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관념운동실행증의 이해: 신경학적 원인을 중심으로

The Understanding of The Ideomotor Apraxia: Focusing on The Neurological Causes

이주현|박진혁|신수정
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2015.01|재활치료과학 (Therapeutic Science for Rehabilitation)|제4권 제1호|pp. 19-28

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원인관념운동실행증실행 모델

초록

서론 : 실행증과 관련된 신경학적 손상에 대한 이해는 병변 부위에 따른 증상을 예측하고 적절한 치료와 목표를 구성하는데 기반이 될 수 있다. 따라서 본 연구는 문헌고찰을 통하여 관념운동실행증의 원인과 행동 오류의 기전을알아보고, 이와 더불어 치료에 이용될 수 있는 근거를 제시하고자 한다. 본론 : 실행의 모델에서 알 수 있듯이 관념운동실행증은 실행 시스템에서 생산적 측면만의 손상으로 발생할 수 있으며 신경학적 부위는 피질하 손상보다는 피질 수준의 손상이 더 흔하다. 제스쳐를 통한 연구에 따르면 팔의 동작과관련하여서는 왼쪽 두정엽, 손가락 자세에 따른 동작은 전두엽의 기능과 관련이 있다. 실제 물체를 사용함으로써얻어질 수 있는 시각, 촉각의 자극들은 익숙한 동작에 대한 기억과는 별도로 올바른 동작을 유도시킬 수 있다. 결론 : 실행은 다양한 신경학적 부위의 처리 과정을 통해 일어나며 다양한 외부의 자극들이 실행에 도움을 줄 수 있음으로 관념운동실행증의 치료에는 이러한 자극들을 이용하는 것이 필요할 것이다.

Abstract

Introduction : The Understanding of neurological lesion relating to apraxia will help to predict symptoms according to a lesion and to establish a proper treatment and goal. So, This study will explain causes and mechanism of a movement error of ideomotor apraxia through literature review and also will suggest the evidence using in treatment. Body : Ideomotor apraxia may occur a damage of the production part in praxis system, and is common in damage of a cortex rater than damage of a subcortex. According to study with gesture, movement of upper limbs is relate of left parietal lobe but finger movement is relate of frontal lobe. The visual and tactile stimulation through using real objects could guide into proper movement aside from memory of a skilled action. Conclusion : Praxis can occur through diverse neurological processing and various external stimulations can help praxis processing. Therefore, the treatment of ideomotor apraxia need to use this stimulations.

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