건반연주 재활프로그램이 수지 접합 환자의손 협응력과 우울감에 미치는 영향 - 증례보고 -

The Effects of Keyboard-Playing Rehabilitation Program on Hand Coordination and Depression for a Patient with Finger Micro-Replantation

본 연구는 건반연주 재활프로그램이 수지 접합 환자의 손 협응력 향상과 우울감 감소에 긍정적인 영향을 미치는지 알아보는 것에 목적이 있다. 산업재해로 좌측 4수지절단 진단을 받은 65세 남성 환자를 선정하여 증례보고로 시행하였고, 6주 간 주 2회, 50분씩 총 12회기를 진행하였다. 본 프로그램은 ‘PSE’, ‘흑 건반 즉흥연주’, ‘TIMP’ 활동으로 설계되었다. 손 협응력의 변화를 측정하기 위하여 Box & Block Test, MIDI Program이 사용되었으며, 우울감의 변화를 측정하기 위하여 CES-D가 사용되었다. 또한 두 변인의 단계별 내용분석이 추가되었다. 그 결과, 대상자는 사전-사후의 ‘Box & Block Test’에서 환측 손의 협응력에 긍정적인 결과를 보였고, ‘MIDI 프로그램을 통한 타력 값’ 측정에서도 환측 손의 타력 값이 향상된 결과를 도출하였다. ‘CES-D’는 사전-사후 간 우울감이 감소된 결과를 도출하였고, 내용 분석을 통해 대상자의 두 변인이 긍정적으로 변화되었음을 추이하였다. 이에 본 연구는 건반연주 재활프로그램이 수지 접합 환자의 손 협응력 향상과 우울감 감소에 재활 치료적 중재 방법이 될 수 있는 가능성을 제시하는 데 그 의의를 갖는다.

The purpose of this study is to examine the effectiveness of the keyboard-playing rehabilitation program on hand coordination and the mental well-being of a patient, after amputated finger micro-replantation. The study was conducted on a 65-year old male patient who had the 4th finger on his left hand cut off in an industrial accident. The case report was carried out over six weeks. The patient received therapy in 50 minute sessions twice a week for total of 12 sessions. This program was comprised of ‘PSE-based hand coordination training’, ‘black keyboard improvisation’, and ‘TIMP-based Arirang numerical score’. Box & Block Test and MIDI Program were used to measure the change of hand coordination, CES-D was used to measure the change of depression, and session content analysis was added to both variables. As a result, when it comes to the finger amputation micro-replantation patient, a positive result was shown to the coordination ability of injured hand in the pre-post ‘Box & Block Test’, and in the measurement of ‘percussing skill value through MIDI program’, the result that the percussing skill value of the injured hand was improved was drawn. In ‘CES-D’ evaluation, the result that the depression declined when the pre-post comparison was carried out was drawn and it was confirmed through the content analysis that the hand coordination and the depression of the subject changed positively depending on each category. Hereby, this study is significant in suggesting the keyboard-playing rehabilitation program can be an affective therapeutic retreatment hand coordination and the patient mental well-being following amputated finger micro-replantation.