후방보행훈련이 만성기 뇌졸중 환자의 정적 균형, 균형 자신감과 보행지구력에 미치는 영향
Effects of Backward Walking Training on Static Balance, Balance Confidence, and Walking Endurance of Patients with Chronic Stroke
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초록
본 연구는 뇌졸중 환자들을 대상으로 후방보행훈련이 정적 균형, 균형 자신감 및 보행지구력에 미치는 영향을 알아보고자 시행하였다. 35명의 만성기 뇌졸중 환자가 연구에 참여하였으며, 대상자들은 두 그룹-실험군(후방보행훈련, 17명)과 대조군(전방보행훈련, 18명)-으로 무작위 배정되었다. 대상자들은 일반적인 물리치료를 동일하게 받았으며, 추가적으로 실험군은 후방보행훈련에 참여하였고, 대조군은 전방보행훈련에 참여하였다. 보행훈련은 6주 동안 주 3회, 30분간 실시하였다. 정적 균형능력을 측정하기 위해 Balance System SD(Biodex, New York)를 이용하였고, 균형 자신감은 한국판 활동-특이적 균형 자신감 척도를 사용하여 측정하였으며, 보행능력은 6분-보행검사로 평가하였다. 본 연구 결과 후방보행그룹의 정적 균형, 균형 자신감과 보행지구력이 전방보행그룹에 비해 더 많은 향상을 보였다(p<.05). 이러한 결과는 후방보행훈련이 뇌졸중 환자의 정적 균형, 균형 자신감 및 보행지구력 향상에 긍정적인 영향을 미칠 수 있음을 시사하며, 뇌졸중 환자의 재활프로그램의 한 부분으로 고려될 수 있을 것이다.
Abstract
This study aimed to describe the effects of backward walking training (BWT) on static balance, balance confidence and walking endurance in patients with chronic stroke. A total of 35 patients with chronic stroke were randomly divided into experimental (BWT; n=17) and control (forward walking training [FWT]; n=18) groups. Both groups underwent a 30-minute session, three times per week for six weeks (18 sessions). Static balance (Balance System SD), Korean Activities-specific Balance Confidence scale (K-ABC), and Six-Minute Walk Test (6MWT) were assessed at baseline, after intervention, and 6 weeks after the cessation of intervention. Two-way repeated measures ANOVA was used to compare differences between and within the groups. Compared to the control group, significant improvement in static balance, balance confidence, and walking endurance was observed in the experimental group (p<.05), and the improvement was maintained at follow-ups. The results suggest that backward walking training may have a positive effect on the static balance, balance confidence, and walking capacity of patients with stroke.
참고문헌 (48)
- Adbdel-Aziem, A.A, "Effectiveness of backward walking training on walking ability in children with hemipatetic cerebral palsy: A randomized controlled trial", Clin Rehabil, 31(6), pp.790~797 (2016)
- 안승헌, "뇌졸중 환자의 한국판 Falls Efficacy Scale의 신뢰도와 타당도", 특수교육재활과학연구, 51(3), pp.363~381 (2012), 특수교육재활과학연구소
- Beninato, M, "Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke", Phys Ther, 89(8), pp.816~825 (2009)
- Bonan, I, "Visual dependence after recent stroke", Ann Readapt Med Phys, 49(4), pp.166~171 (2006)
- Chan, B. K, "Incident fall risk and physical activity and physical performance among older men : the Osteoporotic Fractures in Men Study", Am J Epidemiol, 165(6), pp.696~703 (2007)
- Crapo, R. O, "ATS statement : guidelines for the six minute walk test", Am J Respir Crit Care Med, 166(1), pp.111~117 (2002)
- de Oliveira, C. B, "Balance control in hemiparetic stroke patients : main tools for evaluation", J Rehabil Res Dev, 45(8), pp.1215~1226 (2008)
- Denkinger, M. D, "Relationship between fear of falling and outcomes of an inpatient geriatric rehabilitation population : fear of the fear of falling", J Am Geriatr Soc, 58(4), pp.664~673 (2010)
- DeVita, P, "Lower extremity joint kinetics and energetics during backward running", Med Sci Sports Exerc, 23(5), pp.602~610 (1991)
- El-Basatiny, H.M.Y, "Effect of backward walking training on postural balance in children with hemiparetic cerebral palsy: a randomized controlled study", Clin Rehabil, 29(5), pp.457~467 (2015)
- Ellis-Hill, C. S, "Self-body split : issues of identity in physical recovery following a stroke", Disabil Rehabil, 22(16), pp.725~733 (2000)
- Foster, H, "The effects of backward walking training on balance and mobility in individual with chronic incomplete spinal cord injury : a case report", Phsiother Theory Pract, 32(7), pp.536~545 (2016)
- Fritz, N. E, "Backward walking measures are sensitive to age-related changes in mobility and balance", Gait Posture, 37(4), pp.593~597 (2013)
- Godde, B, "More automation and less cognitive control of imagined walking movements in high- versus low-fit older adults", Frontiers in Aging Neuroscience, 2, pp.139~ (2010), Frontiers Media SA[DOI]
- Goldberg, M.E, "Visuospatial and motor attention in the monkey", Neuropsychologia, 25(1A), pp.107~118 (1987)
- Grasso, R, "Motor patterns for human gait : Backward versus forward locomotion", J Neurophysiol, 80(4), pp.1868~1885 (1998)
- Hooper, T. L, "The effects of graded forward and backward walking on heart rate and oxygen consumption", J Orthop Sports Phys Ther, 34(2), pp.65~71 (2004)
- Houghton, K.M, "Evaluation of static and dynamic postural balance in children with juvenile idiopathic arthritis", Pediatr Phys Ther, 25(2), pp.150~157 (2013)
