동적 신경근 안정화 접근법과 결합한 PNF 중재 프로그램이 소뇌 위축 환자의 균형에 미치는 영향 - 사례보고 -
Effects of Proprioceptive Neuromuscular Facilitation Program Combined with Dynamic Neuromuscular Stabilization Approach on Balance in Patient with Cerebellum Atrophy - Case Report -
Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient’s balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.
목차
Abstract Ⅰ. 서론 Ⅱ. 연구 방법 1. 연구 대상 2. DNSA와 결합한 PNF 중재 프로그램 3. 측정 도구 및 방법 4. 자료 처리 Ⅲ. 연구 결과 1. 신체 기능과 구조 손상에 대한 평가 변화 2. 활동 제한에 대한 평가 변화 Ⅳ. 고찰 Ⅴ. 결론 References
학회를 방문 해 주셔서 감사 드립니다. 대한고유수용성신경근촉진법학회는 오래 전 부터 외국 강사를 초빙 하여 임상적지식을 보급하고, 학술적으로 연구 해 오든 중 1995년 11월11일 제주도에서 창립총회를 했습니다.
고유수용성신경근 촉진법(proprioceptive neuromuscular facilitation, PNF )은 물리치료사인 Margaret Knott 와 의사이며 신경생리학자인 Herman Kabat (1946-1951 )에 의해 고안 되었습니다. PNF 에는 환자 치료를 위한 철학과 치료기법을 포함하고 있습니다. 치료기법에는 운동학습, 운동조절, 운동행동, 생역학, 인지 등등을 고려한 중추신경계손상자를 위한 접근법과 근력강화, 관절가동범위증가, 지구력의증가, 통증 조절등의 정형외과 계열의 환자를 위한 모든 치료법을 포함하고 있습니다
기능 즉 인체의 모든 기관계의 조화로운 통합으로 이루어지는 기능을 향상 발전 시킬 수 있는 통합적 접근 기법입니다.
최근 WHO(2001)가 제정한 ICF( international classification of function )를 충족 할 수 있는 유일한 치료 접근법이라 할 수 있습니다. 많은 학술 연구자, 임상가들이 학회 발전에 참여하여 학문적, 임상적 풍요로움이 넘치는 학회가 될 수 있기를 기원합니다