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고유수용성신경근 촉진법 훈련과 동작관찰 훈련이 뇌졸중 환자의 상지 운동기능에 미치는 효과: 단일사례 연구

Effect of Proprioceptive Neuromuscular Facilitation and Action Observation Training on Upper Extremity Motor Function in Stroke Patient: A Single-Subject Study

윤태원|이문규|박혜령
한국전문물리치료학회 (Korean Research Society of Physical Therapy)|2015.02|한국전문물리치료학회지 (Physical Therapy Korea)|제22권 제1호|pp. 69-78|DOI http://dx.doi.org/10.12674/ptk.2015.22.1.069

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키워드

StrokeProprioceptive neuromuscular facilitationAction observation trainingUpper extremity motor function.
주제분류물리치료학

초록

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A’) was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

Abstract

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A’) was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

참고문헌 (45)

  1. Adler SS, "PNF in Practice: An illustrated guide", pp.2~3 (2008), Springer
  2. Andersen LL, "Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: Implications for rehabilitation", Phys Ther, 86(5), pp.683~697 (2006)
  3. Aziz-Zadeh L, "Lateralization of the human mirror neuron system", J Neurosci, 26(11), pp.2964~2970 (2006)
  4. Bellelli G, "Action observation treatment improves recovery of postsurgical orthopedic patients: Evidence for a top-down effect? Arch Phys Med Rehabil", 91(10), pp.1489~1494 (2010)[DOI]
  5. Buccino G, "Action observation activates premotor and parietal areas in a somatotopic manner: An fMRI study", Eur J Neurosci, 13(2), pp.400~404 (2001)
  6. Buccino G, "role of the mirror neuron system in motor learning", Kinesiology, 38(1), pp.5~15 (2006)
  7. Buccino G, "Neural circuits underlying imitation learning of hand actions: An event-related fMRI study", Neuron, 42(2), pp.323~334 (2004)
  8. Celnik P, "Effects of action observation on physical training after stroke", Stroke, 39(6), pp.1814~1820 (2008)[DOI]
  9. Chae J, "Admission motor impairment as a predictor of physical disability after stroke rehabilitation.", Am J Phys Med Rehabil, 74(3), pp.218~223 (1995)
  10. 최종환, "부가적인 PNF와 웨이트트레이닝이 노인의 일상생활관련 신체적 기능과 슬관절 등속성 근기능에 미치는 영향", 한국체육학회지, 44(1), pp.693~701 (2005), 한국체육학회
  11. Dobkin BH, "Training and exercise to drive poststroke recovery", Nat Clin Pract Neurol, 4(2), pp.76~85 (2008)[DOI]
  12. Ertelt D, "Action observation has a positive impact on rehabilitation of motor deficits after stroke", Neuroimage, 36, pp.T164~T173 (2007)
  13. Ewan LM, "An observation-based intervention for stroke rehabilitation:Experiences of eight individuals affected by stroke", Disabil Rehabil, 32(25), pp.2097~2106 (2010)[DOI]
  14. Franceschini M, "Mirror neurons: Action observation treatment as a tool in stroke rehabilitation", Eur J Phys Rehabil Med, 46(4), pp.517~523 (2010)
  15. Gallese V, "Action recognition in the premotor cortex", Brain, 119(Pt 2), pp.593~609 (1996)
  16. Garrison KA, "The mirror neuron system: A neural substrate for methods in stroke rehabilitation", Neurorehabil Neural Repair, 24(5), pp.404~412 (2010)[DOI]
  17. Grafton ST, "Localization of grasp representations in humans by positron emission tomography. 2. Observation compared with imagination", Exp Brain Res, 112(1), pp.103~111 (1996)
  18. Haslinger B, "Transmodal sensorimotor networks during action observation in professional pianists", J Cogn Neurosci, 17(2), pp.282~293 (2005)
  19. Iacoboni M, "Grasping the intentions of others with one’s own mirror neuron system", PLoS Biol, 3(3), pp.e79~ (2005)
