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하지 무게부하 트레드밀 보행훈련이 뇌졸중 환자의 균형 및 보행에 미치는 효과

The Effect of Treadmill-Based Leg Weight Loading Training on Balance and Gait in Stroke Patients

이형석|이승원
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2011.03|특수교육재활과학연구|제50권 제1호|pp. 89-111

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참고문헌

키워드

뇌졸중stroke균형balance보행gait트레드밀 훈련무게부하weight loadtreadmill training
주제분류기타사회과학

초록

본 연구는 뇌졸중 환자에게 하지 무게부하 트레드밀 보행훈련이 균형 및 보행에 미치는 효과를 알아보고자 시행하였다. 만성 뇌졸중 환자 26명을 대상으로 무작위 배정을 통해 건측 무게부하군(n=9), 환측 무게부하군(n=9), 무부하군(n=8)으로 나누어 진행하였다. 세 군 모두 동일한 물리치료를 주 5회 1시간 6주 동안 받았으며, 추가 30분 동안 건측 무게부하군과 환측 무게부하군에는 각각의 하지에 무게부하를 주고 트레드밀 보행훈련을 하였고, 무부하군은 트레드밀 보행훈련만을 시행하였다. 훈련의 효과를 알아보기 위해 기능적 팔 뻗기 검사(FRT), 체중 지지율, 일어나 걸어가기 검사(TUG), 보행 능력을 검사하였다. 6주 후 FRT와 TUG는 두 무게부하군에서, 체중 지지율은 환측 무게부하군에서 유의하게 개선되었다(p<.05). 보행속도는 건측 무게부하군에서, 분속수는 두 무게부하군에서 유의하게 증가하였다(p<.05). 공간적 보행 특성인 보장과 활보장, 단하지 지지율은 건측 무게부하군에서, 입각기, 유각기 비율은 두 무게부하군에서 개선되었다(p<.05). 본 연구의 결과 무게부하군이 무부하군에 비하여 정적, 동적균형과 보행 능력을 향상시킴으로써 기능적 활동을 증진시키는데 효과적임을 알 수 있었다. 특히 환측 무게부하를 통해 체중지지율을 향상시키고, 건측 무게부하를 통해 보행 능력을 향상시키는 것으로 나타나 임상에서 보행훈련 시 환자의 특성에 맞는 치료 선택의 특이성을 확보할 수 있을 것으로 생각된다.

Abstract

This study was to evaluate the effects of a treadmill-based leg weight loading training on balance and gait in stroke patients. Twenty-six subjects with chronic stroke were participated and randomly allocated to three groups: unaffected weight load group (n=9), affected weight load group (n=9), and no weight group (n=8). Three groups received physical therapy for five session an hour per week during six weeks. Both weight load groups practiced additional treadmill-based leg weight loading training programs and no weight group performed treadmill training on 30 minutes a day, five days a week during six weeks. Outcome measures are functional reach test (FRT), weight distribution, timed up and go (TUG), and gait function. After completion of training, FRT and TUG were increased in weight load groups (p<.05). The weight distribution showed significant improvement in an affected weight load group (p<.05). The gait velocity was increased in an unaffected weight load group and cadence were increased in weight load groups (p<.05). The step length, stride length, and rate of single limb support were increased in an unaffected weigh load group (p<.05). The rates of stance and swing were improved in weight load groups (p<.05). In conclusion, Treadmill- based leg weight loading training improves static balance and dynamic balance, gait function of chronic stroke patients, in comparison with no weight group. Especially, the gait function was improves in unaffected weight load group, weight distribution was improves in affected load group.

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