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아급성 뇌졸중 환자의 낙상경험과 기능적 요인 및 심리적 요인과의 관련성

Relationship of Functional factors and Psychological factors to Fall in Subacute Stroke

이경진|송창호|여세광
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2012.06|특수교육재활과학연구|제51권 제2호|pp. 241-259|DOI http://dx.doi.org/

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키워드

우울뇌졸중Stroke균형balanceFalls낙상효능감Fall efficacy
주제분류기타사회과학

초록

본 연구는 아급성 뇌졸중 환자의 낙상경험과 기능적 요인 및 심리적 요인의 관련성을 조사하고, 낙상의 위험요소를 알아보고자 실시되었다. 연구의 대상자는 독립보행이 가능한 100명의 편마비 환자이며, 낙상경험을 기준으로 낙상군과 비낙상군으로 분류하여 변수간의 관련성 및 낙상을 일으키는 요소를 알아보았다. 기능적 요인은 균형, 기능적 수행능력, 보행, 하지근력을 평가하였고, 심리적 요인은 한국형 낙상효능감과 한국형 노인우울척도를 사용하여 평가하였다. 본 연구의 결과를 통하여 낙상과 관련된 변인들 중 BBS, MBI, TUG, FES-K가 서로 유의한 관련성을 가지고 있었으며, BBS와 MBI 및 FES-K가 뇌졸중 환자의 낙상경험에 영향을 미치는 위험 인자임을 확인하였다. 따라서 향후 낙상을 일으키는 인자 간의 관계를 깊이 있게 규명해야 할 것이며, 보호자 개입 및 환자의 주변 환경과 여건에 대한 폭 넓은 고려가 필요할 것으로 생각한다.

Abstract

This study is to determine the relationship between a falls and the functional performance ability as well as to identify the risk factors of a falls in the stroke patients who are in subacute stage. The subjects used in this study were 100 patients with hemiparesis being able to walk independently. Among them, fallers were identified, and they answered the question in the number of falls. On the basis of their falls, patients were divided into two groups; one group was for fallers and the other was for non-fallers. The cognitive function and mood scale, the Mini-Mental State Examination- Korean (MMSE-K), Falls Efficacy Scale-Kore an (FES-K), and Beck Depression Index-Korean (BDI-K) were used. Physical performance assessments were used to measure the strength of lower limbs (sit to stand test, SIT), balance (Berg balance scale, BBS), gait (timed up & go test, TUG), and basic activity daily living (modified Barthel index, MBI). The results of this study were as follows:The number of falls related to Falls Efficacy Scale-Korean (FES-K) and gait (TUG) and balance (BBS) and basic-ADL (MBI) were the most important variables. Impaired physical function was significantly associated with a falls in both patients who had fallen and patients who had not. Impaired psychological factors were significantly associated with the number of falls in both fallers and non-fallers. In conclusion, this study suggests that the stroke rehabilitations and interventions for risk factors of a falls will have to be addressed in a comprehensive perspective. Also, the results associated with a falls could be an indicator to predict the functional independence in stroke patients.

참고문헌 (54)

