Korean Journal of Occupational Therapy (대한작업치료학회지)

Korean Society of Occupational Therapy (대한작업치료학회)
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The Effect of Constraint-induced Movement Therapy on the Affected Upper Extremity Function and Activities of Daily Living for Stroke Patients

강제유도운동치료가 뇌졸중 환자의 상지 기능 및 일상생활활동에 미치는 영향

Choi, Yoo-Im;Jung, Min-Ye;Chung, Bo-In;Yoo, Eun-Young
최유임;정민예;정보인;유은영

  • Published : 2009.03.30

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Abstract

Objective : The purpose of this study was to investigate the effect of constraint-induced movement therapy (CIT) on the affected upper extremity function and activities of daily living (ADL) for three stroke patients who were admitted into a university affiliated general hospital. Methods : This study was a single-subject experimental research with ABA design, ʻAʼ being the baseline phase and 'B' the experimental phase. The CIT consisted of a restraint of movement of the unaffected upper extremity by placing it in a sling and resting splint for 84.9% of walking hours for 12 consecutive days, combined with 6 hours/day of intensive training of the affected upper extremity. The motor function of each subject's upper extremity was assessed using a Box and Block Test and a Vertical Line Drawing Test. Assessment of each subjectʼs Motor and Process Skills (AMPS) was applied for evaluation of ADL performance ability and took place during the intial and second baseline phases. Results : The average of each of the three subjects' upper extremity function tests improved during the experimental phase more than in the initial baseline phase. Also the test averages of each subject during the second baseline phase improved more than during the initial baseline phase. There was also a significant improvement in the AMPS motor skills of subject 1 and 3, whose affected areas were their dominant hands before their illness. However, the AMPS motor skills of subject 2, whose unaffected area was the subjectʼs dominant hand, did not show significant changes. Conclusion : The results of this study indicate that the CIT had a positive effect on improving the affected upper extremity function in stroke patients. Also, the improved motor functions led to an increase in performance ability of ADL in the subjects whose affected sides were their premorbid dominant upper extremity.

목적 : 강제유도운동치료가 뇌졸중 환자의 상지 기능 및 일상생활활동의 수행 능력에 미치는 효과를 알아보는 것이었다. 연구방법 : 연구 대상은 뇌졸중으로 인한 편마비 진단을 받은 3인이었으며 개별실험 연구방법(single-subject experimental research design) 중 ABA 설계를 사용하였다. 강제유도운동치료는 12일 동안 팔걸이와 보조기로 건측을 깨어있는 시간의 849% 동안 억제하고, 6시간 동안 환측을 집중적으로 치료하는 방법으로 실시하였다. 대상자의 상지 기능은 기초선 과정(5회)과 치료 과정(12회), 기초선 회귀 과정(5회) 동안 상자와 나무토막 검사 그리고 수직선 그리기 검사를 사용하여 측정하였다. 일상생활활동의 수행 능력은 강제유도운동치료 전․후에 Assessment of Motor and Process Skills(AMPS)를 사용하여 측정하였다. 결과 : 대상자의 상지 기능은 기초선 기간보다. 치료 기간 동안에 현저히 향상되었으며 이 향상은 기초선 회귀 과정 동안에도 계속 지속되었다. 일상생활활동의 수행 능력은 대상자 3인 중 2인에서 유의하게 향상되었다. 결론 : 강제유도운동치료는 뇌졸중으로 인한 편마비 환자의 환측 상지 기능을 향상시키는데 효과적이며, 우세손이 환측인 대상자들의 일상생활활동의 수행 능력을 향상시키는 것으로 나타났다. 앞으로의 연구에서는 많은 뇌졸중 환자를 대상으로 강제유도운동치료가 일상생활활동에 미치는 영향에 대하여 우세측과 비우세측에 따른 환측 부위를 고려한 분석이 이루어져야 할 것이며, 강제유도운동치료 효과의 지속성에 대해서 연구되어야 할 것이다.

Keywords

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