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NTIS 바로가기Therapeutic science for rehabilitation = 재활치료과학, v.8 no.4, 2019년, pp.7 - 18
김선호 (원주 영광 병원 작업치료실)
Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and Dec...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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tDCS의 장점은 무엇인가? | ,2009; Stagg & Nitsche, 2011). tDCS는 자극 부위가 넓어 국소자극이 어렵지만, 이동이 간편하고 장비 가격이 저렴하며 소음이 적고 통증이나 불편감이 적은 장점이 있어 최근 임상에서 흔히 사용되고 있다(Jo et al.,2009). | |
강제유도운동치료의 원리는? | 뇌졸중 발병 이후 자발적인 신체 기능의 회복은 뇌안에서 신경가소성의 변화에 의하게 되는데, 재활 훈련 중 하나인 강제유도운동치료(constraint-induced movementtherapy; CIMT)는 건측의 제한을 통해 동측 대뇌반구의 흥분성을 억제 시키고, 환측의 집중적인 과제훈련을 통해 손상 측 대뇌반구의 흥분성을 증가시키는 원리를 바탕으로 임상에서 시행되고 있으며(Liepert,2000), 많은 연구를 통해 대뇌피질의 활동성 변화와 더불어 상지 기능의 회복을 보고하고 있다 (Brunneret al., 2012; Hammer & Lindmark, 2009). | |
경두개 직류 자극의 긍정적인 영향은 무엇인가? | tDCS는 비침습적 뇌 자극기법으로 자극 부위에서 직접적으로는 전위의 흥분성을 변화시키고, 간접적으로 반대편 대뇌에 일치하는 부위에서의 흥분성을 변화시켜 대뇌피질의 신경가소성을 변화를 유도하여 환측의 운동기능에 긍정적인 영향을 준다(Nowak et al.,2009; Stagg & Nitsche, 2011). |
Andrade, S. M., Batista, L. M., Nogueira, L. L. R. F., de Oliveira, E. A., de Carvalho, A. G. C, Lima, S. S., ... Fernandez-Calvo, B. (2017). Constraint-induced movement therapy combined with transcranial direct current stimulation over premotor cortex improves motor function in severe stroke: A pilot randomized controlled trial. Rehabilitation Research and Practice, 1-9. doi: 10.1155/2017/6842549
Ateia, A., Talat, W., Nawito, A., & Elkafrawy, N. (2017). Effect of transcranial direct current stimulation on upper extremity functional recovery in stroke patients. Journal of Advanced Pharmacy Education & Research, 7(4), 486-490.
Bashir, S., & Yoo, W. K. (2013). Cheap technology like transcrinal direct current stimulation (tDCS) could help in stroke rehabilitation in south Asia. Basic Clinical Neuroscience, 4(3), 188-189.
Boggio, P. S., Castro, L. O., Savagim, E. A., Braite, R., Cruz, V. C., Rocha, R. R., ... Fregni, F. (2006). Enhancement of non-dominant hand motor function by andal transctanial direct current stimulation. Neuroscience Letters, 404(1), 232-236. doi: 10.1016/j.neulet.2006.05.051
Boggio, P. S., Nunes, A., Rigonatti, S. P., Nitsche, M. A,, Pascual-Leone, A., & Fregni, F. (2007). Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. Restorative Neurology and Neuroscience, 25(2), 123-129.
Bolognini, N., Vallar, G., Casati, C, Latif, L. A., El-Nazer1, R., Williams, J., ... Fregni, F. (2011). Neurophysiological and behavioral effects of tDCS combined with constraint-induced movement therapy in post stroke patients. Neurorehabilitation and Neural Repair, 25(9), 819-829. doi: 10.1177/1545968311411056.
Brem, A. K., Unterburger, E., Speight, I., & Jancke, L. (2014). Treatment of visuos patial neglect with biparietal tDCS and cognitive training: A single-case study. Frontiers in Systems Neuroscience, 8(180), 1-9. doi: 10.3389/fnsys.2014.00180
Brunner, I., Skouen, J., & Strand, L. (2012). Is modified constraint induced movement therapy more effective than bimanual training in improving arm motor function in the subacute phase post stroke? A randomized controlled trial. Clinical Rehabilitation, 26(12), 1078-1086. doi: 10.1177/0269215512443138
Butts, R. J., Kolar, M. B., & Newman-Norlund, R. D. (2014). Enhanced motor skill acquisition in the non-dominant upper extremity using intermittent theta burst stimulation and transcranial direct current stimulation. Frontiers in Human Neuroscience, 8(451), 1-9. doi: 10.3389/fnhum.2014.00451.
de Aguiar, V., Paolazzi, C. L., & Miceli, G. (2015). tDCS in post-stroke aphasia: Therole of stimulation parameters, behavioral treatment and patient characteristics. Cortex, 63C, 296-316. doi:10.1016/j.cortex.2014.08.015.
