• PNF and Movement
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• 제18권3호
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• pp.305-313
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• 2020

Purpose: The aim of this study was to investigate the relationship between a functional evaluation model and the Fugl-Meyer assessment (FMA) scale in evaluating the upper extremities of stroke patients Methods: Thirty-eight stroke patients were evaluated using the FMA and performed reaching and grasping motions using a three-dimensional motion analysis (Qquas 1 series, Qualisys AB, Sweden). The participants sat on a chair with a backrest. The position of the cup was located at a distance of 80% to the front arm length. The markers were attached to the sternum, acromion, elbow lateral epicondyle, ulnar styloid process, three metacarpal heads, and the distal phalanges of the thumb and index finger. The variables of the correlation between the functional evaluation model and the FMA scale were analyzed. Multiple regression (stepwise) was used to investigate the effect of the kinematic variables. Results: A significant negative correlation was found between the movement time (p < 0.05), movement unit (p < 0.05), and trunk displacement values (p < 0.05) in the FMA total scores, while a positive correlation was found between the peak velocity (p < 0.05) and maximum grip aperture values (p < 0.05). As a result of the multiple regression analysis, the most significant factor was the movement unit, followed by the general movement assessment and trunk displacement. The explained FMA total score value was 62%. Conclusion: This study presents a new functional evaluation model for assessing the reaching and grasping ability of stroke patients. The factors of the proposed functional evaluation model showed significant correlations with the FMA scale scores and confirmed that the new functional evaluation model explained the FMA by 67%. This suggests a new functional evaluation model for reaching and grasping stroke patients.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.35-43
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• 2016

Background: The Functional Gait Assessment (FGA) was developed to measure of gait-related activities. The FGA was translated in Korean but only a few psychometric characteristics had been studied. Objects: The purpose of this study was to evaluate the validity and reliability of the Korean version of FGA scale using Rasch analysis. Methods: The study included 120 patients with stroke (age range=30~83 years; mean${\pm}$standard deviation=$58.3{\pm}11.1$). The FGA and Berg Balance Scale were performed, and were analysed for dimensionality of the scale, item difficulty, scale reliability and separation, and item-person map using Rasch analysis. Results: The 4 rating scale categories of FGA were satisfied with optimal rating scale criteria. The most items of the FGA showed sound item psychometric properties except 2 items ('gait with the horizontal head turns', and 'gait with narrow base of support'), and the 2 misfit items were excluded for all further analyses. The 8 items were arranged in order of difficulty. The most difficult item was 'gait with eyes closed', the middle difficult item was 'gait level surface', and the easiest item was 'gait with vertical head turns.' A person separation reliability was .93 and the person separation index was 3.57. Conclusion: This study suggests that the 8-item Korean FGA are valid measure of assess the gait-related balance performance, and to set the goal of rehabilitation plan in patient with stroke.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.459-466
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• 2016

본 연구는 아급성기 뇌졸중 환자에서 로봇 보조치료법이 운동능력 및 기능적인 회복에 미치는 효과를 알아보고자 하였다. 환자 53명이 연구에 참여하였다. 로봇보조 보행치료군은 고식적인 치료에 추가로 Lokomat$^{(R)}$ 이용하여 하루에 삼십분씩, 일주일에 5회, 4주 동안 시행하였으며, 대조군은 고식적인 치료에 추가로 하루에 삼십분씩 고식적인 치료를 시행 받았다. 모든 환자들은 임상지표의 비교를 위해, 치료 전과 4주간의 치료 후 Fugl-Meyer assessment, Motricity index, functional ambulation category, Berg balance scale, 10m 보행검사, 한국판 수정 바델지수, 한국판 간이 정신 상태검사와 벡 우울증 척도를 평가 받았다. 환자들은 기능회복과 체성 감각 유발전위 검사 결과의 관계를 알아보기 위해 유발 전위 검사를 시행하였다. 아급성기 뇌졸중 환자에서 로봇 보조 보행치료군에서 대조군에 비해 하지의 운동기능, 보행 능력, 일상생활능력의 유의한 호전이 나타났다. 체성 감각 유발 전위 검사의 결과는 임상 지표들의 관련성 분석에서 Motricity index와 한국판 수정 바델지수와 관련이 있는 것으로 나타나 아급성기 뇌졸중 환자의 기능을 예측하는데 유용할 것으로 생각된다. 로봇 보조 보행치료는 아급성기 뇌졸중 환자의 운동기능과 보행기능의 회복을 촉진하는 것으로 생각된다.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.41-46
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• 2002

Purpose : To assess the clinical results of second toe-to-finger transfer in traumatic amputated index finger. Materials and Methods : For the clinical evaluation, we have analyzed 12 patients with ROM of finger joints, pinch power, static two point discrimination, life functional assessment, and patient's satisfaction. Results : In genral ROM was $54.4^{\circ}$ at MP joint, $17^{\circ}$ at PIP joint and $6.7^{\circ}$ at DIP joint. Pinch power was good in 3 cases, fair in 7 cases, and poor in 2 cases. Daily life activity and patient's acceptance were satisfactory. Conclusion : Although transfered toe function may be poorer than normal finger, the hand was restored to a useful, sensate and versatile functional unit.

