디지털융복합연구 (Journal of Digital Convergence)

  • 제12권7호
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  • Pages.297-304
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  • 2014
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  • 2713-6434(pISSN)
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  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
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뇌졸중 환자의 균형능력 회복을 위한 가정운동프로그램 효과

The Effects of Home Based Exercise Program on Balance Recovery in a Post-Stroke Population

  • 장상훈 (김천대학교 물리치료학과) ;
  • 정병옥 (김천대학교 물리치료학과) ;
  • 방현수 (김천대학교 물리치료학과)
  • 투고 : 2014.05.09
  • 심사 : 2014.07.20
  • 발행 : 2014.07.28
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초록

본 연구는 가정운동프로그램이 뇌졸중 환자의 균형능력회복에 미치는 효과를 알아보기 위하여 실시하였다. 본 연구는 2013년 9월에서 2013년 12월까지 실시하였으며, 대상자는 총 20명으로 일반적인 통원 물리치료를 실시한 조군 10명, 일반적인 통원 물리치료를 실시하고 추가적으로 가정운동프로그램을 실시한 운동군 10명으로 나누어 배정하였다. 가정운동프로그램은 신경계 물리치료사가 대상자 집을 방문하여 8주동안 주 2회씩 매회 30분간 시행하였으며 체중이동훈련, 지구력훈련, 운동재훈련, 감각재훈련, 하지운동으로 구성되었다. 균형능력을 평가하기 위하여 Biorescu를 이용하여 족저압, 안정성한계, 동요속도를 측정하였고 임상적인 측정방법 중 하나인 기능적 팔뻗기 검사를 실시하였다. 연구결과 대조군과 운동군은 안정성한계, 동요속도, 기능적 팔뻗기 검사에서 유의한 차이가 나타났다. 본 연구는 가정운동프로그램이 뇌졸중 환자의 균형회복을 회복하는데 효과적인 치료전략 중 하나라는 것을 나타낸다.

The present study was designed to investigate the effect of home based exercise program on balance recovery of stroke patients. In total, 20 participants were assigned to a control group(n=10) or exercise group(n=10) between September 2013 and December 2013. In addition to existing physiotherapy, the exercise group received home based exercise program consisting of weight transfer, training endurance, mobility, sensory retraining, lower limb exercise for 30 minutes, 2 times a week, for 8 weeks, every time for 30 minutes. Balance ability was assessed by measuring foot pressure(FP), limit of stability(LOS) and velocity sway(VS) by using Biorescue and by using the functional reaching test(FRT). To compare the improvement level of each group's balance ability, examination of independent sample T was done. Significant differences between control group and exercise group in LOS, VS of affect side and FRT were observed. This study showed that home based exercise program application was effective strategy on balance recovery in a post stroke population.

