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Effects of Dual-task Training on Chronic Stroke Patients' Balance and Upper Extremity Function

이중과제 훈련이 만성기 뇌졸중 환자의 균형 및 상지기능에 미치는 영향

  • 박주형 (경북전문대학교 작업치료과) ;
  • 김덕주 (청주대학교 작업치료학과)
  • Received : 2016.08.17
  • Accepted : 2016.09.19
  • Published : 2016.10.28

Abstract

The aim of this study was to investigate the effects of dual-task training on balance and upper extremity function with chronic stroke. For seventeen persons with chronic stroke, we executed dual-task training for 4 weeks, five times per week, and 30 minutes each time. Before and after the dual-task training, the patients were tested with Berg Balance Scale(BBS) and BTS FreeEMG 300(BTS FreeEMG 300, BTS, Italy). After the dual-task training, the subjects showed significant changes in the score of BBS(p<.05). And, the subjects' shoulder and elbow movement had negative values of change after the intervention, indicating that there was a positive change. The results of this study show that dual-task training for persons with chronic stroke is a useful therapeutic approach by enhancing the their quality of life through improving balance and upper extremity function.

Keywords

Stroke;Balance;Upper Extremity Function;Muscle Activity

References

  1. K. L. Reed, Quick Reference to occupational therapy, Aspen Publishers Inc, 1991.
  2. F. R. Horak, "Clinical assissment of balance disorders," Gait & posture, Vol.6, pp.79-84, 1997.
  3. S. G. Kirker, J. R. Jenner, and D. S. Simpson, "Changing patterns of postural hip muscle activity during recovery from stroke," Clinical Rehabilitation, Vol.14, No.5, pp.618-626, 2000. https://doi.org/10.1191/0269215500cr370oa
  4. 정미정, 뇌졸중 환자의 일상생활동작 수행정도의 삶의 질, 경희대학교, 석사학위논문, 2000.
  5. C. G. Canning, L. Ada, and E. Woodhouse, "Miltiple-task walking training in people with mild to moderate Parkinson's disease: A pilot study," Clinical Rehabilitation, Vol.22, No.3, pp.226-233, 2008. https://doi.org/10.1177/0269215507082341
  6. G. L. Pellecchia, "Dual-task training reduces impact of cognitive task on postural sway," Journal of motor behavior, Vol.37, No.3, pp.239-246, 2005. https://doi.org/10.3200/JMBR.37.3.239-246
  7. 이예진, 정민예, "뇌졸중 환자에게 적용한 이중과제 훈련이 미치는 효과에 대한 체계적 고찰," 신경재활치료과학, 제5권, 제1호, pp.27-36, 2016.
  8. Y. R. Yang, R. Y. Wang, Y. C. Chen, and M. J. Kao, "Dual-task exercise improves walking ability in chronic stroke: A randomized controlled trial, Archives of physical medicine and rehabilitation," Vol.88, No.10, pp.1236-1240, 2007. https://doi.org/10.1016/j.apmr.2007.06.762
  9. K. I. Erickson, S. J. Colcombe, R. Wadhwa, L. Bherer, M. S. Peterson, P. E. Scalf, J. S. Kim, M. Alvarado, and A. F. Kramer, "Training-induced functional activation changes in dual-task processing: An FMRI study," Cerebral Cortex, Vol.17, No.1, pp.192-204, 2007.
  10. A. Bowen, R. Wenman, J. Mickelborough, J. Foster, E. Hill, and R. Tallis, "Dual-task effects of talking while on velocity and balance following a stroke," Ages Ageing, Vol.30, No.4, pp.319-323, 2001. https://doi.org/10.1093/ageing/30.4.319
  11. J. Muhaidat, D. A. Skelton, A. Kerr, J. J. Evans, and C. Ballinger, "182 are we using the right dual tasks to detect mobility problems? perspectives from older people," Gait & Mental Function, Vol.16, No.1, pp.852-853, 2010.
  12. I. Melzer, I. Tzedek, M. Or, G. Shvarth, O. Nizri, K. Ben-Shitrit, and L. E. Oddsson, "Speed of voluntary stepping in chronic stroke survivors under single- and dual-task conditions: a case-control study," Archives of physical medicine and rehabilitation, Vol.90, No.6, pp.927-933, 2009. https://doi.org/10.1016/j.apmr.2008.12.012