• 한국습지학회지
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• 제13권3호
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• pp.665-675
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• 2011

댐 상류지역 및 주변지역에 위치하고 있는 습지는 댐의 수질개선, 동식물의 서식처 확보 등과 같은 생태보전 및 경관 제공 기능을 제공할 수 있다. 따라서 본 연구에서는 댐이 지니고 있는 습지의 역할을 검토하기 위하여 수문지형학적 방법인 HGM을 이용하여 댐습지의 기능을 평가하였다. 본 연구에서는 우포늪과 보령댐을 기준습지로 선정하여 용담댐의 기능을 평가하였으며, 그 결과 전체적인 기능이 0.6점 이상으로 나타났다. 이는 댐습지와 자연습지를 비교했을 때, 댐습지가 자연습지의 약 60%의 기능을 수행하는 것을 나타낸다. 따라서 댐에 위치하고 있는 습지의 관리와 보전이 잘 이루어진다면 보다 더 효과적으로 기능을 수행할 수 있을 것으로 판단 된다.

• 대한한의학회지
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• 제17권1호
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• pp.48-83
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• 1996

Our conclusions for function evaluation tools of Stroke patients are as follows. 1. Evaluating tools of Activities of Daily Living, Katz Index, Barthel Index, Modified Barthel Index have high validity and reliability because of ease of measuring, high accuracy, consistency, sensitivity and sufficient stastistics, but they mainly measure motor function except sense, mentation, language, and social conception. Therefore cerebrovascular disease and brain injury in trauma patients with lacked acknowledgement and sensation, we are not able to apply these tools. 2. PULSES Profile is a useful scale for measuring the patient's over-all status, upper and lower limb functions, sensory components, excretary functions, and intellectual and emotional adaptabilities. It is recognized as a good, useful tool to evaluate patient's whole function. 3. Motor Assessment Scale was designed to measure the progress of stroke patients. The scale was supplemented with upper arm function items. We believe that the Motor Assessment Scale could be a useful evaluation tool with inter-rater reliability ,test-retest reliability. 4. The existing evaluation tools, Katz Index, Barthel Index, Modified Barthel Index, PULSES Profile, Motor Assessment Scale, mainly measured the rehabilitational motor function of sequela of cerebrovascular patients. On the other hand CNS & INH stroke scale can measure cerebrovascular disease patient's neurologic deficits and over-all stautus, which are recognition ability, speech status, motor function, sensory function, activities of daily living. Those scales have been recognized as useful tools to measure function of cerebrovascular disease patients and have increased in use. 5. Every function evaluation tool was recognized to have some validity and inter-rater, test-retest reliability in items of each evaluation tool and total scores of each evaluation tools, but it is thought that none of these scales have been fully validated and proved reliable. Therefore afterward, the development of a highly reliable rating system may best be accomplished by a careful comparison of several tools, using the same patients and the same observers in order to choose the most reliable items from each. 6. Ideal evaluation tools must have the following conditions; (1) It should show the objective functional statues at the same time. (2) It should be repeated consecutively to know changed function status. (3) It should be easy to observe the treatment program. (4) It should have the same result with another rater to help rater exchange information with treatment team members. (5) It should be practical and simple. (6) The patient should not suffer from the observer.

• 재활치료과학
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• 제9권3호
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• pp.7-21
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• 2020

목적 : 본 연구는 뇌졸중 환자와 노인 환자를 대상으로 퇴원 시기에 이루어지는 평가도구에 대한 체계적 문헌고찰을 통해 평가 항목과 평가도구들을 분석하여 효율적인 퇴원계획을 위한 기초자료를 제공하고자 한다. 연구방법 : 문헌 선정은 PubMed, Medline Complete(EBSCOhost), Scopus를 사용하여 2009년 1월부터 2018년 12월까지의 온라인 데이터에 등록된 연구를 대상으로 최종 22편의 연구를 선정하였고, 연구 설계 및 퇴원 시 주요 평가영역, 하위영역, 평가도구들을 분석하였다. 결과 : 선택된 연구들의 연구 설계 형태는 기술적 연구가 13편(59.2%)으로 가장 많았다. 퇴원 시 평가 영역은 의학적 상태, 일상생활활동, 삼킴 기능, 감각, 이동성, 인지·지각, 의사소통, 감정상태, 가정환경, 환자의 지식과 퇴원을 위한 준비, 사회적지지, 안녕감 등 12개 영역으로 나타났다. 평가 영역에 따라 사용된 평가도구를 분석한 결과, 가장 높은 빈도의 사용을 보이는 평가도구는 일상생활활동을 평가하는 Barthel Index, Functional Independence Measure, 안녕감을 평가하는 Short Form Health Survey, 이동성을 평가하는 Timed Up and Go test 등으로 나타났다. 결론 : 본 연구를 통해 뇌졸중, 노인 환자의 퇴원 시 이루어지는 다양한 평가 영역과 평가도구의 사용과 제한적이나 여러 영역을 포괄하는 평가도구들을 확인할 수 있었다. 이는 뇌졸중 환자의 퇴원 시 고려되는 평가 영역과 효과적인 평가도구의 선택을 돕고 적절한 퇴원계획 중재와 제안을 위한 포괄적인 평가도구의 개발의 기초자료가 될 것이다.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.64-73
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• 2011

