Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Task Gait Exercise Combined with Self-observation Training on Leg Muscle Activity and Gait in Stroke Patients

자기관찰훈련을 병행한 과제보행운동이 뇌졸중 환자의 다리 근활성도와 보행에 미치는 영향

  • 강정일 (세한대학교 물리치료학과) ;
  • 백승윤 (세한대학교 물리치료학과) ;
  • 정대근 (세한대학교 물리치료학과)
  • Received : 2022.07.11
  • Accepted : 2022.08.19
  • Published : 2022.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE: This study examined the effectiveness of task gait exercise combined with self-observation training to provide basic clinical data by analyzing the factors that task gait exercise combined with self-observation training has on the leg muscle activity and gait improvement in stroke patients. METHODS: The subjects were assigned randomly to experimental Group I, which mediated task gait exercise combined with self-observation training, and experimental Group II, which mediated task-walking movement. They received 30-minute interventions three times a week for four weeks. The leg muscle activity and 10 m walking test (10MWT) were conducted as pre-intervention tests, and they underwent a post-test four weeks later in the same manner as the pre-test. RESULTS: A statistically significant difference was observed in all muscles and 10MWT (p < .01) in experimental group I (p < .05), while there were significant differences only in the rectus femoris, biceps femoris, and 10MWT (p < .05). In a comparison of the changes between groups, there were statistically significant differences only in the tibialis anterior, soleus muscle, and 10MWT (p < .05). CONCLUSION: Self-observation training in experimental group I was effective in increasing the leg muscle activity and improving walking speed by discovering and correcting incorrect movements and following a normal gait pattern using the ankle joint. Therefore, the task gait exercise combined with self-observation training should be introduced and actively utilized for the rapid social recovery of stroke patients.

Keywords

Acknowledgement

본 논문은 2022년 세한대학교의 학술연구비에 의하여 지원되었다.

