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The Effects of Neurodevelopmental Treatment Approach Based Undressing Skill Training on the Midline Orientation and Protective Reaction of Children With Cerebral Palsy

신경발달치료 접근법을 기초한 옷 벗기 기술 훈련이 뇌성마비 아동의 신체중심선과 보호반응에 미치는 효과

  • Lee, Hye-Rim (Dept. of Occupational Therapy, Chunnam Techno University) ;
  • Kim, Kyeong-Mi (Dept. of Occupational Therapy, College of Biomedical Science and Engineering, Inje University)
  • 이혜림 (전남과학대학교 작업치료과) ;
  • 김경미 (인제대학교 의생명과학대학 작업치료학과)
  • Received : 2016.08.03
  • Accepted : 2016.08.29
  • Published : 2016.09.11

Abstract

Objective : The purpose of this study was to investigate how undressing skill training based on Neuro-developmental treatment (NDT) approach effected on the midline orientation and protective reaction of children with cerebral palsy (CP). Methods : Two participants of this study were 3 years 5 months old boy and 4 years 5 months old girl, living in B city. They were medically diagnosed as cerebral palsy. Research design used in this study is AB design for a single subject research. There was no intervention on the baseline A phases, and functional activity based NDT was used undressing skill training during the B phases. Midline orientation was tested by Stepping subtest in MAP. Protective reaction was measured by Protective reaction subtest in QUEST. Results : In comparison with the baseline (A), midline orientation was improved above 2 standard deviations at intervention phase (B). and protective reaction was improved above averages in both hands. Conclusion : The study showed undressing skill training based on NDT approach that were effective for midline orientation of children with CP. Undressing skill training was one of the major functional activities. Thus, large studies are required to ensure the training effects.

목적 : 본 연구는 뇌성마비 아동에게 신경발달치료 접근법을 기초한 옷 벗기 기술 훈련에 따른 신체중심선과 보호반응에 미치는 효과를 알아보고자 하였다. 연구방법 : 연구대상은 B시에 거주하는 만 3세 5개월 남아와 만 4세 5개월 여아로 뇌성마비 진단을 받았다. 본 연구는 단일대상연구 중 AB 디자인을 사용하였고, 기초선 기간(A) 2회, 중재 기간(B) 10회로 총 12회기를 실시하였다. 중재는 신경발달치료 접근에 기초한 옷 벗기 훈련을 실시하였고, 평가로 신체중심선은 Miller Assessment for Preschoolers(MAP)의 하위 항목인 Stepping 항목을 사용하였으며, 보호반응은 Quality Upper Extremity Skill Test(QUEST) 검사의 하위 항목인 보호반응 항목을 사용하였다. 결과 : 아동의 신체중심선은 기초선 기간과 비교하여 중재기간이 2표준편차 이상으로 감소하였다. 보호반응은 오른쪽과 왼쪽 모두 중재기간 평균점수가 기초선 평균점수보다 높게 나타났다. 결론 : 뇌성마비 아동에게 신경발달치료접근법을 기초한 옷 벗기 기술 훈련이 신체중심선 향상에 효과적이었다. 앞으로 집단 연구를 통하여 그 효과를 확인하는 것이 필요할 것이다.

Keywords

References

  1. Barnes, M., & Crutchfield, C. (1990). Reflex and vestibular aspects of motor control, motor development and motor learning. Atlanta: Stokesville.
  2. Bax, M., Goldstein, M., Rosenbaum, P., Leviton, A., Paneth, N., Dan, B., et al, (2005). Proposed definition and classification of Cerebral palsy. Developmental Medicine and Child Neurology, 47(8), 571-576. https://doi.org/10.1017/S001216220500112X
  3. Bly, L. (1994). Motor Skills Acquisition in the First Year. US, Arizona: Therapy Skill Builders.
  4. Case-Smith, J., & O'Brien, J. C. (2010). Occupational therapy for Children (6th ed.). St. Louis: Mosby.
  5. DeMatteo, C., Law, M., Russell, D., Pollock, N., Rosenbaum, P., & Walter, S. (1992). Quality of upper extremity skills test. Hamilton, Ontario, Canada: McMaster University.
  6. Harris, S. R. (1981). Effect of neurodevelopmental therapy on motor performance of infants with own's syndrome. Developmental Medicine Child Neurology, 23(4), 477-483.
  7. Hong, E. K. (2014). Examining validity and reliability korean miller assessment for preschoolers (K-MAP). Doctoral dissertation, Inje University, Kimhae.
  8. Kim, K. S. (1994). A Consideration about rehabilitation treatment program of cerebral palsy Children. Korean National University of Physical Education, 17(1), 59-76.
  9. Knox, V., & Evans, A. L. (2002). Evaluation of the functional effects of a course of bobath therapy in children with cerebral palsy: A preliminary study. Developmental Medicine & Child Neurology, 44(7), 447-460.
  10. Lee, B. H. (2007). Effect of neurodevelopmental therapy on motor performance of infants with own's syndrome. Journal of Korean Sport Research, 18(2), 247-258.
  11. Lee, D. G. (2005). The Effects of neurodevelopment therapy on gross motor development in cerebral palsy Children. Master's thesis, Dankook University, Cheonan.
  12. Lee, S. H., Park, E. H., Kim, Y. T. (2000). Single subject research in educational and clinical settings. Seoul: Hakjisa.
  13. Lee, S. Y. (2002). The effect of selective dorsal rhizotomy in spastic cerebral palsied children. Master's thesis, Chonnam National University, Gwangju.
  14. Lingerman, T. M., & Stewart, K. B. (1999). Sensory integration based occupational therapy and functional outcomes in young children with pervasive developmental disorder: A single subject study. American Journal of Occupational Therapy, 53(2), 207-213. https://doi.org/10.5014/ajot.53.2.207
  15. Miller, L. J. (1988). Miller assessment for preschoolers. The Psychological Corporation. Harcourt Brace: Jovanovich. INC.
  16. Pedretti, L. W., & Early, M. B. (2001). Occupational therapy practice skills for physical dysfunction (5th ed.). St. Louis: Mosby.
  17. Sung, I. Y., & Gwon, B. S. (2013). Pediatric rehabilitation. Seoul: Koonja.
  18. Thelen, E., & Spencer, J. P. (1998). Postural control during reaching in young infants: A dynamic systems approach. Neuroscience and Biobehavioral Reviews, 22(4), 507-514. https://doi.org/10.1016/S0149-7634(97)00037-7