives of Physical Medicine and Rehabilitation, 81(12), 1547-1555. doi:10.1053/apmr.2000.16346

상세보기
Henshaw, E., Polatajko, H., McEwen, S., Ryan, J. D., & Baum, C. M. (2011). Cognitive approach to improving participation after stroke: Two case studies. American Journal of Occupational Therapy, 65(1), 55-63. doi:10.5014/ajot.2011.09010

상세보기
Hsieh, C., Hoffmann, T., Gustafsson, L., & Lee, Y. (2012). The diverse constructs use of activities of daily living measures in stroke randomized controlled trials in the years 2005-2009. Journal of Rehabilitation Medicine, 44(9), 720-726. doi:10.2340/16501977-1008

상세보기
Kim, H., Lee, Y. N., Jo, E. M., & Lee, E. Y. (2017). Reliability and validity of culturally adapted executive function performance test for Koreans with stroke. Journal of Stroke and Cerebrovascular Diseases, 26(5), 1033-1040. doi:10.1016/j.jstrokecerebrovasdis.2016.12.013

상세보기
Law, M., Stewart, D., Letts, L., Pollock, N., Bosch, J., & Westmorland, M. (1998). Guidelines for critical review of qualitative studies. McMaster University occupational therapy evidence-based practice research Group, 1-9. Retrieved from https://medfac.tbzmed.ac.ir/Uploads/3/cms/user/File/10/Pezeshki_Ejtemaei/conferance/dav.pdf
Lezak, M. D. (1982). The problem of assessing executive functions. International Journal of Psychology, 17 (1-4), 281-297. doi:10.1080/00207598208247445

상세보기
Martini, R., Rios, J., Polatajko, H., Wolf, T., & McEwen, S. (2015). The performance quality rating scale (PQRS): Reliability, convergent validity, and internal responsiveness for two scoring systems. Disability and Rehabilitation, 37(3), 231-238. doi:10.3109/09638288.2014.913702

상세보기
Polatajko, H. J., McEwen, S. E., Ryan, J. D., & Baum, C. M. (2012). Pilot randomized controlled trial investigating cognitive strategy use to improve goal performance after stroke. American Journal of Occupational Therapy, 66(1), 104-109. doi:10.5014/ajot.2012.001784

상세보기
Poulin, V., Korner-Bitensky, N., Dawson, D. R., & Bherer, L. (2012). Efficacy of executive function interventions after stroke: A systematic review. Topics in Stroke Rehabilitation, 19(2), 158-171. doi:10.1310/tsr1902-158

상세보기
Sansonetti, D., & Hoffmann, T. (2013). Cognitive assessment across the continuum of care: The importance of occupational performance-based assessment for individuals post-stroke and traumatic brain injury. Australian Occupational Therapy Journal, 60(5), 334-342. doi:10.1111/1440-1630.12069

상세보기
Shumway-Cook, A., & Woollacott, M. H. (2007). Motor control: Translating research into clinical practice (3rd ed.). Baltimore, MD: Lippincott Williams & Wilkins.
Skidmore, E. R., Holm, M. B., Whyte, E. M., Dew, M. A., Dawson, D., & Becker, J. T. (2011). The feasibility of meta-cognitive strategy training in acute inpatient stroke rehabilitation: Case report. Neuropsychological Rehabilitation, 21(2), 208-223. doi:10.1080/09602011.2011.552559

상세보기
Toglia, J., & Berg, C. (2013). Performance-based measure of executive function: Comparison of community and at-risk youth. American Journal of Occupational Therapy, 67(5), 515-523. doi:10.5014/ajot.2013.008482

상세보기
Van der Lee, J. H., Beckerman, H., Knol, D. L., De Vet, H. C. W., & Bouter, L. M. (2004). Clinimetric properties of the motor activity log for the assessment of arm use in hemiparetic patients. Stroke, 35(6), 1410-1414. doi:10.1161/01.STR.0000126900.24964.7e

상세보기
Wilson, B. A., Evans, J. J., Emslie, H., Alderman, N., & Burgess, P. (1998). The development of an ecologically valid test for assessing patients with a dysexecutive syndrome. Neuropsychological Rehabilitation, 8(3), 213-228. doi:10.1080/713755570

상세보기
Wolf, T. J., Polatajko, H., Baum, C., Rios, J., Cirone, D., Doherty, M., & McEwen, S. (2016). Combined cognitive-strategy and task-specific training affects cognition and upper-extremity function in subacute stroke: An exploratory randomized controlled trial. American Journal of Occupational Therapy, 70(2), 1-10. doi:10.5014/ajot.2016.017293

상세보기

저자의 다른 논문 :

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증