The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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Structural Equation Modeling of Factors Contributing to Activities of Daily Living in Children With Cerebral Palsy

뇌성마비 아동의 일상생활동작에 영향을 미치는 요인에 관한 구조방정식 모형 검증

  • 박은영 (전주대학교 대체의학대학 재활학과)
  • Published : 2009.10.28
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Abstract

The purpose of this study was to investigate the cause-effect relationship between motor impairments, hand function, gross motor function and activities of daily living (ADL) in children with cerebral palsy through the analysis of structural equation modeling. For this, 105 children with cerebral palsy (between 6 and 12 years old) were assessed about muscle tone and strength, range of motion, abilities of selective motor control, hand function, gross motor function and ADL. The results of this study were follows: Firstly, there were significant correlations between motor impairments of muscle tone, muscle strength, the abilities of selective motor control and ADL (p < .05); Secondly, a good correlation between the gross motor function, hand function and ADL was found in all children (p < .05); Thirdly, the appropriateness of research model was good. This study focused on exploration of the relationship between the motor impairment, gross motor function, hand function and ADL through structural equation modeling.

이 연구는 뇌성마비 아동의 운동손상, 손기능, 대동작 기능과 일상생활동작 수행능력 간의 인과관계를 구조방정식 모형 검증을 통해 알아보기 위해 실시되었다. 이를 위해 만 6~12세 뇌성마비 아동 105명을 대상으로 근긴장도, 근력, 관절가동범위, 선택적 운동조절 능력, 손기능, 대동작 기능, 일상생활동작 수행능력 평가를 실시하였다. 이 연구의 결과는 다음과 같았다: 첫째, 운동손상 변인 중 근긴장도, 근력, 선택적 운동조절 능력은 일상생활동작 수행능력의 하위 영역과 상관이 유의한 것으로 나타났다(p < .05); 둘째, 대동작 기능과 손기능은 일상생활동작 하위 영역과 유의한 상관이 있는 것으로 나타났다(p < .05); 셋째, 뇌성마비 아동의 운동손상, 손기능, 대동작 기능과 일상생활동작 수행능력과의 관계를 알아보기 위해 구조방정식 모형 검증을 실시한 결과, 이 연구의 모형은 적합도가 양호한 것으로 나타났다. 이 연구는 뇌성마비 아동의 운동손상, 손기능, 대동작 기능과 일상생활동작 수행능력 간의 관계를 구조방정식 모형 검증을 통해 규명하였다는데 의의가 있다.

