일상생활활동 기반의 가상현실 훈련이 뇌졸중에 미치는 효과: 문헌 고찰

김선우,김태훈,유명훈,이재신 한국엔터테인먼트산업학회 2023 한국엔터테인먼트산업학회논문지 Vol.17 No.1

The purpose of this study was to systematically analyze the types and effects of activities of daily living based virtual reality training used for stroke patient training. From 2012 to 2022, domestic and foreign literature was searched through Pubmed, ScienceDirect, Koreamed, National Assembly Library, and other databases. The main search key words were "activities of daily living" AND "virtual" AND "stroke". According to the selection/exclusion criteria, 18 articles were finally selected. As a result of the analysis, there was no difference in virtual reality equipment and programs according to stroke onset period and type. Implemented activities of daily living included shower, grooming, washing, and self-care, and instrumental activities of daily living included driving, gardening, feeding animals, caring for animals, cooking, preparing meals, home care, and shopping. As a result of training in all literatures, activities of daily living were improved, and there were significant changes in physical function and cognition. In most of the literature, the virtual reality training group centered on activities of daily living showed greater improvement than the control group. There were significant results in sub-domains such as self-help management, toilet management, mobility, and social cognition. Virtual reality is expected to overcome temporal and spatial constraints to enable training in activities of daily living, which will help in independent performance and return to the community.

클라이언트 중심 가정방문 일상생활훈련이 인지지원등급, 노인의 인지기능, 작업수행, 일상생활수행도에 미치는 영향

손보영 ( Son Boyoung ),방요순 ( Bang Yosoon ) 대한통합의학회 2020 대한통합의학회지 Vol.8 No.4

Purpose : This study aims to investigate the effect of instrument-activities daily living training through client-centered home visitation on the cognitive functions, occupational performance, and instrument-activities daily living of elderly at the cognitive support grade(Grade6). Methods : The subject of this study was a 66-year-old woman living in G Metropolitan City, who has been diagnosed with Alzheimer's and mild dementia. The study period was from March 17, 2020 through June 12, 2020, and the A-B-A' design, among the individual case experiments, was adopted as the study design. For the data analysis, descriptive statistic and visual analysis using graph were used for the change of cognitive functions, occupational performance, and instrument-activities daily living. Results : The instrument-activities daily living provided through client-centered home visitation improved the subject's cognitive functions, occupational performance(performance, satisfaction) and instrument-activities daily living. Conclusion : This study showed that daily life training through client-centered home visitation can help elderly people at the cognitive support grade select for themselves the problems of daily life caused by cognitive decline and practice specific action plans, thereby enabling them to maintain and improve the cognitive functions necessary for the performance of activities, such as comprehension, memory, and thinking skills. In addition, it is thought that the activities based on the subject's preferences, performance, and sense of importance assured the subject of feelings of motivation and the possibility of participation, and had a positive effect on the subject’s performance speed and rate. With the above in mind, Instrument-activities daily living client-centered home visitation is proposed as a potential practical intervention program for individuals. It can help elderly people at cognitive support grade to maintain and improve their functions, thereby delaying the progress of their condition to severe dementia.

