Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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The Effects of Upper Extremities Exercises Using Moving Surface in Sitting on the Function of Upper Extremities for the Patients with Stroke

지지 면에 따른 양측 상지 운동이 뇌졸중 환자의 상지 기능 개선에 미치는 영향

  • Received : 2015.04.10
  • Accepted : 2015.08.06
  • Published : 2015.08.31
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Abstract

The purpose of this study was to find effect of upper extremities exercises using two different supporting surface, mobile surface and fixed surface in sitting on the function of upper extremities for the patients with stroke. The study period was between July 5, 2012 and August 1 2012. The subjects were 20 subjects who were randomly divided into two groups : (1) mobile surface group, (2) fixed surface group. The mobile surface group performed bilateral upper extremities exercise sitting on balance disc, and the fixed surface group was provided fixed surface chair. Both groups performed 30 minutes 5 times per a week for 4weeks. The Manual Functional Test(MFT) and Fugl-Meyer Motor Function Assessment(FMA) was used to measure the differences of upper extremity functions before and after interventions. The results of this study were as follows. First, Both groups, mobile surface group and fixed surface group showed the significant increase(p<.05) in upper extremity function. Second, the improvements of the hand function in mobile surface group showed significant difference comparing with the group with fixed surface. Therefore, the results of this study showed the bilateral hand exercise program on mobile surface is more effective than the fixed surface bilateral hand exercise program for the patients with stroke.

본 연구는 뇌졸중 환자를 대상으로 지지 면에 따른 양측 상지 운동이 상지 기능의 개선을 알아보고자 하였다. 연구기간은 2012년 7월 5일부터 8월 1일 까지 이다. 대상자는 뇌졸중 환자 20명을 무작위로 두 그룹으로 나누어 움직이는 지지 면 군(10명), 고정된 지지 면 군(10명)으로 실시하였다. 움직이는 지지 면 군은 발란스 볼에 앉아 양측 상지 운동을, 고정된 지지 면 군은 고정된 의자에 앉아 양측 상지 운동을 4주간 주5회 30분 적용하였다. 실험 전과 후에는 상지 기능의 변화를 비교하기 위해 상지 기능 검사(Manual Functional Test: MFT)와 상지 운동 기능 평가(Fugl-Meyer Motor Function Assessment: FMA)로 측정하였고 다음과 같은 결과를 얻었다. 첫째, 움직이는 지지 면 군과 고정된 지지 면 군의 각 실험 전, 후 상지 기능은 통계학적으로 유의한 차이를 보였다(p<.05). 둘째, 실험 전, 후 두 군 간의 차이를 비교한 결과 상지 기능에 통계학적으로 유의한 차이를 보였다(p<.05). 이상의 결과로 보아 움직이는 지지 면에서의 양측 상지 운동이 뇌졸중 환자의 상지 기능 개선에 효과적임을 알 수 있었다.

