Physical Therapy Rehabilitation Science

  • 제2권2호
  • /
  • Pages.104-110
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  • 2013
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  • 2287-7576(pISSN)
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  • 2287-7584(eISSN)
물리치료재활과학회 (korean Academy of Physical Therapy Rehabilitation Science)
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The effects of intensive gait training with body weight support treadmill training on gait and balance in stroke disability patients: a randomized controlled trial

  • Lee, Byung Joon (Department of Rehabilitation Medicine, Inje University Sanggye Paik Hospital) ;
  • Lee, Hwang Jae (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Lee, Wan Hee (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • 투고 : 2013.10.23
  • 심사 : 2013.12.17
  • 발행 : 2013.10.26
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초록

Objective: The purpose of this study was to investigate the effects of intensive gait training with body weight support treadmill training on gait and balance in stroke disability patients. Design: Randomized controlled trial. Methods: Twenty-six stroke patients (20 men and 6 women) participated in this study. All subjects were hospitalized patients. They were randomly divided into two groups: the experimental group (body weight supported treadmill training group, n=14) and control group (treadmill group, n=12). The mean ages were 52.07 years (experimental group) and 53.83 years (control group). Subjects in both groups received conventional training 10 times/wk. Subjects in the experimental group practiced body weight supported treadmill training for 30 minutes a day, 3 day/wk. Subjects in the control group practiced treadmill training for 30 minutes. The Berg Balance Scale (BBS) and GAITRite were used to evaluate balance and gait parameters (step length, cadence and gait speed) before and after the intervention. Results: BBS scores in the experimental group showed significantly greater improvement ($4.33{\pm}1.54$), compared with the control group (p<0.05). Significantly greater improvement in the gait speed ($24.13{\pm}4.53$ cm/s), affected side step length ($10.40{\pm}3.42$ cm), sound side step length ($11.97{\pm}3.29$ cm), and cadence ($23.88{\pm}5.52$ step/min), compared with the control group (p<0.05). Conclusions: Intensive gait training with Body Weight Support Treadmill Training may improve gait and balance in subacute stroke.

