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The Effects of Self-Exercise Based on Health Care Application on Upper Extremity Function and Daily Living, Satisfaction in Patients with Stroke

헬스케어 애플리케이션 기반의 자가운동이 뇌졸중 환자의 상지기능, 일상생활, 만족도에 미치는 효과

  • 문종훈 (가천대학교 보건대학원 작업치료학 전공) ;
  • 박인혜 (구미대학교 작업치료과)
  • Received : 2017.01.14
  • Accepted : 2017.06.16
  • Published : 2017.06.30

Abstract

The aim of this study was investigated the effect of self-exercise based on health care application on upper extremity function and daily living, satisfaction in patients with stroke. This experiments were participated in thirty patients with stroke. All subjects allocated that randomized each fifteen patients in experimental and control groups. Subjects of both group received the conventional rehabilitation therapy during 30 min/day, 5 for week, for 4 weeks. Additionally, experimental group performed that self-exercise based on health care application, supervised under caregivers, during 30 min/day. Additionally, control group conducted only self-exercise supervised under caregivers, during 30 min/day. The outcome measures were the JHFT(: Jebsen-Taylor Hand Function Test), FMA(: Fugl-Meyer Assessment), K-MBI(: Korean Modified Barthel Index), VASS(: Visual Analog Satisfaction Scale). In results of study. Two groups showed significant improvements after intervention in all tests(p<.05). In comparison of change score between both group, experimental group showed greater significant improvements than control group in JHFT(p<.05). The experimental group was significant higher than control group in VASS(p<.05). We suggested that self-exercise based on health care application can have a positive effects of the improvements of hand function and satisfaction than usual self-exercise in patients with stroke.

본 연구는 헬스케어 애플리케이션 기반의 자가운동이 뇌졸중 환자의 상지기능, 일상생활, 만족도에 미치는 효과를 알고자 하였다. 본 실험을 위해 뇌졸중 환자 30명이 참여하였다. 모든 대상자는 실험군과 대조군으로 15명씩 무작위로 할당되었다. 두 군은 모두 하루 30분, 주 5회, 4주간 보편적인 재활치료를 동일하게 받았다. 실험군은 헬스케어 애플리케이션 기반의 자가운동을 사용한 자가운동을 30분 추가로 수행하였다. 대조군은 애플리케이션 없이 자가운동을 수행하였다. 결과측정은 중재 전과 후에 젭슨 손기능 검사, Fugl-Meyer 평가, 수정바델지수를 평가하였으며, 중재 후 시각만족도척도를 측정하였다. 연구 결과, 두 군은 중재 전과 후에 모든 측정평가에서 유의한 향상이 있었다(p<.05). 두 군 간 변화량 비교에서 실험군은 대조군보다 젭슨 손기능 검사에서 유의한 향상이 있었다(p<.05). 중재 후, 시각만족척도는 실험군이 대조군보다 유의하게 더 높았다(p<.05). 본 연구의 결과는 헬스케어 애플리케이션 기반의 자가운동은 기존의 자가운동보다 뇌졸중 환자의 손기능과 만족도에 긍정적인 효과를 기대할 수 있다고 시사한다.

