CILT 중재가 비유창성 실어증 환자의 구어의사소통능력과 정보 전달능력에 미치는 효과

The Effects of Constraint-Induced Language Therapy on Language Performance in Korean Individuals with Aphasia

배경 및 목적: 집중적인 치료일정 안에서 구어사용을 극대화 하도록 구조화된 치료프로토콜인 Constraint-Induced Language Therapy (이하 CILT)는 지난 10여년간 많은 연구들을 통해 실어증 환자들에게 효과를 보이는 중재방법으로 알려져 왔다. 본 연구에서는 국내 비유창성실어증 환자를 대상으로 한국어의 특징을 고려한 CILT 중재가 표준화된 검사로 나타나는 구어의사소통능력과 Correct Information Unit (이하 CIU)분석 방법을 통해 알 수 있는 정보전달능력에 미치는 효과를 알아보고자 하였다. 방법: 본 연구는 비유창성 실어증 환자 6명을 대상으로 하루 140분(2.3시간)총 10회의 CILT 중재를 약 3주간의 집중적인 일정으로 실시하였다. 사전-사후 설계로 중재 전에 비하여 중재 후의 파라다이스 한국판 웨스턴 실어증 검사(PㆍK-WAB)의 실어증 지수, 한국판 보스톤 이름대기 검사(K-BNT)의 총점, 총 CIU수, CIU 비율, 분당 CIU수의 변화를 살펴보았다. 결과: CILT 중재 실시 후 PㆍK-WAB 실어증지수와 K-BNT 점수가 유의미하게 향상되었으며, CIU분석의 총 CIU수, CIU 비율, 분당 CIU수 수치가 유의미하게 증가하였다. 논의 및 결론: 본 연구의 결과는 한국어의 특성을 고려한 CILT 중재가 실어증환자에게 효과를 보이는 접근 방법임을 지지하며, CILT 중재에 포함된 다양한 요소별 중재효과에 대한 후속 연구의 필요성을 시사한다.

Background & Objectives: Constraint-induced language therapy (CILT) focuses on improving acquired expressive language deficits after stroke by applying intensive, short-term therapy with a heavy emphasis on verbal language. The present study explored the outcome of a CILT program in Korean individuals with aphasia. The study investigated verbal language abilities through standardized test measures and language sample by Correct Information Unit analysis. Methods: The present study included 6 Korean individuals with aphasia caused by left hemisphere stroke. The study was performed as follows: A 10-day/2.3 hours a day CILT intervention case series were performed with 6 Korean individuals with aphasia following left CVA. Procedures involved card activities using high and low frequency picture stimuli with communicative relevance at 4 levels of complexity, in a small group with a SLP. Participants took turns verbally asking for a card from their partner. A barrier was placed between participants to ensure that they could not use gestures or hand writing to facilitate their requests. In this study, the pretest-posttest design was used. The performances of all subjects were analyzed using a Wilcoxon Signed-Ranks Test. Results: The results obtained in this study were as follows: (1) There was a significant increase in Aphasia Quotient of the Korean version of the Western Aphasia Battery in the post-treatment condition compared to the pre-treatment. (2) There was a significant increase in Korean version of the Boston Naming Test in the post-treatment condition compared to the pre-treatment. (3) There was a significant increase in Correct Information Unit analysis in the post-treatment condition compared to the pre-treatment. Discussion & Conclusion: Results from this study indicated that a CILT program using intensive and forced-use verbal language modality was beneficial to verbal language performance of Korean individuals with aphasia.