본문 바로가기
KERD
논문KCI 등재

이동훈련을 병행한 기능강화훈련이 뇌졸중환자의 하지근력, 균형 및 보행에 미치는 효과

The Effect of Combined with Locomotor and Functional Strengthening Training on Balance and Gait in Patients With Chronic Stroke

이은정|신원섭|송창호
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2010.10|특수교육재활과학연구|제49권 제3호|pp. 151-170

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

뇌졸중균형Balance근력보행GaitChronic strokelocomotor이동훈련기능강화훈련Functional strengthening training
주제분류기타사회과학

초록

본 연구는 이동훈련을 병행한 기능강화훈련이 뇌졸중 환자의 하지근력, 균형 및 보행에 미치는 효과를 알아보고자 시행하였다. 경기도 소재 재활병원에 입원 중인 환자들 중 선정 기준에 의해 선별된 대상자 24명을 무작위로 두 군으로 나누었고, 실험 도중 3명의 탈락자가 발생하여 이동훈련을 병행한 기능강화 훈련을 실시한 실험군 11명과 전통재활훈련을 실시한 대조군 10명으로 진행하였다. 훈련은 두 집단 모두 4주간 주 5회 하루 60분씩 이뤄지도록 하였고, 훈련의 효과를 알아보기 위하여 훈련 전·후에 하지근력, 동적균형, 보행능력을 검사하여 다음과 같은 결론을 얻었다. 실험군과 대조군의 고관절 굴곡근·외전근, 슬관절 신전근, 동적균형능력, 보행능력은 두 집단 모두에서 유의하게 증가하였고(p<.05), 실험방법에 따른 두 집단 간의 차이가 유의하게 나타났다(p<.05). 위의 결과를 통하여 이동훈련을 병행한 기능강화훈련이 뇌졸중 환자의 하지근력, 균형 및 보행능력을 향상시킴으로써 기능적 활동을 증진시키는데 전통재활훈련에 비해 효과적인 운동방법으로, 임상에서 치료에 적극적으로 활용할 수 있을 것으로 생각한다. 앞으로도 뇌졸중 환자의 기능적 활동을 증진시키기 위한 다양한 운동프로그램이 검증 및 개발되고, 치료방법의 비교연구도 이루어져야 할 것이라고 생각한다.

Abstract

This study was to investigate the effect of strength, balance and gait ability through combined with Locomotor and Functional Strengthening training in chronic stroke patients. Participants were randomly allocated to two groups: experimental(n=11) and control(n=10). Both groups received training for 5 session 60 minutes per week during 4 weeks. Experimental group practiced combined with locomotor and functional strengthening training that consisted of treadmill, cycling for each 15 minutes and functional strengthening for 30 minutes a day. Control group practiced conventional therapy on 60 minutes a day. Results were evaluated by strength, static balance, dynamic balance, gait function. The results of study were as follows :There were significantly increased by combined with locomotor and functional strengthening training that the strength of hip flexion, hip abduction, knee flexion, ankle plantar flexion, balance and gait function were significantly increased(p<.05). In conclusion, combined with locomotor and functional strengthening training improves strength, dynamic balance and gait function. These results suggest that combined with locomotor and functional strengthening is feasible and suitable and is more effective in strength, dynamic balance and gait function for individuals with a chronic stroke.

참고문헌 (48)

