감각통합기능장애를 가진 청소년의 작업수행에 초점을 맞춘 작업치료 사례

지석연 (Ji, Seok-Yeon),이경민 (Lee, Kyoung-Min),김미선 (Kim, Mi-Sun) 대한감각통합치료학회 2008 대한감각통합치료학회지 Vol.6 No.1

Introduction : Sensory Integration(SI) theory, science it is developed by an occupational therapist A. Jean Ayres, is the one of the most popular frames of reference used in occupational therapy(OT) intervention. It has been proved as a scientific theory especially in neuroscience discipline through abundant research and practice. Occupational therapists apply the SI therapy with strong clinical reasoning to improve adaptive behaviors of their clients and try to link the adaptive behaviors with occupational performance in the clients’ everyday life. One of the manners regarding clinical reasoning is Top-down approach. In occupational therapy discipline, Top-down approach is well-reflected within two evaluation tools; Canadian Occupational Performance Measure(COPM) and Assessment of Motor and Process Skills(AMPS) and two models of practice; Canadian Model of Occupational Performance(CMOP) and Occupational therapy intervention process model(OTIPM). Objective : The purpose of this paper demonstrates how SI therapy can be employed within OTIPM and how the OT process (evaluation-intervention-outcome) can be structuralized based on the Top-down approach. This single-case study recognizes the impact of a SI therapy for a male adolescent on his occupational performance. Intervention Examined : “P” was 16 years old male adolescent with no diagnosis and junior of the high school when he was referred. P was always with mouth opened, showed difficulties in gathering things need to be prepared and managing and paying money for shopping, and his colleges dislike getting close to him because he can’t was his body well. AMPS was administrated in initial evaluation and reevaluation of P’s occupation performance, Bruininks-Oserestky Test of Motor Proficiency-2(BOT-2) was carried out to assess motor functions and perception skills related in sensory integration, and occupational therapist performed clinical observation in order to complement the evaluation quantitatively and quantitatively. Based on the evaluation, it is concluded that the SI therapy is primary means to improve P’s occupational performance, and three therapeutic approaches were constructed; restorative, acquired and compensatory approach. P showed improved motor and process skills in occupational performance after undergone the occupational therapy. Conclusions : The sensory integration therapy was practical enough to build the bridge between the occupational performance(Top) and the underlying component problems (Bottom). The OTIPM was helpful to identify meaningful occupation for P and P’s family within P’s contexts, and the AMPS was valuable to analyze and clarify the cause of difficulties in the chosen occupational performance. 서 론 : 감각통합은 작업치료의 치료적 중재 근거이론(frames of reference)들에서 가장 중요하고 널리 사용되는 것 중 하나이다. 이는 작업치료사인 Jean Ayres가 클라이언트의 적응행동을 향상하기 위한 목적을 두고 발전된 이론이며, 시작된 이래로 많은 작업치료사들이 같은 목표를 가지고 적용해 왔기 때문이다. 감각통합이론을 적용하는 작업치료사로써, 임상에서 감각통합과 그 목표가 되는 적응행동인 작업수행을 치료의 결과로써 증명해 내는 것은 작업치료의 목표가 작업수행의 향상을 전제로 하는 것이기에 매우 중요하며 도전이 되는 것이다. 본 론 : 본 연구는 작업치료중재과정모델인 OTIPM(Occupational Therapy Intervention Process Model)이라고 하는 하향식(Top-down) 접근의 중재모델을 감각통합의 기능장애를 가지면서 일상의 작업수행에 어려움을 보이는 16세의 청소년에게 적용하여, 감각통합이론의 적용이 작업수행향상에 어떠한 의미를 가지는지 살펴보고자 하였다. 결 론 : 본 연구에서 적용한 OTIPM의 적용 사례를 통해, 감각통합적인 접근은 클라이언트가 일상에서 수행하기 어려웠던 작업수행에 대한 원인을 추론하는 데 유용하였다. 본 연구의 사례에서 감각통합적인 관점과 접근은 작업수행(Top)에 영향을 주는 기본적인 요소적 문제(Bottom)를 연결하는 첫 단계의 중재로써 큰 의미를 가졌고, OTIPM의 적용과정은 클라이언트에게 의미 있는 작업수행을 발견하고 이에 초점을 두어 가장 우선되는 중재를 단계적으로 전개하여, 감각통합치료 이후 실제 작업수행에 초점을 둔 접근을 전개하는 데 유용하였다.

대한 감각통합치료학회 주최 제1회 감각통합치료캠프(도전하는 아이들) 보고

지석연,김경미,Ji, Seok-Yeon,Kim, Kyeong-Mi 대한감각통합치료학회 2003 대한감각통합치료학회지 Vol.1 No.1

To make up extended and intensive sensory integration program, Korean Society of Sensory Integration Therapist(KSSIT) planned and practiced sensory integration camp. Camp were held during 5 days and 7 children with sensory integrative dysfunction were participated in the camp. COPM, Sensory profile, STEP-SI and interview were used for deciding the therapy goals. For preparing the camp, therapists did seminars, discussion and get advices form specialists in US and Japan. Through the camp, as the theme, not only children and parents got the chance of challenging but also therapists challenged by themselves. For this camp KSSIT expected to build up more effective sensory integrative program and research.

