Journal of Music and Human Behavior (인간행동과 음악연구)

Korean Music Therapy Education Association (한국음악치료교육학회)
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A Ukulele Playing Intervention for Improving the Hand Function of Patients With Central Nervous System Damage: A TIMP Case Study

중추신경계 손상 성인 대상 손 기능 향상을 위한 우쿨렐레 활용 치료적 악기연주(TIMP) 사례

  • Joo, Ye-Eun (Namdong General Welfare Center for the Disabled) ;
  • Park, Jin-Kyoung (Ewha Music Rehabilitation Center, Department of Music Therapy, Graduate School, Ewha Womans University)
  • 주예은 (남동장애인종합복지관) ;
  • 박진경 (이화음악재활센터, 이화여자대학교 일반대학원 음악치료학과)
  • Received : 2022.11.02
  • Accepted : 2022.11.29
  • Published : 2022.11.30
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Abstract

The effects of therapeutic instrumental music performance (TIMP) using a ukulele were examined in adults with central nervous system damage and impaired hand functions. The participants were three adults with neurological damage who participated in 30-min sessions twice a week over 6 weeks. Changes in hand function was measured by the Box and Block Test (BBT), the 9-Hole Peg Test (9-HPT), and the Jebsen-Taylor Hand Function Test (JTHFT). Following the intervention, all three participants showed increases in the BBT and 9-HPT scores, indicating positive changes in fine motor coordination and dexterity. In terms of the JTHFT, all three participants showed increases in the "writing" and "card flipping" subtask scores, indicating that the intervention was effective in improving more coordinated finger movements. All participants reported the satisfaction with the intervention. They also pointed out that they were motivated to play the ukulele and that following the intervention used their affected hand more frequently in daily activities. These findings suggest that TIMP with a ukulele for patients with central nervous system damage can have positive effects on their functional hand movements and motivate these patients to practice their rehabilitation exercises.

본 연구는 중추신경계 손상 환자의 우쿨렐레 활용 치료적 악기연주(Therapeutic Instrumental Music Performance, TIMP) 중재 참여에 따른 손 기능 변화를 살펴보고자 하였다. 연구 대상자는 중추신경계 손상으로 인해 손 기능 장애를 동반하는 성인 3명이며, 약 6주간 주 2회 30분씩 총 12회기 중재에 참여하였다. 우쿨렐레 중재는 손가락 동시 움직임, 손가락 협응 움직임, 손가락 개별 움직임 총 3가지 유형의 연주패턴을 기반으로 구성되었으며, 대상자의 손 기능 수준별 개별화된 중재 적용을 시행하였다. 본 연구에서는 검사도구 'Box and Block Test (BBT)', '9-Hole Peg Test (9-HPT)', 'Jebsen and Taylor Hand Function Test (JTHFT)'를 활용하여 대상자들의 사전 및 사후 손 기능을 측정하였으며, 사후 개별 인터뷰를 통해 중재 참여경험을 살펴보았다. 결과에 따르면 대상자 모두 사후검사에서 BBT 수행점수가 향상되었으며, 9-HPT 수행시간과 JTHFT 지표 중 '글씨쓰기'와 '카드 뒤집기' 영역의 수행시간이 단축되는 결과를 나타냈다. 또한, 개별 인터뷰 내용에 따르면 손의 기능적 움직임을 위해 악기를 활용함으로써 환측 손을 더욱 적극적으로 사용하고자 하는 시도가 많아지고, 손 기능 재활훈련에 대한 인식이 더욱 긍정적으로 변화되었음을 확인할 수 있었다. 이는 중추신경계 손상 환자 대상 우쿨렐레 활용 TIMP 중재가 손의 기능적 움직임 개선에 긍정적인 영향을 줄 수 있으며, 나아가 개인의 재활동기 차원에서의 긍정적인 변화도 불러일으킬 수 있음을 시사하는 바이다.

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