한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제16권5호
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  • Pages.3344-3352
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  • 2015
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  • 1975-4701(pISSN)
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  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
권호 표지
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한국형 전산화 인지재활프로그램(CoTras)이 외상성 뇌손상 환자의 전두엽-집행기능에 미치는 영향

Effects of Korean Computer-Based Cognitive Rehabilitation Program(CoTras) on Frontal-Executive Functions in Patients with Traumatic Brain Injury

  • 한승협 (인제대학교 대학원 재활과학협동과정) ;
  • 조은주 (인제대학교 대학원 작업치료학과) ;
  • 노동희 (인제대학교 대학원 융합의과학협동과정) ;
  • 감경윤 (인제대학교 대학원 작업치료학과)
  • Han, Seung-Hyup (Dept. of Rehabilitation Science, Graduate School of Inje University) ;
  • Jo, Eun-Ju (Dept. of Occupational Therapy, Graduate School of Inje University) ;
  • Noh, Dong-hee (Dept. of Health Science and Technology, Graduate School of Inje University) ;
  • Kam, Kyung-Yoon (Dept. of Occupational Therapy, Graduate School of Inje University)
  • 투고 : 2015.02.02
  • 심사 : 2015.05.07
  • 발행 : 2015.05.31
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초록

본 연구는 외상성 뇌손상 환자를 대상으로 한국형 전산화 인지재활프로그램(CoTras)이 전두엽-집행기능에 미치는 효과를 알아보고자 하였다. 2013년 8월부터 2014년 3월까지 경남 창원에 위치하는 C병원에 내원한 외상성 뇌손상 환자 10명을 두 그룹으로 무작위 할당한 후 실험군에게 한국형 전산화 인지재활프로그램을, 대조군에는 자가인지훈련을 1일 1회, 주 5회, 4주 동안 적용하고 그룹 간 비교를 실시하였다. 이때 중재의 효과를 검증하기 위하여 한국판 몬트리올 인지평가(Korean Montreal Cognitive Assessment; K-MoCA), 시계 그리기 검사(Executive Clock Drawing Test; ECDT), 선로잇기 검사(Trail Making Test; TMT), Rey-도형 검사(Rey Complex Figure Test; RCFT)를 사용하였다. 그 결과, 실험군은 K-MoCA, TMT, RCFT-delayed recall에서 유의하게 향상된 반면(p<.05), 대조군은 모든 평가에서 유의한 변화가 없었다. 또한, K-MoCA, TMT, RCFT-delayed recall에서 실험군과 대조군의 변화량이 서로 유의한 차이가 있음을 확인하였다(p<.05). 본 연구는 한국형 전산화 인지재활프로그램이 외상성 뇌손상 환자의 전두엽-집행기능을 향상시키기 위해 국내 임상 환경에서 사용하기에 적절한 중재 도구임을 지지한다.

The purpose of this study is to investigate the effects of Korean computer-based cognitive rehabilitation program (CoTras) on frontal-executive functions in patients with traumatic brain injury (TBI). This study was performed at C hospital in Changwon, Gyeongsangnam-do, Korea from August 2013 to March 2014. Ten patients with TBI were randomly divided into two groups. The experimental group had been given CoTras once a day, five times a week for four weeks, whereas the control group had performed self-cognitive training under the same conditions. To verify the effect of intervention, the following executive function measures were used: Korean Montreal Cognitive Assessment (K-MoCA), Executive Clock Drawing Test (ECDT), Trail Making Test (TMT), Rey-Complex Figure Test (RCFT). Intervention group showed significant increase in K-MoCA, TMT, RCFT-delayed recall (p<.05). However, control group showed no significant change in any test. There was significant difference of changed scores (post test-pre test) between two groups in K-MoCA, TMT and RCFT-delayed recall (p<.05). This study showed that CoTras is effective to improve frontal-executive functions in patients with traumatic brain injury.

