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인지과제를 결합한 장애물 보행훈련이 뇌졸중 환자의 균형과 보행능력 및 일상생활동작에 미치는 효과 -단일사례연구-

Effect of Obstacle Walking Training Combined with Cognitive Tasks on Balance, Gait, and Activities of Daily Living in Patients with Stroke: A Single Case Study

  • 송민정 (익산수요양병원 물리치료실) ;
  • 김범룡 (대자인병원 재활센터)
  • Min-Jeong Song (Department of physical therapy, Iksansoo Rehabilitation Hospital) ;
  • Beom-Ryong Kim (Department of Physical Therapy, Design Hospital)
  • 투고 : 2023.02.26
  • 심사 : 2023.03.28
  • 발행 : 2023.04.30

초록

Purpose: This study aims to compare the effects of obstacle walking training combined with cognitive tasks on balance, gait, and activities of daily living in patients with stroke. Methods: A single-subject design was used, where one stroke patient participated. Obstacle walking training combined with cognitive tasks was performed for 1 hour per day for a total of 10 times during the intervention phase. The subjects were measured five times in the baseline phase, 10 times in the intervention phase, and five times in the follow-up phase. The outcome measurements included the Berg balance scale (BBS), the 10-meter walk test (10 MWT), and the Korean modified Barthel index (K-MBI). Results: In this study, the results showed that the 10 MWT scores during the intervention period improved and that this improvement remained, even during the post-period. In addition, BBS and K-MBI values for stroke patients increased significantly after training. Conclusion: The results of this study revealed that obstacle walking training combined with cognitive task training may be helpful to improve balance, gait, and activities of daily living in stroke patients. Therefore, obstacle walking training combined with cognitive tasks is recommended for stroke patients.

키워드

참고문헌

  1. Abbud GAC, Li KZH, DeMont RG. Attentional requirements of walking according to the gait phase and onset of auditory stimuli. Gait & Posture. 2009;30(2):227-232. https://doi.org/10.1016/j.gaitpost.2009.05.013
  2. Berg K, Wood-Dauphinee S, Williams JI. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scandinavian Journal of Rehabilitation Medicine. 1995;27(1):27-36.
  3. Dobkin BH. Short-distance walking speed and timed walking distance: redundant measures for clinical trials? Neurology. 2006;66(4):584-586. https://doi.org/10.1212/01.wnl.0000198502.88147.dd
  4. Geiger RA, Allen JB, O'Keefe J, et al. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Physical Therapy. 2001;81(4):995-1005. https://doi.org/10.1093/ptj/81.4.995
  5. Huxhold O, Li SC, Schmiedek F, et al. Dual-tasking postural control: aging and the effects of cognitive demand in conjunction with focus of attention. Brain Research Bulletin. 2006;69(3):294-305. https://doi.org/10.1016/j.brainresbull.2006.01.002
  6. Hyndman D, Ashburn A, Yardley L, et al. Interference between balance, gait, and cognitive task performance among people with stroke living in the community. Disability and Rehabilitation. 2006;28(13-14):849-856. https://doi.org/10.1080/09638280500534994
  7. Jung HY, Park BK, Shin HS, et al. Development of the Korean version of modified Barthel index (K-MBI): multi-center study for subjects with stroke. Journal of the Korean Academy of Rehabilitation Medicine. 2007;31(3):283-297.
  8. Kelly-Hayes M, Beiser A, Kase CS, et al. The influence of gender and age on disability following ischemic stroke: the framingham study. Journal of Stroke and Cerebrovascular Diseases. 2003;12(3):119-126. https://doi.org/10.1016/S1052-3057(03)00042-9
  9. 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.
  10. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. The Lancet Neurology. 2009;8(8):741-754. https://doi.org/10.1016/S1474-4422(09)70150-4
  11. 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. Journal of the Korean Society of Physical Medicine. 2016;11(2):83-91. https://doi.org/10.13066/kspm.2016.11.2.83
  12. Nichols DS. Balance retraining after stroke using force platform biofeedback. Physical Therapy. 1997;77(5):553-558. https://doi.org/10.1093/ptj/77.5.553
  13. Park HJ, Lee EJ, Na GM, et al. The effect of dual-task gait training on balance, gait, and activities of daily living for patients with parkinson's disease: a single-subject experimental design. PNF and Movement. 2019;17(3):339-351. https://doi.org/10.21598/JKPNFA.2019.17.3.339
  14. Perry J, Garrett M, Gronley JK, et al. Classification of walking handicap in the stroke population. Stroke. 1995;26(6):982-989. https://doi.org/10.1161/01.STR.26.6.982
  15. Plummer-D'Amato P, Altmann LJ, Saracino D, et al. Interactions between cognitive tasks and gait after stroke: a dual task study. Gait & posture. 2008;27(4):683-688. https://doi.org/10.1016/j.gaitpost.2007.09.001
  16. Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. Journal of Clinical Epidemiology. 1989;42(8):703-709. https://doi.org/10.1016/0895-4356(89)90065-6
  17. Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Archives of Physical Medicine and Rehabilitation. 1997;78(11):1231-1236. https://doi.org/10.1016/S0003-9993(97)90337-3
  18. Shumway-Cook A, Patla AE, Stewart A, et al. Environmental demands associated with community mobility in older adults with and without mobility disabilities. Physical Therapy. 2002;82(7):670-681. https://doi.org/10.1093/ptj/82.7.670
  19. Sim SM, Oh DW. Effect of dual-task training with cognitive motor task on walking and balance functions in patients with chronic stroke: randomized controlled pilot study. Physical Therapy Korea. 2015;22(2):11-20. https://doi.org/10.12674/ptk.2015.22.2.011
  20. Tilson JK, Sullivan KJ, Cen SY, et al. Meaningful gait speed improvement during the first 60 days poststroke: minimal clinically important difference. Physical Therapy. 2010;90(2):196-208. https://doi.org/10.2522/ptj.20090079
  21. Warlow C, van Gijm J, Dennis M, et al. Stroke: practical management. 3rd ed. United Kingdom. Wiley-Blackwell. 2008.
  22. Yang YR, Chen YC, Lee CS, et al. Dual-task-related gait changes in individuals with stroke. Gait & Posture. 2007;25(2):185-190. https://doi.org/10.1016/j.gaitpost.2006.03.007
  23. Yang YR, Tsai MP, Chuang TY, et al. Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial. Gait & Posture. 2008;28(2):201-206. https://doi.org/10.1016/j.gaitpost.2007.11.007