한국전문물리치료학회지 (Physical Therapy Korea)

  • 제25권2호
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  • Pages.1-12
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  • 2018
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  • 1225-8962(pISSN)
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  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
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편마비 환자의 앉은 자세에서 일어서기 동작 시 의자 높이와 발의 조건이 생체역학적 요소에 미치는 영향

The Effects of Chair Height and Foot Condition on the Biomechanical Factors in Sit-to-Stand Movement of Hemiplegic Patients

  • 김동훈 (한서대학교 대학원 물리치료학과) ;
  • 김택훈 (한서대학교 보건학부 물리치료학과) ;
  • 최흥식 (한서대학교 보건학부 물리치료학과) ;
  • 노정석 (한서대학교 보건학부 물리치료학과) ;
  • 최규환 (안산대학교 물리치료학과) ;
  • 김기송 (호서대학교 생명보건대학 물리치료학과)
  • Kim, Dong-hoon (Dept. of Physical Therapy, The Graduate School, Hanseo University) ;
  • Kim, Tack-hoon (Dept. of Physical Therapy, Division of Health Science, Hanseo University) ;
  • Choi, Houng-sik (Dept. of Physical Therapy, Division of Health Science, Hanseo University) ;
  • Roh, Jung-suk (Dept. of Physical Therapy, Division of Health Science, Hanseo University) ;
  • Choi, Kyu-hwan (Dept. of Physical Therapy, Ansan University) ;
  • Kim, Ki-song (Dept. of Physical Therapy, College of Life&Health Sciences, Hoseo University)
  • 투고 : 2017.12.26
  • 심사 : 2018.05.02
  • 발행 : 2018.05.21
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초록

Background: It is very difficult for hemiplegic patients to effectively perform the sit-to-stand (STS) movements independently because of several factors. Moreover, the analysis of STS motion in hemiplegic patients has been thus far confined to only muscle strength evaluation with little information available on structural and environmental factors of varying chair height and foot conditions. Objects: This study aimed to analyze the change in biomechanical factors (ground reaction force, center of mass displacement, and the angle and moment of joints) of the joints in the lower extremities with varying chair height and foot conditions in hemiplegic patients while they performed the STS movements. Methods: Nine hemiplegic patients voluntarily participated in this study. Their STS movements was analyzed in a total of nine sessions (one set of three consecutive sessions) with varying chair height and foot conditions. The biomechanical factors of the joints in the lower extremities were measured during the movements. Ground reaction force was measured using a force plate; and the other abovementioned parameters were measured using an infra-red camera. Two-way repeated analysis of variance was performed to determine the changes in biomechanical factors in the lower extremities with varying chair height and foot conditions. Results: No interaction was found between chair height and foot conditions (p>.05). All measured variables with varying chair height showed a significant difference (p<.05). Maximum joint flexion angle, maximum joint moment, and the displacement of the center of mass in foot conditions showed a significant difference (p<.05); however the maximum ground reaction force did not show a significant difference (p>.05). Conclusion: The findings suggest that hemiplegic patients can more stably and efficiently perform the STS movement with increased chair height and while they are bare-foot.