키워드

참고문헌

  1. World Health Organization. Neurological disorders : public health challenges. WHO press, 2006, Available From : http://www.who.int/mental_health/neurology/neurological _disorders_report_web.pdf?ua=1,(accessed Jan., 18, 2015)
  2. A. A. Hyder, C. A. Wunderlich, P. Puvanachandra, G. Gururaj, and O. C. Kobusingye, "The impact of traumatic brain injuries: a global perspective", NeuroRehabilitation, Vol.22, No.5, pp.341-353, 2007.
  3. J. Ghajar, "Traumatic brain injury", The Lancet, Vol.356, No.9233, pp.923-929, 2000. DOI: http://dx.doi.org/10.1016/S0140-6736(00)02689-1
  4. E. Bagiella, T. A. Novack, B. Ansel, R. Diaz-Arrastia, S. Dikmen, T. Hart, and N. Temkin, "Measuring outcome in traumatic brain injury treatment trials: recommendations from the traumatic brain injury clinical trials network", The Journal of Head Trauma Rehabilitation, Vol.25, No.5, pp.375-382, 2010. DOI: http://dx.doi.org/10.1097/HTR.0b013e3181d27fe3
  5. L. J. Carroll, J. D. Cassidy, L. Holm, J. Kraus, V. G. Coronado, and WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury, "Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury", Journal of Rehabilitation Medicine, Suppl 43, pp.113-125, 2004. DOI: http://dx.doi.org/10.1080/16501960410023877
  6. V. L. Feigin, & D. A. Bennett, "Handbook of clinical neuroepidemiology.", p.201-202, Nova Science Publishers, 2007.
  7. S. Sinha, P. Gunawat, A. Nehra, and B. S. Sharma, "Cognitive, functional, and psychosocial outcome after severe traumatic brain injury: a cross-sectional study at a tertiary care trauma center", Neurology India, Vol.61, No.5, pp.501-506, 2013. DOI: http://dx.doi.org/10.4103/0028-3886.121920
  8. G. Zappala, M. Thiebaut de Schotten, and P. J. Eslinger, "Traumatic brain injury and the frontal lobes: What can we gain with diffusion tensor imaging?", Cortex, Vol.48, No.2, pp.156-165, 2012. DOI: http://dx.doi.org/10.1016/j.cortex.2011.06.020
  9. M. F. Kraus, T. Susmaras, B. P. Caughlin, C. J. Walker, J. A. Sweeney, and D. M. Little, "White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study", Brain : A Journal of Neurology, Vol.130, No.10, pp.2508-2519, 2007. DOI: http://dx.doi.org/10.1093/brain/awm216
  10. C. D. Marquez de la Plata, J. Garces, E. Shokri Kojori, J. Grinnan, K. Krishnan, R. Pidikiti, J. Spence, S. Devous MD, C. Moore, R. McColl, C. Madden, and R. Diaz-Arrastia, "Deficits in functional connectivity of hippocampal and frontal lobe circuits after traumatic axonal injury", Archives of Neurology, Vol.68, No.1, pp.74-84, 2011. DOI: http://dx.doi.org/10.1001/archneurol.2010.342
  11. C. Chayer and M. Freedman, "Frontal lobe functions", Current Neurology and Neuroscience Reports, Vol.1, No.6, pp.547-552, 2001. DOI: http://dx.doi.org/10.1007/s11910-001-0060-4
  12. M. J. Kane and R. W. Engle, "Working-memory capacity and the control of attention: the contributions of goal neglect, response competition, and task set to Stroop interference", Journal of Experimental Psychology: General, Vol.132, No.1, pp.47-70, 2003. DOI: http://dx.doi.org/10.1037/0096-3445.132.1.47
  13. L. Godbout and J. Doyon, "Mental representation of knowledge following frontal-lobe or postrolandic lesions", Neuropsychologia, Vol.33, No.12, pp.1671-1696, 1995. DOI: http://dx.doi.org/10.1016/0028-3932(95)00047-X
  14. G. A. Marshall, D. M. Rentz, M. T. Frey, J. J. Locascio, K. A. Johnson, and R. A. Sperling, "Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease", Alzheimer's & Dementia, Vol.7, No.3, pp.300-308, 2011. DOI: http://dx.doi.org/10.1016/j.jalz.2010.04.005
