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하네스를 착용한 상하지 협응 패턴운동이 만성 뇌졸중 환자의 보행능력과 균형능력에 미치는 영향

The Effect of Coordinative Pattern Exercise of Upper and Lower Extremities use Harness for Walking Ability and Balance Ability in Chronic Stroke Patients

  • Kim, Beom-Ryong (Department of Physical Therapy, Wonkwang Health Science University) ;
  • Bang, Dae-Hyouk (Department of Physical Therapy, Graduate School of Daejeon University) ;
  • Bong, Soon-Young (Department of Physical Therapy, Graduate School of Seonam University)
  • 투고 : 2015.08.10
  • 심사 : 2015.09.02
  • 발행 : 2015.09.30

초록

Purpose: The current study seeks to examine the effect of coordinative pattern exercises of the upper and lower extremities using harnesses and walking rails on the walking and balance abilities of chronic stroke patients, and to develop effective programs and training methods to improve the functions of such patients. Methods: Subjects included 16 patients with hemiplegia caused by stroke. The subjects were randomly divided into an experimental group (n=8), on which coordinative pattern exercises of the upper and lower extremities were conducted, and a comparison group (n=8) that received typical exercise therapy. The experimental group underwent 30 minutes of typical exercise therapy and 30 minutes of coordinative pattern exercises of the upper and lower extremities, while the comparison group underwent typical exercise therapy for 30 minutes twice a day, five days per week for a six-week period. To evaluate walking ability, 10-m walking tests (10MWT) and 6-m walking tests (6MWT) were conducted. To assess balance ability, timed up and go tests (TUG) were performed. Results: After the intervention, significant (p<0.05) differences were seen in the 10MWT, 6MWT, and TUG in both the experimental and comparison groups. As for the 10MWT, the experimental group showed more significant improvement than the comparison group (p<0.05). In terms of the 6MWT, no significant differences were found between the groups, while the experimental group showed more significant differences than the comparison group in the TUG (p<0.05). Conclusion: The results from the current research indicate that training programs that apply coordinative pattern exercises of the upper and lower extremities with harnesses are extremely effective for improving the walking and balance abilities of chronic stroke patients.

키워드

참고문헌

  1. Bobath B. Adult hemiplegia evaluation and treatment: evaluation and treatment. 3rd ed. London. William H Med Book Ltd. 1970.
  2. Carr JH. Shepherd RB. Neurological rehabilitation: optimizing motor performance. 2nd ed. New York. Churchill Livingstone. 2010.
  3. Cho HS. The effect of coordinative pattern exercise of upper and lower extremities for balance and gait in chronic stroke patients. Daejeon University. Dissertation of Doctorate Degree. 2014.
  4. Choi JH, Kim YR, Kwon HC. Effects of pelvic and lower extremity exercise on the gait in patients with hemiplegia. Korean Research Society of Physical Therapy. 1997;4(1):20-29.
  5. Choi WJ, Seo TH. The effects of PNF skater pattern on the balance in stroke patients. Journal of the Korea Entertainment Industry Association. 2015;9(2): 289-298.
  6. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Archives of Physical Medicine and Rehabilitation. 2000;81(4):409-417. https://doi.org/10.1053/mr.2000.3839
  7. Dietz B. Let's sprint, let's skate. Innovationen im PNF-Konzept. Heidelberg. Springer. 2009.
  8. Horak FB. Clinical assessment of balance disorders. Gait & Posture. 1997;6(1):76-84. https://doi.org/10.1016/S0966-6362(97)00018-0
  9. Jeong WS, Jeong JY, Kim CK, et al. Effect of lower limb muscle activity on balancing through sprinter patterns of PNF. Journal of the Korea Contents Association. 2011;11(3):281-292. https://doi.org/10.5392/JKCA.2011.11.3.281
  10. Jeong WS, Park SK, Park JH, et al. Effect of PNF combination patterns on muscle activity of the lower extremities and gait ability in stroke patients. Journal of the Korea Contents Association. 2012;12(1):318-328. https://doi.org/10.5392/JKCA.2012.12.01.318
  11. Kang JI, Kim BR, Park SK, et al. Effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients. The Journal of Korean physical therapy. 2015;27(4):258-263. https://doi.org/10.18857/jkpt.2015.27.4.258
  12. Kim SH, Lee DK, Kim EK. Effect of aquatic exercise on balance and depression of stroke patients. The Journal of Korean physical therapy. 2014;26(2):104-109.
  13. Lee HJ. The effect of 8-week of combined physical therapy with aerobic exercises on balance and gait ability in hemiplegic stroke patients. The Korean Society of Sports Science. 2015;24(2):1085-1095.
  14. Lim CG. Effects of proprioceptive neuromuscular facilitation (PNF) pattern exercise using the sprinter and the skater on balance and gait function in the stroke patients. The Journal of Korean physical therapy. 2014;26(4):249-256.
  15. Mossberg KA. Reliability of a timed walk test in persons with acquired brain injury. American Journal of Physical Medicine & Rehabilitation. 2003;82(5):385-390. https://doi.org/10.1097/01.PHM.0000052589.96202.BE
  16. Myers T. Anatomy trains 3rd ed. New York. Churchill Livingstone. 2014.
  17. Patterson KK, Parafianowicz I, Danells CJ, et al. Gait asymmetry in community-ambulating stroke survivors. Archives of Physical Medicine and Rehabilitation. 2008;89(2):304-310. https://doi.org/10.1016/j.apmr.2007.08.142
  18. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  19. Rode G, Tiliket C, Boisson D. Predominance of postural imbalance in left hemiparetic patients. Scandinavian Journal of Rehabilitation Medicine. 1997;29(1):11-16.
  20. Shim HB, Cho HY, Choi WH. Effects of the trunk stabilization exercise on muscle activity in lumbar region and balance in the patients with hemiplegia. The Journal of Korean physical therapy. 2014;26(1):33-40.
  21. Shin JH,. Oh DW,. Kim JS. Effect of nordic walking training on walking function of patients with stroke. Journal of Special Education & Rehabilitation Science. 2010;49(2)181-194.
  22. Statistics Korea. 2014년 사망원인통계결과. 2015.
  23. Swisher AK, Goldfarb AH. Use of the six-minute walk/run test to predict peak oxygen consumption in older adults. Cardiopulmonary Physical Therapy Journal. 1998;9(3):3-5.
  24. Trueblood PR, Walker JM, Perry J, et al. Pelvic exercise and gait in hemiplegia. Physical Therapy. 1989;69(1):18-26. https://doi.org/10.1093/ptj/69.1.18
  25. van Loo MA, Moseley AM, Bosman JM, et al. Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study. Brain Injury. 2004;18(10):1041-1048. https://doi.org/10.1080/02699050410001672314
  26. Walker C, Brouwer BJ, Culham EG. Use of visual feedback in retraining balance following acute stroke. Physical Therapy. 2000;80(9):886-895.
  27. Wang RY. Effect of proprioceptive neuromuscular facilitation on the gait of patients with hemiplegia of long and short duration. Physical Therapy. 1994;74(12):1108-1115. https://doi.org/10.1093/ptj/74.12.1108
  28. Werner C, Bardeleben A, Mauritz KH, et al. Treadmill training with partial body weight support and physiotherapy in stroke patients: a preliminary comparison. European Journal of Neurology. 2002;9(6):639-644. https://doi.org/10.1046/j.1468-1331.2002.00492.x