Effects of a Tilting Training Program on Lower Extremities Function, Depression, and Self-efficacy among Stroke Inpatients

기대기 훈련프로그램이 뇌졸중 입원환자의 하지 기능, 우울 및 자기효능감에 미치는 효과

  • Published : 2006.06.01

Abstract

Purpose: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. Method: The subjects were 60'stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, $\chi^2-test$, and t-test using the SPSS/Win 10.0 computerized program. Result: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. Conclusion: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.

Keywords

References

  1. Ada, L., Goddard, E., McCully, J., Stavrinos, T., & Bampton, J. (2005). Thirty minutes of positioning reduces the development of shoulder external rotation contracture after stroke: a randomized controlled trial. Arch Phys Med Rehabil, 86, 230-234 https://doi.org/10.1016/j.apmr.2004.02.031
  2. Bandura, A. A. (1977). Self-efficacy toward a unifying theory of behavioral change. Psychol Review, 84, 191-215 https://doi.org/10.1037/0033-295X.84.2.191
  3. Beck, A. T. (1974). The development of depression, a cognitive model: the psychology of depression: contemporary theory and research. New York: John Wiely & Sons
  4. Bobath, B. (1990). Adult hemiplegia : evaluation and treatment. 3rd ed., London, Heinemann Medical Books
  5. Bohannon, R. W. (1991). Strength deficits also predict gait performance in patients with stroke. Percept Mot Skills, 73(1), 146 https://doi.org/10.2466/PMS.73.4.146-146
  6. Cho, B. H. (2001). The effect of a multidisciplinary team approach on the rehabilitation of stroke survivors. Doctoral dissertation, Catholic University, Seoul
  7. Cho, G. H., Lee, S. M., & Woo, Y. K. (2004). The effects of a task-related circuits program on functional improvements in stroke patients. KAUTPT, 11(3), 59-70
  8. DeLisa, J., Gans, B., & Bockeneck, W. L. (1999). Rehabilitation Medicine Principles and Practice. Hagerstown : Lippincott, Williams, & Wilkins
  9. Dobrovolny, C. L., Ivey, F. M., Rogers, M. A., Sorkin, J. D., & Macko, R. F. (2003). Reliability of treadmill exercise testing in older patients with chronic hemiparetic stroke. Arch Phys Med Rehabil, 84, 1308-1312 https://doi.org/10.1016/S0003-9993(03)00150-3
  10. Duncan, P., Richards, L., Wallace, D., Stoker-Yates, J., Pohl, P., Luchies, C., Ogle, A., & Studenski, S. (1998). A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke, 29(10), 2055-2060 https://doi.org/10.1161/01.STR.29.10.2055
  11. Friedman, P. J. (1991). Gait recovery after hemiplegic stroke. Int Disabil Studies, 12, 119-122
  12. Geurts, A. C. H., Haart, M., van Nes, I. J. W., & Duysens, J. (2005). A review of standing balance recovery from stroke. Gait Posture, 22, 267-281 https://doi.org/10.1016/j.gaitpost.2004.10.002
  13. Ham, M. Y. (2001). An effects of individualized early rehabilitation education program for patients acute ischemic cerebrovascular disease. Doctoral dissertation, Chungang University, Seoul
  14. Hesses, S., Reiter, F., Jahnke, M., Dawson, M., Sarkodie-Gyan, T., & Mauritz, K. H. (1997). Asymmetry of gait initiation in hemiparetic stroke subjects. Arch Phys Med Rehabil, 78, 719-724 https://doi.org/10.1016/S0003-9993(97)90079-4
  15. Hodgson, C. (1998). Prevalence and disabilities of community-living seniors who report the effects of stroke. Can Med Assoc J, 159, suppl 9-14
