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손가락 타판과제를 통한 편측 뇌손상 환자의 동측운동결함 분석

Analysis of Ipsilateral Motor Deficits during Finger Tapping Task in Patients with Unilateral Brain Damage

권용현|최진호
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2005.12|특수교육재활과학연구|제44권 제4호|pp. 195-213

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키워드

동측운동결함손가락 타판과제편측 뇌손상ipsilateral motor deficitfinger tapping taskunilateral brain damage논문접수 : 2005. 11. 5 / 수정본 접수 : 2005. 12. 9 / 게재 승인 : 2005. 12. 14
주제분류기타사회과학

초록

최근 편측 뇌손상 환자는 기본적이고 단순한 운동, 시공간적 협응 운동, 숙련된 기민성 운동과 같은 다양한 운동과제를 수행하는 동안 동측 손에서 운동결함이 보고되고 있다. 그러나 실행증, 반대측 상지의 장애정도, 발병 후 기간 등의 많은 임상적 변수에 의해 시지를 이용한 길항반복운동의 실험적 설계에서 동측운동결함은 아직까지 명확하지 않다.본 연구의 목적은 편측 뇌손상 환자 34명(오른쪽 뇌손상 17명, 왼쪽 뇌손상 17명)을 대상으로 동측 시지를 이용한 타판과제를 수행하는 동안 동측 운동결함을 환자군의 연령과 성별이 일치하는 정상군 34명과 비교하여 관찰하였다. 모든 연구대상자는 시작 명령과 함께 시지만 버튼에 닫도록 하여 15초 동안 가능한 빠르게 타판하도록 하였다. 사전 연습은 3번 실시하였고, 실제 측정은 3번 실시하여 타판의 횟수, 타판간 간격의 표준편차의 평균을 측정분석하였다.본 연구결과 편측 뇌손상 환자는 타판과제를 수행하는 동안 최대타판횟수가 감소되었고, 타판간 간격의 일관성이 떨어졌으며, 특히 왼쪽 뇌손상 환자에서 동측 손가락의 운동결함이 심하게 나타났다. 그러므로 양쪽 손 운동을 실행하는데 필요한 운동조절과정에서 왼쪽 대뇌반구가 중요한 역할을 하는 것으로 사료된다.

Abstract

Several investigations has been recently reported the impaired movement of the hand ipsilateral to a unilateral brain lesion in variety of motor tasks, such as basic simple movement, visuospatial coordinated movement and skilled dexterity. However, the ipsilateral motor deficit remained unclear in experimental design of diadochokinetic movement through index finger tapping, owing to numbers of clinical variables such as apraxia, severity of contralateral upper extremity, time after onset day. A major aim of the present study was to investigate ipsilateral index finger tapping in patients with right hemisphere damage(n=17) and left hemisphere damage(n=17) comparing with the sex-age matched normal subjects(n=34). All subjects was instructed to tap the button as soon as possible during 15 seconds. We analysed the maximal tapping number and the standard deviation of intertap interval which was considered as the typical rapid-simple repetitive movement. Findings revealed that stroke patients with unilateral brain lesion show lower maximal tapping number and lack consistency of intertap interval during tapping task. Especially patients with left hemisphere damage showed more impairment of ipsilateral finger movement with both dependent variables. In view of these results, we speculate that left hemisphere has a important contribution to the processing of motor control that is necessary for execution of both hand movement.

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