본문 바로가기
KERD
논문KCI 등재

기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련이 뇌졸중 환자의 보행과 균형에 미치는 영향

The Effect of A Combined Functional Electrical Stimulation with Progressive Speed Treadmill Training for Gait and Balance Performance in Stroke Survivors

최원재|이승원|전광열
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2014.09|특수교육재활과학연구|제53권 제3호|pp. 365-383|DOI http://dx.doi.org/10.15870/jsers.2014.09.53.3.365

2

조회

0

다운로드

6

인용

0

참고문헌

키워드

뇌졸중Stroke균형Balance보행Gait기능적 전기 자극점진적 속도 트레드밀 훈련Progressive speed treadmill trainingFunctional electronic stimulation
주제분류기타사회과학

초록

본 연구는 뇌졸중 환자를 대상으로 기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련이 보행능력과 균형능력에 미치는 영향을 알아보고자 하였다. 뇌졸중 환자 29명을 무작위로 나누어 기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련군, 점진적 속도 트레드밀 훈련군, 자신이 선택한 속도 트레드밀 훈련군으로 선정하였다. 훈련은 2주간 주 5회, 매 회 20분간 실시하였고 모든 대상자들은 훈련 전, 후로 보행능력과 균형능력 검사를 실시하였다. 모든 훈련군에서 균형은 유의한 증가를 보였으며(p<.05), 기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련 시 보행의 모든 변수에서 유의하게 증가하였다(p<.05). 점진적 속도 트레드밀 훈련 시 보행속도, 보장과 활보장에서 유의하게 증가하였고(p<.05), 자신이 선택한 속도 트레드밀 훈련 시 보행속도, 활보장에서 유의하게 증가하였다(p<.05). 또한, 기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련군과 자신이 선택한 속도 트레드밀 훈련군간 모든 변수에서 유의한 차이가 있었다(p<.05). 위의 결과를 통하여 기능적 전기 자극을 병행한 점진적 속도 트레드밀 훈련이 뇌졸중 환자의 보행능력과 균형능력을 향상시키는데 효과적인 중재방안으로 활용될 수 있을 것이다.

Abstract

This study was to investigate the therapeutic effects of a combined functional electrical stimulation (FES) with progressive speed treadmill (PST) training on stroke patient’s for performance of gait and balance. Subjects were randomly allocated to three groups: a combined FES with PST training group (n=10), PST training group (n=9), self-selected speed treadmill (SST) training group (n= 10). Subjects in a combined FES with PST training group and PST training group conducted treadmill training for 30 seconds, 8 trials, 5 session a week, total 2 weeks and SST training group conducted treadmill training for 20 minutes, 5 sessions a week, total 2 weeks. All subjects were conducted general rehabilitation physical therapy for 5 day a week, total 2 weeks. There are results of evaluation for gait and balance performance. There are a significant improve gait velocity, cadence, step length, stride length (p<.05) and Berg Balance Scale (BBS) score (p<.05) on a combined FES with PST training group. There are a significant improve gait velocity, step length, stride length (p<.05) and Berg Balance Scale(BBS) score (p<.05) on PST training group. There are a significant improve gait velocity, stride length (p<.05) and Berg Balance Scale (BBS) score (p<.05) on SST training group. Also, there are a significant difference gait velocity, cadence, step length, stride length and BBS (p<.05) on a combined FES with PST training group better than SST training group. In conclusion, this study suggests that a combined FES with PST training could offer ability better in stroke patients for the gait and balance performance. This study suggest that a combined FES with PST training is feasible and suitable on rehabilitation for individuals with the stroke patients.

참고문헌 (39)

