12주간의 저항성 운동이 뇌졸중으로 인한 편마비 환자의 보행능력에 미치는 영향
Effects of a 12-week Resistance Exercise Training on Gait in Ambulatory Chronic Hemiparetic Stroke Patients
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본 연구의 목적은 12주간 탄력 밴드를 이용하여 실시한 저항성 운동 트레이닝이 편마비 환자의 보행능력에 미치는 영향을 규명하는 것이다. 뇌졸중으로 인한 편마비 환자 26명을 선정하여 트레이닝 집단 13명과 비교 집단 13명으로 구성하였다. 트레이닝 집단은 일일 60분, 주 3회, 12주간의 탄력 밴드를 이용한 저항성 트레이닝을 실시하였고, 비교 집단은 평상시 생활을 그대로 유지하도록 하였다. 운동 트레이닝의 내용은 Smith et al.(1999), Dean et al.(2000), Weiss et al.(2000), 그리고 김현수와 김남정(2003) 등의 연구방법을 기초로 하였다. 트레이닝 집단의 경우 12주간의 근력 강화 운동 프로그램 실시 후 10m 보행 속도에서 25.97% 향상되었으며, 비교 집단의 경우 3.8%의 향상을 보였다. 10m 보행 시 분당 걸음수는 트레이닝 집단의 경우 17.55% 향상되었으며, 비교 집단의 경우 4.16% 향상되어 10m 보행능력 검사에 있어서는 트레이닝 집단에서 통계적으로 의미 있는 향상을 가져왔다. 6m 걷기에 있어 트레이닝 집단의 경우 27.33% 향상되었으며, 비교 집단의 경우 9.90%의 향상되었고, 3m 뒤고 걷기 75.52% 향상되었으며, 비교 집단의 경우 28.85% 향상을 가져와 트레이닝 집단에서 통계적 의미 있는 향상을 가져왔다. 4개 계단 오르기와 4개 계단 내려오기 및 2.44m 반환점 되돌아 앉기에 있어 트레이닝 집단에서 각각 36.00%, 30.00%, 26.04% 향상되었으며, 비교 집단에서 각각 14.58%, 16.67%, 9.02% 향상을 가져와 트레이닝 집단에서 통계적으로 의미 있는 향상을 보였다. 이상의 결과를 토대로 볼 때, 12주간 탄력 밴드를 이용한 저항성 운동 트레이닝은 뇌졸중으로 인한 편마비 환자의 보행능력에 의미 있는 개선을 가져온 것으로 나타났다. 따라서 편마비 환자와 장애인 및 노인과 같이 근력 약화에 의해 보행에 장애가 있어 삶의 질 저하를 가져온 대상자에게 상해 발생률이 상대적으로 낮은 탄력 밴드 저항성 운동은 보행능력의 긍정적 개선을 통해 일상생활에서의 기능 향상과 생활 범위의 확대에 있어 의미 있는 운동 프로그램이라고 판단된다.
Abstract
The study was designed to investigate the effects of a 12-week resistance exercise training on gait in ambulatory chronic hemiparetic stroke patients. Twenty six patients were volunteered to participate in the study as subjects and were assigned randomly into one of two groups, i.e., resistance exercise training group (TR: n=13) and control group (CON: n=13). The pretest-posttest randomized-groups design was utilized in the study. In pre test, 10m gait test, and 6m forward walk, 3m back walk, Stairs up 4 steps, Stairs down 4 steps, 2.44m up and go were measured. In the 10m gait test, 10m gait, 10m gait cadence, and 10m gait stride were measured. The subjects in the TR group went through the resistance exercise training utilizing the thera-band, performed for 60 minutes per session, three times per week for 12 weeks, whereas the subjects in the CON group were asked not to change their normal life style during the intervention period. In post test, all variables were measured again as same manner as the pre test. The data collected in the pre and post tests at the TR and the CON group were compared utilizing two-way ANOVA. The results obtained in the present study were as follows: 1) There were significant increase in 10m gait speed and 10m gait stride in the TR group due to the training. 2) There were statistically significant enhancement in 6m forward walk (32.46%), 3m back walk (75.52%), Stairs up 4 steps (36%), Stairs down 4 steps (30%), 2.44m up and go (26.04%) in the TR group. There were training effects in the variables, considering the changes occurred in the CON group. It was concluded that the 12-week resistance exercise training elicited the enhancement of the gait.
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