지역사회 보행 훈련이 뇌졸중 환자의 하지 근활성도 및 동적 균형 능력, 보행 척도에 미치는 효과
The effects of Community Ambulation Training on Muscle Activity of the Lower Extremities and Dynamic Balance Ability, Gait Scale in Stroke Patients
2
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
본 연구는 뇌졸중으로 인한 편마비 환자에게 지역사회 보행 훈련과 트레드밀 보행 훈련을 적용하였을 때 하지 근활성도 및 동적 균형 능력, 보행 척도에 어떠한 영향을 미치는지 알아보기 위해서 실시하였다. 뇌졸중 환자 27명을 대상으로 지역사회 보행 훈련군 14명과 트레드밀 보행 훈련군 13명을 무작위로 배정하였다. 하지 근활성도 측정은 활동전위의 실효치 값으로 분석 하였고, 동적 균형 능력 검사와 6분 걷기 검사, 위스콘신 보행 척도를 사용하였다. 훈련은 6주 동안 1주일에 3회, 각 30분씩 지역사회 보행 훈련 군은 지역사회 훈련을 트레드밀 보행 훈련군은 트레드밀 보행 훈련을 실시하였다. 집단 내와 집단 간 비교를 위하여 대응표본 t-검정과 독립표본 t-검정을 시행하였다. 지역사회 보행 훈련군은 대퇴사두근, 슬괵근, 비복근, 전경골근의 근활성도, 동적 균형 능력, 6분 걷기 검사, 위스콘신 보행 척도에서 유의한 차이가 있었다(p<.05). 트레드밀 보행 훈련군은 대퇴사두근, 슬괵근, 비복근, 전경골근의 근활성도, 동적 균형 능력, 위스콘신 보행 척도에서 유의한 차이가 있었다(p<.05). 지역사회 보행 훈련 군과 트레드밀 보행 훈련군의 훈련 전후 비교에서 대퇴사두근, 슬괵근, 전경골근의 근활성도, 동적 균형 능력, 6분 걷기 검사, 위스콘신 보행 척도에서 유의한 차이가 있었다(p<.05). 이러한 결과는 지역사회 보행 훈련과 트레드밀 보행 훈련이 만성 뇌졸중 환자의 하지 근활성도와 균형 능력 향상에 긍정적인 영향을 미치며, 트레드밀 보행 훈련에 비해 지역사회 보행 훈련이 더 효율적일 수 있음을 의미한다.
Abstract
The purpose of this study was to examine the effect of the performance of a certain community ambulation training on Muscle Activity of the Lower Extremities and Dynamic Balance Ability, Gait Scale in Stroke Patients. Twenty-seven chronic stroke patient participated. Participants were randomly divided into either community ambulation training group(n=14) and treadmill gait training group. for the lower limbs muscle activity, RMS of action potential were analyzed and dynamic balance test, 6 minute walk test, wisconsin gait scale. The training process included training 3 times a week for 6 weeks, 30 minutes per session. The data was analyzed using a paired t-test and independent t-test to determine the statistical significance. The statistical analysis showed significant differences for the Quadriceps, Hamstring, Gastrocnemius, Tibia anterior, Dynamic balance test, 6 minute walk test, Wisconsin gate cale for the walking community ambulation training group(p<.05). The treadmill training group showed significant differences for the Quadriceps, Hamstring, Gastrocnemius, Tibia anterior, Dynamic balance test, Wisconsin gate scale (p<.05). The statistical analysis showed significant differences in the change rate for the Quadriceps, Hamstring, Tibia anterior, Dynamic balance test, 6 minute walk test, Wisconsin gate scale for the walking community ambulation training group and treadmill training group(p<.05). These results show that walking community ambulation training and treadmill training have a positive effect on muscle activity of lower extremities and dynamic balance, and walking community ambulation training is more effective than treadmill training.