  1. Ada, L., "A treadmill and overground walking program improves walking in persons residing in the community after stroke: a placebo- controlled, randomized trial", Archives of Physical Medicine and Rehabilitation, 84(10), pp.1486~1491 (2003)
  2. Bale, M., "Does functional strength training of the leg in subacute stroke improve physical performance? A pilot randomized controlled trial", Clinical Rehabilitation, 22(10), pp.911~921 (2008)
  3. Bohannon, R. W., "Gait performance of hemiparetic stroke patients: selected variables", Archives of Physical Medicine and Rehabilitation, 68(11), pp.777~781 (1987)
  4. Brown, D. A., "Limb-loaded cycling program for locomotor intervention following stroke", Physical Therapy, 85(2), pp.159~168 (2005)
  5. Carr, J. H., "Neurological rehabilitation" (1998), Boston
  6. Chen, G, "Gait deviations associated with post-stroke hemiparesis: improvement during treadmill walking using weight support, speed, support stiffness, and handrail hold", Gait and Posture, 22(1), pp.57~62 (2005)
  7. De Quervain, I. A., "Gait pattern in the early recovery period after stroke", Journal of Bone and Joint Surgery, 78(10), pp.1506~1514 (1996)
  8. Dean, C. M., "Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial", Archives of Physical Medicine and Rehabilitation, 81(4), pp.409~417 (2000)
  9. Engardt, M., "Dynamic muscle strength training in stroke patients: effects on knee extension torque, electromyographic activity, and motor function", Archives of Physical Medicine and Rehabilitation, 76(5), pp.419~425 (1995)
  10. Franceschini, M., "Walking after stroke: what does treadmill training with body weight support add to overground gait training in patients early after stroke?: a single-blind, randomized, controlled trial", Stroke, 40(9), pp.3079~3085 (2009)
  11. Fujiwara, T., "Effect of pedaling exercise on the hemiplegic lower limb", American Journal of Physical Medicine and Rehabilitation, 82(5), pp.357~363 (2003)
  12. Hachisuka, K., "Disuse muscle atrophy of lower limbs in hemiplegic patients", Archives of Physical Medicine and Rehabilitation, 78(1), pp.13~18 (1997)
  13. Hamrin, E, "Muscle strength and balance in post-stroke patients", Upsala Journal of Medical Sciences, 87(1), pp.11~26 (1982)
  14. Hesse, S., "Body weight-supported treadmill training after stroke", Current atherosclerosis reports, 3(4), pp.287~294 (2001)
  15. Ivey, F. M, "Exercise rehabilitation after stroke", NeuroRx : the journal of the American Society for Experimental NeuroTherapeutics, 3(4), pp.439~450 (2006)
  16. Janssen, T. W., "Effects of electric stimulation-assisted cycling training in people with chronic stroke", Archives of Physical Medicine and Rehabilitation, 89(3), pp.463~469 (2008)
  17. Katz-Leurer, M., "The influence of early cycling training on balance in stroke patients at the subacute stage. Results of a preliminary trial", Clinical Rehabilitation, 20(5), pp.398~405 (2006)
  18. Kim, C. M., "The relationship of lower-extremity muscle torque to locomotor performance in people with stroke", Physical Therapy, 83(1), pp.49~57 (2003)
  19. Kim, C. M., "Effects of isokinetic strength training on walking in persons with stroke: a double-blind controlled pilot study", Journal of Stroke Cerebrovascular Disease, 10(6), pp.265~273 (2001)
  20. Krebs, D. E, "Functional vs. strength training in disabled elderly outpatients", American Journal of Physical Medicine and Rehabilitation, 86(2), pp.93~103 (2007)
  21. Kwakkel, G., "Effects of intensity of rehabilitation after stroke. A research synthesis", Stroke, 28(8), pp.1550~1556 (1997)
  22. Laufer, Y, "Weight-bearing shifts of hemiparetic and healthy adults upon stepping on stairs of various heights", Clinical Rehabilitation, 14(2), pp.125~129 (2000)
  23. Lee, M. J., "Comparison of effect of aerobic cycle training and progressive resistance training on walking ability after stroke: a randomized sham exercise-controlled study", Journal of the American Geriatrics Society, 56(6), pp.976~985 (2008)
  24. Lin, P. Y., "The relation between ankle impairments and gait velocity and symmetry in people with stroke", Archives of Physical Medicine and Rehabilitation, 87(4), pp.562~568 (2006)
  25. Lindquist, A. R., "Gait training combining partial body-weight support, a treadmill, and functional electrical stimulation: effects on poststroke gait", Physical Therapy, 87(9), pp.1144~1154 (2007)
  26. Morris, S. L., "Outcomes of progressive resistance strength training following stroke: a systematic review", Clinical Rehabilitation, 18(1), pp.27~39 (2004)
  27. Mulroy, S, "Use of cluster analysis for gait pattern classification of patients in the early and late recovery phases following stroke", Gait and Posture, 18(1), pp.114~125 (2003)
  28. Nadeau, S., "Analysis of the clinical factors determining natural and maximal gait speeds in adults with a stroke", American Journal of Physical Medicine and Rehabilitation, 78(2), pp.123~130 (1999)
  29. Nyberg, L., "Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies", Stroke, 26(5), pp.838~842 (1995)
  30. Olney, S. J., "Work and power in gait of stroke patients", Archives of Physical Medicine and Rehabilitation, 72(5), pp.309~314 (1991)
  31. Ouellette, M. M., "High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors", Stroke, 35(6), pp.1404~1409 (2004)
  32. Pai, Y. C., "Center of mass velocity-position predictions for balance control", Journal of Biomechanics, 30(4), pp.347~354 (1997)
  33. Perry, J., "Gait analysis" (1992), SLACK
  34. Perry, J., "Classification of walking handicap in the stroke population", Stroke, 26(6), pp.982~989 (1995)
  35. Plummer, P., "Effects of stroke severity and training duration on locomotor recovery after stroke: a pilot study", Neurorehabil Neural Repair, 21(2), pp.137~151 (2007)
  36. Podsiadlo, D., "The timed "Up & Go": a test of basic functional mobility for frail elderly persons", Journal of the American Geriatrics Society, 39(2), pp.142~148 (1991)
  37. Rimmer, J. H, "Exercise training in a predominantly African-American group of stroke survivors", Medicine and Science in Sports and Exercise, 32(12), pp.1990~1996 (2000)
  38. Schmid, A, "Improvements in speed-based gait classifications are meaningful", Stroke, 38(7), pp.2096~2100 (2007)
  39. Sharp, S. A, "Isokinetic strength training of the hemiparetic knee: effects on function and spasticity", Archives of Physical Medicine and Rehabilitation, 78(11), pp.1231~1236 (1997)
  40. Skilbeck, C. E, "Recovery after stroke", Journal of Neurology, Neurosurgery and Psychiatry, 46(1), pp.5~8 (1983)
  41. Steffen, T. M., "Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds", Physical Therapy, 82(2), pp.128~137 (2002)
  42. Sullivan, K., "Combined task-specific training and strengthening effects on locomotor recovery post-stroke: a case study", Journal of Neurological Physical Therapy, 30(3), pp.130~141 (2006)
  43. Sullivan, K. J, "Effects of task-specific locomotor and strength training in adults who were ambulatory after stroke: results of the STEPS randomized clinical trial", Physical Therapy, 87(12), pp.1580~1602 (2007)
  44. Sullivan, K. J, "Step training with body weight support: effect of treadmill speed and practice paradigms on poststroke locomotor recovery", Archives of Physical Medicine and Rehabilitation, 83(5), pp.683~691 (2002)
  45. Suzuki, K., "Determinants and predictors of the maximum walking speed during computer-assisted gait training in hemiparetic stroke patients", Archives of Physical Medicine and Rehabilitation, 80(2), pp.179~182 (1999)
  46. Tang, A., "Effects of an aerobic exercise program on aerobic capacity, spatiotemporal gait parameters, and functional capacity in subacute stroke", Neurorehabilitation Neural Repair, 23(4), pp.398~406 (2009)
  47. Teixeira-Salmela, L. F, "Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors", Archives of Physical Medicine and Rehabilitation, 80(10), pp.1211~1218 (1999)
  48. Wade, D. T., "The hemiplegic arm after stroke: measurement and recovery", Journal of Neurology, Neurosurgery and Psychiatry, 46(6), pp.521~524 (1983)

