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The Effects of Balance and Trunk Repositioning Sense with Multisensorial Training using Visual Cue Deprivation in Subacute Stroke Patients

시각 통제를 이용한 다중감각 훈련이 아급성 뇌졸중 환자의 균형 및 체간위치감각에 미치는 효과

  • So, Dong-Hak (Department of Physical Therapy, Sahmyook University) ;
  • Lee, Wan-Hee (Department of Physical Therapy, Sahmyook University) ;
  • Yun, Mi-Jung (Department of Physical Therapy, Sahmyook University)
  • 소동학 (삼육대학교 물리치료학과) ;
  • 이완희 (삼육대학교 물리치료학과) ;
  • 윤미정 (삼육대학교 물리치료학과)
  • Received : 2012.11.12
  • Accepted : 2013.02.06
  • Published : 2013.02.28

Abstract

This study was to investigate the effects of balance and trunk repositioning sense through multisensorial training using visual cue deprivation in subacute stroke patients. Multisensorial training group practiced after visual deprivation, control group practiced in the same training except visual deprivation with thirty subjects. Both groups were conducted training programs on sixty minutes a day, five days a week during four weeks. The subjects were evaluated by static balance, dynamic balance and trunk repositioning sense in the pre-posttest. There was significant improvement by multisensorial training that static balance, dynamic balance and the trunk repositioning sense between pretest and post test (p<.05). There were significantly differences in the amount of change of dynamic balance, trunk repositioning sense between the two groups(p<.05). Through this study, multisensorial training suggest that is effective in the improvement of dynamic balance and trunk repositioning sense.

본 연구는 시각 통제를 이용한 다중감각 훈련이 아급성 뇌졸중 환자의 균형 및 체간위치감각에 미치는 영향을 알아보고자 시행하였다. 뇌졸중 환자 30명을 대상으로, 다중감각 훈련군은 시각통제 후 훈련을 실시하였고, 대조군은 안대로 눈을 가린 것을 제외하고는 실험군과 동일한 훈련을 실행 하였다. 두 군 모두 훈련 과정은 4주간 주 5회 60분 동안 실시하였다. 대상자들은 사전, 사후 평가로 정적 균형, 동적 균형 및 체간위치감각을 검사하였다. 본 연구의 결과는 다중감각 훈련군에서 훈련 전, 후를 비교한 결과 정적 균형, 동적 균형, 체간위치감각에서 유의한 향상이 나타났고(p<.05), 두 그룹 사이에서는 동적 균형, 체간위치감각에서 유의한 차이가 나타났다(p<.05). 본 연구의 결과를 통하여 다중감각 훈련은 동적 균형 및 체간위치감각을 향상시키는데 효과적인 훈련방법으로 제시 할 수 있다.