  13. P. Silsupadol, V. Lugade, A. Shumway-Cook, P. van Donkelaar, L. S. Chou, U. Mayr, and M. H. Woollacott, "Training-related chages in dual-task walking performance of elderly persons with balance impairment: a double-blind randomized controlled trial," Gait Posture, Vol.9, No.4, pp.634-639, 2009.
  14. 박해균, 이중과제 운동이 뇌졸중 환자의 체간조절능력과 균형에 미치는 영향, 삼육대학교, 석사학위논문, 2011.
  15. 김여진, 뇌졸중 환자의 이중과제 균형 훈련이 균형과 일상생화동작에 미치는 영향, 대구대학교, 석사학위논문, 2009.
  16. 이재한, 앉은 자세에서의 이중운동과제 훈련이 만성 뇌졸중 환자의 체간 조절 능력과 균형에 미치는 효과, 삼육대학교, 석사학위논문, 2011.
  17. 장연식, 백지영, 오명화, 이성아, "이중과제수행이 뇌졸중 환자의 체간조절능력과 상지기능에 미치는 효과," 재활복지, 제16권, 제2호, pp.311-331, 2012.
  18. M. F. Folstein, S. E. Folstein, and P. R McHugh, "Mini-mental state: A practical method for grading the cognitive state of patients for the clinician," J Psychiatric research, Vol.12, No.3, pp.189-198, 1975. https://doi.org/10.1016/0022-3956(75)90026-6
  19. 권용철, 박종한, "노인용 한국판 Mini-Mental State Examination(MMSE-K)의 표준화 연구," 신경정신의학, 제28권, 제1호, pp.125-135, 1989.
  20. K. O. Berg, S. L. Wood-Dauphinee, and J. I. Williams, "Measuring balance in elderly: Preliminary development of an instrument," Physiotherapy (Canada), Vol.41, pp.304-311, 1989. https://doi.org/10.3138/ptc.41.6.304
  21. L. D. Bogle Thorbahn and R. A. Newton, "Use of the Berg balance test to predict falls in elderly persons," Physical Therapy, Vol.76, Vol.6, pp.576-583, 1996. https://doi.org/10.1093/ptj/76.6.576
  22. F. Molteni, A. Caimmi, A. Cazzaniga, G. Gasperini, E. Giandomenico, and C. Giovanzana, "Using surface dynamic electromyography during upper extremity robotic training," Europa Medicaphysica. Vol.44, No.3, pp.1-3, 2008.
  23. M. E. Busse, C. M. Wiles, and R. W. van Deursen, "Muscle co-activation in neurological conditions," Physical Therapy Reviews, Vol.10, No.4, pp.247-253, 2005. https://doi.org/10.1179/108331905X78915
  24. C. M. Dean, L. R. Carol, and M. Fransine, "Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial," Physical Therapy, Vol.81, No.4, pp.409-417, 2000.
  25. J. J. Lee, H. J. Lee, J. H. Park, E. Y. Han, M. J. Kim, and H. Y. Jung, "The Korean version of berg balance scale as an index of activity related to ambulation in subjects with stroke," Journal of Korean Academy of Rehabilitation Medicine, Vol.31, No.4, pp.400-403, 2007.
  26. 최재호, 이중과제훈련이 급성뇌졸중 환자의 균형에 미치는 영향, 단국대학교, 석사학위논문, 2009.
  27. 지상구, 남기원, 김명권, "운동 이중 과제 훈련이 아급성기 뇌졸중 환자의 균형 및 보행에 미치는 효과," 특수교육재활과학연구, 제51권, 제3호, pp.331-345, 2012.
  28. 김경, 김진섭, 오덕원, "뇌졸중으로 인한 편마비환자의 하지와 상지 기능향상을 위한 상상연습의 임상적 효과에 대한 체계적 고찰," 특수교육재활과학연구, 제49권, 제4호, pp.201-220, 2010.
  29. 정민예, 전혜선, 박흥석, 최문석, 김정란, 유은영, "편마비 환자의 강제유도운동치료가 편측 상지의 운동 형상학적 변수에 미치는 효과 분석," 대한작업치료학회지, 제15권, 제1호, pp.67-80, 2007.
  30. H. E. J. Veeger, D. J. Magermans, J. Nagels, E. K. J. Chadwick, and F. C. T. van der Helm, "A kinematical analysis of the shoulder after arthroplasty during a hair combing task," Clinical Biomechanics, Vol.21, pp.39-44, 2006. https://doi.org/10.1016/j.clinbiomech.2005.09.012
  31. 황규연, 씨름 샅바 잡기유형별 상지의 근전도 분석, 중앙대학교, 석사학위논문, 2006.
  32. H. Ma and C. A. Trombly, "Effects of task complexity on reaction time and movement kinematics in elderly people," American Journal of Occupational Therapy, Vol.58, No.2, pp.150-158, 2004. https://doi.org/10.5014/ajot.58.2.150
  33. J. E. Cooper, E. Shwedyk, A. O. Quanbury, J. Miller, and D. Hidebrand, "Elbow joint restriction: effect on functional upper limb motion during performance of three feeding activities," Archives of Physical Medicine and Rehabilitation, Vol.74, No.8, pp.805-809, 1993. https://doi.org/10.1016/0003-9993(93)90005-U