After stroke, many people have problems with balance during movement. Balance is essential for the optimal functioning of the locomotor system and the performance of many activities of daily living. The Functional Gait Assessment (FGA) is a clinical tool for evaluating balance ability during walking. The test consists of ten tasks, seven tasks of the Dynamic Gait Index and three additional tasks. The purpose of this study was to evaluate the reliability and internal consistency of data obtained with the Korean version of the FGA when used with people after suffering a stroke. One-hundred participants, at least three months poststroke and able to walk at least six meters with or without a walking aid, participated in the study (age range=30~83 years; $mean{\pm}SD=58.8{\pm}10.9$). Two physical therapists and two physical therapy students rated the FGA. Intrarater and interrater reliability of the FGA were assessed using kappa statistic and intraclass correlation coefficients (2,1). The internal consistency of the FGA was assessed using the Cronbach alpha. The Cronbach alpha was good (${\alpha}$=.86~.93). The intrarater (intraclass correlation coefficient=.92~.95) and interrater reliability (intraclass correlation coefficient=.91, .95) of the total scores administered by the therapists and students were good, whereas the reliability for single item scores when administered by the physical therapists was moderate to good (kapa value=.42~.97). This study found that intrarater and interrater reliability for total FGA scores and internal consistency were good. Therefore, the Korean version of the FGA can be used as a reliable tool to assess the functional gait performance of patients after stroke.

• 재활치료과학
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• 제6권2호
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• pp.11-28
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• 2017

목적: 본 연구는 뇌졸중 환자를 위한 일상생활활동 평가도구에 관해 체계적 고찰함으로써 임상 및 연구에서 자료로 활용되고자 하였다. 연구방법: 2001년부터 2016년까지 학회지에 게재된 논문을 검색하기 위하여 Pubmed, Embase, Cochrane, NDSL 데이터베이스를 사용하여"stroke AND activities of daily living AND occupational therapy AND assessment OR evaluation OR measurement"를 검색하여 체계적 고찰을 하였다. 평가도구의 종류와 사용빈도를 분석한 후 이에 대한 경향을 파악하였다. 또한 국제 기능 장애 건강 분류(International Classification of Functioning, Disability and Health; ICF) 모델의 분류 기준에 맞추어 활동과 참여에 대한 평가도구를 분류하였다. 결과: 총 111개의 논문이 최종적으로 분석되었으며, 30개의 평가도구가 확인되었다. 최근 들어 뇌졸중 환자를 대상으로 한 연구 게재편수가 증가함에 따라 평가도구의 종류와 사용빈도가 증가하였다. 가장 많이 사용되는 평가도구는 기능적 독립성 측정(Functional Independence Measure; FIM), 바델 지수(Barthel Index; BI)와 캐나다작업수행측정(Canadian Occupational Performance Measure; COPM)이었다. ICF 모델의 분류 기준에 따라 분석한 결과 대부분의 도구는 활동에 대한 평가도구로 참여에 대한 평가도구 수는 매우 적었다. 결론: 본 연구는 뇌졸중 환자의 일상생활활동 수행능력을 측정하기 위해 사용된 평가도구를 체계적으로 고찰하였다. 연구 결과 FIM, BI와 같은 특정한 도구가 많이 사용되었다. 앞으로는 평가도구의 특성에 맞춰 적절한 평가가 이루어 질 수 있도록 다양한 평가도구를 사용한 연구가 진행되어 근거기반의 작업치료를 뒷받침 해 주어야 한다. 또한 ICF 모델의 분류 기준 중 참여에 대한 평가도구의 개발이 이루어져야 할 것이다.

• 한국전문물리치료학회지
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• 제13권2호
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• pp.1-8
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• 2006

The main purposes of this study were to find the correlation between walking ability assessment tools using the Modified Barthel Index (MBI), Functional Independence Measure (FIM), Spinal Cord Injury Measurement II (SCIM II), Walking Index for Spinal Cord Injury (WISCI), walking velocity, and walking endurance. The study population consisted of 56 patients with spinal cord injury referred to the department of Rehabilitative Medicine in the National Rehabilitation Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed by MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance. The data were analyzed using Pearson correlation analysis and X2. There was significant correlation between the MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance (p<.01). In particular, WISCI has a significant correlation with SCIM II(p<.001). Therefore the WISCI scale is an appropriate assessment tool to predict the gait ability of patients with spinal cord injury. Further study about MBI, FIM, SCIM II, WISCI, walking velocity, and walking endurance is needed using a longitudinal study design.