• The Journal of Korean Physical Therapy
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• 제23권5호
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• pp.43-47
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• 2011

Purpose: Apraxia is characterized by loss of the ability to execute learned, skilled, sequential purposeful movements which cannot be accounted for by elementary disturbances of strength, coordination, sensory, lack of comprehension, attention, and willingness etc. For an accurate diagnosis and treatment of patients with apraxia, an understanding of the prevalence rate and clinical characteristics of apraxia is necessary. The purpose of this study was to estimate the apraxia prevalence rate. Methods: The apraxia prevalence rate was investigated via an apraxia assessment tool in 137 stroke patients, and the clinical characteristics of general stroke patients and stroke patients with apraxia were compared. Results: 14 (1 left hemiplegia, 8 right hemiplegia, 5 quadri hemiplegia) of a total of 137 stroke patients were diagnosed with apraxia. The group of stroke patients with apraxia showed lower values of mmt, mbc and fac than those of general stroke patients. Conclusion: The apraxia prevalence rate of stroke patients was approximately 10%, while the clinical function of stroke patients with apraxia was generally inferior to that of general stroke patients.

• The Journal of Korean Physical Therapy
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• 제18권2호
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• pp.7-16
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• 2006

The purpose of this study was to review the limb apraxia. It includes the evaluation and neurophysiological aspects for limb apraxia. Limb apraxia comprised a wide spectrum of higher-order motor disorders that results from acquired brain disease affecting the performance of skilled and/or learned movements with the forelimbs and is a common sequela of left brain damage that consists of a deficit in performing gestures to verbal command or to imitation. There are two forms in limb apraxia; ideational apraxia and ideomotor apraxia. A assessment of limb apraxia typically includes pantomiming and imitation of transitive, intransitive, and meaningless gestures. Limb apraxia has been attributed to damage confined to the cerebral cortex, cortico-cortical connecting pathways, and basal ganglia.

• 한국컴퓨터정보학회논문지
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• 제22권5호
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• pp.51-56
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• 2017

The purpose of this study was to identify differences in cognitive function according to the presence or absence of apraxia and the tasks most relevant to the cognitive function among the various types of tasks in the apraxia test. The subjects were 42 community residents who participated in a cognitive rehabilitation program related to dementia in a Chungbuk area. MMSE-K and BCoS(Birmingham Cognitive Screen) apraxia test were administered to all subjects. The apraxia test includes three types of tasks, gesture production tasks that make meaningful movements according to verbal instructions, gesture recognition tasks that display behavior after make sense of meanings, and meaningless imitation task. Apraxia group(n=30, MMSE-K mean score: 25) showed lower cognitive function than group without apraxia(n=12, MMSE-K mean score: 28). All tasks in the apraxia test showed a significant correlation with cognitive function, but the meaningless imitation task had a negligible correlation. The apraxia test is a good way to assess cognitive function, and it may be more effective to use meaningful behavior to replace cognitive testing.

• 디지털융복합연구
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• 제14권6호
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• pp.527-533
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• 2016

본 연구는 실행증이 일상생활수준에 영향을 미치는지 알아보기 위해서 실시되었다. 뇌졸중 환자 38명이 참여하였으며 대상자들에게 Birmingham Cognitive Screen(BCoS) 실행증 검사와 일상생활동작 검사인 K-MBI 평가를 실시하였다. BCoS 실행증 검사의 cutoff score를 이용하여 환자들의 실행증 유무를 판별하고 실행증이 있는 환자들은 특징적인 유형으로 구별하여 일상생활수준을 ANOVA로 비교분석하였다. 그 결과 실행증 환자는 18명, 실행증이 없는 환자는 20으로 구분되었으며, 두 환자 군의 일상생활수준의 차이는 없었다(p>0.05). 그러나 실행증 환자군을 세부유형으로 분류하고 비교한 결과 개인위생, 식사하기, 용변처리, 계단오르기, 대변조절, 소변조절의 유의미한 차이를 보였다(F=4.431~9.193, p<0.05). 실행증은 일상생활 수행에 부정적인 영향을 주므로 뇌졸중 환자를 관리하는 다 영역의 전문가들은 실행증 여부를 확인하고, 이에 대한 정보를 서로 공유하여 잠재적 일상생활의 문제를 고려한 정책 및 치료 프로그램을 고안해야 할 것이다.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.49-53
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• 1997

Aberrations in VOT measures in apraxia of speech are indicative of speech motor programming impairment. In English, overlaps of VOT between voiceless and voiced plosives have been frequently observed in patients with apraxia of speech. Unlike English, Korean plosives constitute trichotomy in terms of manner of production, that is, voiceless aspirated /p', t', k'/ ; voiceless or voiced, weakly aspirated /p-b, t-k, k-g/ ; or voiceless, heavily aspirated /p, t, k/. In this spectrographic study, VOT measures during Korean plosives produced by a patient with apraxia of speech were compared to those by age- and gender- matching normal subjects. The results indicated that there were partial overlaps between VOT of /b, d, g/ and those of /p, t, k/, implying that the errors were phonetic in nature. In addition, larger VOT variabilities in apraxia of speech compared to the normals were noted.

