DOI QR코드

DOI QR Code

만성편마비 환자의 재활 운동 유형이 일어서기 동작의 운동학 및 운동역학적 변인에 미치는 영향

The Effect of Rehabilitation Training Programs on the Kinetic and Kinematic Parameters During Sit-To-Stand in Chronic Stroke Patients

  • 발행 : 2006.06.30

초록

The purpose of this study was to analyze the effect of different types of rehabilitation training program on the kinetic and kinematic parameters during sit-to-stand movement(STS) in chronic stroke patients. Two groups of hemiparetic patients, experimental and control, participated in the study. The experimental group participated in a 10-week training program (three sessions/wk, $1{\sim}1.5\;hr/session$) consisting of a warm-up, aerobic exercises, lower extremity strengthening. and a cool-down. The control group participated in an aerobic exercise. Three dimensional kinematic analysis and force platform; were used to analyze the duration of STS, lower extremity angle, and weight bearing ability. The experimental group which had more strength of lower extremity displayed decrease in duration of STS. However, the control group showed increases in duration during sit-to-stand movement. The control group flexed their trunk more than the group did Therefore, it took more time to extend their trunk during STS. The duration in sit-to-stand was affected by the strength of lower extremity and the angle of trunk movement. The angles of ankle and knee joint had an influenced on duration of STS. The post experimental group performed with their feet near the front leg of the chair during sit-to-stand, therefore the duration was decreased. The repetitive sit-to-stand movements as a resistance exercise was effective to hemiparetic patients in learning mechanism of sit-to-stand. The control group showed decreased differences in the vertical ground reaction forces between paretic and non-paretic limbs. Their training program included strengthening exercise that may help improving weight bearing ability. The control group showed increases in the center of pressure in the anteroposterior and mediolateral displacement. This means that the stability of movement was low in the control group. Their training program which combined aerobic and strengthening exercises that are more effective to improve the stability of movement.

