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발렌버그 증후군(Wallenberg’s Syndrome) 환자에게 적용한 구강운동촉진기술(OMFT)과 신경근전기자극치료(Neuromusclular Electrical Stimulation; NMES) 효과: 단일 사례 연구

Effect of Oral Motor Facilitation Technique (OMFT) and Neuromuscular Electrical Stimulation (NMES) Applied to a Patient With Wallenberg’s Syndrome: A Case Study

민경철|우희순|손영수
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2022.11|재활치료과학 (Therapeutic Science for Rehabilitation)|제11권 제4호|pp. 69-83|DOI https://doi.org/10.22683/tsnr.2022.11.4.069

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키워드

뇌졸중StrokeDysphagia연하장애구강운동촉진기술발렌버그 증후군신경근전기자극치료Neuromuscular electrical stimulationOral motor facilitation techniqueWallenberg syndrome

초록

목적 : 본 연구는 발렌버그 증후군 환자에게 적용한 구강운동촉진기술(OMFT) 프로토콜과 신경근전기자극치료(NMES)의 임상 적용 효과의 가능성을 확인하고자 하였다. 연구방법 : 발렌버그 증후군 환자 1명을 대상으로 OMFT와 NMES를 4주 동안 주 5일, 1일 2회로 각각40회씩 적용하였다. 중재 전․후의 변화를 비교하기 위해 포괄적 구강안면기능척도(COFFS), 한국판Mann 삼킴 능력 평가(K-MASA), 침습-흡인 척도(PAS)를 사용하여 평가하였다. 자료 분석은 중재 전·후의점수 변화를 비교하였다. 결과 : 본 연구에 참여한 대상자에게 중재 전․후로 구강안면기능과 삼킴능력이 향상되었다. 구강운동기능 중 혀 운동에 비교적 많은 기능적 호전이 나타났으며, 인두기 삼킴이 가능해지는 정도로 평가되었고, VFSS를 통한 PAS 평가에서도 5점으로 증상의 개선이 관찰되었다. 결론 : 체계적인 OMFT와 운동강도의 NMES를 적용한 초기 연하재활치료는 구강 운동 기능과 연하장애개선에 가능성을 확인하였다. 향후 OMFT와 NMES를 적용한 중재의 효과에 대한 보완 연구가 필요할것이다.

Abstract

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

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