• 음성과학
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• 제12권4호
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• pp.247-254
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• 2005

This study aimed at clarifing clinical effects of eight-step continuum treatment in a patient who showed apraxia of speech after stroke. The eight-step continuum treatment consisted of 8 steps and its clinical efficacy has been proven with American apraxic patients. However, it has not been clinically proven to be effective in Korean patients with apraxia of speech as of yet. Therefore, this study was conducted in an effort to provide preliminary clinical evidence regarding its effectiveness regardless of the linguistic differences between Korean and English. The therapy took place twice a week for 6 months, a total of 48 times. The results showed that the patient's receptive language was improved from 83% to 89% and 37% in accuracy, and expressive language from 15% to 37%. It seemed that spontaneous recovery did not playa role in his improvement since the study was conducted 2 years after the stroke. In addition, the improvement of expressive language was much greater(22%) than that of receptive language(6%), which implied that the therapy was effective in apraxia of speech because apraxia of speech is relatively confined to expressive ability, more specifically motor programming and sequencing.

• 대한지역사회작업치료학회지
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• 제4권2호
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• pp.11-22
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• 2014

목적 : 본 연구는 상상연습과 과제활동을 병행한 중재방법을 통하여 관념운동 실행증 환자의 상지 움직임 속도와 정확성에 어떠한 효과을 미치는지 알아보고자 한다. 연구방법 : 대전 소재한 재활전문 요양병원에 입원하고 있는 뇌졸중 환자 2명을 대상으로 상상연습과 과제활동을 1주일에 5회기씩 총 20회기에 걸쳐 실시하였다. 중재 전 후 실행증의 변화를 비교하기 위하여 Ideomotor apraxia test를 시행하였고, 상지기능의 변화를 알아보기 위하여 MFT를 사용하였다. 상지 움직임 속도와 정확성은 시각적 그래프를 이용하여 분석하였다. 결과 : 대상자 모두 실행증 증상의 감소를 보였으나, 상지기능에는 눈에 띄는 변화는 없었다. 과제수행 총 수행시간은 376.67초에서 355.24초, 434.60초에서 391.33초로 감소했다. 과제수행 마지막 컵을 내려놓는 시간은 15.67초에서 13.30초, 20.80초에서 10.73초로 감소하였다. 옮긴 물의 양은 52.38ml에서 49.70ml, 50.89ml에서 50.09ml로 모두 50ml에 가까워지는 결과를 보였다. 결론 : 상상연습과 과제활동을 병행한 중재방법은 실행증 증상을 감소시켰으며, 상지 움직임의 속도와 정확성에 긍정적인 효과를 미치는 것으로 확인되었다. 향후 관념운동 실행증 환자에게 효과적으로 적용할 수 있는 중재방법으로 여겨진다.

• 재활치료과학
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• 제4권1호
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• pp.19-28
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• 2015

서론 : 실행증과 관련된 신경학적 손상에 대한 이해는 병변 부위에 따른 증상을 예측하고 적절한 치료와 목표를 구성하는데 기반이 될 수 있다. 따라서 본 연구는 문헌고찰을 통하여 관념운동실행증의 원인과 행동 오류의 기전을 알아보고, 이와 더불어 치료에 이용될 수 있는 근거를 제시하고자 한다. 본론 : 실행의 모델에서 알 수 있듯이 관념운동실행증은 실행 시스템에서 생산적 측면만의 손상으로 발생할 수 있으며 신경학적 부위는 피질하 손상보다는 피질 수준의 손상이 더 흔하다. 제스쳐를 통한 연구에 따르면 팔의 동작과 관련하여서는 왼쪽 두정엽, 손가락 자세에 따른 동작은 전두엽의 기능과 관련이 있다. 실제 물체를 사용함으로써 얻어질 수 있는 시각, 촉각의 자극들은 익숙한 동작에 대한 기억과는 별도로 올바른 동작을 유도시킬 수 있다. 결론 : 실행은 다양한 신경학적 부위의 처리 과정을 통해 일어나며 다양한 외부의 자극들이 실행에 도움을 줄 수 있음으로 관념운동실행증의 치료에는 이러한 자극들을 이용하는 것이 필요할 것이다.

• 음성과학
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• 제12권2호
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• pp.101-108
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• 2005

Apraxia of phonation (AOP) has often been described as a feature of apraxia of speech or of severe non-fluent type of aphasia. Pure AOP is rare and, to our knowledge, only two cases have been reported. Brain lesion sites of the reported cases were not those sites known to be responsible for apraxia of speech. This study presents a case of AOP which resulted from the secondary stroke in the left corona radiata immediately following the first stroke in the left temporoparietal lobe. A 61-year old right-handed man shwoed a global type of aphasia after the first cerebral infarction, but was able to generate spontaneously some short fragments of speech. On the day after the first infarction, he suffered from the secondary infarction, leaving him a complete loss of voluntary phonation. He did not showed any significant change in language functions. Several occurrences of involuntary phonation were observed upon laughing or crying. He was also able to cough unintentionally. A vidoe-stroboscopic examination failed to reveal any evidence of structural and functional impairment in larynx. Although this case is not of pure form of AOP, AOP appeared after the secondary stroke without significant changes of language impairment since the first stroke. Therefore, AOP may be a consequence of the brain lesion from the secondary stroke even though we cannot rule out the possibility of an additive effect of the secondary to the first stroke.

• Annals of Clinical Neurophysiology
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• 제4권1호
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• pp.63-66
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• 2002

Blepharospasm and apraxia of lid opening(ALO) are non-paralytic causes of involuntary eyelid closure. Clinically it is difficult to differentiate blepharospasm and ALO, and these two conditions are sometimes associated. We report a case of pretarsal blepharospasm presenting as apraxia of lid opening. 55-year-old woman was noted to have voluntary eye opening difficulty. We synchronously record the electromyographic(EMG) from the levator palpebrae superioris and the orbicularis oculi muscles in this patient. This results suggested that she has a variant of blepharospasm due to abnormal contraction in the pretarsal orbicularis oculi.