- 장숙랑, "한국어판 낙상효능 척도와 활동 특이적 균형자신감 척도의 타당도 및 신뢰도", 대한노인병학회, 7(4), pp.255~268 (2003)
- Jorgensen, L, "Higher incidence of falls in long-term stroke survivors than in population controls : depressive symptoms predict falls after stroke", Stroke, 33(2), pp.542~547 (2002)
- Katsavelis, D, "Variability of lower extremity joint kinematics during backward walking in a virtual environment", Nonlinear Dynamics Psychol Life Sci, 14(2), pp.165~178 (2010)
- Kim, K. H, "Effects of forward & backward walking training with progressive body weight supported on stroke patients’ ambulatory ability", Phys Ther Rehabil Sci, 3(2), pp.77~85 (2014)
- Kim, S, "Validity and reliability of the Korean version of the activities-specific balance confidence scale in individual with stroke", Doctor, pp.2011
- Kosak M, "Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke", J Rehabil Res Dev, 42(1), pp.103~107 (2005)
- Kurz, M. J, "Stride-time variability and sensorimotor cortical activation during walking", Neuroimage, 59(2), pp.1602~1607 (2012)
- Lee, M, "Kinematic and kinetic analysis during forward and backward walking", Gait Posture, 38(4), pp.674~678 (2013)
- Marigold, D. S, "Exercise leads to faster postural reflexes, improved balance and mobility, and fewer falls in older persons with chronic stroke", J Am Geriatr Soc, 53(3), pp.416~423 (2005)
- Michaelsen, S. M, "Effect of backward walking treadmill training on walking capacity after stroke : a randomized clinical trial", Int J Stroke, 9(4), pp.529~532 (2014)
- Milot, M. H, "Muscular utilization of the plantarflexors, hip flexors and extensors in persons with hemiparesis walking at self-selected and maximal speeds", J Electromyogr Kinesiol, 17(2), pp.184~193 (2007)
- Mullie, Y, "Role of proprioceptive information to control balance during gait in healthy and hemiparetic individuals", Gait Posture, 40(4), pp.610~615 (2014)
- Murphy, S. L, "Characteristics associated with fear of falling and activity restriction in community-living older persons", J Am Geriatr Soc, 50(3), pp.516~520 (2002)
- Nadeau, S, "Head and trunk stabilization strategies during forward and backward walking in healthy adults", Gait Posture, 18(3), pp.134~142 (2003)
- Peters, S, "Motor and visuospatial attention and motor planning after stroke : considerations for the rehabilitation of standing balance and gait", Phys Ther, 95(10), pp.1423~1432 (2015)
- Powell, L.E, "The Activities-specific Balance Confidence(ABC)Scale", J Gerontol A Biol Sci Med Sci, 50(1), pp.28~34 (1995)
- Rapport, L. J, "Predictors of fall among right-hemisphere stroke patients in the rehabilitation setting", Arch Phys Med Rehabil, 74(6), pp.621~626 (1993)
- Rose, D. K, "A backward walking training program to improve balance and mobility in acute stroke : a pilot randomized controlled trial", J Neurol Phys Ther, 42(1), pp.12~21 (2018)
- Roos, P. E, "Patellofemoral joint compression forces in backward and forward running", J. Biomech, 45(9), pp.1656~1660 (2012)
- Schinkel-Ivy, A, "Relationship between fear of falling, balance confidence, and control of balance, gait, and reactive stepping in individuals with sub-acute", Gait Posture, 43, pp.154~159 (2016)
- Schmitz, R, "Intertester and intratester reliability of a dynamic balance protocol using the biodex balance system", J Sport Rehab, 7(2), pp.95~101 (1998)
- Schmitz, T. J, "Physical Rehabilitation: Assessment and Treatment" (2006), FA Davis Company
- Shumway-Cook, A, "Motor Control: Translating Research into Practice" (2011), Lippincott Williams & Wilkins
- Stolze, H, "Falls infrequent neurological diseases : prevalence, risk factors and aetilolgy", J Neurol, 251(1), pp.79~84 (2004)
- Taylor-Piliae, R. E, "Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors", Arch Phys Med Rehail, 95(5), pp.816~824 (2014)
- Testerman, C, "Evaluation of ankle instability using the Biodex Stability System", Foot Ankle Int, 20(5), pp.317~321 (1999)
- Thorstensson, A, "How is the normal locomotor program modified to produce backward walking", Exp Brain Res, 61(3), pp.664~668 (1986)
- Torkia, C, "Balance confidence : A predictor of perceived physical function, perceived mobility, and perceived recovery 1 year following inpatient stroke rehabilitation", Arch Phys Med Rehabil, 97(7), pp.1064~1071 (2016)
- Winter, D. A, "Backward walking: a simple reversal of forward walking", J Mot Behav, 21(3), pp.291~305 (1989)
- Yang, Y. R, "Gait outcomes after additional backward walking training in patients with stroke : a randomized controlled trial", Clin Rehabil, 19(3), pp.264~273 (2005)
