The Journal of Korean Physical Therapy

  • 제26권5호
  • /
  • Pages.365-371
  • /
  • 2014
  • /
  • 1229-0475(pISSN)
  • /
  • 2287-156X(eISSN)
대한물리치료학회 (The Korean Society of Physical Therapy)
권호 표지

전정감각 자극훈련이 뇌졸중 환자의 균형과 보행에 미치는 영향

The Effects of Vestibular Sensory Stimulation Training on Balance and Gait in the Patients with Stroke

  • 정혜연 (대전대학교 보건의료대학원 물리치료학과) ;
  • 최종덕 (대전대학교 자연과학대학 물리치료학과)
  • Jeong, Hye-Yeon (Department of Physical Therapy, The Graduate School of Health and Medicine, Daejeon University) ;
  • Choi, Jong-Duk (Department of Physical Therapy, College of Natural Science, Daejeon University)
  • 투고 : 2014.09.15
  • 심사 : 2014.10.14
  • 발행 : 2014.10.25
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The aim of this study is to examine the effects of training in vestibular sensory stimulation on balance and gait of stroke patients. Methods: Twenty patients were randomly assigned to either the experimental group (n=10) or the control group (n=10). Patients in the experimental group received rotational stimulation training, vertical-horizontal stimulation training, gait training on a flat surface with vestibular sensory stimulation, and gait training on soft ground with vestibular sensory stimulation. Patients in the control group received general treadmill gait training. The intervention was applied four times per week, 25 minutes each time, for a period of four weeks. We measured Berg Balance Scale (BBS), Biodex Balance System, Timed up to Go (TUG) test and Dynamic Gait Index (DGI) to evaluate balance and gait ability. Results: BBS differed significantly in both groups between before and after the intervention (p<0.05) and changes in BBS after the intervention differed between the two groups (p<0.05). According to the Biodex Balance System test result, only the experimental group showed significant changes in balance in the conditions of static eyes open (SEC), dynamic eyes open (DEO), and dynamic eyes closed (DEC) (p<0.05). TUG test results differed significantly between prior to and after the training in both the experimental group and the control group (p<0.05) and changes in TUG after the intervention differed significantly between the two groups (p<0.05). DGI results showed significant change after the intervention in the experimental group only (P<0.05). Conclusion: Training in vestibular sensory stimulation was effective in improving static-dynamic balance and gait ability of stroke patients.