Keywords

References

  1. Winstein CJ, Miller JP, Blanton S, et al., "Methods for a multisite randomized trial to investigate the effect of constraint-induced movement therapy in improving upper extremity function among adults recovering from a cerebrovascular stroke", Neurorehabil Neural Repair, Vol. 17, No. 3, pp. 137-152, 2003. DOI: http://dx.doi.org/10.1177/0888439003255511
  2. Wade DT, Wood VA, Hewer RL. "Recovery after stroke the first 3months", J Neorol Neurosurg Psychiatry, Vol 48, pp7-13, 1985. DOI: http://dx.doi.org/10.1136/jnnp.48.1.7
  3. J. H. Lee, S. B. Kim, K. W Lee, et al., "The effect of prolonged Inpatient rehabilitation therapy in subacute stroke patients", Ann Rehabil Med, Vol. 36, pp.16-21, 2012. DOI: http://dx.doi.org/10.5535/arm.2012.36.1.16
  4. Mahabir D, Bidcman L, Gulliford MC, "Stroke in trinidad and tobago: burden of illness and risk factors", Rev panam Salud Publica, Vol. 4, No. 4, pp. 233-237, 1998. DOI: http://dx.doi.org/10.1590/S1020-49891998001000002
  5. De Haart M, Geurts AC, Huide koper SC, et al., "Recovery of standing balance in post acute stroke patients: a rehabilitation cohort study", Arch Phys Med Rehabil, Vol. 85, No. 6, pp. 886-895, 2004. https://doi.org/10.1016/j.apmr.2003.05.012
  6. Nyberg L, Gustafson Y, "Patient Fall in stroke Rehabilitation", Stroke, Vol. 26, No. 1, pp. 838-842, 1995. DOI: http://dx.doi.org/10.1161/01.STR.26.5.838
  7. Dickstein R, Abulaffio N, "Postural sway of the affected and non affected pelvis and leg instance of hemiparetic patients", Arch Phys Med Rehabil, Vol. 81, No. 3, pp. 364-367, 2000. DOI: http://dx.doi.org/10.1016/S0003-9993(00)90085-6
  8. Kerrigan DC, Karvosky EM, Riley PO, "Spastic Paretic Stiff-Legged Gait: joint kinetics", Arch Phys Med Rehabil, Vol. 80, No. 4, pp. 244-249, 2001. DOI: http://dx.doi.org/10.1097/00002060-200104000-00002
  9. Carr J, Shepherd R, "Stroke Rehabilitation: Guidelines for Exercise and Training to Optimize Motor Skill", Oxford: Elsevier, 2004.
  10. Varoqui D, Froger J, Lagarde J, et al., "Changes in preferred postural patterns following stroke during intentional ankle/hip coordination", Gait and Posture, Vol. 32, No. 1, pp. 34-38, 2010. DOI: http://dx.doi.org/10.1016/j.gaitpost.2010.03.004
  11. Horak FB., Henry SM., Shumway-Cook A. "Postural perturbations: new insights for treatment of balance disorders", Phys Ther, Vol. 77, No. 3, pp. 517-533, 1997. https://doi.org/10.1093/ptj/77.5.517
  12. Bonan MD, Alain P, Yelnik MD, "Subjective Visual Vertical Perception Relates to Balance in Acute Stroke", Arch Phys Med Rehabil, Vol. 87, No. 4, pp. 642-646, 2006. DOI: http://dx.doi.org/10.1016/j.apmr.2006.01.019
  13. Yelnik AP, Le Breton F, Colle FM, et al., "Rehabilitation of balance after stroke with multisensorial training: a single-blind randomized controlled study", Neurorehabil Neural Repair, Vol. 22, No. 5, pp. 468-476, 2008. DOI: http://dx.doi.org/10.1177/1545968308315996
  14. Massion J, Amblard B, Assaiante C, et al., "Body orientation and control of coordinated movements in microgravity", Brain Res Brain Res Rev, Vol. 28, No.1-2, pp. 83-91, 1998. DOI: http://dx.doi.org/10.1016/S0165-0173(98)00029-0
  15. Shumway-Cook A, Wollacott M, "Attentional demands and postural control: the effect of sensory context", J Gerontol A Biol Sci Med Sci, Vol. 55, No. 1, pp. 245-356, 2000. https://doi.org/10.1093/gerona/55.4.M245
  16. Bonan MD, Eric Vicaut MD. "Reliance on Visual Information After Stroke. PartII: Effectiveness of a Balance Rehabilitation Program With Visual Cue Deprivation After Stroke. A Randomized Controlled Trial" Arch Phys Med Rehabil, Vol. 85, No. 2, pp. 274-278, 2004. DOI: http://dx.doi.org/10.1016/j.apmr.2003.06.016
  17. Marigold DS, Eng J. "The relationship of asymmetric weight-bearing with postural sway and visual reliance in stroke", Gait and Posture, Vol. 23, No. 2, pp. 249-255, 2005. DOI: http://dx.doi.org/10.1016/j.gaitpost.2005.03.001
  18. Yelnik AP, Kassouha A, Bonan IV, et al., "Postural visual dependence after recent stroke: assessment by optokinetic stimulation", Gait and Posture, Vol. 24, No. 3, 262-269, 2005. DOI: http://dx.doi.org/10.1016/j.gaitpost.2005.09.007
  19. K. T. Yoo, "12 weeks complex exercise's effects on daily living activity, proprioceptive perception, muscle activities and balance of hemiplegia patients", dissertation, Kyung Hee University, Korea, 2008.
  20. Ryerson S, Byl NN, Brown DA, et al., "Altered trunk position sense and its relation to balance functions in people post-stroke", J Neurol Phys Ther Vol 32, No 1, pp. 14-20, 2008. https://doi.org/10.1097/NPT.0b013e3181660f0c
  21. Podsiadlo D, Richardson S, "The timed "Up and Go": a test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, Vol. 39, No. 2, pp. 142-148, 1991. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  22. Ryerson S, By NN, Brown DA, et al., "Altered trunk position sense and its relation to balance function sin people post-stroke", J Neurol Phys Ther, Vol. 32, No. 1, pp. 14-20, 2008. https://doi.org/10.1097/NPT.0b013e3181660f0c
  23. L. Y. Seop, "The Effects of Visual control Balance training on the Balance in the Patients with Stroke", Master's thesis, Daege University, 2009.
  24. J. S. Kuk, "The Effect of Balance with Visual Cue Deprivation and Visual Feedback Training in Stroke Patients", Master's thesis, Daege University, 2010.
  25. Walker C, Brouwer BJ, Culham EG, "Use of visual feedback in retraining balance following acute stroke", Phys Ther, Vol. 80, No. 9, pp. 886-895, 2000.
  26. K. H. Cho, W. H. Lee, "Changes to Balance and Trunk Repositioning Sense According to Frequency of falls in stroke patients", Korean J Health Promot, Vol. 11, No. 1, pp. 48-55, 2011.
  27. Goldberg A, Hernandez ME, Alexander NB, "Trunk repositioning errors are increased in balance-impaired older adults", J Gerontol A Biol Sci Med Sci, Vol. 60, No. 10, pp. 1310-1314, 2005. DOI: http://dx.doi.org/10.1093/gerona/60.10.1310
  28. Marigold DS, Eng JJ, "The relationship of asymmetric weight-bearing with postural sway and visual reliance in stroke", Gait and Posture, Vol. 23, No. 2, pp. 249-255, 2006. https://doi.org/10.1016/j.gaitpost.2005.03.001
  29. Preuss R, Grenier S, McGill S, "The effect of test position on lumbar spine position sense", J Orthop Sports Phys Ther, Vol. 33, No. 2, pp. 73-78, 2003. DOI: http://dx.doi.org/10.1016/j.gaitpost.2005.03.001