뇌성마비 환자와 조력자의 협업 재활 운동을 위한 원격 운동 시스템 UX 디자인 연구

안수진 ( Sujin An ),유승헌 ( Seung Hun Yoo ) 디자인융복합학회 2024 디자인융복합연구 Vol.23 No.4

재활 운동은 환자들의 운동 능력 향상뿐 아니라, 삶의 질 향상에도 의의를 두어 중요성이 강조된다. 이때 중증 뇌성마비 환자는 조력자의 도움이 필수적이며, 심적·신체적으로 많은 영향을 주고받기 때문에 양측 모두에 대한 고려가 중요하다. 하지만 두 참여자 모두를 고려한 서비스 및 시스템은 매우 부족한 실정이며, 이에 본 연구는 두 참여자의 협업 재활 운동을 위한 원격 시스템의 UX 디자인을 탐구하고, 시스템을 도출 및 제안하는 것을 목적으로 한다. 연구 방법은 첫째, 뇌성마비 환자와 조력자의 특성, 재활 운동의 필요성과 현존하는 원격 재활 운동 시스템의 현황을 파악하였다. 둘째, 원격 재활 운동 서비스 사용 행태와 사용자별 특성 파악을 위해 사용자조사 및 분석을 진행하였다. 셋째, 구체적인 UX 디자인 요소 개발을 위해 앞선 조사 내용에 기반하여 프로그램 요소를 도출 및 개발하였다. 넷째, 기존 디자인과 개발 디자인을 구분하여 사용자테스트를 진행하고, 사후인터뷰를 통해 검증 결과를 도출하였다. 연구 결과, 연구 결과를 반영한 개발 디자인이 모든 항목에서 높은 점수가 확인되었으며, 본 연구에서 제시한 결과는 향후 다양한 재활 운동 서비스 개발에 활용될 수 있을 것으로 기대된다. Rehabilitation exercises are emphasized for their importance in improving patients' physical abilities and quality of life. This is crucial for severe cerebral palsy patients requiring caregiver support due to the significant mutual mental and physical influence, necessitating consideration for both parties. However, services and systems catering to both are significantly lacking. This study aims to explore the UX design of a remote system for collaborative rehabilitation exercises for these patients and their caregivers, aiming to propose such a system. The research method involved understanding the characteristics of cerebral palsy patients and caregivers, the need for rehabilitation exercises, and the current state of existing remote rehabilitation systems. Secondly, a user survey and analysis were conducted to grasp the usage patterns of remote rehabilitation services and the characteristics and needs of users. Thirdly, based on the information from previous surveys, program elements were developed for specific UX design elements. Fourthly, user testing was conducted to differentiate between the existing and developed designs, with final verification results obtained through post-interviews. The developed design, informed by the research findings, scored higher in all aspects than the existing design. The outcomes of this study are expected to be utilized in developing future rehabilitation exercise services.

Intravenous Patient-controlled Analgesia for Postoperative Pain Management in Patients with Cerebral Palsy

Won Joan Yoo(유원준),Chin Youb Chung(정진엽),In Ho Choi(최인호),Tae-Joon Cho(조태준),Joon O Lee(이준오),Hee-Soo Kim(김희수),Chong Sung Kim(김종성) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.5

목적: 뇌성마비 환자에서 fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법(intravenous patient-controlled analgesia) 의 수술 후 통증 조절에 대한 안전성과 효용성을 평가하고자 하였다. 대상 및 방법: 60명의 환자를 대상으로 수술의 복잡성에 따라 대 수술과 소 수술로 나누어 두 군으로 분류하였고 각 군을 수술 후 통증 조절 방법에 따라 fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법을 사용한 군과 pethidine정맥 주사를 사용한 군으로 세분하였다. 통증의 강도는 Wong-Baker’s faces pain scale에 따라 평가하였다. 결과: 대 수술군에서는 경정맥 자가 통증 치료법을 사용한 환자군에서 pethidine을 사용한 환자군보다 유의한 통증의 감소가 있었고 소 수술군에서는 경정맥 자가 통증 치료법을 사용한 환자군과 pethidine을 사용한 환자군 사이에 유의한 통증 감소 효과의 차이는 없었다. Fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법과 pethidine정맥 주사 요법에 따른 부작용은 큰 차이를 보이지 않았다. 결론: Fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법은 뇌성마비 소아 환자에서 수술 후 중등도 이상의 통증 조절에 있어 안전하고 효과적이다. Purpose: The purpose of this study was to evaluate the safety and efficacy of intravenous patient-controlled analgesia (PCA) with fentanyl and ketorolac for postoperative pain management in patients with cerebral palsy. Materials and Methods: Sixty patients were categorized based on operation complexity into either a minor operation group or a major operation group, and then subdivided based on the analgesic methods used, i.e., intravenous PCA with fentanyl and ketorolac or intravenous pethidine injection. Pain intensity was assessed using the Wong-Baker's faces pain scale. Results: In the major operation group, patients that received PCA had significantly lower pain scores than those who received intravenous pethidine injection, while no significant differences in pain scores were observed in the minor operation group. Moreover, the side effects of these two analgesic methods did not differ significantly. Conclusion: Intravenous PCA with fentanyl and ketorolac is effective and safe for moderate to severe postoperative pain control in pediatric patients with cerebral palsy.