  1. 이승원, "하지 무게부하 트레드밀 보행훈련이 뇌졸중 환자의 균형 및 보행에 미치는 효과", 특수교육재활과학연구, 50(1), pp.89~111 (2011), 특수교육재활과학연구소
  2. Ada, L., "A treadmill and overground walking program improves walking in persons residing in the community after stroke : a placebo-controlled, randomized trial", Arch Phys Med Rehabil, 84(10), pp.1486~1491 (2003)
  3. Barbeau, H., "The role of rehabilitation in the recovery of walking in the neurological population", Curr Opin Neurol, 14(6), pp.735~740 (2001)
  4. Bowden, M. G., "Anterior-posterior ground reaction forces as a measure of paretic leg contribution in hemiparetic walking", Stroke, 37(3), pp.872~876 (2006)
  5. Carr, J. H., "Neurological rehabilitation: optimizing motor performance" (1998), Butterworth-Heinemann
  6. Chen, C. L., "Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery", Am J Phys Med Rehabil, 82(12), pp.925~935 (2003)
  7. Chen, G., "Gait differences between individuals with post-stroke hemiparesis and non-disabled controls at matched speeds", Gait Posture, 22(1), pp.51~56 (2005)
  8. Daly, J. J., "Recovery of coordinated gait : randomized controlled stroke trial of functional electrical stimulation(FES)versus no FES, with weight-supported treadmill and over-ground training", Neurorehabil Neural Repair, 25(7), pp.588~596 (2011)
  9. Dean, C. M., "Task-related circuit training improves performance of locomotor tasks in chronic stroke : a randomized, controlled pilot trial", Arch Phys Med Rehabil, 81(4), pp.409~417 (2000)
  10. Dickstein, R., "Rehabilitation of gait speed after stroke : a critical review of intervention approaches", Neurorehabil Neural Repair, 22(6), pp.649~660 (2008)
  11. Dobkin, B. H., "An Overview of Treadmill Locomotor Training with Partial Body Weight Support : A Neurophysiologically Sound Approach Whose Time Has Come for Randomized Clinical Trials", Neurorehabil Neural Repair, 13(3), pp.157~165 (1999)
  12. Granat, M. H., "Peroneal stimulator; evaluation for the correction of spastic drop foot in hemiplegia", Arch Phys Med Rehabil, 77(1), pp.19~24 (1996)
  13. Harris-Love, M. L., "Hemiparetic gait parameters in overground versus treadmill walking", Neurorehabil Neural Repair, 15(2), pp.105~112 (2001)
  14. Hase, K., "Effects of therapeutic gait training using a prosthesis and a treadmill for ambulatory patients with hemiparesis", Arch Phys Med Rehabil, 92(12), pp.1961~1966 (2011)
  15. Hausdorff, J. M., "Effects of a new radio frequency-controlled neuroprosthesis on gait symmetry and rhythmicity in patients with chronic hemiparesis", Am J Phys Med Rehabil, 87(1), pp.4~13 (2008)
  16. Hesse, S., "Restoration of gait by combined treadmill training and multichannel electrical stimulation in non-ambulatory hemiparetic patients", Scand J Rehabil Med, 27(4), pp.199~204 (1995)
  17. Kesar, T. M., "Functional electrical stimulation of ankle plantarflexor and dorsiflexor muscles : effects on poststroke gait", Stroke, 40(12), pp.3821~3827 (2009)
  18. Kesar, T. M., "Combined effects of fast treadmill walking and functional electrical stimulation on post-stroke gait", Gait Posture, 33(2), pp.309~313 (2011)
  19. Kleim, J. A., "Synaptogenesis and Fos expression in the motor cortex of the adult rat after motor skill learning", J Neurosci, 16(14), pp.4529~4535 (1996)
  20. Kottink, A. I., "Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop : a randomized controlled trial", Phys Ther, 88(4), pp.437~448 (2008)
  21. Lau, K. W., "Speed-dependent treadmill training is effective to improve gait and balance performance in patients with sub-acute stroke", J Rehabil Med, 43(8), pp.709~713 (2011)
  22. Lindquist, A. R., "Gait training combining partial body-weight support, a treadmill, and functional electrical stimulation : effects on poststroke gait", Phys Ther, 87(9), pp.1144~1154 (2007)
  23. McCain, K. J., "Locomotor treadmill training with partial body-weight support before overground gait in adults with acute stroke : a pilot study", Arch Phys Med Rehabil, 89(4), pp.684~691 (2008)
  24. Moore, J. L., "Locomotor training improves daily stepping activity and gait efficiency in individuals poststroke who have reached a"plateau"in recovery", Stroke, 41(1), pp.129~135 (2010)
  25. Nelson Wong, E., "Increased fall risk is associated with elevated co-contraction about the ankle during static balance challenges in older adults", Eur J Appl Physiol, 112(4), pp.1379~1389 (2012)
  26. Nilsson, L., "Walking training of patients with hemiparesis at an early stage after stroke : a comparison of walking training on a treadmill with body weight support and walking training on the ground", Clin Rehabil, 15(5), pp.515~527 (2001)
  27. Page, S. J., "Mental practice in chronic stroke : results of a randomized, placebo-controlled trial", Stroke, 38(4), pp.1293~1297 (2007)
  28. Patterson, S. L., "Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke : a preliminary report", J Rehabil Res Dev, 45(2), pp.221~228 (2008)
  29. Pohl, M., "Speed-dependent treadmill training in ambulatory hemiparetic stroke patients : a randomized controlled trial", Stroke, 33(2), pp.553~558 (2002)
  30. Rhea, C. K., "Gait dynamics following variable and constant speed gait training in individuals with chronic stroke", Gait Posture, 36(2), pp.332~334 (2012)
  31. Rushton, D. N., "Functional Electrical Stimulation and rehabilitation-an hypothesis", Med Eng Phys, 25(1), pp.75~78 (2003)
  32. Salbach, N. M., "A task-orientated intervention enhances walking distance and speed in the first year post stroke : a randomized controlled trial", Clin Rehabil, 18(5), pp.509~519 (2004)
  33. Sabut, S. K., "Functional electrical stimulation of dorsiflexor muscle : effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients", NeuroRehabilitation, 29(4), pp.393~400 (2011)
  34. Sheffler, L. R., "Peroneal nerve stimulation versus an ankle foot orthosis for correction of footdrop in stroke : impact on functional ambulation", Neurorehabil Neural Repair, 20(3), pp.355~360 (2006)
  35. Sullivan, K. J., "Step training with body weight support : effect of treadmill speed and practice paradigms on poststroke locomotor recovery", Arch Phys Med Rehabil, 83(5), pp.683~691 (2002)
  36. Tong, R. K., "Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke : a randomized controlled trial", Arch Phys Med Rehabil, 87(10), pp.1298~1304 (2006)
  37. van Swigchem, R., "Near-Normal Gait Pattern With Peroneal Electrical Stimulation as a Neuroprosthesis in the Chronic Phase of Stroke : A Case Report", Arch Phys Med Rehabil, 92(2), pp.320~324 (2011)
  38. Visintin, M., "The effects of body weight support on the locomotor pattern of spastic paretic patients", Can J Neurol Sci, 16(3), pp.315~325 (1989)
  39. Weerdesteyn, V., "Falls in individuals with stroke", J Rehabil Res Dev, 45(8), pp.1195~1213 (2008)