키워드

참고문헌

  1. D. T. Wade, R. L. Hewer, Functional abilities after stroke: measurement, natural history and prognosis. Journal of Neurology, Neurosurgery & Psychiatry, Vol. 50, No. 2, pp. 177-182, 1987. https://doi.org/10.1136/jnnp.50.2.177
  2. K. M. Michael, J. K. Allen, R. F. Macko, Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness. Archives of Physical Medicine and Rehabilitation, Vol. 86, No. 8, pp. 1552-1556, 2005. https://doi.org/10.1016/j.apmr.2004.12.026
  3. T. Askim, S. Morkved, A. Engen, K. Roos, T. Asd, B. Indredavik, Effects of a Community-Based Intensive Motor Training Program Combined With Early Supported Discharge After Treatment in a Comprehensive Stroke Unit A Randomized, Controlled Trial. Stroke, Vol. 41, No. 8, pp. 1697-1703, 2010. https://doi.org/10.1161/STROKEAHA.110.584284
  4. J. H. Lin, C. L. Hsieh, S. K. Lo, H. M. Chai, L. R. Liao, Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients. The Kaohsiung Journal of Medical Sciences, Vol. 20, No. 1, pp. 18-22, 2004. https://doi.org/10.1016/S1607-551X(09)70079-8
  5. P. Duncan, L. Richards, D. Wallace, J. Stoker-Yates, P. Pohl, C. Luchies, A. Ogle, S. Studenski, A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke, Vol. 29, No. 10, pp. 2055-2060, 1998. https://doi.org/10.1161/01.STR.29.10.2055
  6. P. Roderick, J. Low, R. Day, T. Peasgood, M. A. Mullee, J. C. Turnbull, T. Villar, J. Raftery, Stroke rehabilitation after hospital discharge: a randomized trial comparing domiciliary and day-hospital care. Age and Ageing, Vol. 30, No. 4, pp. 303-310, 2001. https://doi.org/10.1093/ageing/30.4.303
  7. J. B. Young, A. Forster, The Bradford community stroke trial: results at six months. British Medical Journal, Vol. 304, No. 6834, pp. 1085-1089, 1992. https://doi.org/10.1136/bmj.304.6834.1085
  8. A. Shurnway-Cook, D. Anson, S. Haller, Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Archives of Physical Medicine and Rehabilitation, Vol. 69, No. 6, pp. 395-400, 1988.
  9. C. M. Sackley, B. I. Baguley, S. Gent, P. Hodgson, The use of a balance performance monitor in the treatment of weight-bearing and weight transference problems after stroke. Physiotherapy, Vol. 78, No. 12, pp. 907-913, 1992. https://doi.org/10.1016/S0031-9406(10)60498-1
  10. P. A. Goldie, T. M. Bach, O. M. Evans, Force platform measures for evaluating postural control: reliability and validity. Archives of Physical Medicine and Rehabilitation, Vol. 70, No. 7, pp. 510-517, 1989.
  11. D. S. Nichols, Balance retraining after stroke using force platform biofeedback. Physical Therapy, Vol. 77, No. 5, pp. 553-558, 1997. https://doi.org/10.1093/ptj/77.5.553
  12. S. M. Waller, M. G. Prettyman, Arm training in standing also improves postural control in participants with chronic stroke. Gait & Posture, Vol. 36, No. 3, pp. 419-424, 2012. https://doi.org/10.1016/j.gaitpost.2012.03.025
  13. A. C. H. Geurts, M. de Haart, I. J. W. van Nes, J. Duysens, A review of standing balance recovery from stroke. Gait & Posture, Vol. 22, No. 3, pp. 267-281, 2005. https://doi.org/10.1016/j.gaitpost.2004.10.002
  14. L. A. Hale, J. Piggot, Exploring the Content of Physiotherapeutic Home-Based Stroke Rehabilitation in New Zealand. Archives of Physical Medicine and Rehabilitation, Vol. 86, No. 10, pp. 1933-1940, 2005. https://doi.org/10.1016/j.apmr.2005.04.011
  15. S. F. Tyson, L. H. DeSouza, Reliability and validity of functional balance tests post stroke. Clinical Rehabilitation, Vol. 18, No. 8, pp. 916-923, 2004. https://doi.org/10.1191/0269215504cr821oa
  16. D. Wicke, R. Coppin, S. Payne, Teamworking in nursing homes. Journal of Advanced Nursing, Vol. 45, No. 2, pp. 197-204, 2004. https://doi.org/10.1046/j.1365-2648.2003.02881.x
  17. E. Y. Kim, E. H. Cho, K. J. June, Factors influencing use of home care and nursing homes. Journal of Advanced Nursing, Vol. 54, No. 4, pp. 511-517, 2006. https://doi.org/10.1111/j.1365-2648.2006.03839.x
