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6 주간의 체간 유연성 운동이 만성 뇌졸중 환자의 균형과 보행, 낙상 위험도에 미치는 영향
Effects of 6 Week Thoracic Flexibility Exercise on Balance, Gait Parameters and Fall Risk in Patients with Chronic Stroke; A randomized controlled study 원문보기

한국산학기술학회논문지 = Journal of the Korea Academia-Industrial cooperation Society, v.21 no.6, 2020년, pp.498 - 507  

박동환 (경인의료재활센터병원) ,  이강성 (한서대학교 의료복지공학과)

초록
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본 연구는 만성 뇌졸중 환자를 대상으로 체간 유연성 운동이 앉은 자세 균형, 정적 균형, 보행 척도, 그리고 낙상 위험도에 어떠한 영향을 미치는지를 규명하고자 실시되었다. 만성 뇌졸중 참가자는 대조 그룹(12명)과 체간 유연성 운동 그룹(12명)으로 무작위로 배정되었다. 두 그룹 모두 표준 재활 치료 30분을 실시하였고, 체간 유연성 운동 그룹은 체간 유연성 운동을 일주일에 3번, 6주간 추가로 시행하였다. 모든 참가자는 체간 장애 척도, 정적 균형 능력, 보행 속도, 분당 보행 수, 그리고 낙상 위험도를 운동 전과 운동 종료 후에 평가하였다. 본 연구 결과에서 체간 유연성 운동 그룹은 대조 그룹과 비교하여 체간 장애 척도(t=-3.57, p=.002)와 보행 속도(t=-3.29, p=.003) 그리고 분당 보행 수(t=-2.77, p=.011)는 유의하게 증가하였고, 정적 균형 능력(t=5.37, p<.001)과 낙상 위험도(t=6.33, p<.001)는 유의하게 감소되었다. 또한, 체간 유연성 운동 그룹은 초기 평가와 비교하여 모든 평가 항목에서 유의하게 개선되었다(p<.05). 이상의 결과에서 6주간의 흉추 유연성 운동 후, 만성 뇌졸중 환자에게 있어 앉은 자세 균형 능력, 정적 균형 능력, 보행 척도, 그리고 낙상 위험도에서 긍정적인 효과가 나타났으며, 이후 다른 운동과 비교하여 효과를 검증하는 후속연구가 필요한 것으로 사료된다.

Abstract ▼ AI-Helper 아이콘AI-Helper

The purpose of this study was to examine the effects of thoracic flexibility exercise on sitting balance, static standing balance, gait parameters, and the fall risk of patients with chronic stroke. The participants were randomized into the control (n=12) and thoracic flexibility exercise groups (n=...

주제어

#Thoracic Flexibility Exercises   #Stroke Rehabilitation   #Postural Balance   #Gait Analysis   #Fall Risk  

표/그림 (4)

