대한물리의학회지 (Journal of the Korean Society of Physical Medicine)

  • 제9권4호
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  • Pages.475-483
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  • 2014
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  • 1975-311X(pISSN)
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  • 2287-7215(eISSN)
대한물리의학회 (The Korean Society of Physical Medicine)
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닫힌 사슬 하지 저항운동이 뇌졸중 환자의 보행에 미치는 영향

Effects of Close Kinetic Chain Resistant Exercise of Lower Extremity on the Gait with Stroke

  • 문상훈 (라온 휴 병원 물리치료실) ;
  • 김영민 (한국교통대학교 물리치료학과)
  • Moon, Sang-Hun (Department of physical therapy, RAON HUE Hospital) ;
  • Kim, Young-Min (Department of Physical Therapy, Korea National University of Transportation)
  • 투고 : 2014.09.24
  • 심사 : 2014.11.05
  • 발행 : 2014.11.30
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초록

PURPOSE: The purpose of the study was to determine the effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke patients. METHODS: The subjects were 50 patients who were diagnosed with cerebrovascular accident. They were randomly assigned either to a close kinetic chain resistant exercise of lower extremity group (study group)(n=25) or open kinetic chain resistant exercise of lower extremity exercise group (control group)(n=25). Gait abilities were measured by using Timed Up & Go (TUG) test, Functional Gait Assessment (FGA) and spatio-temporal gait variable that were velocity, cadence, stride length, double limb support by 3 axises wireless accelerometer and sway angle of center of mass by same instrument. RESULTS: Study group and control group before and after the intervention there were significantly difference in TUG, FGA, spatio-temporal gait variables and sway angle of center of mass (p<.05). There were significantly different between study group and control group for all variables at post-exercise. CONCLUSION: When all is said and done it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with stroke. In its final analysis when applying resistant exercise of lower extremity to stroke patients' gait, close kinetic chain is more effective than open kinetic chain.