Keywords

References

  1. Thom. T., Haase. N., Rosamond. W., Howard. V., Rumsfeld. J., Manolio. T., and Lloyd-Jones, D., "Heart disease and stroke statistics--2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee," Circulation, vol. 113, no. 6, 2006, pp. 2361-2372.
  2. Wade. T. and Hewer. L., "Functional abilities after stroke: measurement, natural history and prognosis," J. of Neurology, Neurosurgery and Psychiatry, vol. 50, no. 2, 1987, pp. 177-182. https://doi.org/10.1136/jnnp.50.2.177
  3. King. B., "Quality of life after stroke." Stroke, vol. 27, no. 9, 1996, pp. 1467-1472. https://doi.org/10.1161/01.STR.27.9.1467
  4. Liepert. P. and Joachim K.. "Treatment-induced cortical reorganization after stroke in humans." Stroke, vol. 31, no. 6, 2000, pp. 1210-1216. https://doi.org/10.1161/01.STR.31.6.1210
  5. S. Jang, Y. Kim, S. Cho, J. Lee, J. Park, J. Won, and Y. Kwon, "Cortical reorganization induced by task-oriented training in chronic hemiplegic stroke patients," Neuroreport, vol. 14, no. 1, 2003, pp. 137-141. https://doi.org/10.1097/00001756-200301200-00025
  6. Moreland. D., Thomson. A., and Fuoco. R., "Electromyographic biofeedback to improve lower extremity function after stroke: a meta-analysis," Archives of Physical Medicine and Rehabilitation, vol. 79, no. 2, 1998, pp. 134-140. https://doi.org/10.1016/S0003-9993(98)90289-1
  7. Zimmermann-Schlatter, Andrea, et al. "Efficacy of motor imagery in post-stroke rehabilitation: a systematic review." J. of Neuroengineering and Rehabilitation, vol. 5, no. 1, 2008, pp. 539-547.
  8. Wolf. L., Winstein. J., Miller. P., Taub, E., Uswatte, G., Morris, D. and Excite Investigators, "Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial," Jama, vol. 296, no. 17, 2006, pp. 2095-2104. https://doi.org/10.1001/jama.296.17.2095
  9. Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, and Scheets PL., "Observation of amounts of movement practice provided during stroke rehabilitation," Archives of Physical Medicine and Rehabilitation, vol. 90 no. 2, 2009, pp. 1692-1698. https://doi.org/10.1016/j.apmr.2009.04.005
  10. R. Park, S. Kim, and S. Choi, "The Effect of Upper Extremity Exercise Program for Hemiplegic Stroke Patients," The Korean Academic Society Of Adult Nursing, vol. 16, no. 4, 2004, pp. 626-635.
  11. J. Moon and Y. Won, "Effects of orofacial exercises training program using smart phone on swallowing function and tongue strength in acute stroke patients with dysphagia," J. of the Korea Institute of Electronic Communication Sciences, vol. 11, no. 10, 2016, pp. 995-1002. https://doi.org/10.13067/JKIECS.2016.11.10.995
  12. J. Moon and Y. Won, "The Effects of Orofacial Training Video Program using Smart Device on Oral Cavity Structure and Function, Diadochokinetic Rate in Acute Stroke Patients with Dysarthria," J. of the Korea Institute of Electronic Communication Sciences, vol. 12, no. 4, 2017, pp. 1095-1104.
  13. K. Kim, K. Nam, J. Lee, Y. Choi, H. Im, J. Lim, and J. Paik. "Effects of Full-Time Integrated Self Upper-Extremity Training Program on Functional Recovery and Length of Stay in Stroke Patients," Annals of Rehabilitation Medicine, vol. 34, no. 4, 2010, pp. 417-423.
  14. B. Koo, E. Kim, M. Park, C. Park, and J. Shim, "The Effect on Functional Recovery of Self Exercise Program in Stroke," Journal of Special Education & Rehabilitation Science, vol. 47, no. 1, 2008, pp. 331-347.
  15. I. Song, J. Cho, Y. Kim, H. Kim, H. Jin, and Y. Kang, "The use of smartphone applications in stroke rehabilitation in Korea," Brain and Neurorehabilitation, vol. 6 no. 1, 2013, pp. 33-40. https://doi.org/10.12786/bn.2013.6.1.33