관련 논문AI추천

하지 무게부하 트레드밀 보행훈련이 뇌졸중 환자의 균형 및 보행에 미치는 효과이승원, 이형석특수교육재활과학연구소 · 특수교육재활과학연구2011 · 제50권 제1호전동식 보행 훈련이 만성 뇌졸중 환자의 보행과 이동성 및 동적 균형 능력에 미치는 효과박창식, 안승헌특수교육재활과학연구소 · 특수교육재활과학연구2012 · 제51권 제4호지역사회 보행 훈련이 뇌졸중 환자의 하지 근활성도 및 동적 균형 능력, 보행 척도에 미치는 효과지상구, 차현규특수교육재활과학연구소 · 특수교육재활과학연구2012 · 제51권 제4호이동훈련을 병행한 기능강화훈련이 뇌졸중환자의 하지근력, 균형 및 보행에 미치는 효과송창호, 신원섭, 이은정특수교육재활과학연구소 · 특수교육재활과학연구2010 · 제49권 제3호장애물 통과 트레드밀 보행훈련이 뇌졸중 환자의 보행기능에 미치는 효과김현숙, 정연규, 정연재한국전문물리치료학회 · 한국전문물리치료학회지2013 · 제20권 제3호기능적 전기자극을 병행한 거울치료가 만성 뇌졸중 환자의 균형 및 보행능력에 미치는 영향에 관한 융합적 연구김경훈, 김동훈한국융합학회 · 한국융합학회논문지2018 · 제9권 제10호

이 간행물의 다른 논문 (18건)

아급성기 뇌졸중 환자들의 낙상 예측을 위한 modified Postural Assessment Scale for Stroke와 Berg Balance Scale의 타당도박창식pp. 1-18학교현장실습을 통한 예비 특수교사의 교직 적성 및 인성 변화 탐색이형하, 권충훈pp. 19-37발달장애학생의 미래 성인기 자립생활을 위한 학령기 중심의 특수교육학 연구과제 고찰도명애, 김영준pp. 39-68척수장애인의 신체활동 참여에 영향을 미치는 요인김춘종, 송호준pp. 69-86평생교육기관 종사자의 장애인에 대한 은유(metaphor) 분석서보순, 안성우pp. 87-109
원문 보기