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참고문헌

  1. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet 2011;377:1693-702. https://doi.org/10.1016/S0140-6736(11)60325-5
  2. Dickstein R, Dunsky A, Marcovitz E. Motor imagery for gait rehabilitation in post-stroke hemiparesis. Phys Ther 2004;84: 1167-77.
  3. Yan T, Hui-Chan CW, Li LS. Functional electrical stimulation improves motor recovery of the lower extremity and walking ability of subjects with first acute stroke: a randomized placebo- controlled trial. Stroke 2005;36:80-5. https://doi.org/10.1161/01.STR.0000149623.24906.63
  4. Suh JH, Han SJ, Jeon SY, Kim HJ, Lee JE, Yoon TS, et al. Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients. NeuroRehabilitation 2013. [Epub ahead of print]
  5. Sale P, Franceschini M, Waldner A, Hesse S. Use of the robot assisted gait therapy in rehabilitation of patients with stroke and spinal cord injury. Eur J Phys Rehabil Med 2012;48:111-21.
  6. Silver KH, Macko RF, Forrester LW, Goldberg AP, Smith GV. Effects of aerobic treadmill training on gait velocity, cadence, and gait symmetry in chronic hemiparetic stroke: a preliminary report. Neurorehabil Neural Repair 2000;14:65-71. https://doi.org/10.1177/154596830001400108
  7. Lamontagne A, Fung J. Faster is better: implications for speedintensive gait training after stroke. Stroke 2004;35:2543-8. https://doi.org/10.1161/01.STR.0000144685.88760.d7
  8. Peurala SH, Airaksinen O, Huuskonen P, Jäkälä P, Juhakoski M, Sandell K, et al. Effects of intensive therapy using gait trainer or floor walking exercises early after stroke. J Rehabil Med 2009; 41:166-73. https://doi.org/10.2340/16501977-0304
  9. Visintin M, Barbeau H, Korner-Bitensky N, Mayo NE. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke 1998;29:1122-8. https://doi.org/10.1161/01.STR.29.6.1122
  10. Malouin F, Potvin M, Prévost J, Richards CL, Wood-Dauphinee S. Use of an intensive task-oriented gait training program in a series of patients with acute cerebrovascular accidents. Phys Ther 1992;72:781-9. https://doi.org/10.1093/ptj/72.11.781
  11. Chung EJ, Lee BH. The effects of treadmill training on dynamic balance and gait function in stroke patients: a pilot randomized controlled trial. Phys Ther Rehabil Sci 2013;2:39-43.
  12. McCain KJ, Pollo FE, Baum BS, Coleman SC, Baker S, Smith PS. Locomotor treadmill training with partial body-weight support before overground gait in adults with acute stroke: a pilot study. Arch Phys Med Rehabil 2008;89:684-91. https://doi.org/10.1016/j.apmr.2007.09.050
  13. Sousa CO, Barela JA, Prado-Medeiros CL, Salvini TF, Barela AM. Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study. J Neuroeng Rehabil 2011;8:48. https://doi.org/10.1186/1743-0003-8-48
  14. Ada L, Dean CM, Morris ME. Supported treadmill training to establish walking in non-ambulatory patients early after stroke. BMC Neurol 2007;7:29. https://doi.org/10.1186/1471-2377-7-29
  15. Ada L, Dean CM, Morris ME, Simpson JM, Katrak P. Randomized trial of treadmill walking with body weight support to establish walking in subacute stroke: the MOBILISE trial. Stroke 2010;41:1237-42. https://doi.org/10.1161/STROKEAHA.109.569483
  16. Lindquist AR, Prado CL, Barros RM, Mattioli R, da Costa PH, Salvini TF. Gait training combining partial body-weight support, a treadmill, and functional electrical stimulation: effects on poststroke gait. Phys Ther 2007;87:1144-54. https://doi.org/10.2522/ptj.20050384
  17. Sullivan KJ, Knowlton BJ, Dobkin BH. Step training with body weight support: effect of treadmill speed and practice paradigms on poststroke locomotor recovery. Arch Phys Med Rehabil 2002;83:683-91. https://doi.org/10.1053/apmr.2002.32488
  18. Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther 2008;88:559-66. https://doi.org/10.2522/ptj.20070205
  19. de Oliveira CB, de Medeiros IR, Frota NA, Greters ME, Conforto AB. Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev 2008;45:1215-26. https://doi.org/10.1682/JRRD.2007.09.0150
  20. Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med 1995;27:27-36.
  21. Bilney B, Morris M, Webster K. Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait. Gait Posture 2003;17:68-74. https://doi.org/10.1016/S0966-6362(02)00053-X
  22. Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture 2004;20:20-5. https://doi.org/10.1016/S0966-6362(03)00068-7
  23. Laufer Y, Dickstein R, Chefez Y, Marcovitz E. The effect of treadmill training on the ambulation of stroke survivors in the early stages of rehabilitation: a randomized study. J Rehabil Res Dev 2001;38:69-78.
  24. Peurala SH, Tarkka IM, Pitkänen K, Sivenius J. The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke. Arch Phys Med Rehabil 2005;86: 1557-64. https://doi.org/10.1016/j.apmr.2005.02.005
  25. Combs SA, Dugan EL, Ozimek EN, Curtis AB. Bilateral coordination and gait symmetry after body-weight supported treadmill training for persons with chronic stroke. Clin Biomech (Bristol, Avon) 2013;28:448-53. https://doi.org/10.1016/j.clinbiomech.2013.02.001
  26. Michael KM, Allen JK, Macko RF. Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness. Arch Phys Med Rehabil 2005;86:1552-6. https://doi.org/10.1016/j.apmr.2004.12.026
  27. Yavuzer G, Eser F, Karakus D, Karaoglan B, Stam HJ. The effects of balance training on gait late after stroke: a randomized controlled trial. Clin Rehabil 2006;20:960-9. https://doi.org/10.1177/0269215506070315
  28. Stephenson JL, Lamontagne A, De Serres SJ. The coordination of upper and lower limb movements during gait in healthy and stroke individuals. Gait Posture 2009;29:11-6. https://doi.org/10.1016/j.gaitpost.2008.05.013
  29. Kawahira K, Shimodozono M, Ogata A, Tanaka N. Addition of intensive repetition of facilitation exercise to multidisciplinary rehabilitation promotes motor functional recovery of the hemi plegic lower limb. J Rehabil Med 2004;36:159-64. https://doi.org/10.1080/16501970410029753
  30. Dombovy ML. Understanding stroke recovery and rehabilitation: current and emerging approaches. Curr Neurol Neurosci Rep 2004;4:31-5. https://doi.org/10.1007/s11910-004-0008-6
  31. French B, Thomas LH, Leathley MJ, Sutton CJ, McAdam J, Forster A, et al. Repetitive task training for improving functional ability after stroke. Cochrane Database Syst Rev 2007;(4): CD006073.
  32. Barbeau H, Visintin M. Optimal outcomes obtained with body-weight support combined with treadmill training in stroke subjects. Arch Phys Med Rehabil 2003;84:1458-65. https://doi.org/10.1016/S0003-9993(03)00361-7

피인용 문헌

  1. An Exploratory Clinical Study on an Automated, Speed-Sensing Treadmill Prototype With Partial Body Weight Support for Hemiparetic Gait Rehabilitation in Subacute and Chronic Stroke Patients vol.11, pp.None, 2013, https://doi.org/10.3389/fneur.2020.00747