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문제 해결 과제 운동이 만성 뇌졸중 편마비 장애인의 기립 균형 및 보행에 미치는 효과

The Effects of Problem-Solving Task Training on a Functional Standing Balance and Gait of Chronic Stroke Patients.

이경진|신원섭|송창호|이동엽
한국특수체육학회 (Korean Society Of Adapted Physical Activity)|2008.12|한국특수체육학회지 (Korean Journal of Adapted Physical Activity)|제16권 제4호|pp. 97-115|DOI 10.17006/kjapa.2008.16.4.97

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참고문헌

키워드

뇌졸중운동 기능Stroke균형Balance보행GaitMotor Function문제 해결 과제 운동Problem Solving Task Training

초록

본 연구의 목적은 만성 뇌졸중 편마비 장애인을 대상으로 문제 해결 과제 운동을 적용 하여 운동 전·후의 기능적 기립 균형, 보행에 미치는 효과를 분석하여 뇌졸중 편마비 장 애인에게 인지과제를 접목한 운동방법의 효용성을 확인하고자 하는 것이다. 연구의 대상 자는 뇌졸중으로 진단받고 내원하고 있는 6개월 이상 된 만성 뇌졸중 편마비 장애인으로 하였으며 독립적 보행 시 통증과 기립 균형에 영향을 주는 신경학적 손상, 근골격계 손 상이 있는 대상자, 약식정신상태검사(MMSE-K)의 점수가 21점 이하인 자는 제외하였다. 선정기준에 부합된 자를 문제 해결 과제 운동 군과 보존적 운동 군을 각각 9명으로 구성 하였고 문제 해결 과제 운동 군은 시각적 인지 과제 운동과 보존적 운동을 병행하였고 보존적 운동 군은 자전거와 상지에르고미터를 주 5일, 총 8주 간 수행하였다. 운동 실시 전·후에 기능적 기립 균형, 시공간적 보행변수를 평가하여 얻은 결과는 다음과 같다. 첫 째, 문제 해결 과제 운동 군과 보존적 운동 군 모두 운동 후 기능적 기립 균형 능력이 유의하게 증가하였고 집단간의 유의한 차이가 있었다(p<.05). 둘째, 문제 해결 과제 운동 군은 운동 후 보행속도, 분속수, 활보장, 보장이 모두 유의하게 증가하였으나(p<.05), 보존 적 운동 군은 유의하게 증가하지 못하였다. 이상의 결과에 따라 문제 해결 과제 운동이 기능적 기립 균형 향상과 보행 향상에 효과가 있는 것으로 나타났다. 특히 문제 해결 과 제 운동이 만성 뇌졸중 편마비 장애인에게 효용이 있는 것으로 나타났다. 차후 만성 뇌 졸중 편마비 장애인의 기능적 기립 균형과 보행향상을 위한 새로운 중재 방법으로 이용 할 수 있는 기초 자료가 될 것으로 기대한다.

Abstract

The purpose of this study was to investigate the effect of Problem-solving task training on a functional standing balance and gait of chronic stroke patients. Each one of Nine patients who were randomly assigned to problem solving task training group and conservative training group were evaluated in this study. Subjects participated in the exercsie program was practiced five days a week for 8 weeks. The paired t-test was performed to analyze differences between pre-exercise and post-exercise and Independent t-test was compared with different group. α=.05 set up with the significant level. The following results were obtained of evaluated was functional standing balance, spitio-temporal gait parameter to practiced by pre-exercise and post-exercise. The major findings of this study were the functional standing balance, and gait parameter were significantly improved(p<.05) after completion of problem solving task exercise. The functional standing balance, gait in problem-solving task training group from the standing balance and gait according to exercise method was more significant difference than conservative training group(p<.05). In conclusion, we suggested problem-solving task training to improve standing, balance, gait velocity, cadence, stride, and step which contribute to general gait ability among patients with chronic stroke.

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