Therapeutic Science for Rehabilitation (재활치료과학)

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

DOI QR Code

The Effects of Functional Task Training on Activities of Daily Living in the Fall Experienced Elderly

기능적 과제훈련이 낙상경험노인의 일상생활수행능력에 미치는 영향: 단일대상연구

  • Woo, Ji Hee (Dept. of Occupational Therapy, Graduate School of Yonsei University) ;
  • Park, Hae Yean (Dept. of Occupational Therapy, College of Health Science, Yonsei University) ;
  • Kim, Jong Bae (Dept. of Occupational Therapy, College of Health Science, Yonsei University)
  • 우지희 (연세대학교 일반대학원 작업치료학과) ;
  • 박혜연 (연세대학교 보건과학대학 작업치료학과) ;
  • 김종배 (연세대학교 보건과학대학 작업치료학과)
  • Received : 2015.11.30
  • Accepted : 2016.01.31
  • Published : 2016.01.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : The purpose of this study was to investigate the effects of occupational therapeutic intervention including functional task training on activities daily living of falls experienced elderly. Methods : This study used a single subject experimental design with alternating treatment and reversal design. One participant who have had falls experience among the community-dwelling elderly completed. This study a total of 18 sessions were conducted. Fall Efficiency Scale(FES), Berg Balance Scale(BBS) and task modification scale were used to assess the activities of daily living during each session, and Canadian Occupational Performance Measure(COPM) and Assessment of Home-based Activities(AHA) were used to evaluate the activities of daily living at pre-and post-test. Results : The participant showed significant improvements in the FES, BBS scores. However, the improvement was greater when progressive resistance exercise was practised along with functional task training. COPM and AHA scores improved at post-test. Conclusions : These findings provide evidence for occupational therapeutic intervention for falls-experienced elderly.

목적 : 본 연구는 낙상 후 회복에 대한 개입으로 기능적 과제훈련이 포함된 작업치료적 중재가 낙상경험노인의 일상 생활수행능력에 어떠한 영향을 미쳤는지 알아보고자 한다. 연구방법 : 본 연구는 지역사회에 거주하는 낙상경험노인 1명을 대상으로 하였으며, 반전설계에 동시 중재 교차설계를 더한 것이다. 총 실험회기는 18회로 기초선 A와 A'는 주 3회 2주간 걸쳐 6회, 중재과정 B는 2가지 중재가 동일한 날 점진적 저항근력운동의 낙상중재프로그램 1회, 점진적 저항근력운동에 기능적 과제훈련이 더해진 낙상중재 프로그램 1회가 오전, 오후 교대로 적용하여 주 3회씩 4주간 총 12회 진행하였다. 기초선 6회기, 중재 매 회기 마다 버그균형척도(Berg-Balance Scale), 과제수정척도(Task Modification Scale), 한국어판 낙상 효능감(Korean versioin Fall Efficiency Scale)을 측정하였고 실험 전, 후에 대상자의 일상생활수행능력을 비교하기 위해 캐나다 작업수행평가(Canadian Occupational Performance Measurement)와 가정 내 일상생활활동평가(Assessment of Home-Based Activities)로 측정하였다. 결과 : 중재 전, 후에 일상생활수행능력은 수행도보다 만족도에서 향상되었고, 가정 내 일상생활활동의 독립성과 안전성 영역에서 점수가 더 향상됨을 보였다. 점진적 저항근력운동만 중재했을 때보다 점진적 저항근력운동에 기능적 과제훈련이 더해진 중재 후 낙상효능감과, 버그균형점수에서 통계적으로 더 큰 변화를 보였다. 결론 : 본 연구는 낙상을 경험한 노인을 대상으로 한 작업치료 중재의 근거를 제시하는데 의의가 있다.

