Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
권호 표지
DOI QR코드

DOI QR Code

The impact of convergence balance training and taping on spasticity and balance ability in patients with chronic stroke

균형훈련과 테이핑 융복합 적용이 뇌졸중 환자의 발목관절 경직 및 균형능력에 미치는 영향

  • Park, Shin-Jun (Dept. of Physical Therapy, Graduate School, Yongin University) ;
  • Kim, Tae-Hyun (Dept. of Physical Therapy, Graduate School, Yongin University) ;
  • Go, Jun-Hyeok (Dept. of Physical Therapy, Graduate School, Yongin University) ;
  • Youn, Pong-Sub (Dept. of Physical Therapy, Graduate School, Yongin University)
  • 박신준 (용인대학교 물리치료학과 일반대학원) ;
  • 김태현 (용인대학교 물리치료학과 일반대학원) ;
  • 고준혁 (용인대학교 물리치료학과 일반대학원) ;
  • 윤봉섭 (용인대학교 물리치료학과 일반대학원)
  • Received : 2017.05.31
  • Accepted : 2017.07.20
  • Published : 2017.07.28
Download PDF
⟨ Previous Next ⟩

Abstract

The study was performed to determine the impact of the gastrocnemius taping with balance training on spasticity and balance ability of the ankle joint. A total of 25 stroke subjects were divided into two groups: a taping with balance training (n=14), a sham taping with balance training (n=11). Spasticity assesment was scored by modified ashworth scale. Balance ability assesment was performed by functional reach test (FRT), the timed up & go test (TUG). The stability index (SI), the left-right weight distribution (left-right WD), the toe-heel weight distribution (toe-heel WD) were analyzed in the eyes open conditions(EO) and eyes closed conditions(EC) conditions using by the Tetrax interactive balance system. The experimental group showed a significant improvement in SI, left-right WD and toe-heel WD in the EO and EC, MAS, FRT, TUG. In comparison between the groups, a significant improvement was detected in FRT, TUG, SI and left-right WD in the EO, and left-right WD and toe-heel WD in the EC. It was found out that a short period of balance training with taping is effective on spasticity and balance ability in stroke patients. Therefore, any stroke patient without skin damage is encouraged to use the gastrocnemius taping for balance rehabilitation.

본 연구는 뇌졸중 환자에게 균형훈련과 동시에 장딴지근에 테이핑을 적용하여 발목관절 경직 및 균형능력에 미치는 영향을 알아보고자 진행된 연구이다. 뇌졸중 환자 25명은 장딴지근에 테이핑을 적용한 상태에서 균형훈련을 한 연구군 14명, 거짓 테이핑을 적용한 상태에서 균형훈련을 한 대조군 11명으로 나뉘었다. 경직 평가는 수정된 ashworth 척도로 점수화 하였고, 균형능력 평가는 기능적 팔뻗기와 일어나 걸어가기 검사, TETRAX를 이용하여 눈 뜨고 감은 상태에서의 안정성 지수(stability index), 왼쪽 오른쪽 체중지지도, 앞 뒤 체중지지도를 선택하여 분석하였다. 연구군은 경직, 기능적 팔뻗기, 일어나 걸어가기, 눈 뜨고 감은 상태에서의 안정성 지수, 왼쪽 오른쪽 체중지지도, 앞 뒤 체중지지도에 유의한 개선이 있었다. 두 군간 비교에서는 연구군이 대조군보다 기능적 팔뻗기, 일어나 걸어가기, 눈 뜬 상태에서 안정성 지수, 왼쪽 오른쪽 체중지지도, 눈 감은 상태에서 왼쪽 오른쪽 체중지지도 앞 뒤 체중지지도에 유의한 개선을 보였다. 테이핑 적용상태에서 단기간의 균형훈련은 뇌졸중 환자의 경직 및 균형능력에 효과적인 것을 알 수 있었다. 그러므로 피부에 손상 및 이상이 없는 뇌졸중 환자라면 균형재활에 있어 장딴지근 테이핑 적용을 적극 권고하는 바이다.