한국과 일본의 감각통합 교육 프로그램의 변화

김경미,지석연,강은아,김미선,남궁영,이지영,Kim, Kyung-Mi,Ji, Seok-Yeon,Kang, Eun-A,Kim, Mi-Sun,NamGung, Young,Lee, Ji-Young 대한감각통합치료학회 2005 대한감각통합치료학회지 Vol.3 No.1

Six members of Korean association of sensory integration(KASI) participated the treatment course named C-course of japanese association for the study of sensory integrative dysfunction(JASSID) during Jul. 27$\sim$Aug. 3, 2005. After the course, we investigated the education program of Japan and Korea and how it had been changed and developed. Through investigating JASSID with history for 23 years and KASI with history for 8 years, we find out that the common contents of sensory integration exist and the diversities of their own cultural and social contexts also exist. In korea, KASI would develop our own educational program and research based on having the close relationship with Japan and other former country developed education of sensory integration.

혼합형 감각조절장애 아동에 대한 단기집중 감각통합치료 프로그램의 효과-사례보고

김은영,지석연,Kim, Eun-Young,Ji, Seok-Yeon 대한감각통합치료학회 2006 대한감각통합치료학회지 Vol.4 No.1

Objective : This single-subject study explored the effect of short-term intensive sensory integration therapy program which was provided in a 2006 sensory integration treatment course on adaptive response of a four-year-girl with sensory modulation disorder(mixed pattern). Method : Based on results of the assessment to the child, her therapist offers an organized sensory integration program during four days. Results : Improvement of child's movement quality and variety in physical environment in therapy rooms and interaction with her therapist were observed. Conclusions : This report of the case will be helpful for occupational therapists who plan to intervent with a short-term intensive sensory integration therapy program. In addition, the need for consideration of consultation with the child's parents is discussed.

감각조절장애 아동에 대한 감각통합 치료적용-사례보고

김미혜,지석연,Kim, Mi-Hye,Ji, Seok-Yeon 대한감각통합치료학회 2006 대한감각통합치료학회지 Vol.4 No.1

Objective : To summarize and interpret observations of responses of child with sensory modulation disorder during four therapy sessions in order to contribute to future studies. Method : Analyze treatment goals and strengths and weaknesses of four therapy sessions and discuss implications of therapy. Results : Child's adaptive responses were improved throughout the therapy sessions. Conclusions : Intensive sensory integration therapy is needed continuously. Future study with this participant is needed to explore more effectiveness of sensory integration therapy.

작동 고도에 따른 관통형 핀틀 노즐의 추력 특성 연구

정기연(Kiyeon Jeong),홍지석(Ji-Seok Hong),허준영(Junyoung Heo),성홍계(Hong-Gye Sung),양준서(Juneseo Yang),하동성(Dongsung Ha) 한국추진공학회 2016 한국추진공학회지 Vol.20 No.4

Numerical simulations have been performed to investigate thrust characteristics of a through-type pintle nozzle with or without flow separation at various operating altitudes. The low Reynolds number k-ε with compressibility correction proposed by Sarkar are applied. The detail flow structures are observed and static pressures along nozzle wall are compared with experimental results. The flow separation in the pintle nozzle disappears and jet plume strongly expands as its operating altitude increases. To evaluate the thrust characteristics, the momentum term and pressure term of thrust are analyzed. Thrust and thrust coefficient at altitude 20 km are about 10% more than them at the ground 0km.

일본감각력개정판(JSI-2)에 의한 발달장애아동과 정상아동의 감각처리능력 비교에 관한 예비연구

지석연 대한감각통합치료학회 2003 대한감각통합치료학회지 Vol.1 No.1

Objective : To describe the sensory-based behaviors of children with developmental disorders as reported on the JSI-2. Methods : The scores of children with disability were compared with those of children without disability. JSI-2 was completed by parents of 38 children with disability 3 through 6 years of age and 36 children without disability 3 through 6 years of age. Results : The scores of children with disability were significantly different from that of children without disability for 6 of 8 factors, including vestibular, tactile, auditory, visual and other. There is no significant differences of age or sex. Conclusion : From this study, it is found that children with disability have deficit in a variety of sensory processing abilities as measured by JSI-2. Further research is needed to replicate and develop these findings.

다양한 악성 종양에서의 말초혈액조혈 모세포이식을 통한 고용량 항암치료

김현수,구성현,최소연,조요한,지석배,박준성,박희붕,황성철,유희석,전미선,조용관,김효철 대한조혈모세포이식학회 1996 대한조혈모세포이식학회지 Vol.1 No.1

High dose chemotherapy with autologous stem cell transplantation is a new therapeutic strategy for various malignancy, especially leukemia, lymphoma, breast cancer. Recently, increasing number of trials has been done in solid tumors responsive to conventional chemotherapy using high dose chemotherapy and autologous peripheral blood stem cell transplantation. At Ajou University Hospital, between August 1995 and September 1996, 60 patients received high dose chemotherapy with peripheral blood stem cell transplantation, which in cluded 20 stomach cancers, 16 breast cancers, 15 lymphomas, 4 lung cancers, 3 ovarian cancers, 1 cervix cancer and 1 cancer of unknown primary cancer. Median age of patients was 44 years(range, 19 to 66), and male to female ratio was 0.7:1. The median time to recovery to neutrophil count more than 0.5x109/L was 11 days, and platelet count more than 20x109/L and 50x109/L was 13 and 17 days. With high dose chemotherapy in 41 patients who had relapsed or refractory disease, the complete remission was achieved in 34%(14/41) of patients and overall response rate was 83%(34/41). There was high response rate in spite of various tumor and various status of disease. In with stomach cancer and breast cancer who were given HDCT with adjuvant treatment aim, high dose chemotherapy was well tolerated with minimal non-hematogic toxicity and morbidity. During high dose chemotherapy, there was three transplantation related death, 2 sepsis and 1 veno-occlusive disease. Our experience suggest is well tolerated procedure which confers that high dose chemotherapy with peripheral blood transplantation will be a promising treatment modality for the relapsed and refractory tumors, as well as for patients with high risk for relapse following curative surgical resection.