[논문]Effect of upper extremity coordination exercise during standing on the paretic side on balance, gait ability and activities of daily living in persons with stroke

Kim, Ju-O; Lee, Byoung-Hee

doi:10.14474/ptrs.2017.6.2.53

Effect of upper extremity coordination exercise during standing on the paretic side on balance, gait ability and activities of daily living in persons with stroke 원문보기

Physical therapy rehabilitation science, v.6 no.2, 2017년, pp.53 - 58

Kim, Ju-O (Department of Physical Therapy, Bethesda Hospital) , Lee, Byoung-Hee (Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University)

Abstract ▼ AI-Helper

Objective: The purpose of this study was to determine the effect of upper extremity coordination exercise (UECE) during standing on the paretic side on balance, gait ability and activities of daily living (ADL) in persons with stroke. Design: A randomized controlled trial. Methods: A total of 27 patients with hemiplegic diagnosis after stroke were divided into two groups. Fourteen patients were in the study group and 13 patients were in the control group. The study group received conventional physical therapy and UECE during standing on the paretic side. The control group received conventional physical therapy and simple upper extremity exercise (SUEE). Subjects in both groups were given upper extremity training for 30 minutes per day, five times a week for 4 weeks. Initial evaluation was performed before treatment and reevaluated 4 weeks later to compare the changes of balance, gait ability and ADL (Korean version of modified Barthel index, K-MBI). Results: Both groups showed a significant effect for balance, gait ability and ADL (p<0.05). In the Independent t-test, between both groups showed a significant effect for balance and gait ability except ADL (p<0.05). Conclusions: In this paper, we investigated the changes in balance, walking, and ADL through UECE. We found significant changes in the study group and the control group. Results of the present study indicated that UECE during standing on the paretic side for 4 weeks had an effect on balance, gait ability and ADL (K-MBI) in persons with hemiplegia after stroke.

주제어

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문제 정의

07 cm. An important finding of this study was a statistically significant improvement in the function of the paretic upper extremity after the UECE. This means that balance ability of the study group is improved.
In this paper, we investigated the changes in balance, walking, and ADL through UECE. We found significant changes in the study group and the control group.
However, the effects of UECE during standing on a paretic side on functional movements of hemiplegic patients after stroke remain unclear. Therefore, the objective of this study was to determine the effects of UECE during standing on a paretic side on activity of daily living, balance and gait ability of stroke patients.
The effects of upper extremity co-ordination exercise (UECE) have been demonstrated in previous studies [3,9,12]. These studies were conducted with walking or meaningless upper limb movement. However, the effects of UECE during standing on a paretic side on functional movements of hemiplegic patients after stroke remain unclear.

제안 방법

All operations are simple, without special constraints, and allow compensation on the other side. All the participants in both groups received 30 minutes per sessions of conventional physical therapy for 5 sessions per week for 4 weeks. The main reasons for 3 drop-outs from the study were a personal issue.
Previous studies evaluated functional changes on ADL [10]. In this paper, we investigated the changes in ADL through balance enhancement due to changes in upper limb function, and found significant changes in the study group using K-MBI.
To assess the general characteristics of the subjects, descriptive statistics was used. Paired t-test used to define the differences between pretest and posttest in each group, and independent t-test was used to define the differences between study group and control groups after 4 weeks of training. Statistical significance was considered when p-value was less than 0.
27 participants were randomly assigned with computer lottery study group (UECE; n=14) and control group (simple upper extremity exercise [SUEE]; n=13). The UECE applied in this study was a revised version of that used in a previous study [17,18]. Generally, upper limb exercise methods did not emphasize the stabilization of the shoulder, and the compensatory action of the opposite side occurred.
, Armonk, NY, USA). To assess the general characteristics of the subjects, descriptive statistics was used. Paired t-test used to define the differences between pretest and posttest in each group, and independent t-test was used to define the differences between study group and control groups after 4 weeks of training.

대상 데이터

This study was conducted at Bethesda Hospital. A total of 27 patients who were admitted to inpatient rehabilitation center were selected as the study group. The inclusion criteria were: those who have been diagnosed with hemiplegia for more than 6 months [13]; those who were able to respond properly from a sensory stimuli given by the examiner with over 24 points in mini mental state examination [14]; those who were able to carry out instructions given by verbal command [15]; those who were independent in ambulation with or without a walking aid [16]; and those who understood the content of study and agreed to participate actively (Figure 1).
This study was conducted at Bethesda Hospital. A total of 27 patients who were admitted to inpatient rehabilitation center were selected as the study group.

데이터처리

This study enrolled 27 patients, 14 patients in the study group and 13 patients in the control group, and analyzed intervention effects with both paired t-test and independent t-test. Results are presented in Table 1.

성능/효과

Results of the present study indicated that UECE during standing on a paretic side for 4 weeks had an effect on the Balance, gait ability and ADL (K-MBI) of hemiplegic patients after stroke.
The study group exhibited significantly greater improvement than the control group in the TUG (t=−0.571, p=0.023), FRTA (t=−0.222, p=0.031), and FRTN (t=−0.700, p=0.012), whereas no significant difference was found between the groups for the K-MBI score (t=1.297, p=0.081; Table 1).

후속연구

In future studies, more efficient research should be done to improve the balance, gait ability and activity of daily living of stroke patients by revising and supplementing the contents of this paper.

