본문 바로가기
KERD
논문KCI 등재

독립보행이 가능한 강직성 뇌성마비 아동들의 수직 및 수평 장애물 통과에 영향을 미치는 요인 분석

An Analysis of Factors Affecting Vertical and Horizontal Obstacle Crossing in Independently Ambulatory Children With Spastic Cerebral Palsy

오덕원|이수진
한국전문물리치료학회 (Korean Research Society of Physical Therapy)|2011.09|한국전문물리치료학회지 (Physical Therapy Korea)|제18권 제3호|pp. 16-25

1

조회

0

다운로드

1

인용

0

참고문헌

주제분류물리치료학

초록

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 ㎝ in height or width; total of 6 conditions). A ‘fail’ was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

Abstract

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 ㎝ in height or width; total of 6 conditions). A ‘fail’ was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.

참고문헌 (37)

  1. 권범선, "소아재활의학" (2006), 군자출판사
  2. 안승철, "우리 아이 머리에선 무슨 일이 일어나고 있을까" (2009), 궁리출판사
  3. 윤범철, "신경계 질환별 물리치료" (2003), 현문사
  4. 정통령, "체질량지수와 이상체중을 이용한 비만도 판정기준간의 일치도 비교: 서울지역 일개 건강증진센터 수신자를 대상으로", 가정의학학회지, 22(12), pp.1765~1771 (2001)
  5. Amatachaya S, "Factors related to obstacle crossing in independent ambulatory patients with spinal cord injury", J Spinal Cord Med, 33(2), pp.144~149 (2010)
  6. Berger W, "Characteristics of locomotor control in children with cerebral palsy", Neurosci Biobehav Rev, 22, pp.579~582 (1998)
  7. Chou LS, "Minimum energy trajectories of the swing ankle when stepping over obstacles of different heights", J Biomech, 30, pp.115~120 (1997)
  8. Chou LS, "Motion of the whole body’s center of mass when stepping over obstacles of different heights", Gait Posture, 13(1), pp.17~26 (2001)
  9. Dodd KJ, "A randomized clinical trial of strength training in young people with cerebral palsy", Dev Med Child Neurol, 45, pp.652~657 (2003)
  10. Fernandes T, "Independent mobility for children with disabilities", Int J Ther Rehabil, 13(7), pp.329~333 (2006)
  11. Forssberg H, "A neural control model for human locomotion development: Implications for therapy", Med Sport Sci, 36, pp.174~181 (1992)
  12. Fowler EG, "Promotion of physical fitness and prevention of secondary conditions for children with cerebral palsy: Section on pediatrics research summit proceedings", Phys Ther, 87(11), pp.1495~1510 (2007)
  13. Gage JR, "Gait analysis: Principles and applications", J Bone Joint Surg Am, 77(10), pp.1607~1623 (1995)
  14. Günel MK, "Investigation of interobserver reliability of the Gillette functional assessment questionnaire in children with spastic diparetic cerebral palsy", Acta Orthop Traumatol Turc, 44(1), pp.63~69 (2010)
  15. Hayek S, "The effect of community-prescribed ankle-foot orthoses on gait parameters in children with spastic cerebral palsy", J Child Orthop, 1(6), pp.325~332 (2007)
  16. Holsbeeke L, "Capacity, capability, and performance: Different constructs or three of a kind", Arch Phys Med Rehabil, 90(5), pp.849~855 (2009)
  17. Johnson A, "Prevalence and characteristics of children with cerebral palsy in Europe", Dev Med Child Neurol, 44(9), pp.633~640 (2002)
  18. Law LS, "Gait adaptation of children with cerebral palsy compared with control children when stepping over an obstacle", Dev Med Child Neurol, 47(5), pp.321~328 (2005)
  19. Lawman HG, "The relationship between psychosocial correlates and physical activity in underserved adolescent boys and girls in the ACT trial", J Phys Act Health, 8(2), pp.253~261 (2011)
  20. Leonard C, "Deficits in reciprocal inhibitions of children with cerebral palsy as revealed by H reflex testing", Dev Med Child Neurol, 32, pp.974~984 (1990)
  21. Liao HF, "The relation between standing balance and walking function in children with spastic diplegic cerebral palsy", Dev Med Child Neurol, 39(2), pp.106~112 (1997)
  22. Palisano RJ, "Effect of environmental setting on mobility methods of children with cerebral palsy", Dev Med Child Neurol, 45(2), pp.113~120 (2003)
  23. Palisano RJ, "Social and community participation of children and youth with cerebral palsy is associated with age and gross motor function classification", Phys Ther, 89(12), pp.1304~1314 (2009)
  24. Paul SM, "Evaluating interventions to improve gait in cerebral palsy: A meta-analysis of spatiotemporal measures", Dev Med Child Neurol, 49(7), pp.542~549 (2007)
  25. Petrarca M, "Stepping over obstacles of different heights: Kinematic and kinetic strategies of leading limb in hemiplegic children", Gait Posture, 24(3), pp.331~341 (2006)
  26. Rodby-Bousquet E, "Use of manual and powered wheelchair in children with cerebral palsy: A cross-sectional study" (2010), BMC Pediatr
  27. Rosenbaum P, "A report: The definition and classification of cerebral palsy", Dev Med Child Neurol Suppl, 109, pp.8~14 (2007)
  28. Said CM, "Effect of stroke on step characteristics of obstacle crossing", Arch Phys Med Rehabil, 82(12), pp.1712~1719 (2001)
  29. Said CM, "Control of lead and trail limbs during obstacle crossing following stroke", Phys Ther, 85(5), pp.413~427 (2005)
  30. Salminen AL, "Mobility devices to promote activity and participation: A systematic review", J Rehabil Med, 41(9), pp.697~706 (2009)
  31. Shumway-Cook A, "Environmental demands associated with community mobility in older adults with and without mobility disabilities", Phys Ther, 82(7), pp.670~681 (2002)
  32. Tefft D, "Cognitive predictors of young children's readiness for powered mobility", Dev Med Child Neurol, 41(10), pp.665~670 (1999)
  33. Trefler E, "Outcomes of wheelchair systems intervention with residents of long-term care facilities", Assist Technol, 16(1), pp.18~27 (2004)
  34. van der Heide JC, "Postural muscle dyscoordination in children with cerebral palsy", Neural Plast, 12(2-3), pp.197~203 (2005)
  35. White H, "Clinically prescribed orthoses demonstrate an increase in velocity of gait in children with cerebral palsy: A retrospective study", Dev Med Child Neurol, 44(4), pp.227~232 (2002)
  36. Williams EN, "Investigation of the timed 󰡐up & go󰡑 test in children", Dev Med Child Neurol, 47(8), pp.518~524 (2005)
  37. Woollacott MH, "Postural dysfunction during standing and walking in children with cerebral palsy: What are the underlying problems and what new therapies might improve balance", Neural Plast, 12(2-3), pp.211~219 (2005)

