뇌졸중 환자의 균형능력과 타이밍 기능평가의 신뢰도와 타당도
Reliability and Validity of Timing-Functional Movement and Balance Ability in Patients with Stroke
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
본 연구의 목적은 뇌졸중 환자를 대상으로 청각적 피드백을 이용한 타이밍-기능적 움직임 능력과 균형 능력 사이의 상관관계를 알아보고 이를 통해 타이밍-기능적 움직임 평가도구 개발의 기초자료를 제공하고자 하였다. 뇌졸중 환자 30명을 대상으로 균형능력을 알아보기 위해 Function in sitting test, Berg balance scale, modified Postural assessment scale for stroke, 10 Meter walk test, Timed up & go를 실시하였고, 청지각 능력 평가와 균형 능력 카테고리에 따른 네가지 타이밍-기능적 움직임 측정 방법을 실시하였다. 타이밍-기능적 움직임의 검사-재검사 신뢰도는 급간 내 상관계수(ICCs)를 이용하였다. 측정 변수들 간의 선형적인 연관성을 알아보기 위해 피어슨 상관계수를 나타내었다. 절대적 신뢰도는 측정오차의 정량화를 위해 표준 오차 측정(standard error of measurement; SEM)을 이용하였다. 연구 결과 FIST점수와 벽면에 손 짚기는 유의한 음의 상관관계를 보였다(r=-.693, r=-.465, r=-.364). BBS점수와 발판에 발 올리기는 유의한 음의 상관관계를 보였다(r=-.511, r=-.492). mPASS점수와 발판에 발 올리기는 유의한 음의 상관관계를 보였다(r=-.463, r=-.500). 10MWT 값과 한 발짝 내딛기는 유의한 양의 상관관계를 보였다(r=.376, r=.369). TUG 값과 한 발짝 내딛기는 유의한 양의 상관관계를 보였다(r=.437, r=.471, r=.379). 네 가지 측정 방법 모두 ICC=.986 이상으로 높은 검사-재검사 신뢰도를 보였다. 버튼 누르기 방법과 벽 짚기 방법의 SEM은 측정한 평균값의 10%보다 작아 신뢰할 만한 수준이었다. 연구결과를 통해 세 가지 측정 방법 모두 균형능력과 높은 연관성이 있어 타이밍-기능 평가 도구로 활용이 가능 할 것이다.
Abstract
The previous studies have shown that the use of auditory feedback to improve balance ability and the improvement of upper limb ability of stroke patients through Rhythmic auditory stimulation using Interactivity metronome have been actively studied. However, there are insufficient studies to evaluate the patient's balance ability including control of lower extremity and trunk. Therefore, the purpose of this study is to provide basic data for the development of Timing-functional movement test tool to evaluate the balance ability of stroke patients. The design of this study was a cross sectional design, involving 30 patients with stroke. Timing-functional movement test-retest reliability was measured by intraclass correlation coefficients (ICCs) and Kappa values. The Pearson correlation coefficient was used to examine the linear relationship between measured variables. Absolute reliability was measured by standard error of measurement(SEM). Timing-functional movement test methods showed high test-retest reliability with ICC=.986 or better. The Function in sitting test and Wall touch was significantly negative correlated(r=-.693, r=-.465, r=-.364). The Berg balance scale and Step on the stool was significantly negative correlated(r=-.511, r=-.492). The modified Postural assessment scale for stroke and Step on the stool was significantly negative correlated(r=-.463, r=-.500). The 10 Meter walk test and One step in front was significantly positive correlated(r=.376, r=.369). The Timed up & go and One step in front was significantly positive correlated(r=.437, r=.471, r=.379). In this study, we investigated the clinical usefulness of Timing-functional movement using auditory feedback in evaluating the balance ability of stroke patients and found that it is useful for evaluating the balance ability of stroke patients with high reliability and validity.
