DOI QR코드

DOI QR Code

과제 지향적 상상훈련이 만성 뇌졸중 환자의 상지 기능과 일상생활활동에 대한 다중회귀분석

The Effect of Task oriented Imagination Training on the Function of Upper limb and Daily Activities of Chronic Stroke Patients

  • 손영효 (첨단우암병원) ;
  • 김승일 (동신대학교 작업치료학과) ;
  • 정화식 (동신대학교 작업치료학과) ;
  • 박수희 (호남대학교 작업치료학과) ;
  • 정현애 (동신대학교 작업치료학과)
  • 투고 : 2015.09.09
  • 심사 : 2015.10.23
  • 발행 : 2015.10.31

초록

본 연구는 과제 지향적 상상훈련이 만성 뇌졸중 환자의 상지 기능과 일상생활활동에 미치는 효과를 알아보고자 실시하였다. 연구 대상은 3개월 이상 경과된 만성 뇌졸중환자 30명으로 실험군과 대조군에 각각 15명씩 분배하였다. 실험군은 과제 지향적 훈련과 상상훈련을 병행하여 실시하였으며, 대조군은 과제 지향적 훈련만을 실시하였고, 모든 중재는 8주간 주5회 회30분씩 시행되었다. 중재에 따른 변화를 알아보기 위해 상지 기능은 MFT, OPTIMAL을, 일상생활활동은 MBI를 사용하여 측정하였다. 본 연구의 결과는 실험군과 대조군 모두 상지 기능과 일상생활활동의 향상을 보였으며(p<.001), 실험군이 더 향상된 것으로 나타났다.

This study is aimed at identifying the effect the task-oriented imagination training of chronic stroke patients have on the function of upper limb and their daily activities(: ADL). The research subjects were composed of 30 chronic stroke patients with over three months of ailment history, with each group composed of 15 patients assigned to the experiment group and the control group, respectively. The experiment group was subjected to the task-oriented training and the imagination training at the same time, while the control group was subjected to the task-oriented training only. All Interventions were performed for 5 times per week over the period of 8 weeks and 30 minutes per session. In order to monitor the changes as a result of the Intervention program, the MFT and OPTIMAL were employed for the upper limb function while the MBI was employed for the ADL to measure the values before and after the Intervention, respectively, with the results shown below. As a result, MFT, OPTIMAL and MBI showed significant difference between before and after in group. And Mental practice group showed more improvement.

