뇌성마비 아동의 쓰기, 읽기, 칠판보기, 식사하기 활동에 따른 착석 압력 변화 분석
The Analysis of Seating Pressure Changes in Writing, Reading, Blackboard Viewing, and Eating Activities of Children with Cerebral Palsy
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본 연구는 뇌성마비 아동이 학교에서 앉은 자세로 수행하는 활동(쓰기, 읽기, 칠판 보기, 식사하기) 중 자세 변화와 착석 압력 간의 관계를 분석하여, 효과적인 자세 관리 방안을 제시하고자 하였다. D재활의원에서 치료 중인 경직형 뇌성마비 아동 34명(양하지 마비 16명, 우측 편마비 9명, 좌측 편마비 7명, 사지마비 2명)을 대상으로 하였다. 착석압력 측정 장비(XSENSOR)를 사용하여 각 활동별 평균압력, 최대압력, 접촉면적을 측정하였으며, SPSS 25 프로그램을 이용해 반복측정 분산분석을 실시하였다. 모든 측정 변수에서 쓰기 활동이 가장 낮은 값을, 칠판보기가 가장 높은 값을 보였다(p<0.01). 구체적으로 평균압력은 쓰기 활동에서 38.1±4.5 mmHg, 칠판보기에서 41.7±5.2 mmHg로 나타났으며, 최대압력은 쓰기 활동에서 170.3±68.1 mmHg, 칠판보기에서 203.8±62.2 mmHg였다. 접촉면적 역시 쓰기 활동에서 897.9±235.7 in², 칠판보기에서 943.6±248.0 in²로 측정되었다. 2D 이미지 분석 결과, 동적 활동에서는 압력 분산이 효과적으로 이루어진 반면, 정적 활동에서는 압력이 특정 부위에 집중되는 경향을 보였다. 본 연구는 일상적 학습 활동을 통한 뇌성마비 아동의 착석 압력 관리 가능성을 입증하였다. 동적 활동에서의 효과적인 압력 분산은 교육 현장에서 다양한 동적 활동이 통합된 프로그램의 필요성을 시사하며, 이는 학교, 치료 현장, 가정에서 쉽게 적용할 수 있는 실천적 중재 방안으로 활용될 수 있다.
Abstract
This study aimed to analyze the relationship between postural changes and seating pressure during school activities (writing, reading, blackboard viewing, and eating) in children with cerebral palsy to suggest effective posture management strategies. The study included thirty-four children with spastic cerebral palsy (sixteen with diplegia, nine with right hemiplegia, seven with left hemiplegia, and two with quadriplegia) receiving treatment at D rehabilitation clinic. Average pressure, peak pressure, and contact area were measured using XSENSOR pressure mapping equipment, and repeated measures ANOVA was performed using the SPSS 25 program. All measured variables showed the lowest values during writing activities and the highest values during blackboard viewing (p<0.01). Specifically, the average pressure was 38.1±4.5 mmHg during writing and 41.7±5.2 mmHg during blackboard viewing, while peak pressure was 170.3±68.1 mmHg during writing and 203.8±62.2 mmHg during blackboard viewing. Contact area was also measured at 897.9±235.7 in² during writing and 943.6±248.0 in² during blackboard viewing. An analysis of 2D images revealed effective pressure distribution during dynamic activities, while pressure tended to concentrate in specific areas during static activities. This study demonstrated that seating pressure in children with cerebral palsy can be effectively managed through routine learning activities. The effective pressure distribution during dynamic activities suggests the need for educational programs that incorporate various dynamic activities, which can be practically implemented in schools, clinical settings, and homes.
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