융합정보논문지 (Journal of Convergence for Information Technology)

중소기업융합학회 (Convergence Society for SMB)
권호 표지
DOI QR코드

DOI QR Code

물리치료 중재에 따라 뇌졸중 환자의 발목관절가동범위 증진에 미치는 비교

Comparison of Physical Therapy Interventions on the Improvement of Ankle Joint Range of Motion with Stroke Patients

  • 유병호 (남서울대학교 물리치료학과) ;
  • 최태석 (남서울대학교대학원 물리치료학전공) ;
  • 이상빈 (남서울대학교 물리치료학과)
  • Ryu, Byeong Ho (Department of Physical Therapy, Namseoul University) ;
  • Choi, Tae Seok (Department of Physical Therapy, Graduate of Namseoul University) ;
  • Lee, Sang Bin (Department of Physical Therapy, Namseoul University)
  • 투고 : 2019.11.10
  • 심사 : 2019.12.20
  • 발행 : 2019.12.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구의 목적은 뇌졸중 환자의 발목관절 가동범위를 증가시키기 위한 중재를 실시한 후 발목가동범위 변화를 비교한 것이다. 본 연구는 총 45명의 뇌졸중 환자를 경사대, PNF 스트레칭 그리고 관절가동술 방법에 따라 각 3군으로 나누어 8주간 실시한 후 발바닥 굽힘과 발등 굽힘을 측정하였다. 발바닥 굽힘은 집단 간에 차이가 유의하게 있었고(p<.001), 시기별 집단 간 차이에서도 차이가 유의하였다. 발등 굽힘은 관절가동술을 적용한 군 내에서 유의하게 증가하였으며(p<.05), 집단 간, 시기별 유의하였다(p<.05). 본 연구를 통해 발목의 가동범위를 증가시키기 위한 방법으로 스트레칭과 관절가동술이 효과가 있음을 알 수 있었다. 향후 연구에서는 뇌졸중 환자의 발목가동범위 증가가 미치는 또 다른 영향에 대한 연구가 있기를 기대한다.

The purpose of this study to compare the effect of physical therapy interventions on the improvement of ankle joint range of motion with stroke patients. Total subjects were 45 stroke patients, who were divided into a group using inclined boards(n=15), a group of receiving stretching(n=15), and a group of receiving joint mobilization(n=15). The experiment was performed for 8 weeks. The plantar flexion showed significant differences both groups and by periods. The dorsiflexion showed significant differences between groups and by periods, and the group in changes within groups by periods. This study found that stretching and joint mobilization are effective as an intervention method to increase the range of motion on ankle joint. Future study is expected to investigate other effects of increased ankle range of motion in stroke patients.