  1. 박종한, "노인용 한국판 Mini-Mental State Examination (MMSE-K) 의 표준화 연구. 제2편: 구분점 및 진단적 타당도", 28, pp.125~135 (1989), 신경정신의학회
  2. 이경진, "BIORescue 프로그램을 이용한 인지과제균형훈련이 노인의 정적균형, 동적균형, 시지각에 미치는 효과", 특수교육재활과학연구, 51(1), pp.211~229 (2012), 특수교육재활과학연구소
  3. 이경진, "하지근력강화를 강조한 불안정한 면에서의 보행매트훈련이 노인의 보행과 하지근력에 미치는 영향", 특수교육재활과학연구, 50(4), pp.419~435 (2011), 특수교육재활과학연구소
  4. 한홍무, "Beck Depression Inventory 의 한국판 표준화 연구", 최신의학, 21, pp.69~75 (1978)
  5. Andersson, A. G., "Fear of falling in stroke patients: Relationship with previous falls and functional characteristics", International Journal of Rehabilitation Research, 31(3), pp.261~263 (2008)
  6. Berg, K., "Measuring balance in the elderly: Preliminary development of an instrument", Physiotherapy Canada, 41(6), pp.304~311 (1989)
  7. Berg, K. O., "Measuring balance in the elderly: Validation of an instrument. Canadian journal of public health", Revue canadienne de sante publique, 83, pp.S7~S11 (1992)
  8. Briderman, A., "Depression and falls among community dwelling elderly people: A search for common risk factors", Journal of Epidemiology and Community Health, 56(8), pp.631~636 (2002)
  9. Brouwer, B., "Normal variability of postural measures: Implications for the reliability of relative balance performance outcomes", Scandinavian journal of rehabilitation medicine, 30(3), pp.131~137 (1998)
  10. Chiu, A., "comparison of four functional tests in discriminating fallers from non-fallers in older people", Disability & Rehabilitation, 25(1), pp.45~50 (2003)
  11. Dean, C., "Motor assessment scale scores as a measure of rehabilitation outcome following stroke", Australian Journal of Physiotherapy, 38(1), pp.31~35 (1992)
  12. Duncan, P. W., "Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident", Physical therapy, 63(10), pp.1606~1610 (1983)
  13. Engberg, W., "Balance-related efficacy compared with balance function in patients with acute stroke", Physiother Theory Pract, 24(2), pp.105~111 (2007)
  14. Feibel, J., "Depression and failure to resume social activities after stroke", Archives of physical medicine and rehabilitation, 63(6), pp.276~277 (1982)
  15. Forster, A., "Incidence and consequences offalls due to stroke: A systematic inquiry", Bmj, 311(6997), pp.83~86 (1995)
  16. Friedman, S. M., "Falls and fear of falling: Which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention", Journal of the American Geriatrics Society, 50(8), pp.1329~1335 (2002)
  17. Fugl-Meyer, A., "The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance", Scandinavian journal of rehabilitation medicine, 7(1), pp.13~31 (1975)
  18. Graafmans, W., "Falls in the elderly: A prospective study of risk factors and risk profiles", American journal of epidemiology, 143(11), pp.1129~1136 (1996)
  19. Granger, C. V., "Outcome of comprehensive medical rehabilitation: Measurement by PULSES profile and the Barthel Index", Archives of physical medicine and rehabilitation, 60(4), pp.145~154 (1979)
  20. 구미옥, "노인 낙상예방 맞춤운동의 개발 및 효과", Journal of Korean Academy of Nursing, 36(2), pp.341~352 (2006), 한국간호과학회
  21. Harris, J. E., "Relationship of balance and mobility to fall incidence in people with chronic stroke", Physical therapy, 85(2), pp.150~158 (2005)
  22. Hill, K., "Assessment and management of falls in older people", Internal medicine journal, 34(9), pp.557~564 (2004)
  23. Hughes, C., "Relationship among performance on stair ambulation, Functional Reach, and Timed Up and Go tests in older adults", Issues Aging, 21, pp.18~22 (1998)
  24. Hyndman, D., "Fall events among people with stroke living in the community: Circumstances of falls and characteristics of fallers. 1", Archives of physical medicine and rehabilitation, 83(2), pp.165~170 (2002)
  25. Hyndman, D., "People with stroke living in the community: Attention deficits, balance, ADL ability and falls", Disability & Rehabilitation, 25(15), pp.817~822 (2003)
  26. Ikai, T., "Dynamic postural control in patients with hemiparesis", American journal of physical medicine & rehabilitation, 82(6), pp.463~469 (2003)
