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소뇌질환 환자들의 운동기능 회복을 위한 재활운동 원리와 전략

Strategy and Principle of Rehabilitation for Functional Motor Recovery in Patients with Cerebellar Disease

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초록

퇴행성 신경계 뇌질환 환자들의 재활운동은 환자들의 독립적인 일상생활 영위와 삶의 질 향상을 위해서 필수적이며 중요하다. 소뇌는 다양한 신체감각 정보 처리를 통해 신체의 조화로운 협응 움직임, 안정적인 자세 및 균형 유지 그리고 동작의 사전 계획 및 실행과 운동기술의 학습에 중요한 역할을 한다. 퇴행성 뇌질환 중 하나인 소뇌손상 및 위축은 균형 및 보행능력의 퇴보를 야기하여 소뇌질환 환자들의 최소한의 삶을 영위하는데 많은 어려움을 유발시키고 있다. 뇌졸중 및 파킨슨병 환자들의 운동기능 회복을위한 재활운동의 효과성은 널리 확인되고 있지만 이와 달리 소뇌질환 환자들을 위한 효과적인 재활운동방법과 그 효과성에 대한 연구는 상대적으로 최근에서야 수행되고 있으며, 체계적으로 정립되지 않아, 환자들에게 재활운동과 관련된 유용한 정보를 제공하지 못하고 있다. 이로 인해 질환에 적합하지 않은재활운동을 함으로써 그 효과성이 상대적으로 미흡하게 나타나거나, 재활운동과 관련된 운동지침이나 가이드라인을 제시하지 못하고 있다. 이 논문에서는 소뇌질환 환자들의 재활운동의 효과와 관련된 선행연구들의 결과를 살펴보고, 이를 토대로 환자들의 균형과 보행능력 향상과 회복을 돕기 위한 재활운동 기법에 대해서 제시하였다. 구체적으로 효과적인 재활운동을 위한 7가지 전략을 제시하여 각 단계별에 맞춰서 훈련 내용을 설명하였으며, 실제 사례에서 적용된 운동질환 증상 단계별에 맞는 운동유형을 소개하였다. 이러한 재활운동 방법은 향후 소뇌질환 환자들의 운동기능 회복을 위한 중요한 지침이 될 수 있을것으로 기대된다.

Abstract

Cerebellum receives and integrates proprioceptive input from all parts of the body and plays an important role in the estimation of sensory consequences of motor commands. Clinical studies show that it contributes to the upper and lower coordination, balance and walking. Since the degenerative cerebellar disease is progressive and movement disorders are mostly accompanied by impaired balance and walking, the rehabilitation training is necessary for the patients who suffer from cerebellar disease in order to prevent degeneration of motor function required in a daily life. However, there is limited evidence that whether rehabilitation training improves motor functions of the patients. The purpose of this review paper was to explore of guideline and strategy for the patients with cerebellar disease on the rehabilitation. We provide 7 training strategies to improve on the balance and functional walking and how to apply for the patients such as stage of disease. This results will be able to offer the useful information to research, and patients will be provided information to the management and rehabilitation exercise.

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