  18. I. Melzer, N. Benjuya, J. Kaplanski, N. Alexander, Association between ankle muscle strength and limit of stability in older adults. Age and Ageing, Vol. 38, No. 1, pp. 119-123, 2008. https://doi.org/10.1093/ageing/afn249
  19. S. I. Lin, Association between sensorimotor function and functional and reactive balance control in the elderly. Age and Ageing, Vol. 34, No. 4, pp. 358-363, 2005. https://doi.org/10.1093/ageing/afi089
  20. J. H. Lin, C. L. Hsieh, S. K. Lo, H. M. Chai, L. R. Liao, Preliminary study of the effect of low-intensity home-based physical therapy in chronic stroke patients. The Kaohsiung Journal of Medical Sciences, Vol. 20, No. 1, pp. 18-22, 2004. https://doi.org/10.1016/S1607-551X(09)70079-8
  21. J. S. Chern, C. Y. Lo, C. Y. Wu, C. L. Chen, S. Yang, F. T. Tang, Dynamic postural control during trunk bending and reaching in healthy adults and stroke patients. American Journal of Physical Medicine & Rehabilitation, Vol. 89, No. 3, pp. 186-197, 2010. https://doi.org/10.1097/PHM.0b013e3181c56287
  22. P. Era, E. Heikkinen, I. Gause-Nilsson, M. Schroll, Postural balance in elderly people: change over five-year follow-up and its predictive value for survival. Aging clinical and experimental research, Vol. 14, No. 3, pp. 37-46, 2002.
  23. P. Era, K. Avlund, J. Jokela, I. Gause-Nilsson, E. Heikkinen, B. Steen, M. Schroll, Postural balance and self-reported functional ability in 75-year-old men and women: a cross-national comparative study. Journal of American Geriatrics Society, Vol 45, No. 1, pp. 21-29, 1997. https://doi.org/10.1111/j.1532-5415.1997.tb00973.x
  24. P. B. Thapa, P. Gideon, R. L. Fought, M. Kormicki, W. A. Ray, Comparison of clinical biomechanical measures of balance and mobility in elderly nursing home residents. Journal of the American Geriatrics Society, Vol. 42, No. 5, pp. 493-500, 1994. https://doi.org/10.1111/j.1532-5415.1994.tb04970.x
  25. O. Pyoria, P. Era, U. Talvitie, Relationships between standing balance and symmetry measurements in patients following recent strokes(${\leq}3$ weeks) or older strokes(${\geq}6$ months). Physical Therapy, Vol 84, No. 2, pp. 128-136, 2004.
  26. G. R. Fernie, C. I. Gryfe, P. J. Holliday, A. Llewellyn, The relationship of postural sway in standing: the incidence of falls in geriatric subjects. Age and Ageing, Vol. 11, No. 1, pp. 11-16, 1982. https://doi.org/10.1093/ageing/11.1.11
  27. P. F. Meyer, L. I. E. Oddsson, C. J. D. Luca, Reduced plantar sensitivity alters postural responses to lateral perturbations of balance. Experimental Brain Research, Vol. 157, No. 4, pp. 526-536, 2004. https://doi.org/10.1007/s00221-004-1868-3
  28. R. W. Simmons, C. Rchardson, R. Pozos, Postural stability of diabetic patients with and without cutaneous sensory deficit in the foot. Diabetes Research and Clinical Practice, Vol. 36, No. 3, pp. 153-160, 1997. https://doi.org/10.1016/S0168-8227(97)00044-2
  29. C. Wutzke, V. Mercer, M. Lewek, Influence of lower extremity sensory function on locomotor adaptation following stroke: a review. Topic in Stroke Rehabilitation, Vol. 20, No. 3, pp. 233-240, 2013. https://doi.org/10.1310/tsr2003-233
  30. A. Mansfield, C. J. Danells, J. L. Zettel, S. E. Black, W. E. Mcllroy, Determinants and consequences for standing balance of spontaneous weight-bearing on the paretic side among individuals with chronic stroke. Gait & Posture, Vol. 38, No. 3, pp. 428-432, 2013. https://doi.org/10.1016/j.gaitpost.2013.01.005
  31. L. von Koch, J. de Pedro-Cuesta, V. Kostulas, J. Almazan, L. Widen Holmqvist, Randomized controlled trial of rehabilitation at home after stroke: one-year follow-up of patient outcome, resource use and cost. Cerebrovascular Diseases, Vol. 12, No. 2, pp. 131-138, 2001. https://doi.org/10.1159/000047692
  32. N. S. Redzuan, J. P. Engkasan, M. Mazlan, S. J. Freddy Abdullah, Effectiveness of a video-based therapy program at home after acute stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, Vol. 93, No. 12, pp. 2177-2183, 2012. https://doi.org/10.1016/j.apmr.2012.06.025