본문 바로가기
KERD
논문KCI 등재

가상현실 프로그램을 이용한 로봇-보행 훈련이 급성기 척수손상환자의 보행능력 및 일상생활 수행능력에 미치는 영향

Effects of Robot-assist training using virtual reality program on Gait ability in patient with acute spinal cord injury

노현정|강태우|송명수|방대혁
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2012.09|특수교육재활과학연구|제51권 제3호|pp. 347-362

1

조회

0

다운로드

9

인용

0

참고문헌

키워드

보행능력gait ability급성기 척수손상환자로봇-보행 훈련acute spinal cord injuryRobot-assist training
주제분류기타사회과학

초록

본 연구는 가상현실 프로그램을 이용한 로봇-보행 훈련이 급성기 척수손상환자의 보행능력에 미치는 효과를 평가하기 위해 실시되었다. 본 연구에 22명의 척수손상환자가 참여하였다. 연구 대상은 척수손상환자를 각각 11명씩 무작위로 배정하였다. 모든 환자들은 보존적 물리치료를 받았으며, 실험군에게 추가적으로 로봇-보행훈련을 20분 동안 시행하였다. 본 연구의 평가 도구는 균형능력평가(TETRAX), 10M 보행검사, 6분 걷기 검사, 수정된 바델 지수였다. 측정은 중재 전, 후로 실시하였다. 중재 후 군내에서 실험군과 대조군의 균형능력평가(TETRAX), 10M 보행검사, 6분 걷기 검사, 수정된 바델 지수의 중재 전, 후 값에서 유의한 차이를 보였다(p<.05). 실험군은 중재 전, 후 차이값이 균형능력평가(TETRAX), 10M 보행검사, 6분 걷기 검사, 수정된 바델 지수에서 각각 36.81±12.22, 4348±6.46, 45.72±22.76, 32.54±13.02 향상되었고, 대조군은 각각의 평가에서 24.81±22.08, 39.52±8.7, 24.63±19.9, 19.27±11.69 향상되었다. 두 군 간의 중재 후의 평가 비교에서 중재 후 균형능력평가(TETRAX), 10M 보행검사, 6분 걷기 검사, 수정된 바델지수에서 유의한 차이가 있었다(p<.05). 이는 로봇-보행훈련이 척수손상환자의 보행능력에 긍정적인 영향을 미친다는 것을 의미한다. 앞으로 이러한 연구 결과를 일반화시키는 것이 필요할 것이라고 사료된다.

Abstract

The purpose of this study was to determine the effect of Robot-assist training on gait ability in patients with spinal cord injury. 22 patients with spinal cord injury were recruited for this study. The subjects were randomly assigned to either the experimental group(EG) or the control group(CG), with 11 patients in each group. All subjects received a routine physical therapy. The robot-assist training was for 20 min in the case of the EG subjects. The assessment tools of this study involved the balance ability(TETRAX), 10m walking test, 6minutes walking test, modified barthel index. The measurements were recorded before the intervention and after the intervention. In the cases of the EG subjects and CG subjects, the variables measured after the intervention significantly differed from balance ability(TETRAX), 10m walking test, 6minutes walking test, modified barthel index measured before the intervention (p<.05). Also, there were significant differences in balance ability(TETRAX), 10m walking tets, 6minutes walking test, modified barthel index at post test between the 2 groups (p<.05). The findings indicate that robot-assist training exerts a positive effect on gait ability in patient with spinal cord injury. Further studies are required to generalize the result of this study.

참고문헌 (42)

