motor and cognitive - perceptual disability could occur in patients who have suffered brain 
 damage from a stroke , which could undermine their capacity to perform daily activities1 . carr and shepherd suggested task - oriented 
 training as a treatment method to help improve deteriorated motor skills of stroke patients 
 and their capacity to perform daily activities , and diverse functional activities properly 
 applied to patients can help improve their actual motor skills and capacity to perform daily 
 activities2 . task - oriented training 
 refers to programs that focus on special functional tasks that unite the muscular skeletal 
 system and nervous system3 and treatments 
 that encourage active participation and focus on functional tasks rather than simple , 
 repetitive training of normal motion patterns4 . research on task - oriented training has been active lately , but 
 application of new research results in the clinical environment is impractical because most 
 patients are hospitalized for short periods and programs often have long application 
 periods , which are usually longer than three weeks5 . thus , the aim of this research was to determine the treatment 
 effect of a short period of task - oriented training ( two weeks ) on upper extremity function 
 and performance of daily activities in chronic stroke patients . the subjects of this research were two patients diagnosed with hemiparalysis from stroke 
 and hospitalized in k korean hospital . the general characteristics of the subjects are noted 
 in table 1table 1.general characteristics of the subjectsagegenderdiagnosisaffected sidedominant handmonths from stroke onsetmmse - kparticipant 138maleischemiclt.rt.2438participant 254maleischemiclt.rt.3654 . subject one was a 38-year - old male who was diagnosed with middle cerebral 
 artery infarction and left hemiparalysis and had been hospitalized for 24 months . subject 
 two was a 54-year - old male who was diagnosed with middle cerebral artery infarction and left 
 hemiparalysis and had been hospitalized for 29 months . subjects one and two were both 
 naturally right - handed before their strokes and receiving conservative physical therapy and 
 work treatment for 30 minutes a day , five times a week . the patients volunteered to 
 participate and understood the objectives and contents of this study , and both showed a 
 willingness to actively participate in the study . the patients and their guardians signed an 
 informed consent form after receiving information about the purpose and methods of the 
 study . also , the study was approved by the inje university faculty of health science human 
 ethics committee . the inclusion criteria for the research subjects were as follows : 
 diagnosis of cerebral infarction , reasonable communication skills and 24 points or more on 
 the mini - mental status examination for koreans ( mmse - k ) , no hemineglect phenomenon , and a 
 brunnstrom recovery stage of four or higher . this study used an interrupted time series 
 ( its ) design to determine whether task - oriented activity had an effect greater than that of 
 natural recovery on impairment of the hemiplegic arm and hand of the subjects after a 
 stroke . its designs are characterized by the collection of multiple observations over time 
 that are  interrupted  by an intervention or treatment6 . evaluation was performed four times , that is , once a week for three 
 weeks before the intervention and once after the intervention . easily accessible and 
 most - often - used tools in the clinical environment were chosen as evaluation tools . the 
 functional independence measure ( fim ) was used for assessment of subjects capacity to 
 perform daily activities , and the manual function test ( mft ) was used for assessment of the 
 level of upper limb function . the fim is a tool for assessing the capacity of disabled 
 patients to perform daily activities objectively ; it is widely used and has a reliability 
 level of 0.830.96 among inspectors7 . the 
 mft is a tool for assessing the functional level of upper limbs in the area of daily 
 activity performance and the recovery process . its reliability level among inspectors and by 
 repeated evaluation is indicated by a cronbach s alpha coefficient of 0.95 or higher , and 
 its inner consistency validity is 0.95 or higher8 . task - oriented training was provided to each patient for 30 minutes 
 a day , five times a week for two weeks . the task - oriented training provided to the patients 
 included six different types of training that could be performed by the patients themselves . the activities were as follows : changing hospital gowns , throwing a tennis ball into a 
 basket , stacking cones , moving pegs , wiping tables with a towel , and passing rings along 
 curved rods . data analysis included descriptive analysis of mean differences to test whether 
 the task - oriented training had a larger positive effect on impairment than natural recovery . 
 for each participant , individual pre - intervention data points were used to determine the 
 mean pre - intervention score for each measure ; the same procedure was followed to obtain mean 
 post - intervention scores . table 2table 2.mean pre- and post - intervention scores and mean differencesmeasurepre - intervention meanpost - intervention meanmean differencemftparticipant 118.020.02.0participant 222.224.01.8fimparticipant 1121.0122.01.0participant 2124.0124.00.0mft : manual function test ; fim : functional independence measure shows the upper extremity function and adl scores before and after the 
 task - oriented training . the before , after , and mean difference scores for all measures are 
 presented in table 2 . improvements were shown 
 for most items of the subjects , and only the fim in subject two showed no difference between 
 the pre - intervention and post - intervention scores . the primary purpose of this study was to evaluate whether task - oriented training has a 
 positive effect on upper extremity function and adl compared with natural recovery of people 
 in the chronic phase after a stroke . the results of this study confirmed the positive effect 
 of task - oriented training on all items except the fim results of subject two . the subjects 
 in this research participated in the task - oriented training for thirty minutes a day , five 
 times a week for two weeks , which is a relatively short application period compared with 
 most previous studies , which have applied long task - oriented training periods of three weeks 
 or more5 . however , this research method is 
 more suitable for a clinical environment with short periods of hospitalization . nevertheless , consistent with the results of previous studies of task - oriented training , the 
 present study also observed a positive effect on the affected side upper extremity . this 
 indicates the possibility that even a short period of task - oriented training can produce 
 positive treatment effects . also , task - oriented training had a positive effect on the 
 affected upper extremity even though the subjects in this research were chronic stroke 
 patients this corresponds with the results of kim s research , in which electrical 
 stimulation of the dermatomes combined with task - oriented movements was applied to chronic 
 stroke patients and resulted in improvement of hand functions9 . however , there was no improvement in subject two s capacity for 
 daily activity after the intervention in the present study . possible explanations for this 
 include the fact that subject two was older than subject one and the possibility that 
 subject two s capacity to perform daily activities was already high . the clinical 
 significance of this research is the introduction of a more easily applicable form of 
 task - oriented training for chronic stroke patients in a clinical environment compared with 
 many other previous studies that also employed task - oriented training and confirmation of 
 the possibility that it is an effective treatment . however , there are some limitations to 
 this research : generalizing the results of this research is difficult due to the small 
 number of subjects , and since the two subjects were not treated simultaneously , the possible 
 influence of external treatment variables can not be excluded .
[ purpose ] the aim of this study was to determine the effects that task - oriented training 
 has on upper extremity function and performance of daily activities by chronic stroke 
 patients . [ subjects and methods ] task - oriented training was applied to two chronic 
 hemiplegic patients in this research . 
 the training was provided to each patient for 30 
 minutes a day , five times a week for two weeks . 
 the treatment program included six 
 different types of training that could be performed by the patients themselves . 
 evaluation 
 was performed four times , that is , once a week for three weeks before the intervention and 
 once after the intervention . 
 the change in upper extremity function was measured with the 
 manual function test , and the change in performance of daily activity was measured with 
 the functional independence measure . [ results ] the upper extremity function of both 
 subjects was improved after application of task - oriented training . however , in the 
 performance of daily activities , subject one showed improvement compared to with before 
 the intervention , whereas subject two showed the same results . 
 [ conclusion ] this research 
 confirmed that two weeks of task - oriented training for chronic stroke patients is effective 
 for improvement of upper extremity function and performance of daily activities by chronic 
 stroke patients .