노인의 후각기능, 인지기능, 우울 및 일상생활수행능력 간의 관계

윤현진,차혜경,이희주 한국웰니스학회 2022 한국웰니스학회지 Vol.17 No.3

This study is a research study to investigate the correlation between olfactory function, cognitive function, depression, and activities of daily living in the elderly in Korea. The subjects were 140 elderly people in C city. The average age was 75.69±8.92 years, and there were no significant differences in cognitive function, olfactory function, depression, and activities of daily living according to gender. However, there were significant differences in cognitive function, olfactory function, depression, and activities of daily living according to age, education, alcohol consumption or not (p<.001), Cognitive function and olfactory function(r=.769, p<.001), cognitive function and depression(r=-.374, p<.001), Cognitive function and restrictions on activities of daily living(r=-.806, p< .001), olfactory perception and restrictions on activities of daily living(r=-.506, p<.001) were significantly correlated. Therefore, the olfactory function of the elderly was found to have a positive correlation with cognitive function. On the other hand, it was analyzed that there was a negative correlation between cognitive function and depression, cognitive function and restriction on activities of daily living, olfactory perception and restriction on activities of daily living. Based on the results of this study, I would like to suggest as following. First, It is necessary to repeat the correlation study by expanding the number of study subjects. Second, the necessity of developing a program to improve the olfactory function is suggested to improve cognitive function, reduce depression, and improve activities of daily living of the elderly. In addition, it is necessary to generalize a screening program that regularly evaluates cognitive and olfactory functions in the elderly. Third, since the olfactory test method of the olfactory test tool (CC-SIT) was difficult for the elderly, it is necessary to develop a Korean-style olfactory tool that can test with the smell and method familiar to the elderly. 본 연구는 노인의 후각기능과 인지기능, 우울 및 일상생활수행능력 간의 상관성을 알아보기 위한 조사연구이다. 대상은 C 지역의 노인 140명이다. 평균연령은 75.69±8.92세였으며, 성별에 따른 인지기능, 후각기능, 우울, 일상생활수행능력은 유의한 차이가 없었다. 그러나 연령, 교육, 음주 유무에 따른 인지기능, 후각기능, 우울, 일상생활수행능력 등에서 유의한 차이가 있었으며(p<.001), 인지기능과 후각기능(r=.769, p<.001), 인지기능과 우울 (r=-.374, p<.001), 인지기능과 일상생활수행능력의 제한 (r=-.806, p<.001), 후각인지와 일상생활능력의 제한 (r=-.506, p<.001)은 유의한 상관관계가 있었다. 따라서 노인의 후각기능은 인지기능과 정의 상관성이 있는 것으로 파악되었다. 반면, 인지기능과 우울, 인지기능과 일상생활수행능력의 제한, 후각인지와 일상생활수행능력의 제한과는 음의 상관성이 있는 것으로 분석되었다. 본 연구 결과를 토대로 다음과 같이 제언하고자 한다. 첫째, 연구 대상자 수를 확대하여 상관성 연구의 반복 연구가 필요하다. 둘째, 노인의 인지기능 향상 및 우울 감소, 일상생활수행능력 향상을 위해 후각기능 향상을 위한 프로그램개발을 제언한다. 아울러 노인에게서 인지기능과 후각기능을 정기적으로 평가하는 검진 프로그램의 일반화가 필요하다. 셋째, 후각 검사 도구(CC-SIT)의 후각 검사 방법이 노인이 시행하기 어려웠으므로, 노인에게 익숙한 냄새 및 방법으로 검사할 수 있는 한국형 후각 도구 개발이 필요하다.

만성요통으로 신경차단술을 받은 농촌 노인들의 사회적 지지와 일상생활 활동장애에 관한 연구

최인영,황문숙 한국지역사회간호학회 2019 지역사회간호학회지 Vol.30 No.2

Purpose: This study is to investigate the low back pain, social support, impediment in daily living activities and to identify factors affecting impediment in elderly farmer’ daily living activities. Methods: The participants were 128 elderly farmers who had received nerve block. Data were collected using a structured questionnaire from February to March, 2018. They were analyzed using t-test, ANOVA, pearson’s correlation coefficient, and linear multiple regression. Results: The score of low back pain was 6.27±1.69 (10 points), that of social support 2.92±0.76 (1~5 points), and that of impediment in activity of daily living 2.01±0.82 (0~5 points). Factors affecting impediment in activity of daily living were found to include age (p=.017), daily hours of farm work (p<.001), fear for the nerve block (p<.001), low back pain (p<.001), and social support (p<.001); the explanatory power of these variables was 58.8%. Conclusion: This study has found the controllable factors affecting impediment in activity of daily living among the rural elderly engaging in farm work include low back pain, social support, and daily farming hours. Therefore, to reduce impediment in activity of daily living among them, it is necessary to develop nursing interventions that can improve impediment in activity of daily living through reduction of daily farming hours using local resources. It is also desirable to improve their health status by reducing low back pain, and develop and apply social supports with health education programs that fit the local resources and the needs of the rural elderly.