관련 논문AI추천

점진적 과제지향 저항훈련이 뇌졸중환자의 하지근력, 균형 및 보행에 미치는 효과송창호, 인태성, 최경우특수교육재활과학연구소 · 특수교육재활과학연구2010 · 제49권 제2호과제지향적 기능운동이 만성 뇌졸중 편마비 장애인의 근력, 균형 및 보행능력에 미치는 효과송창호, 신원섭, 이동엽, 이석민, 이승원한국특수체육학회 · 한국특수체육학회지2008 · 제16권 제3호전동식 보행 훈련이 만성 뇌졸중 환자의 보행과 이동성 및 동적 균형 능력에 미치는 효과박창식, 안승헌특수교육재활과학연구소 · 특수교육재활과학연구2012 · 제51권 제4호기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련이 뇌졸중 환자의 보행과 균형에 미치는 영향이승원, 전광열, 최원재특수교육재활과학연구소 · 특수교육재활과학연구2014 · 제53권 제3호중량조끼를 이용한 부하보행훈련이 뇌졸중 환자의 정적균형과 동적균형에 미치는 영향송창호, 신승호, 이경진특수교육재활과학연구소 · 특수교육재활과학연구2011 · 제50권 제3호지역사회 보행 훈련이 뇌졸중 환자의 하지 근활성도 및 동적 균형 능력, 보행 척도에 미치는 효과지상구, 차현규특수교육재활과학연구소 · 특수교육재활과학연구2012 · 제51권 제4호

이 간행물의 다른 논문 (14건)

자폐를 가진 유아를 위한 효과적인 교육적 접근법에 관한 질적 연구김건희pp. 1-20불연속 개별시도 훈련(Discrete Trial Training: DTT)을 적용한 수개념 프로그램이 발달장애아동의 수개념 형성에 미치는 효과:사례연구진흥신pp. 21-56자세변화에 따른 피드백 호흡훈련이 뇌졸중 환자의 흉곽용적과 폐기능에 미치는 영향서교철, 김경pp. 57-74호흡곤란 환자에서 검사자세와 흉곽 가동성에 따른 최대기침유량, 최대흡기/호기압력의 변화정종화, 박민철pp. 75-89인지행동적 분노조절프로그램이 공격성향이 있는 아동의 분노통제능력과 또래관계에 미치는 효과반지정, 서경희pp. 91-108
원문 보기