경직성 뇌성마비아동의 상지기능 강화를 위한 치료적 악기연주활동

Abstract

본 연구는 뇌성마비 아동들의 잔존능력을 유지 및 강화시키고 사회적 적응능력을 높이고자 치료적 악기연주를 통하여 경직성 뇌성마비 아동의 상지기능을 강화하는데 있다. 본 프로그램은 2010년 9월 2일부터 2010년 11월 5일까지 서울 소재 J특수학교 학생 4명을 대상으로 주 2회 45분씩 11주간, 총 12회기의 음악치료로 진행되었다. 연구자는 단일대상 연구체계인 ABA 설계로 하였으며 조작적 정의에 따라 사례연구로 분석하였다. 진단평가세션에서는 4회기에 걸쳐 대상자들의 음악적 환경에 대한 적응 반응을 탐색하고 상지기능을 진단하였다. 도입단계에서는 3회기에 걸쳐 선호하는 음악과 악기사용을 통하여 친밀감 및 참여 동기를 형성하였다. 개입단계에서는 6회기기에 걸쳐 다양한 음악요소들을 사용하여 상지기능을 강화하였다. 종결단계에서는 3회기에 걸쳐 향상된 수준이 유지되는지 확인하였다. 대상자들을 면밀히 관찰하기 위해 매 세션마다 캠코더를 이용하여 아동들의 활동을 녹화하였다.;Recently, the survival number of premature infants and low-birth-weight infants are increasing due to advanced medical developments. However, 5 to 7% of the babies are born with Cerebral Palsy condition and 80% of them suffer from Spastic Cerebral Palsy. Due to extreme tension, the children suffering such condition are observed with less movements in their upper and lower body parts. This leads to more difficulties in active movements during their adult life causing them less social adaptation and involvement. Therefore, the main goal of the researcher was to motivate and reinforce residual ability of these children and to improve upper extremity functions in hand movements in order to promote their social adaptation skills. As a result, this paper aims to target and examine the effects of TIMP on upper extremity function in Spastic Cerebral Palsy conditioned children. The study was conducted for two months, twice of a week, 45 minutes with four Spastic Cerebral Palsy patients who were enrolled in J special school for handicapped children. In order to examine their upper extremity functions, the baseline measurements were held for two times and TIMP sessions took place 12 times. After the baseline measurements, improvement of voluntary involvement was encouraged by promoting motivation and constructing positive activities. Also, in order to reinforce strengthening practice, musical stimulation was conducted. During the last three sessions the researcher examined the improvement of the upper extremity function and finalized the outcome. The results of this research showed overall grasping function of 33% when using egg shakers which is 12.3% increase from the baseline measurement. The overall operating function when using tambourine proved to be 11.8 times which increased 4.8 times from the baseline measurement. Also, the average operating function with touch bell is 6.4 times which is 4.9 times more than the baseline measurement. When using wind-chime the average total reaching time is 10.5 seconds and this is shortened 17.1 seconds from the baseline measurement. The overall playing time is 7.3 seconds and the signs of extension is observed with 5.7 seconds increase from the baseline measurement. In conclusion, these following results obtained by using proffered music, instruments, syncopated rhythm, staccato, accents proved to be very effective on children with Spastic Cerebral Palsy. It is highly recommended that such music therapy programs are encouraged with the recognition of proper use and care of music and instruments when treating the children.