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참고문헌

  1. Anne S, Marjorie HW. Motor control: Theory and practical applications. 1ed. Baltimore, Maryland, Lippincott Williams & Wilkins. 1995;257-259.
  2. Brouwer BJ, Walker C, Rydahl SJ, et al. Reducing fear of falling in seniors through education and activity programs: A randomized trial. J Am Geriatr Soc. 2003;51(6):829-834. https://doi.org/10.1046/j.1365-2389.2003.51265.x
  3. Brunt D, Greenberg S, Wankadia MA, et al. The effect of foot placement on sit to stand in healthy young subjects and patients with hemiplegia. Arch Phys Med Rehabil. 2002;83(7):924-929. https://doi.org/10.1053/apmr.2002.3324
  4. Carr JH, Shepherd RB, Nordholm L, et al. Investigation of a new motor assessment scale for stroke patients. Phys Ther. 1985;65(2):175-180. https://doi.org/10.1093/ptj/65.2.175
  5. Demura S, Sato S, Minami M, et al. Gender and age differences in basic ADL ability on the elderly: Comparison between the independent and the dependent elderly. J Physiol Anthropol Appl Human Sci. 2003;22(1):19-27. https://doi.org/10.2114/jpa.22.19
  6. Dickstein R, Nissan M, Pillar T, et al. Foot-ground pressure pattern of standing hemiplegic patients: Major characteristics and patterns of improvement. Phys Ther. 1984;64(1):19-23. https://doi.org/10.1093/ptj/64.1.19
  7. Etnyre B, Tomas DQ. Event standardization of sit-to-stand movements. Phys Ther. 2007;87(12):1651-1666. https://doi.org/10.2522/ptj.20060378
  8. Feland JB, Hager R, Merrill RM. Sit-to-stand transfer: Performance in rising power, transfer time and sway by age and sex in senior athletes. Br J of Sports Med. 2005;39(11):e(39). https://doi.org/10.1136/bjsm.2005.018564
  9. Gillen G. Stroke rehabilitation: A function-based approach. 3ed. New York, Elsevier, 2010;4-25.
  10. Horak FB. Clinical measurement of postural control in adults. Phys Ther. 1987;67(12):1881-1885. https://doi.org/10.1093/ptj/67.12.1881
  11. Hughes MA, Samsa G, Schenkman M, et al. The relative importance of strength and balance in chair rise by functionally impaired older individuals. J Am Geriatr Soc. 1996;44(12):1441-1446. https://doi.org/10.1111/j.1532-5415.1996.tb04068.x
  12. Hwang SJ, Son JS, Kim JY, et al. Analysis of joint movements and changes of muscle length during STS(sit-to-stand) at various sitting heights in the korean elderly's daily life. J Biomed Eng. 2008;29(6):484-492.
  13. Jeong HY, Kim JW, Kwon YR, et al. Asymmetry of the reaction forces on thighs and feet during sit-to-stand movement in normal subjects. J Biomed Eng. 2013;34(14):197-203.
  14. Jeong JH. Survey report on the safety of flooring at home. Korea Consumer Agency, 2012:13-15.
  15. Johannsen L, Broetz D, Karnath HO. Leg orientation as a clinical sign for pusher syndrome. BMC Neurol. 2006;6(30):1-15. https://doi.org/10.1186/1471-2377-6-30
  16. Kim EJ, Hwang BG, Lee SY, et al. The effects of gait component and muscular activity on unstable surface balance training in stroke patients. Journal of Rehabilitation Research. 2010;14(4):329-346.
  17. Kim HT. The Effects of foot placement and lifting on lower extremity muscle activity and foot pressure during sit to stand and stand to sit in hemiparetic patients. Seonam University, Master Thesis. 2008.
  18. Kim JS, Kang SY, Kim JK. Weight bearing study using digital scales in hemiplegic patients. J Korean Acad Rehabill Med. 2000;24(6):1055-1060.
  19. Kim YH. Comparison on the onset time of muscles contraction during sit to standing positions between normal children and children with spastic diplegia. Yong-In Univercity, Master Thesis. 2003.
  20. Kim YH, Kim NK, Cha EJ. A comparative study on clinical balance score and quantitative assessment of postural sway using force platform. J Korean Acad Rehabill Med. 1995;19:782-792.
  21. Kim YJ, Park JW. The influence of unstable shoes on kinematics and kinetics of the lower limb joint during sit-to-stand task. J Kor Phys Ther. 2016;28(1):14-21.
  22. Kim WH. Effect of task-oriented approach on weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement in chronic stroke patients. Phys Ther Korea. 2011;18(2):18-26.
  23. Laufer Y, Sivan D, Schwarzmann R, et al. Standing balance and functional recovery of patients with right and left hemiparesis in the early stages of rehabilitation. Neurorehabil Neural Repair. 2003;17(4):207-213. https://doi.org/10.1177/0888439003259169
  24. Lee HS, Choi HS, Kwon OY. A literature review on balance control factors. Phys Ther Korea. 1996;3(3):82-91.
  25. Lee SH. Change of ground reaction force by standing posture depending on the height of chair. HanYang University, Master Thesis. 2006.
