균형손상 노인에서 발목관절 전략 운동의 균형증진 효과
Effect of Ankle Strategy Exercise on Improvement of Balance in Elderly with Impaired Balance
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초록
연구배경 노인에서 넘어짐을 예방하기위한 균형증진 운동은 매우 중요하다. 본 연구의 목적은 정적 및 동적 상태, 그리고 팔 내 뻗기 동안에 서 있는 자세조절에 발목관절 전략 촉진 운동의 효과를 알아보는데 있다. 방 법 연구대상자는 59명(평균 나이=76.5세, 평균 키=148.9 cm, 평균 체중=58.5 kg)이었으며, 최근 6개월 동안 어떠한 운동에도 참여 한 적이 없으며, 무작위로 할당된 세 군은 발목전략 운동군, 발목강화 운동군, 그리고 대조군이다. 두 운동군에는 주 3일 50 분 씩 8주 동안 운동에 참여하였다. 자료 수집은 운동 전, 운동 후, 그리고 추적 시기에 하였다. 통계분석은 SPSS 12.0을 이 용하여 반복측정 일요인 분산분석을 하였으며 최소유의성 차이로 사후검정을 하였다. 결 과 기능적 팔 뻗기는 두 운동군에서 모두 대조군에 비해 유의하게 증가하였으며 (P<.01), 발목전략 운동군과 발목강화 운동군 간 에는 차이가 없었다. 눈을 뜨거나 감고 서 있을 때 전ㆍ후 방향의 압력중심의 이동 속도, 그리고 내측 비복근의 근 수축 개 시시간은 발목강화 운동군에 비해 발목전략 운동군에서 유의하게 감소하였다 (P<.05). 결 론 이상의 결과로 미루어보면, 균형손상 노인에서 8주 동안의 발목전략 운동 및 발목강화 운동이 자세조절에 효과적이다. 또한, 균형 기능 향상에 발목전략 운동이 발목강화 운동 보다 더 효과적인 치료전략이라고 사료된다.
Abstract
Background The purpose of this study was to investigate the effect of ankle strategy facilitating exercise on postural control in a static and perturbed stance. Methods Fifty-nine subjects were randomly assigned into ankle strategy exercise group (ASE), ankle strengthening exercise group (SE), or control group (CON). Two exercise groups participated in 50 minutes 3 days a week for 8 weeks. One-way analysis of variance with repeated measures was used to determine the statistical difference. Results Reach test scores increased significantly both exercise groups compared to the CON group after exercise (P<.01). Postural test showed sway velocity in anteroposterior direction, and onset time in medial gastrocnemius decreased significantly in the ASE compared to SE (P<.05). Conclusions These findings suggest that both exercise groups were effective in improving the postural control in the elderly, and ASE was more effective than SE in enhancement of balance function. (
참고문헌 (37)
- Bonnie RJ, "Reducing the burden of injury: Advancing prevention and treatment. Committee on injury prevention and control. Division of health promotion and disease prevention, institute of medicine. 1st ed" (1999), National Academy Press
- Campbell AJ, "Falls in old age: a study of frequency and related clinical factors", Age Ageing, 10(4), pp.264~270 (1981)
- Gehlsen GM, "Falls on the elderly: part II, balance, strength, and flexibility", Arch Phys Med Rehabil, 71, pp.739~741 (1990)
- Nevitt MC, "Risk factors for recurrent nonsyncopal falls: a prospective study", J Am Med Assoc, 261, pp.2663~2668 (1989)
- Horak FB, "Central programming of postural movements: Adaptation to altered support-surface configurations", J Neurophysiol, 55(6), pp.1369~1381 (1986)
- Shumway-Cook A, "Motor control: theory and practical applications. 1st ed" (1995), Williams & Wilkins
- Horak FB, "Components of postural dyscontrol in the elderly: A review", Neurobiol Aging, 10, pp.727~738 (1989)
- Mackey DC, "Postural steadiness during quiet stance dose not associate with ability to recover balance in older women", Clin Biomech, 20, pp.776~783 (2005)
- Almeida GL, "Postural strategy to keep balance on the seesaw", Gait Posture, 23, pp.17~21 (2006)
- Menz HB, "Foot and ankle risk factors for falls in older people: a prospective study", J Gerontol A Biol Sci Med Sci, 61(8), pp.866~870 (2006)
- Lord SR, "The effect of a 12-month exercise trial on balance, strength and falls in older women: a randomized controlled trial", J Am Geriatr Soc, 43(11), pp.1198~206 (1995)
- Gras LZ, "A comparision of hip versus ankle exercises in elders and the influence on balance and gait", 27(2), pp.39~46 (2004)