AI 본문요약
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제안 방법

  • A pilot test was performed on 6 volunteers to determine the number of chronic stroke patients required for this study. A power analysis was performed using G-power software (G-power software 3.
  • Baseline demographic variables were compared between the groups using an independent t-test for continuous data and the chi-square test of independence for categorical data. After the 6-week intervention, independent t-tests were used to compare differences between group means, and paired t-tests were used to compare within-group means. Statistical significance was set at p values of ɑ=.
  • The TIS score ranges from 0 to a maximum of 23 points, with a higher score indicating better trunk performance. For each test, a 2, 3, or 4 point ordinal scale was used. The reliability of the TIS was found to be 0.
  • 27 cm to collect foot placement data. For this study, the patients were instructed to stand in front of the gait board at a distance of 1 m, and then walk at a comfortable speed until they reached the end of the board. Measurement of gait parameters was repeated three times, and the mean value of three trials was computed.
  • [11]. The TFE group performed 3 times a week for 6 weeks at the same location under the guidance of the same physical therapist to ensure consistent performance of the protocol and the safety of all enrolled participants (Figure 1).
  • The participants individually performed the TFE (seated thoracic extension with foam roller and kneeling thoracic extension) training (Figure 2). The TFE performed two exercise programs for stroke patients 3 times a week for 6 weeks, 10 minutes a day. The steps for the seated thoracic extension with foam roller include the following [11]: the exercise was started by sitting in a high-back chair with a foam roller across the thoracic spine; the chin was pulled in, the spine straightened, and then the participant crossed their arms on their chest to maintain alignment; they then breathed in and extended back behind the chair.
  • The inclusion criteria were as follows: a diagnosis of hemiplegia due to hemorrhagic or ischemic stroke ≥6 months after onset to minimize the effects of natural recovery; an independent gait possible over 10 meters without assistive devices; a minimum score of 24 on the Korean Mini-Mental State Examination; and the ability to perform the exercises.
  • The recruitment period for this study was from November 1 to November 29, 2019, and was conducted on 24 chronic stroke patients who participated in the experiment from December 2, 2019, to January 31, 2020. The participant characteristics and outcome measures, specifically sitting balance, static standing balance, gait speed, cadence, and fall risk, were assessed on study day 1 and 1 day after 6 weeks of intervention, were measured by an examiner who was blinded to the grouping. Throughout the trial, all subjects underwent the same standard rehabilitation therapy for 30 minutes per session: the first 10 minutes of the active and passive range of motion exercises were allocated to the lower limb of the affected side, the next 10 minutes was spent on weight-bearing training during sitting and standing, and the final 10 minutes was allotted to walking.
  • The participants individually performed the TFE (seated thoracic extension with foam roller and kneeling thoracic extension) training (Figure 2). The TFE performed two exercise programs for stroke patients 3 times a week for 6 weeks, 10 minutes a day.
  • Thus, the purpose of this study was to examine the effects of a 6-week program of TFE on sitting balance, static standing balance, gait speed, cadence, and fall risk in patients with chronic stroke. The research hypothesis was that the TFE group would produce better improvements in sitting balance, static standing balance, gait speed, cadence, and fall risk than the control group in patients with chronic stroke.
  • This study examined the effects of the TFE with respect to sitting balance, static standing balance, gait speed, cadence, and fall risk in patients with chronic stroke. Our findings indicate that the TFE significantly improves TIS, static standing balance, gait speed, cadence, and fall risk compared to the control group.
  • This study used a randomized controlled trial with 2 groups. Participants were randomly assigned to either the TFE group (n=12) or the control group (n=12) group using the second generator (1 or 2, 1 indicating the control group and 2 indicating the TFE group) to generate random processing permutations from the online randomization program (http://www.
  • The participant characteristics and outcome measures, specifically sitting balance, static standing balance, gait speed, cadence, and fall risk, were assessed on study day 1 and 1 day after 6 weeks of intervention, were measured by an examiner who was blinded to the grouping. Throughout the trial, all subjects underwent the same standard rehabilitation therapy for 30 minutes per session: the first 10 minutes of the active and passive range of motion exercises were allocated to the lower limb of the affected side, the next 10 minutes was spent on weight-bearing training during sitting and standing, and the final 10 minutes was allotted to walking. After standard rehabilitation therapy, 10 minutes of rest was performed and a TFE group was performed an additional 10 minutes of treatment for TFE.
  • Although TFE improves balance and functional ability in individuals with low back pain, to date it appears that its usefulness in patients with chronic stroke has not been investigated. Thus, the purpose of this study was to examine the effects of a 6-week program of TFE on sitting balance, static standing balance, gait speed, cadence, and fall risk in patients with chronic stroke. The research hypothesis was that the TFE group would produce better improvements in sitting balance, static standing balance, gait speed, cadence, and fall risk than the control group in patients with chronic stroke.

대상 데이터

  • The results of the power analysis showed that this study required 6 patients per group. A total of 37 stroke patients were assessed for eligibility. Out of it, 13 patients were excluded for not meeting the inclusion criteria.
  • Gait speed and cadence were measured using the GAITRite system (CIR Systems, Easton, PA, USA). The GAITRite includes a 366 cm long, 61 cm wide electronic gait mat in which 13,824 sensors are vertically arranged at intervals of 1.27 cm to collect foot placement data. For this study, the patients were instructed to stand in front of the gait board at a distance of 1 m, and then walk at a comfortable speed until they reached the end of the board.
  • Out of it, 13 patients were excluded for not meeting the inclusion criteria. The present study involved 24 patients with chronic stroke from Y hospital, Seoul, and was randomly assigned to two groups (control group= 12, TFE group= 12). The inclusion criteria were as follows: a diagnosis of hemiplegia due to hemorrhagic or ischemic stroke ≥6 months after onset to minimize the effects of natural recovery; an independent gait possible over 10 meters without assistive devices; a minimum score of 24 on the Korean Mini-Mental State Examination; and the ability to perform the exercises.
  • com). The recruitment period for this study was from November 1 to November 29, 2019, and was conducted on 24 chronic stroke patients who participated in the experiment from December 2, 2019, to January 31, 2020. The participant characteristics and outcome measures, specifically sitting balance, static standing balance, gait speed, cadence, and fall risk, were assessed on study day 1 and 1 day after 6 weeks of intervention, were measured by an examiner who was blinded to the grouping.
  • 05. The results of the power analysis showed that this study required 6 patients per group. A total of 37 stroke patients were assessed for eligibility.

데이터처리

  • Normality was examined using the one-sample Kolmogorov-Smirnov test. Baseline demographic variables were compared between the groups using an independent t-test for continuous data and the chi-square test of independence for categorical data. After the 6-week intervention, independent t-tests were used to compare differences between group means, and paired t-tests were used to compare within-group means.

이론/모형

  • The PASW Statistics 18 software suite (SPSS, Chicago, IL, USA) was used for all statistical analyses. Normality was examined using the one-sample Kolmogorov-Smirnov test. Baseline demographic variables were compared between the groups using an independent t-test for continuous data and the chi-square test of independence for categorical data.
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