  26. Li Y, McClure PW. Pratt N. The effect of hamstring muscle stretching on standing posture and on lumbar and hip motions during forward bending. Phys Ther. 1996;76(8):836-845. https://doi.org/10.1093/ptj/76.8.836
  27. Lomaglio MJ, Eng JJ. Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke. Gait Posture. 2005;22(2):126-131. https://doi.org/10.1016/j.gaitpost.2004.08.002
  28. Lord SE, McPherson K, McNaughton HK, et al. Community ambulation after stroke how important and obtainable is it and what measures appear predictive? Arch Phys Med Rehabil. 2004;85(2):234-239. https://doi.org/10.1016/j.apmr.2003.05.002
  29. Mazza C, Benvenuti F, Bimbi C, et al. Association between subject functional status, seat height, and movement strategy in sit-to-stand performance. J Am Geriatr Soc. 2004;52(10):1750-1754. https://doi.org/10.1111/j.1532-5415.2004.52472.x
  30. Medeiros DL, Conceicao JS, Graciosa MD, et al. The influence of seat heights and foot placement positions on postural control in children with cerebral palsy during a sit-to-stand task. Res Dev Disabil. 2015;43(44):1-10. https://doi.org/10.1016/j.ridd.2015.05.004
  31. Mercier L, Audet T, Hebert R. et al. Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke. Stroke. 2001;32(11):2602-2608. https://doi.org/10.1161/hs1101.098154
  32. Millington PJ, Myklebust BM, Shamles GM. Biomechanic analysis of the sit to stand motion in elderly persons. Arch Phys Med Rehabil. 1992;73(7):609-617.
  33. Neumann DA Kinesiology of the Musculoskeletal System: Foundations for physical rehabilitation. 2ed. Seoul, Epublickorea Co., 2010:556-560.
  34. Norre ME. Sensory interaction testing in platform posturography. J Laryngol Otol. 1993;107(6):496-501. https://doi.org/10.1017/S0022215100123564
  35. Onell A. The vertical ground reaction force for analysis of balance? Gait Posture. 2000;12(1):7-13. https://doi.org/10.1016/S0966-6362(00)00053-9
  36. Park J, Woo YK, Park SY. Effects of sit-to-stand training on unstable surface on balance in subject with stroke. Phys Ther Kor. 2013;20(3):01-08. https://doi.org/10.12674/ptk.2013.20.3.001
  37. Park JW, Kim YJ. The influence of high-heeled shoes on kinematics and kinetics of the knee joint during sit-to-stand task. J Kor Phys Ther. 2015;27(5):304-310. https://doi.org/10.18857/jkpt.2015.27.5.304
  38. Roy G, Nadeau S, Gravel D, et al. The effect of foot position and chair height on the asymmetry of vertical forces during sit-to-stand and standto-sit tasks in individuals with hemiparesis. Clin Biomech (Bristol, Avon). 2006;21(6):585-593. https://doi.org/ 10.1016/j.clinbiomech.2006.01.007
  39. Savelberg HH, Fastenau A, Willems PJ, et al. The load/capacity ratio affects the sit-to-stand movement strategy. Clin Biomech (Bristol, Avon). 2007;22(7):805-812. https://doi.org/10.1016/j.clinbiomech.2007.05.002
  40. Schenkman M, Riley PO, Pieper C. Sit to stand from progressively lower seat heights-alterations in angular velocity. Clin Biomech (Bristol, Avon). 1996;11(3):153-158. https://doi.org/10.1016/0268-0033(95)00060-7
  41. Scholz JP, Reisman D, Schoner G. Effects of varying task constraints on solutions to joint coordination in a sit-to-stand task. Exp Brain Res. 2001;141(4):484-500. https://doi.org/10.1007/s002210100878
  42. Schultz AB, Alexander NB, Ashton-Miller JA. Biomechanical analysis of rising from a chair. J Biomech. 1992;25(12):1283-1391.
  43. Shin JB, Lee JS. The effect of visual feedback on postural control during sit-to-stand movements of brain-damaged patients under different support conditions. Phys Ther Korea. 2012;19(3):40-50. https://doi.org/10.12674/ptk.2012.19.3.040
  44. Sun S. Kinetic analysis of sit-to-stand movement with change of chair heights in able-bodied 60s and 20s women. Pusan National University, Doctoral Dissertation. 2010.
  45. Taub E, Miller N, Novack T, et al. Technique to improve chronic motor deficits after stroke. Arch Phys Med Rehabil. 1993;74(14):347-354.
  46. Vearrier LA, Langan J, Shumway-Cook A, et al. An intensive massed practice approach to retraining balance post-stroke. Gait Posture. 2005;22(2):154-163. https://doi.org/10.1016/j.gaitpost.2004.09.001
  47. Yoo YJ, Kinetic analysis of sit-to-stand movement in stroke patients. Korean journal of physical education. 2004;43(4):521-529.
  48. Yoshioka S, Nagano A, Hay DC, et al. Peak hip and knee joint moments during a sit-to-stand movement are invariant to the change of seat height within the range of low to normal seat height. Biomed Eng online. 2014;13(1):13-27. https://doi.org/10.1186/1475-925x-13-27