Journal of The Korean Society of Integrative Medicine (대한통합의학회지)

Korean Society of Integrative Medicine (대한통합의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Gait Pattern in Hemiplegia Patients through Progressive Speed Increase Treadmill Training

점진적인 속도증진 트레드밀 훈련이 뇌졸중 환자의 보행패턴에 미치는 영향

  • 이형수 (광주보건대학교 물리치료과)
  • Received : 2013.12.28
  • Accepted : 2014.02.14
  • Published : 2014.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

연구목적 : 본 연구의 목적은 8주간의 점진적인 속도증진 훈련이 뇌졸중환자의 족저압, 보행주기, 보행대칭성에 어떠한 영향을 주는지 알아보는 것이다. 연구방법 : 연구에 참여한 대상자들은 뇌졸중으로 진단 받고 N병원에 입원한 편마비환자 20명(실험군 10명, 대조군 10명)을 대상으로 하였다. 이들은 모두 물리치료와 작업치료를 받았고, 실험군은 주3회, 8주간의 트레드밀 보행훈련를 받았고, 대조군은 받지 않았다. 실험전, 후에 F-scan을 이용하여 보행주기, 보행대칭성을 검사하였다. 연구결과 : 8주 후, 보행주기는 실험군의 양하지지지기 I II, 단하지지지기에서 모두 유의하게 증가하였으나, 대조군에서는 양하지지지기 II, 단하지지지기에서 유의하게 증가하였다. 유각기는 실험군과 대조군 모두 유의하지는 않았다. 보행대칭성은 입각기 대칭성에서 대조군과 비교하여 실험군에서 유의하게 증가하였으나, 유각기 대칭성은 실험군과 대조군 모두 유의하지 않았다. 결론 : 뇌졸중 환자에 있어 보행훈련은 보행주기과 보행대칭성과 를 개선시키며, 특히 점진적인 속도 증진훈련은 양하지지지기, 단하지지지기, 입각기 보행대칭성에 효과적인 방법으로 사용될 수 있을 것으로 보인다.

