낙상빈도에 따른 뇌졸중 환자의 균형과 체간위치감각의 변화
Changes to Balance and Trunk Repositioning Sense According to Frequency of Falls in Stroke Patients
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연구배경: 본 연구의 목적은 낙상의 빈도에 따른 뇌졸중 환자의 균형능력과 고유수용성 위치감각의 변화를 알아보고자 함에 있다. 방법: 본 연구는 서울시 북부노인병원 재활의학과에 입원해 물리치료를 받고 있는 총 55명의 뇌졸중 대상자를 비낙상경험군(n=20), 1회낙상경험군(n=19) 그리고 반복낙상경험군(n=15)으로 나누어 눈을 뜬 상태와 눈을 감은 상태의 좌우, 전후 자세동요속도와 체간위치오류를 측정하여 비교, 분석하였다. 결과: 측정 결과, 좌우, 전후 자세동요속도에서 눈을 뜬 상태와 눈을 감은 상태 모두 군간 유의한 차이를 나타내었고(P<0.05), 세 군 모두 시각을 차단하였을 경우 좌우, 전후 자세동요속도에서 유의한 차이를 나타내었다(P<0.05). 또한 체간위치오류에서 군간 유의한 차이를 나타내었다(P<0.05). 결론: 연구를 통해 뇌졸중 환자에서 낙상의 빈도가 높을수록 자세동요속도와 체간위치오류가 증가하는 것을 확인할 수 있었다. 이러한 결과는 추후 뇌졸중 환자의 낙상을 예방하기 위한 균형 훈련에 있어 적절한 방향을 제시하는 요소가 될 수 있을 것으로 생각한다.
Abstract
Background: The purpose of this study was to investigate the relationship between the changes to postural sway velocity and trunk repositioning errors and the frequency of falls in stroke patients. Methods: Fifty-five stroke patients, divided into three groups (no falls group: 20, one fall group: 19, repeated falls group: 16), stood quietly with eyes open and closed on a force platform while postural sway velocity was quantified by the center of pressure measures. Trunk repositioning errors were measured in standing while the subjects performed forward flexion movements. Results: We found a significant difference between the groups for postural sway velocity in medial-lateral and anterior-posterior directions with eyes open and closed (P<0.05). With the eyes closed, there were significant differences between the three groups in the postural sway velocity (P<0.05) and the trunk repositioning errors changed significantly (P<0.05). Conclusions: Our results demonstrate that the increase in falls may increase visual dependence for postural control velocity and trunk repositioning errors. These results may be useful in balance training to prevent falls in stroke survivors.
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