대한물리의학회지 (Journal of the Korean Society of Physical Medicine)

  • 제15권4호
  • /
  • Pages.37-45
  • /
  • 2020
  • /
  • 1975-311X(pISSN)
  • /
  • 2287-7215(eISSN)
대한물리의학회 (The Korean Society of Physical Medicine)
권호 표지
DOI QR코드

DOI QR Code

The Immediate Effects of Neck and Trunk Stabilization Exercises on Balance and Gait in Chronic Stroke Patients

  • Choe, Yu-Won (Department of Rehabilitation Sciences, Graduate School, Daegu University) ;
  • Kim, Myoung-Kwon (Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University)
  • 투고 : 2020.09.16
  • 심사 : 2020.10.16
  • 발행 : 2020.11.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

PURPOSE: The purpose of this study was to identify the effects of neck stabilization exercise combined with trunk stabilization exercise on balance and gait function in patients with chronic stroke. METHODS: Twenty-two chronic stroke patients were included in this study. The experimental group subjects (n = 11) performed neck stabilization (15 min) and trunk stabilization (15 min) exercises, while the control group subjects (n = 11) performed trunk stabilization exercise only for 30 min. Before and after the intervention, the subjects underwent static balance and gait testing. RESULTS: The 95% confidence ellipse area, center of pressure (COP) path length, and COP average velocity were significantly lower in both groups after the intervention compared to before intervention (p < .05). The average stance force on the affected side increased significantly in both groups after the intervention (p < .05). The changes in the static balance variables were larger in the experimental group than in the control group. The cadence, gait velocity, and single leg support increased significantly in both groups after intervention (p < .05). The changes in the gait variables were larger in the experimental group than in the control group. CONCLUSION: Trunk stabilization is a beneficial intervention, but the combination of neck stabilization with trunk stabilization is a more effective method to increase the gait and static balance in chronic stroke patients.