References

  1. World Health Organization. Stroke, Cerebrovascular accident. 2014.
  2. Wong KS, Caplan LR, Kim JS. Stroke mechanisms. Intracranial Atherosclerosis: Pathophysiology, Diagnosis and Treatment. 2016;40:58-71. https://doi.org/10.1159/000448302
  3. Najafi Z, Rezaeitalab F, Yaghubi M, et al. The effect of biofeedback on the motor -muscular situation in rehabilitation of stroke patients : A randomized controlled trial. Journal of Caring Sciences. 2018;7(2):89-93. https://doi.org/10.15171/jcs.2018.014
  4. Bonan I V, Colle FM, Guichard JP, et al. Reliance on visual information after stroke. Part I: Balance on dynamic posturography. Arch Phys Med Rehabil. 2004; 85(2):268-73. https://doi.org/10.1016/j.apmr.2003.06.017
  5. Rodgers SL, Rodgers MM, Macko RF, et al. Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke. J Rehabil Res Dev. 2008;45(2):221-8. https://doi.org/10.1682/JRRD.2007.02.0024
  6. Stinear CM, Lang CE, Zeiler S, et al. Advances and challenges in stroke rehabilitation. Neurology. 2020;19(4):348-60.
  7. Lee S, Lee K, Song C. Gait training with bilateral rhythmic auditory stimulation in stroke patients: a randomized controlled trial. Brain Sci. 2018;8(9):164. https://doi.org/10.3390/brainsci8090164
  8. Garrison KA, Winstein CJ, Aziz-Zadeh L. The mirror neuron system: a neural substrate for methods in stroke rehabilitation. Neurorehabil Neural Repair. 2010;24(5):404-12. https://doi.org/10.1177/1545968309354536
  9. Seo K, Park SH, Park K. The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients' dynamic balance ability. J Phys Ther Sci. 2015;27(5):1459-62. https://doi.org/10.1589/jpts.27.1459
  10. Srivastava A, Taly AB, Gupta A, et al. Bodyweight-supported treadmill training for retraining gait among chronic stroke survivors: A randomized controlled study. Ann Phys Rehabil Med. 2016;59(4):235-41. https://doi.org/10.1016/j.rehab.2016.01.014
  11. Fujiwara T, Kawakami M, Honaga K, et al. Hybrid assistiveneuromuscular dynamic stimulation therapy: a new strategy forimproving upper extremity function in patients with hemiparesisfollowing stroke. Neural Plast. 2017:1-5.
  12. Lee GJ, An HJ. The Effects of Videotaped Self-Observation on the Development of Insight among Schizophrenic Clients. J Korean Acad Psychiatr Ment Health Nurs. 2002;11(1):89-97.
  13. Thomas G, Morgan K, Harris K. Albert Bandura. Learning in Sports Coaching: Theory and Application. 2016;22-33
  14. Kim DJ. Effect of Self-Monitoring Utilizing Smart Phone on Sports Skill Learning: A Holistic Perspective. The Korean Society for Holistic Convergence Education. 2016;20(1):43-54
  15. Jung HY. The Effects of Self-Observation Training and Action Observation Training on Physical Function and EEG in Patients with Chronic Stroke. Master's Degree. Nambu University. 2017.
  16. Boyd BS, Wanek L, Gray AT, et al. Mechanosensitivity during lower extremity neurodynamic testing is diminished in individuals with Type 2 Diabetes Mellitus and peripheral neuropathy: a cross sectional study. BMC neurology. 2010;10(1):1-14. https://doi.org/10.1186/1471-2377-10-1
  17. Pekna M, Pekny M, Nilsson M. Modulation of neural plasticity as a basis for stroke rehabilitation. Stroke. 2012;43(10):2819-28. https://doi.org/10.1161/STROKEAHA.112.654228
  18. Alawieh A, Zhao J, Feng W. Factors affecting post-stroke motorrecovery: Implications on neurotherapy after brain injury. Behav Brain Res. 2016;340:94-101. https://doi.org/10.1016/j.bbr.2016.08.029
  19. Robson N, Faller II KJ, Ahir V, et al. Creating a virtual perception for upper limb rehabilitation. Int J Bioprint and Biological Engineering. 2017;11(4):152-7.
  20. Lee DK, Kim JS, Kim TH, et al. Comparison of the electromyographic activity of the tibialis anterior and gastrocnemius in stroke patients and healthy subjects during squat exercise. J. Phys. Ther. Sci. 2015;27(1):247-9. https://doi.org/10.1589/jpts.27.247
  21. Cheng DK, Nelson M, Brooks D, et al. Validation of stroke-specific protocols for the 10-meter walk test and 6-minute walk test conducted using 15-meter and 30-meter walkways. Top Stroke Rehabil. 2020;27(4):251-61. https://doi.org/10.1080/10749357.2019.1691815
  22. Park YA, Kim HS, Ahn MH, et al. Effet of Action Observation on Upper Extremity Function and Activity of Daily Living Level in Cronic Stroke Patiens. KMTS. 2014;6(2):37-46.
