Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지

The Relation Between the Fugl-Meyer Motor Assessment and Walking and Balance Ability in Stroke Patient

뇌졸중 환자에서 기능평가와 보행 및 균형과의 관련성

  • Bae, Won-Sik (Department of Physical Therapy, Sanggye Paik Hospital) ;
  • Lee, Geon-Choel (Department of Physical Therapy, Kyoungnam College University of Information & Technology) ;
  • Nam, Hyoung-Chun (Department of Physical Therapy, Gyeongbuk College)
  • 배원식 (상계백병원 물리치료실) ;
  • 이건철 (경남정보대학 물리치료과) ;
  • 남형천 (경북전문대학 물리치료과)
  • Received : 2011.01.07
  • Accepted : 2011.02.06
  • Published : 2011.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : The purposes of this study were to find correlations among Fugl-Meyer Assessment Scale, walking velocity, walking asymmetry and balance ability. Methods : The study sample consisted of 50 stroke patients referred to the Department of Rehabilitation Medicine in the Sanggye Paik, Ilsan Paik, Seoul Paik, and Dobong Hospital. All subjects were ambulatory with or without an assistive device. All participants were assessed on Fugl-Meyer Assessment scale and walking velocity, walking asymmetry. The data were analyzed using independent t-test, ANOVA, and multiple regression. Results : The results revealed that upper extremity coordination, balance and pain items of Fugl-Meyer Assessment scale were significantly correlated with walking velocity and upper extremity and upper extremity motor and balance items of Fugl-Meyer Assessment scale were significantly correlated with walking asymmetry. Fugl-Meyer Assessment scale was not significantly correlated with Static Balance Index, Dynamic Balance Index and Weight Distribution Asymmetry Index. Their power of explanation regarding comfortable walking velocity and comfortable walking asymmetry were 60.3%, 42.5% respectively. Conclusion : These results showed that Fugl-Meyer Assessment scale is significantly correlated with walking velocity, asymmetry and not significantly correlated with balance ability. Therefore Fugl-Meyer Assessment scale is an appropriate assessment tool to predict walking ability of patients with stroke. Futher study about walking velocity and asymmetry by change of Fugl-Meyer Assessment scale is needed using a longitudinal study design.