Keywords

References

  1. Tyson. S. F, Hanley. M, Chillala. J, Selley. A, Tallis. R. C, "Balance disability after stroke.", Physical therapy, Vol. 86, No. 1, pp. 30-38, 2006. https://doi.org/10.1093/ptj/86.1.30
  2. Geurts. A. C, de Haart. M, van Nes. I. J, Duysens. J, "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
  3. Nichols. D. S, "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
  4. Niam. S, Cheung. W, Sullivan. P. E, Kent. S, Gu. X, "Balance and physical impairments after stroke." Archives of physical medicine and rehabilitation, Vol. 80, No. 10, pp. 1227-1233, 1999. https://doi.org/10.1016/S0003-9993(99)90020-5
  5. Jung-Eun Lee, "The effect of balance trainer training with transcutaneous nerve stimulation of spastisity and balance of choronic stroke patient." Department of physical therapy, Graduate school, Sahmyook University. 2013.
  6. K. G. Lee, M. H. Chun, B. R. Kim, S. H. Kang, "The effect of biofeedback balance training using interractive balance system in acute stroke patient." J korean acad rehab med, Vol. 33, No. 1, pp. 41-47, 2009.
  7. D. J. Yang, S. K. Park, Y. H. Uhm, "Impact of virtual reality based neuromuscular postural control fusion training on balance ability and jump performance of soccer players with functional ankle instability." Journal of digital convergence, Vol. 14, No. 11, pp. 357-367, 2016. https://doi.org/10.14400/JDC.2016.14.11.357
  8. Vattanasilp. W, Ada. L, Crosbie. J, "Contribution of thixotropy, spasticity, and contracture to ankle stiffness after stroke." Journal of neurology, neurosurgery & psychiatry, Vol. 69, No. 1, pp. 34-39, 2000. https://doi.org/10.1136/jnnp.69.1.34
  9. G. U. Jang, M. G. Kweon, S. Park, J. Y. Kim, J. W. Park, "A study of structural foot deformity in stroke patients." Journal of physical therapy science, Vol. 27, No. 1, pp. 191-194, 2015. https://doi.org/10.1589/jpts.27.191
  10. H. C. Kwon, "A study of various factors influencing standing balance of independent ambulatory hemiparetic patients." The Journal of Korean Physical Therapy, Vol. 1, No. 1, pp. 15-25, 1989.
  11. Jaraczewska. E, Long. C, "Kinesio taping in stroke: improving functional use of the upper extremity in hemiplegia." Topics in stroke rehabilitation, Vol. 13, No. 3, pp. 31-42, 2006. https://doi.org/10.1310/33KA-XYE3-QWJB-WGT6
  12. Carda. S, Molten. F, "Taping versus electrical stimulation after botulinum toxin type A injection for wrist and finger spasticity. A case-control study." Clinical rehabilitation, Vol. 19, No. 6, pp. 621-626, 2005. https://doi.org/10.1191/0269215505cr879oa
  13. Santamato. A, Micello. M. F, Panza. F, Fortunato. F, Picelli. A, Smania. N, Logroscino. G, Fiore. P, Ranieri. M, "Adhesive taping vs daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial." Clinical rehabilitation, Vol. 29, No. 1, pp. 50-58, 2015. https://doi.org/10.1177/0269215514537915
  14. S. J. Park, K. H. Cho, "The effects trunk correction taping on trunk muscle activity and stability, upper extremity function in stroke patients." Journal of digital convergence, Vol. 15, No. 2, pp. 411-419, 2017. https://doi.org/10.14400/JDC.2017.15.2.411
  15. Y. R. Kim, J. G. Hur, J. Y. Ko, "Effects of lower leg taping on balance and gait ability in stroke patients." Korea journal of sport, Vol. 10, No. 1, pp. 373-385, 2012.
  16. W. I. Kim, Y. H. Park, Y. B. Sung, C. W. Nam, J. H. Lee, "Influence of kinesio taping for stroke's ankle joint versus ankle-foot orthosis on muscle stimulation and gait ability in stroke's foot drop." International journal of bio-science and bio-technology, Vol. 8, No. 1, pp. 263-274, 2016.
  17. Lazarus. Catherine, "The use of Kinesio$^{(R)}$ tape for the treatment of foot drop in a patient with sub-Acute stroke: a case report." Doctoral dissertation, Florida Gulf Coast University. 2013.
  18. Y. H. Bae, H. G. Kim, K. S. Min, S. M. Lee, "Effects of lower-leg kinesiology taping on balance ability in stroke patients with foot drop." Evidence-based complementary and alternative medicine, Vol. 2015, pp. 1-5, 2015.
  19. J. H. Lee, H. W. Jung, K. Kim, J. H. Park, C. K. Kim, "Effects of spiral balance taping on postural balance ability in stroke patient." Korean journal of oriental physiology & pathology, Vol. 23, No. 4, pp. 908-913, 2009.
  20. Cortesi. M, Cattaneo. D, Jonsdottir. J, "Effect of kinesio taping on standing balance in subjects with multiple sclerosis: a pilot study." Neuro rehabilitation, Vol. 28, No. 4, pp. 365-372, 2011.
  21. Tamburella. F, Scivoletto. G, Molinari. M, "Somatosensory inputs by application of kinesio taping: effects on spasticity, balance, and gait in chronic spinal cord injury." Frontiers in human neuroscience, Vol. 8, No. 367, pp. 86-94, 2014.