  20. Iacoboni M, "Cortical mechanisms of human imitation", Science, 286(5449), pp.2526~2528 (1999)
  21. Jette DU, "Physical therapy interventions for patients with stroke in inpatient rehabilitation facilities", Phys Ther, 85(3), pp.238~248 (2005)
  22. Jung HS, "Effect on muscle questionnaire of knee osteoarthritis with lower extremity patterns of the proprioceptive neuromuscular facilitation", Korean Soc Phys Med, 2(1), pp.21~30 (2007)
  23. Kawahira K, "Addition of intensive repetition of facilitation exercise to multidisciplinary rehabilitation promotes motor functional recovery of the hemiplegic lower limb", J Rehabil Med, 36(4), pp.159~164 (2004)
  24. 김대경, "고유수용성 신경근 촉진법에 의한 편마비 환자의 보행 및 계단 오르기 변화", 대한물리치료학회지, 11(3), pp.57~64 (1999), 대한물리치료학회
  25. 김종만, "동작관찰훈련이 뇌졸중 환자의 손 조작능력에 미치는 영향", 한국전문물리치료학회지, 17(2), pp.17~24 (2010), 한국전문물리치료학회
  26. 이문규, "동작관찰훈련이 뇌졸중 환자의 상지 기능에 미치는 영향", 한국전문물리치료학회지, 18(2), pp.27~34 (2011), 한국전문물리치료학회
  27. Maeda F, "Transcranial magnetic stimulation studies of the human mirror neuron system", International Congress Series, 1232, pp.889~894 (2002)
  28. Mathiowetz V, "Adult norms for the box and block test of manual dexterity", Am J Occup, 39(6), pp.386~391 (1985)
  29. Morris DM, "The reliability of the wolf motor function test for assessing upper extremity function after stroke", Arch Phys Med Rehabil, 82(6), pp.750~755 (2001)
  30. Muthukumaraswamy SD, "Mu rhythm modulation during observation of an object-directed grasp", Brain Res Cogn Brain Res, 19(2), pp.195~201 (2004)
  31. Oberman LM, "EEG evidence for mirror neuron dysfunction in autism spectrum disorders", Brain Res Cogn Brain Res, 24(2), pp.190~198 (2005)
  32. 박병규, "뇌졸중 환자의 상지 운동기능 회복양상", 대한뇌졸중학회지, 5(1), pp.89~95 (2003), 대한뇌졸중학회
  33. Pelosin E, "Action observation improves freezing of gait in patients with Parkinson’s disease", Neurorehabil Neural Repair, 24(8), pp.746~752 (2010)[DOI]
  34. Refshauge KM, "Science-Based Rehabilitation: Theories into practice", pp.1~3 (2005), Butterworth-Heinemann
  35. Rizzolatti G, "The mirror neuron system and its function in humans", Anat Embryol (Berl), 210(5-6), pp.419~421 (2005)
  36. Rizzolatti G, "The mirror-neuron system", Annu Rev Neurosci, 27, pp.169~192 (2004)
  37. Rizzolatti G, "Mirror neurons and their clinical relevance", Nat Clin Pract Neurol, 5(1), pp.24~34 (2009)[DOI]
  38. Rizzolatti G, "Premotor cortex and the recognition of motor actions", Brain Res Cogn Brain Res, 3(2), pp.131~141 (1996)
  39. 신영일, "PNF 패턴에 기초한 탄력밴드 훈련이 척수손상 환자의 상지 기능에 미치는 영향", 대한물리치료학회지, 16(3), pp.152~160 (2004), 대한물리치료학회
  40. Song MS., "A study on comparison of proprioceptive neuromuscular facilitation and general exercise in the treatment of frozen shoulder", The Journal of Korean Academy of Physical Therapist, 2(2), pp.487~494 (1995)
  41. Strafella AP, "Modulation of cortical excitability during action observation: A transcranial magnetic stimulation study", Neuroreport, 11(10), pp.2289~2292 (2000)
  42. Tremblay C, "Action observation and execution: Intracranial recordings in a human subject", Neurology, 63(5), pp.937~938 (2004)
  43. Umilta MA, "I know what you are doing. A neurophysiological study", Neuron, 31(1), pp.155~165 (2001)
  44. Wolf SL, "Assessing wolf motor function test as outcome measure for research in patients after stroke", Stroke, 32(7), pp.1635~1639 (2001)
  45. Wolf SL, "Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients", Exp Neurol, 104(2), pp.125~132 (1989)

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