키워드

참고문헌

  1. 김종만 & 노정석 (1997). 발의 위치가 편마비 환자의 의자에서 일어서기에 미치는 영향. 한국전문물리치료학회지, 4(1), 30-38.
  2. 통계청(2002), 사망원인별 사망자수. from http://www.nso.go.kr
  3. Abdel-Aziz, YI & Karara HM. (1971). Direct linear transformation from comparator coordinates into object space coordinates in close-range photogrammetry. Proceedings of the symposium on close-range photogrammetry. Falls Church, VA American Society of Photogrammetry. 1-18.
  4. Alexander NB, Schultz AB, Warwick DN. (1991). Rising from a chair: Effects of age and functional ability on performance biomechanics. J Gerontol, 46(3), 91-98. https://doi.org/10.1093/geronj/46.3.M91
  5. American College of Sports Medicine(2002). ACSMs guidelines for exercise testing and prescription(6th ed.) Philadelphia: Williams & Wilkins.
  6. Best-Martini E & Bothenhagen-Digenova KA (2003). Exercise for fail elders. Human Kinetics.
  7. Brunt D, Greenberg B, Wankadia S, Trimble M, & Shechtman O. (2002). The effect of foot placement on sit-to-stand in healthy young subjects and patients with hemiplegia. Arch Phys Med Rehabil, 83, 924-929. https://doi.org/10.1053/apmr.2002.3324
  8. Cameron DM, Bohannon RW, Garrett GE, Owen SV & Cameron DA. (2003). Physical impairments related to kinetic energy during sit-to-stand and curb-climbing following stroke. Clinical Biomechanics, 18, 332-340. https://doi.org/10.1016/S0268-0033(03)00023-8
  9. Canning CG, Ada L, O'Dwyer N. (1999). Slowness to develop force contributes to weakness after stroke. Arch Phys Med Rehabil, 80, 66-70. https://doi.org/10.1016/S0003-9993(99)90309-X
  10. Cheng PT, Liaw MY, Wong MK, Tang FT, Lee MY, & Lin PS. (1998). The sit-to-stand movement in stroke patients and its correlation with falling. Arch Phys Med Rehabil, 79(Sep), 1043-1046. https://doi.org/10.1016/S0003-9993(98)90168-X
  11. Cheng PT, Wu SH, Liaw MY, Wong AMK, Tang FT. (2001). Symmetrical body-weight distribution training in stroke patients and its effect on fall prevention Arch Phys Med Rehabil, 82(Dec), 1650-1654. https://doi.org/10.1053/apmr.2001.26256
  12. Chou SW, Wong AMK, Leong CP, Hong WS, Tang FT, & Lin TH(2003). Postural control during sit-to stand and gait in stroke patients. Am J. Phys. Med. Rehabil, 82(1), 42-47. https://doi.org/10.1097/00002060-200301000-00007
  13. Dean CM, Richard CL, & Malouin F. (2000). Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil, 81, 409-417. https://doi.org/10.1053/mr.2000.3839
  14. Dickstein R, Nissan M Pillar T, & Scheer D (1984). Foot-ground pressure pattern of standing hemiplegic patients: major characteristics and patterns of improvement. Phys Ther, 64, 19-23.
  15. Eng JJ, & Chu KS. (2002). Reliability and comparison of weight bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil, 83, 1138-1344. https://doi.org/10.1053/apmr.2002.33644
  16. Hesse S, Schauer M, Petersen M, & Jahnke M(1998). Sit-to-stand manoeuvre in hemiparetic patients before and after a 4-week rehabilitation programme. Scand J Rehab Med, 30, 81-86. https://doi.org/10.1080/003655098444174
  17. Ikeda ER, Schenkman ML, Riley PO & Hodge WA (1991). Influence of age on dynamics of rising from a chair. Physical Therapy, 71(6), 473-481.
  18. Jorgensen HS, Nakayama H, Raaschou HO, & Olsen TS. (1995). Recovery of walking function in stroke patients: the Copenhagen stroke study. Arch Phys Med Rehabil, 76, 27-32. https://doi.org/10.1016/S0003-9993(95)80038-7
  19. Khemlani MM, Carr JH, & Crosbie WJ (1999). Muscle synergies and joint linkages in sit-to-stand under two initial foot positions. Clinical Biomechanics, 14, 236-246. https://doi.org/10.1016/S0268-0033(98)00072-2
  20. Kwon, Y. H(2003). KWON3D Motion Analysis Package Version 3.0 User's Reference Manual. Seoul, Korea : Visol corp.
  21. Millington PJ, Mykelbust BM, & Shambes CM (1992). Biomechanical analysis of the sit-to-stand motion in elderly persons. Arch Phys Med Rehabil, 73(jul), 609-617.
  22. Park ES, Park CI, Lee HJ, Kim DY, Lee DS, & Cho SR (2003). The characteristics of sit-to-stand transfer in young children with spastic cerebral palsy based on kinematic and kinetic data. Gait and Posture, 17, 43-49. https://doi.org/10.1016/S0966-6362(02)00055-3
  23. Perry J, Garrett, M, Gronley JK, & Mulroy SJ. (1995). Qassification of walking handicap in the stroke population Stroke, 26(6), 982-989. https://doi.org/10.1161/01.STR.26.6.982
  24. Sackley CM (1991). Falls, sway, and symmetry of weight-bearing after stroke, Int Disabil Stud, 13, 1-4. https://doi.org/10.3109/03790799109166267
  25. Schenkman ML, Berger RA, Riley PO. (1990). Whole-body movements during rising to standing from sitting. Phys Ther, 70, 638-651.
  26. Sharp SA & Brouwer BJ (1997). Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Archives of Physical Medicine and Rehabilitation, 78(11), 1231-1236. https://doi.org/10.1016/S0003-9993(97)90337-3
  27. Shepherd RB & BAppSc HPK (1996). Some biomechanical consequences of varying foot placement in sit-to-stand in young women. Scand J Rehabil Med, 28, 79-88.
  28. Smith GV, Silver KHC, Goldberg AP, Macko RF. (1999). "Task-Oriented" exercise improves hamstring strength and spastic reflexes in chronic stroke patients. Stroke, 30, 2112-2118. https://doi.org/10.1161/01.STR.30.10.2112
  29. Teixeira-Salmela LF, Olney SJ, Nadeau S, & Brouwer B. (1999). Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors. Arch Phys Med Rehabil, 80, 1211-1218. https://doi.org/10.1016/S0003-9993(99)90018-7
  30. Weinstein CJ, Gardner ER, McNeal DR, Barto PS, Nicholson DE (1989). Standing balance training effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil, 70, 755-762.
  31. Winter, DA Prince R, Stergious P, & Powell C (1993) Medial-lateral and anterior posterior motor response associated with centre of pressure changes in quiet standing. Neurosci Res Comm, 12, 141-148.
  32. Wolfson, L, Judge J., Whipple R, & King M (1995). Strength is a major factor in balance, gait, and the occurrence of falls. Journal of Gerontology, series A Biological Sciences and Medical Sciences, 50, 64-67.

피인용 문헌

  1. Biomechanical Analysis of the Elderly Gait with a Walking Assistive Device vol.17, pp.2, 2007, https://doi.org/10.5103/KJSB.2007.17.2.001
  2. Kinematic Analysis of Rising from a Chair in Healthy and Stroke Subjects vol.17, pp.2, 2007, https://doi.org/10.5103/KJSB.2007.17.2.103