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The Effect of Ankle Joint Muscle Strengthening Training and Static Muscle Stretching Training on Stroke Patients' Plantar Pressure and Gait

발목관절의 근력 강화 훈련과 정적 근육 신장 훈련이 뇌졸중 환자의 족저압 및 보행에 미치는 영향

  • Received : 2011.12.02
  • Accepted : 2012.03.08
  • Published : 2012.03.31

Abstract

This study was intended to implement ankle joint dorsi flexion training against ankle muscule strength weakening that erodes stroke patients' gait performance to examine the effect of the training on stroke patients' plantar pressure and gait ability. In this study, 36 stroke patients diagnosed with stroke due to cerebral infarction or cerebral hemorrhage were divided to measure 10MWS which are stroke patients' gait variables maximum plantar pressure by area of the sole by collecting data using an F-scan system during gait. Given these results of the study, compared to other training groups, the ankle muscule strength reinforcing training group showed statistically significant increases of maximum plantar pressure in the great toe, the toe and the first metatasal areas too and thus it can be said that this training increases forward thrust during stroke patients' foot end taking off and positively affects stroke patients' ability to perform gait.

본 연구는 뇌졸중 환자의 보행수행을 저하시키는 발목 등쪽 굽힘근의 약화에 대해 발목 근력 강화 훈련과 정적 근육 신장 훈련을 이용하여 등쪽 굽힘을 시행한 훈련이 뇌졸중 환자의 족저압 및 보행에 미치는 영향을 알아보고자 하였다. 연구는 편마비 뇌졸중 환자 36명을 대상으로 뇌졸중 환자의 보행변수인 10m 걷기를 측정하고, 발바닥의 각 영역별 최대 족저압의 측정은 F-scan system을 사용하여 자료를 수집하여 연구하였다. 본 연구에서 각 훈련 전과 훈련 후의 보행의 변화 연구에서 발목 근력 강화 훈련군과 정적 근육 신장 훈련군은 10m 보행속도검사에서 보행속도가 감소하여 뇌졸중 환자의 보행에 좋은 영향을 미친다고 할 수 있겠다. 뇌졸중 환자 발의 압력측정에서 발목 근력 강화 훈련군 에서는 다른 그룹에 비해서 무지부, 족지부, 제1중족골두에서 최대 족저압이 증가 하였다.

