지역사회-적응 보행 훈련프로그램이 뇌졸중 환자의 보행 기능에 미치는 영향
Effects of Community-based Adaptive Ambulation Training on Walking Function in Patients with Post-stroke Hemiparesis
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연구배경: 만성 뇌졸중 환자를 대상으로 보행기능 향상을 위해 고안된 지역사회-적응 보행 훈련프로그램이 실내 및 실제 지역사회 환경에서의 보행능력에 어떤 영향을 미치는지 알아보고자 시행되었다. 방법: 본 연구는 만성 뇌졸중 환자 18명을 무작위 방법으로 실험군 9명, 대조군 9명으로 구분하여 시행되었다. 실험군은 1주일에 3회, 1회당 1시간씩 4주 동안 지역사회-적응 보행 훈련프로그램을 시행하였다. 실내 보행능력 평가를 위해 10 m 보행속도검사, Timed Up and Go (TUG) 검사, 6분 걷기 검사를 실시하였으며, 지역사회 보행능력은 세 가지 상황(주차장, 은행방문, 횡단보도)에서 평가되었다. 뇌졸중 회복 정도와 삶의 질과의 연관성을 알아보기 위해 뇌졸중 영향척도를 사용하여 평가하였다. 결과: 실험 전과 후의 비교에서 실험군은 10 m 보행속도 검사, TUG 검사, 6분 걷기 검사, 그리고 세 가지 지역사회 조건의 보행속도 평가에서 유의한 차이를 보였으며(P< 0.05), 실험 전과 후의 변화율에서 실험군과 대조군 사이에 유의한 차이를 보였다(P<0.01). 또한 실험 후 평가된 뇌졸중 영향척도에서 실험군과 대조군 사이에 근력, 손의 기능, 그리고 기분과 정서 영역에서 유의한 차이를 보였다(P< 0.05). 결론: 지역사회-적응 보행 훈련프로그램은 만성 뇌졸중 환자의 보행능력 및 삶의 질과 관계된 지역사회 보행능력에 긍정적인 영향을 미친다.
Abstract
Background: The purpose of this study was to identify the effects of community-based adaptive ambulation training programs on the gait velocity of stroke patients indoors and in the community. Methods: The study included 18 patients with chronic stroke symptoms randomly divided into experimental group (EG, n=9) or control group (CG, n=9). The EG participated in community-based adaptive training three times a week for four weeks, each training session lasting one hour. The assessments were based on indoor walking [10 m walking velocity, Timed Up and Go (TUG) test, and 6-minute walk test], community ambulation (walking velocity in a parking lot, visiting banks, and at pedestrian crossings), and the stroke impact scale (SIS). Results: The statistical analysis showed significant improvements in the 10 m walking velocity, TUG test, and 6-minute walk test after the four weeks in the EG (P<0.05), but not in the CG (P>0.05). In addition, the walking velocity of the EG improved significantly in the three community ambulation situations after the training (P<0.05). In the SIS, strength, hand function, and emotion domains showed significant improvements (P<0.05). Conclusions: These findings suggest that community-based adaptive ambulation training can improve the indoor walking ability of patients with post-stroke hemiparesis as well as their community ambulation ability, which is closely related to quality of life. Further studies are necessary to generalize the findings of this study.
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