편마비환자의 건측 신발 높이에 따른 보행 특성 연구
A Study on the Characteristics of Gait for Hemiplegia Patients with Shoe Lift to the Unaffected Limb
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
본 연구는 뇌졸중으로 인한 편마비 환자에게 건측 신발의 높이 조절이 보행의 특성에 미치는 영향을 알아보기 위하여 시행되었다. 서울 R병원에서 뇌졸중으로 인해 치료를 받고 있거나, 치료의 경험이 있는 편마비 환자를 대상으로 하였으며, 연구대상자는 15명의 편마비 환자(남=15)로 보조도구 없이 보행이 가능한 환자들로 선정하였다. 대조군은 신경학적 과거병력이 없고 환자군과 나이, 신장, 연령이 비슷한 14명의 정상인(남=14)으로 선정하였다. 환자군은 일반보행과 건측 신발에 1cm, 2cm 밑창을 적용한 보행을 한 후 VICON 512 Motion Analysis System을 사용하여 검사 및 분석하였고, 보행특성중 시ㆍ공간적인 지표와 운동형상학적인 지표에 대해 일반보행, 1cm, 2cm 밑창 적용에 따라 비교 분석하였으며, 대조군과 비교 분석하여 다음과 같은 결과를 얻었다. 첫째, 환자군에서 건측 신발 밑창 적용에 따라 시ㆍ공간지표에서 유의한 차이를 나타내었다(p<.05). 둘째, 환자군에서 건측 신발 밑창 적용에 따라 입각기 최대각의 운동형상학적 지표에서 유의한 차이를 나타내었다(p<.05). 셋째, 환자군에서 건측 신발 밑창 적용에 따라 유각기 최대각의 운동형상학적 지표에서 유의한 차이를 나타내었다(p<.05). 이상의 결과를 통해서 편마비 환자의 보행시 건측 신발 밑창 적용에 따라 시ㆍ공간적인면과 운동형상학적인면에서 모두 효과적인 것으로 나타났다. 그러므로 편마비 환자의 보행훈련시 건측 신발의 밑창 높이를 올리는 것이 환측과 건측의 대칭성을 향상시켜 보행능력의 개선에 효과적인 것으로 나타났고, 또한 편마비 환자의 기능적인 측면과 일상생활 등에서의 수행력의 증가를 기대할 수 있다.
Abstract
The purpose of this research is to investigate the effect of shoe lift to the unaffected limb on the gait in hemiplegia patients. The objects were patients who were inpatients or outpatients due to stroke at Dep. of Rehabilitation medicine section Physical Therapy of R hospital in Seoul. And we carried out the gait analysis by dividing them with two group. Patients group were 15 persons hemiplegia, and controls group were 14 age-matched healthy persons. Patients group divided three conditions : one condition had applied on the hemiplegic gait, another had done 1cm shoe outsole lift gait and the other had done 2cm shoe outsloe lift gait. The gait analysis was used with VICON 512 Motion Analysis System. Following are the results of comparative analysis about the effect of before and after applied on shoe outsole according to the Spatio-temporal, Kinematic parameters. The results were First, about Spatio-temporal parameters the applied shoe outsole lift to the unaffected limb on the condition there was significant(p<.05). Second, at the Kinematic parameters the applied shoe outsloe lift to the unaffected limb on the condition had the significant during stance phase(p<.05). Third, at the Kinematic parameters the applied shoe outsloe lift to the unaffected limb on the condition had the significant during swing phase(p<.05). In conclusions, the use of shoe outsole on the gait in Hemiplegia patients improves gait pattern and performance. Shoe outsole improved spatio-temporal parameter and kinematic parameters in patients with Hemiplegia. Therefore at the rehabilitation training of Hemiplegia patients shoe outsole would be used for recovery and gait reeducation, may arise through the patients functional ability. Clinical application of shoe outsloe may be another model of rehabilitation program for treatment of patients with Hemiplegia.