Keywords

References

  1. Armstrong DM(1986). Supraspinal contributions to the initiation and control of locomotion in the cat. Prog Neurobiol, 26(4), 273-361. https://doi.org/10.1016/0301-0082(86)90021-3
  2. Asanuma H, Keller A(1991). Neurobiological basis of motor learning and memory. Concepts Neuroscience, 2, 1-30.
  3. Atrice M, Gonter M, Griffin D, et al(1995). Traumatic spinal cord injury. In: Umphred D, (Ed.). Neurological Rehabilitation. St Louis, Mosby Co.
  4. Barbeau H, Rossignol S(1987). Recovery of locomotion after chronic spinalization in the adult cat. Brain Res, 412(1), 84-95. https://doi.org/10.1016/0006-8993(87)91442-9
  5. Basso DM(1998). Neuroplasticity of descending and segmental systems after spinal cord contusion. Neurol Report, 2, 48-53.
  6. Craik RL, Dutterer L(1995). Spatial and temporal characteristics of foot fall patterns. In: Craik RL, Oatis CA (Eds.). Gait analysis: theory and application. St Louis, Mosby-Year Book.
  7. Dietz V, Colombo G, Jensen L(1994). Locomotor activity in spinal man. Lancet, 344(8932), 1260-1263. https://doi.org/10.1016/S0140-6736(94)90751-X
  8. Dobkin BH(1999). An overview of treadmill locomotor training with partial body weight support: a neurophysiologically sound approach whose time has come for randomized clinical trials. Neurorehabil Neural Repair, 13(3), 157-166. https://doi.org/10.1177/154596839901300301
  9. Dewald JPA(1987). Sensorimotor neurophysiology and the basis of neurofascilitation therapeutic techniques. In: Brandstater ME, Basmajian JV, (Eds.). Stroke Rehabilitation. 1st (Ed.). Baltimore, Williams & Wilkins.
  10. Finger S(1988). Brain injury and recovery theoretical and controversial issues. New York, Plenum Press.
  11. Hesse S, Bertelt C, Jahnke MT, et al(1995). Treadmill training with partial body weight support compared with physiotherapy in nonambulatory hemiparetic patients. Stroke, 26(6), 976-981. https://doi.org/10.1161/01.STR.26.6.976
  12. Hesse S, Bertelt C, Schaffrin A, et al(1994). Restoration of gait in nonambulatory hemiparetic patients by treadmill training with partial body-weight support. Arch Phys Med Rehabil, 75(10), 1087-1093. https://doi.org/10.1016/0003-9993(94)90083-3
  13. Hesse S(1999). Treadmill training with partial body weight support in hemiparetic patients-further research needed. Neurorehabil Neural Repair, 13(3), 179-182. https://doi.org/10.1177/154596839901300306
  14. Harkema SJ, Hurley SL, Patel UK, et al(1997). Human lumbosacral spinal cord interprets loading during stepping. J Neurophysiol, 77(2), 797-811. https://doi.org/10.1152/jn.1997.77.2.797
  15. Kidd G, Musa I, Lawes N(1992). Understanding neuromuscular plasticity. London, Edward Arnold.
  16. Kwakkel G, Wagenaar RC, Twisk JW, et al(1999). Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomized trial. Lancet, 354(9174), 191-196. https://doi.org/10.1016/S0140-6736(98)09477-X
  17. Liston R, Mickelborough J, Harris B, et al(2000). Conventional physiotherapy and treadmill re-training for higher-level gait disorders in cerebrovascular disease. Age Ageing, 29(4), 311-318. https://doi.org/10.1093/ageing/29.4.311
  18. Lovely RG, Gregor RJ, Roy RR, et al(1986). Effect of training on the recovery of full-weight bearing stepping in the adult spinal cat. Exp Neurol, 92, 421-435. https://doi.org/10.1016/0014-4886(86)90094-4
  19. Macko RF, DeSouza CA, Tretter LD, et al(1997). Treadmill aerobic exercise training reduces the energy expenditure and cardiovascular demands of hemiparetic gait in chronic stroke patients. A preliminary report. Stroke, 28(2), 326-330. https://doi.org/10.1161/01.STR.28.2.326
  20. Mayr A, Kofler M, Quirbach E, et al(2007). Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis. Neurorehabil Neural Repair, 21(4), 307-314. https://doi.org/10.1177/1545968307300697
  21. Nutt JG, Marsden CD, Thompson PD(1993). Human walking and higher-level gait disorders, particularly in the elderly. Neurol, 43(2), 268-279. https://doi.org/10.1212/WNL.43.2.268
  22. Patel UK, Dobkin BH, Edgerton VR, et al(1998). The response of neural locomotor circuits to changes in gait velocity (abstract). Soc Neurosci, 24, 2104.
  23. Pohl M, Mehrholz J, Ritschel C, et al(2002). Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: A randomized controlled trial. Stroke, 33(2), 553-558. https://doi.org/10.1161/hs0202.102365
  24. Richards CL, Malouin F, Wood-Dauphinee S, et al(1993). Task-specific physical therapy for optimizaton of gait recovery in acute stroke patients. Arch Phys Med Rehabil, 74(6), 612-620. https://doi.org/10.1016/0003-9993(93)90159-8
  25. Rossignol S, Barbeau H, Julien C(1986). Locomotion of the adult chronic spinal cat and its modification by plasticity of the Mammalian Spinal Cord. Spoleto, Italy: Springer-Verlag.
  26. Somers MF(1992). Spinal cord injury: functional rehabilitation. Norwalk, Conn: Appleton & Lange.
  27. Smith JL, Smith LA, Zernicke RF, et al(1982). Locomotion in exercised and nonexercised cats cordotomized at two and twelve weeks of age. Exp Neurol, 76(2), 393-413. https://doi.org/10.1016/0014-4886(82)90217-5
  28. Smith GV, Silver KH, Goldberg AP, et al(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
  29. Visintin M, Barbeau H(1989). The effects of body weight support on the locomotor pattern of spastic paretic patients. Can J Neurol Sci, 16(3), 315-325. https://doi.org/10.1017/S0317167100029152
  30. Visintin M, Barbeau H, Korner-Bitensky N, et al(1998). A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke, 29(6), 1122-1128. https://doi.org/10.1161/01.STR.29.6.1122
  31. Werner C, Bardeleben A, Mauritz KH, et al(2002). Treadmill training with partial body weight support and physiotherapy in stroke patients: a preliminary comparison. Eur J Neurol, 9(6), 639-644. https://doi.org/10.1046/j.1468-1331.2002.00492.x
  32. Wernig A, Muller S(1992). Laufband locomotion with body weight support improved walking in persons with severe spinal cord injuries. Paraplegia, 30(4), 229-238. https://doi.org/10.1038/sc.1992.61

Cited by

  1. The Effect of Treadmill Gait Training in an Adjusted Position from Functional Training System on Chronic Stroke Patients' Walking and Balance Ability vol.12, pp.1, 2017, https://doi.org/10.13066/kspm.2017.12.1.35