참고문헌 (30)
- 강태우, "급성기 뇌졸중 환자들에 대한 상지 및 하지 순환식 과제-지향 훈련의 효과 비교", 특수교육재활과학연구, 50(3), pp.135~151 (2011), 특수교육재활과학연구소
- 차현규, "시각 되먹임 훈련을 병행한 상상연습이 편마비 환자의 균형과 보행 능력에 미치는 효과", 특수교육재활과학연구, 51(2), pp.337~354 (2012), 특수교육재활과학연구소[DOI]
- Ada, L., "A treadmill and overground walking program improves walking in persons residing in the community after stroke: A placebo controlled, randomized trial", Arch Phys Med Rehabil, 84(10), pp.1486~1491 (2003)
- Dunsky, R., "Home-based motor imagery training for gait rehabilitation of people with chronic post stroke hemiparesis", Arch Phys Med Rehabil, 89(8), pp.1580~1588 (2008)
- Hill, K., "Balance and mobility outcomes for stroke patients: A comprehensive audit", Aust J Physiother, 43(3), pp.173~180 (1997)
- Jang, S. H., "Cortical reorganization induced by task-oriented training in chronic hemiplegic stroke patients", NEUROREPORT, 14(1), pp.137~141 (2003), LIPPINCOTT WILLIAMS & WILKINS
- Kirker, S. G., "Changing patterns of postural hip muscle activity during recovery from stroke", Clin Rehabil, 14(6), pp.618~626 (2000)
- Lerner-Frankiel, M. B., "Functional community ambulation: What are your criteria? Clin Manage", Phys Ther, 6(2), pp.12~15 (1986)
- Lord, S. E., "Measurement of community ambulation after stroke: Current status and future developments", Stroke, 36(7), pp.1457~1461 (2005)
- Lord, S. E., "How feasible is the attainment of community ambulation after stroke? A pilot randomized controlled trial to evaluate community-based physiotherapy in subacute stroke", Cilni Rehabil, 22(3), pp.215~225 (2008)
- Lord, S. E., "Measurement of community ambulation after stroke: Current status and future developments", Stroke, 36(7), pp.1457~1461 (2005)
- Melvyn, R., "Gait coordination after stroke: benefit of acoustically paced treadmil walking", Phys Ther, 87(8), pp.1009~1022 (2007)
- Moseley, A., "Treadmill training more effective than Bobath training in improving walking following stroke", Aust J Physiother, 51(3), pp.192~ (2005)
- Mossberg, K. A., "Reliability of a timed walk test in persons with acquired brain injury", Am J Phys Med Rehabil, 82(5), pp.385~390 (2003)
- Neumann, D. A., "Kinesiology of the Musculoskeletal System: Foundation for Rehabilitation" (2010), Mosby & Elsevier
- Park, H. Y., "Effectiveness of community-based ambulation training for walking function of post-stroke hemiparesis: A randomized controlled pilot trial", Clin Rehabil, 25(5), pp.451~459 (2011)
- Patterson, K. K., "Gait asymmetry in communityambulating stroke survivors", Archives of physical medicine and rehabilitation, 89(2), pp.304~310 (2008)
- Perry, J., "Classification of walking handicap in the stroke population", stroke, 26(6), pp.982~989 (1995)
- Robinett, C. S., "Functional ambulation velocity and distance requirements in rural and urban communities: A clinical report", Phys Ther, 68(9), pp.1371~1373 (1988)
- Rodriquez, A. A., "Gait training efficacy using a home based practice model in chronic hemiplegia", Arch Phys Med Rehabil, 77(8), pp.801~805 (1996)
- Roerdink, M., "Gait coordination after stroke: Benefits of acoustically paced treadmill walking", Phys Ther, 87(8), pp.1009~1022 (2007)
- Salbach, N. M., "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)
- Shumway-Cook, A., "Environmental demands associated with community mobility in older adults with and without mobility disabilities", Phys ther, 82(7), pp.670~681 (2002)
- Shumway-Cook, A., "Predicting the probability for falls in community dwelling older adults using the timed up & go test", Phys Ther, 80(9), pp.896~903 (2000)
- Srivastava, A., "Post-stroke balance training: Role of force platform with visual feedback technique", J Neurol Sci, 287(1), pp.89~93 (2009)
- Stephenson, J. L., "The coordination of upper limb movements during gait in healthy and stroke individuals", Gait Posture, 29(1), pp.11~16 (2009)
- Weiss, T., "Activation process during mental practice in stroke patients", International Journal of Psychophysiology, 17(1), pp.91~100 (1994)
- William, S. P., "Practical Electromyography" (2007), Lippincott Williams & Wilkins
- Yang, Y. R., "Virtual reality-based training improves community ambulation in individuals with stroke: A randomized controlled trial", Gait Posture, 28(2), pp.201~206 (2008)
- Yang, Y. R., "Task-oriented progressive resistance strength training improved muscle strength and functional performance in individual with stroke", Clin Rehabil, 20(10), pp.860~870 (2006)