점진적 관찰감소 동작관찰훈련이 만성 뇌졸중 환자의 상지기능에 미치는 영향

국문 초록 (Abstract)

목적 : 본 연구는 인지 중재 비율을 조절한 점진적 관찰감소 동작관찰훈련과 기존의 동작관찰훈련에 대한 상지기능 변화를 비교하여 효율적인 중재 방법을 알아보고자 실시하였다. 연구방법 : 14명의 만성 뇌졸중 환자를 대상으로 7명의 실험군은 점진적 관찰감소 동작관찰훈련을, 7명의 대조군은 기존의 동작관찰훈련을 주 3회, 30분씩, 4주간 실시하였고 각 군은 기존에 실시하던 전통적 작업치료 및 물리치료 역시 시행하였다. 상지 운동기능의 사전, 사후 평가는 울프운동기능검사(Wolf Motor Function Test; WMFT), 상지기능장애 설문지(Disabilities of the Arm, Shoulder and Hand; DASH), 상자와 나무토막 검사(Box and Block Test; BBT)를 사용하였고, 각 군의 중재 전과 후의 차이는 윌콕슨 부호 순위검정(Wilcoxon signed-ranks test), 두 군 간의 중재 후 효과 비교는 맨 휘트니검정(Mann-Whitney U test)을 사용하여 분석하였다. 결과 : 점진적 관찰감소 동작관찰훈련군과 기존의 동작관찰훈련군은 모두 WMFT, DASH, BBT에서 통계적으로 유의한 변화가 있었다(p<.05). 점진적 관찰감소 동작관찰훈련군과 기존의 동작관찰훈련군의 상지기능 변화량 비교에서는 WMFT의 소요시간과 DASH의 점수에서 점진적 관찰감소 동작관찰훈련군이 더 많은 변화 가 있었으며 통계적으로 유의한 차이가 있었다(p<.05). 결론 : 본 연구 결과 중재기간에 따라 인지 중재 비율을 고려한 점진적 관찰감소 동작관찰훈련이 기존의 동작관찰훈련보다 상지기능 향상에 효과적이었다는 것을 알 수 있었다. 따라서 만성 뇌졸중 환자의 상지기능 향상을 위한 동작관찰훈련의 중재 시 인지비율을 고려한 중재 전략이 필요하다.

다국어 초록 (Multilingual Abstract)

Objective: The purpose of this study was to investigate the effective intervention methods of upper extremity function changes in gradually decreasing action observation training and existing action observation training. Methods: The study subjects were 14 chronic stroke patients. Seven experimental groups performed gradually decreasing action observation training, and seven control groups performed existing action observation training. The intervention period was conducted for 3 times a week for 4 weeks for all groups. All groups also performed conventional occupational therapy and physical therapy. Wolf Motor Function Test(WMFT), Disabilities of the Arm, Shoulder and Hand(DASH), and a Box and Block Test(BBT) were used for pre- and post- assessments of the upper extremity motor function. The difference between before and after intervention was determined using a Wilcoxon signed ranks test for each group. A comparison of the post-intervention effects between the two groups was made using the Mann-Whitney U test. Results: There were statistically significant changes in WMFT, DASH, and BBT in both the experimental and control groups (p<.05). The changes in the upper extremity function between the two groups were compared, and the time of the WMFT and DASH scores in the experimental group were larger and statistically significant (p<.05). Conclusion: As a result of the study, gradually decreasing action observation training is considered more efficient than existing action observation training to improve the upper extremity function of chronic stroke patients. Therefore, intervention strategies that take into account the cognitive rate during the intervention of the action observation training are needed, as are subsequent studies with various subjects and functional evaluations needed.

목차 (Table of Contents)

• 국문초록
• Ⅰ. 서 론
• Ⅱ. 연구 방법
• 1. 연구 대상 및 기간
• 2. 연구 도구
• 3. 중재 방법
• 4. 연구 절차
• 5. 분석 방법
• 2. 중재 전 집단 간 동질성 검증
• 3. 중재 전·후 상지기능 변화 비교
• 4. 점진적 관찰감소 동작관찰훈련군과 기존의 동작관찰훈련군의 상지기능 변화량 비교
• Ⅳ. 고 찰
• Ⅴ. 결 론
• References
• Abstract

참고문헌 (Reference)

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