키워드

참고문헌

  1. Lee MS, Lee JH, Park SK et al. The effect of ankle joint taping applied to patients with hemiplegia on their gait velocity and joint angles. J Korean Soc Phys Ther. 2012;24(2):157-62.
  2. Jung JH, Kim JH. Correlation between bilateral reciprocal leg press test and The balance in chronic stroke patient. J Korean Soc Phys Ther. 2013;25(4):180-6.
  3. Jung MS, Park JW. The relationship between balance test and fear of falling in community dwelling elderly. J Korean Soc Phys Ther. 2012;24(1):23-8.
  4. Tyson SF, Hanley M, Chillala J et al. Balance disability after stroke. Phys Ther. 2006;86(1):30.
  5. Song BK. Effect of somatosensory stimulation on upper limb in sensory, hand function, postural control and ADLs within sensorimotor deficits after stroke. J Korean Soc Phys Ther. 2012;24(5):291-9.
  6. Kim MG, Kim JH, Park JW. The effect of turning training on figure of 8 tract on stroke patients' balance and walking. J Korean Soc Phys Ther. 2012;24(2):143-50.
  7. Maurer C, Schweigrat G, Mergner T. Pronounced over estimation of support surface tilt during stance. Exp Brain Res. 2006;168(12):4150.
  8. Keenan MA, Perry J, Jordan C. Factors affecting balance and ambulation following stroke. Clin Orthop. 1984;182:165-71.
  9. Kim JH. Relationship between gait symmetry and functional balance, walking performance in subjects with stroke. J Korean Soc Phys Ther. 2014;26(1):1-8.
  10. Bonan IV, Colle FM, Guichard JP et al. Reliance on visual information after stroke. part I: balance on dynamic posturography. Arch Phys Med Rehabil. 2004;85(2):268-73. https://doi.org/10.1016/j.apmr.2003.06.017
  11. Ayres AJ. Sensory integration dysfunction: test score constellations. part II of a final project report. sensory integration international, 1986.
  12. Rhee CK. Vestibular rehabilitation. Korean Academy of Audiology. 2010;6(1):1-9.
  13. Yelnik AP, Kassouha A, Bonan IV et al. Post Korean Academy of Audiology ural visual dependence after recent stroke: Assessment by optokinetic stimulation. Gait Posture. 2006;24(3):262-9. https://doi.org/10.1016/j.gaitpost.2005.09.007
  14. Ayres, Jean A. Sensory integration and the child. Seoul, koonja, 2006:115.
  15. Nashner LM, Black FO, Wall C. Adaptation to altered support and visual conditions during stance: patients with vestibular deficits. J Neurosci. 1982;2(5):536-44.
  16. Noh SL. A restructured vestibular.proprioceptive sensation training program for cerebral palsied gait function and its effects. Daegu University. Dissertation of Master's Degree. 1999.
  17. Park MO. The effects of vestibular stimulation training on balance for the children with cerebral palsy. Dankook University. Dissertation of Master's Degree. 2009.
  18. Herdman SJ. Exercise strategies in vestibular disorder. Ear Nose throat J. 1990;68(12):961-4.
  19. Hirsch MA, Toole T, Maitland CG et al. The effects of balance training and high-intensity resistance training on persons with idiopathic parkinson's disease. Arch Phys Med Rehabil. 2003;84(8):1109-17. https://doi.org/10.1016/S0003-9993(03)00046-7
  20. Niewboer A, Kwakkel G, Rochester L et al. Cueing training in the home improves gait-related mobility in Parkinson's disease: the rescue trial. J Neurosurg. 2007;78(2):134-40.
  21. Szturm T, Ireland DJ, Lessing-Tymer M. Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction. J Vestib Res. 1994;4(6): 461-9.
  22. Lim JH, Park JS, Cho WS. The effect of mechanical horsebackriding training velocity on vestibular functions and static postural balance in healthy adults. 2013;25(5):288-96.
  23. Hwang SS. The Effects of vestibular stimulation on balance and fundamental psychological process of children with central nervous system dysfunction. Dankook University. Dissertation of Master's Degree. 1998.
  24. Lee GH. Effect of vestibular rehabilitation on postural control and sensory organization in patients with parkinson's disease. kinesiology. 2013;15(4):129-40.
  25. Yu HY. The effect of vestibular- and proprioceptive sensory program on the posture balance and occupational performance. Inje university. Dissertation of Master's Degree. 2013.
  26. Beninato M, Portney LG, Sulivan PE. Using the international classification of functioning, disability and health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther. 2009;89(8):816-25. https://doi.org/10.2522/ptj.20080160
  27. Kim JH. A study on the correlation between static, dynamic standing balance symmetry and walking function in stroke. J Korean Soc Phys Ther. 2012;24(2):73-81.
  28. Arnold BL, Schmitz RJ. Examination of balance measures produced by the biodex stability system. J Athl Train. 1998;33(4):323-7.
  29. Podsiadlo D, Richardson S. The timed up & go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2)142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  30. Shumway-Cook A, Woollacott MH. Motor control: theory and practical applications. Baltimore: Williams & Wilkins. 1995.
  31. An SH, Sea HD, Chung YJ. Reliability and validity the korean version of the dynamic gait index in patients with stroke. Journal of Special Education & Rehabilitation Science. 2011;50(2):289-306.
  32. Kang TW, Oh DW. Literature review of walking performance tests for people with post-stroke hemiparesis. Kor J Neural Rehabil. 2013;3(2):28-43.
  33. Bonan IV, Marquer A, Eskiizmirliler S et al. Sensory reweighting in controls and stroke patients. Clin Neurophysiol. 2013;124(4):713-22. https://doi.org/10.1016/j.clinph.2012.09.019
  34. Nashner LM. Adapting reflexes controlling the human posture. Exp Brain Res. 1976;26(1):59-72.
  35. Perennou DA, Amblard B, Laassel EM et al. Understanding the pusher behavior of some stroke patients spatial deficits: a pliot study. Arch Phys Med Rehabil. 2002;83(4):570-5. https://doi.org/10.1053/apmr.2002.31198
  36. Jung JH, K JH. Correlation between bilateral reciprocal leg press test and the balance in chronic stroke patient. J Korean Soc Phys Ther. 2013;25(4):180-6.
  37. Badke MB, Miedaner JA, Shea TA et al. Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap. Ann Otol Rhinol Laryngol Suppl. 2005;114(1):48-54. https://doi.org/10.1177/000348940511400109
  38. Kwon HM. The effect of balance control and vestibular function by an aquatic rotation control and the obstacle avoidance underwater with hemiplegia patients. Dongshin University. Dissertation of Master's Degree. 2010.
  39. Smania N, Picelli A, Gandolfi M et al. Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis. Neurosci. 2009;29(5):313-9. https://doi.org/10.1523/JNEUROSCI.4093-08.2009
  40. Han BI, Song HS, Kim JS. Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercise. J Korean Soc Phy Ther. 2011;7(4):184-96.