DOI QR코드

DOI QR Code

휠체어 허리 지지대와 궁둥 패드가 뇌졸중 환자의 목, 몸통 각도 및 가슴우리 확장에 미치는 영향

Effects of Wheelchair Back Support and Ischial Pad on Neck, Trunk Angle and Chest Expansion in Stroke Patients

  • 안재영 (강동대학교 물리치료과) ;
  • 전경수 (강동대학교 물리치료과) ;
  • 최혜진 (강동대학교 물리치료과) ;
  • 박재홍 (강동대학교 물리치료과) ;
  • 권정은 (강동대학교 물리치료과) ;
  • 신지연 (강동대학교 물리치료과) ;
  • 신한솔 (강동대학교 물리치료과) ;
  • 권지수 (강동대학교 물리치료과) ;
  • 정혜지 (강동대학교 물리치료과) ;
  • 박신준 (강동대학교 물리치료과)
  • An, Jae-Young (Department of Physical Therapy, GangDong University) ;
  • Jeon, Kyung-Soo (Department of Physical Therapy, GangDong University) ;
  • Choi, Hye-Jin (Department of Physical Therapy, GangDong University) ;
  • Park, Jae-Hong (Department of Physical Therapy, GangDong University) ;
  • Kwon, Jeong-Eun (Department of Physical Therapy, GangDong University) ;
  • Shin, Ji-Yeon (Department of Physical Therapy, GangDong University) ;
  • Sin, Han-Sol (Department of Physical Therapy, GangDong University) ;
  • Gwon, Ji-Su (Department of Physical Therapy, GangDong University) ;
  • Jeong, Hye-Ji (Department of Physical Therapy, GangDong University) ;
  • Park, Shin-Jun (Department of Physical Therapy, GangDong University)
  • 투고 : 2018.05.17
  • 심사 : 2018.08.20
  • 발행 : 2018.08.28

초록

본 연구의 목적은 휠체어를 사용하는 뇌졸중 환자에게 허리 지지대와 궁둥 패드가 목, 몸통 각도와 가슴우리 확장에 미치는 영향을 즉각적으로 알아보고자 함이다. 15명의 뇌졸중 환자는 허리 지지대 사용, 궁둥 패드 사용, 허리 지지대와 궁둥 패드 동시 사용, 사용하지 않았을 때를 반복적으로 측정하였다. 측정은 휴대폰 카메라를 이용하여 목과 몸통 각도를 측정하였고, 가슴우리 확장은 줄자를 이용하였다. 연구 결과 허리 지지대와 궁둥 패드 동시 사용이 사용하지 않았을 때 보다 목, 몸통 각도, 아래쪽 가슴우리 확장에 유의하게 증가하였다. 본 연구를 통해 휠체어를 사용하는 뇌졸중 환자에게 허리 지지대와 궁둥 패드 동시 사용이 뇌졸중 환자의 가슴우리 확장과 목, 몸통 각도 증가에 즉각적인 영향을 미친다는 것을 알 수 있었다. 향후 연구에는 더 많은 대상자와 중재를 지속시켜 장기간의 변화를 확인할 필요가 있겠다.

The purpose of this study was to investigate the immediate effect of lumbar support and ischial pad on neck, trunk angle and chest expansion for stroke patients using wheelchair. Fifteen stroke patients were measured repeatedly when a lumbar support using(L support), a Ischial pad using(I Pad), a Lumbar support with ischial pad using(L With I), and non using it(Non using). The measurement of the neck and trunk angle was confirmed using a mobile phone camera, and chest expansion was performed using a tapeline. L With I increased significantly in neck and trunk angle and lower chest expansion than non using. This study shows that simultaneous use of lumbar support and ischial pad for stroke patients using wheelchair can increase the neck and trunk angle, chest expansion immediately. Future studies will need to identify more long-term changes by continuing intervention with more subjects.

