인지기능 장애인의 보행에 관한 국내·외 운동역학적 연구동향
Biomechanical research trend on gait patterns of patients with cognitive impairment : A domestic and international perspective
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
본 연구의 목적은 인지기능 장애 평가를 위한 보행검사의 활용도를 확인하고 향후 관련 주제의 연구를 진행함에 있어 제언하기 위함이다. 이를 위해 “치매와 보행”, “Dementia와 Gait”라는 키워드를 이용해 DBpia, Pubmed에서 검색 및 발췌한 문헌 18건을 비교 분석하였다. 문헌 선별 및 분류 기준은 치매 관련 연구, 연구대상자 중 인지기능장애인 포함 여부와 운동(역)학적 분석방법 사용여부를 기준으로 선별하여 연구대상자의 중증정도, 연구 설계 방법, 측정변인으로 구분하였다. 선별한 문헌을 분석한 결과, 국내·외 문헌 모두 인지기능과 보행에 관해 기능적 보행평가 도구를 이용하여 시공간적 변인을 가장 많이 측정하였다. 그 외 족저압 분석기, 3차원 동작분석을 이용해 보행변인을 측정하였으며, 연구 설계방법은 중재연구가 가장 많았다. 기능적 보행평가 도구의 경우, 문헌 간 상이한 결과가 도출되었고 족저압 분석기를 이용해 측정한 보행변인 중 cadence 이외의 보행변인에 대해서도 문헌 간 상이한 결과가 보고되었다. 3차원 동작분석을 이용한 1건의 연구에서 측정한 각운동학 보행변인은 다른 문헌에서 측정하지 않아 비교할 수 없었다. 현재까지 보행변인이 인지기능 저하에 따른 직접적인 연관성의 근거가 부족하여 인지기능 장애 평가를 위한 보행검사는 아직 임상적 적용에 한계가 있는 것으로 확인되었다. 따라서 환자-대조군 연구와 다양한 운동역학적 변인을 활용한 접근이 필요한 것으로 확인되었다.
Abstract
The study aims to determine the utility of gait assessments for evaluating cognitive impairment and provide recommendations for future research. A comparative analysis was conducted on 18 literature sources extracted from DBpia and PubMed using keywords such as "dementia and gait". Selection criteria included dementia-related studies, inclusion of individuals with cognitive impairments, and the use of kinetic and kinematic analysis methods. The selected literature was analyzed and categorized based on the severity of participants, research design, and measured variables. Both domestic and international studies predominantly utilized functional gait assessment tools to measure spatio-temporal variables related to cognitive function and gait. Additionally, plantar pressure analysis systems and 3D motion analysis were employed to measure gait variables. Intervention studies were the most common research design. Diverse results were found among the literature regarding functional gait assessment tools, and varying outcomes were reported for gait variables measured using plantar pressure analysis systems beyond cadence. Only one study utilizing 3D motion analysis was identified, making it difficult to compare with other literature. Currently, there is insufficient evidence linking gait variables directly to cognitive impairment, indicating limitations in the clinical application of gait assessments for evaluating cognitive impairment. Therefore, case-control group studies and the utilization of diverse biomechanical variables are recommended.Studies on cognitive dysfunction and functional gait evaluation tools that can be measured without equipment and spatio-temporal variable measurement have shown conflicting results. Even if the measurement environment changes, functional gait evaluation tools or gait variables that are consistently derived from factors such as cognitive dysfunction are needed. To this end, more case-control studies should be conducted than intervention studies, and in addition to functional gait evaluation tools and spatio-temporal variables, it is considered necessary to analyze various kinetic or kinematic gait variables using various measurement equipment such as 3D motion analysis.
참고문헌 (39)
- 권애령, "치매환자의 보행에 관한 근거기반 중재에 대한 체계적 고찰", 한국콘텐츠학회 논문지, 21(2), pp.667~675 (2021), 한국콘텐츠학회[DOI]
- 권영후, "초청 리뷰 논문 최근 10년간 ‘체육과학연구’의 연구 동향: 운동역학", 체육과학연구, 23(2), pp.221~231 (2012), 국민체육진흥공단 한국스포츠정책과학원[DOI]
- 기백석, "노인성기억장애(Age-Associated Memory Impairment)개념적 및 임상적고찰", 노인정신의학, 5, pp.3~11 (2001)
- 국제치매정책동향 2017, "김빈나", 보건복지부, ~ (2017)
- 김종민, "GAITRite 보행 시스템을 이용한치매 노인의 보행 분석", 한국임상보건과학회지, 5(1), pp.816~824 (2017)
- 안나영, "경증 치매여성노인의 16주간 규칙적인 운동프로그램 수행 후 신체구성, 체력 및 인지기능의 변화", 코칭능력개발지, 21(1), pp.109~116 (2019), 한국코칭능력개발원[DOI]
- 이재현, "이중과제를 이용한 작업치료 프로그램이 경도인지장애 노인의 인지기능 및 보행에 미치는 효과", 대한작업치료학회지, 28(1), pp.109~125 (2020), 대한작업치료학회[DOI]
- 주혜정, "요양병원 입원 치매노인을 위한 율동적 걷기프로그램이 보행, 인지 및 낙상위험에 미치는 효과", Journal of Korean Biological Nursing Science, 20(3), pp.141~149 (2018), 한국기초간호학회[DOI]
- 최기영, "낙상예방 운동 프로그램이 치매 노인의 균형, 보행과 하지 근력, 심리사회적 특성에 미치는 영향", 대한물리의학회지, 14(1), pp.75~89 (2019), 대한물리의학회[DOI]
- 한정훈, "보행과 인지장애의 연관성", Dementia and Neurocognitive Disorders(대한치매학회지), 12(4), pp.94~99 (2013), 대한치매학회[DOI]
- Beauchet, O., "Anti-dementia drugs and changes in gait : A pre-post quasi-experimental pilot study", BioMed Central Neurology, 13(1), pp.1~6 (2013)
- Benedict, R. H., "Limitation of the Mini-Mental State Examination for the detection of amnesia", Journal of Geriatric Psychiatry and Neurology, 5(4), pp.233~237 (1992)
- Bruderer-Hofstetter, M., "Effective multicomponent interventions in comparison to active control and no interventions on physical capacity, cognitive function and instrumental activities of daily living in elderly people with and without mild impaired cognition-A systematic review and network meta-analysis", Ageing Research Reviews, 45, pp.1~14 (2018)
