Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
권호 표지
DOI QR코드

DOI QR Code

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

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

  • Park, Seong-Sun (Pyeongtaek Vision Hospital) ;
  • Kim, Su-kyung (Dept. of Occupational Therapy, Konyang University) ;
  • Yoo, Doo-Han (Dept. of Occupational Therapy, Konyang University) ;
  • Kim, Hee (Dept. of Occupational Therapy, Konyang University)
  • 박성순 (평택비전병원) ;
  • 김수경 (건양대학교 의과학대학 작업치료학과) ;
  • 유두한 (건양대학교 의과학대학 작업치료학과) ;
  • 김희 (건양대학교 의과학대학 작업치료학과)
  • Received : 2020.03.12
  • Accepted : 2020.03.30
  • Published : 2021.02.28
Download PDF
⟨ Previous Next ⟩

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.

목적 : 본 연구는 원격재활에 기반 한 작업치료가 뇌졸중 환자의 실행기능, 일상생활수행, 작업수행에 영향을 미치는지 알아보고자 한다. 연구방법 : 지역사회에 거주하며, 재활병원에 외래로 통원하는 환자 30명을 실험군과 대조군에 각각 15명씩 무작위 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 중심의 과제수행을 측정하기 위해서 캐나다 작업수행 측정(Canadian Occupational Performance Measure; COPM)을 이용하였다. 결과 : 중재 후 실험군과 대조군은 모두 실행기능, 수단적 일상생활활동, 작업수행에서 유의한 변화가 있었으나(p<.05), 기본적 일상생활수행에서는 유의한 변화가 없었다. 집단 간 비교에서는 작업수행에서만 실험군이 대조군보다 유의하게 더 많은 증진이 나타났다. 결론 : 원격재활과 작업치료는 뇌졸중 환자의 실행기능, 수단적 일상생활수행, 작업수행의 향상에 긍정적인 영향을 미친다. 작업치료에 병행된 원격재활은 뇌졸중 환자의 작업수행에 추가적인 효과가 있음을 근거로써 제시한다.