Keywords

References

  1. 김병조, 이현옥, 안소윤. 노력성 호흡운동에 의한 편마비환자의 보행 비대칭율 개선. 대한물리치료학회지. 2004;16(4):633-43.
  2. 김유철, 박미연, 장순자 등. 뇌졸중 환자의 보행에 영향을 미치는 인자. 대한재활의학회지. 1992;16(4):443-51.
  3. 김진국. 급성 뇌경색 환자의 기능회복에 관한 예비적 연구. 대한신경과학회지. 1992;10(3):298-307.
  4. 안승헌, 박창식, 이현주. 뇌졸중 환자의 균형과 기능 수행 및 보행검사를 위한 평가도구의 비교: BBS, TUG, Fugl-Meyer, MAS-G, C-MGS, MBI. 한국전문물리치료학회지. 2007;14(3):64-71.
  5. 이승원, 신원섭, 인태성 등. 부하자극이 만성뇌졸중환자의 정적 균형, 근육활성도에 미치는 효과. 대한물리치료학회지. 2009;21(1):19-25.
  6. 이영정, 권오윤, 이충휘 등. 뇌졸중 환자에서 Fugl-Meyer 평가척도와 보행속도, Timed Up & Go 검사와의 상관관계. 한국전문물리치료학회지. 2004;11(1):1-17.
  7. 정한신, 윤정규. 편마비 환자의 골반운동이 균형능력에 미치는 영향. 한국전문물리치료학회지. 2006;13(3):41-8.
  8. 통계청. 사망원인통계. 통계청. 2006.
  9. Anderson TP. Rehabilitation of patient with complete stroke. In F. J. Kottke, & J. F. Lehmann (Eds.). Krusen' handbook of physical medicine and rehabilitation. 4thEd. Philadelphia: W.B. Saunder's Company. 1990
  10. Bohannon RW. Walking after stroke: comfortable versus maximum safe speed. Int J Rehabil Res. 1992;15(3):246-8. https://doi.org/10.1097/00004356-199209000-00009
  11. Carr JH, Shepherd RB, Nordholm L et al. Investigation of a new motor assessment scale for stroke patients. Phys Ther. 1985;65(2):175-80. https://doi.org/10.1093/ptj/65.2.175
  12. Dettmann MA, Linder MT, Sepic SB. Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient. Am J Phys Med. 1987;66(2):77-90.
  13. Friedman PJ. Spatial neglect in acute stroke: the line bisection test. Scand J Rehabil Med. 1990;22(2):101-6.
  14. Fugl-Meyer AR, Jaasko L, Leyman I et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.
  15. Garland SJ, Ivanova TD, Willems DA et al. Recovery of standing balance and functional mobility after stroke. Arch Phys Med Rehabil. 2003;84(12):1753-9. https://doi.org/10.1016/j.apmr.2003.03.002
  16. Giulliani C, Genova PA, Purser KE et al. Limb trajectory in non-disabled subjects under two conditions of external constraint compared with non-paretic limb of subjects with hemiparesis. Neuroscience Abstracts. 1993;19:990.
  17. Gladstone DJ, Black SE, Danells CJ. The Fugl-Meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair. 2002;16(3):232-40. https://doi.org/10.1177/154596802401105171
  18. Goldie PA, Evans OM, Matyas TA. Deficit and change in gait velocity during rehabilitation after Stroke. Arch Phys Med Rehabil. 1996;77(10): 1074-82. https://doi.org/10.1016/S0003-9993(96)90072-6
  19. Guralnik JM, Balfour JL, Ferrucci L et al. Progressive versus catastrophic loss of the ability to walk: implications for the prevention of mobility loss. J Am Geriatr Soc. 2001;49(11):1463-70. https://doi.org/10.1046/j.1532-5415.2001.4911238.x
  20. Harrt M, Geurts AC, Huidekoper SC et al. Recovery of standing balance in post acute stroke patients: A rehabilitation cohort study. Arch Phys Med Rehabil. 2004;85(6) :886-95. https://doi.org/10.1016/j.apmr.2003.05.012
  21. Hesse S, Bardeleben A, Chaler J et al. Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. Arch Phys Med Rehabil. 2001;82(11):1547-50. https://doi.org/10.1053/apmr.2001.26607
  22. Hsu AL, Jan MH, Tang PF. Analysis of Impairments Influencing Gait Velocity and Asymmetry of Hemiplegic Patients After Mild to Moderate Stroke. Arch Phys Med Rehabil. 2003;84(8):1185-93. https://doi.org/10.1016/S0003-9993(03)00030-3
  23. Kollen B, Kwakkel G, Lindeman E. Hemiplegic gait after stroke: Is measurement of maximum speed required? Arch Phys Med Rehabil. 2006;87(3):358-63. https://doi.org/10.1016/j.apmr.2005.11.007
  24. Lennon S. Gait re-education based on the Bobath concept in two patients with hemiplegia following stroke. Phys Ther. 2001;81(3):924-35.
  25. Pang MY, Harris JE, Eng JJ. A community-based upper-extremity group exercise program improves motor function and performance of functional activities in chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2006;87(1):1-9. https://doi.org/10.1016/j.apmr.2005.08.113
  26. Mauritz KH. Gait training in hemiplegia. Eur J Neurol. 2002;9(1):23-9. https://doi.org/10.1046/j.1468-1331.2002.00344.x
  27. Mayo NE, Kirkland S, Neville D et al. Hospitalization and case-fatality rates for stroke in Canada from 1982 through 1991. The Canadian collaborative study group of stroke hospitalization. Stroke. 1996;27(7):1215-20. https://doi.org/10.1161/01.STR.27.7.1215
  28. Nadeau S, Arsenault AB, Bourbonnais D et al. Analysis of the clinical factors determining natural and maximal gait speeds in adults with a stroke. Am J Phys Med Rehabil. 1999;78(2):123-30. https://doi.org/10.1097/00002060-199903000-00007
  29. de Oliveira CB, de Mediros IR, Forta NA et al. Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev. 2008;45(8):1215-26. https://doi.org/10.1682/JRRD.2007.09.0150
  30. Richards CL, Dumas F, Malouin F et al. Gait velocity as an outcome measure of locomotor recovery after stroke. In: Craik RL, Oatis C. Gait analysis: Theory and application. St-Louis; Mosby, 1995.
  31. Roth EJ, Merbitz, C, Mroczek K et al. Hemiplegid gait. Relationships between walking speed and other temporal parameters. Am J Phys Med Rehabil. 1997;76(2):128-33. https://doi.org/10.1097/00002060-199703000-00008
  32. Ryerson, S, Levit, K. Functional movement reeducation. New York: Churchill Livingstone. 1997.
  33. Shelton FD, Reding M, Volpe BT. Motor impairment as a predictor of functional recovery and guide to rehabilitation treatment after stroke. Neurorehabil Neural Repair. 2001;15(3):229-37. https://doi.org/10.1177/154596830101500311
  34. Wall JC, Turnbull GI. Gait asymmetries in residual hemiplegia. Arch Phys Med Rehabil. 1986;67(8): 550-3.