참고문헌 (29)

Trombly CA, Wu CY. Effect of rehabilitation tasks on organization of movement after stroke. Am J Occup Ther 1999;53: 333-44.

상세보기
Woodson C, Bandy WD, Curis D, Baldwin D. Relationship of isokinetic peak torque with work and power for ankle plantar flexion and dorsiflexion. J Orthop Sports Phys Ther 1995;22: 113-5.

상세보기
Stephenson JL, Lamontagne A, De Serres SJ. The coordination of upper and lower limb movements during gait in healthy and stroke individuals. Gait Posture 2009;29:11-6.

상세보기
Cromwell RL, Aadland-Monahan TK, Nelson AT, Stern-Sylvestre SM, Seder B. Sagittal plane analysis of head, neck, and trunk kinematics and electromyographic activity during locomotion. J Orthop Sports Phys Ther 2001;31:255-62.

상세보기
Winter DA, Patla AE, Frank JS, Walt SE. Biomechanical walking pattern changes in the fit and healthy elderly. Phys Ther 1990;70:340-7.

상세보기
Selles RW, Li X, Lin F, Chung SG, Roth EJ, Zhang LQ. Feedback-controlled and programmed stretching of the ankle plantarflexors and dorsiflexors in stroke: effects of a 4-week intervention program. Arch Phys Med Rehabil 2005;86:2330-6.

상세보기
Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Stroke. Neurologic and functional recovery the Copenhagen Stroke Study. Phys Med Rehabil Clin N Am 1999;10:887-906.

상세보기
Hendrickson J, Patterson KK, Inness EL, McIlroy WE, Mansfield A. Relationship between asymmetry of quiet standing balance control and walking post-stroke. Gait Posture 2014;39: 177-81.

상세보기
Scena S, Steindler R, Ceci M, Zuccaro SM, Carmeli E. Computerized functional reach test to measure balance stability in elderly patients with neurological disorders. J Clin Med Res 2016; 8:715-20.

상세보기
Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel index for stroke rehabilitation. J Clin Epidemiol 1989; 42:703-9.

상세보기
Jang SH, Rah UW, Kim YC, Park YS, Jo D, Kim YC; Korean Academy of Medical Sciences. Development of Korean academy of medical sciences guideline-rating the impairment in pain. J Korean Med Sci 2009;24 Suppl 2:S330-7.

상세보기
Heller A, Wade DT, Wood VA, Sunderland A, Hewer RL, Ward E. Arm function after stroke: measurement and recovery over the first three months. J Neurol Neurosurg Psychiatry 1987;50:714-9.

상세보기
Patterson SL, Forrester LW, Rodgers MM, Ryan AS, Ivey FM, Sorkin JD, et al. Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil 2007;88: 115-9.

상세보기
Dunsky A, Dickstein R, Marcovitz E, Levy S, Deutsch JE. Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis. Arch Phys Med Rehabil 2008;89:1580-8.

상세보기
Lin JJ, Hanten WP, Olson SL, Roddey TS, Soto-quijano DA, Lim HK, et al. Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol 2005;15: 576-86.

상세보기
Pang MY, Eng JJ, Dawson AS. Relationship between ambulatory capacity and cardiorespiratory fitness in chronic stroke: influence of stroke-specific impairments. Chest 2005;127:495-501.

상세보기
Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother 2006;52:241-8.

상세보기
Awad A, Shaker H, Shendy W, Fahmy M. Effect of shoulder girdle strengthening on trunk alignment in patients with stroke. J Phys Ther Sci 2015;27:2195-200.

상세보기
Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8.

상세보기
Horstmann S, Koziol JA, Martinez-Torres F, Nagel S, Gardner H, Wagner S. Sonographic monitoring of mass effect in stroke patients treated with hypothermia. Correlation with intracranial pressure and matrix metalloproteinase 2 and 9 expression. J Neurol Sci 2009;276:75-8.

상세보기
Park JH, Hwangbo G, Kim JS. The effect of treadmill-based incremental leg weight loading training on the balance of stroke patients. J Phys Ther Sci 2014;26:235-7.

상세보기
Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil 2002;83:1138-44.

상세보기
Jette AM. Toward a common language for function, disability, and health. Phys Ther 2006;86:726-34.

상세보기
Patterson SL, Rodgers MM, Macko RF, Forrester LW. Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke: a preliminary report. J Rehabil Res Dev 2008;45:221-8.

상세보기
Hill TR, Gjellesvik TI, Moen PM, Torhaug T, Fimland MS, Helgerud J, et al. Maximal strength training enhances strength and functional performance in chronic stroke survivors. Am J Phys Med Rehabil 2012;91:393-400.

상세보기
Oujamaa L, Relave I, Froger J, Mottet D, Pelissier JY. Rehabilitation of arm function after stroke. Literature review. Ann Phys Rehabil Med 2009;52:269-93.

상세보기
Nakayama H, Jorgensen HS, Raaschou HO, Olsen TS. Compensation in recovery of upper extremity function after stroke: the Copenhagen stroke study. Arch Phys Med Rehabil 1994;75: 852-7.

상세보기
Hsieh CL, Sheu CF, Hsueh IP, Wang CH. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke 2002;33:2626-30.

상세보기
Hardwick DD, Lang CE. Scapular and humeral movement patterns of people with stroke during range-of-motion exercises. J Neurol Phys Ther 2011;35:18-25.

상세보기

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