일상생활능력과 치매

양영순,양현덕,홍윤정,김정은,박문호,나해리,한일우,김상윤 대한치매학회 2012 Dementia and Neurocognitive Disorders Vol.11 No.2

Activities of daily living (ADL) refer to the ability to care for self and perform daily activities within an individual’s place or in outdoor environments. ADL comprise two main categories: Basic or physical ADL and Instrumental ADL. The latter allows for the earlier detection of functional decline than the former. The cognitive changes in neurodegenerative dementias contribute to the impaired ability of the patients to take care of themselves. Activities of daily living is a major criterion for diagnosing dementia. Furthermore, it has recently been emphasized that some impairment of activities of daily living, particularly of complex instrumental functions, is already present even in mild cognitive impairment prodromal stage of dementia, although mild cognitive impairment is distinguished from dementia by the absence of significant deficit in activities of daily living. The impaired activities of daily living increase the rate of institutionalization of the patients with dementia to nursing home and inevitably bring about the changes in the qualities of life not only of the patients but their caregivers. One of the best ways to evaluate the degree of impairment in activities of daily living and the care burden is through standardized functional assessment tools according to the severity of dementia. These tools provide objective data, thereby allowing the clinicians to judge decline and improvement in the functional status and to plan individualized care. In this review, we will review the clinical significance of evaluating ADL, the assessment tools according to the severity of dementia, and therapeutic approaches to enhance the functional levels. We will also review the impact of the impaired ADL on the quality of life among the patients and their care providers.

도시 재가노인의 건강관련 생활양식과 일상생활동작에 관한 연구

송경옥,김공현 인제대학교 지역사회의학연구소 1998 硏究論文集 Vol.5 No.-

The purpose of this study was to investigate how health related lifestyles influence activities of daily living and instrumental activities of daily living among elders living at home, and thus to provide basic data for the development of supportive elderly health care programs. 204 elders aged 65 years and over, living in Wanwol-dong of Masan City were randomly selected, and interviewed at their home with a structured questionnaire by the investigator from March 1 to 14 in 1997. SPSS WIN/PC program was used for the processing data and for providing the statistics including χ²-test and t-test. Major results were as follows : 1. There were no significant differences in economic variables activities of daily living and self-perceived health status by sex, but there were significant differences in health related practices by sex, activities of daily living by self-perceived health status, and instrumental activities of daily living by the self-perceived health status. (p$lt;0.05 or p$lt;0.01) 2. Each average score of ADL, IADL and TADL was significantly difference by self-perceived health status. (p$lt;0.01) 3. 14.7% of the subjects were not able to practice one of 10 ADL without help and there was significant difference in the distribution by sex. (p$lt;0.01) In conclusion, it is necessary to take these results into consideration in the process of developing health care programs for elders, and to conduct in-depth studies for such lifestyles which influence health of elders and reduce their ability of daily living.

인지기능 장애 노인들의 신체적 일상생활동작에 영향을 주는 요인

박종한,김주찬,조성완,손형석 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

목 적 : 인지기능 장애를 지닌 노인들에서 신체적 일상생활동작(activities of daily living, ADL)에 영향을 끼치는 변수들을 찾아 보았다. 연구 대상과 방법 : 대구시의 어느 양노원 노인들 90명에게 한국판 mini-mental state examnination (MMSEK). Barthel ADL, 단축형 Blessed 치매 평가 척도, 운동력 지수를 평가하였다. 그들 중에서 MMSEK 교정 점수가 24점 이하였던 노인들 45명 자료들이 분석되었다. 결 과 : Barthel ADL 변량의 42%는 운동의 지수 점수로 설명되었다. 단축형 Blessed 치매 평가 척도의 점수를 포함시키면 설명력은 48%로 증가했다. 연령, 교육, 그리고 MMSEK 교정 점수는 Barthel ADL 변량를 설명하지 못했다. 결 론 : 인지기능 장애가 있는 노인들에게는 사지의 운동력과 치매의 정도가 신체적 ADL에 큰 영향을 끼쳤으나 연령, 교육, MMSEK 교정 점수 등은 중요하지 않은 것 같다. Objectives : This study was conducted to investigate factors influencing physical activities of daily living in the elderly with cognitive impairment. Methods : The Barthel activities of daily living, modified Blessed Dementia Rating Scale, Korean version of mini-mental state examination, Motoricity Index were administered to 45 elderly people whose corrected MMSEK scores were 24 or less. They were inhabitants in an institution in Taegu : Results : Of the aforementioned 5 variables, the Motoricity Index could account for 42% of the variance of the Barthel activities of daily living. If the modified Blessed Dementia Rating Scale score was included in the multiple regression, the accountable portion of the Barthel activities of daily living variance increased by 6% only. Conclusion : Motor function of the limbs and severity of dementia may be the most important variables in the physical activities of daily living of the elderly with cognitive impairment.

