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뇌졸중 환자의 건측 상지 운동 제한 치료 시 중도 탈락과 치료 의욕의 중요성

The Importance of Motivation and Dropping Out from Treatment in Constraint-induced Movement Therapy for Stroke Patients

김경미|김형준|오선영|서지현|김승수|유연환|장순자|손미옥|최수원
대한재활의학회 (Korean Academy Of Rehabilitation Medicine)|2008.02|Annals of Rehabilitation Medicine|제32권 제1호|pp. 20-25

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참고문헌

키워드

StrokeHemiparesisCIMTArm function
주제분류재활의학

초록

Objective: To assess the effect of motivation for treatment and to find out causes of dropping out from treatment in performing the constraint-induced movement therapy (CIMT). Method: Forty six stroke patients were treated with CIMT for 2 weeks. Prior to and after treatment, Fugl-Meyer motor assessment (FMA), Wolf motor function test (WMFT), box and block test (BBT), and 9 hole peg test, motor activity log (MAL) were performed, and for the evaluation of treatment motivation, motivation score (MS) was assessed in 24 patients. Results: After 2 weeks of CIMT treatment, the mean value of FMA increased by 15.1%, WMFT by 19.5%, BBT by 35.8%, the time of 9 hole peg test decreased by 20.2%, and the “How well” sub-score of the increased MAL was 59.6% (p＜0.05). Larger improvement of FMA score was observed in patients with high MS (p＜0.05). Twelve out of 46 patients were dropped, 5 patients (18.5%) among 27 right side hemiplegic patients and 7 patients (38.9%) of 19 left side hemiplegic patients gave up the treatment in the middle, and the MS score of the quitted patients (35.3 point) was lower than that of patients who did not quit (40.5 point) (p＜0.05). Conclusion: After 2 weeks of CIMT treatment, larger improvement of movement capacity was observed in patients with high motivation. Among patients with low treatment motivation and old age, many patients were dropped out during CIMT.

Abstract

Objective: To assess the effect of motivation for treatment and to find out causes of dropping out from treatment in performing the constraint-induced movement therapy (CIMT). Method: Forty six stroke patients were treated with CIMT for 2 weeks. Prior to and after treatment, Fugl-Meyer motor assessment (FMA), Wolf motor function test (WMFT), box and block test (BBT), and 9 hole peg test, motor activity log (MAL) were performed, and for the evaluation of treatment motivation, motivation score (MS) was assessed in 24 patients. Results: After 2 weeks of CIMT treatment, the mean value of FMA increased by 15.1%, WMFT by 19.5%, BBT by 35.8%, the time of 9 hole peg test decreased by 20.2%, and the “How well” sub-score of the increased MAL was 59.6% (p＜0.05). Larger improvement of FMA score was observed in patients with high MS (p＜0.05). Twelve out of 46 patients were dropped, 5 patients (18.5%) among 27 right side hemiplegic patients and 7 patients (38.9%) of 19 left side hemiplegic patients gave up the treatment in the middle, and the MS score of the quitted patients (35.3 point) was lower than that of patients who did not quit (40.5 point) (p＜0.05). Conclusion: After 2 weeks of CIMT treatment, larger improvement of movement capacity was observed in patients with high motivation. Among patients with low treatment motivation and old age, many patients were dropped out during CIMT.

참고문헌 (26)

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