Comparison of effects of Feedback vs Repeative task training on lower extremity function in patients with chronic hemiplegia

만성편마비 환자에게 반복과제와 피드백 과제의 운동프로그램이 하지운동기능과 낙상효능감에 미치는 효과

  • 안명환 (을지대학교 보건대학원) ;
  • 안창식 (을지대학교 물리치료학과)
  • Received : 2010.10.05
  • Accepted : 2011.01.18
  • Published : 2011.02.28

Abstract

Purpose : The purpose of this study was to compare the effects of performing feedback vs repeative tasks on lower extremity motor function and falls efficacy in chronic hemiplegic patients. Methods : 40 hemiplegic patients took part in this study. The average age of the feedback-task group was 68.45 years and 68.20 in the repeative-task group. All subjects participated in the study for 8 weeks, doing exercises 3 per day per week. All participants were assessed by using the Berg balance scale (BBS), the lower-extremity subscale of the Fugel-Meyer assessment of sensorimotor impairment (FMLE), and the falls efficacy scale (FES). The data were analyzed using a paired t-test. Results : After 8 weeks of exercise training, the results of this study were: the BBS and FMLE of hemiplegic patients showed a feedback-task and repeative-task groups (p<0.05). The FES of hemiplegic patients also showed a significant difference between the quantitative-task and qualitative-task groups (p<0.05). Conclusion : We present findings suggesting that chronic hemiplegic patients could improve their standing balance ability better through a feedback-task exercise program, as opposed to a repeative-task exercise program.

