장애물 넘기 트레드밀 보행 훈련이 편마비 노인 환자의 시간적 및 공간적 보행 요인에 미치는 영향
The Effects of Treadmill Gait Training with Obstacle Crossing on Temporal and Spatial Gait Parameters in Patients with Post Stroke Hemiplegia
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초록
이 연구는 뇌졸중으로 인한 편마비 환자를 대상으로 장애물 넘기 트레드밀 보행 훈련이 시간적 및 공간적 보행 요인에 어떠한 영향을 주는지를 밝히는데 그 목적이 있다. 연구의 대상은 편마비 환자 21명을 장애물 넘기 트레드밀 보행 훈련 집단(TOG, n=7), 트레드밀 보행 훈련 집단(TGG, n=7) 및 대조 집단(CON, n=7)으로 분류하여 TOG와 TGG는 1회 20분, 주 3회, 8주간의 장애물 넘기 트레드밀 보행 훈련 및 트레드밀 보행 훈련을 각각 시행하였으며, CON은 트레드밀 보행 훈련을 시행하지 않았다. 시간적 보행 요인(10MWT, 보행 속력, 한걸음 시간 및 한발짝 시간) 및 공간적 보행 요인(한걸음 길이, 한발짝 길이, 디딤기 비율 및 흔듦기 비율)은 훈련 전과 훈련 8주 후에 각각 측정하였다. 이요인 반복측정 분산분석, 대응표본 t-검정, 그리고 사후검정에 따른 다중 비교를 실시하였다. 10MWT, 한걸음 시간 및 한발짝 시간은 TOG 및 TGG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 감소하였으며(p<.05), 보행 속력은 TOG 및 TGG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 증가하였다(p<.01). 한걸음 길이, 한발짝 길이 및 디딤기 비율은 TOG 및 TGG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 증가하였으며(p<.05), 흔듦기 비율은 TOG 및 TGG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 감소하였다(p<.01). 한발짝 시간은 CON 및 TGG와 비교해서 TOG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 감소하였다(p<.05). 한걸음 길이, 한발짝 길이 및 디딤기 비율은 CON 및 TGG와 비교해서 TOG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 증가하였다(p<.05). 흔듦기 비율은 CON 및 TGG와 비교해서 TOG에서 훈련 전과 비교하여 훈련 후에 각각 유의하게 감소하였다(p<.05). 이상의 결과, 이 연구에서 편마비 환자의 장애물 넘기 트레드밀 보행 훈련은 트레드밀 보행 훈련에 비해 시간적 및 공간적 보행 요인에 보다 효과적인 사실을 증명하였다.
Abstract
The purpose of study was to determine the effects of treadmill gait training with obstacle crossing on temporal and spatial gait parameters in patients with post stroke hemiplegia. Twenty-one patients with post stroke hemiplegia were divided into treadmill gait training with obstacle-crossing group (TOG, n=7), treadmill gait training without obstacle-crossing group (TGG, n=7) and control group (CON, n=7). TOG and TGG were performed exercise for 20 minutes, three times a week, and for 8 week. Temporal gait parameters (10MWT, gait velocity, stride time, step time) and spatial gait parameters (stride length, step length, stance phase rate, swing phase rate) were measured before and after exercise training. Statistical analyses was done using the Two-way ANOVA with repeated measures, paired t-test, and multiple comparisons according to the Tukey HSD tests. 10MWT, stride time and step time were significantly decreased in TOG and TGG after 8 week compared to before (p<.05). Velocity was significantly increased in TOG and TGG after 8 week compared to before (p<.01). Stride length, step length and stance phase rate were significantly increased in TOG and TGG after 8 week compared to before (p<.05). Swing phase rate was significantly decreased in TOG and TGG after 8 week compared to before (p<.01). Step time was significant decreased in TOG compared with CON and TGG (p<.05, respectively). Stride length, step length and stance phase rate were significant increased in TOG compared with CON and TGG (p<.05, respectively). Swing phase rate was significant decreased in TOG compared with CON and TGG (p<.05, respectively). These findings demonstrated that the treadmill gait training with obstacle crossing was more effective than that without obstacle crossing to improve the temporal and spatial gait parameters in hemiplegia patients.
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