The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
권호 표지

The Effect of Medical Exercise Therapy Program on Ankle pain, Range of Motion, Stress After Traumatic Injury, and Depression in a Stroke Patient with Inflammation on Subcutaneous Bursa of Ankle Joint: Case Study

발목관절 피하밑주머니에 문제가 있는 뇌졸중 환자에게 의학적 운동치료가 발목 통증, 관절가동범위, 외상 후 스트레스 증상, 우울증에 미치는 영향: 사례연구

  • Yu, Chang-seon (Dept. of Physical Therapy, Dongguk University International Hospital In Ilsan) ;
  • Chai, Kyoung-ju (Dept. of Physical Therapy, Kyungbok University)
  • 유창선 (동국대학교 일산병원 물리치료실) ;
  • 채경주 (경복대학교 물리치료과)
  • Received : 2015.11.12
  • Accepted : 2015.12.13
  • Published : 2015.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study was to investigate the effect of 8-weeks medical exercise therapy on ankle pain, range of motion, stress symptom after traumatic injury, and depression, in a 51 years old stroke patient with right ankle joint inflammation. Method: The 8-weeks medical exercise therapy program was applied to 4 grades of Dosage 1 (1-3 weeks), Dosage 2 (4-5 weeks), Dosage 3 (6-7 weeks), and Dosage 4 (8 weeks) on right ankle joint inflammation in a female with right hemiplegia admitted to D hospital located in Gyeonggi-do. Result: The findings showed that visual analogue scale (VAS) scores improved from 8 to 0-1 scores, passive range of motion (ROM) increased to 5 degrees more than before, Korean-version impact of event scale-revised (IES-R-K) scores increased from 61 to 31 scores, and Korean-version beck depression inventory II (BDI-II-K) scores decreased from 51 to 17 scores. As such, the 8-week medical exercise therapy program may decrease the pain, increase ROM, improve stress after traumatic injury, and improve depression symptom. Conclusion: The presented evidence suggests that exercise and physical activity have beneficial effects on depression symptoms. It is possible to apply the medical exercise therapy for modulating pain experience and treating pain. Also, it may be effective methods to treat the psychological aspects of pain.