Keywords

References

  1. O'Sullivan, S. B., Thomas, J. & Schmitz. Physical Rehabilitation : Assessment and Treatment (4th ed). Philadelphia: F. A. Davis Co. 2001.
  2. Lundy-Ekman. L. . Neuroscience : Fundamentals for rehabilitation (3rd ed.). W.B. Saunders. 2007
  3. Shumway-Cook, A., & woollacott, M. H. Motor Control: Translating research into clinical practice (3rd ed.). Philadelphia: Lippincott Williams &Wilkins. 2007.
  4. Mauritz, K. H. Gait training in hemiplegia. Eur J Neurol, 9 Suppl 1(23-29); dicussion 53-61. 2002.
  5. Caillet, F., Mertens, P., Rabaseda, S., & Botsson, D. Three dimensional gait analysis and controlling spastic foot on stroke patients. Ann Readapt Med Phys, 46, 119-131. 2003. https://doi.org/10.1016/S0168-6054(03)00015-1
  6. Kollen, B., van de Port, I., Lindeman, E., Twisk, J., & Kwakkel, G. Predicting improvement in gait after stroke : a longitudinal prospective study. Stroke, 36(12), 2676-2680. 2005. https://doi.org/10.1161/01.STR.0000190839.29234.50
  7. Maynard, V., Bakheit, A. M., & Shaw, S. Comparison of the impact of a single session of isokinetic or isotonic muscle stretch on gait in patients with spastic hemiparesis. Clin Rehabil, 19(2), 146-154. 2005. https://doi.org/10.1191/0269215505cr853oa
  8. Lexell, J., & Flansbjer, U. B. Muscle strength training, gait performance and physiotherapy after stroke. Minerva Med, 99(4), 353-368. 2008.
  9. Franceschini, M., Carda, S., Agosti, M., Antenucci, R., Malgrati, D., & Cisari, C. Walking after stroke: what does treadmill training with body weight support add to overground gait training in patients early after stroke?: a single-blind, randomized, controlled trial. Stroke, 40(9), 3079-3085. 2009. https://doi.org/10.1161/STROKEAHA.109.555540
  10. Donald. A. Neumann.. Kinesiology of the musculoskeletal system. USA: Mosby Publication, 528-552. 2002.
  11. Achache V., Mazevet D., Iglesias C., Lackmy A.,.Nielsen J.B, Katz R., Marchand-Pauvert V. Enhanced spinal excitation from ankle flexors to knee extensors during walking in stroke patients. Clinical Neurophysiology, 121, 930-938. 2010. https://doi.org/10.1016/j.clinph.2009.12.037
  12. Lee., Kwon., Park The effect of passive stretching on the spasticity of ankle plantar flexor muscles.J Korean Acad Rehab Med . 25(6) 987-992 2001.
  13. Chaitow L. Muscle energy technique. Kim., Park., Hwang,. Youngmoon. 2001.
  14. Weiss, A., Suzuki, T., Bean, J., & Fielding, R. A. High intensity strength training improves strength and functional performance after stroke. Am J Phys Med Rehabil, 79(4), 369-376. 2000. https://doi.org/10.1097/00002060-200007000-00009
  15. Dean, C. M., Richards, C. L., & Malouin, F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil, 81(4), 409-417. 2000. https://doi.org/10.1053/mr.2000.3839
  16. Hutchins, M. D., Becque, M. D., Gearhart, R. F., & Carroll, P. J. . Accuracy of 1RM predication equations for the bench press and iceps curl. Medicine & Science in Sports & Exercise, 34(5), 535. 2002.
  17. Whitney, S. L., Poole, J. L., & Cass, S. P. A review of balance instruments for older adults. Am J Occup Ther, 52(8), 666-671 1998. https://doi.org/10.5014/ajot.52.8.666
  18. Runge, C. F., Shupert, C. L., Horak, F. B., & Zajac, F. E. Ankle and hip postural strategies defined by joint torques. Gait Posture, 10(2), 161-170. 1999. https://doi.org/10.1016/S0966-6362(99)00032-6
  19. Chen B., & Bates B. T. Comparison of F-scan in-solea nd AMTI forceplate system in measuring vertical ground reaction force during gait. Physiotherapy Theory and Practice, 16, 43-53. 2000. https://doi.org/10.1080/095939800307601
  20. Bohannon, R. W. . Device for increasing passive ankle dorsi flexion at home. Suggestion from the field. PhysTher, 65(10), 1521. 1985.
  21. Fan Gao., Yupeng Ren., Elliot J. Roth., Richard Harvey., Li-Qun Zhang. Effects of repeated ankle stretching on calf muscle-.tendon and ankle biomechanical properties in stroke survivors. Clinical Biomechanics, 11(3), 159-164. 2011.
  22. Andrews, A. W., & Bohannon, R. W. Short-term recovery of limb muscle strength after acute stroke. Arch Phys Med Rehabil, 84(1), 125-130. 2003. https://doi.org/10.1053/apmr.2003.50003
  23. Ouellette, M. M., LeBrasseur, N. K., Bean, J. F., Phillips, E., Stein, J., Frontera, W. R., & Fielding, R. A. High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors. Stroke, 35(6), 1404-1409. 2004. https://doi.org/10.1161/01.STR.0000127785.73065.34
  24. Han., Ryu., Lee. Analysis of plantar foot pressure distribution for walking direction switch during walking in healthy adults. Scientific Exercise. 17(4), 515-523. 2008. https://doi.org/10.15857/ksep.2008.17.4.515

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