참고문헌 (29)
- 권영실, "뇌졸중으로 인한 편마비환자의 보행분석 I. 시간-거리변수, 골반경사각 및 지면반발력-수직력 중심", 대한물리치료학회지, 10(1), pp.127~138 (1998)
- 서정환, "편마비 환자의 보행시 신발 교정에 따른 에너지 소모의 감소", 대한재활의학회지, 23(1), pp.17~23 (1999)
- 안창식, "정상인과 편마비 환자의 보행분석 연구", 대한물리치료학회지, 14(3), pp.143~148 (2002)
- 윤승호, "임상 보행 분석" (1994), 도서출판 세진기획
- 이동욱, "편마비환자의 환측 하지 외회전 정도가 기립균형에 미치는 영향", 대한물리치료학회지, 15(3), pp.503~512 (2003)
- 이윤경, "뇌졸중 환자에서 보행 중 에너지 소모", 석사, pp.1998
- 통계청, "2006년 사망 및 사망원인 통계", pp.www.nso.go.kr, http:
- Aruin AS, "Compelled weightbearing in persons with hemiparesis following stroke : The effect of a lift insert and goal-directed balance exercise", Journal of rehabilitation research and development, 37(1), pp.65~72 (2000)
- Bobath B., "Adult Hemiplegia Evaluation and Treatment.3rd ed", Butterworth-Heinemann (1990)
- Boehme R., "Myofascial Release and Its Application To Neurode velopmental Treatment" (1981), Boehme Workshops
- Carr JH, "Investigation of a new motor assessment scale for stroke patients", Physical therapy, 65(2), pp.175~180 (1985)
- Chaudhuri S, "The effect of shoe lifts on static and dynamic postural control in individuals with hemiparesis", Archives of physical medicine and rehabilitation, 81(11), pp.1498~1503 (2000)
- Dettmann MA, "Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient", Am J Phys Med, 66(2), pp.77~90 (1987)
- Di Fabio RP, "Extraneous movement associated with hemiplegic postural sway during dynamic goal-directed weight redistribution", Archives of physical medicine and rehabilitation, 71(6), pp.365~371 (1990)
- Galley PM, "Human movement", pp.197~206 (1985), Churchill Livingstone
- George C., "Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds", Gait & Posture, 22(1), pp.51~56 (2005)
- Hamman RG., "Training effects during repeated therapy sessions of balance training using visual feedback", Arch Phys Med Rehabil, 73(8), pp.738~744 (1992)
- Holt RR., "Ground reaction force after a sideways push as a measure of balance in recovery from stroke", Clinical rehabilitation, 14(1), pp.88~95 (2000)
- Howard G., "Changes in survival following stroke in five North Carolina counties observed during two different periods", Stroke, 20(3), pp.345~350 (1989)
- Hsu AL., "Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke", Arch Phys Med Rehabil, 84(8), pp.1185~1193 (2003)
- 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)
- Norkin CC.Gait analysis.In:O’sullivan SB,Schmita TJ, "Gait analysis in : Physical Rehabilitation : Assessment and treatment. 3rd ed" (1994), FA Davis
- Pomeroy VM., "Need to focus research in stroke rehabilitation", Lancet, 355(9206), pp.836~837 (2000)
- Reginella RL., "Postural sway with earth-fixed and body-referenced finger contact in young and older adults", J Vestib Res, 9(2), pp.103~109 (1999)
- Rodriguez GM., "The effect of shoe wedges and lifts on symmetry of stance and weight bearing in hemiparetic individuals", Arch Phys Med Rehabil, 83(4), pp.478~482 (2002)
- Ryerson S., "Functional movement reeducation : a contemporary model for stroke rehabilitation", Churchill Livingstone (1997)
- Ryerson S., "Functional movement reeducation : a contemporary model for stroke rehabilitation" (1997), Churchill Livingstone
- Sackley CM., "The use of a balance performance monitor in the treatment of weight-bearing and weight-transference problems after stroke", Physiotherapy, 78(12), pp.907~913 (1992)
- Wall JC., "Gait asymmetries in residual hemiplegia", Archives of physical medicine and rehabilitation, 67(8), pp.550~553 (1986)