  16. Kim, C. J. (1995). The effects of exercise therapy applied in an efficacy expectation promoting program on self-efficacy and metabolism. Unpublished master's thesis, Yonsei University, Seoul
  17. Kim, C. M., Eng, J. J., MacIntyre, D. L., & Dawson, A. S. (2001). Effects of isokinetic strength training on walking in persons with stroke : a double-blind controlled pilot study. J Stroke Cerebrovasc Dis, 10(6), 265-273 https://doi.org/10.1053/jscd.2001.123775
  18. Kim, K. S., Seo, H. M., Kim, E. J., Jeong, I. S., Choe, E. J., & Jeong, S. I. (2000). Effects of 5 weeks self-help management program on reducing repression and promoting activity of daily livings, grasping power, hope and self-efficacy. Korean J Rehabil Nurs, 3(2), 196-211
  19. MacKay-Lyons, M. J., & Makrides, L. (2002). Exercise capacity early after stroke. Arch Phys Med Rehabil, 83, 1697-1702 https://doi.org/10.1053/apmr.2002.36395
  20. Moreland, J. D., Goldsmith, C. H., Huijbregts, M. P., Anderson, R. E., Prentice, D. M., Brunton, K. B., O'Brien, M. A., & Torresin, W. D. (2003). Progressive resistance strengthening exercise after stroke: a single-blind randomized controlled trial. Arch Phys Med Rehabil, 84, 1433-1440 https://doi.org/10.1016/S0003-9993(03)00360-5
  21. Radloff, L. S. (1977). The CES-D scale : a self-report depression scale for research in the general population. J Appl Psychol Measurement, 1, 385-401 https://doi.org/10.1177/014662167700100306
  22. Robinson-Smith, G., Johnston, M. V., & Allen, J. (2000). Self care self-efficacy, quality of life, and depression after stroke. Arch Phys Med Rehabil, 81, 460-464 https://doi.org/10.1053/mr.2000.3863
  23. Rodriquez, A. A., Black, P. O., & Kile, K. A. (1996). Gait training efficacy using a home-based practice model in chronic hemiplegia. Arch Phys Med Rehabil, 77, 801-805 https://doi.org/10.1016/S0003-9993(96)90260-9
  24. Salbach, N. M., Mayo, N. E., Robichaud-Ekstrand, S., Hanley, J. A., Richards, C. L., & Wood-Dauphinee, S. (2005). The effects of a task-oriented walking intervention on improving balance self-efficacy poststroke: a randomized controlled trial. J Am Geriatr Soc, 53, 576-582 https://doi.org/10.1111/j.1532-5415.2005.53203.x
  25. Shaughnessy, M., Resnick, B. M., & Macko, R. F. (2004). Reliability and validity testing of the short self-efficacy and outcome expectation for exercise scales in stroke survivors. J Stroke Cerebrovasc Dis, 13(5), 214-219 https://doi.org/10.1016/j.jstrokecerebrovasdis.2004.07.002
  26. Sherer, M., Maddux, J. E., Mercandnte, B., Prentice-Dinn, S., Jacobs, B., & Rogers, R. W. (1982). The self-efficacy scale: construction and validation. Psychol Rep, 51, 663-671 https://doi.org/10.2466/pr0.1982.51.2.663
  27. Smith, G. V., Silver, K. H. C., Goldberg, A. P., & Macko, R. F. (1999). 'Task-oriented' exercise improves hamstring strength and spastic reflexes in chronic stroke patients. Stroke, 30(10), 2112-2118 https://doi.org/10.1161/01.STR.30.10.2112
  28. Song, K. H., & Park, H. S. (2001). The effect of exercise for activity of daily living and depression in stroke patients. Korean J Rehab Nurs, 4(2), 146-154
  29. Suh, Y. O. (1999). Effects of rehabilitation program on functional recovery in stroke patients. J Korean Acad Nurs, 29(3), 665-678 https://doi.org/10.4040/jkan.1999.29.3.665
  30. Wade, D., Wood, V., Heller, A., Magges, J., & Hewer, R. L. (1987). Walking after stroke. Scand J Rehabil Med, 19, 25-30