DOI QR코드

DOI QR Code

Effects of Audiovisual Biofeedback(RAPAEL Smart Pegboard) on Cognitive Function of Stroke Patients

시청각 바이오피드백 훈련(RAPAEL Smart Pegboard)이 뇌졸중 환자의 인지기능에 미치는 영향

  • Received : 2020.04.04
  • Accepted : 2020.05.21
  • Published : 2020.08.31

Abstract

Objective : The purpose of this study is to investigate the effects of audiovisual biofeedback training using RAPAEL Smart Pegboard on the cognitive function of stroke patients. Methods : A total of 20 participants were divided into an intervention group and a control group, with 10 patients per group K-MoCA and NCSE were used for pre and post intervention evaluation. The intervention method of the intervention group provided traditional occupational therapy and audiovisual biofeedback training, and the control group provided traditional occupational therapy and participated in self-activity programs. Results : K-MoCA revealed a significant difference in visuo-spatial and executive functions, attention, memory, and overall score in the internvention group compared to the control group (p<.05). In addition, the results of NCSE showed that there was a significant difference in attention, memory, and overall score in the intervention group compared to the control group (p<.05). Conclusion : We confirmed that the audiovisual biofeedback training had a positive effect on the cognitive function of stroke patients. Therefore, it could be useful tool for the rehabilitation of stroke patients in future occupational therapy clinical environments.

목적 : 본 연구는 라파엘 스마트 페그보드를 사용한 시청각 바이오피드백 훈련이 뇌졸중 환자의 인지기능에 미치는 영향에 대해 알아보고자 한다. 연구방법 : 본 연구는 시청각 바이오피드백 훈련을 적용한 중재집단 10명, 자가 활동 프로그램을 적용한 대조집단 10명으로 구분하여 총 20명의 뇌졸중 환자를 대상으로 진행하였다. 중재 전·후의 인지기능 평가는 K-MoCA와 NCSE를 사용하였고, 중재집단의 중재 방법은 전통적 작업치료와 시청각 바이오피드백 훈련을 10주간, 주 3회, 30분씩, 총 30회기 제공하였으며, 대조집단에는 전통적 작업치료와 자가 활동 프로그램을 중재집단과 같은 기간 동안 제공하였다. 결과 : 첫째, 중재 전·후에 따른 집단 간 K-MoCA의 결과는 중재집단이 대조집단보다 시공간 및 집행기능, 주의력, 기억력, K-MoCA 전체 점수 항목에서 유의한 차이가 있는 것으로 나타났다(p<.05). 둘째, 중재 전·후에 따른 집단 간 NCSE의 결과는 중재집단이 대조집단보다 주의력, 기억력, NCSE 전체 점수 항목에서 유의한 차이가 있는 것으로 나타났다(p<.05). 결론 : 본 연구에서는 시청각 바이오피드백 훈련을 통해 뇌졸중 환자의 전반적인 인지기능에 긍정적인 효과가 있음을 확인하였고, 특히 시공간과 관련된 영역과 주의력 및 기억력 향상에 더욱 효과가 있음을 확인하여 해당 도구가 작업치료 임상 환경에서 뇌졸중 환자의 재활을 위한 도구로 유용하게 사용될 수 있을 것으로 생각한다. 따라서 추후 연구에서는 라파엘 스마트 페그보드를 사용한 시청각 바이오피드백 훈련의 다양한 임상적 연구가 진행되어야 할 것으로 생각한다.