키워드

참고문헌

  1. D. A. Neumann. (2017). Kinesiology of the musculoskeletal system: Foundations for physical rehabilitation, 3rd ed. Mosby.
  2. M. C. Rosa, A. Marques, S. Demain & C. D. Metcalf. (2014). Lower limb co-contraction during walking in subjects with stroke: A systematic review. Journal of Electromyography and Kinesiology, 24, 1-10. https://doi.org/10.1016/j.jelekin.2013.10.016
  3. L. K. Kwah, R. D. Herbert, L. A. Diong & J. L. Clarke. (2012). Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke. Archives of Physical Medicine and Rehabilitation, 93, 1185-1190. https://doi.org/10.1016/j.apmr.2012.02.009
  4. M. Manca, G. Ferraresi, M. Cosma, L. Cavazzuti, M. Morelli, M. G & Benedetti. (2014). Gait patterns in hemiplegic patients with equinus foot deformity. BioMed research International, 939316. 1-7.
  5. E. de Vlugt, J. H. de Groot, K. E. Schenkeveld, J. H. Arendzen, F. C. van der Helm & C. G. Meskers. (2010). The relation between neuromechanical parameters and Ashworth score in stroke patients. Journal of Neuroengineering and Rehabilitation, 7(1), 35. https://doi.org/10.1186/1743-0003-7-35
  6. F. Gao, Y. Ren, E. J. Roth, R. Harvey & L. Q. Zhang. (2011). Effects of repeated ankle stretching on calf muscle. tendon and ankle biomechanical properties in stroke survivors. Clinical Biomechanics, 11(3), 159-164. https://doi.org/10.1016/0268-0033(95)00047-X
  7. A. W. Andrews & R. W. Bohannon. (2003). Short-term recovery of limb muscle strength after acute stroke. Archives of physical medicine and rehabilitation, 84, 125-130. https://doi.org/10.1053/apmr.2003.50003
  8. B. J. Kim, S. K. Lee & M. K. Kim. (2007). The Effects of Ankle Strength Exercise and Functional Electrical Stimulation on the Ability of Balance Control and Gait in Stroke Patients. Korean Society of Sport and Leisure Studies, 31, 921-931. https://doi.org/10.51979/KSSLS.2007.11.31.921
  9. J. S. Wang, S. B. Lee & S. H. Moon. (2016). The immediate effect of PNF pattern on muscle tone and muscle stiffness in chronic stroke patient. Journal of Physical Therapy Science, 28(3), 967-970. https://doi.org/10.1589/jpts.28.967
  10. S. C. Chen, Y. L. Chen, C. J. Chen, C. J. Lai, W. H. Chiang & W. L. Chen. (2005). Effects of surface electrical stimulation on the muscle-tendon junction of spastic gastrocnemius in stroke patients. Disability and Rehabilitation, 27(3), 105-110. https://doi.org/10.1080/09638280400009022
  11. J. W. Park, K. S. Nam & M. Y. Back. (2005). The relationship between the plantar center of pressure displacement and dynamic balance measures in hemiplegic gait. Physical Therapy Korea. 12(1), 11-21.
  12. K. H. Park & W. B. Kim. (2014). The effects of ankle strategy exercise on balance of patients with hemiplegia. Journal of Korean Society Physical Medicine, 9(1), 75-82. https://doi.org/10.13066/kspm.2014.9.1.75
  13. J. Vaillant et al. (2008). Effect of manipulation of the feet and ankles on postural control in elderly adults. Brain Research Bulletin, 75, 18-22. https://doi.org/10.1016/j.brainresbull.2007.07.009
  14. D. Cruz-Diaz, R. Lomas-Vega, M. C. Osuna-Perez, F. Hita-Contreras & A. Martinez-Amat. (2015). Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disability and Rehabilitation, 37(7), 601-610. https://doi.org/10.3109/09638288.2014.935877
  15. M. C. Hoch & P. O. McKeon. (2011). Joint Mobilization Improves Spatiotemporal Postural Control and Range of Motion in Those with Chronic Ankle Instability. Journal Of Orthopaedic Research, 29(3), 326-332. https://doi.org/10.1002/jor.21256
  16. C. Kisner & L. A. Colby. (2012). Therapeutic Exercise: Foundations and Techniques. 2nd ed. F.A. Davis Company, Philadelphia.
  17. D. Klein, J. William & T. Wayne. (2002). PNF training and physical function in assisted-living older adults. Journal of aging and physical activity, 41(10), 476-488.
  18. K. C. Seo, S. H. Park & K. Y. Park. (2015). The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients' dynamic balance ability. Journal of Physical Therapy Science, 2, 1459-1462.
  19. S. J. Lee, B. S. Kwon & C. H. Park. (2001). The Effect of Passive Stretching on the Spasticity of Ankle Plantar Flexor Muscles. Journal of the Korean Academy of Rehabilitation Medicine, 25(6), 987-992.
  20. H. Ahmed, A. Lqbal, S. Anwer & A. Alghadir. (2015). Effect of modified hold-relax stretching and static stretching on hamstring muscle flexibility. Journal of Physical Therapy Science, 27(2), 535-538. https://doi.org/10.1589/jpts.27.535
  21. V. Jacques et al. (2008). Effect of manipulation of the feet and ankles on postural control in elderly adults. Brain Research Bulletin, 75, 18-22. https://doi.org/10.1016/j.brainresbull.2007.07.009
  22. M. Hoch & P. Mckeon. (2011). Joint Mobilization Improves Spatiotemporal Postural Control and Range of Motion in Those with Chronic Ankle Instability. Journal Of Orthopaedic Research, 29(3), 326-332. https://doi.org/10.1002/jor.21256
  23. K. Banks & E. Hengeveld.(2014). Maitland's Peripheral Manipulation. Management of Neuromusculoskeletal Disorders, 2, 1-65.
  24. W. S. Hong & K. W. Kim. (2009). Reliability of measurement devices for measuring the ankle joint motion. The Journal of Korean Academy of Orthopedic Manual Therapy, 15(1), 1-8.
  25. D. Y. Jung, E. K. Kwon, O. Y. Kwon, C. Yi, J. S. Oh & J. H. Weon. (2009). Effect of Medial Arch Support on Displacement of the Myotendinous Junction of the Gastrocnemius During Standing Wall Stretching. Journal of Orthopaedic and Sports Physical Therapy, 39(12), 867-74. https://doi.org/10.2519/jospt.2009.3158
  26. J. S. Kim, H. Y. Lee, S. Y. Ahn, B. O. Koo & S. S. Bae. (2004). Characteristics Change of Spatial and Temporal Parameters of Gait in Spastic Hemiplegic Patients by Reciprocal Inhibition. The journal of Korean society of physical therapy, 16(4), 645-660.
  27. P. Kluding & M. Santos. (2008). Effects of Ankle Joint Mobilization in Adults Poststroke: A pilot Study. Archives of Physical Medicine and Rehabilitaion, 86, 499-56.