Keywords

References

  1. American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 74, 1-87. doi:org/10.5014/ajot.2020.74S2001
  2. Angeleri, F., Angeleri, V. A., Foschi, N., Giaquinto, S., & Nolfe, G. (1993). The influence of depression, social activity, and family stress on functional outcome after stroke. Stroke, 24(10), 1478-1483. doi:10.1161/01.STR.
  3. Baum, C. M., Connor, L. T., Morrison, T., Hahn, M., Dromerick, A. W., & Edwards, D. F. (2008). Reliability, validity, and clinical utility of the executive function performance test: Ameasure of executive function in a sample of people with stroke. American Journal of Occupational Therapy, 62(4), 446-455. doi:10.5014/ajot.62.4.446
  4. Baum, C. M., Morrison, T., Hahn, M., & Edwards, D. F. (2003). Test manual: Executive function performance test. St. Louis, MO: Washington University. Retrieved from https://www.ot.wustl.edu/about/resources/executive-function-performance-test-efpt-308
  5. Blundon, G., & Smits, E. (2000). Cognitive rehabilitation: A pilot survey of therapeutic modalities used by Canadian occupational therapists with survivors of traumatic brain injury. The Canadian Journal of Occupational Therapy, 67(3), 184-196.
  6. Boehm, N., Muehlberg, H., & Stube, J. E. (2015). Managing poststroke fatigue using telehealth: A case report. American Journal of Occupational Therapy, 69(6), 1-7. doi:10.5014/ajot.2015.016170
  7. Burns, R. B., Crislip, D., Daviou, P., Temkin, A., Vesmarovich, S., Anshutz, J., ... Jones, M. L. (1998). Using telerehabilitation to support assistive technology. Assistive Technology, 10(2), 126-133. doi:10.1080/10400435.1998.10131970
  8. 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
  9. Chen, J., Jin, W., Dong, W. S., Jin, Y., Qiao, F. L., Zhou, Y. F., & Ren, C. C. (2017). Effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia: A randomized controlled trial. American Journal of Physical Medicine & Rehabilitation, 96(3), 152-160. doi:10.1097/PHM.0000000000000559
  10. Choi, J. H., Park, J. W., Kwon, Y. H. (2006). Assessment and neurophysiology of the limb apraxia: Review article. Korean Journal of Physical Therapy, 18(2). 7-16.
  11. Cub, E. H., Scholte, O. P., Reimet, W. J., Thissen, M. C., & van Kuylk-Minis, M. A. (2003). Reliability and validity of the canadian occupational performance measure in stroke patients. Clinical Rehabilitation, 17(4), 402-409. doi:10.1002/oti.190PDFPDF
  12. Delight Room. (2016). Telerehabilitation'Alarmy'application. Retrieved from https://alar.my/
  13. Elliott, R. (2003). Executive functions and their disorders: Imaging in clinical neuroscience. British Medical Bulletin, 65(1), 49-59. doi:10.1093/bmb/65.1.49
  14. European Commission. (2014, April). Green paper on mobile health ("mHealth"), 10(4) 1-20. Retrieved from https://ec.europa.eu/digital-single-market/en/news/green-paper-mobile-health-mhealth
  15. Hayes, S., Donnellan, C., & Stokes, E. (2013). Associations between executive function and physical function poststroke: A pilot study. Physiotherapy,99(2), 165-171. doi:10.1016/j.physio.2012.05.002
  16. Henneman, E. A., Gawlinski, A., & Giuliano, K. K. (2012). Surveillance: A strategy for improving patient safety in acute and critical care units. Critical Care Nurse, 32(2), 9-18. doi:10.4037/ccn2012166
  17. Hsieh, C. L., Hoffmann, T., Gustafsson, L., & Lee, Y. C. (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
  18. Jung, H. Y., Park, B. G., Shin, H. S., Kang, Y. G., Peun, S. B., Baek, N. J. ... Han, T. R. (2007). Development of the korean version of modified barthel Index (K-MBI): Multi-center study for subjects with Stroke. Journal of Korean Academy of Rehabilitation Medicine, 31(3), 283-297.
  19. Kang, D. H., Noh, C. S., Ji, S. Y., Kim, J. K., Lee, T. Y., & Park, S. Y. (2005). A correlation between the Canadian Occupational Performance Measure and the Assessment of Motor and Process Skills: A Pilot Study. The Journal of Korean Society of Occupational Therapy, 13(1), 25-35.
  20. Kang, S. J., & Choi, S. M. (2000). A study on burden and well-being of primary caregivers of patients with a stroke. The Journal of Basic Nursing Science. 12(2), 09-21.
  21. Kegel, J., Dux, M., & Macko, R. (2014). Executive function and coping in stroke survivors. Neurorehabilitation, 34(1), 55-63. doi:10.3233/NRE-131010
  22. Kim, H., Lee, Y. N., Jo, E. M., & Lee, E. Y. (2016). Reliability and validity of culturally-adapted Executive Function Performance Test for Koreans (EFPT-K) with Stroke. Journal of Stroke and Cerebrovascular Disease, 26(5), 1033-1040. doi:10.1016/j.jstrokecerebrovasdis.2016.12.013
  23. Kim, W. H., Hwang, M. O., & Park, E. Y. (2007). The effect of physical and occupational therapy on activities of daily living in stroke inpatients at least 3 months after stroke. Physical Therapy Korea, 14(1), 74-81.
