Journal of Korean Society of Neurocognitive Rehabilitation (한국신경인지재활치료학회지)

The Korean Society of Cognitive Therapeutic Exercise (한국인지운동치료협회)
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Effects of Task Training for Cognitive Activation of Stroke Patients on Upper Function and Activities of Daily Living

뇌졸중 환자의 인지활성화를 위한 과제 훈련이 상지기능 및 일상생활동작에 미치는 영향

  • Kim, Yu-Jeong (Dept. of Occupational Therapy, Yonseimadu Hospital) ;
  • Kang, Bo-Ra (Dept. of Occupational Therapy, Yonseimadu Hospital) ;
  • Ahn, Si-Nae (Dept. of Occupational Therapy, Cheongju University)
  • 김유정 (연세마두병원 작업치료실) ;
  • 강보라 (연세마두병원 작업치료실) ;
  • 안시내 (청주대학교 작업치료학과)
  • Received : 2018.05.22
  • Accepted : 2018.10.18
  • Published : 2018.12.30
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Abstract

The purpose of this study is to investigate the effect of task training for cognitive activation of upper extremity on upper limb function and activities of daily living and to suggest intervention in rehabilitation treatment. From January to February of 2018, nine stroke patients were arbitrated 30 minutes a day, five days a week, for four weeks. For the experimental group, the therapist has induced the group using the linguistic guidance to patients, so they utilize the cognition strategy. The control group conducted active exercises in a range of motion using the instruments and passive exercises in a range of motion to reduce the stiffness of joints and upper limbs. As muscle strengthening exercises, the patients were assigned to work on the biceps muscle of arm, triceps muscle of arm, and deltoid according to the individual patient's muscular strength level. For the experimental group, the MBI was improved by ten points at maximum, and K-AMPS motor skills showed the improvements of 1.0 logit at maximum, and processing skills showed improvements of 0.6 logits at maximum. In MFT, the maximum improvement was by two points. For the control group, MBI was improved by five points at maximum, and 0.2 maximum improvements were shown in K-AMPS' motor skills and 0.3 maximum improvements in processing skills. MFT showed no change. The conclusion is that the challenges to enable training for stroke patients give a positive impact on upper limb function and activities of daily living.

목적: 뇌졸중 환자의 인지활성화를 위한 과제 훈련이 상지기능 및 일상생활동작에 미치는 영향을 알아보고, 재활 치료 시 중재를 제언하고자 한다. 방법: 2018년 1월부터 2월까지 뇌졸중 환자 9명을 대상으로 4주 동안 주 5회 30분씩 중재하였다. 실험군은 5가지 과제를 치료사의 언어적 가이드를 통해 환자가 인지전략을 사용하도록 유도하고 환자 스스로 생각하고 말하는 과정을 통해 과제수행의 문제점을 해결하도록 하였다. 대조군은 상지근육과 관절의 경직을 감소시키기 위한 수동적 관절 가동 범위 운동과 도구를 이용한 능동적 관절 가동 범위 운동을 시행하였고, 근력운동으로는 일상생활활동에서 가장 많이 쓰이는 위팔 두갈래근, 위팔 세갈래근, 삼각근을 근력수준에 맞추어 실시하였다. 결과: 실험군에서 MBI는 최대 10점 향상되었고, K-AMPS의 운동기술은 최대 1.0 logit의 향상이 나타났으며 처리기술에서는 최대 0.6 logit의 향상이 나타났다. MFT에서는 최대 2점의 향상이 나타났다. 대조군에서 MBI는 최대 5점 향상되었고, K-AMPS의 운동기술은 최대 0.2 logit의 향상 나타났으며 처리기술에서는 최대 0.3 logit의 향상이 나타났다. MFT에서는 점수 변화가 없었다. 결론: 뇌졸중 환자에게 인지활성화를 위한 과제 훈련이 상지기능 및 일상생활동작에 긍정적인 영향을 준다.

Keywords

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