- Amiridis I, "Static balance improvement in elderly after dorsiflexors electro-stimulation training", Eur J Appl Physiol, 94(4), pp.424~433 (2005)
- Robinovitch SN, "Effect of strength and speed of torque development on balance recovery with the ankle strategy", J Neurophysiol, 88(2), pp.613~620 (2002)
- Mills EM, "The effect of low-intensity aerobic exercise on muscle strength, flexibility, and balance among sedentary elderly persons", Nurs Res, 43(4), pp.207~211 (1994)
- Shigematsu R, "Dance-based aerobic exercise may improve indices of falling risk in older women", Age Aging, 31(4), pp.261~266 (2002)
- Fong S-M, "The effects on sensorymotor performance and balance with Tai Chi training", Arch Phys Med Rehabil, 87(1), pp.82~87 (2006)
- Lin MR, "Community-Based Tai Chi and its effect on injurious falls, balance, gait, and fear of falling in older people", Phys Ther, 86(9), pp.1189~1201 (2006)
- Horak FB, "Effects of neurological disorders on postural movement strategies in the elderly. In Falls, balance and gait disorders in the elderly" (1992), Elsevier
- Buchner DM, "The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults", J Gerontol A Biol Sci Med Sci, 52(4), pp.218~224 (1997)
- McMurdo ME, "A randomized controlled trial of a home exercise programme for elderly people with poor mobility", Age Ageing, 24(5), pp.425~428 (1995)
- Rubenstein LZ, "Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men", J Gerontol A Biol Sci Med Sci, 55(6), pp.317~321 (2000)
- Duncan PW, "Functional reach: a new clinical measure of balance", J Gerontol, 456(6), pp.192~197 (1990)
- Lamontagne A, "Mechanisms of disturbed motor control in ankle weakness during gait after stroke", Gait Posture, 15(3), pp.244~255 (2002)
- Zipp P, "Recommendations for the standardization of lead positions in surface electromyography", Eur J Appl Physiol, 50, pp.40~54 (1982)
- DiFabio RP, "Reliability of computerized surface electromyography for determining the on set of muscle activity", Phys Ther, 67(1), pp.43~48 (1987)
- 권오윤, "고관절 신전시 요통환자와 정상인의 슬괵근, 대둔근, 요추기립근의 근 수축 개시시간 비교", 한국전문물리치료학회지, 9(2), pp.33~42 (2002), 한국전문물리치료학회
- 정이정, "최대 등척성 수축시 표면근전도에서 근 수축 개시점 결정을 위한 기법들의 신뢰도", 한국전문물리치료학회지, 10(1), pp.51~62 (2003), 한국전문물리치료학회
- DeLorme TL, "Restoration of muscle power by heavy resistance exercise", J Bone Joint Surg Am, 27, pp.645~667 (1945)
- DeLorme TL, "Technics of progressive resistance exercise", Arch Phys Med, 29, pp.263~273 (1948)
- Li F, "Tai Chi: improving functional balance and predicting subsequent falls in older persons", Med Sci Sports Exerc, 36(12), pp.2046~2052 (2004)
- Winter DA, "Stiffness control of balance in quiet standing", J Neurophysiol, 80(3), pp.1211~1221 (1998)
- Woollacott MH, "Aging and postural control: change in sensory organization and muscular coordination", Int J Aging Hum Dev, 23(2), pp.97~114 (1986)
- Shumway-Cook A, "A systems analysis of postural dyscontrol in traumatically brain-injured patients", J Head Trauma Rehabil, 5(4), pp.51~62 (1990)
- Mackey DC, "Mechanisms underlying agerelated differences in ability to recover balance with the ankle strategy", Gait Posture, 23(1), pp.59~68 (2006)
- Pajala S, "Contribution of genetic and environmental effects to postural balance in older female twins", J Appl Physiol, 96(1), pp.308~315 (2004)
- Era P, "Postural balance and self-reported functional ability in 75-year-old men and women: A cross-national comparative study", J Am Geriatr Soc, 45(1), pp.21~29 (1997)