• 재활치료과학
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• 제4권1호
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• pp.7-17
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• 2015

목적 : 본 연구의 목적은 집중적 양손활동훈련을 편측 뇌성마비 아동에게 적용한 후 상지 재활 효과와 양손 협응 능력의 변화를 살펴본 연구에 대해서 분석하는 것이다. 연구방법 : 2004년부터 2014년 현재까지 국내 외 학회지에 게재된 논문을 RISS, Pubmed를 통해 검색하였다. 1, 2차 분류를 통해 총 6개의 실험연구 논문이 대상논문으로 선정되었다. 결과 : 선정된 6편의 문헌은 모두 국외 논문이었으며, PEDro score는 5점 이상으로 높은 편 이었다. 사용된 중재는 강제유도운동치료의 변형형태가 가장 많았으며, 상지기능과 양손 협응 측정 위한 평가도구로는 AHA와 JTTHF가 가장 많은 빈도를 보였고, 그 외 QUEST, ABILHAND-Kids, COPM, GAS, PEDI, 3-D movement kinematics가 중재효과의 다양한 측면을 평가하는데 사용되었다. 고찰 : 본 연구를 통하여 집중적 양손활동훈련이 편측 뇌성마비아동의 상지 기능뿐만 아니라 양손 협응에 긍정적인 영향을 준다는 것을 확인하였고, 더 나아가 양손 협응이 요구되는 대부분의 일상생활의 참여에 도움을 줄 수 있음을 알아보았다. 이와 같은 결과는 작업치료사로서 국내 임상가들에게 편측 뇌성마비 아동을 위한 새로운 중재방법의 기초자료를 제시하고, 효과적인 치료 접근법을 알려주는 데 도움이 될 것이다.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.67-76
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• 2002

We report the reorganization of motor network resulted from intensive unilateral coordination training and the effect of cross education on the untrained side in patient with traumatic brain injury using functional magnetic resonance imaging (fMRI). A 22 year-old male patient who had suffered from diffuse axonal injury for 58 months showed coordination deficit in the left hand at initial examination. Intensive motor training including complex finger movements and coordination activities using a metronome was introduced to the patient 4 hours per day for a week. FMRI was performed on a 3T ISOL Forte scanner. All functional images were analyzed using SPM-99 software. Hand function was improved after training not only in the trained left hand, but also in the untrained right hand. There was no activation in the right primary motor area (M1) during left hand movement before training whereas robust activation of left M1 was demonstrated by the right hand movement. Profuse activation of bilateral prefrontal lobes was seen during both hand movements before training. After training of left hand, right M1 became prominently activated during the left hand motion. The activation of bilateral prefrontal lobes disappeared after training not only for the left hand movement but also for the right, which clearly demonstrated the effect of cross education. This case report demonstrated the learning-dependent reorganization of the M1 and the effect of cross education.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.77-87
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• 2010

The present case study highlights the effects of a novel Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST) on morphological changes and associated upper extremity (UE) muscle strength and motor performance in a child with spastic quadriplegic cerebral palsy (CP). The Child, a 10-year-old girl with spastic quadriplegic CP, was treated with CHRIST for 60 minutes a day, five times a week, for 5 weeks. The CHRIST was designed to improve motor function and strength. Clinical tests including the modified Wolf Test, Jebsen-Taylor Hand Function Test, and Pediatric Motor Activity Log questionnaire were used to determine motor function. Ultrasound imaging was performed to determine the changes in the cross-section area (CSA) of the extensor carpi radialis (ECR) and triceps brachii (TRI). Muscle strength was measured with a dynamometer at pretest, and post-test, and 3-month follow-up. Ultrasound imaging data showed that the CSAs of both ECR and TRI muscles were enhanced as a function of the intervention. These changes were associated with muscle strength and motor performance and their effects remained even at a 3-month follow-up test. Our results suggest that the CHRIST was effective at treating muscle atrophy, weakness and motor dysfunction in a child with spastic quadriplegic CP.