키워드

참고문헌

  1. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice (3rd ed). Lippincott Williams & Wilkins. 2007.
  2. Jeon SH, Lee SM, Kim JH. Therapeutic effects of reaching with forward bending of trunk on postural stability, dynamic balance, and gait in individuals with chronic hemiparetic stroke. J Phys Ther Sci. 2015;27(8):2447-51. https://doi.org/10.1589/jpts.27.2447
  3. Kim H, Her JG, Ko J. Effect of horseback riding simulation machine training on trunk balance and gait of chronic stroke patients. J Phys Ther Sci. 2014;26(1):29-32. https://doi.org/10.1589/jpts.26.29
  4. Karthikbabu S, John MS, Manikandan N, et al. Role of trunk rehabilitation on trunk control, balance and gait in patients with chronic stroke: a pre-post design. Neuroscience & Medicine. 2011.
  5. Verheyden G, Vereeck L, Truijen S, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20(5): 451-8. https://doi.org/10.1191/0269215505cr955oa
  6. Duarte E, Marco E, Muniesa JM, et al. Trunk control test as a functional predictor in stroke patients. J Rehabil Med. 2002;34(6):267-72. https://doi.org/10.1080/165019702760390356
  7. Hsieh CL, Sheu CF, Hsueh IP, et al. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke. 2002;33(11):2626-30. https://doi.org/10.1161/01.str.0000033930.05931.93
  8. Verheyden G, Nieuwboer A, De Wit L, et al. Trunk performance after stroke: an eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry. 2007;78(7):694-8. https://doi.org/10.1136/jnnp.2006.101642
  9. Haruyama K, Kawakami M, Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients: a randomized controlled trial. Neurorehabil Neural Repair. 2017;31(3):240-9. https://doi.org/10.1177/1545968316675431
  10. Cabanas-Valdes R, Bagur-Calafat C, Girabent-Farres M, et al. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: a randomized controlled trial. Clin Rehabil. 2016;30(10):1024-33. https://doi.org/10.1177/0269215515609414
  11. Ting-Ting L, Meng-Jie L, Ya-Qian L, et al. Effects of core stability exercise on rehabilitation in stroke patients with hemiplegia: a meta-analysis. TMR Non-Drug Therapy. 2018;1(2):41-52.
  12. Yu SH, Park SD. The effects of core stability strength exercise on muscle activity and trunk impairment scale in stroke patients. J Exerc Rehabil. 2013;9(3):362. https://doi.org/10.12965/jer.130042
  13. Chung EJ, Kim JH, Lee BH. The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J Phys Ther Sci. 2013;25(7):803-6. https://doi.org/10.1589/jpts.25.803
  14. Lee JY, Park JS, Lee DH, et al. Effect of the trunk muscle stabilization training on balance for chronic stroke patients. Journal of the Korea Academia-Industrial cooperation Society. 2012;13(3):1212-9. https://doi.org/10.5762/KAIS.2012.13.3.1212
  15. Kim GM, Oh DW. Neck proprioceptive training for balance function in patients with chronic poststroke hemiparesis: a case series. J Phys Ther Sci. 2014;26(10):1657-9. https://doi.org/10.1589/jpts.26.1657
  16. Boyd-Clark LC, Briggs CA, Galea MP. Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine. 2002; 27(7):694-701. https://doi.org/10.1097/00007632-200204010-00005
  17. Bove M, Courtine G, Schieppati M. Neck muscle vibration and spatial orientation during stepping in place in humans. J Neurophysiol. 2002;88(5):2232-41. https://doi.org/10.1152/jn.00198.2002
  18. Song GB, Park EC. Effects of neck and trunk stabilization exercise on balance in older adults. J Kor Phys Ther. 2016;28(4):221-6. https://doi.org/10.18857/jkpt.2016.28.4.221
  19. Seo HJ, Lee MJ, Oh TY. The effects of neck strengthening exercise on postural control in sitting position during reaching in children with spastic diplegia. J Korean Soc Neur Ther. 2012;16(16):17-24.
  20. Freitas SM, Duarte M, Latash ML. Two kinematic synergies in voluntary whole-body movements during standing. J Neurophysiol. 2006;95(2):636-45. https://doi.org/10.1152/jn.00482.2005
  21. Lee JH, Choi JD. The effects of upper extremity task training with symmetric abdominal muscle contraction on trunk stability and balance in chronic stroke patients. J Phys Ther Sci. 2017;29(3):495-7. https://doi.org/10.1589/jpts.29.495
  22. Hides J, Richardson C, Hodges P. Local segmental control. In: Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain (2nd ed). London, England. Churchill Livingstone. 2004.
  23. Falla D, Jull G, Russell T, et al. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther. 2007;87(4):408-17. https://doi.org/10.2522/ptj.20060009
  24. Jull GA, Falla DL, Treleaven JM, et al. A therapeutic exercise approach for cervical disorders (3rd ed). Edinburgh, United Kingdom. Elsevier. 2004.
  25. Falla D, Bilenkij G, Jull G. Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine. 2004;29:1436-40. https://doi.org/10.1097/01.BRS.0000128759.02487.BF
  26. Falla D, Jull G, O'Leary S, et al. Further evaluation of an EMG technique for assessment of the deep cervical flexor muscles. J Electromyogr Kinesiol. 2006;16:621-8. https://doi.org/10.1016/j.jelekin.2005.10.003
  27. Mayoux-Benhamou MA, Revel M, Vallee C, et al. Longus colli has a postural function on cervical curvature. Surg Radiol Anat. 1994;16(4):367-71. https://doi.org/10.1007/BF01627655
  28. Nakhaee Z, Rahimi A, Abaee M, et al. The relationship between the height of the medial longitudinal arch (MLA) and the ankle and knee injuries in professional runners. The Foot. 2008;18(2):84-90. https://doi.org/10.1016/j.foot.2008.01.004
  29. Soltani N, Rahimi A, Naimi SS, et al. Studying the Balance of the Coper and Non-Coper ACL-Deficient Knee Subjects. Asian J Sports Med. 2014;5(2):91-8.
  30. Wong T, Ma A, Liu K, et al. Balance control, agility, eye-hand coordination, and sport performance of amateur badminton players: A cross-sectional study. Medicine. 2019;98(2):e14134. https://doi.org/10.1097/md.0000000000014134
  31. In T, Lee K, Song C. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials. Med Sci Monit. 2016;22:4046-53. https://doi.org/10.12659/MSM.898157
  32. Choi W, Han D, Kim J, Lee S. Whole-Body Vibration Combined with Treadmill Training Improves Walking Performance in Post-Stroke Patients: A Randomized Controlled Trial. Med Sci Monit. 2017;23:4918-25. https://doi.org/10.12659/MSM.904474
  33. Menz HB, Latt MD, Tiedemann A, et al. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture. 2004;20(1):20-5. https://doi.org/10.1016/S0966-6362(03)00068-7
  34. Shin JW, Song GB, Ko J. The effects of neck and trunk stabilization exercises on cerebral palsy children's static and dynamic trunk balance: case series. J Phys Ther Sci. 2017;29(4):771-4. https://doi.org/10.1589/jpts.29.771
  35. Keshner EA, Woollacott MH, Debu B. Neck, trunk and limb muscle responses during postural perturbations in humans. Exp Brain Res. 1988;71(3):455-66. https://doi.org/10.1007/BF00248739
  36. Dubey L, Karthikbabu S, Mohan D. Effects of Pelvic Stability Training on Movement Control, Hip Muscles Strength, Walking Speed and Daily Activities after Stroke: A Randomized Controlled Trial. Ann Neurosci. 2018; 25(2):80-9. https://doi.org/10.1159/000486273
  37. Tyson SF. Trunk kinematics in hemiplegic gait and the effect of walking aids. Clin Rehabil. 1999;13(4):295-300. https://doi.org/10.1191/026921599666307333
  38. Kong SW, Jeong YW, Kim JY. Correlation between balance and gait according to pelvic displacement in stroke patients. J Phys Ther Sci. 2015;27(7):2171-4. https://doi.org/10.1589/jpts.27.2171
  39. Park BS, Kim JH, Kim MY, et al. Effect of a muscle strengthening exercise program for pelvic control on gait function of stroke patients. J Phys Ther Sci. 2015;27(3): 641-4. https://doi.org/10.1589/jpts.27.641