Keywords

References

  1. Alcalde Tirado, P. (2010). Fear of falling. Revista Espanola de Geriatria y Gerontologia, 45(1), 38-44 doi:10.1016/j.regg.2009.10.006
  2. Berg, K. O., Maki, B. E., Williams, J. I., Holiday, P. J., & Wood-Dauphinee, S. L. (1992). Clinical and laboratory measures of postural balance in an elderly population. Archives Physical Medicine Rehabilitation, 73(11), 1073-1080.
  3. Cambell, A. J., Robertson, M. C., Gardner, M. M., Norton, R. N., & Buchner, D. M. (1999). Falls prevention over 2 years: A randomized controlled trial in women 80years and older. Age and Ageing, 28, 513-518. https://doi.org/10.1093/ageing/28.6.513
  4. Carpenter, L., Baker, G. A., & Tyldesly, 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. https://doi.org/10.1177/000841740106800102
  5. Chang, K. Y., & Woo, H. S. (2010). Influence of fall-preventive occupational therapy applied to elderly in the community upon balance ability. Journal of Korea Contents Association, 10(3), 232-240. https://doi.org/10.5392/JKCA.2010.10.3.232
  6. Choo, J., & Kim, E. K. (2012). Health-related quality of life of fallers vs non-fallers in community-dwelling elderly people. Journal of Muscle Joint Health, 19(3), 373-382. doi: 10.5953./JMJH.2012.19.3.373
  7. De Vreede, P. L., Samson, M. M., van Meeteren, N. L., van der Bom, J. G., Duursma, S. A., & Verhaar, H. J. (2004). Functional tasks exercise versus resistance exercise to improve daily function in older women: A feasibility study. Archives of Physical Medicine and Rehabilitation, 85, 1952-1961. http://dx.doi.org/10.1016/j.apmr.2004.05.006
  8. De Vreede, P. L., Samson, M. M., van Meeteren, N. U., Duursma, S. A., & Verhaar, H. J. (2005). Functional task exercise versus resistance strength exercise to improve daily function in older women: A randomized, controlled trial. Journal of the American Geriatrics Society, 53, 2-10. http://dx.doi.org/ 10.1111/j.1532-5415.2005.53003.x
  9. Fielding R. A., LeBrasseur, N. K., Cuoco, A., Bean, J., Mizer, K., & Fiatarone Singh, M. A. (2002). High velocity resistance training increases skeletal muscle peak power in older women. Journal of American Geriatric Society, 50, 655-662. https://doi.org/10.1046/j.1532-5415.2002.50159.x
  10. Gill, T. M., & Kurland, B. F. (2003). Prognostic effect of prior disability episodes among non disabled community-living older persons. American Journal of Epidemiology, 158, 1090-1096. http://dx.doi.org/10.1093/aje/kwg237
  11. Hill, K., & Schwarz, J. (2004). Assessment and management of falls in older people. Journal of Internal Medicine, 34, 557-564. doi:10.1111/j.1445-5994.2004.00668.x
  12. Jang, I., S., & Park, E. O. (2013). The prevalence and factors of falls among the community dwelling elderly. The Journal of Korean Public Health Nursing, 27(1), 89-101. http://dx.doi.org/10.5932/JKPHN.2013.27.1.89
  13. Jang, S. N., Cho, S. I., Ou, S. W., Lee, E. S., & Baik, H. W. (2003). The validity and reliability of korean Fall Efficacy Scale(FES) and Activities-specific Balance(ABC). The Journal of Korean Geriatrics Society, 7(4), 255-268.
  14. Jeon, B. J., Lee, J. S., Lee, O. J., Shim, M. S., Han, S. J. & Chang, Y. S. (2009). A study on the factors affecting falls of the elderly in rural areas. The Journal of Korean Society of Occupational Therapy, 17(4), 99-112.
  15. Jorstad, E. C., Hauer, K., Becker, C., Lamb, S. E. (2005). Measuring the psychological outcomes of falling: A systematic review. Journal of the American Geriatrics Society, 53(5), 501-510. http://dx.doi.org/1-.1111/j.1532-5415.2005.53172.x https://doi.org/10.1111/j.1532-5415.2005.53172.x