Medial Lemniscus Lesion in Pediatric Hemiplegic Patients without Corticospinal Tract and Posterior Thalamic Radiation Lesion

Jung, Yong Jae,Jang, Sung Ho,Yeo, Sang Seok,Lee, Eunsil,Kim, Saeyoon,Lee, Dong Gyu,Kim, Han Sun,Son, Su Min S. Karger AG 2012 European neurology Vol.67 No.4

<P>Abstract</P><P><I>Objectives:</I> Using diffusion tensor imaging (DTI), we investigated the state of medial lemniscus (ML), corticospinal tract (CST), and posterior thalamic radiation (PTR), which were expected as probable reasons for clinical hemiplegia in pediatric patients, especially those who showed impaired fine motor control and proprioception, but no definite motor weakness or spasticity. <I>Methods:</I> We recruited 13 hemiplegic patients and 8 age-matched healthy control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for the bilateral ML, CST, and PTR were calculated and compared between the affected hemisphere of the patient (AP), the unaffected hemisphere of the patient (UP), and the mean value of the bilateral hemispheres in control subjects (MC). <I>Results:</I> FA and ADC values for the CST and PTR did not differ significantly between the AP, UP, and MC subgroups (p > 0.05). However, the FA value for the ML in AP showed a significant decrease, compared with that in UP (p = 0.012) and MC (p = 0.047). DTT for the CST and PTR showed preserved integrity and ML in the UP also had continuity to the cortex; however, ML in AP showed disruption. <I>Conclusions:</I> Using DTI, we demonstrated that the ML lesion might be related to clinical hemiplegia in pediatric patients.</P><P>Copyright © 2012 S. Karger AG, Basel</P>

2010년 주요 의료 판결 분석

이정선,서영현,유현정 대한의료법학회 2011 의료법학 Vol.12 No.1

Verdicts related to major medical litigation given by the Seoul Central District Court, the Seoul High Court and the Supreme Court in 2010 were analyzed. It’s shown that in cases of the medical negligence regarding the occurrence of neonatal cerebral palsy, the plaintiff claims were dismissed using criteria proposed by associations of Obstetrics and Gynecology and Pediatrics in US, and thereof the burden of plaintiffs to prove the medical negligence has increased. In addition, in case of that the expected survival period of infants gets longer, payments for treatment and nursing after survival period determined by judges are made and it was judged to compensate it as a periodical indemnity. In case for the explanation obligation the most frequently mentioned in the medical litigation, in addition to cases of invoking the existing theory of explanation obligation, verdicts to mention the instructions of theory regarding instruction explanation obligation and the possibility of compensation for damages on property are given. Particularly, in cases for a liability of reparation by exaggerating the effects and not disclosing the risks related to treatment with stem cells, even if the treatment not approved by Food and Drug Administration is in violation of the Pharmaceutical Affairs Law, it’s not illegal as violation in Pharmaceutical Affairs Law itself. But there is a certain verdict to present the possibility of an extension of the theory of explanation obligation by acknowledging the liability of reparation caused by illegal acts with no explanations of effects and risks of treatment with stem cell by doctors and pharmaceutical companies. In an incident in which a mental patient fell and died through the opened door of the roof at the hospital, a liability of reparation was acknowledged due to defects in structure installation management and this verdict drew an attention since the overall management responsibility about patients including structures was acknowledged to the hospital besides the obligations on medical practice. In case of the verdict without giving the opportunity to state the opinion with respect to the main legal issues, the responsibility of the court was emphasized since the court did not fulfill the explanation obligations. There were some cases in which payments for nursing and caring to a patient in vegetative state during the plastic surgery was admitted. However, in dental-related incidents, the proportion of cases in which plaintiff won was low since the difficulty of proving may be reflected. In the area of administrative litigation, unlike the existing position regarding arbitrary medical charge cover collected from patients in hospital, the verdict to admit the legitimacy of collection of medical treatment was given and attracted the attention of people. Verdict in which the expression related to medical advertisement was not exaggerated disposed the original verdict and pointed out the problem of excessive regulations on medical advertisement. The effort to analyze the trend of verdicts of court through reviewing the decisions and to organize should be continued, but the full decision should be disclosed as a base, and people and systems to enable the all time monitoring should be prepared.

모우 : 뇌성마비 장애인의 구강운동을 돕는 모바일 어플리케이션

이호정(Hojung Lee),박은미(Eunmee Park),전벼리(Byeori Jeon),이진선(Jinseon Lee),이유나(Youna Lee),윤재영(Jae Young Yun) 한국디자인학회 2020 한국디자인학회 학술발표대회 논문집 Vol.2020 No.6