  15. T. Okura, B. L. Plassman, and K. M. Langa, "The association of executive function with limitations in instrumental activities of daily living among older adults in the United States: The aging, demographics, and memory study", Alzheimer's & Dementia, Vol.6, No.4, Supplement, pp.S483-S484, 2010. DOI: http://dx.doi.org/10.1016/j.jalz.2010.05.1611
  16. M. M. Sohlberg and C. A. Mateer, Introduction to cognitive rehabilitation: Theory and practice., p.414, Guilford Press, 1989.
  17. K. D. Cicerone, D. M. Langenbahn, C. Braden, J. F. Malec, K. Kalmar, M. Fraas, T. Felicetti, L. Laatsch, J. P. Harley, T. Bergquist, J. Azulay, J. Cantor, and T. Ashman, "Evidence-Based Cognitive Rehabilitation: Updated Review of the Literature From 2003 Through 2008", Archives of Physical Medicine and Rehabilitation, Vol.92, No.4, pp.519-530, 2011. DOI: http://dx.doi.org/10.1016/j.apmr.2010.11.015
  18. H. R. Lee, J. Y. Kim, and D. S. Han, "A Survey on the Cognitive Rehabilitation of Occupational Therapy in Korea", Journal of Korean Society of Occupational Therapy, Vol.20, No.2, pp.73-84, 2012.
  19. J. I. Kwon, H. G. Moon, M. J. Park, S. H. Park, A. R. Jeong, H. J. Jin, and C. Jang, "The effect of computer-aided cognitive rehabilitation program(REHACOM) and Natural Sound on improving Attention & Concentration", The Journal of Korean Society of Health Sciences, Vol.5, No.1, pp.75-88, 2008.
  20. D. H. Kim, Y. N. Cho, and H. C. Kwon, "The Effect of Rehacom on Cognitive Function and Activities of Daily Living for Traumatic Brain Injury", Journal of Special Education & Rehabilitation Science, Vol.52, No.1, pp.197-216, 2013.
  21. S. H. Kim and J. M. Lee, "The effects of computerized cognitive rehabilitation on social cognition for patients with TBI", Journal of Special Education & Rehabilitation Science, Vol.52, No.2, pp.77-91, 2013.
  22. S. G. Ahn, B. H. Oh, M. H. Hyun and K. J. Yu, " The Effect of Attention Training Using Computer-Aided Cognitive Rehabilitation Program(REHACOM) in Chronic Schizophrenics", Journal of the Korean Neuropsychiatric Association, Vol.36, No.1, pp.72-79, 1997.
  23. W. J. Bae, Y. K. Park, Y. W. Choi, S. H. Han, K. Y. Kam, "The Effects of Computer-Assisted Cognitive Rehabilitation on the Cognitive Function and ADL Performance in Patients After a Chronic Stroke According to Age", Journal of Korean Society of Occupational Therapy, Vol.21, No.2, pp.75-89, 2013.
  24. Y. G. Kim, "Development of a Korean computer-based cognitive rehabilitation program(CoTras) for patients with cognitive disabilities and the validation of its effects", 2011.
  25. Y. G. Kim, "The Effects of Korean Computer-based Cognitive Rehabilitation Program(CoTras) for the Cognition and ADL in Stroke", Journal of Korean Society of Occupational Therapy, Vol.19, No.3, pp.75-88, 2011.
  26. Y. G. Kim, "The Effect on Computer-based Cognitive Rehabilitation Program(CoTras) for the Visual Perception in Brain Injury", Journal of Rehabilitation Research, Vol.16, No.3, pp.401-419, 2012.
  27. Y. W. Kang, J. S. Park, K. H. Yu, and B. C. Lee, "A Reliability Validity, and Normative Study of the Korean-Montreal Cognitive Assessment(K-MoCA) as an Instrument for Screening of Vascular Cognitive Impairment(VCI)", The Korean Journal of Clinical Psychology, Vol.28, No.2, pp.549-562, 2009. DOI: http://dx.doi.org/10.15842/kjcp.2009.28.2.013
  28. K. S. Lee, H. K. Cheong, B. H. Oh, C. H. Hong, and D. W. Lee, "Reliability and Validity of Four Scoring Methods of Clock Drawing Test for Screening Dementia and Mild Cognitive Impairment", Dementia and Neurocognitive Disorders, Vol.8, No.1, pp.53-60, 2009.
