뇌졸중 환자에서 신체인식에 대한 감각변환 훈련의 효과

Effect of Sensory Information Transfer Training About Perception of Body in Stroke Patients

뇌졸중 환자에게 신체인식을 위해 인지과정을 통한 감각변환 훈련을 적용해보고, 신체인식과 그에 따른 일상생활활동 회복에 미치는 영향을 알아보는 것이다. 방법: 본 연구는 사례연구로 인지기능은 정상이지만 신체인식의 어려움을 갖고 있는 58세 왼편마비 환자를 대상으로 실시하였다. 10주 동안 감각변환 훈련을 적용하였으며 신체인식과 일상생활의 작업수행을 측정하여 비교하였다. 중재전·후 평가로 신체인식은 인지운동프로파일로, 일상생활의 작업수행은 Assessment of Motor and Process Skills (AMPS)로 측정하였고, 시각적 분석을 통해 중재 효과를 비교하였다. 결과: 신체인식에 대한 평가로 인지운동프로파일에서 개선되는 결과를 보였다. 일상생활의 작업수행 평가결과 AMPS의 운동기술은 중재 전 0.33로짓에서 중재 후 0.64로짓으로 0.31로짓 증가하였고, 처리기술은 중재 전 0.66로짓에서 1.21로짓으로 0.55로짓 증가하였다. 결론: 뇌졸중 환자에게 인지과정을 통한 감각변환 훈련은 신체인식의 증진과 일상생활의 작업수행에 긍정적인 영향을 주었다. 향후 뇌졸중 환자의 재활에서 신체인식에 대한 훈련도 고려해야 할 것이다.

This research is to find out the influences on the recovery of Activity of Daily Living (ADL) according to perception of body by applying sensory Information transfer training through cognitive process for perception of body in stroke patients. Methods: In this research, the target was on a 58 years old left hemiplegia patient who has difficulty of perception of body while having normal cognitive functions. For 10 weeks, sensory Information transfer training was applied and occupational performance of ADL and perception of body were measured and compared. For the pre--intervention and post-intervention assessment, perception of body was measured with profile of cognitive therapeutic exercise profile while occupational performance was measured with Assessment of Motor and Process Skills (AMPS), and the intervention effect was compared through visual analysis. Results: For the assessment on perception of body, cognitive exercise profile showed improvement. As a result of the occupational performance assessment of daily living, motor skill of AMPS was 0.33 before intervention and raised to 0.64 after the intervention (increasing 0.31logit), and the process skill increased 0.55 logit from 0.66 before intervention to 1.21 after intervention. Conclusion: Sensory transfer training through cognitive process to stroke patients gave positive influence in occupational performance of daily life and also increased perception of body. Training about perception of body shall be considered in rehabilitation of stroke patients in the future. (J Korean Society of Neurocognitive Rehabilitation 2014;6:47--53)