본문 바로가기
KERD
논문KCI 등재

고관절 관절가동기법이 뇌졸중 환자의 고관절 가동성, 균형과 보행능력에 미치는 효과

Effect of Hip Joint Mobilization on Hip Mobility, Balance and Gait With Stroke Patients

장현정|김선엽|김영훈
한국전문물리치료학회 (Korean Research Society of Physical Therapy)|2014.05|한국전문물리치료학회지 (Physical Therapy Korea)|제21권 제2호|pp. 8-17|DOI http://dx.doi.org/10.12674/ptk.2014.21.2.008

2

조회

0

다운로드

4

인용

0

참고문헌

키워드

StrokeBalanceMobilizationGaitHip Joint
주제분류물리치료학

초록

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group (n1=14) and the general neurodevelopment therapy (NDT) group (n2=16). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

Abstract

The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group (n1=14) and the general neurodevelopment therapy (NDT) group (n2=16). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

참고문헌 (36)

  1. Aalto TJ, "Effect of passive stretch on reproducibility of hip range of motion measurements", Arch Phys Med Rehabil, 86(3), pp.549~557 (2005)
  2. Burns SA, "Short-term response of hip mobilizations and exercise in individuals with chronic low back pain: A case series", J Man Manip Ther, 19(2), pp.100~107 (2011)[DOI]
  3. Cleland JA, "Immediate effects of thoracic manipulation in patients with neck pain : A randomized clinical trial", Man Ther, 10(2), pp.127~135 (2005)
  4. Eich HJ, "Aerobic treadmill plus Bobath walking training improves walking in subacute stroke : A randomized controlled trial", Clin Rehabil, 18(6), pp.640~651 (2004)
  5. Elveru RA, "Goniometric reliability in a clinical setting. Subtalar and ankle joint measurements", Phys Ther, 68(5), pp.672~677 (1988)
  6. Ferreira GE, "Immediate effects of hip mobilization on pain and baropodometric variables--A case report", Man Ther, 18(6), pp.628~631 (2013)[DOI]
  7. Fonseca ST, "Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation", pp.476~486 (2007), Saunders Elsevier
  8. Gardner MJ, "Orthopedic issues after cerebrovascular accident", Am J Orthop(Belle Mead NJ), 31(10), pp.559~568 (2002)
  9. 마상렬, "회외발에 대한 족관절 관절가동술이 균형능력에 미치는 영향", 한국데이터정보과학회지, 20(3), pp.527~539 (2009), 한국데이터정보과학회
  10. Holmes JD, "Validity of the Nintendo Wii® balance board for the assessment of standing balance in Parkinson’s disease", Clin Rehabil, 27(4), pp.361~366 (2013)[DOI]
  11. 김영훈, "뇌졸중 환자의 고관절 관절가동범위와 대퇴골두 전방가동성, 보행 능력간에 상관관계", 대한물리의학회지, 9(1), pp.35~44 (2014), 대한물리의학회
  12. Kirker SG, "Stepping before standing : Hip muscle function in stepping and standing balance after stroke", J Neurol Neurosurg Psychiatry, 68(4), pp.458~464 (2000)
  13. Kisner C, "Therapeutic Exercise:Foundations and techniques", pp.51~76 (2007), F.A. Davis Company
  14. Kluding PM, "Effects of ankle joint mobilizations in adults poststroke: A pilot study", Arch Phys Med Rehabil, 89(3), pp.449~456 (2008)[DOI]
  15. 공성아, "탄력 밴드 트레이닝이 뇌졸증 편마비자의 일상생활 수행능력과 관절 ROM에 미치는 영향", 한국특수체육학회지, 16(1), pp.117~134 (2008), 한국특수체육학회
  16. Liu J, "Use of the six-minute walk test poststroke: Is there a practice effect?", Arch Phys Med Rehabil, 89(9), pp.1686~1692 (2008)[DOI]
  17. Lord SE, "The effect of environment and task on gait parameters after stroke : A randomized comparison of measurement conditions", Arch Phys Med Rehabil, 87(7), pp.967~973 (2006)
  18. Mahabir D, "Stroke in trinidad and tobago : Burden of illness and risk factors", Rev Panam Salud Publica, 4(4), pp.233~237 (1998)
  19. Messier S, "Dynamic analysis of trunk flexion after stroke", Arch Phys Med Rehabil, 85(10), pp.1619~1624 (2004)
  20. Morris S, "Reliability of measurements obtained with the timed"up & go"test in people with parkinson disease", Phys Ther, 81(2), pp.810~818 (2001)
  21. Mulligan BR., "Manual Therapy: NAGS, SNAGS, MWM’S, etc", pp.121~125 (1999), Plane View Service Ltd
  22. Park CS, "The effects of additional action observational training for functional electrical stimulation treatment on weight bearing, stability and gait velocity of hemiplegic patients", J Phys Ther Sci, 25(9), pp.1173~1175 (2013)[DOI]
  23. 박대성, "뇌졸중 환자들의 균형평가를 위한 Balancia 프로그램의 신뢰도와 타당도", 한국산학기술학회논문지, 14(6), pp.2767~2772 (2013), 한국산학기술학회[DOI]
  24. Park SJ, "The effects of trunk and pelvic stabilization exercise using a sling on functional improvement in chronic stroke patient", 석사, pp.2010
  25. Podsiadlo D, "The timed"up and go" : A test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, 39(2), pp.142~148 (1991)
  26. Ryerson S, "Functional Movement Reeducation: A contemporary model for stroke rehabilitation", pp.29~31 (2006), Churchill Livingstone
  27. Ryerson S, "Functional Movement Reduction: A contemporary model for stroke rehabilitation", pp.15~48 (1997), Churchill Livingstone
  28. Sahrmann SA., "Diagnosis and Treatment of Movement Impairment Syndromes", pp.165~181 (2005), Mosby
  29. Salbach NM, "A task-orientated intervention enhances walking distance and speed in the first year post stroke : A randomized controlled trial", Clin Rehabil, 18(5), pp.509~519 (2004)
  30. Sharp SA, "Isokinetic strength training of the hemiparetic knee : Effects on function and spasticity", Arch Phys Med Rehabil, 78(11), pp.1231~1236 (1997)
  31. Schindler-Ivenss, "Lower extremity passive range of motion in community-ambulating stroke survivors", J Neurol Phys Ther, 32(1), pp.21~31 (2008)[DOI]
  32. 손효영, "체중이동 훈련을 통한 관절가동화기법이 편마비환자의 균형 및 보행속도에 미치는 영향", 한국전문물리치료학회지, 19(1), pp.10~18 (2012), 한국전문물리치료학회
  33. Steffen TM, "Age-and gender-related test performance in community-dwelling elderly people : Six-minute walk test, Berg balance scale, timed up & go test, and gait speeds", Phys Ther, 82(2), pp.128~137 (2002)
  34. Suzuki Y, "Intermittent control with ankle, hip, and mixed strategies during quiet standing: A theoretical proposal based on a double inverted pendulum model", J Theor Biol, 310, pp.55~79 (2012)[DOI]
  35. Yang YR, "Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke", Clin Rehabil, 20(10), pp.860~870 (2006)
  36. Young W, "Assessing and training standing balance in older adults: A novel approach using the ‘Nintendo Wii’ balance board", Gait Posture, 33(2), pp.303~305 (2011)[DOI]