  29. K. I. Shulman, D. Pushkar Gold, C. A. Cohen, and C. A. Zucchero, "Clock-drawing and dementia in the community: A longitudinal study," International Journal of Geriatric Psychiatry, Vol.8, No.6, pp.487-496, 1993. DOI: http://dx.doi.org/10.1002/gps.930080606
  30. M. D. Lezak, Neuropsychological Assessment, Oxford University Press, p.371-537, 2004.
  31. U. Mayr and S. W. Keele, "Changing internal constraints on action: the role of backward inhibition", Journal of Experimental Psychology: General, Vol.129, No.1, pp.4-26, 2000. DOI: http://dx.doi.org/10.1037/0096-3445.129.1.4
  32. L. M. Binder, "Constructional strategies on complex figure drawings after unilateral brain damage", Journal of Clinical and Experimental Neuropsychology, Vol.4, No.1, pp.51-58, 1982. DOI: http://dx.doi.org/10.1080/01688638208401116
  33. S. W. park, I. H. Park, and S. J. You, "The Effects of Korean Computer-based Cognitive Rehabilitation Program(CoTras) for the Cognition and Visual Perception and ADL in Brain Injury", Journal of Occupational Therapy for the Aged and Dementia, Vol.7, No.2, pp.47-57, 2013.
  34. L. Grant, Neuropsychological Assessment of Neuropsychiatric and Neuromedical Disorders, p.42-65, Oxford University Press, 2009.
  35. E. L. Glisky, D. L. Schacter, and E. Tulving, "Computer learning by memory-impaired patients: Acquisition and retention of complex knowledge", Neuropsychologia, Vol.24, No.3, pp.313-328, 1986. DOI: http://dx.doi.org/10.1016/0028-3932(86)90017-5
  36. H. K. Kim, "Clinical Evaluation of the Frontal Lobe Syndrome Using Kims Frontal-Executive Neuropsychological Test", The Korean Journal of Rehabilitation Psychology, Vol.8, No.2, pp.173-190, 2001.
  37. G. A. Kim and M. J. Lee, "according to severity of brain injury = Memory disturbance and Executive dysfunction of patients with traumatic brain injury", The Korean Journal of Clinical Psychology, Vol.24, No.4, pp.849-867, 2005.
  38. U. Bivona, P. Ciurli, C. Barba, G. Onder, E. Azicnuda, D. Silvestro, R. Mangano, J. Rigon, and R. Formisano, "Executive function and metacognitive self-awareness after severe traumatic brain injury", Journal of the International Neuropsychological Society, Vol.14, No.05, pp.862-868, 2008. DOI: http://dx.doi.org/10.1017/S1355617708081125
  39. S. S. Lee, B. K. Yoo, Y. T. Kim, and H. S. Kim, "Functions of Orbitofrontal Cortex", Journal of the Korean Society of Biological Therapies in Psychiatry, Vol.13, No.1, pp.36-44, 2007.
  40. M. C. Welsh and B. F. Pennington, "Assessing frontal lobe functioning in children: Views from developmental psychology", Developmental Neuropsychology, Vol.4, No.3, pp.199-230, 1988. DOI: http://dx.doi.org/10.1080/87565648809540405
  41. K. K. Kim, Y. Joo, J. S. Kim, J. B. Lee, O. L. Kim, W. S. Seo, D. S. Bae, and B. H. Koo, "The Subjective Psycholopathology in Patients with Traumatic Brain Injury According to their Severity with and without Frontal Lobe Injury", Journal of the Korean Society of Biological Therapies in Psychiatry, Vol.16, No.1, pp.63-71, 2010.
  42. Y. N. Cho, H. K. Kim, and H. C. Kwon, "The Effects of Computerized Cognitive Rehabilitation on Cognitive Function in Elderly Post-stroke Patients", Journal of Special Education & RehabilitationScience, Vol.51, No.4, pp.261-278, 2012.
  43. J. H. Jeong, J. M. Lee, and S. I. Song, "The Effects of Computerized Cognitive Rehabilitation Program (Rehacom) on Executive Function in Stroke Patients", Journal of Special Education & Rehabilitation Science, Vol.53, No.1, pp.357-371, 2014. DOI: http://dx.doi.org/10.15870/jsers.2014.03.53.1.357