키워드

참고문헌

  1. R. W. Bohannon, D. Cassidy & S. Walsh. (1995). Trunk muscle strength is impaired multidirectionally after stroke. Clinical rehabilitation, 9(1), 47-51. DOI : 10.1177/JDC
  2. Y. Zakaria, U. Rashad & R. Mohammed, (2010). Assessment of malalignment of trunk and pelvis in stroke patients. Egypt J Neurol Psychiat Neurosurg, 47(4), 599-604.
  3. M. Karatas, N. Cetin, M. Bayramoglu & A. Dilek. (2004). Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. American journal of physical medicine & rehabilitation, 83(2), 81-87. DOI : 10.1097 https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  4. S. Ryerson, N. N. Byl, D. A. Brown, R. A. Wong & J. M. Hidler. (2008). Altered trunk position sense and its relation to balance functions in people post-stroke. Journal of Neurologic Physical Therapy, 32(1), 14-20. DOI : 10.1097 https://doi.org/10.1097/NPT.0b013e3181660f0c
  5. H. Asai, H. Tsuchiyama, T. Hatakeyama, P. T. Inaoka & K. Murata. (2015). Relationship between the ability to perform the sit-to-stand movement and the maximum pelvic anteversion and retroversion angles in patients with stroke. Journal of physical therapy science, 27(4), 985-988. DOI : 10.1589 https://doi.org/10.1589/jpts.27.985
  6. Y. R. Iyengar, K. Vijayakumar, J. M. Abraham, Z. K. Misri, B. V. Suresh, & B. Unnikrishnan. (2014). Relationship between postural alignment in sitting by photogrammetry and seated postural control in post-stroke subjects. NeuroRehabilitation, 35(2), 181-190. DOI : 10.3233
  7. H. W. Jung et al. (2013). The Study on Correlation between the Forward Head Posture and Spinal Alignment, Journal of Oriental Rehabilitation Medicine, 23(4), 195-202. DOI : 10.13075
  8. Hobson, D. A., & Tooms, R. E. (1992). Seated lumbar/pelvic alignment. A comparison between spinal cord-injured and noninjured groups. Spine, 17(3), 293-298. https://doi.org/10.1097/00007632-199203000-00009
  9. J. I. Kang, D. K. Jeong & H. Choi. (2018). Correlation between pulmonary functions and respiratory muscle activity in patients with forward head posture. Journal of physical therapy science, 30(1), 132-135 DOI : 10.1589 https://doi.org/10.1589/jpts.30.132
  10. E. G. Culham, H. A. Jimenez & C. E King. (1994). Thoracic kyphosis, rib mobility, and lung volumes in normal women and women with osteoporosis. Spine, 19(11), 1250-1255. DOI : 10.1097 https://doi.org/10.1097/00007632-199405310-00010
  11. E. Kapreli, E. Vourazanis & N. Strimpakos. (2008). Neck pain causes respiratory dysfunction. Medical hypotheses, 70(5), 1009-1013. DOI : 10.1016 https://doi.org/10.1016/j.mehy.2007.07.050
  12. V. E. Ezeugwu, M. Olaogun, C. E. Mbada & R. Adedoyin. (2013). Comparative Lung Function Performance of Stroke Survivors and Age‐matched and Sex‐matched Controls. Physiotherapy Research International, 18(4), 212-219. DOI : 10.1002 https://doi.org/10.1002/pri.1547
  13. S. Ogiwara & K. Ogura. (2001). Antero-posterior excursion of the hemithorax in hemiplegia. Journal of Physical Therapy Science, 13(1), 11-15. DOI : 10.1589 https://doi.org/10.1589/jpts.13.11
  14. D. T. Reid, D. Hebert & D. Rudman. (2001). Occupational performance in older stroke wheelchair users living at home. Occupational Therapy International, 8(4), 273-286. DOI : 10.1002 https://doi.org/10.1002/oti.151