Keywords

References

  1. Bae, Y. S. (2001). The effects of visual and auditory feedback on pain reduce (Master's thesis). Yongin University, Yongin.
  2. Bang, Y. S. (2007). The effects of task-oriented activities on the cognitive function and performance of activities of daily living in stroke patients. Journal of Korean Society Occupational Therapy, 15(3), 49-61.
  3. Bartels, M. N., Duffy, C. A., & Beland, H. E. (2016). Pathophysiology, Medical Management, and Acute Rehabilitation of Stroke Survivors. In Gillen, G. (Ed.), Stroke rehabilitation: A function-based approach (4th ed., pp. 2-45). St. Louis, Missouri: Elsevier.
  4. Bazanova, O. M., Mernaya, E. M., & Shtark, M. B. (2009). Biofeedback in psychomotor training. Electrophysiological basis. Neuroscience and Behavioral Physiology, 39(5), 437-447. doi:10.1007/s11055-009-9157-z
  5. Bonan, I. V., Yelnik, A. P., Colle, F. M., Michaud, C., Normand, E., Panigot, B., ... Vicaut, E.(2004). Reliance on visual information after stroke. Part II: Effectiveness of balance rehabilitation program with visual cue deprivation after stroke: A randomized controlled trial. Archives Physical Medicine and Rehabilitation, 85(2), 274-278. doi:10.1016/j.apmr.2003.06.016
  6. Broadbent, D. E. (1958). The effects of noise on behaviour. In Broadnent, D. E. (Ed.), Perception and communication (1st ed., pp. 81-107). Oxford, UK: Pergamon. Retrieved from http://www.communicationcache.com/uploads/1/0/8/8/10887248/d_e._broadbent_-_perception_and_communication_1958.pdf
  7. Carson, R. G., & Swinnen, S. P. (2002). Coordination and movement pathology: Model of structure and function. Acta Psychologica, 110(2-3), 357-364. doi:10.1016/s0001-6918(02)00042-2
  8. Chae, G. S. (2015). The effects of a computer-based cognitive rehabilitation program(CoTras) on the attention and memory of patients with stroke (Master's thesis). Inje University, Gimhae.
  9. Cho, Y. J., & Kwon, J. S. (2019). The feasibility of audio visual biofeedback training on unilateral neglect of stroke: The pilot study. The Journal of Korean Society of Cognitive Rehabilitation, 8(1), 37-58.
  10. Choi, W. J. (2011). The effect of the cognitive motor dual task using the auditory feedback on chronic stroke patients gait, balance and the inattention (Master's thesis). Sahmyook University, Seoul.
  11. Cicerone, K. D., Dahlberg, C., Kalmar, K., Langenbahn, D. M., Malec, J. F., Bergquist, T. F., ... Morse, P. A. (2000). Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives Physical Medicine and Rehabilitation, 81(12), 1596-1615. doi:10.1053/apmr.2000.19240
  12. Dault, M. C., de Haart, M., Geurts, A. C., Arts, I. M., & Nienhuis, B. (2003). Effects of visual center of pressure feedback on postural control in young and elderly healthy adults and in stroke patients. Human Movement Science, 22(3), 221-236. doi:10.1016/s0167-9457(03)00034-4
  13. Dursun, N., Dursun, E., & Kilic, Z. (2001). Electromyographic biofeedback-controlled exercise versus conservative care for patellofemoral pain syndrome. Archives Physical Medicine and Rehabilitation, 82(12), 1692-1695. doi:10.1053/apmr.2001.26253
  14. Jeong, W. M., Choi, H. S., & Park, K. J. (1999). Neurobehavioral cognitive status examination(NCSE) in brain-injured patients. Journal of Korean Society Occupational Therapy, 7(1), 1-16.
  15. Jung, J. H., Cho, Y. N., & Chae, S. Y. (2011). The effect of task-oriented movement therapy on upper extremity, upper extremity function and activities of daily living for stroke patients. Journal of Rehabilitation Research, 15(3), 231-253.
  16. Khallaf, M. E., Gabr, A. M., & Fayed, E. E. (2014). Effect of task specific exercises, gait training, and visual biofeedback on equinovarus gait among individuals with stroke: Randomized controlled study. Neurology Research International, 2014, 1-9. doi:10.1155/2014/693048
  17. Kiernan, R. J., Mueller, J., Langston, J. W., & Van Dyke, C. (1987). The neurobehavioral cognitive status examination: A brief but quantitative approach to cognitive assessment. Annals of Internal Medicine, 107(4), 481-485. doi:10.7326/0003-4819-107-4-481
  18. Kim, H. T., & Lee, J. H. (2007). Application of biofeedback in psychological settings. Korean Journal of Psychology, 2007(1), 94-95.
  19. Kim, J. H., & Oh, M. H. (2014). IT based EMG biofeedback training on the effects of upper extremity function in chronic stroke patients. The Journal of the Korea Institute of Electronic Communication Sciences, 9(1), 41-50. doi:10.13067/JKIECS.2014.9.1.41
  20. Kim, J. Y., & Kim, D. K. (2017). The effect of visual biofeedback exercise on the recovery of balance in stroke patients. Korea Proprioceptive Neuromuscular Facilitation Association, 15(2), 201-208. doi:10.21598/JKPNFA.2017.15.2.201