노인의 시각, 청각 및 일상생활활동의 관계에 대한 인지기능의 매개효과

남상훈(Sanghun Nam),홍익표(Ickpyo Hong) 대한신경계작업치료학회 2023 재활치료과학 Vol.12 No.1

목적 : 노화에 따른 인지 및 신체기능의 저하는 노인 대상에 흔한 증상이다. 노화에 따른 대표적인 기능저하로 시각과 청각, 인지기능, 일상생활활동의 제한이 있다. 이에 따른 많은 연구들이 각 변수 간의 관계성을조사하였다. 하지만 네 개의 변수 간의 관계성을 파악한 연구는 미흡하다. 따라서 본 연구에서 시각및 청각과 일상생활활동 간의 관계에서 인지기능의 매개효과를 알아보고자 한다. 연구방법 : 본 연구의 대상자는 국민건강보험공단에서 제공하는 건강보험자료 공유서비스에서 노인 장기요양 DB의 36,767명을 대상으로 하였다. 독립변수로 시각과 청각 변수를 추출하였고 종속변수로 기본적 및 수단적 일상생활활동 변수를 추출하였다. 매개변수로는 인지기능 변수를 추출하였다. 추출한변수들을 활용하여 매개효과를 알아보기 위해 경로분석을 진행하였다. 결과 : 대상자는 여성이 27,250명(74.12%)으로 대부분이었으며, 평균 연령은 82.91세(SD = 5.92)이었다. 시각과 기본적 및 수단적 일상생활활동 간의 인지기능 매개효과를 알아본 결과, 시각과 기본적 일상생활활동 간의 관계에서 인지기능이 30%, 시각과 수단적 일상생활활동 간의 관계에서 인지기능이 42% 부분매개 역할을 하였다. 청각과 기본적 및 수단적 일상생활활동 간의 인지기능 매개효과는 기본적일상생활활동에서 50%, 수단적 일상생활활동에서 53% 부분매개 역할을 하였다. 결론 : 노화에 따른 기능저하와 관련된 예방 프로그램은 많은 국가사업으로 진행되어오고 있다. 본 연구의결과를 활용한 시각, 청각, 인지기능, 일상생활활동의 관계를 감안하여 예방 프로그램을 수립한다면성공적인 노화를 도모하는데 도움이 될 것으로 사료된다. Objective : The typical decline in function due to aging includes limitations in vision, hearing, cognitive function, and activities of daily living. Therefore, this study evaluated the mediating effect of cognitive function on the relationship between vision and hearing and activities of daily living. Methods : The participants in this study were 36,767 persons from the long-term care database on older adults provided by the National Health Insurance Sharing Service. The extracted variables were: (i) independent variables: visual and hearing; (ii) dependent variables: basic and instrumental daily living activities; and (iii) mediator variables: cognitive function. Regression analysis was performed evaluate the mediating effects of the extracted variables. Results : Cognitive function showed a mediating effect of 30% on the relationship between vision and basic daily life activities and 42% in the relationship with instrumental daily life activities. The mediating effect was 50% in the relationship between hearing and basic activities of daily living, and 53% in the relationship with instrumental activities of daily living. Conclusion : Prevention programs for functional decline due to aging are in progress in Korea. Based on the results of this study, establishing a prevention program would help promote successful aging.

