DOI QR코드

DOI QR Code

Comparison of Balance Ability between Stable and Unstable Surfaces for Chronic Stroke Patients

불안정 지지면과 안정 지지면에서의 만성 뇌졸중 환자의 균형 능력 비교

  • Lee, Ji-Yeun (Department of Physical Therapy, Andong Science Collage) ;
  • Roh, Hyo-Lyun (Department of Occupational Therapy, Kangwon National University)
  • 이지연 (안동과학대학 물리치료과) ;
  • 노효련 (강원대학교 작업치료학과)
  • Received : 2011.06.20
  • Accepted : 2011.08.11
  • Published : 2011.08.31

Abstract

This study was to investigate the balancing and clinical abilities using stable and unstable surface of stroke patients who surface changes in balance of body. The subjects of this study were 30 stroke patients(16 males and 14 females). They were separated into two groups and did balance reinforcing exercise on stable and unstable surfaces for five times a week for six weeks. To evaluate their balancing ability, they performed functional standing balance test, functional forward arm stretching test. performance-oriented mobility assessment was performed. The balancing exercises were modified from preceding studies and consisted of 6 difference exercises. The functional standing test with open and close eyes and performance-oriented mobility assessment, the unstable surface exercise group and the stable surface exercise group improved significantly. The forward arm stretching test was the unstable surface exercise group improved. This study found that the balancing exercise on unstable surface was more effective than on stable surface for stroke patients. Thus, exercise on unstable surface has more positive effects on the improvement of balancing abilities of stroke patients.

본 연구는 만성 뇌졸중 환자를 대상으로 하여 불안정한 지지면과 안정 지지면에서의 균형 훈련이 균형능력향상에 어떠한 영향을 주는지 알아보고자 한다. 이 연구의 대상자는 만성 뇌졸중 환자 30명(남: 16, 여: 14)으로 안정지지면 군과 불안정 지지면 군으로 무작위로 배분하여 주 5회 6주 동안 실시하였다. 균형증진 운동은 선행 연구를 참조하여 수정 보완한 것으로 6가지의 운동으로 구성하였다. 대상자들의 균형능력의 측정은 기능적 기립 균형 검사, 기능적 전방 팔 뻗기 검사, 실행능력 지향형 운동성 평가를 이용하였다. 기능적 기립 균형검사와 실행능력 지향형 운동성 평가에서는 안정지지면 운동군과 불안정 지지면 운동군 두 군에서 향상되었다. 기능적 전방 팔 뻗기 검사에서는 불안정 지지면 군에서만 향상되었다. 따라서, 안정 지지면에서의 운동도 만성 뇌졸중 환자의 균형능력 향상을 시키지만 불안정 지지면 운동군에서의 균형운동이 균형 능력 향상에 더 효과적인 것으로 나타났다.