Keywords

References

  1. S.Y., An, "Motor control: Theory and Dractical applications", Young Moon Publisher, 2006.
  2. "The cause of death", 2010. http://www.nso.go.kr
  3. Luke., C., Dodd., K., J., & Brock., K., J, "Out Comes of the bobath concept on upper limb recovery following stroke", Clinical Rehabilitation, vol 18(8), pp. 888-898, 2004. DOI: http://dx.doi.org/10.1191/0269215504cr7930a
  4. Gowland C., Bruin de H., Basmajian V J., Plews N., Burcea lon, "Agonist and antagonist activity during voluntary upper limb movement in patients with stroke", Physther, vol 72, pp. 624-633, 1992. DOI: http://dx.doi.org/content/7219/624
  5. McCombe Waller, S., & Whitall, J, "Fine motor control in Adults with and without chronic hemiparesis: Baseline comparison to nondisabled adults and effects of bilateral arm training", Arch Phys Med Rehabil, vol 85, pp. 1076-1083, 2004. DOI: http://dx.doi.org/10.1016/i.apmr.2003.10.020
  6. Feys, H., M., De Weerdt, WJ., Seiz, BE., Cox Steck, GA., Spichiger, R, Wereeck, LE., Putaman, K, D., & Van Hydonck, G., A, "Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke", Stroke, vol 29, pp. 785-792, 1998. DOI: http://dx.doi.org/10.1161/01.STR.29.4.785
  7. J. B., Yang, "A study on the disease-related, psychosocial and environmental factors affecting health-related quality of life of elderly stroke survivors", Graduate School of Social Welfare Sungkyunkwan University, 2009.
  8. Sivenius J, Pyoala K, Heinonen OP, Salonen J, Riekkinen P, "The significance of rehabilitation of stroke-A controlled trial", Stroke, vol 16, pp. 928-931, 1985. DOI: http://dx.doi.org/10.1161/01.STR.16.6.928
  9. Y. S., Jan, "The effect of dual task performance on the trunk contral ability and upper extremity function of patients with stroke", Dept. of Occupational Therapy Graduate School of Dong Shin University, 2012.
  10. Van Delden AEl, Peper CE., Beek., Pj., Kwakkl G, "Unilateral Versus bilateral upper limb exercise therapy after stroke: a systematic review", J Rehabil Med, vol 44(2), pp. 106-17, 2012. DOI: http://dx.doi.org/10.2340/16501977-0928
  11. Van der Burg, J. C., Van wegen, E. E., & Van Dieen, J. H, "Postural control of the trunk during unstable sitting in Pakinson's disease", Pakinsonism Relat Disord, vol 12(8), pp. 492-498, 2006. DOI: http://dx.doi.org/10.1016/j.gaitpost.2006.11.077
  12. Edwards, S., "Neurological Physiotherapy: A Problem-solving approach", New York: Churchill Livingstone, 1996.
  13. Kwakkel, G., Wagenaar, R., C., Kollen, B., J., & Lankhorst, G., J., "Predicting disability in stroke-a critical review of the literature", Age Ageing vol 26(6), pp. 479-489, 1996. DOI: http://dx.doi.org/10.1093/ageing/25.6.479
  14. Gregory J Lehman, Trish Gordon, et al, "Replacing a swiss ball for and exercise bench causes variable changes in trunk muscle activity during upper limb strength exercise", Dynamic Medicine, vol 4(6), pp. 1-7, 2005. DOI: http://dx.doi.org/10.1186/1476-5918-4-6
  15. Akuthota V., & Nadler SF, "Core strengthening", Arch Phys Med Rehabil, vol 85(1), pp. 86-92, 2004. DOI: http://dx.doi.org/10.1053/j.apmr.2003.12.005
  16. Summers JJ., Kagerer F.A., Garry M,I., Hiraga C.Y., Loftus Andrea, Cauraugh J.H., "Bilateral and unilateral movement training on upper limb function in chronic stroke patients: A TMS study", Journal of the Neurological Sciences, vol 252, pp. 76-82, 2007. DOI: http://dx.doi.org/10.1016/j.jns.2006.10.011
  17. Kahn Leonard E., Lum peter S., Rymer W. Zev., MD, Reinkensmeyer David J., "Robot-assisted movement training for the stroke impaired arm: Does it matter what the robot does?" Journal of Rehabilitation Research Development, vol43(5), pp. 619-630, 2006. DOI: http://dx.doi.org/10.1682/JRRD.2005.03.0056