  22. Grampurohit. N, Pradhan. S, Kartin. D, "Efficacy of adhesive taping as an adjunt to physical rehabilitation to influence outcomes post-stroke: a systematic review." Topics in stroke rehabilitation, Vol. 22, No. 1, pp. 72-82, 2015. https://doi.org/10.1179/1074935714Z.0000000031
  23. Pandyan. A. D, Johnson. G. R, Price. C. I, Curless. R. H, Barnes. M. P, Rodgers. H, "A review of the properties and limitations of the Ashworth and Modified Ashworth Scales as measures of spasticity." Clinical rehabilitation, Vol. 13, No. 5, pp. 373-383, 1999. https://doi.org/10.1191/026921599677595404
  24. S. H. Bae, J. I. Lee, K. Y. Kim, "Usefulness of myotonometer for measurement of tissue compliance on medialis gastrocnemius in patients with stroke." Journal of the korea academia-industrial cooperation society, Vol. 13, No. 3, pp. 1129-1137, 2012. https://doi.org/10.5762/KAIS.2012.13.3.1129
  25. Ng. S. S, Hui-Chan. C. W, "The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke." Archives of physical medicine and rehabilitation, Vol. 86, No. 8, pp. 1641-1647, 2005. https://doi.org/10.1016/j.apmr.2005.01.011
  26. Duncan. P. W, Studenski. S, Chandler. J, Prescott. B, "Functional reach: predictive validity in a sample of elderly male veterans." Journal of gerontology, Vol. 47, No. 3, pp. 93-98, 1992. https://doi.org/10.1093/geronj/47.3.M93
  27. Duncan. P. W, Weiner. D. K, Chandler. J, Studenski. S, "Functional reach: a new clinical measure of balance. Journal of gerontology, Vol. 45, No. 6, pp. 192-197, 1990.
  28. Akkaya. N, Doganlar. N, Celik. E, Aysse. S. E, Akkaya. S, Gungor. H. R, Sahin. F, "Test-retest reliability of TETRAX$^{(R)}$ static posturography system in yong adults with low physical activity level." International journal of sports physical therapy, Vol. 10, No. 6, pp. 893-900, 2015.
  29. S. H. Bae, G. D. Kim, K. Y. Kim, "Spinal Motor Neuron and Electroencephalogram Changes after Different Kinesio Taping Method Therapy in normal People." International Journal of contents, Vol. 13, No. 11, pp. 791-799, 2013.
  30. Chen. S. C, Chen. Y. L, Chen. C. J, Lai. C. H, Chiang. W. H, Chen. W. L, "Effects of surface electrical stimulation on the muscle-tendon junction of spastic gastrocnemius in stroke patients." Disability and rehabilitation, Vol. 27, No. 3, pp. 105-110, 2005. https://doi.org/10.1080/09638280400009022
  31. van der Salm. A, Veltink. P. H, IJzerman. M. J, Groothuis-Oudshoom. K. C, Nene. A. C, Hermerns. H. J, "Comparison of electric stimulation methods for reduction of triceps surae spasticity in spinal cord injury." Arch phys med rehabil. Vol. 87, No. 2, pp. 222-228, 2006. https://doi.org/10.1016/j.apmr.2005.09.024
  32. Yoshida. A, Kahanov. L, "The effect of kinesio taping on lower trunk range of motions." Research in sports medicine, Vol. 15, No. 2, pp. 103-112, 2007. https://doi.org/10.1080/15438620701405206
  33. Tang. A, Tao. A, Soh. M, Tam. C, Tan. H, Thompson. J, Eng. J. J, "The effect of interventions on balance self-efficacy in the stroke population: a systematic review and meta-analysis." Clinical rehabilitation, Vol. 29, No. 12, pp. 1168-1177, 2015. https://doi.org/10.1177/0269215515570380
  34. D. D. Kim, S. J. Park, "The immediate effects of spiral taping on improvement of gait abilityin patients with chronic stroke." Journal of digital convergence, Vol. 15, No. 4, pp. 529-536, 2017. https://doi.org/10.14400/JDC.2017.15.4.529
  35. J. C. Cho, B. K. Lee, S. C. Chon. "The most effective number of elastic taping applications on the muscle activity and maximum peak of the wrist extensor muscle in patients wisth troke." journal of the ergonomics society of korea, Vol. 33, No. 6, pp. 533-541, 2014. https://doi.org/10.5143/JESK.2014.33.6.533
  36. S. J. Choi, D. W. Oh, "The effects of intensive chest mobility exercise on increasing pulmonary function and gait in stroke patients." Journal of special education & rehabilitation science, Vol. 51, No. 2, pp. 221-239, 2012.
  37. S. B. Jeon, H. S. Choi, "Effects of Side Walking Training on Balance and Gait in Stroke Patients" Journal of digital convergence, Vol. 13, No. 10, pp. 541-548, 2015. https://doi.org/10.14400/JDC.2015.13.10.541
  38. H. S. Choi, S. B. Jeon, "Effect of Backward Walking Training on Balance Capability and Gait Performance in Patients With Stroke" Journal of digital convergence, Vol. 13, No. 1, pp. 367-373, 2015. https://doi.org/10.14400/JDC.2015.13.1.367
  39. M. K. Jeong, D. W. Oh, "Effects of 12-week balance training with visual feedback onbalance and walking functions in patients with chronic stroke." Journal of digital convergence, Vol. 11, No. 11, pp. 537-544, 2013. https://doi.org/10.14400/JDPM.2013.11.11.537
  40. Y. S. Jeong, "Effects of self stretching exercise and movement with mobilization in lunge position on the muscle activity and balance in chronic stroke patients." Journal of digital convergence, Vol. 11, No. 10, pp. pp. 549-556, 2013. https://doi.org/10.14400/JDPM.2013.11.10.549