  16. Kang, J. H., & Hwang, B. R. (2013). Community dwelling female elder's fall experience. Journal of Welfare for the Aged, 60, 259-286.
  17. Kim, S. K. (2005). The risk factors and occupational therapy. The Journal of Korean Society of Occupational therapy, 13(3), 69-76.
  18. Korean National Statistical Office (2012). The aged population statistics. retrieved from http://kosis.kr/wnsearch/totalSearch.jsp
  19. Lee, H. J., Yi, C. H., & Yoo, E. Y. (2002). Correlations among the berg balance scale, gait parameters, and falling, in the elderly. Korean Research Society of Physical Therapy, 9(3), 47-65.
  20. Lee, Y. S. (2003). Study on the effect of exercise program using thera-band on the physical strength and the balance sensation relevant to health "targeting aged men residing in the elderly nursing facilities" (Master's thesis). Dongkuk University, Seoul.
  21. Lim, N. G., Shim, G. B., Kim, Y. B., Park, J. R., Kam, E. Y., & Lee, M. S. (2002). A study on the prevalence and associated factors of falls in some rural elderly. The Korean Geriatrics Society, 6(3), 183-196.
  22. Manini, T. M., Cook, S. B., Vanamam, T., Marko, M., & Ploutz-Snyder, L. L. (2006). Evaluating task modification as an objective measure of functional limitation: Repeatability and comparability. The Journal of Gerontology. Series A, Biological Science and medical sciences, 61(7), 718-725. https://doi.org/10.1093/gerona/61.7.718
  23. Manini, T., Marko, M., VanArnam, T., Cook, S., Fernhall, B., ... Ploutz-Snyder, L. (2007). Efficacy of resistance and task-specific exercise in older adults who modify tasks of everyday life. Journal of Gerontology, Series A: Biological sciences and medical sciences, 62, 616-623. https://doi.org/10.1093/gerona/62.6.616
  24. National Health Insurance Service. (2014). The first half year health insurance statistics. Seoul, Korea: Author.
  25. Orellano, E., Colon, W. I., & Arbesman, M. (2012). Effect of occupation-and activity-based interventions on instrumental activities of daily living performance among community dwelling older adults : A systematic review. American Journal of Occupational Therapy, 66, 292-300. Retrieved from http://dx.doi.org/10.5014/ajot.2012.003053
  26. Penninx, B. W., Messier, S. P., Rejeski, W. J., Williamson, J. D., DiBari, M., ... Pahor, M. (2001). Physical exercise and the prevention of disability in activities of daily living in older persons with osetoarthritis. Archives of Internal Medicine, 161, 2309-2316. doi: 10.1001/archinte.161.19.2309
  27. Schepens, S., Sen, A., Painter, J. A., & Murphy, S. L. (2012). Relationship between fall-related efficacy and activity engagement in community dwelling older adults: A meta analytic review. American Journal of Occupational Therapy, 66(2), 137-148. doi:10.5014/ajot.2012.001156
  28. Statistics Korea.(2014). 2014 statistics on the aged. Seoul, Korea: Author.
  29. Tinetti, M. E., Richman, D., & Powell, L. (1990). Fall efficacy as a measure of fear of falling. Journal of Gerontology, 45(6), 239-243. https://doi.org/10.1093/geronj/45.6.P239
  30. Vaapio, S., Salminen, M., Vahlberg, T., & Kivela, S. L. (2011). Increased muscle strength improves managing in activities of daily living in fall-prone community-dwelling older women. Aging Clinical and Experimental reasearch, 23(1), 42-48. doi:10.3275/6860
  31. Yang, N. Y., Jung, M. Y., Yoo, E. Y., Park, J. H., Lee, J. S., & Chang, K. Y. (2014). Developmental of Home-based activities (AHA)Assessment. Journal of Korean Society of Occupational Therapy, 22(3), 1-10. http://dx.doi.org /10.14519/jksot.2014.22.3.01
  32. Yoo, Y, K. (2010). Falls and functional levels associated with falls in older people living. Journal of Korean Gerontological Nursing, 12(1), 40-50.