Keywords

References

  1. 김중선, 장종성. 뇌졸중 환자의 Scale for Contraversive Pushing의 신뢰도 연구. 대한물리치료학회지. 2009;21(4):31-36.
  2. 김희자. 만성 질환을 가진 재가 노인의 사회적지지, 우울 및 삶의 질. 원광대학교 대학원. 석사학위논문. 2001.
  3. 박창일, 문재호. 재활의학. 한미의학. 990-991, 2012.
  4. 이선미, 은헌정. 한국판 사건 충격 척도의 신뢰도 및 타당도에 관한 연구. 대한신경정신의학회. 1999; 38(3):501-513.
  5. 임선영, 이은정, 정성원, 등. 한국판 벡 우울 척도 2판의 타당화 연구. 대한불안학회지. 2011;7(1):48-53.
  6. 임현희. 소방대원의 외상 후 스트레스 관련요인. 인제대학교 대학원. 석사학위논문. 2012.
  7. 은헌정, 권태완, 이선미 등. 한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구. 대한신경정신의학회. 2005;44(3):303-310.
  8. 정혜선. 불임주부의 스트레스, 디스트레스와 결혼 만족도에 관한 연구. 동아대학교 교육대학원, 석사학위논문. 1993.
  9. 조영환. Medical Exercise Therapy가 뇌졸중 환자의 발목관절 근활성도와 보행능력에 미치는 영향. 동신대학교 대학원. 석사학위논문. 2011.
  10. 최창순. 지하철 기관사의 기질 및 성격특성에 따른 외상 후 스트레스 장애위험도. 한양대학교 대학원. 석사학위논문. 2015.
  11. Osteras H, Osteras B, Torstensen TA. Is post-operative exercise therapy necessary in patients with degenerative meniscus? A randomized controlled trial with one year follow-up. Knee Surg Sports Traumatol Arthrosc. 2014;22(1):200-206. https://doi.org/10.1007/s00167-012-2354-2
  12. Andersen HS, Christensen AK, Petersen GO. Post-traumatic stress reactions amongst rescure workers after a major rail accident. Anxiety Res. 1991;4(3):245-251. https://doi.org/10.1080/08917779108248778
  13. Beck AT, Ward CH, Mendelson M, et al. An in ventory for measuring depression. Arch Gen Psychiatriy. 1961;4:561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
  14. Bender T, Nagy G, Barna I. The effect of physical therapy on beta-endorphin levels. Eur J Appl Physiol. 2007;100(4):371-82. https://doi.org/10.1007/s00421-007-0469-9
  15. Benedetti F, Thoen W, Blanchard C, et al. Pain as a reward: Changing the meaning of pain from negative to positive co-activates opioid and cannabinoid systems. pain. 2013;154(3):361-367. https://doi.org/10.1016/j.pain.2012.11.007
  16. Brody LT, Hall CM. Therapeutic Exercise: Moving Toward Function. Lippincott Williams & Wilkins. 3rd ed. 2011.
  17. Dinas PC, Koutedakis Y, Flouris AD. Effects of exercise and physical activity on depression. Ir J Med Sci. 2011;180(2):319-325. https://doi.org/10.1007/s11845-010-0633-9
  18. Dohrenwend BS, Dohrenwend BP. Stressful Life Events: Their Nature and Effects. John wiley & Sons Inc. 1974.
  19. Faugli HP, Jacobsen F, Leirvik R, et al. The Norwegian Medical Exercise Therapy Institute. 1996;8-17.
  20. Francis K. The role of endorphins in exercise: A review of current knowledge. J Orthop Sports Phys Ther. 1983;4(3):169-173. https://doi.org/10.2519/jospt.1983.4.3.169
  21. Frank JB, Kosten TR, Giller EL, et al. A randomized clinical trial of phenelzine and imipramine for post-traumatic stress disorder. Am J Psychiatry. 1998;145(10):1289-1291.
  22. Gao F, Ren Y, Roth EJ, et al. Effects of repeated ankle stretching on calf muscle-tendon and ankle biomechanical properties in stroke survivors. Clinical Biomech. 2011;26(5):516-522. https://doi.org/10.1016/j.clinbiomech.2010.12.003
  23. Goldfarb AH, Jamurtas AZ. Beta-endorphin response to exercise. An update. Sports Med. 1997;24(1):8-16. https://doi.org/10.2165/00007256-199724010-00002
  24. Hackett ML, Yapa C, Parag V, et al. Frequency of depression after stroke: A systematic review of observational studies. Stroke 2005;36(6):1330-1340. https://doi.org/10.1161/01.STR.0000165928.19135.35
  25. Harber VJ, Sutton JR. Endorphins and exercise. Sports Med. 1984;1(2):154-171. https://doi.org/10.2165/00007256-198401020-00004
  26. Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: A measure of subjective stress. Psychosom Med. 1979;41:209-218. https://doi.org/10.1097/00006842-197905000-00004
  27. Joseph S. Psychosomatic evaluation of Horowitz's Impact of Event Scale: A review. J Trauma Stress. 2000;13(1):101-113. https://doi.org/10.1023/A:1007777032063
  28. Loras H, Osteras B, Torstensen TA, Osteras H. Medical exercise therapy for treating musculoskeletal pain: A narrative review of results from randomized controlled trails with a theoretical perspective. Physiother. Res. Int. 2015;20(3):182-190. https://doi.org/10.1002/pri.1632
  29. Lowenthal MF, Chiriboga D. Social stress and adaptation : Toward a life-course perspective. American Psychological Association. 1973.
  30. Mcnair PJ, Marshall RN, Maquire K. Swelling of the knee: effects of exercise on quadriceps muscle strength. Arch Phys Med Rehabil. 1996;77(9):896-899. https://doi.org/10.1016/S0003-9993(96)90277-4
  31. Melzack R, Wall PD. Pain mechanisms: A new theory. Science. 1965;150:971-979. https://doi.org/10.1126/science.150.3699.971
  32. Menz HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in order people. J Gerontol A Biol Sci Med Sci. 2005;60(12):1546-1552. https://doi.org/10.1093/gerona/60.12.1546
  33. Miller J, Gross A, D'Sylva J, et al. Manual therapy and exercise for neck pain: A systematic review. Man Ther. 2010;15(4):334-354. https://doi.org/10.1016/j.math.2010.02.007
  34. Morgan WP. Affective beneficence of vigorous physical activity. Med Sci Sports Exerc. 1985;17(1):94-100.
  35. Osteras B, Osteras H, Torstensen TA. Long-term effects of medical exercise therapy in patients with patellofemoral pain syndrome: Results from a single-blinded randomized controlled trial with 12 months follow-up. Physiotherapy. 2013;99(4):311-316. https://doi.org/10.1016/j.physio.2013.04.001
  36. Osteras Berit, Osteras Havard, Torstensen TA, et al. Dose-response effects of medical exercise therapy in patients with patellofemoral pain syndrome: A randomised controlled clinical trial. Physiotherapy. 2013;99(2):126-131. https://doi.org/10.1016/j.physio.2012.05.009
  37. Pierce EF, Pate DW. Mood alterations in older adults following acute exercise. Percept Mot Skills. 1994;79(1):191-194. https://doi.org/10.2466/pms.1994.79.1.191
  38. Schwarz L, Kindermann W. Changes in ${\beta}$-endorphin levels in response to aerobic exercise. Sports Med. 1992;13(1):25-36. https://doi.org/10.2165/00007256-199213010-00003
  39. Torstensen TA, Ljunggren AE, Meen HD, et al. Efficiency and costs of medical exercise therapy, conventional physiotherapy, and self-exercise in patients with chronic low back pain. A pragmatic, randomized, single-blinded, controlled trial with 1-year follow-up. Spine. 1998;23(23):2616-2624. https://doi.org/10.1097/00007632-199812010-00017
  40. Torstensen TA. The Mirror Book: How to understand and deal with pain and stress. Sweden. Holten Institute AB. 2015.
  41. Van de Port IG, Kwakkel G, van Wijk I, et al. Susceptibility to deterioration of mobility long-term after stroke: A prospective cohort study. Stroke. 2006;37(1):167-171. https://doi.org/10.1161/01.STR.0000195180.69904.f2
  42. Wilson JP, Keane TM. Assessing psychological trauma and PTSD. The Guilford Press. New York. 1st ed. 1997, p399-411.
  43. Yarkony GM, Roth EJ, Heinemann AW, et al. Benefits of rehabilitation for traumatic spinal cord injury. Multivariate analysis in 711 patients. Arch Neurol. 1987;44(1):93-96. https://doi.org/10.1001/archneur.1987.00520130071020
  44. Yule W, Udwin O. Screening child survivors for post-traumatic stress disorders: experiences from the 'Jupiter' sinking. Br J Clin Psychol. 1991;30(2):131-138. https://doi.org/10.1111/j.2044-8260.1991.tb00928.x
  45. Zhou, Yuan Zhou, Ninghua Wang, et al. hanges of Achilles tendon properties via 12-week PNF based robotic rehabilitation of ankle joints with spasticity and/or contracture. Conf Proc IEEE Eng Med Biol Soc. 2014:1214-1217.