장애물 넘기 여부에 따른 트레드밀 보행 훈련이 편마비 환자의 보행주기 중에 엉덩관절, 무릎관절 및 발목관절의 움직임에 미치는 영향
Effects of Treadmill Gait Training according to Obstacle Crossing on the Hip, Knee and Ankle Joint Motion during Gait Cycle in Patients with Post Stroke Hemiplegia
2
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
PURPOSE: The purpose of this study was to determine the effects of treadmill gait training according to obstacle crossing on the hip, knee and ankle joint motion during gait cycle in patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into 3 groups as treadmill gait training with obstacle crossing group (TOG, n=7), treadmill gait training without obstacle crossing group (TGG, n=7) and control group (CON, n=7). TOG and TGG were performed treadmill gait training with and without obstacle crossing for 20 minutes, three times a week, and for 8 weeks. Hip, knee and ankle joint motion were measured before and after treadmill gait training. Statistical analyses was done using the ANCOVA and paired t-test. RESULTS: Hip, knee and ankle joint motion were significantly increased in TOG and TGG after 8 weeks compared to before (p<.05, respectively). Hip, Knee and ankle joint motion were significantly increased in TOG compared with CON and TGG (p<.05, respectively). CONCLUSIONS: TOG was more effective than both TGG and CON in order to improve hip, knee and ankle joint motion in hemiplegia patients. Especially, treadmill gait training with obstacle crossing significantly improved to improve lower limb joint movement during the gait cycle.
Abstract
PURPOSE: The purpose of this study was to determine the effects of treadmill gait training according to obstacle crossing on the hip, knee and ankle joint motion during gait cycle in patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into 3 groups as treadmill gait training with obstacle crossing group (TOG, n=7), treadmill gait training without obstacle crossing group (TGG, n=7) and control group (CON, n=7). TOG and TGG were performed treadmill gait training with and without obstacle crossing for 20 minutes, three times a week, and for 8 weeks. Hip, knee and ankle joint motion were measured before and after treadmill gait training. Statistical analyses was done using the ANCOVA and paired t-test. RESULTS: Hip, knee and ankle joint motion were significantly increased in TOG and TGG after 8 weeks compared to before (p<.05, respectively). Hip, Knee and ankle joint motion were significantly increased in TOG compared with CON and TGG (p<.05, respectively). CONCLUSIONS: TOG was more effective than both TGG and CON in order to improve hip, knee and ankle joint motion in hemiplegia patients. Especially, treadmill gait training with obstacle crossing significantly improved to improve lower limb joint movement during the gait cycle.
참고문헌 (33)
- Pang MYC, "Determinants of satisfaction with community reintegration in older adults with chronic stroke : role of balance self-efficacy", Phys Ther, 87(3), pp.282~291 (2007)
- Duncan PW, "Stroke disability", Phys Ther, 74(5), pp.399~407 (1994)
- Schindler-Ivens S, "Lower extremity passive range of motion in community-ambulating stroke survivors", JNPT, 32(1), pp.21~ (2008)
- Sharp SA, "Isokinetic strength training of the hemiparetic knee : effects on function and spasticity", Arch Phys Med Rehabil, 78(11), pp.1231~1236 (1997)
- Gracies J., "Pathophysiology of spastic paresis. I: Paresis and soft tissue changes", Muscle Nerve Off J Am Assoc Electrodiagn Med, 31(5), pp.535~551 (2005)
- Caillet F, "Three dimensional gait analysis and controlling spastic foot on stroke patients", Annales de Readaptation et de Medecine Physique: Revue Scientifique de La Societe Francaise de Reeducation Fonctionnelle de Readaptation et de Medecine Physique, 46, pp.119~131 (2003)
- Chen CL, "Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery", Am J Phys Med Rehabil, 82(12), pp.925~935 (2003)
- Perry J, "Gait analysis : normal and pathological function", J Pediatr Orthop, 12(6), pp.815~ (1992)
- Kerrigan DC, "Spastic paretic stiff-legged gait : joint kinetics", Am J Phys Med Rehabil, 80(4), pp.244~249 (2001)
- Bohannon RW, "Relationship between static muscle strength deficits and spasticity in stroke patients with hemiparesis", Phys Ther, 67(7), pp.1068~1071 (1987)
- Kottink AI, "A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia", Arch Phys Med Rehabil, 88(8), pp.971~978 (2007)
- Kaltenborn FM, "Manual mobilization of the joint", Extrem, 21~28 (1999)
- Mulligan BR, "Manual Therapy: Nags, Snags, Prp’s, Etc" (1992), Plane View Services
- Salbach NM, "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)
- Dietz V., "Body weight supported gait training: From laboratory to clinical setting", Brain Res Bull, 78(1), pp.1~6 (2009)
- Macko RF, "Treadmill training improves fitness reserve in chronic stroke patients", Arch Phys Med Rehabil, 82(7), pp.879~884 (2001)
- Hesse S, "Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients", Arch Phys Med Rehabil, 82(11), pp.1547~1550 (2001)
- 박승진, "슬링을 이용한 체간 및 골반의 안정화 운동이 만성 뇌졸중 환자의 기능증진에 미치는 효과", 석사, 임상운동, pp.2010
- Kwok T, "Quality of life of stroke survivors : a 1-year follow-up study", Arch Phys Med Rehabil, 87(9), pp.1177~1182 (2006)
- Said CM, "Effect of stroke on step characteristics of obstacle crossing", Arch Phys Med Rehabil, 82(12), pp.1712~1719 (2001)
- Ditor DS, "The effects of body-weight supported treadmill training on cardiovascular regulation in individuals with motor-complete SCI", Spinal Cord, 43(11), pp.664~673 (2005)
- Amatachaya S, "Factors related to obstacle crossing in independent ambulatory patients with spinal cord injury", J Spinal Cord Med, 33(2), pp.144~149 (2010)
- Chen HC, "Stepping over obstacles: gait patterns of healthy young and old adults", J Gerontol, 46(6), pp.M196~M203 (1991)
- Erni T, "Obstacle avoidance during human walking : learning rate and cross-modal transfer", The Journal of siology, 534(1), pp.303~312 (2001)
- Hayes HB, "An in vitro spinal cord–hindlimb preparation for studying behaviorally relevant rat locomotor function", J Neurophysiol, 101(2), pp.1114~1122 (2009)
- Eltoukhy M, "Evaluation of the performance of digital video analysis of human motion : Dartfish tracking system", Int J Sci Eng Res, 3(3), pp.1~6 (2012)
- Borel S, "Video analysis software increases the interrater reliability of video gait assessments in children with cerebral palsy", Gait Posture, 33(4), pp.727~729 (2011)
- Ganley KJ, "Gait kinematics and kinetics of 7-year-old children : a comparison to adults using age-specific anthropometric data", Gait Posture, 21(2), pp.141~145 (2005)
- 김선녀, "편마비 환자의 장애물 보행", Annals of Rehabilitation Medicine, 33(6), pp.668~674 (2009), 대한재활의학회
- Decker MJ, "Gender differences in lower extremity kinematics, kinetics and energy absorption during landing", Clin Biomech, 18(7), pp.662~669 (2003)
- Schache AG, "On the expression of joint moments during gait", Gait Posture, 25(3), pp.440~452 (2007)
- Neumann DA, "Kinesiology of the Musculoskeletal System-e-Book:Foundations for Rehabilitation" (2013), Elsevier Health Sciences
- Chou LS, "Increasing obstacle height and decreasing toeobstacle distance affect the joint moments of the stance limb differently when stepping over an obstacle", Gait Posture, 8(3), pp.186~204 (1998)