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대한물리의학회지 = Journal of the korean society of physical medicine, v.14 no.3, 2019년, pp.91 - 107
이제욱 (대구대학교 재활산업학과) , 황보각 (대구대학교 물리치료학과)
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PURPOSE: This study examined the effects of breathing exercise in the water on the pulmonary function and maximum phonation time in children with cerebral palsy. METHODS: The subjects were 24 children with cerebral palsy at GMFCS levels I-III, who were allocated randomly to either the aquatic breath...
| 핵심어 | 질문 | 논문에서 추출한 답변 |
|---|---|---|
| 뇌성마비는 무엇인가? | 뇌성마비는 태아 혹은 영아에서 비진행성 뇌손상으로 인한 신경학적 증상을 유발하는 질환으로 감각, 인지, 의사소통, 지각, 행동장애 및 경련 등으로 인한 기능적 활동과 일상생활의 제한을 초래하는 대표적인 소아질환이다[1]. 의학의 발전으로 주산기 의료적 관리가 발달하고 제왕절개를 통한 분만이 증가함에 따라 분만과정에서 발생할 수 있는 손상의 위험이 감소하고 정상분만하는 경우가 많아졌으나 조산과 초저체중아로 출생하는 뇌성마비 고위험군의 생존율이 증가하고 있다. | |
| 뇌성마비로 인한 증상은 무엇인가? | 뇌성마비는 비정상적인 사지의 근력이나 조절과 반사, 근긴장도 이상, 비대칭적 자세변형, 비정상적인 흔들림, 균형장애 등이 나타나고, 이러한 기능적 장애가 영구적인 장애를 초래하여 운동조절의 어려움을 유발한다[3]. 이러한 운동장애는 보행과 같은 기능적 활동의 제한뿐 아니라, 비정상적인 호흡패턴을 유발하거나[4], 호흡기능의 어려움과 호흡기계 감염률, 사망률을 높이게 된다. | |
| 뇌성마비 아동의 호흡기능 향상을 위한 수중운동이 가진 수중환경의 특성들의 장점은 무엇인가? | 수중운동은 뇌성마비 아동의 호흡기능을 향상하기 위한 중재 방법의 하나로 지상에서의 중재 방법이 가진 제한 점을 보완하고 부력, 점성, 수온, 정수압과 같은 수중환경의 특성으로 뇌성마비 재활에 유용하게 사용될 수 있다[13]. 부력은 참여자의 근육과 관절에 중력부담을 덜어주며 부상 및 통증을 예방하는 장점이 있다[14]. 물의 높은 밀도는 몸 전체에 저항을 부여함으로써 근지구력과 신체에너지 소비량을 증가시키고[15] 수온은 중추신경계 손상이 있을 때 나타나는 과긴장이나 경직을 감소하거나 이완시킨다[16]. 정수압은 외부수용기와 고유수용기를 광범위하게 자극하고 호흡근뿐만 아니라 폐와 다른 내장기관에 압력을 증가시킨다[17,18]. 정수압의 영향을 가장 많이 받는 것은 복부이며, 복부가수압에 의해 압박을 받게 되면 내장이 가로막을 눌러 저절로 가로막 호흡이 촉진되는데 무의식적으로 숨을 쉬는 깊은 호흡을 하게 됨으로써 호흡과 관련된 근의 저항을 유도하여 폐기능의 향상을 가져온다[19]. 또한 수중에서 수행 가능한 엎드려 뜨고 일어서기, 잠수하기, 수영과 같은 여러 활동들은 호흡조절과 같은 선행훈련이 필수적으로 이루어져야 하고 이러한 훈련들은 폐활량을 증가시킨다. 이처럼 수중운동은 전신운동으로 심폐기관 발달, 근긴장 완화와 근지구력 발달, 균형감각과 안정성 증진에 효과적이고[20,21] 뇌성마비 아동에게 심리적 안정과 새로운 경험에 대한 흥미를 유발해 오랜 시간 운동에 적극적으로 참여할 수 있게 한다[22]. |
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