탄성밴드 운동이 양하지 뇌성마비 아동의 대근운동 기능과 균형능력에 미치는 효과: 사례연구 = The Effects of Thera-Band for the Gross Motor Function and Balance of Children with Cerebral Palsy

국문 초록 (Abstract)

본 연구는 탄성밴드 운동이 뇌성마비 아동의 대근운동 기능과 균형능력에 미치는 영향을 알아보고자 하였다. 연구대상은 P시에 거주하는 경직형 양하지 뇌성마비 여아 3명이었으며, 대상자간 중다기초선 설계를 사용하였다. 연구과정은 기초선기간, 중재기간, 유지선기간으로, 주 3회씩 30분간 24회기로 진행되었다. 대근운동기능은 대근운동 기능평가(Gross Motor Function Measure; GMFM)를 사용하여 측정하였으며, 균형은 아동균형척도(Pediatric Balance Scale; PBS)을 사용하여 측정하였다. 본 연구의 결과는 다음과 같다. 아동의 대근운동기능과 균형능력은 세 아동 모두에서 기초선기간과 비교하여 중재기간에 보다 향상되었다. 중재가 제거된 유지기간에도 중재결과 향상된 능력이 다소 감소하거나 유지되었다. 따라서 탄성밴드를 이용한 근력강화 운동은 뇌성마비 아동의 대근운동 기능과 균형능력의 향상에 효과적이었다. 그러나 본 연구는 연구 대상자의 수가 적고, 경증의 경직형 양하지 뇌성마비에게만 적용된 것이므로 일반화시키기에는 어려움이 있다. 그러므로 향후에는 뇌성마비 유형 및 근 긴장도 정도를 고려한 다양한 중재가 이루어져야 할 것이다.

다국어 초록 (Multilingual Abstract)

The purpose of this study is to verify the effects of muscle strengthing exercise with thera band for the balance and gait of children with CP. The subject is three girl diagnosed with spasticity diplegia CP. who live in P city. A multiple probe design across subjects design was used for this study. The procedure consisted of 8 weeks, a week per 3times of baseline phase, treatment phase, maintain phase. The gross motor function ability was measured by GMFM, balance ability was measured by PBS. According to this study, all subject`s gross motor function ability, balance ability, gait ability were improved. Therefore, this study showed that muscle strengthing exercise with thera band provided positive treatment effects on the improvement of the gross motor function and balance of the subject with CP. But this study has some limitations in that it is somewhat difficult to generalize owing to the insufficient number of the subject and the CP type in the experiment. Therefore, the future research should be done more extensively with the consideration of these aspects.

참고문헌 (Reference)

1 고명숙, "한글판 아동 균형척도(Pediatric Balance Scale)의 측정자간 신뢰도" 한국전문물리치료학회 15 (15): 86-95, 2008

2 김승국, "특수교육학" 양서원 1996

3 정해동, "지체장애아동교육" 교육과학사 2000

4 김종만, "신경해부생리학" 도서출판 정담 2000

5 정보인, "뇌성마비 영유아 바로 키우기" 교육과학사 2000

6 Verheyden G, "Trunk performance after stroke and the relationship with balance, gait and functional ability" 20 (20): 451-458, 2006

7 Duarte E, "Trunk control test as a functional predictor in stroke patients" 34 (34): 267-272, 2002

8 Levitt, S., "Treatment of cerebral palsy and motor delay" Black Scientific Publication 1982

9 Bleck E, E., "The sense of balance" 36 : 377-378, 1994

10 Bache, C. E., "The management of spastic diplegia" 17 : 88-104, 2003

11 Fowler, E. G., "The effect of quadriceps femoris muscle strengthening exercises on spasticity in children with cerebral palsy" 81 (81): 1215-1223, 2001

12 Dodd, K. J., "Systematic review of the effectiveness of strength-training programs for people with cerebral palsy" 83 : 1157-1164, 2002

13 Chan, C. W., "Some techniques for the relief of spasticity and their physiological basis" 38 : 85-89, 1986

14 Luukinen, H., "Risk factors for recurrent falls in the elderly in long-term institutional care" 109 : 57-65, 1995

15 Hughes, C. J, "Resistance preperties of thera-band tubing during shoulder abduction exercise" 29 (29): 413-430, 1999

16 Kramer J. F., "Relationships among measure of walking efficiency, gross motor ability, and isokinetic strength in adolescents with cerebral palsy" 6 : 3-8, 1994

17 Damiano, D. L., "Relation of gait analysis to gross motor function in cerebral palsy" 38 (38): 389-396, 1996

18 Chapman, C. E., "Recovery of function following unilateral lesions of the bulbar pyramid in the monkey" 53 (53): 374-387, 1982

19 Styer-Acevedo, J., "Physical Therapypy for the child with cerebral palsy. in: Pediatric physical Therapy(3rd ed)" Lippincott Williams & Wilkins 107-162, 1999

20 Franjoine M. R, "Pediatric balance scale; A modified version of the berg balance scale for the school-age child with mild to moderate motor impairment" 15 (15): 114-128, 2003

21 함용운, "PNF 패턴을 이용한 세라밴드 운동이 상지 굴곡근의 등장성 근력에 미치는 효과" 26 (26): 49-56, 2000

22 Berger W., "Normal and impaired development of children's gait" 3 : 163-170, 1984

23 Lowes, L. P., "Muscle force and range of motion as deter-minants of standing balance in children with cerebral palsy" 24 (24): 57-77, 2004

24 Shumway-Cook, A., "Motor control ; Theory and parcticalapplications" Williams & Willns 1995

25 Suzan K. Effgen, "Meeting the physical Therapy Needs of Children" F.A. Davis Company 169-170, 2005

26 O'Connell, D.G., "Improvement in wheelchair propulsion in pediatric wheelchair users through resistance training; a pilot study" 76 : 368-372, 1995

27 Damiano, D. L., "Functional outcomes of strength training in spastic cerebral palsy" 79 (79): 119-125, 1998

28 Damiano, D. L., "Effects for quadriceps femoris muscle strengthening on crouch gait in children with spastic diplegia" 75 (75): 658-667, 1995

29 MacPhail, H. E., "Effect of isokinetic strength-training functional ability and walking efficiency in adolescents with cerebral palsy" 37 (37): 763-775, 1995

30 Page, P., "Developing resistive exercise programs using Thera-band Elastic bands & tubing" 48-60, 2000

31 Horak H, B., "Clinical measurement of postural control in adults" 67 : 1881-1885, 1987

32 Rodda, J., "Classification of gait patterns in spastic hemiplegia and spastic diplegia; a basis for a management algorithm" 5 : 98-108, 2001

33 Maruishi, M., "Cerebral palsy in adults; Independent effects of muscle strength and muscle tone" 82 (82): 637-641, 2001

34 Lepage, C., "Association between characteristics of locomotion and accomplishment of life habits in children with cerebral palsy" 78 (78): 458-469, 1998

35 Ferdjallah M, "Analysis of postural control synergies during quiet standing in healthy children and children with cerebral palsy" 17 : 203-210, 2002

36 Vera-Gracia, F. J., "Abdominal muscle response during curl-ups on both stable and labile surfaces" 80 (80): 564-569, 2000

37 Bobath, K., "A neurological basis for the treatment of cerebral palsy. 2nd ed" William Heinemann Medical Books Ltd 1980