Keywords

References

  1. 구봉오. 안구운동이 성인 편마비환자의 균형회복에 미치는 영향. 대구대학교 대학원 박사학위 논문. 미간행. 2002.
  2. 권용철, 박종한. 노인용 한국판 Mini-Mental State Examination(MMSE-K)의 표준화 연구: 제1편 MMSE-K의 개발. 대한신경정신의학회지. 1989;28(1):125-35.
  3. 김대영. 주 조절점 핸들링을 이용한 항중력운동이 편마비 환자의 자세적 대응에 미치는 영향. 한국 Bobath 학회지. 2001;6(1):13-26.
  4. 김보현. 과제 지향적 훈련이 뇌졸중 환자의 체간 조절 능력, 균형 및 보행에 미치는 영향. 삼육대학교 대학원 석사학위 논문. 2009.
  5. 김원호, 이충휘, 정보인 등. 노인의 균형유지 능력에 영향을 미치는 요인. 한국전문물리치료학회지. 1998; 5(3):21-33.
  6. 김종만, 안덕현. 강직성 편마비 환자에서의 운동장애는 강직 때문인가? 근육약화 때문인가? 한국전문물리치료학회지. 2002;9(3):125-35.
  7. 김중휘. 가상현실 프로그램이 뇌졸중 환자의 균형과 보행 및 뇌 활성화에 미치는 영향. 박사학위 논문, 대구대학교, 대구. 2005.
  8. 위인찬. 과제지향 훈련이 편마비 환자의 균형능력에 미치는 영향. 부산가톨릭대학교 대학원 석사학위논문. 2005.
  9. 유인영. HSEP를 적용한 낙상예방프로그램이 재가노인의 신체균형과 보행, 하지근력, 낙상공포 및 낙상효능감에 미치는 효과. 한국노년학, 2009;29(1):259-73.
  10. 유지성, 박창현, 하현근 등. 뇌졸중환자에서의 로봇보조 보행치료 후 뇌가소성. Brain & NeuroRehabilitation 2008;1(1):29-34. https://doi.org/10.12786/bn.2008.1.1.29
  11. 윤선희. 노인 요양 보장제도 도입에 관한 인식 조사: 뇌졸중 환자 부양자 중심으로, 석사학위논문, 경희대학교, 서울. 2006.
  12. 이한숙, 최홍식, 권오윤 등. 균형조절 요인에 관한 고찰. 한국전문물리치료학회지 1996;3(3):82-91.
  13. 임숙현, 이경오, 오경순 등. 낙상예방교육이 입원노인환자의 낙상에 대한 지식, 낙상효능감, 낙상예방행위에 미치는 효과. 임상간호연구지, 2005;8:53-88.
  14. 정경훈, 하현근, 신희준 등. 만성 뇌졸중 환자에서 운동 기능 회복에 대한 로봇-보조 보행치료의 효과. 대한재활의학회지. 2008;32(3):258-66.
  15. 한태륜, 방문석, 김연희 등. 뇌졸중의 재활, 재활의학(3판). 서울. 군자출판사. 2008.
  16. 황지혜, 정향미, 이미화 등. 낙상예방 프로그램이 뇌졸중 환자의 보행, 균형 및 낙상효능감에 미치는 효과. 임상간호연구 2010;16(1):27-37.
  17. Belgen B, Beninato M, Sullivan PE et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87(4):554-61. https://doi.org/10.1016/j.apmr.2005.12.027
  18. Beninato M, Portney LG, Sullivan 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 (2):205-14.
  19. Berg KO, Maki B, Williams JI et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil.. 1992;73(11):1073-80.
  20. Bohannon RW. Strength deficits also predict gait performance in patients with stroke. Percept Mot Skills. 1991;73(1):146. https://doi.org/10.2466/pms.1991.73.1.146
  21. Carr JH, Shepherd RB. Stroke Rehabilitation. Newton. MA. Butterworth helenemann. 2003.
  22. Cheng PT, Wu SH, Liaw MY, et al. Symmetrical body-weight distribution training in stroke patients and its effect on fall prevention. Arch Phys Med Rehabil. 2001;82(12):1650-4. https://doi.org/10.1053/apmr.2001.26256
  23. Dean CM, Richards Cl, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke : A randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4): 409-17. https://doi.org/10.1053/mr.2000.3839
  24. Dickstein R, Pillar T, Nissan M et al . Foot-ground pressurepattern of standing hemiplegic patients : Major caracteristics and patterns of improvement. Phys Ther. 1984;64(1):19-23. https://doi.org/10.1093/ptj/64.1.19
  25. Health Education Authority. Physical activity and the prevention an management of falls and accidents among older people a frame work for practice. london. HEA. 1999.
  26. Kim YS, Ki SS, Kim BE et al. For stroke patients & caregiver, Korean hospital, Kyung Hee University. 2005.
  27. Martins T, Ribeiro J P, Garrett C. Disability and quality of life of stroke survivors: Evaluation nine months after discharge. Rev Neurol. 2006;42(11):655-9.
  28. McCullum G, Shumway-Cook A. Assessment and treatment of balance deficits. In : Montgomery, P., Connolly, b., eds. motor Control and Physical Theraphy. Hixson, T.N. Chattanooga Group. 1991.
  29. Nasher LM. sensory, neuromuscular, and biomechanical contributions to human balance. Proceedings of the American Physical Therapy Association forum. APTA, 1989;853-933.
  30. Salbach NM, Mayo NM, Wood-Dauphinee S et al. A task-orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial. Clin Rehabil. 2004; 18(5):509-19. https://doi.org/10.1191/0269215504cr763oa
  31. Niam S, Cheung W, Sullivan PE et al.. Balance and physical impairments after stroke. Arch Phys Med Rehabil. 1999;80(10):1227-33. https://doi.org/10.1016/S0003-9993(99)90020-5
  32. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction on balance : Suggestion from the field. Phys Ther. 1986;66(10):1584-50.
  33. Silsupadol P, Shumway-Cook A, Lugade V et al. Effect of single-task versus dual-task training on balance performance in older adults: A double-blind, randomized controlled trial. Arch Phys Med Rehabil. 2009;90(3):381-87. https://doi.org/10.1016/j.apmr.2008.09.559
  34. Rand MK, Alberts JL, Stelmach GE et al. The inflence of movement segment difficulty on movements with two-stroke sequence. Exp Brain Res. 1997;115(1): 137-46. https://doi.org/10.1007/PL00005673
  35. Rand MK, Stelmach GE, Bloedel JR. Movement accuracy constraints in Parkinson's disease patients. Neuropsychologia. 2000;38(2):203-12. https://doi.org/10.1016/S0028-3932(99)00059-7
  36. Rogers MM. Musculoskeletal Consideration on production and control of movement. Motor Control and Physical Therapy. Hixson, TN. Chattanooga Group. 1991.
  37. Trombly CA, Radomski MV. Occupational therapy for physical dysfunction. 5th ed. Baltimore. Lippincott Williams & Wilkins. 2002.
  38. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. Journal of Gerontlogy: Psychological Sciences, 1990;45(6):239-43. https://doi.org/10.1093/geronj/45.6.P239
  39. Winter DA. In: A,B,C, (Anatomy, Biomechanics and control) of balance during standing and walking. Waterloo, Ontario, Canada. 1995.