순수감각 뇌졸중 환자에서 상지인식양상 개선이 상지운동 및 감각 기능에 미치는 영향 = The Effect of Improved Upper Extremity Recognition Patterns on Upper Extremity Movement and Sensory Function of Pure Sensory Stroke Patients

다국어 초록 (Multilingual Abstract)

Objective : This qualitative case study is designed to find out the possible effect of improving upper extremity cognition on pure sensory stroke patients caused by thalamus and brain stem hemorrhage. Methods : The subject of the research was 66 year-old male patient with left hemiparesis caused by thalamus and brain stem hemorrhage. A 45 minutes of CTE (CognitiveTherapeutic Exercise) had applied to him for 8 weeks, from August 26th to October 28th in 2010. In accordance with CTE, various training programs had been performed : exercise of affected upper extremity, training on articular angle of shoulder and elbow joint for improving the motor and sensory function of affected upper extremity, training for recognizing distance and direction of fingersand wrist joint using small panel with various shapes drawn and pegboards with different height, tactile function training using antenna panel. Results : According to a review of pinch strength of finger, MFT, FMA, BBT, and sensory injury, motor and sensory function was reported to had improved 4 weeks and 8weeks after the initial evaluation. And in the profile of CTE, clinicopathologic characteristics, cognition, attention, image, linguistic and learning sense had seen improvement. Conclusion : The improvement of a human body obtained by CTE is proved to have positive impact on treatment of pure sensory stroke patient.

국문 초록 (Abstract)

목적: 시상및중간뇌출혈로인한순수감각뇌졸중환자에서 상지인식양상 개선이 상지운동 및 감각 기능에 미치는 영향에 대한 기초 자료를 제시하고자 한다. 방법: 본 연구의 대상자는 시상 및 중간뇌 출혈 로인한 좌측 편마비를 가진 66세 남자 환자로 2010년 8월 26일부터10월28일 까지 8주 동안 하루 1회 45분씩 인지운동치료를 적용하였다. 인지운동치료는 손상 측 상지에 대한 운동 및 감각 기능 개선을 위하여 어깨관절과 팔꿈치관절의 관절각에 대한 훈련, 높이가 다른 패그보드와 다양한 형태가 그려진 소형판넬을 사용한 손가락과 손목관절의 거리 및 방향의 인식을 위한 훈련, 촉각판을 사용한 촉각 인식 훈련을 각각 수행하였다. 결과: 초기평가4주후와8주후에 손의 집기 악력, MFT, FMA, BBT, 감각손상 정도의 재평가 실시 결과 상지의 운동 및 감각기능이 향상되었다. 또한 인지운동치료 프로파일에서 병리적 특성,인식양상,주의집 중양상,이미지양상,언어양상, 학습양상에서도 개선을 나타냈다. 결론: 인지운동치료를 적용한 인식양상개선이순수감각 뇌졸중 환자의 상지운동 및 감각 기능의 개선에 효과가 있었다.

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