관련 논문AI추천

뇌성마비 아동에서 대동작기능평가(GMFM)와 보행의 시공간적 변수와의 관계권오윤, 이영희, 이정림, 조상현한국전문물리치료학회 · 한국전문물리치료학회지2001 · 제8권 제1호전방 보행기와 후방 보행기가 뇌성마비아동의 보행 특성과 신체 정렬상태에 미치는 영향원종임, 이재호한국전문물리치료학회 · 한국전문물리치료학회지2000 · 제7권 제2호패브릭 발목 보조기가 경직성 뇌성마비 아동의 시공간적 보행 변수에 미치는 즉각적인 효과심연주, 이동률, 이충휘한국전문물리치료학회 · 한국전문물리치료학회지2014 · 제21권 제1호트레드밀에서 뒤로걷기 훈련이 경직성 양하지 뇌성마비 아동의 보행에 미치는 영향: 사전 연구김성경, 김원호, 류영욱한국전문물리치료학회 · 한국전문물리치료학회지2012 · 제19권 제3호Contributing Factors Analysis for the Changes of the Gross Motor Function in Children With Spastic Cerebral Palsy After Physical Therapy김성헌, 이태임, 진주련, 한경희대한재활의학회 · Annals of Rehabilitation Medicine2013 · 제37권 제5호Effect of Hinged Ankle-Foot Orthoses on Standing Balance Control in Children with Bilateral Spastic Cerebral Palsy김동진, 나동욱, 박은숙연세대학교의과대학 · Yonsei Medical Journal2010 · 제51권 제5호

이 간행물의 다른 논문 (10건)

엎드려 누운 자세에서 엉덩관절 폄시 내적, 외적 안정화 방법이 큰 볼기근의 선택적 근활성에 미치는 영향이동규, 윤지연, 오재섭, 김태호, 문세나, 노경희pp. 1-7만성 뇌졸중 환자에서 편안한 호흡 시 건측과 마비측으로 복근 두께 비교이충휘, 신헌석, 이영정, 이규완pp. 8-15일어서기 동작 시 시상면 골반 기울임이 엉덩관절과 무릎관절의 운동형상학에 미치는 영향최보람, 김현숙, 임인혁pp. 26-37국내 노인을 대상으로 한 낙상예방 운동프로그램이 근력증가에 미치는 효과: 메타분석신인수, 박소연pp. 38-484주간의 스위스 볼과 전신진동기를 이용한 교각안정화 운동이 노인 여성의 균형과 보행에 미치는 효과최흥식, 김택훈pp. 49-58
원문 보기