뇌졸중 환자의 일상생활활동이 사회적 관계망에 미치는 영향

전영혜,이재신,김수경,전병진 대한작업치료학회 2013 대한작업치료학회지 Vol.21 No.2

목적 : 본 연구의 목적은 뇌졸중 환자의 사회적 관계망 특성을 알아보고, 뇌졸중 환자의 일상생활활동이 사회적 관계망에 미치는 영향을 알아보고자 하였다. 연구방법 : 본 연구는 2012년 9월 5일부터 2012년 11월30일까지 대전, 충청남도, 경기도에 위치하는 병원에서 재활치료를 받는 95명의 뇌졸중 환자를 대상으로 조사하였다. 사회적 관계망에 대한 설문지는 대상자가 직접 작성하였고, 일상생활활동 평가는 담당 치료사가 작성하여 자료를 수집하였다. 사회적 관계망 집단별 분석은 빈도 분석과 독립표본 t 검정을 이용하였다. 사회적 관계망과 일상생활활동과의 관계는 피어슨의 상관계수와 회귀분석 을 사용하여 분석하였다. 결과 : 뇌졸중 환자의 사회적 관계망은 이웃이나 친구와의 관계에 비해 가족과 밀접한 관계를 맺고 있었다. 뇌졸중 환자의 기본적 일상생활활동 수행이 독립적일수록 이웃 및 친구와의 관계 형성이 잘 되고, 의존적일수록 가족과의 관계가 밀접하였다. 수단적 일상생활활동 수행은 독립적일수록 가족, 이웃, 친구 세 집단 모두 사회적 관계망 형성을 잘하는 것으로 나타났다. 결론 : 뇌졸중 환자의 사회적 관계망은 가족 중심적 유형이며, 일상생활 수행능력과 사회적 관계망의 밀접한 관련성 을 알 수 있었다. 따라서 뇌졸중 환자의 일상생활활동의 독립성은 물론, 가족관계 뿐 아니라 이웃 및 친구와의 관계망 형성에 작업치료사들의 관심과 접근이 요구된다. Objective : The purpose of this study was to identify the social network type of patients suffering from a stroke to find out the effects of their activities of daily living. Methods : This study analyzed 95 survey questionnaires given to stroke patients receiving rehabilitation treatment at hospitals located in the Daejeon, Chungcheongnamdo, and Gyeonggido areas. The survey questionnaires were collected from September 5, 2012 to November 30, 2012. The activities of daily living of the patients were evaluated by an occupational therapist, and the social network questionnaires were written directly under the supervision of this same therapist. Results : As the social networks of patients post-stroke, the relationships with family members were closer than the relationships with neighbors or friends. Stroke patients who perform basic activities of daily living independently have closer relationships between their neighbors and friends, and those with dependent activities of daily living have closer relationships with their family. When performing instrumental activities of daily living for the stroke patients more independently, the social networks for all groups including family, friends, and neighbors, appeared to be good. Conclusion : This study determined the types of family-centered social networks of stroke patients. We were also able to determine the correlation between social networks and activities of daily living for stroke patients. The results of this study suggest that stroke patients with a good ability to perform activities of daily living, and who have social support through good relationships with their neighbors and friends, should return to society.

뇌졸중 환자의 사회적 지지, 자아존중감 및 재활동기가 일상생활 수행능력에 미치는 영향

이지예 ( Ji Ye Lee ),김혜숙 ( Hye Sook Kim ) 경희대학교 동서의학연구소 2014 동서간호학연구지 Vol.20 No.2

Purpose: The purposes of this study were to evaluate the degree of social support, self-esteem, and motivation for rehabilitation in stroke patients and examine correlations between activities of daily living and study variables. Furthermore, this study explored factors that influence on activities of daily living. Methods: The study population was 192 stroke patients admitted in two general hospitals and two rehabilitation hospitals in M city. We collected the data using the structured questionnaires from July 11 to September 30, 2013. Results: The higher degree of social support, self-esteem, motivation for rehabilitation, the higher performance level for activities of daily living. Influencing factors of activities of daily living in the participants were motivation for rehabilitation(β=.32, p<.001) and social support(β=.31, p<.001). The model explained 45.9% of the variance. Conclusion: This study shows that intrinsic motivation of change in stroke patients themselves, a strong will to return to society and social supports are important factors on activities of daily living. Therefore, it is needed to develop a systemic nursing intervention improving activities of daily living in stroke patients through positive social support from patients’ family members and health care providers.