  15. S. Y. Park, I. H. Lee, C. B. Jeon, Y. S. Lee & J. H. Choi. (2010). Comparison of the sitting pressure of stroke patients according to seat shapes. Journal of Korean Engineering Association, 2010(10), 15-19.
  16. A. Ukita, S. Nishimura, H. Kishigami & T. Hatta. (2015). Backrest Shape Affects Head-Neck Alignment and Seated Pressure. Journal of Healthcare Engineering, 6(2), 179-192. DOI : 10.1260 https://doi.org/10.1260/2040-2295.6.2.179
  17. F. Lin, S. Parthasarathy, S. J. Taylor, D. Pucci, R. W. Hendrix & M. Makhsous. (2006). Effect of different sitting postures on lung capacity, expiratory flow, and lumbar lordosis. Archives of physical medicine and rehabilitation, 87(4), 504-509. DOI : 10.1016 https://doi.org/10.1016/j.apmr.2005.11.031
  18. G. R. Cho. (2016). A Comparative Study on the Cost of Customized-manufacture assistive device services between people with physical disabilities and brain lesions. Journal of Rehabilitation Welfare Engineering & Assistive Technology, 2016(11), 103-104.
  19. L. J. Lee, A. T. Chang, M. W. Coppieters & P. W. Hodges. (2010). Changes in sitting posture induce multiplanar changes in chest wall shape and motion with breathing. Respiratory physiology & neurobiology, 170(3), 236-245. DOI : 10.116 https://doi.org/10.1016/j.resp.2010.01.001
  20. K. Samuelsson, M. Bjork, A. M. Erdugan, A. K. Hansson & B. Rustner. (2009). The effect of shaped wheelchair cushion and lumbar supports on under-seat pressure, comfort, and pelvic rotation. Disability and Rehabilitation: Assistive Technology, 4(5), 329-336. DOI : 10.1080
  21. S. H. Ko, Y. S. KIM, & B. C. Yoon. (2011). Influence of the Lumbar Spine Adjustment using the Lumbar Roll Support on Head and Neck Posture in Older Adults. The Korea Contents Association, 11(12), 800-806. DOI : 10.5392
  22. H. Goda, T. Hatta, H. Kishigami, A. Suzuki & T. Ikeda. (2015). Does a Novel-Developed Product of Wheelchair Incorporating Pelvic Support Prevent Forward Head Posture during Prolonged Sitting?. PloS one, 10(11), e0142617. DOI : 10.1371 https://doi.org/10.1371/journal.pone.0142617
  23. S. E. Bockenhauer, H. Chen, K. N. Julliard & J. Weedon. (2007). Measuring thoracic excursion: reliability of the cloth tape measure technique. The Journal of the American Osteopathic Association, 107(5), 191-196.
  24. S. Karthikbabu, M. Chakrapani, S. Ganeshan, K. C. Rakshith, S. Nafeez, & V. Prem. (2012). A review on assessment and treatment of the trunk in stroke: a need or luxury. Neural regeneration research, 7(25), 1974. https://doi.org/10.3969/j.issn.1673-5374.2012.25.008
  25. Davies & M. Patricia. (1990). Right in the middle: selective trunk activity in the treatment of adult hemiplegia. Germany : German Copyright Law DOI : 10.1007
  26. J. M. Kim, & C. H. YI. (2004). Neurological Physical Therapy, Seoul : Jungdam Media.
  27. M. Makhsous, F. Lin, R. W. Hendrix, M. Hepler & L. Q. Zhang (2003). Sitting with adjustable ischial and back supports: biomechanical changes. Spine, 28(11), 1113-1121. DOI : 10.1097 https://doi.org/10.1097/01.BRS.0000068243.63203.A8
  28. D. A. Neumann,(2010). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. second edition, Mosby Elsevier. pp443-444
  29. H. Y. Jang, & J. H. KIm. (2016). A Comparison of Cardiopulmonary Function, RPE, and Blood Lactate following in Wheelchair Treadmill and Arm Ergometer GXT Test through Convergence. Journal of Digital Convergence, 14(9), 553-561. https://doi.org/10.14400/JDC.2016.14.9.553