  24. Kunawararak, P., Pongpanich, S., Chantawong, S., Pokaew, P., Traisathit, P., Srithanaviboonchai, K., & Plipat, T. (2011). Tuberculosis treatment with mobile-phone medication reminders in northern Thailand. Southeast Asian Journal of Tropical Medicineand Public Health, 42(6), 1444-1451.
  25. Lai, J. C., Woo, J., Hui, E., & Chan, W. M. (2004). Telerehabilitation-a new model for community-based stroke rehabilitation. Journal of Telemedicine and Telecare, 10(4), 199-205. doi:10.1258/1357633041424340
  26. Langhorne, P., & Duncan, P. (2001). Does the organization of postacute stroke care really matter? Stroke, 32(1), 268-274. doi:10.1161/01.STR.32.1.268
  27. Laver, K. E., Schoene, D., Crotty, M., George, S., Lannin, N. A., & Sherrington, C. (2013). Telerehabilitation services for stroke. Cochrane Database of Systematic Reviews 2013, 12, 1-42. doi:10.1002/14651858.CD010255.pub2
  28. Lin, K. H., Chen, C. H., Chen, Y. Y., Huang, W. T., Lai, J. S., Yu, S. M., & Chang, Y. J. (2014). Bidirectional and multi-user telerehabilitation system: Clinical effect on balance, functional activity, and satisfaction in patients with chronic stroke living in long-term care facilities. Sensors, 14(7), 12451-12466. doi:/10.3390/s140712451
  29. Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index: A simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland State Medical Journal, 14, 61-65.
  30. Maskill, L., & Tempest, S. (Eds.). (2017). Neuropsychology for occupational therapists: Cognition in occupational performance (17th ed.). John Wiley & Sons.
  31. Miller, J. F., & Miller, J. F. (2000). Coping with chronic illness: Overcoming powerlessness (3th ed.). Philadelphia, PA: FA Davis.
  32. Motta, K., Lee, H., & Falkmer, T. (2014). Post-stroke driving: Examining the effect of executive dysfunction. Journal of Safety Research, 49, 1-38. doi:10.1016/j.jsr.2014.02.005
  33. Ownsworth, T., & Shum, D. (2008). Relationship between executive functions and productivity outcomes following stroke. Disability and Rehabilitation, 30(7), 531-540. doi:10.1080/09638280701355694
  34. Pan, A. W., Chung, L., & Hsin-Hwei, G. (2003). Reliability and validity of the canadian occupational performance measure for clients with psychiatric disorders in Taiwan. Occupational Therapy International, 10(4), 269-277. doi:10.1002/oti.190
  35. Park, S. W, Jang, K. E., Lee, H. S., & Park, D. S. (1999). 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), 1-8.
  36. Postolache, G., Moura, C. M., Girao, P. S., & Postolache, O. (2011, April). Rehabilitative telehealthcare for post-stroke outcome assessment. 2011 5th International Conference on, 408-413. doi:10.4108/icst.pervasivehealth.2011.246141
  37. 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
  38. Putrino, D. (2014). Telerehabilitation and emerging virtual reality approaches to stroke rehabilitation. Current Opinion in Neurology, 27(6), 631-636. doi:10.1097/WCO.0000000000000152
  39. Rand, D., Eng, J. J., Liu-Ambrose, T., & Tawashy, A. E. (2010). Feasibility of a 6-month exercise and recreation program to improve executive functioning and memory in individuals with chronic stroke. Neurorehabilitation and Neural Repair, 24(8), 722-729. doi:10.1177/1545968310368684
  40. Redzuan, N. S., Engkasan, J. P., Mazlan, M., & Abdullah, S. J. F. (2012). Effectiveness of a video-based therapy program at home after acute stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 93(12), 2177-2183. doi:10.1016/j.apmr.2012.06.025
  41. Russell, T. G. (2007). Physical rehabilitation using telemedicine. Journal of Telemedicine and Telecare, 13(5), 217-220.doi:10.1258/135763307781458886
  42. Sarfo, F. S., Ulasavets, U., Opare-Sem, O. K., & Ovbiagele, B. (2018). Tele-rehabilitation after stroke: An updated systematic review of the literature. Journal of Stroke and Cerebrovascular Diseases, 27(9), 2306-2318. doi:10.1016/j.jstrokecerebrovasdis.2018.05.013
  43. Shah S., Banclay, F., & Cooper, B. (1989). Improving the sensitivity of the barhel index for stroke rehabilitation. Journal of Clinical Epidemiology, 42(8), 703-709. doi:/10.1016/0895-4356(89)90065-6
  44. Sim, Y. B., Seo, Y. J., Kim, J. M., Kim, S. H., & Sung, D. H. (2012). Factors related to the intent to use the medical application (M-APP) of smart phone of hospital nurses. Health Policy and Management, 22(2), 249-262. doi:10.4332/KJHPA.2012.2.22.2.249
  45. Tchero, H., Tabue-Teguo, M., Lannuzel, A., & Rusch, E. (2018). Telerehabilitation for stroke survivors: Systematic review and meta-analysis. Journal of Medical Internet Research, 20(10), 1-10. doi:10.2196/10867
  46. Van Den Berg, M., Crotty, M., Liu, E., Killington, M., Kwakkel, G., & Van Wegen, E. (2016). Early supported discharge by caregiver-mediated exercises and e-health support after stroke: A proof-of-concept trial. Stroke, 47(7), 1885-1892. doi:/10.1161/STROKEAHA.116.013431