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The Effect of Constraint-Induced Movement Therapy(CIMT) With Cognitive-Perceptual Training on Upper Extremity Function of Stroke Patients With Mild Cognitive Impairment

경도 인지손상을 가진 뇌졸중 환자의 상지 기능에 미치는 강제유도운동치료(CIMT)와 인지-지각 훈련의 병행 효과

  • Kim, Hun-Ju (Department of Occupational Therapy, Dongju College) ;
  • Shin, Joong-Il (Department of Occupational Therapy, Choonhae College of Health Science) ;
  • Kam, Kyung-Yoon (Department of Occupational Therapy Graduate School, FIRST research group, Institute of Aged Life Redesign, U-Healthcare Research Center, Inje University)
  • 김훈주 (동주대학 작업치료과) ;
  • 신중일 (춘해보건대학 작업치료과) ;
  • 감경윤 (인제대학교 의생명공학대학 작업치료학과, FIRST연구사업단, 고령자라이프리디자인 연구소, 유비쿼터스-헬스케어 연구소)
  • Received : 2011.10.06
  • Accepted : 2011.12.13
  • Published : 2011.12.31

Abstract

The purpose of this study is to examine effects of constraint-induced movement therapy(CIMT) and/or cognitive-perceptual training(CPT) on the change of hand function in cerebrovascular accident(CVA) patients and to evaluate the change in the amount and quality of use of the affected upper extremity in performing daily living tasks. The subjects of study were 10 patients who had been under rehabilitation for more than three months after CVA onset. They were all determined as mild cognition impairment according to NCSE or MVPT test. For CIMT group, to restrict the movement of the unaffected hand the subjects had been worn modified resting arm-splint in daytime for 4 weeks. For CIMT+CPT group, the subjects were performed CPT with CIMT and control group had been under conventional occupational therapy for the same period. CIMT+CPT group showed significant improvement in simulated feeding, lifting large light objects, and lifting large heavy objects of Jebsen-Taylor Hand Function Test. CIMT group also showed significant improvement compared with control group. The mean changes of the amount of use(AOU) of the affected arm had a statistically significant difference among groups (p<.05). While CIMT+CPT group had the biggest change in the quality of movement(QOM) of upper extremity of the affected side, CTL group showed the smallest change. Both CIMT and CIMT+CPT groups had statistically significant difference in the change in the quality of movement in upper extremity of affected side with CTL group(p<.05), but there was not significant difference between CIMT group and CIMT+CPT group. CIMT performed to the patients of stroke, with mild impairment in cognitive perceptual abilities showed the improvement in hand movement and AOU and QOM of upper extremity in the affected side and the combination of CIMT with CPT showed synergic effects.

Keywords

CIMT;cognitive-perceptual training;stroke;Motor Activity Log

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