관련 논문AI추천

체중이동 훈련을 통한 관절가동화기법이 편마비환자의 균형 및 보행속도에 미치는 영향손효영, 최종덕한국전문물리치료학회 · 한국전문물리치료학회지2012 · 제19권 제1호편마비 환자의 발목관절에 시행된 메이틀랜드 관절가동술과 움직임을 동반한 관절가동술이 관절가동범위, 정적 및 동적 균형, 족저압, 보행 능력에 미치는 영향에 관한 연구심현보, 이준용, 최율정대한정형도수물리치료학회 · 대한정형도수물리치료학회지2022 · 제28권 제1호만성 편마비 환자의 발목에 적용한 능동운동을 동반한 관절가동술이 하지근력과 보행의 시공간적 변수에 미치는 영향안창만, 원종임한국전문물리치료학회 · 한국전문물리치료학회지2012 · 제19권 제3호발과 발목에 적용한 관절가동기법이 뇌졸중 환자의 균형 능력에 미치는 영향허우리, SONGBRIAN BYUNG특수교육재활과학연구소 · 특수교육재활과학연구2016 · 제55권 제2호움직임을 동반한 관절가동술 적용 전 시행된 연부조직가동술이 뇌졸중 환자의 족관절 가동범위, 근 조직, 균형에 미치는 즉각적인 효과장우석, 최순호대한정형도수물리치료학회 · 대한정형도수물리치료학회지2020 · 제26권 제1호물리치료 중재에 따라 뇌졸중 환자의 발목관절가동범위 증진에 미치는 비교유병호, 이상빈, 최태석중소기업융합학회 · 융합정보논문지2019 · 제9권 제12호

이 간행물의 다른 논문 (8건)

척추 안정화 운동 방법들에 따른 배근육의 근 활성도 비교윤태림, 이규완, 이충휘, 김기송, 이지현pp. 1-7이중과제 훈련이 뇌졸중 환자의 균형 및 보행에 미치는 영향원종임, 정세라pp. 18-27불안정 지지면에서 정적 서기 동안 구두 굽 높이의 변화에 따른 자세 조절 전략사공우원, 안덕현pp. 28-36뇌졸중 환자의 낙상 예측을 위한 평가도구 비교원종임pp. 37-47Effect of Craniocervical Flexion on Muscle Activities of Scapula Upward Rotator Muscle During Push-Up Plus Exercise in Subject With Winging of Scapula김정아, 이충휘, 임원빈, 신헌석, 용준형, 송시정pp. 48-56
원문 보기