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뇌졸중 이후 운전 시뮬레이터와 Dynavision 훈련이 인지 및 운전 수행 능력에 미치는 효과 비교

Comparing Effects of Driving Simulator and Dynavision Training on Cognitive Ability and Driving Performance After Stroke

  • 최성열 (광주여자대학교 작업치료학과) ;
  • 이재신 (건양대학교 작업치료학과) ;
  • 김수경 (건양대학교 작업치료학과) ;
  • 차태현 (건양대학교 작업치료학과)
  • Choi, Seong-Youl (Department of Occupational Therapy, Kwangju women's University) ;
  • Lee, Jae-Shin (Department of Occupational Therapy, Konyang University) ;
  • Kim, Su-Kyoung (Department of Occupational Therapy, Konyang University) ;
  • Cha, Tae-Hyun (Department of Occupational Therapy, Konyang University)
  • 투고 : 2018.07.30
  • 심사 : 2018.11.26
  • 발행 : 2018.12.30

초록

연구목적 : 본 연구의 목적은 뇌졸중 환자에게 운전 시뮬레이터와 Dynavision 훈련의 효과를 인지 평가와 주행 중 운전수행 능력 평가를 통해 비교하고, 두 가지 훈련방법의 차이에 대한 임상적 근거를 제시하는 것이다. 연구방법 : 본 연구를 위해 뇌졸중 환자 21명을 선정하여 무작위로 운전 시뮬레이터 훈련 집단(N=11)과 Dynavision 훈련 집단(N=10)으로 분류하고 각각 15회기의 훈련을 실시하였다. 대상자들의 주행 중 운전수행 능력 측정을 위해 운전 시뮬레이터 시나리오 시스템 평가를 실시하였고, 인지 능력을 측정하기 위해 DriveABLE Cognitive Assessment Tool(DCAT), Trail Making Test-A, Trail Making Test-B 그리고 Mini Mental State Examination-K 평가를 실시하였다. 결과 : 운전 시뮬레이터 훈련 집단은 모든 인지 능력평가와 대부분 운전수행 능력에서 통계적으로 유의미한 향상이 확인되었다. Dynavision 훈련 집단은 Trail Making Test-A를 제외한 모든 인지 능력 평가와 브레이크 페달 반응시간, 중앙선 침범 평균 시간 및 비율, 차선이탈 비율의 운전수행 능력에서 통계적으로 유의미하게 향상 되었다. 그리고 두 가지 훈련의 변화량은 도로주행평가의 결과 예측 지수와, 충돌사고 및 위험상황 발생 횟수에서 유의미한 차이를 보였으며, 이 변수들의 변화량은 두 가지 훈련방법의 적용 차이에 따라 모든 변수가 20% 이상의 인과적 영향력이 있음이 확인되었다. 결론 : 뇌졸중 환자의 운전훈련 방법으로 운전 시뮬레이터와 Dynavision 훈련은 모두 효과적인 중재방법임을 확인하였다. 특히 운전 시뮬레이터는 뇌졸중 환자의 운전수행 능력 전반을 향상시킬 수 있는 효과적인 훈련이며, Dynavision 훈련과는 20%의 설명력으로 훈련효과의 차이가 확인되었다.

Objective : The purpose of this study was to compare with the effects of driving simulator and Dynavision training after stroke through the test of cognitive ability and driving performance. Methods : Twenty-one stroke patients were randomly classified to the driving simulator training group (N=11) and Dynavision training group (N=10), and were carried out respectively training for 15 times. The driving performances was measured by the driving simulator test, and cognitive-perceptive abilities was measured by the DriveABLE Cognitive Assessment Tool, Trail Making Test-A, Trail Making Test-B and Mini Mental State Examination-K. Results : The driving simulator training group showed significant changes in all cognitive tests and most of driving performances. The Dynavision training group also showed significant changes in all cognitive tests except for Trail Making Test-A and some driving performances. The significant differences on both groups were found regarding the estimated degree of results on the on-road evaluation, the number of off road accidents and collisions. In addition, the causal influence of the two training methods on these variables was analyzed to be more than 20%. Conclusion : The driving simulator and Dynavision training were found to be effective intervention in the driving rehabilitation after stroke. In particular, it was confirmed that the driving simulator is an effective training to improve overall driving ability of stroke patients. In addition, the difference in training effect between the two training methods was found to be more than 20%.

키워드

참고문헌

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