  1. 강형규, "타원형 기구 보행, 트레드밀 보행 및 지면 보행이 하지 근육의 근 활성도에 미치는 영향", 특수교육재활과학연구, 51(1), pp.253~266 (2012), 특수교육재활과학연구소
  2. 권용철, "노인용 한국판 Mini-Mental State Examination(MMSE-K)의 표준화 연구-제2편: 구분점 및 진단적 타당도", 신경정신의학, 28(3), pp.508~513 (1989)
  3. 신원섭, "가상현실을 이용한 재활운동이 뇌손상 환자의 기능회복에 미치는 효과", 특수교육재활과학연구, 48(3), pp.49~64 (2009), 특수교육재활과학연구소
  4. Aimee, L. Betker, "Gamebased Exercises for Dynamic Short-Sitting Balance Rehabilitataion of People With Chronic Spinal Cord and Traumatic Brain Injuries", Phys Ther, 87(10), pp.1389~1398 (2007)
  5. Andreas Mayr, "Prospective, Blinded, randomized crossover study of gait rehabilitation in stroke patients using the lokomat gait orthosis", Neurorehabil Neural Repair, 21(4), pp.307~314 (2007)
  6. Barbeau, H., "The role of rehabilitation in the recovery of walking in the neurological population", Curr Opin Neurol, 14(6), pp.735~740 (2001)
  7. Behrman, H. L., "Locomotor training after human spinal cord injury: a series of case studies", Phys ther, 80(7), pp.688~700 (2000)
  8. Burns, S. P., "Recovery of ambulation in motor-incomplete tetraplegia", Arch Phys Med Rehabil, 78(11), pp.1169~1172 (1997)
  9. Butland, R. J. A., "Two-, six-, and twelve-minute walking tests in respiratory disease", Br Med J, 284(5), pp.1607~1608 (1982)
  10. Crozier, K. S., "Spinal cord injury: Prognosis for ambulation based on sensory examination in patients who are initially motor complete", Arch Phys Med Rehabil, 72(2), pp.119~121 (1991)
  11. Dietz, V., "Locomotor capacity and recovery of spinal cord function in paraplegic patients: a clinical and electrophysiological evaluation", Electroencephalogr Clin Neurophysiol, 109(2), pp.140~153 (1998)
  12. Dobkin, B. H., "Modulation of locomotor-l ike EMG activity in subjects with complete and incomplete spinal cord injury", J Neurol Rehabil, 9(4), pp.183~190 (1995)
  13. Dobkin, B. H., "Functional rewiring of brain and spinal cord after injury: the three Rs of neural repair and neurological rehabilitation", Curr Opin Neurol, 13(6), pp.655~659 (2000)
  14. Dobkin, B. H., "Strategies for stroke rehabilitation", Neurology, 3(9), pp.528~536 (2004)
  15. Field-Fote, E. C., "Locomotor training approaches for individuals with spinal cord injury: a preliminary report of spinal cord injury: a preliminary report of walking-related outcomes", J Neurol Phys Ther, 29(3), pp.127~137 (2005)
  16. Forssberg, H., "Spinal locomotor functions and descending control. Brainstem Control of Spinal Mechanisms" (1982), Elsevier Biomedical
  17. Harkema, S. J., "Human lumbosacral spinal cord interprets loading during stepping", J Neurophysiol, 77(2), pp.797~811 (1997)
  18. Hesse, S., "Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patientes", Arch phys Med Rehabil, 82(11), pp.1547~1550 (2001)
  19. Hobart, J. C., "The five item Barthel index", J Neurol Neurosurg Psychiatr, 71(2), pp.225~230 (2001)
  20. Hornby, T. G., "Robotic-assisted, body-weight-supported treadmill training in individuals following motor incomplete spinal cord injury", Physical Therap, 85(1), pp.52~66 (2005)
  21. Klavora, P., "Rehabilitation of visuomotor skills in poststroke patients using the dynavision appartus", percep Mot Skills, 86(1), pp.23~30 (1998)
  22. Lapointe, R., "Functional communtiry ambulation requirements in incomplete spinal cord injured subjects", spinal cord, 39(6), pp.327~335 (2001)
  23. Laufer, Y., "Standing balance and functional recovery of patient with right and left hemiparesis in the early stages of rehabilitation", Neurorehabil Neural Repai, 17(4), pp.207~213 (2003)
  24. Liston, R. A., "Reliability and validity of measurese obtained from stroke patient using the Balance Master", Arch Phys Med Rehabil, 77(5), pp.425~430 (1996)
  25. Lum, P., "Robotic devices for movement therapy after stroke: Current status and challenges to clinical acceptance", Top Stroke Rehabil, 8(4), pp.40~53 (2002)
  26. Mantovani, F., "Sense of presence in virtual training: Enhancing skills acquisition and transfer of knowledge through learning experience in virtual environments", EMERGING COMMUNICATION, 5, pp.167~182 (2003)
  27. Marsolais, E. B., "The Case Western Reserve University hybrid gait orthosis", J Spinal Cord Med, 23(2), pp.100~108 (2000)
  28. Miller, E. W., "Body weight support treadmill and overground ambulation training for stroke", Phys Ther, 82(1), pp.53~61 (2002)
  29. 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)
  30. Pollock, A., "Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke", Cochrane Database syst Rev, (2), pp.001920~ (2003)
  31. Protas, E. J., "Supported treadmill ambulation training after spinal cord injury: a pilot study", Arch Phys Med Rehabil, 82(6), pp.825~831 (2001)
  32. Rossignol, S., "Neural control of stereotypic limb movements", Comprehensive physiology (1996)
  33. Schmidt, R. A., "Motor control and Learning: A Behavioral Emphasis" (2005), Human Kinetics publishers
  34. Shah, S., "Improving the sensitivity of the Barthel Index for stroke rehabilitation", J Clin Epidemiol, 42(8), pp.703~709 (1989)
  35. Tania, Lam, "A systematic review of the efficacy of gait rehabilitation strategies for spinal cord injury", Topics in Spinal Cord Injury Rehabilitation, 13(1), pp.32~57 (2007)
  36. Teasell, R., "An evidence based review of stroke rehabilitation", Topics in Stroke Rehabilitation, 10(1), pp.29~58 (2003)
  37. Visintin, M., "The effects of body weight support on the locomotor pattern of spastic paretic patients", Can J Neurol Sci, 16(3), pp.315~325 (1989)
  38. Water, R. L., "Motor and sensory recovery following incomplete paraplegia", Arch Phys Med Rehabil, 75(1), pp.67~72 (1994)
  39. Werning, A., "Laufband locomotion with body weight support improved walking in persons with severe spinal cord injuries", Paraplegia, 30(4), pp.229~238 (1992)
  40. Wirz, M., "Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial", Arch Phys Med Rehabil, 86(4), pp.672~680 (2005)
  41. Yang, L., "Further development of hybrid functional electrical stimulation orthoses", Spinal Cord, 34(10), pp.611~614 (1996)
  42. Zhang, I., "A virtual reality environment for evaluation of a daily living skill in brain injury rehabilitation: reliability and validity", Arch Phys Med Rehabil, 84(8), pp.1118~24 (2003)

