The Journal of Korean Physical Therapy

  • 제31권5호
  • /
  • Pages.311-316
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  • 2019
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  • 1229-0475(pISSN)
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  • 2287-156X(eISSN)
대한물리치료학회 (The Korean Society of Physical Therapy)
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The Effect of Lower Extremity Strengthening Exercise Using Sliding Stander on Balance and Spasticity in Chronic Stroke: A Randomized Clinical Trial

  • Mun, Byeong Mu (Kumi Movement Development Center) ;
  • Park, Jin (Department of Physical Therapy, Graduate School, Daegu University) ;
  • Kim, Tae Ho (Department of Physical Therapy, Graduate School, Daegu University)
  • 투고 : 2019.09.11
  • 심사 : 2019.09.30
  • 발행 : 2019.10.31
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초록

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

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참고문헌

  1. Geurts AC, de Haart M, van Nes IJ et al. A review of standing balance recovery from stroke. Gait Posture. 2005;22(3):267-81. https://doi.org/10.1016/j.gaitpost.2004.10.002
  2. Bohannon RW. Muscle strength and muscle training after stroke. J Rehabil Med. 2007;39(1):14-20. https://doi.org/10.2340/16501977-0018
  3. Farmer SF, Swash M, Ingram DA et al. Changes in motor unit synchronization following central nervous lesions in man. J Physiol. 1993; 463(1):83-105. https://doi.org/10.1113/jphysiol.1993.sp019585
  4. Gemperline JJ, Allen S, Walk D et al. Characteristics of motor unit discharge in subjects with hemiparesis. Muscle Nerve. 1995;18(10):1101-14. https://doi.org/10.1002/mus.880181006
  5. Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil. 2002;83(8):1138-44. https://doi.org/10.1053/apmr.2002.33644
  6. Campbell FM, Ashburn AM, Pickering RM et al. Head and pelvic movements during a dynamic reaching task in sitting: implications for physical therapists. Arch Phys Med Rehabil. 2001;82(12):1655-60. https://doi.org/10.1053/apmr.2001.26818
  7. Laufer Y, Dickstein R, Resnik S et al. Weight-bearing shifts of hemiparetic and healthy adults upon stepping on stairs of various heights. Clin Rehabil. 2000;14(2):125-9. https://doi.org/10.1191/026921500674231381
  8. Rekand T. Clinical assessment and management of spasticity: a review. Acta Neurol Scand Suppl. 2010;(190):62-6.
  9. O'Dell MW, Lin CC, Harrison V. Stroke rehabilitation: strategies to enhance motor recovery. Annu Rev Med. 2009;60:55-68. https://doi.org/10.1146/annurev.med.60.042707.104248
  10. Francisco GE, McGuire JR. Poststroke spasticity management. Stroke. 2012;43(11):3132-6. https://doi.org/10.1161/STROKEAHA.111.639831
  11. Bale M, Strand LI. Does functional strength training of the leg in subacute stroke improve physical performance? A pilot randomized controlled trial. Clin Rehabil. 2008;22(10-11):911-21. https://doi.org/10.1177/0269215508090092
  12. Ouellette MM, LeBrasseur NK, Bean JF et al. High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors. Stroke. 2004;35(6):1404-9. https://doi.org/10.1161/01.STR.0000127785.73065.34
  13. Byun SD, Jung TD, Kim CH et al. Effects of the sliding rehabilitation machine on balance and gait in chronic stroke patients - a controlled clinical trial. Clin Rehabil. 2011;25(5):408-15. https://doi.org/10.1177/0269215510385850
  14. Miller GJ, Light KE. Strength training in spastic hemiparesis: should it be avoided? NeuroRehabilitation. 1997;9(1):17-28. https://doi.org/10.1016/S1053-8135(97)00011-5
  15. Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Arch Phys Med Rehabil. 1997; 78(11):1231-6. https://doi.org/10.1016/S0003-9993(97)90337-3
  16. Freire B, Dias CP, Goulart NB et al. Achilles tendon morphology, plantar flexors torque and passive ankle stiffness in spastic hemiparetic stroke survivors. Clin Biomech. 2017;41:72-6. https://doi.org/10.1016/j.clinbiomech.2016.12.004
  17. Tung FL, Yang YR, Lee CC et al. Balance outcomes after additional sit-to-stand training in subjects with stroke: a randomized controlled trial. Clin Rehabil. 2010;24(6):533-42. https://doi.org/10.1177/0269215509360751
  18. Mercer VS, Chang SH, Williams CD et al. Effects of an exercise program to increase hip abductor muscle strength and improve lateral stability following stroke: a single subject design. J Geriatr Phys Ther. 2009;32(2): 6-15. https://doi.org/10.1519/00139143-200932020-00003
  19. Um YJ, Jang HY, Lee SM. Taping therapy simultaneously applied to the ankle and hip joint: effect on balance and gait in patients with chronic stroke. J Kor Phys Ther. 2019;31(1):49-55. https://doi.org/10.18857/jkpt.2019.31.1.49
  20. Park JH, Kim YM, Lee NK. The effects of repetitive sit-to-stand training with a paretic-side asymmetrical foot position on the balance of chronic stroke subjects. J Kor Phys Ther. 2015;27(3):169-73. https://doi.org/10.18857/jkpt.2015.27.3.169
  21. Engardt M, Grimby G. Adapted exercise important after stroke. Acute and long-term effects of different training programs. Lakartidningen. 2005;102(6):392-4.
  22. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67(2):206-7. https://doi.org/10.1093/ptj/67.2.206
  23. Butler PB, Thompson N, Major RE. Improvement in walking performance of children with cerebral palsy: preliminary results. Dev Med Child Neurol. 1992;34(7):567-76. https://doi.org/10.1111/j.1469-8749.1992.tb11487.x