  21. Kim, K. U., & Oh, H. W. (2019). The effects of digital sensory perceptual training on hand function and visual-motor integration in children with developmental disabilities. Journal of The Korean Society of Integrative Medicine, 7(4), 141-150. doi:10.15268/ksim.2019.7.4.141
  22. Kim, Y. J., Lee, S. J., & Lee, Y. M. (2010). The change of electroencephalogram according to bio-feedback training in dementia. Journal of the Korean Society of Physical Medicine, 5(3), 313-322.
  23. Kober, S. E., Schweiger, D., Witte, M., Reichert, J. L., Grieshofer, P., Neuper, C., & Wood, G. (2015). Specific effects of EEG based neurofeedback training on memory functions in post-stroke victims. Journal of Neuroengineering and Rehabilitation, 12(107), 1-13. doi:10.1186/s12984-015-0105-6
  24. Lee, J. Y., Lee, D. W., Cho, S. J., Na, D. L., Jeon, H. J., Kim, S. K., ... Cho, M. J. (2008). Brief screening for mild cognitive impairment in elderly outpatient clinic: Validation of the Korean version of the montreal cognitive assessment. Journal of Geriatric Psychiatry and Neurology, 21(2), 104-110. doi:10.1177/0891988708316855
  25. Luft, A. R., McCombe-Waller, S., Whitall, J., Forrester, L. W., Macko, R., Sorkin, J. D., ... Hanley, D. F. (2004). Repetitive bilateral arm training and motor cortex activation in chronic stroke: A randomized controlled trial. Journal of American Medical Association, 292(15), 1853-1861. doi:10.1001/jama.292.15.1853
  26. Mazza, V., Turatto, M., Rossi, M., & Umilta, C. (2007). How automaticare audiovisual links in exogenous spatial attention? Neuropsychologia, 45(3), 514-522. doi:10.1016/j.neuropsychologia.2006.02.010
  27. McDonald, J. J., Teder-Salejarvi, W. A., & Hillyard, S. A. (2000). Involuntary orienting to sound improves visual perception. Nature, 407(6806), 906-908. doi:10.1038/35038085
  28. Mousavi, S. Y., Low, R., & Sweller, J. (1995). Reducing cognitive load by mixing auditory and visual presentation modes. Journal of Educational Psychology, 87(2), 319-334. doi:10.1037/0022-0663.87.2.319
  29. Neofect. (2017). Raphael smart pegboard. Retrieved from https://www.neofect.com/kr/smart-pegboard
  30. Park, J., Kim, B. R., & Kim, T. H. (2018). Effects of visual feedback and rhythmic auditory stimulation on walking of stroke patients induced by treadmill walking training. Korean Research Society of Physical Therapy, 25(2), 53-61. doi:10.12674/ptk.2018.25.2.053
  31. Park, J. M. (2019a). Effects of bio-feedback training on upper extremity function for stroke patients (Unpublished Master's thesis). Dongseo University, Busan.
  32. Park, S. J. (2019b). Intervention research analysis on the application of computer-based cognitive rehabilitation program (Master's thesis). Daegu University, Daegu.
  33. Phipps, S. C. (2006). Assessment and intervention for perceptual dysfunction. In Pendleton, H. M., & Schultz-Krohn, W. (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (6th ed., pp. 573-588). St. Louis: Mosby Elsevier.
  34. Ponsfold, J. L., Olver, J. H., & Curran, C. (1995). A profile of outcome: 2 years after traumatic brain injury. Brain Injury, 9(1), 1-10. doi:10.3109/02699059509004565
  35. Rizzo, A. A., Bowerly, T., Buckwalter, J. G., Klimchuk, D., Mitura, R., & Parsons, T. D. (2006). A virtual reality scenario for all seasons: The virtual classroom. CNS Spectrums, 11(1), 35-44. doi:10.1017/s1092852900024196
  36. Sackley, C. M., Baguley, B. I., Gent, S., & Hodgson, P. (1992). The use of a balance performance monitor in the treatment of weight-bearing and weighttransference problems after stroke. Physiotherapy, 78(12), 907-913. doi:10.1016/S0031-9406(10)60498-1
  37. Shin, Y. A. (2019). Effects of biofeedback training on the pharyngeal function of stroke patients with swallowing disorder (Master's thesis). Daegu University, Daegu.
  38. Thaut, M. H., Leins, A. K., Rice, R. R., Argstatter, H., Kenyon, G. P., McIntosh, G. C., ... Fetter, M. (2007). Rhythmic auditory stimulation improves gait more than NDT/Bobath training in near-ambulatory patients early poststroke: A single-blind, randomized trial. Neurorehabilitation and Neural Repair, 21(5), 455-459. doi:10.1177/1545968307300523
  39. Yoo, C. M. (2018). The effect of it based e-link biofeedback training on visual perception of patients with acute stroke (Master's thesis). Inje University, Gimhae.
  40. Zijlstra, A., Mancini, M., Chiari, L., & Zijlstra, W. (2010). Biofeedback for training balance and mobility tasks in older populations: A systematic review. Journal of Neuroengineering and Rehabilitation, 7, 1-15. doi:10.1186/1743-0003-7-58