선택한 단어 수는 입니다.
최소 단어 이상 선택하여야 합니다.
최소 단어 이상 선택하여야 합니다.
선택한 단어 수는 30입니다.
최대 10 단어까지만 선택 가능합니다.
최대 10 단어까지만 선택 가능합니다.
가설 설정
- We hypothesized that there would be differences between PSITT group and non-PSITT(CPT) group in the % gait cycle of single support phase, in the gait symmetry of single support(support phase in affected side/support phase in non-affected side) and swing phase(swing phase in affected side/swing phase in non-affected side), and in the displacement of COP after 8 weeks treadmill training.
제안 방법
- All subjects were evaluated before commencement of training and again at the completion of the 8-week training period. The outcome variables(gait cycle, gait symmetry, and foot pressure) were measured using the F-scan(Foot-scan, ver.
- Eligible subjects had to be at least 12 weeks from their first supratentorial stroke. Further inclusion criteria included: (1) ambulatory, all of them were able to walk without personal assistance (functional ambulation categories=3), (2) no evidence of heart failure, absence of ischemia or during exercise, appropriate rise in systolic blood pressure during exercise, and the absence of non-sustained or sustained ventricular tachycardia, (3) no other orthopedics or neurological diseases impairing mobility, and (4) able to understand at least simple instructions and the meaning of the study. The average age of the group was 55.
- The 20 subjects were randomized into one of two groups: the experimental group(PSITT, n=10), and the control group(non-PSITT, n=10) by block randomization on the basis of the initial time required to walk 45 meters without assistance(Table 1). The experimental group received gait training on a treadmill while full weight bearing on their lower extremities for 8 weeks at a frequency of three times a week(20 minutes duration), and also received the conventional physical therapy for 20 minutes, three times a week.
- The 20 subjects were randomized into one of two groups: the experimental group(PSITT, n=10), and the control group(non-PSITT, n=10) by block randomization on the basis of the initial time required to walk 45 meters without assistance(Table 1). The experimental group received gait training on a treadmill while full weight bearing on their lower extremities for 8 weeks at a frequency of three times a week(20 minutes duration), and also received the conventional physical therapy for 20 minutes, three times a week. The conventional physical therapy following the Neurodevelopmental or 'Bobath'(NDT) concept, included gait-preparatory maneuver’s while sitting and standing and the practice of gait itself either on the floor or on the stairs.
- The purpose of the present study was to determine if there was a difference in the gait cycle, gait symmetry, and foot pressure of Hemiplegia patients with and without 8 weeks PSITT(progressive speed increase treadmill ambulation training) in order to evaluate the effectiveness of the PSITT program.
- The strategy focused on a straight trunk and limb alignment with proper weight shift and weight bearing onto the Hemiplegia limb during the loading phases of gait, as well as stepping to advance the limb forward. Training programs are shown in Table 2.
대상 데이터
- There were two main limitations of our research design. First, only 20 hemiplegia patients in the Korean National Rehabilitation Center were used in this study. Second, because the investigators collecting the data were aware of group membership of the participants, our expectations may have influenced their performance.
데이터처리
- A paired t-test was used to determine differences in the change of outcome variables(gait cycle, gait symmetry, and foot pressure) within each group during the training period. An independent t-test was used to determine differences of mean in the outcome variables between two groups(experimental and control group).
- A paired t-test was used to determine differences in the change of outcome variables(gait cycle, gait symmetry, and foot pressure) within each group during the training period. An independent t-test was used to determine differences of mean in the outcome variables between two groups(experimental and control group). For all tests, and α-level of 5% was assumed.
성능/효과
- The three hypotheses that were supported were that there would be differences between PSITT group and non-PSITT(CPT) group in the % gait cycle of double support Ⅰ phase and double support Ⅱ phase, single support phase and the gait symmetry in single support phase that there would be differences between PSITT group and non-PSITT(CPT) group in the displacement of COP after 8 weeks of treadmill training. The hypothesis that was not supported was that there would be differences between PSITT group and non-PSITT(CPT) group in the gait symmetry of swing phase after 8 weeks treadmill training. Instead, we found that the gait symmetry in swing phase increased significantly, but the fait symmetry in swing phase decreased significantly in the PSITT group(p<.
- We found support for 3 of our 3 hypotheses. The three hypotheses that were supported were that there would be differences between PSITT group and non-PSITT(CPT) group in the % gait cycle of double support Ⅰ phase and double support Ⅱ phase, single support phase and the gait symmetry in single support phase that there would be differences between PSITT group and non-PSITT(CPT) group in the displacement of COP after 8 weeks of treadmill training. The hypothesis that was not supported was that there would be differences between PSITT group and non-PSITT(CPT) group in the gait symmetry of swing phase after 8 weeks treadmill training.
- This study demonstrates that gait therapy with the PSITT is an effective approach because it results in better gait ability(normal gait patten, gait symmetry, larger supporting phase in affected side and enlargement of step length) in ambulatory hemiplegia patients in comparison with the CPT(Bobath of PNF). However, the timing, intensity, and duration of the PSITT training, as well as its long-term effects on other areas of physical performance and fitness, require further investigation in more rigorous, randomized controlled studies.
- We showed herein that the 8 weeks PSITT(progressive speed increase treadmill ambulation training) program decreased the % cycle values of double support Ⅰphase(EG: 6.22±3.34 versus CG: 2.29±2.45; p<.05), double support Ⅱ phase(EG: 7.57±3.89 versus CG: 2.35±2.23; p<.01) of the PSITT group significantly(p<.05), and the % cycle of single support phase at affected side increased significantly in both groups(EG:-11.55±2.65 versus CG: 4.90±1.94; p<.01).
후속연구
- Second, because the investigators collecting the data were aware of group membership of the participants, our expectations may have influenced their performance. Further research is needed to continue perfecting this strategy. It is important to investigate “What is the most effective timing, intensity, and duration of the PSITT training?”, and “What is PSITT training's long-term effects on other areas of physical performance and fitness?”
- This study demonstrates that gait therapy with the PSITT is an effective approach because it results in better gait ability(normal gait patten, gait symmetry, larger supporting phase in affected side and enlargement of step length) in ambulatory hemiplegia patients in comparison with the CPT(Bobath of PNF). However, the timing, intensity, and duration of the PSITT training, as well as its long-term effects on other areas of physical performance and fitness, require further investigation in more rigorous, randomized controlled studies.
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