  16. G. Kim and J. Kim, "Intelligent Self Learning System for Keyboard Instrument using a Smartphone," J. of the Korea Institute of Electronic Communication Sciences, vol. 9, no. 9, 2014, pp. 999-1004. https://doi.org/10.13067/JKIECS.2014.9.9.999
  17. H. Jang, W. Shin, H. Song, J. Ahn, and T. Jung, "A gait analysis using smart phone images of the knee joint angle and stride length," J. of Rehabilitation Welfare Engineering and Assistive Technology, vol 7, no. 2, 2013, pp. 139-144.
  18. S. Choi, "The effect of cognitive training application to cognitive function of stroke Patients," Master's Thesis, Daegu University, 2015.
  19. M. Heo, Y. Kim, W. Kim, H. Kim, S. Gwak, G. Son, and S. Son, "Application development to improve upper extremity function after stroke," J. of the Korea Entertainment Industry Association, vol. 9, no. 2, 2015, pp. 363-369. https://doi.org/10.21184/jkeia.2015.06.9.2.363
  20. Jebsen. H., Taylor. N., and Trieschmann, B, "An objective and standardized test of hand function," Archives of Physical Medicine and Rehabilitation, vol. 50, no. 6, 1969, pp. 311-319.
  21. H. Kim, S. Kim, and T. Han, "New Scoring System for Jebsen Hand Function Test," Annals of Rehabilitation Medicine, vol. 31, no. 6, 2007, pp. 623-629.
  22. Fugl. R., Jaasko. L., and Leyman. I, "The post-stroke hemplegic patient," Scandinavian J. of Rehabilitation Medicine, vol. 7, no. 1, 1975, pp. 13-31.
  23. Sanford. J., Moreland,. J., and Swanson. R. "Reliability of the Fugl-Meyer Assessment for testing motor performance in patients following stroke," Physical Therapy, vol. 73, no. 7, 1993, pp. 447-454. https://doi.org/10.1093/ptj/73.7.447
  24. Granger. V., Albrecht. L., and Hamilton. B. "Outcome of comprehensive medical rehabilitation: Measurement by PULSES profile and the Barthel Index," Archives of Physical Medicine and Rehabilitation, vol. 60, no. 3, 1979, pp. 145-154.
  25. Singer. J, "Determination of the minimal clinically significant difference on a patient visual analog satisfaction scale," Academic Emergency Medicine, vol. 5, no. 10, 1998, pp. 1007-1011. https://doi.org/10.1111/j.1553-2712.1998.tb02781.x
  26. J. Harris. J. Eng, W. Miller, and A. Dawson, "A self-administerd graded repetitive arm supplementary program(GRASP) improves arm function during impatient stroke rehabilitation : A multi-site randonmized controlled trial," Stroke, vol. 40, no. 6, 2009, pp. 2123-2128. https://doi.org/10.1161/STROKEAHA.108.544585
  27. J. Harris, J. Eng, W. Miller, and A. Dawson, "The Role of caregiver involvement in up per-limb treatment in individuals with subacute stroke," Physical Therapy, vol. 90, no. 9, 2010, pp. 1302-1310. https://doi.org/10.2522/ptj.20090349
  28. H. Ko, J. Park, K. Lee, E. Lee, and M. Oh, "The effect of action-observational physical training based on mirror neuron system on upper extremity function and activities of daily living in stroke patient," J. of the Korea Institute of Electronic Communication Sciences, vol. 9, no. 1, 2014, pp. 123-130. https://doi.org/10.13067/JKIECS.2014.9.1.123
  29. J. Moon, K. Kim, and Y. Won, "Correlations and Comparison among Swallowing Function, Dietary Level, Cognitive Function, Daily Living according to Characteristic in Stroke Patients with Dysphagia," Journal of Rehabilitation Research, vol. 20, no. 4, 2016, pp. 265-281. https://doi.org/10.16884/JRR.2016.20.4.265
  30. H. Woo, W. Park, and T. Cha, "Correlation between Korean-WMFT functional score and activity of daily living," J. of Korean Society of Occupational Therapy, vol. 20, no.3, 2012, pp. 95-104.
  31. Y. Chung, E. Song, K. Lee, J. Ahn, J. Seong, and M. Song, "Correlations of the Stroke Rehabilitation Assessment of Movement, Berg Balance Scale, and Modified Barthel Index in Patients With Acute Stroke," Korean Research Society of Physical Therapy, vol. 18, no. 2, 2011, pp. 52-59.