Keywords

References

  1. T. S. Ingram, "The Long Term Care of the Patient Suffering from Cerebral Palsy I," J. of the Irish Medicine Association, Vol.67, No.8, pp.205-213, 1974.
  2. D. J. Bartlett and R. J. Palisano, "A Multivariate Model of Determinants of Motor Change for Children with Cerebral Palsy," Physical Therapy, No.80, Vol.6, pp.598-610, 2000.
  3. A L. Scherzer and I. Tscharnuter, Early Diagnosis and Therapy in Cerebral Palsy: A Primer on Infant Developmental Problems (2nd ed.), Marcel Dekker, 1990.
  4. A. T. Pakula K. V. N. Braun, and M. Yeargin-Allsopp, "Cerebral Palsy: Classification and Epidemiology," Physical Medicine and Rehabilitation Clinics of North America, No.20, pp.425-452, 2009.
  5. F. Stanley, E. Blair, and E. Alberman, Cerebral Palsy: Epidemiology and Causal Pathways, Mac Keith Press, 2000
  6. 홍창의, 소아과학, 대한교과서, 1999.
  7. 박창일, 뇌성마비의 재활, 은평천사원 기념세미나, 2004.
  8. 정순민, 장애인의 재활, 복지, (주)중앙경제, 1999.
  9. 정진우, 일상생활동작과 기능훈련, 대학서림, 1991.
  10. M. Maruishi, Y. Mano, T. Sasaki, N. Shinmyo, H. Sato, and T. Ogawa, "Cerebral Palsy in Adults: Independent Effects of Muscle Strength and Muscle Tone," No.82, Vol.5, pp.637-641, 2001. https://doi.org/10.1053/apmr.2001.22336
  11. J. Styer- Acevedo, Physical Therapy for the Child with Cerebral palsy. In: J. Tecklin (ed.), Pediatric Physical Therapy (3rd ed.) (pp.107-162), Lippincott Williams & WIlkins. 1999.
  12. R. Blank, R. von Kries, and H. von Voss, "Conductive Education for Children with Cerebral Palsy: Effects on Hand Motor Functions Relevant to Activities of Daily Living," Archives Physical Medicine & Rehabilitation, No.89, pp.251-259, 2008.
  13. 조순자, 송병호, "Conductive Education 프로그램이 경직형 뇌성마비학생의 일상생활동작 수행 능력에 미치는 효과", 특수교육학연구, 제39권, 제3호, pp.313-332, 2004.
  14. 고명숙, 유은영, 정민예, "뇌성마비 아동의 근력 강화 운동이 보행과 일상행활동작에 미치는 영향", 한국스포츠리서치, 제16권, 제5호, pp.137-144, 2005.
  15. 김정우, "뇌성마비인의 일상생활활동(ADL) 결정 요인에 관한 경로분석", 한국사회복지학, 제58권, pp.7-85, 2006.
  16. 김정우, 김봉선, "기능제한(Functional Limitation)관점에서 본 뇌성마비인의 일상생활수행능력과 취업여부의 관계에 대한 연구", 한국사회복지학, 제59권, 제1호, pp.223-249, 2007.
  17. I. P. Hsueh, S. H. Huang, M. H. Chen, S. D. Jush, and C. L. Hsieh, "Evaluation of Stroke Patients with Extended Activities of Daily living Scale in Taiwan," Disability and Rehabilitation, No.22, Vol.1, pp.495-500, 2000.
  18. S. Ostensjo, E. B. Carberg, and N. K. Vollestad, "Everyday Functioning in Young Children with Cerebral Palsy," Developmental Medicine & Child Neurology, No.45, pp.603-612, 2003.
  19. S. Ostensjo, E. B. Carlberg, and N. K. Vollestad, "Everyday Functioning in Young Children with Cerebral Palsy: Functional Skills, Caregiver Assistance, and Modifications of the Environment," Developmental Medicine & Child Neurology, Vol.45, No.9, pp.603-612, 2004. https://doi.org/10.1111/j.1469-8749.2003.tb00964.x
  20. J. C. Campbell and K. L. Soeken, "Women's Responses to Battering: A Test of the Model," Research in Nursing & Health, No.22, pp.49-58, 1999.
  21. B. J. Riegel, K. A. Darcup, and D. A. Glaser, "A Longitudinal Causal Model of Cardiac Invalidism Following Myocardial Infarction", Research in Nursing & Health, No.47, pp.285-292, 1998.
  22. M. Ford-Gilboe, "Family Strengths, Motivation, and Resources as Predictors of Health Promotion Behavior in Single-parent and Tow-parent Families," Research in Nursing & Health, No.20, pp.205-217, 1997.
  23. R, Bohannon and M. Smith, "Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity," Physical Therapy, No.67, pp.206-216, 1987.
  24. N. B. Reese, Muscle and Sensory Testing (2nd ed), Elsevier Saunders, 2005.
  25. M. L. Palmer and M. Epler, Clinical Assessment Procedures in Physical Therapy, Lippincott, 1990.
  26. R. N. Boyd and H. K. Grahm, "Objective Measures of Clinical Findings in the Use of Botulinum Toxin Type A for the Management of Children with Cerebral Palsy," No.6, pp.523-535, 1999.
  27. C. Morris and D. Bartlett, "Gross Motor Function Classification System: Impact and Utility," Developmental Medicine & Child Neurology, Vol.46, No.1, pp.60-65, 2004. https://doi.org/10.1111/j.1469-8749.2004.tb00436.x
  28. I. E. Asher, Occupational Therapy Assessment Tools, The American Occupational Therapy Association, 1996.
  29. P. A. Sperle, K. J. Ottenbacher, S. L. Braun, S. J. Lane, and S. Nochajski, "Equivalence Reliability of the Functional Independence Measure for Children (WeeFlM) Administration Methods", American J. of Occupational Therapy, Vol.51, No.1, pp.35-41, 1997. https://doi.org/10.5014/ajot.51.1.35
  30. 홍세희, "구조방정식 모형의 적합도 지수 선정기준과 그 근거", 한국임상심리학회지: 임상, 제19권, 제1호, pp.161-177, 2000.
  31. 김계수, AMOS 구조방정식 모형분석(5판), 한나래, 2004.
  32. R. H. Hoyle and A. T. Panter, Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and application. Thousand, SAGE, 1995.
  33. M. K. Gunnel, A. Mutlu, T. Tarsuslu, and A. Livanelioglu, "Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the Functional Status (WeeFlM) in Children with Spastic Cerebral Palsy," No.168, Vol.4, pp.477-485, 2008.
  34. S. R. Harris, Functional Abilities in Context. Foundation for Physirol Therapy, Alexandria, 1991.
  35. S. K. Campbell, Physical Therapy for Children, WB Saunders Co., 1994.
  36. K. C. Kuban and A. Leviton, "Cerebral palsy", The New England Journal of Medicine, No.330, Vol.3, pp.188-195, 1994.