Keywords

References

  1. Hocherman S, Dickstein R, Pillar T., "Platform training and postural stability in hemipelgia", Arch Phys Med Rehabil, 65, 10, pp. 588-592, 1984.
  2. Dickstein R, Nissan M, Pillar T, et al., "Foot ground pressure pattern of standing hemiplegia patient", Phys Ther, 64, 1, pp. 19-23, 1984. https://doi.org/10.1093/ptj/64.1.19
  3. Elbert T, Pantev C, Wienbruch C, et al., "Increased cortical representation of the fingers of the left hand in string players", Science, 270, 5234, pp. 305-307, 1995. https://doi.org/10.1126/science.270.5234.305
  4. Peurala SH, Kononen P, Pitkanen K., "Postural instability in patients with chronic stroke", Restor Neurol Neurosci, 25, 2, pp. 101-108, 2007.
  5. Horak FB., "Clinical measurment of postural control in adults", Phys Ther, 67, pp. 1881-1885, 1987. https://doi.org/10.1093/ptj/67.12.1881
  6. Lee HS, Choi HS., "A Literature Review on Balance Control Factors", Jour Kore Acade Univer Trained Physi Thera, 3, 3, pp. 82-91, 1996.
  7. Shumway-Cook A, Horak FB., "Assessing the influence of sensory interaction of balance Suggestion from the field", Phys Ther, 66, 10, pp. 1548-1550, 1986. https://doi.org/10.1093/ptj/66.10.1548
  8. Shumway-Cook A, Woollacott MH., "Motor control: translating research into clinical practice", 3rd ed, Philadelphia, Lippincott Williams & Wilkins, pp. 3-83. 2007.
  9. Lee SH, "The Differences between Aero step Exercises and Weight training on Posture, Physical Fitness, Balance, and Hormone Levels in the Elderly", Ewha Womans University, master's thesis, 2007.
  10. Duncan PW, Weiner DK, Chandler J et al., "Functional reach : anew clinical measure of balance", Journal of Gerontology, 45, 6, pp. 192-197, 1990. https://doi.org/10.1093/geronj/45.6.M192
  11. Weiss A, Suzuki T, Bean J, et al,. "High intensity strength training improves strength and functional performance after stroke", Am J Phys Med Rehabil, 79, 4, pp. 369-376, 2000. https://doi.org/10.1097/00002060-200007000-00009
  12. Lee DY, Lee HH, Song CH., "The Effect of Visual Feedback Training on Standing Balance and Motor Function in Chronic Stroke Patients" Korea sport research, 18, 4, pp. 287-297, 2007.
  13. Cho MS, Lee DY., "The Effect of Standing Balance and Ambulation, Activities of Daily living Using Bio-feedback training with Weight bearing in the less than 3 months and more than 6 months groups Hemiparesis Patients", Jour Special Education & Rehabitation Science, 46, 3, pp. 123-142. 2007.
  14. Bach-y-Rita P., "Process of recovery from stroke. in : Brandstater ME, Basmajian Jv, eds. Stroke Rehabilitation", Baltimore, Williarn & Wilkins, 1987.
  15. Brunnstrom, S., "Movement therapy in hemiplegia: A neurophysiological approach". NewYork, Harper & Row, 1970.
  16. Verhagen E, Bobbert M, Inklaar M, et al., "The effect of a balance training programme on centre of pressure excursion in one-leg stance", Clin Biomech, 20, 10, pp. 1094-1100, 2005. https://doi.org/10.1016/j.clinbiomech.2005.07.001
  17. Dean CM, Richards CL, Malouin F., "Task-related circuit training improves performance of locomotor tasks in chronic stroke", Arch Phys Med Rehabil, 81, pp. 409-147, 2000. https://doi.org/10.1053/mr.2000.3839
  18. Bogle TLD, Newton RA., "Use of the Berg Balance Test to predict falls in elderly persons", Phys Ther, 76, 6, pp. 576-585, 1996. https://doi.org/10.1093/ptj/76.6.576
  19. Pandyan AD, Price CI, Rodgers H, et al., "Biomechanical examination of a commonly used measure of spasticity", Clin Biomech, 16, 10, pp. 859-865, 2001. https://doi.org/10.1016/S0268-0033(01)00084-5
  20. Faber MJ, Bosscher RJ, van Wieringen PC., "Clinimetric Properties of the performance-oriented mobility assessment", Phys Ther, 86, 7, pp. 944-954, 2006.
  21. Granacher U, Gollhofer A, Strass D., "Training induced adaptations in characteristics of postural reflexes in elderly men", Gait and Posture, 24, 4, pp. 459-466, 2006. https://doi.org/10.1016/j.gaitpost.2005.12.007
  22. Haart M, Geurts AC, Huidekoper SC., "Recovery of standing balance in postacute stroke patients: A rehabilitation cohort study", Arch Phys Med Rehabil, 85, 6, pp. 886-895, 2004. https://doi.org/10.1016/j.apmr.2003.05.012
  23. Matsusaka N, Yokoyama S, Tsursaki T, et al., "Effects of ankle disk training combined with tactile stimulation to the leg and foot on functional instability of the ankle", Am J Sports Med, 29, 1, pp. 25-30, 2001. https://doi.org/10.1177/03635465010290010901
  24. Di fabio RP, Badke MB., "Relationship of sensory organization to balance function in patients with hemiplegia", Phys Ther, 70, 9, pp. 542-548, 1990. https://doi.org/10.1093/ptj/70.9.542
  25. Bruhn S, Kullmann N, Gollhofer A., "Combinatory effects of high-intensity-strength training and sensorimotor training on muscle strength", Int J Sports Med, 27, 5, pp. 401-406, 2006. https://doi.org/10.1055/s-2005-865750
  26. Irion JM., "Use of the zymball in rehabilitation of spinal dysfunction, J Am Orthopaedic Phys Ther Clin. 1, 2, pp. 375-98, 1992.

Cited by

  1. Effects of Exercise Program by Type on Balance Ability and Muscle Activity In A Standing Posture vol.12, pp.7, 2014, https://doi.org/10.14400/JDC.2014.12.7.411
  2. Effect of Flexi-bar exercise on postural alignment and balance ability in juvenile soccer players vol.16, pp.8, 2015, https://doi.org/10.5762/KAIS.2015.16.8.5296
  3. Effects of Gastrocnemius and Lumbar Back Muscle Exercise on Standing Balance vol.4, pp.2, 2013, https://doi.org/10.5854/JIAPTR.2013.10.25.618