[논문]뇌졸중 환자의 운동공포증과 낙상공포 사이의 관계에 대한 융합 연구

조성배; 최원재; 정지혜; 박지유; 이승원

doi:10.15207/jkcs.2019.10.10.033

뇌졸중 환자의 운동공포증과 낙상공포 사이의 관계에 대한 융합 연구
Convergence Study on the Relationship between Kinesiophobia and Fear of Falling in Patients with Stroke 원문보기

한국융합학회논문지 = Journal of the Korea Convergence Society, v.10 no.10, 2019년, pp.33 - 41

조성배 (삼육대학교 대학원 물리치료학과) , 최원재 (삼육대학교 SMART 재활연구소) , 정지혜 (삼육대학교 대학원 물리치료학과) , 박지유 (삼육대학교 대학원 물리치료학과) , 이승원 (삼육대학교 SMART 재활연구소)

초록
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본 연구의 목적은 뇌졸중 환자의 운동공포증과 낙상공포 사이에 융합적 관계를 조사하는 것이다. 총 113명의 뇌졸중 환자가 본 연구에 참여하였다. 참여자는 재활병원 입원환자로 낙상 효능감 척도(FES), 운동공포증을 위한 번역된 탐파 척도(TSK-13), 및 활동-특이성 균형 자신감 척도(ABC)를 포함한 3가지 다른 설문지를 작성하도록 요청하였다. TSK-13과 FES는 약한 음의 상관관계를 보였고(r=-0.226), TSK-13과 ABC는 중등도 음의 상관관계가 나타났다(r=0.838). FES는 ABC와 비교했을 때 매우 강한 양의 상관관계가 나타났다(r=0.838). 낙상을 경험한 환자는 낙상을 경험하지 않은 환자보다 유의하게 낮은 FES와 ABC 점수를 보였다(p<0.05). 이 결과는 뇌졸중 환자가 경증 운동공포증을 가지고 있으며, 운동공포증은 낙상공포와 관련이 있음을 제시하고 있습니다. 앞으로 뇌졸중 재활에 있어 운동공포증의 평가가 필요할 것으로 사료된다.

Abstract ▼ AI-Helper

This study aimed to investigate the convergence relationship between kinesiophobia and fear of falling in patients with stroke. A total of 113 patients with stroke participated in this study. Participants underwent inpatient rehabilitation and completed surveys with three different questionnaires including the fall efficacy scale (FES), translated Tampa Scale for Kinesiophobia 13 (TSK-13), and activity-specific balance confidence scale (ABC). TSK-13 and FES showed weak negative correlation (r=-0.226), and TSK-13 and ABC showed moderate negative correlation (r=-0.300). FES had a very strong positive relationship compared with ABC (r=0.838). Faller showed significantly low FES and ABC scores compared with non-faller (p<0.05). These results present that patients with stroke had mild kinesiophobia, and kinesiophobia is related to fear of falling. It is necessary to evaluate kinesiophobia in stroke rehabilitation.

주제어

표/그림 (9)

표 Table 1. General characteristics of subjects
표 Table 2. The Internal Consistency and Test-retest Reliability
표 Table 3. Average scores of the scales
표 Table 4. TSK-13 severity levels
표 Table 5. Correlation coefficients of TSK-13, FES, and ABC
표 Table 6. Correlation coefficients of TSK-13, FES, and ABC in subjects with fall experience
표 Table 7. Correlation coefficients of TSK-13, FES, and ABC in subjects with pain
표 Table 8. Differences in means of TSK-13, FES, and ABC in subjects with fall experience
표 Table 9. Differences in means of TSK-13, FES, and ABC in subjects with pain

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문제 정의

(2015) reported that FOF avoidance behavior is a good predictor of return to community in individuals with stroke[8]. The study suggested that the multidimensional interventions involving physical, psychological, and behavioral factors are necessary for community reintegration of patients with stroke undergoing rehabilitation. However, the previous study did not include fear avoidance of pain or injury.
Although avoidance behaviors and pain have been proven to have a negative effect on rehabilitation, the evidence on the effects of kinesiophobia in patients with stroke was lack. Therefore, this study aimed to demonstrate the relationship between kinesiophobia and FOF in patients with stroke.
Therefore, this study aimed to investigate the relationship between kinesiophobia and FOF in patients with stroke. There were similarities in the avoidance behavior models of kinesiophobia[23] and FOF[24].
This was the first survey study designed to investigate the relationship between kinesiophobia and FOF in patients with stroke. This study may suggest that patients with stroke who experienced fall during rehabilitation had both kinesiophobia and FOF.

제안 방법

The general characteristics of participants who met the selection criteria were evaluated, and the participants completed 3 different questionnaires:fall efficacy scale (FES), the Korean version of Tampa Scale for Kinesiophobia 13 (TSK-13), and activity-specific balance confidence scale (ABC). TSK-13 was translated to the Korean language by a bilingual professor; then, it was checked for comprehensibility, adaptability, and validation by a committee that consisted of researchers, professors, and experienced physical therapists.
This study is a cross-sectional study, and volunteers were recruited from multi-hospitals. The survey was conducted from November to December 2016.

대상 데이터

The ABC is a self-report questionnaire that measures the individual’s own perceived level of balance confidence during common indoor and outdoor activities of daily living. The scale has 16 items with an 11-level score in each item, ranging from 0% (not confident) to 100% (fully confident and does not lose balance during the activity)[21].
This study is a cross-sectional study, and volunteers were recruited from multi-hospitals. The survey was conducted from November to December 2016. Patients with stroke who could understand the questionnaire items themselves and fill them out were included in the study.

데이터처리

Cronbach’s α was used to evaluate internal consistencies of TSK-13, FES, and ABC, where intraclass correlation coefficient was used in measuring the test-retest reliability of TSK-13.
Moreover, independent t-test was used to analyze differences between groups with and without fall experience, and between groups with and without pain. A statistical significance level was set 0.

성능/효과

In this study, relationship between kinesiophobia and FOF was estimated moderate (r between TSK-13 and ABC = -0.300). This result supports that of a previous study, which also investigated the relationship between kinesiophobia and FOF in patients with Parkinson’s disease[25].
814). To measure test-retest reliability of TSK-13, nine subjects were selected, and test-retest reliability of TSK-13 showed high with ICC of 0.854. Table 2.

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