참고문헌 (39)
- Ahmed, S., "The Stroke Rehabilitation Assessment of Movement (STREAM): a comparison with other measures used to evaluate effects of stroke and rehabilitation", Physical therapy, 83(7), pp.617~630 (2003)
- 안명환, "뇌졸중 환자의 균형 증진을 위한 체감형 전자게임 훈련에 적용되는 되먹임 방식에 따른 효과", 대한물리의학회지, 7(4), pp.401~409 (2012), 대한물리의학회
- 안승헌, "보행에 제한이 있는 뇌졸중 환자들의 한국어 번안 기능적 앉기 검사의 신뢰도와 타당도", 특수교육재활과학연구, 55(3), pp.471~486 (2016), 특수교육재활과학연구소[DOI]
- Asanuma, H., "Neuronal mechanisms of motor learning in mammals", Neuroreport, 2, pp.217~224 (1991)
- Bartscherer, M. L., "Interactive Metronome training for a 9-year-old boy with attention and motor coordination difficulties", Physiotherapy Theory and Practice, 21, pp.257~269 (2005)
- Beaton, D. E., "Guidelines for the process of cross-cultural adaptation of self-report measures", Spine, 25(24), pp.3186~3191 (2000)
- Beckelhimer, S. C., "Computer-based rhythm and timing training in severe, stroke-induced arm hemiparesis", American Journal of Occupational Therapy, 65(1), pp.96~100 (2011)
- Beckerman, H., "Smallest real difference, a link between reproducibility and responsiveness", Quality of Life Research, 10(7), pp.571~578 (2001)
- Berg, K. O., "Measuring balance in the elderly: preliminary development of an instrument", Physiother can, 41(6), pp.304~311 (1989)
- Bonan, I. V., "Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial", Archives of physical medicine and rehabilitation, 85(2), pp.274~278 (2004)
- 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)
- Debaere, F., "Brain areas involved in interlimb coordination: a distributed network", Neuroimage, 14(5), pp.947~958 (2001)
- Gorman, S. L., "Examining the function in sitting test for validity, responsiveness, and minimal clinically important difference in inpatient rehabilitation", Arch Phys Med Rehabil, 95(12), pp.2304~2311 (2014)
- Gorman, S. L., "Development and validation of the Function In Sitting Test in adults with acute stroke", J Neurol Phys Ther, 34(3), pp.150~160 (2010)
- Halsaa, K. E., "Assessments of interrater reliability and internal consistency of the Norwegian version of the Berg Balance Scale", Archives of physical medicine and rehabilitation, 88(1), pp.94~98 (2007)
- 현동수, "리듬청각자극을 이용한 후방 보행 훈련이 뇌졸중 환자의보행과 균형에 미치는 영향", 한국산학기술학회논문지, 14(12), pp.6237~6245 (2013), 한국산학기술학회[DOI]
- Jeong, S., "Effects of a theory-driven music and movement program for stroke survivors in a community setting", Applied Nursing Research, 20(3), pp.125~131 (2007)
- 전현주, "청각적 생체 되먹임 훈련과 공차기 훈련이 뇌졸중 환자의 체중지지율에 미치는 영향", 대한물리의학회지, 9(4), pp.363~373 (2014), 대한물리의학회
- 정지혜, "상호작용식 메트로놈(Interactive Metronome; IM) 훈련이 편마비 뇌성마비 아동의 신체 양측 협응과 균형능력, 상지기능에 미치는 효과: 개별 실험 연구", 대한작업치료학회지, 21(2), pp.37~48 (2013), 대한작업치료학회
- 김정두, "뇌졸중 환자의 초기 접지기를 강조한 청각적-피드백 보행훈련이 균형능력과 보행기능에 미치는 영향", 대한물리의학회지, 10(4), pp.49~57 (2015), 대한물리의학회
- 김경미, "성인지적장애인에 대한 상호작용식 메트로놈(Interactive Metronome) 중재가 타이밍과 집중력, 양측 협응, 균형능력에 미치는 영향: 단일사례연구", 특수교육재활과학연구, 54(3), pp.349~364 (2015), 특수교육재활과학연구소[DOI]
- Kim SJ., "Motor learning and control" (2010), Daehan Media
- 권혜림, "뇌졸중 환자의 시선 방향 조절이 균형과 보행에 미치는 영향", 대한물리의학회지, 8(3), pp.425~431 (2013), 대한물리의학회
- 이정아, "한국판 버그 균형척도 평가도구의 라쉬분석", 한국전문물리치료학회지, 13(3), pp.49~56 (2006), 한국전문물리치료학회
- 이규영, "The Effects of Closed Kinetic and Open Kinetic Chain Exercises Using Knee Reposition Sense in Chronic Stroke Patients", 대한물리치료학회지, 26(3), pp.182~190 (2014), 대한물리치료학회
- Liston, R. A., "Reliability and validity of measures obtained from stroke patients using the balance master", Archives of physical medicine and rehabilitation, 77(5), pp.425~430 (1996)
- Mirelman, A., "Audio-biofeedback training for posture and balance in patients with Parkinson's disease", Journal of neuroengineering and rehabilitation, 8(1), pp.35~ (2011)
- Morice, A., "Two-, six-, and 12-minute walking test in respiratory disease", British medical journal (Clinical research ed.), 285(6337), pp.295~ (1982)
- Morris S, "Reliability of measurements obtained with the Timed “Up & Go” test in people with Parkinson disease", Phys Ther, 81(2), pp.810~818 (2001)
- Persson, C. U., "A validation study using a modified version of Postural Assessment Scale for Stroke Patients:Postural Stroke Study in Gothenburg (POSTGOT)", Journal of NeuroEngineering and Rehabilitation, 8, pp.57~ (2011)
- Podsiadlo D, "The timed "Up & Go": a test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, 39(2), pp.142~148 (1991)
- Robertson, J. V., "The trunk as a part of the kinematic chain for reaching movements in healthy subjects and hemiparetic patients", Brain research, 1382, pp.137~146 (2011)
- Richman, J., "Research methodology and applied statistics, part 3: measurement procedures in research", Physiother Can, 32(4), pp.253~257 (1980)
- Shahraki, M., "Effect of rhythmic auditory stimulation on gait kinematic parameters of patients with multiple sclerosis", Journal of medicine and life, 10(1), pp.33~ (2017)
- Shank, T. M., "A Retrospective outcomes study examining the effect of interactive metronome on hand function", Journal of Hand Therapy, 28(4), pp.396~402 (2015)
- Suh, J. H., "Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients", NeuroRehabilitation, 34(1), pp.193~199 (2014)
- Thaut, M. H., "Rhythmic auditory stimulation improves gait more than NDT", Bobath training in near-ambulatory patients early poststroke: a single-blind, randomized trial, 2007, pp.21(5), 455~459
- Thaut, M. H., "Distinct cortico-cerebellar activations in rhythmic auditory motor synchronization", Cortex, 45(1), pp.44~53 (2009)
- Trombly CA, "Occupational therapy for physical dysfunction" (2002), Lippincott