키워드

참고문헌

  1. S. A. Sharp and B. J. Brouwer, "Isokinetic strength training of the hemiparetic knee: Effects on function and spasticity," Archives of Physical Medicine and Rehabilitation, vol. 78, no. 11, 1997, pp. 1231-1236. https://doi.org/10.1016/S0003-9993(97)90337-3
  2. L. Mercier, T. Audet, R. Hebert, A. Rochette, and M. F. Dubois, "Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke," Stroke, vol. 32, no. 11, 2001, pp. 2602-2608. https://doi.org/10.1161/hs1101.098154
  3. E. Seo, H. Beak, and J. Kim, "The effect of Direct Swallowing Treatment on the Swallowing Function and Quality of Life of the Stroke Patient," J. of the Korea Institute of Electronic Communication Science, vol. 8, no. 9, 2013, pp. 1413-1420. https://doi.org/10.13067/JKIECS.2013.8.9.1413
  4. S. D. Ryerson, Hemiplegia in D. A. Umphred(Ed) Neurological rehabilitation. 4th edition. St. Louis, MO: Mosby, 2001.
  5. D. Corbetta, V. Sirtori, L. Moja, and R. Gatti, "Constraint-Induced Movement Therapy in stroke patients: Systematic review and meta-analysis," European J. of Physical and Rehabilitation Medicine, vol. 46, no. 4, 2010, pp. 537-544.
  6. C. A. Trombly and M. V. Radomski, Occupational therapy for physical dysfunction. Philadelphia: Lippincott Williams & Wilkins, 2002.
  7. 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 Science, vol. 9, no. 1, 2014, pp. 123-130. https://doi.org/10.13067/JKIECS.2014.9.1.123
  8. J. Kim and M. Oh, "IT based EMG biofeedback training on the effects of upper extremity function in chronic stroke patients," J. of the Korea Institute of Electronic Communication Science, vol. 9, no. 1, 2013, pp. 41-50. https://doi.org/10.13067/JKIECS.2014.9.1.41
  9. G. Yavuzer, R. Selles, N. Sezer, S. Suutbeyaz, J. B. Bussmann, F. Kooseoglu, M. B. Atay, and H. J. Stam, "Mirror therapy improves hand function in subacute stroke: A randomized controlled trial," Archives of Physical Medicine and Rehabilitation, vol. 89, no. 3, 2008, pp. 393-398. https://doi.org/10.1016/j.apmr.2007.08.162
  10. J. H. Carr and R. B. Shepherd, In movement science foundations for physical therapy in rehabilitation. Austin: Pro-Ed, 2000.
  11. J. Jung, Y. Jo, and S. Chae, "The Effect of Task-Oriented Movement Therapy on Upper Extremity, Upper Extremity Function and Activities of Daily Living for Stroke Patients," J. of Rehabilitation Resarch, vol. 15, no. 3, 2011, pp. 231-253.
  12. C. Y. Wu, C. A. Trombly, and K. Lin, "A kinematic study of contextual effects on reaching per for mance in persons with and without stroke: Influence of object availability," Achives of Physical Medicine and Rehabilitation, vol. 81, no. 1, 2000, pp. 95-101. https://doi.org/10.1016/S0003-9993(00)90228-4
  13. J. H. Carr and R. B. Shepherd, Stroke Rehabilitation. Newton, MA: Butterworth-Helenemann, 2003.
  14. T. Weiss, E. Hansen, and L. Beyer, "Activation process during mental practice in stroke patients," Int. J. of Psychophysiology, vol. 17, no. 1, 1994, pp. 91-100. https://doi.org/10.1016/0167-8760(94)90059-0
  15. S. M. Kosslyn, C. Ganis, and W. C. Thompson, "Neural foundation of imagery," Natural Reviews Neuroscience, vol. 2, no. 9, 2001, pp. 635-642. https://doi.org/10.1038/35090055
  16. F. Filimon, J. D. Nelson, D. J. Hagler, and M. I. Sereno, "Human cortical representations for reaching: mirror neurons for execution, observation, and imagery," Neuroimage, vol. 37, no. 4, 2007, pp. 1315-1328. https://doi.org/10.1016/j.neuroimage.2007.06.008
  17. C. A. Trombly and C. Y. Wu, "Effect of rehabilitation tasks on organization of movement after stroke," The American J. of Occupational Therapy, vol. 53, no. 4, 1999, pp. 333-344. https://doi.org/10.5014/ajot.53.4.333
  18. S. J. Page, P. Levine, S. A. Sisto, and M. V. Johnston, "Mental practice combined with physical practice for upper-limb motor deficit in subacute stroke," Physical Therapy, vol. 81, no. 8, 2001, pp. 1455-1462. https://doi.org/10.1093/ptj/81.8.1455
  19. T. E. Hewett, K. R. Ford, P. Levine, and S. J. Page, "Reaching Kinematics to measure motor change after mental practice in stroke," Topics in stroke Rehabilitation, vol. 14, no. 4, 2007, pp. 23-29. https://doi.org/10.1310/tsr1404-23
  20. D. Bang, Y. So, and H. Cho, "Imagery training effects of Upper limb function and Activities of daily living in Subracute Stroke Patients," The J. of Digital Policy & Management, vol. 11, no. 8, 2013, pp. 235-242.