  18. Whitall, J., McCombe Waller, S., Silver, K. H., & Macko, R. H., & Macko, R. F., "Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke", Stroke, vol 31(10), pp. 2390-2395, 2000. DOI: http://dx.doi.org/10.1161/01.STR.31.10.2390
  19. Luft, A. R., McCombe-Waller, S., Whitall, J., Forrester, L. W., Macko, R., Sorkin, J. D., et al, "Repetitive bilateral arm training and motor cortex activation in chronic stroke: a randomized controlled trial", JAMA, vol 292(15), pp. 1853-1861, 2004. DOI: http://dx.doi.org/10.1001./jama.292.15.1853
  20. Aruin, A., S., Santos Marcio J, "Role of lateral muscles and body orientation in feedforward postural control", Exp Brain Res, vol 184(4), pp. 547-559, 2008. DOI: http://dx.doi.org/10.1007/s00221-007-1123-9
  21. Hall, J., M., & Dean, C., M., Channon, E., F., "Sitting training early after stroke improves sitting ability and quality and carries over to standing up but to walking: a randomised trial", Aust J Physiother, vol 53(2), pp. 97-102, 2007. DOI: http://dx.doi.org/10.1016/S0004-9514(07)70042-9
  22. S. J., Lee, "The effects of symmetrical bilateral upper-limb training on upper-limb function & Activity of daily living for chronic hemiplegic patients", Dept. of Special Education, Dan kook university, 2010.
  23. J. Y., Lee, J. S., Park, J., et. "The Effects of exercising on unstable surfaces on the balance ability of stroke patients", Journal of physical Therapy science, vol 23(5), pp. 789-792, 2011. DOI: http://dx.doi.org/10.1589/jpts.23.789
  24. Akshatha Nayak, S., Karthikbabu, K., Vijayakumar, ZK., Misri, BV., Suresh, Sailakshmi Ganeshmi Ganeshmi., et al, "Comparison of physio ball and plinth trunk exercises regimens on trunk control and functional balance in patients with acute stroke: a pilot randomized controlled trial", Clinical Rehabilitation, vol 25(8), pp. 709-719, 2011. DOI: http://dx.doi.org/10.1177/0269215510397393
  25. J. H., Lee, "The effect of task-oriented movement therapy on upper motor function patterns and reorgazation of motor network for stroke patients", Dept.. of Rehabilitation Science Grauate School, Daegu University, 2002.
  26. S. H., Jang, Y., H., Kim, S., H., Cho, J., H., Lee, J., W., Park, & Y., H., Kwon, "Cortical reorganization induced by task-oriented training in chronic hemiplegic stroke patients", Neuroreport, vol 14(1), pp. 137-141, 2003. DOI: http://dx.doi.org/10.1097/01.wnr.0000051544.96524.f2
  27. Nakamura R., Moriyama S., "Rehabilitation manual 8: Manual Function Test(MFT) and functional occupational therapy for stroke patients", National Rehabilitation Center for the Disabled, 2000.
  28. Fugl-Meyer, A., R., Jaasko, L., & Leyman, I., "The post-stroke hemiplegic patient", Scandinavian journal of Rehabilitation Medicine, vol 7(1), pp. 13-31, 1975.
  29. Grade stone, D., J., Danells., C., J., & Black., S., E, "The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties", Neurorehhabil Neural Repair, vol 16(3), pp. 232-240, 2002. DOI: http://dx.doi.org/10.1177/154596802401105171
  30. S. Y., An, "The effect of core stability exercise on function of upper extremities and activities daily of living in patients with stroke", Dept. of Physical Therapy Graduate School of Rehabilitation Health Science Yong in University, 2009.
  31. S. H., Yu, "The effects of stability of the lower trunk strength exercise on muscle activity and the functions of the upper limbs in stroke patients", Dept. of Physical Therapy Graduate School of Dongshin University, 2008.
  32. J. H., Lee, "The effect of dual motor task training on sitting for trunk control ability and balance in patients with chronic stroke", Dept. of physical therapy graduate school suhmyook university, 2011.
  33. Kaminski, T., Bock, C., & Gentile, A., "The coordination between trunk and arm motion during pointing movements", Experimental Brain Research, vol 106(3), pp. 457-466, 1995. DOI: http://dx.doi.org/10.1007/BF00231068