Horticulture, Environment, and Biotechnology : HEB

Korean Society of Horticultural Science (한국원예학회)
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Effect of Horticultural Therapy on Functional Rehabilitation in Hemiplegic Patients after Stroke

원예 치료가 뇌졸중 후 편마비 환자의 기능적 재활에 미치는 영향

Kim, Soo-Yun;Son, Ki-Cheol;Jeong, Hee-Jin;Yoo, Jung-Hun;Kim, Byung-Sik;Park, Si-Woon
김수연;손기철;정희진;유정헌;김병식;박시운

  • Published : 20030000
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Abstract

This study was conducted to evaluate the influence of horticultural therapy (HT) activities on the improvement in rehabilitation of individuals with stroke patients. For this study, 42 individuals among poststroke hemiplegic patients participated in patient stroke rehabilitation program of National Rehabilitation Center were randomly assigned to two groups; 21 for the control group without any structured activities and 21 for the treatment group with HT program. Treatment group attended an 1 h HT program 5 times per week for 6 weeks. The program carried out during HT included various activities such as seeding, growing, and utilization of postharvest products to make them to experience a whole life cycle of plants. For evaluating the effect of program, several scales including self-esteem scale, powerlessness scale, beck depression inventory (BDI), neurobehavioral cognitive status examination (NCSE), motor-free visual perception test (MVPT), and functional independence measure (FIM) were applied. Measurements were conducted at 2 times periods; before and after 6 weeks HT programs. In treatment group, the self-esteem scale and the powerlessness were significantly improved (P<0.001), and BDI score, MVPT raw score, and FIM were also significantly decreased (both at P<0.01). Among the items of NCSE, similarity score was significantly increased (P<0.05). In the control group, even though FIM and BDI showed significant improvement (P<0.05), the self-esteem scale, the powerlessness, and MVPT were not altered meaningfully. According to the these results, self-esteem, powerlessness, and perceptual function in treatment group which HT program was applied were significantly improved as compared to those of control group. Therefore, it could be concluded that HT was very effective as one of the alternative medicines and played an important role in rehabilitation of the stroke patients, especially in neuropsychological aspects.

본 연구는 원예 치료가 뇌졸중으로 인한 편마비 환자들의 재활에 미치는 영향을 알아보고자 수행하였다. 국립재활병원에 입원 중인 뇌졸중 후 편마비 환자 중 연구 참여를 동의한 환자 42명을 대상으로 대조군 21명, 치료군 21명을 임의로 선정하였다. 원예 치료 프로그램은 주 5회 6주씩 실시되었으며, 실내 작업이 가능한 파종에서 수확까지의 생활환을 경험할 수 있는 식물 재배 및 수확물을 이용한 장식 프로그램들로 시행하였다. 프로그램은 환자를 수동적인 입장에 두지 않고 능동적인 주체자로 삼으며, 식물을 통하여 마음을 안정시키고 부정적 성향을 완화시키며, 식물의 성장 과정이 성취감 및 좌절감 극복에 도움이 되도록 지도하였다. 또한, 타인과 유대관계 및 사회성 향상을 유도하였으며, 결과물을 소유하고, 주기적인 식물 관리로 시간의 변화를 인식하도록 구성하였다. 원예 치료의 효과를 살펴보고자 프로그램 전과 후 치료군과 대조군에 있어 자아 존중감 척도, 무력감, 우울(Beck depression inventory; BDI), functional independence measure(FIM), 비운동성시지각 검사(motor free visual perception test form; MVPT), neurobehavioral cognitive status examination(NCSE)를 각각 평가하였다. 그 결과 치료군은 자아 존중감이 25.001.33에서 31.331.12로 향상되었으며, 무력감이 39.952.15에서 26.521.18로, BDI가 21.272.73에서 13.332.74로 유의하게 감소되었다. NCSE의 세부 항목인 유사성은 3.760.53에서 4.820.45로 향상되었으며, MVPT는 23.931.77에서 27.531.67로 유의하게 향상되었다. FIM의 총 점수와 운동 영역, 인지 영역은 각각 72.333.26에서 89.623.18로, 48.522.15에서 64.292.36으로, 24.091.29에서 25.711.03으로 향상되었다. 대조군은 FIM의 운동 영역, 인지 영역과 BDI에서 유의한 향상이 보여졌으나 자아존중감, 무력감, MVPT, NCSE는 유의한 변화가 없었다. 본 연구결과 치료군은 대조군과 비교하여 자아 존중감, 무력감, 지각기능에서 매우 유의한 향상이 나타났다. 따라서 원예 치료는 뇌졸중 환자에게 있어 신경 심리적인 면에 특히 효과적이며, 이들의 재활 치료에 중요한 역할을 하는 것으로 판단된다.

Keywords

References

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