  27. Jang, S. N., "The validity and reliability of Korean fall efficacy scale (FES) and activities-specific balance confidence scale (ABC)", Journal of the Korean Geriatrics Society, 7(4), pp.255~268 (2003)
  28. Jorgensen, L., "Higher incidence of falls in long-term stroke survivors than in population controls", Stroke, 33(2), pp.542~547 (2002)
  29. Kim, P., "Quality of life of stroke survivors", Quality of Life Research, 8(4), pp.293~301 (1999)
  30. Kwakkel, G., "Effects of augmented exercise therapy time after stroke", Stroke, 35(11), pp.2529~2539 (2004)
  31. Lamb, S., "Risk factors for falling in home-dwelling older women with stroke", Stroke, 34(2), pp.494~501 (2003)
  32. Langhorne, P., "Medical complications after stroke: A multicenter study", Stroke, 31(6), pp.1223~1229 (2000)
  33. Lord, S. R., "Falls in older people: Risk factors and strategies for prevention" (2007), Cambridge Univ Press
  34. Mackintosh, S. F. H., "Falls and injury prevention should be part of every stroke rehabilitation plan", Clin Rehabil, 19(4), pp.441~451 (2005)
  35. Ng, S. S., "The timed up & go test: Its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke", Archives of physical medicine and rehabilitation, 86(8), pp.1641~1647 (2005)
  36. Nicholas, D. S., "Balance retraining after stroke using force platform biofeedback", Phys. Ther, 77(5), pp.553~558 (1997)
  37. Nikolaus, T., "Preventing falls in communitydwelling frail older people using a home intervention team(HIT): Results from the randomized falls-HIT trial", Journal of American Geriatric Society, 51(3), pp.300~305 (2003)
  38. Pang, M. Y. C., "Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density", Osteoporosis International, 19(7), pp.919~927 (2008)
  39. Patel, A. T., "The relation between impairments and functional outcomes poststroke", Archives of physical medicine and rehabilitation, 81(10), pp.1357~1363 (2000)
  40. Penninx, B. W. J. H., "Depressive symptoms and physical decline in community-dwelling older persons", JAMA: The journal of the American Medical Association, 279(21), pp.1720~1726 (1998)
  41. Perry, J., "Kinesiology of lower extremity bracing", Clinical orthopaedics and related research, 102, pp.18~31 (1974)
  42. Rapport, L., "Predictors of falls among right-hemisphere stroke patients in the rehabilitation setting", Archives of physical medicine and rehabilitation, 74(6), pp.621~626 (1993)
  43. Shumway-Cook, A., "Predicting the probability for falls in community-dwelling older adults", Physical therapy, 77(8), pp.812~819 (1997)
  44. Shumway-Cook, A., "Attentional demands and postural control: The effect of sensory context", Journals of Gerontology-Biological Sciences and Medical Sciences, 55(1), pp.10~16 (2000)
  45. Singh, A., "Functional and neuroanatomic correlations in poststroke depression: The Sunnybrook Stroke Study", Stroke, 31(3), pp.637~644 (2000)
  46. Sohng, K. Y., "The survey of activities and fear of falling in the community dwelling elderly", J Korean Acad Public Health Nurs, 15(2), pp.324~333 (2001)
  47. Stapleton, T., "A pilot study of attention deficits, balance control and falls in the subacute stage following stroke", Clin Rehabil, 15(4), pp.437~444 (2001)
  48. Swan, L., "Improving balance by performing a secondary cognitive task", British Journal of Psychology, 95(1), pp.31~40 (2004)
  49. Thorbahn, L. D. B., "Use of the Berg Balance Test to predict falls in elderly persons", Physical therapy, 76(6), pp.576~583 (1996)
  50. Tiedemann, A., "The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people", Age and ageing, 37(4), pp.430~435 (2008)
  51. Tinetti, M. E., "Falls efficacy as a measure of fear of falling", Journal of gerontology, 45(6), pp.239~243 (1990)
  52. Watanabe, Y., "Fear of falling among stroke survivors after discharge from inpatient rehabilitation", International Journal of Rehabilitation Research, 28(2), pp.149~152 (2005)
  53. Wu, G., "Evaluation of the effectiveness of Tai Chi for improving balance and preventing falls in the older population-a review", J Am Geriatr Soc, 50(4), pp.746~754 (2002)
  54. 유인영, "노인 단독가구의 낙상과 주거환경 문제", 한국생활환경학회지, 12(3), pp.199~205 (2005), 한국생활환경학회

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