Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
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Effects of CO-OP Interventions on Affected Upper Extremity Use, Execution Function and Occupational Performance in Patients With Stroke

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

  • Kim, Gyeong-Sil (Dept. of Occupational Therapy, Konyang University) ;
  • Kim, Hee (Dept. of Occupational Therapy, Konyang University)
  • 김경실 (건양대학교 일반대학원 작업치료학과) ;
  • 김희 (건양대학교 의과학대학 작업치료학과)
  • Received : 2020.04.19
  • Accepted : 2020.05.21
  • Published : 2021.05.31
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Abstract

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.

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.

Keywords

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