de Morton, N. A. (2009). The PEDro scale is a valid measure of the methodological quality of clinical trials: A demographic study. Australian Journal of Physiotherapy, 55(2), 129-133, doi: 10.1016/S0004-9514(09)70043-1
Figlewski, K., Blicher, J. U., Mortensen, J., Severinsen, K. E., Nielsen, J. F., & Andersen, H. (2017). Transcranial direct current stimulation potentiates improvements in functional ability in patients with chronic stroke receiving constraint-induced movement therapy. Stroke, 48(1), 229-232. doi: 10.1161/STROKEAHA.116.014988
Hammer, A. M., & Lindmark, B. (2009). Effects of forced use on arm function in the subacute phase after stroke: A randomized, clinical pilot study. Physical Therapy, 89(6), 526-539. doi:10.2522/ptj.20080017
Hummel, F., Celnik, P., Giraux, P., Floel, A., Wu, W. H., Gerloff, C., & Cohen, L. G. (2005). Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain, 128(3), 490-499. doi: 10.1093/brain/awh369
Jo, J. M., Kim, Y. H., Ko, M. H., Ohn, S. H., Joen, B., & Lee, K. H. (2009). Enhancing the working memory of stroke patients using tDCS. American Journal of Physical Medicine & Rehabilitation, 88(5), 404-409. doi: 10.1097/PHM.0b013e3181a0e4cb.
Liepert, J., Bauder, H., Wolfgang, H. R., Miltner, W. H, Taub, E., & Weiller, C. (2000). Treatment-induced cortical reorganization after stroke in humans. Stroke, 31(6), 1210-1216. doi:10.1161/01.STR.31.6.1210
Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A., ... Pascual-Leone, A. (2008). Transcranial direct current stimulation: State of the art 2008. Brain Stimulation, 1(3), 206-223. doi:10.1016/j.brs.2008.06.004.
Nowak, D. A., Grefkes, C., Ameli, M., & Fink, G. R. (2009). Interhemispheric competition after stroke: Brain stimulation to enhance recovery of function of affected hand. Neurorehabilitation and Neural Repair, 23(7), 641-656. doi: 10.1177/1545968309336661
Page, S. J., Sisto, S., Johnston, M. V., & Levine, P. (2002). Modified constraintinduced therapy after subacute stroke: A preliminary study. Neurorehabilitation and Neural Repair, 16(3), 290-295. doi: 10.1177/154596830201600307
Peurala, S. H., Kantanen, M. P., Sjogren, T., Paltamaa, J., Karhula, M., & Heinonen, A. (2012). Effectiveness of constraint-induced movement therapy on activity and participation after stroke: A systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 26(3), 209-223. doi:10.1177/0269215511420306
Rocha, S., Silva, E., Foerster, A., Wiesiolek, C., Chagas, P. A., Machado, G., ... Monte-Silva, K. (2016). The impact of transcranial direct current stimulation (tDCS) combined with modified constraint-induced movement therapy (mCIMT) on upper limb function in chronic stroke: A double blind randomized controlled trial. Disability and Rehabilitation, 38(7), 653-660. doi: 10.3109/09638288.2015.1055382.
Rushworth, M. F., Johansen-Berg, H., Gobel, S. M., & Devlin, J. T. (2003). The left parietal and premotor cortices: Motor attention and selection. Neuroimage, 20(l1), 89-100.
Sawaki, L., Wu, C. W., Kaelin-Lang, A., & Cohen, L. G. (2006). Effects of somatosensory stimulationon use-dependent plasticity in chronic stroke. Stroke, 37(1), 246-247. doiI: 10.1161/01.STR.0000195130.16843.ac
Schlaug, G., Renga, V., & Nair, D. (2008). Transcranial direct current stimulation in stroke recovery. Archives of Neurology, 65(12), 1571-1576.
Stagg, C. J., & Nitsche, M. A. (2011). Physiological basis of transcranial direct current stimulation. Neuroscientist, 17(1), 37-53. doi: 10.1177/10738584103 86614
Takebayashi1, T., Takahashi, K., Moriwaki, M., Sakamoto, T., & Domen, K. (2017). Improvement of upper extremity deficit after constraint-induced movement therapy combined with and without preconditioning stimulation using dual-hemisphere transcranial direct current stimulation and peripheral neuromuscular stimulation in chronic stroke patients: A pilot randomized controlled trial. Frontiers in Neurology, 8(568), 1-8. doi: 10.3389/fneur.2017.00568.
Uy, J., & Ridding, M. C. (2003). Increased cortical excitability induced by transcranial DC and peripheral nerve stimulation. Journal of Neuroscience Methods, 127(2), 93-97. doi:10.1016/S0165-0270(03)00142-0
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