- Crum, R. M., "Population-based norms for the mini-mental state examination by age and educational level", Journal of American Medical Association, 269(18), pp.2386~2391 (1993)
- Dawson, N., "Improved functional performance in individuals with dementia after a moderate-intensity home-based exercise program : A randomized controlled trial", Journal of Geriatric Physical Therapy, 42(1), pp.18~27 (2019)
- de Souto Barreto, P., "Exercise or social intervention for nursing home residents with dementia: A pilot randomized, controlled trial", Journal of the American Geriatrics Society, 65(9), pp.E123~E129 (2017)[DOI]
- Eichenbaum, H., "The role of the hippocampus in navigation is memory", Journal of Neurophysiology, 117(4), pp.1785~1796 (2017)
- Gebhard, D., "Feasibility and effectiveness of a biography-based physical activity intervention in institutionalized people with dementia : Quantitative and qualitative results from a randomized controlled trial", Journal of Aging and Physical Activity, 30(2), pp.237~251 (2021)
- Graff-Radford, J., "New insights into atypical alzheimer's disease in the era of biomarkers", The Lancet Neurology, 20(3), pp.222~234 (2021)
- Hausdorff, J. M., "Gait dynamics, fractals and falls : Finding meaning in the stride-to-stride fluctuations of human walking", Human Movement Science, 26(4), pp.555~589 (2007)
- Kegelmeyer, D. A., "Immediate effects of treadmill walking in individuals with lewy body dementia and huntington’s disease", Gait &Posture, 86, pp.186~191 (2021)
- Khoo, I., "Relationship between depressive symptoms and cognitive, psychological, and physical performance in community-dwelling older people with cognitive impairment", Dementia and Geriatric Cognitive Disorders, 50(5), pp.482~490 (2021)
- Lin, Y. -C., "Comparison of motor performance of upper and lower extremities in dual-task tests in patients with mild alzheimer’s dementia", Aging Clinical and Experimental Research, 28, pp.491~496 (2016)
- Lissek, V., "Preventing dementia? Interventional approaches in mild cognitive impairment", Neuroscience & Biobehavioral Reviews, 122, pp.143~164 (2021)
- Livingston, G., "Dementia prevention, intervention, and care : 2020 report of the lancet commission", The Lancet, 396(10248), pp.413~446 (2020)
- Montero-Odasso, M., "Donepezil improves gait performance in older adults with mild alzheimer's disease : A phase II clinical trial", Journal of Alzheimer's Disease, 43(1), pp.193~199 (2015)
- Montero-Odasso, M., "Donepezil for gait and falls in mild cognitive impairment : A randomized controlled trial", European Journal of Neurology, 26(4), pp.651~659 (2019)
- "Frontal lobe syndrome" (2022)[URL]
- Ramírez, F., "Dual-task gait as a predictive tool for cognitive impairment in older adults : A systematic review", Frontiers in Aging Neuroscience, 13, pp.923~ (2021)
- Rucco, R., "Spatio-temporal and kinematic gait analysis in patients with frontotemporal dementia and alzheimer’s disease through 3d motion capture", Gait & Posture, 52, pp.312~317 (2017)
- Sanders, L., "Effects of low-and high-intensity physical exercise on physical and cognitive function in older persons with dementia : A randomized controlled trial", Alzheimer's Research & Therapy, 12, pp.1~15 (2020)
- Schlichting, M. L., "Hippocampal–medial prefrontal circuit supports memory updating during learning and post-encoding rest", Neurobiology of Learning and Memory, 134, pp.91~106 (2016)
- Schwenk, M., "Improvements in gait characteristics after intensive resistance and functional training in people with dementia : A randomised controlled trial", BioMed Central Geriatrics, 14(1), pp.1~9 (2014)
- Takakusaki, K., "Neurophysiology of gait : from the spinal cord to the frontal lobe", Movement Disorders, 28(11), pp.1483~1491 (2013)
- Thrane, G., "The association between timed up and go test and history of falls : The Tromsø study", BioMed Central Geriatrics, 7, pp.1~7 (2007)
- Toots, A., "Walking aids moderate exercise effects on gait speed in people with dementia : A randomized controlled trial", Journal of the American Medical Directors Association, 18(3), pp.227~233 (2017)
- van den Elsen, G. A., "Effects of tetrahydrocannabinol on balance and gait in patients with dementia : A randomised controlled crossover trial", Journal of Psychopharmacology, 31(2), pp.184~191 (2017)
- Wang, L., "Changes in hippocampal volume and shape across time distinguish dementia of the alzheimer type from healthy aging", Neuroimage, 20(2), pp.667~682 (2003)
- Yang, Q., "Gait change in dual task as a behavioral marker to detect mild cognitive impairment in elderly persons : A systematic review and meta-analysis", Archives of Physical Medicine and Rehabilitation, 101(10), pp.1813~1821 (2020)