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구강운동촉진기술(Oral Motor Facilitation Technique)이 뇌졸중 환자의 구강운동기능에 미치는 효과

Effect of Oral Motor Facilitation Technique on Oral Motor Function in Stroke Patients

민경철|우희순|손영수
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2023.11|재활치료과학 (Therapeutic Science for Rehabilitation)|제12권 제4호|pp. 135-151

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키워드

뇌졸중StrokeDysphagia연하장애구강운동촉진기술구강운동치료포괄적 구강안면기능척도Comprehensive Oro-Facial Function Scale (COFFS)Oral Motor Facilitation Technique (OMFT)Oral Motor Therapy

초록

목적 : 본 연구는 구강운동촉진기술(oral motor facilitation technique, OMFT)이 뇌졸중 환자의 구강운동기능에 미치는 효과를 확인하기 위한 목적으로 시행되었다. 연구방법 : 연하장애를 동반한 뇌졸중 환자 72명을 대상으로 시행되었다. 실험군과 대조군은 난수표를활용하여 36명씩 무작위로 분류하였고, 두 그룹 사전-사후 검사 설계로 진행되었다. 실험군은 OMFT 중재를, 대조군은 전통적 연하재활치료를 각각 30분간 1일 1회, 주 5회로 4주 동안 총 20회기 적용하였다. 구강운동기능 평가를 위해 포괄적 구강안면기능척도(Comprehensive Oro-Facial Function Scale, COFFS)를 사용하였고, 기간별 치료 효과 확인을 위한 반복측정 분산분석(repeated ANOVA), 두 그룹간 변화량 차이 분석을 위해 독립표본 t -검정(independence t -test)을 시행하였다. 결과 : 두 그룹 모두 COFFS의 총점이 향상되었다. 실험군은 아래턱 및 입술 움직임, 볼 부풀리기, 혀움직임에서 유의한 변화가 나타났다. 또한 저작 분포도, 음식물 유출, 고체형 및 액체형 음식 삼킴, 목소리 변화 항목에서 치료 기간에 따른 유의한 차이가 있었고, 아래턱 벌리고 닫기 항목에서 두 그룹사이에서 유의한 차이를 보였다. 결론 : OMFT가 뇌졸중으로 인한 연하장애 환자의 구강운동기능에 긍정적인 영향을 미치는 것으로 확인되었으며, 임상에서 기초적인 근거로 활용할 수 있을 것으로 기대된다.

Abstract

Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t -test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

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