  21. J. Hwang, "The Effect of Mental Practice on Function of Upper Extremity in stroke patients," Society of Occupational Therapy for the Agged and Dementia, vol. 7, no. 1, 2013, pp. 46-56.
  22. Y. Kwon and J. Park, "Korean Version of Mini-Mental State Examination(MMSE-K) Part I: Development of the Test for the Elderly," J. Korean Neuropsychiaty Assoc, vol. 28, no. 1, 1989, pp. 125-135.
  23. A. Issac and D. F. Marks, "Individual differences in mental imagery experience: Developmental changes and specialization," British J. of Psychology, vol. 85, no. 4, 1994, pp. 479-500. https://doi.org/10.1111/j.2044-8295.1994.tb02536.x
  24. M. J. Bouska and E. Kwatny, Manual for the application of the Motor-free visual perception test to the adult population. Philadelphia: Temple University Rehabilitation Reserch and Training Center, 1983.
  25. M. Kim, "A Study of Manual Functional Test for C.V.A," J. of Korean Society of Occupational Therapy, vol. 2, no. 1, 1994, pp. 19-26.
  26. A. A. Guccione, T. J. Mielenz, R. F. DeVellis, M. S. Goldstein, J. K. Freburger, R. Pietrobon, S. C. Miller, L. F. Callahan, K. Harwood, and T. S. Carey, "Development and testing of a self-report instrument to measure actions: outpatient physical therapy improvement in movement assessment log(OPTIMAL)," Physical therapy, vol. 85, no. 6, 2005, pp. 515-530.
  27. F. I. Mahoney and D. Barthel, "Functional evaluation: The Barthel Index," Maryland State Medical J., vol. 14, 1965, pp. 56-61.
  28. J. H. Carr and R. B. Shepherd, Neurological Rehabilitation 2nd. New York: Churchill Livingstone, 2010.
  29. J. Kim, Y. Kook, K. Kim, J. Kim, H. Park, M. Song, Y. Wu, M. Lee, and M. Jung, Neurological Rehabilitaion. 2nd Edtion. Seoul: Panmun Education. 2012
  30. D. E. Krebs, D. M. Scarborough, and C. A. McGibbon, "Functional vs. strength training in disabled elderly outpatients," American J. of Physical Medicine and Rehabilitation, vol. 86, no. 2, 2007, pp. 93-103. https://doi.org/10.1097/PHM.0b013e31802ede64
  31. W. Shin, S. Lee, S. Lee, D. Lee, and C. Song, "The Effects of Task-Oriented Functional Training on a Muscle Strength, Balance and Gait Ability of Chronic Stroke Patients," J. of Adapped Physical Activity, vol. 16, no. 3, 2008, pp. 149-165. https://doi.org/10.1123/japa.16.s1.s149
  32. S. M. Braun, A. J. Beurkens, P. J. Borm, T. Schack, and D. T. Wade, "The effects of mental practice in stroke rehabilitation: A systematic review," Archives of physical medicine and rehabilitation, vol. 87, no. 6, 2006, pp. 842-852. https://doi.org/10.1016/j.apmr.2006.02.034
  33. A. Dunsky, R. Dickstein, E. Marcovitz, S. Levy, and J. Deutsch, "Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis," Archives of Physical Medicine and Rehabilitation, vol. 89, no. 8, 2008, pp. 1580-1588. https://doi.org/10.1016/j.apmr.2007.12.039
  34. R. Van Leeuwen and T. J. Inglis, "Mental practice and imagery: a potential role in stroke rehabilitation," Physical therapy reviews, vol. 3, no. 1, 1998, pp. 47-52. https://doi.org/10.1179/ptr.1998.3.1.47
  35. C. Jung, Y. Lee, H. Lee, and Y. Jung, Sports Psychology. Seoul: Medical Korea, 2009.
  36. A. Dunsky, R. Dickstein, C. Ariav, J. Deutsch, and E. Marcovitz, "Motor imagery practice in gait rehabilitation of chronic post-stroke hemiparesis: four case studies," Int. J. of Rehabilitation Research, vol. 29, no. 4, 2006, pp. 351-356. https://doi.org/10.1097/MRR.0b013e328010f559
  37. M. Lamirand and D. Rainey, "Mental imagery, relaxation, and accuracy of basketball foul sooting," Perceptual and Motor Skills, vol. 78, no, 3, 1994, pp. 1229-1259. https://doi.org/10.2466/pms.1994.78.3c.1229
  38. N. Maclean, P. Pound, C. Wolfe, and A. Rudd, "The concept of patient motivation. A qualitative analysis of stroke professional' attitudes," Stroke, vol. 33, no. 1, 2002, pp. 444-452. https://doi.org/10.1161/hs0202.102367
  39. H. C. Dijkerman, M. Ietswaart, M. Johnston, and R. S. MacWalter, "Does motor images training improve hand function in chronic troke patients? A Pliot study," Clinical Rehabilitation, vol. 18, no. 5, 2004, pp. 538-549. https://doi.org/10.1191/0269215504cr769oa
  40. B. Kim, "The Effects of Affer-Effects of Task-Oriented Activities of Daily Living and Quality of Life of Stroke Patients," Master's Thesis, Daegu University, 2012.
  41. Y. Choi, "The Effects of Mental Practice for Performing of Functional Activities to Unilateral Neglect and ADL in Person With Stroke," Korea Academia-Industial Cooperation Society, vol. 10, no. 12, 2009, pp. 3879-3887. https://doi.org/10.5762/KAIS.2009.10.12.3879