관련 논문AI추천

척수신경손상 환자의 보행훈련 전,후의 능동적 근육제어의 변화이동철, 이영신, 임현균, 셔우드아더대한의용생체공학회 · 의공학회지2003 · 제24권 제2호Robot-Assisted Gait Training in Individuals With Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsKim Yong Wook, Lee Su Ji, Park Jong Mi, Shin Ji Cheol대한재활의학회 · Annals of Rehabilitation Medicine2024 · 제48권 제3호Effect of Robotic-Assisted Gait Training in Patients With Incomplete Spinal Cord Injury김나영, 김지용, 박한결, 신지철대한재활의학회 · Annals of Rehabilitation Medicine2014 · 제38권 제6호재활 후 척수손상환자 보행능력의 양상과 보조 장구 사용 실태신영일, 이형수한국전문물리치료학회 · 한국전문물리치료학회지2005 · 제12권 제1호척수 손상 환자의 라이프 스타일 개선을 위한 재활 중재 효과: 무작위 대조군 연구의 체계적 고찰 및 메타분석박혜연, 하성규대한신경계작업치료학회 · 재활치료과학2020 · 제9권 제4호Improved Gait Speed After Robot-Assisted Gait Training in Patients With Motor Incomplete Spinal Cord Injury: A Preliminary Study김수정, 김혜리, 김혜원, 문재근, 신현수, 양성필, 이범석, 이혜진, 임문희, 조덕윤, 한지아, 황승원대한재활의학회 · Annals of Rehabilitation Medicine2017 · 제41권 제1호

이 간행물의 다른 논문 (18건)

직업재활시설 유형재편 후 성과분석나운환pp. 1-19주의력 결핍 과잉행동 문제를 지닌 아동의 진단과정에 따른 부모 인식 연구신윤희pp. 21-44DACUM 기법을 이용한 심리ㆍ행동적응지도사의 직무모형에 관한 연구양일모pp. 45-71Assistive Technology Device Predisposition Assessment의 국내적용을 위한 번안연구이혜경pp. 73-97성폭력으로 인한 PTSD 아동의 외상중심 미술치료적 접근을 통한 사례연구정명선pp. 99-120
원문 보기