일상생활 동작 중심 거울치료를 적용한 뇌졸중 환자의 상지 기능 회복 -증례보고- (The Effect of Mirror Therapy focused on Activities of daily living on Recovery of Upper Limb Function and Strength in Acute Hemiplegia after Stroke -Case Report-)

서지정보

· 발행기관 : 임상인체동작과학회
· 수록지 정보 : 임상인체동작과학회지 / 17권 / 1호 / 25 ~ 37페이지
· 저자명 : 하치심, 최희진, 김현정, 손미남, 유동엽, 권보영, 김은경, 정민우

초록

Background and Purpose The aim of this study was to determine the effect of Mirror therapy focused on activities of daily living on recovery of motor function of upper limb and on the changes of corticospinal excitability in acute hemiplegia after stoke. Subjects and Methods The 2 subjects(2 males) were patients with stroke. Subjects(onset <6 months, K MMSE >24) received mirror therapy focused on activities of daily living for 30 minutes after each treatment, additionally with the traditional rehabilitation programs, 5 days per week for 4 weeks. Some activities of mirror therapy were selected with consideration for interests and experiences of the subjects. To measure the improvement of motor function of upper limb, we performed Fugl Meyer assessment(FMA), manual function test(MFT), Jamar strength test and pinch force test for each sessions. And before and after the 4 weeks intervention, Motor Evoked Potential(MEP)s of the Abductor Digit Minimi(ADM) of affected upper limb were obtained by the repetitive Transcranial Magnetic Stimulation (rTMS) to investigate the changes of corticospinal excitability. Results The 2 subjects showed significant improvements in FMA, MFT, Jamar strength test and Pinch force test. One subject showed the response at the reassessment, compared to ‘no response’ at the initial assessment, although that is ‘prolonged’ latency and ‘low’ amplitude. The other showed increased MEP amplitude compared to initial assessment. Conclusions Mirror therapy focused on activities of daily living can be used as an adjuvant therapeutic technique by improving motor function of upper limb and facilitating of corticospinal excitability for acute hemiplegia. Further individual studies of mirror therapy focused on activities of daily living should be conducted in order to generalize the effects.

영어초록

Background and Purpose The aim of this study was to determine the effect of Mirror therapy focused on activities of daily living on recovery of motor function of upper limb and on the changes of corticospinal excitability in acute hemiplegia after stoke. Subjects and Methods The 2 subjects(2 males) were patients with stroke. Subjects(onset <6 months, K MMSE >24) received mirror therapy focused on activities of daily living for 30 minutes after each treatment, additionally with the traditional rehabilitation programs, 5 days per week for 4 weeks. Some activities of mirror therapy were selected with consideration for interests and experiences of the subjects. To measure the improvement of motor function of upper limb, we performed Fugl Meyer assessment(FMA), manual function test(MFT), Jamar strength test and pinch force test for each sessions. And before and after the 4 weeks intervention, Motor Evoked Potential(MEP)s of the Abductor Digit Minimi(ADM) of affected upper limb were obtained by the repetitive Transcranial Magnetic Stimulation (rTMS) to investigate the changes of corticospinal excitability. Results The 2 subjects showed significant improvements in FMA, MFT, Jamar strength test and Pinch force test. One subject showed the response at the reassessment, compared to ‘no response’ at the initial assessment, although that is ‘prolonged’ latency and ‘low’ amplitude. The other showed increased MEP amplitude compared to initial assessment. Conclusions Mirror therapy focused on activities of daily living can be used as an adjuvant therapeutic technique by improving motor function of upper limb and facilitating of corticospinal excitability for acute hemiplegia. Further individual studies of mirror therapy focused on activities of daily living should be conducted in order to generalize the effects.

참고자료

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