Journal of Music and Human Behavior (인간행동과 음악연구)

Korean Music Therapy Education Association (한국음악치료교육학회)
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Exploring the Use of Melody During RAS Gait Training for Adolescents with Traumatic Brain Injury: A Case Study

외상성 뇌손상 청소년 대상 리듬청각자극(RAS) 보행 훈련 시 선율 적용 사례

  • Park, Hye Ji (Yonsei University Severance Hospital Department of Rehabilitation Medicine)
  • 박혜지 (연세대학교 세브란스병원 재활의학과)
  • Received : 2015.09.21
  • Accepted : 2015.11.20
  • Published : 2015.11.30
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Abstract

The purpose of this study was to examine the effects of rhythmic auditory stimulation (RAS) on gait parameters, with and without the presence of a melody, for adolescents with traumatic brain injury (TBI). Three adolescents with TBI received a total of ten individual RAS training sessions. At pre and posttest, spatiotemporal parameters including cadence, velocity and kinematic parameters were measured using the VICON 370 Motion Analysis System. The results showed no significant difference in gait velocity between the two conditions, thus the presence of the melody condition did not impact the outcome of RAS gait training. On the other hand, all participants showed improvement in gait function after RAS training. The cadence, velocity, stride length, and symmetry were increased and the stride time was reduced after training. The motion analysis demonstrated that the movement patterns of hip and knee joints improved, as they were more similar to normal gait, which indicates that the walkings tance became more stable. The research findings indicate that rhythm is the primary factor in mediating gait functions via RAS training. This study also supports that RAS training can effectively improve the gait function for adolescents with TBI.

본 연구는 외상성 뇌손상 청소년을 대상으로 리듬청각자극(RAS) 적용 시 선율의 유무에 따른 보행 훈련 효과를 비교하고, 보행인자의 변화를 알아보고자 시행하였다. 이를 위해 3명의 외상성 뇌손상 청소년을 대상으로 사전 사후 평가를 제외한 총 8회의 보행훈련을 진행하였다. 회기별 중재 시 선율 유무에 따른 보행 속도 차이를 비교하였고, 훈련 효과에 따른 시공간적 지표 및 운동 형상학적 지표 변화 비교를 위해 VICON 370 Motion Analysis System을 사용하여 보행 지표를 측정하였다. 연구 결과 RAS 보행 훈련 시 제공한 음악 자극 형태에 따라 보행 속도에 미치는 유의미한 영향이 없으므로, 선율의 사용 유무는 보행 훈련 효과와 직접적인 관련이 없음을 알 수 있었다. 또한 사전사후 검사 결과, RAS 보행 훈련 후 분속수, 보행 속도, 활보장, 활보장 시간, 보행 대칭성이 공통적으로 개선되었으며, 대상자 모두 공통적으로 고관절 및 슬관절의 움직임에서 필요 이상의 과도한 굴곡이나 신전이 감소함에 따라 양측의 비대칭성 감소 및 움직임의 안정성이 증가한 모습을 보였다. 리듬 적용과 리듬 자극에 선율을 반영한 음악 자극 적용에 따른 보행 속도 간 차이를 비교한 본 연구 결과는 운동기능을 위한 RAS 적용 시, 일정한 간격의 리듬자극에 의한 리듬-운동 동조화가 핵심 기제로 작용함을 시사한다. 또한, 본 연구는 외상성 뇌손상 청소년을 대상으로 RAS 보행 훈련을 통한 보행 기능뿐만 아니라 보행 패턴의 개선을 살펴본 것에 의의가 있다.

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References

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