[논문]Effects of Underwater Treadmill Gait Training on Gait, Balance, and Pulmonary Function in Stroke Patients

Yang, Ho-june; Choi, Jong-duk

doi:10.12674/ptk.2015.22.4.034

Effects of Underwater Treadmill Gait Training on Gait, Balance, and Pulmonary Function in Stroke Patients 원문보기

한국전문물리치료학회지 = Physical Therapy Korea, v.22 no.4, 2015년, pp.34 - 43

Yang, Ho-june (Dept. of Physical Therapy, The Graduate School, Daejeon University) , Choi, Jong-duk (Dept. of Physical Therapy, College of Health & Medical Science, Daejeon University)

Abstract ▼ AI-Helper

The purpose of this study was to compare the effects of underwater treadmill gait training (UTGT) and overground treadmill gait training (OTGT) on the gait, balance ability and pulmonary function of stroke patients. Twenty subjects were recruited for this study. The subjects were randomly assigned to two groups: UTGT ($n_1$=10) and OTGT ($n_2$=10). The 10 m walk test (10 MWT), Berg Balance Scale, Timed Up and Go (TUG) test, center of pressure, pulmonary function of forced vital capacity (FVC), forced expiratory volume after 1 sec (FEV1) and FEV1/FVC were measured before and after 4 weeks of training. Both groups undertook the gait training for 30 min a day, 3 times a week, for 4 weeks, and rating of perceived exertion of the groups were measured and compared. All the studied variables were significantly improved in both groups (p.05). There was significant between-group difference in all of the variables, except in the 10 MWT (p>.05). These findings suggest that UTGT is more effective than OTGT in improving the balance and pulmonary functions of stroke patients.

주제어

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가설 설정

In addition, earlier studies had used velocity-based indicators which were objective and did not consider subjective issues, such as a patient’s psychological stability or the environment. In the our study, we hypothesized that UTGT would be more effective than OTGT in improving the gait, balance, and pulmonary function of stroke patients. To test this hypothesis, we examined differences in the effects of UTGT and OTGT on stroke patients’ balance, gaits, and pulmonary functions at the same exercise intensity according to the patients’ RPE scores.

제안 방법

The subjects were randomly assigned to the experimental group (n1=10, UTGT group) and the control group (n2=10, OTGT group). Both groups underwent the interventions for 30 min per time, 3 times per week, for 4 weeks. An initial assessment was conducted before the intervention, and a final assessment was conducted 4 weeks.
Timed Up and Go (TUG) tests were conducted to assess the patients’ dynamic balance and gait ability. The assessment method consists of standing, walking 3 m, and returning to sit again. TUG test is usefully used for stroke patients with lower extremity disorders because the measuring method is not complicated and has been reported as having high validity and reliability (intra-class coefficient=.
The inclusion criteria were subjects with heights in the range of 150∼175 ㎝ who could independently walk for at least 10 m using a walking aid or under the supervision of a therapist, a score of less than 45 points on the Berg Balance Scale (BBS), no musculoskeletal disease or other neurological disease, and a score of 24 points or higher on the Korean version of Mini-Mental Status Examination for the measurement of RPE score according to the Borg scale.
The subjects were randomly assigned to the experimental group (n1=10, UTGT group) and the control group (n2=10, OTGT group). Both groups underwent the interventions for 30 min per time, 3 times per week, for 4 weeks.
The current study findings provide clinical evidence that UTGT is more effective to improve the gait, balance and pulmonary ability in stroke patients. The subjects were underwent UTGT and OTGT for 30 min per time, 3 times per week, for 4 weeks. The results show that UTGT results in improved balance ability and pulmonary functions then OTGT.
To test this hypothesis, we examined differences in the effects of UTGT and OTGT on stroke patients’ balance, gaits, and pulmonary functions at the same exercise intensity according to the patients’ RPE scores.

대상 데이터

The study consisted of 20 stroke patients with gait disturbances and poor respiratory function in D Hospital in Daejeon. All of the protocols used in this study were approved by the University of Daejeon.

데이터처리

The intergroup normality was tested, and the data did not satisfy the required normality. Therefore, non-parametric tests were conducted. Intergroup homogeneity was verified through chi-squared tests and the Mann-Whitney U test.

성능/효과

We can conclude that UTGT is more effective than OTGT in improving balance ability and pulmonary functions. Based on the findings of the present study, various physical characteristics of water such as buoyancy, hydrostatic pressure, and viscosity may provide resist to respiratory muscles, stability to body sway and efficient exercise with reducing fear of falling in the stroke patients. Our results suggest that UTGT should included in be the exercise programs of stroke patients.
In the our study, although UTGT was more effective than OTGT in improving balance ability, but its effects on gait ability were insignificant. The effects of UTGT and OTGT on stroke patients, the gait and balance ability were significantly more improved in the UTGT group (Kim et al, 2011).
In the our study, the gait ability, balance ability, and pulmonary functions of both the UTGT and OTGT groups improved, but the balance ability and pulmonary functions were better in the UTGT group. The gait ability was the same in both groups.
The gait ability was the same in both groups. The results of the gait ability, balance ability, and pulmonary functions of the two groups revealed that the UTGT was more effective than that of the OTGT with respect to improvements in balance ability and pulmonary functions but not in gait ability.
The subjects were underwent UTGT and OTGT for 30 min per time, 3 times per week, for 4 weeks. The results show that UTGT results in improved balance ability and pulmonary functions then OTGT. We can conclude that UTGT is more effective than OTGT in improving balance ability and pulmonary functions.

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