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참고문헌

  1. Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother. 2006;52(4):241-8. https://doi.org/10.1016/S0004-9514(06)70003-4
  2. Ahn YH, Ahn SH, Kim, H et al. Can stroke patients walk after complete lateral corticospinal tract injury of the affected hemisphere? Neuroreport. 2006;17(10):987-90. https://doi.org/10.1097/01.wnr.0000220128.01597.e0
  3. An CS, Jung S. A study on gait analysis of normal adult and hemiplegia patients. The Korean society of physical therapy. 2002;14(3):143-8.
  4. An SH, Jung YJ, Park SY. The effects of trunk control ability on balance, gait, and functional performance ability in patients with stroke. Korean academy of university trained physical therapists. 2010;17(2):33-42.
  5. Bae SS, Kim TS, Kim OJ. A study of resistive therapeutic exercise prescription. The journal of Korean society of physical therapy. 1999;11(1):149-56.
  6. Byun SD, Jung TD, Kim CH et al. Effects of the sliding rehabilitation machine on balance and gait in chronic stroke patients-a controlled clinical trial. Clin Rehabil. 2011;25(5):408-15. https://doi.org/10.1177/0269215510385850
  7. Chae JB, Lee MH. The effects of somatosensory training on the spatiotemporal gait parameters and balance in patients with stroke. J Korean Soc Phys Med. 2010;5(4):587-96.
  8. Cramp MC, Greenwood RJ, Gill M et al. Low intensity strength training for ambulatory stroke patients. Disabil Rehabil. 2006;28(13-14):883-9. https://doi.org/10.1080/09638280500535157
  9. Crenna P. Spasticity and 'spastic' gait in children with cerebral palsy. Neurosci Biobehav Rev. 1998;22(4):571-8. https://doi.org/10.1016/S0149-7634(97)00046-8
  10. Dietz V, Berger W. Interlimb coordination of postrure in patients with spastic paresis. Impaired function of spinal reflexes. Brain. 1984;107(Pt3):965-78. https://doi.org/10.1093/brain/107.3.965
  11. Dobkin BH. Clinical Practice. Rehabilitation after Stroke. N Engl J of Med. 2005;352(16):1677-84. https://doi.org/10.1056/NEJMcp043511
  12. Flansbjer UB, Miller M, Downham D et al. Progressive resistance training after stroke: effects on muscle strength, muscle tone, gait performance and perceived participation. J Rehabil Med. 2008;40(1):42-8. https://doi.org/10.2340/16501977-0129
  13. Hardie K, Hankey GJ, Jamrozik K et al. Ten-Year risk of first recurrent stroke and disability after first-ever stroke in the Perth Community Stroke Study. Stroke. 2004;35(3):731-5. https://doi.org/10.1161/01.STR.0000116183.50167.D9
  14. Hesse S, Werner C, Paul T et al. Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. Arch Phys Med Rehabil. 2001;82(11):1547-50. https://doi.org/10.1053/apmr.2001.26607
  15. Holten O, Faugli H. Medisinsk trenignsterapi. Oslo. Universitets foriaget. 1994.
  16. Iwasaki T, Shiba N, Matsuse H et al. Improvement in knee extension strength through training by means of combined electrical stimulation and voluntary muscle contraction. Tohoku J Exp Med. 2006;209(1):33-40. https://doi.org/10.1620/tjem.209.33
  17. Jang JW. The change of muscle activation in quadriceps femoris muscle during taking open kinetic chain exercise and closed kinetic chain exercise: on the subject of soccer players. Master's Thesis, Korea University, 2003.
  18. Kelly JO, Kilbreath SL, Davis GM et al. Cardiorespiratory fitness and walking ability in subacute stroke patients. Arch phys med rehabil. 2003;84(12):1780-5. https://doi.org/10.1016/S0003-9993(03)00376-9
  19. Kim DU. Effects of gluteus medius strengthening exercise on the balance and gait speed of adult hemiplegic patients. Master's Thesis, Catholic University of Pusan, 2008.
  20. Kim HG, Ko JY, Hur JG. Effect of a closed chain and open chain resistance exercise on lower extremity muscle activity, balance, gait for the patients with stroke. J Korean Acad Ther. 2010;2(1):73-82.
  21. Kim YJ. The effects of closed kinetic chain exercises on the stability of the knee joints of patients with anterior cruciate ligament reconstruction. Master's Thesis, Daegu Yniversity, 2007.
  22. Kurugant U, Parker P, Rickards J et al. Strength and muscle co-activation in older adults after lower limb strength training. International Journal of Industrial Ergonomics. 2006;36(9):761-6. https://doi.org/10.1016/j.ergon.2006.05.006
  23. Lamontagne A, Malouin F, Richards DL. Contribution of passive stiffness to ankle plantarflexion moment during gait after stroke. Arch phys med rehabil. 2000;81(3):351-8. https://doi.org/10.1016/S0003-9993(00)90083-2
  24. Lee HK, Hwang SJ, Cho SP et al. Development of novel step detection algorithm for gait evaluation of patients with hemiplegia based on trunk accelerometer. J Biomed Eng Res. 2009;30(3):213-20.
  25. Lee SK, Park MC, Shim JM et al. The effect of closed kinetic chain exercise with FES of the gluteus medius on gait in stroke. J Korean Soc Phys Med. 2011;6(1):1-8.
  26. Morris SL, Dodd KJ, Morris ME. Outcomes of progressive resistance strength training following stroke: a systematic review. Clin Rehabil. 2004;18(1):27-39. https://doi.org/10.1191/0269215504cr699oa
  27. Nam KY, Kim KM, Park SW et al. The effects of sliding rehabilitation machine in patients with hemiplegia. Korean stroke society. 2006;8(1):86-91.
  28. Nugent JA, Schurr KA, Adams RD. A dose-response relationship between amount of weight-bearing exercise and walking outcome following cerebrovascular accident. Arch Phys Med Rehabil. 1994;75:399-402. https://doi.org/10.1016/0003-9993(94)90162-7
  29. Palmitier RA, An KN, Scott SG et al. Kinetic chain exercise in knee rehabilitation. Sprots Med. 1991;11(6):402-13. https://doi.org/10.2165/00007256-199111060-00005
  30. Perry J, Burnfield JM. Gait analysis: normal and pathological function. 2nd edition. New Jersey. Slack Co. 2010.
  31. Pinninger GJ, Steele JR, Thorstensson A et al. Tension regulation during lengthening and shortening actions of the human soleus muscle. Eur J Appl Physio. 2000;81(5):375-83. https://doi.org/10.1007/s004210050057
  32. Podsiadlo D, Richardson S. The Timed UP & GO: a test basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  33. Prentice WE. Rehabilitation techniques in sports medicine. 2nd ed. St. Louis. Times Mirror/Mosby College Pub. 1990.
  34. Saunders M. Weight training and conditioning, In Sanders, B (cd). London. Sports Physical Therapy. Appleton and Lange. 1990.
  35. Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Arch phys med rehabil. 1997;78(11):1231-6. https://doi.org/10.1016/S0003-9993(97)90337-3
  36. Statistics Korea. 2012 statistically chronological list of the cause of death. Daejeon. Statistics Korea. 2012.
  37. Sterr A, Freivogel S. Intensive training in chronic upper limb hemiparesis does not increase spasticity or synergies. Neurology. 2004;63(11):2176-7. https://doi.org/10.1212/01.WNL.0000145605.20476.07
  38. Won JI, Yu KH. Reliability of the functional gait assessment in patients with stroke. Korean research society of physical therapy. 2011;18(1):64-73.

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