편측 종아리 절단장애인에서 두 가지 소켓에 따른 사용만족도와 보행특성 비교: 단일사례연구
A Comparison of The Prosthetic Satisfaction and Gait Characteristics Between Two Sockets in A Unilateral Transtibial Amputee
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초록
본 연구는 편측 종아리 절단장애인을 대상으로 KBM(Kondylen-Bettung Munster) 및 TSB(Total Surface Bearing) 소켓이 각각 적용된 의지 착용이 사용만족도와 보행 특성에 미치는 영향을 알아보고자 하였다. 연구 대상자는 K-4 활동 수준으로 스포츠 활동에 적극적으로 참여하는 편측 종아리 절단장애인 1명을 선정하였다. 의지 사용만족도 설문지(PEQ, prosthetic evaluation questionnaire)를 사용하여 만족도를 조사하였고, 2분 보행검사(2 minute walk test)와 영상분석 프로그램을 통해 보행 능력(capacity)과 보장(step length)을 비교하였다. 실험은 단일대상연구 중 A-B-A-B 디자인을 적용하였다. KBM 의지에 비하여 TSB 종아리 의지를 착용하였을 때, PEQ 설문 점수가 증가하였고, 2분 보행검사 결과가 개선되었으며, 건측과 절단측의 보장 차이가 감소하였다. 본 연구를 통해 TSB 종아리의지가 소켓의 편안함과 현가기능 및 보행 능력을 향상시키고, 같은 시간 동안 보다 멀리 걸을 수 있어 운동 능력이 개선되었으며, 보행 동안 양측 다리의 보장이 더욱 대칭적으로 나타났다. 이러한 결과에 따라 종아리 절단장애인의 보행 편위(gait deviation)를 감소시킬 수 있고 일상생활 및 운동 활동에 보다 효율적일 수 있다는 임상적 사례를 제시한다.
Abstract
The purpose of this study was to investigate the differences of a prosthetic satisfaction and gait characteristics between KBM and TSB socket of prosthesis in unilateral transtibial amputee. An active(K-4 level) subject has participated in this study. A subjective completed the prosthesis evaluation questionnaire(PEQ) with embedded satisfaction-related questions, and underwent two minute walk test and quantitative two-dimensional motion analysis to compare the walking capacity and step length. This study is a single subject design(A-B-A-B). As a result, compared with a KBM socket, a TSB socket showed that composite scores for the PEQ and two minute walk test were increased, while a distance of step length between both legs was reduced. Through the result of this study, a comfort, suspension function and walking capacity were improved, and also steps were more symmetric during gait, when TSB socket was worn. It suggest that gait deviations were decreased when the prosthesis with TSB socket was adopted, so transtibial amputees were able to adapt their daily living and sporting activities effectively.
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