  23. Courtine G, Schieppati M. Human walking along acurved path. II. Gait features and emg patterns. E ur J N eurosci. 2003;18(1):91-205.
  24. Kim YH. Effect of task gait training on gait performance of patients with chronic storke. Master's Degree. Hallym University Graduate School of Health Sciences. 2014.
  25. Chen MH, Pan TL, Li CT, et al. Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study. Br J Psychiatry. 2015;206(4):302-7. https://doi.org/10.1192/bjp.bp.113.143610
  26. Yang HC, Lee CL, Lin RH, et al. Effect of biofeedback cycling training on functional recovery and walking ability of lower extremity in patients with stroke. Kaohsiung J Med Sci. 2014;30(1):35-42. https://doi.org/10.1016/j.kjms.2013.07.006
  27. Kim JM, Yang BI, Lee MK. The Effect of Action Observational Physical Training on Manual Dexerity in Stroke Patients. PTK. 2010;17(2):17-24
  28. Choi YA, Kim JS, Lee DY. Effects of fast and slow squatexercises on the muscle activity of the paretic lower extremity inpatients with chronic stroke. J. Phys. Ther. Sci. 2015;27(8):2597-9. https://doi.org/10.1589/jpts.27.2597
  29. Lim JW. A Study on the Correlation Analysis of the Leg Muscle Activity, H-Reflex, and Gait of Stroke Patients with Forward and Backward Pedaling Exercise. Master's Degree. Graduate School of Sehan Universit. 2022.
  30. Kim SJ, Lee HJ. The Effects of Dual Task Training According to Variability of Walking Environment on Balance, Gait and Function of Stroke Patients. Journal of The Korean Society of Integrative Medicine. 2021;9(2):23-33. https://doi.org/10.15268/KSIM.2021.9.2.023
  31. Song SY, Song YH, Lee HM. The Effects of Action Observational Physical Training with Rhythmic Auditory Stimulation on Muscle Activity of the Lower Extremity and Gait Ability in Patients with Chronic Stroke. J Korean Soc Phys Med. 2018;13(2);137-45. https://doi.org/10.13066/kspm.2018.13.2.137
  32. Simonsen EB, Moesby LM, Hansen LD, et al. Redistribution of joint moments during walking in patientswith drop-foot. Clinical Biomechanics. 2010;25(9):949-52. https://doi.org/10.1016/j.clinbiomech.2010.06.013
  33. Kerrigan DC, Karvosky ME, Riley PO. Spastic paretic stiff-legged gait: joint kinetics. Am J Phys Med Rehabil. 2001;80(4):244-9. https://doi.org/10.1097/00002060-200104000-00002
  34. Lee JE, Lee HS. Effects of treadmill gait training according to obstacle crossing on the hip, knee and ankle joint motion during gait cycle in patients with post stroke hemiplegia. Exercise Science. 2019;28(3):248-55. https://doi.org/10.15857/ksep.2019.28.3.248
  35. Said CM, Goldie PA, Patla AE, et al. Effect of stroke on step characteristics of obstacle crossing. Arch Phys Med Rehabil. 2001;82(12):1712-9. https://doi.org/10.1053/apmr.2001.26247
  36. Bang DH, Shin WS, Kim SY, et al. The effects of action observationaltraining on walking ability in chronic stroke patients: Adouble-blind randomized controlled trial. Clin Rehabil. 2013;27(12):1118-25. https://doi.org/10.1177/0269215513501528
  37. Noh HJ, Kuk EJ, Kim JM. The Effect of Action Observation Physical Training on Sit-to-Stand and Balance in Chronic Stroke Patients. Kor J Neural Rehabil. 2011;1(2):11-20.
  38. Lee HM, Lee JA. The Effects of Dual-task Action Observation Physical Training on the Walking Ability and Activities of Daily Living in Chronic Stroke Patients. J Korean Soc Phys Med. 2016;11(2):83-91.
  39. Shin JM. Factors related to vertical obstacle crossingin independent ambulatory patients with stroke. Master's Degree. Graduate school of Cheongju University. 2020.
  40. Kim TH, Park SB. Changes in theelectroencephalogram patterns during motor imagery andaction observation of elbow flexion and extension. Journalof Sport and Leisure Studies. 2007;31(11):987-99. https://doi.org/10.51979/KSSLS.2007.11.31.987
  41. Kim JS. Effect of Motor Imagery Training and Action Observation Training on Gait and Balance in Post Stroke patients. Doctor's Degree. Graduate School Daegu University. 2012.
  42. Lee SW, Lee JH, Lee YW. The Effect of Dual Motor TaskTraining while Sitting on Trunk Control Ability andBalance of Patients with Chronic Stroke. J Spec EducRehabil Sci. 2012;51(2):301-18.
  43. Oh TY, Cha MB, Ock EJ, et al. The Effect of Gait Velocity on Muscle Activation and the Correlation of Muscles in the Lower Limb. JKSNT. 2022;26(2):25-31.