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Effects of Backward Walking Training in the Gait ability and Foot Pressure of Hemiplegia Patients

편마비 환자의 후방보행훈련이 보행능력과 족저압에 미치는 영향

  • Lee, Byung-Hoon (Group of Industry-Academy Cooperation, Chunnam-Techno University) ;
  • Jeong, Jin-Gyu (Department of Physical Therapy, Chunnam-Techno University) ;
  • Kim, Chan-Kyu (Department of Physical Therapy, Gwangju Health University)
  • 이병훈 (전남과학대학교 산학협력단) ;
  • 정진규 (전남과학대학교 물리치료과) ;
  • 김찬규 (광주보건대학교 물리치료과)
  • Received : 2014.07.15
  • Accepted : 2014.12.11
  • Published : 2014.12.31

Abstract

This study examined the gait ability and foot pressure after backward walking training in hemiplegia patients after stroke to provide evidence for the application of backward walking to the rehabilitation of those patients. Twenty hemiplegia patients hospitalized at one rehabilitation hospital were enrolled in this study, which was conducted from 23 April to 18 May, 2012. The subjects were randomized into either the experimental group or control group. The control group received general physical therapy for 30 minutes and the experimental group received 20 minutes of physical therapy and 10 minutes of backwards walking training five times a week for four weeks. The gait ability and foot pressure of both feet were measured quantitatively and compared. The results showed the weight bearing (entire foot, anterior and posterior of foot) of the paralyzed foot during the stance phase showed a significant difference (p<.05). The difference in the foot pressure of right and left feet was more significant in the experimental group than that of the control group (p<.05). Therefore, this study confirmed that backward walking training in a rehabilitation program would be helpful for improving the gait ability of hemiplegia patients after stroke.

본 연구는 뇌졸중으로 인한 편마비 환자의 후방보행 훈련에 따른 보행능력과 족저압을 분석하여 편마비환자의 재활시 활용할 수 있는 근거자료를 제시하고자 시행하였다. 일개 재활병원에 입원 중인 편마비 환자 20명을 대상으로 2012년 4월 23일부터 5월 18일까지 시행하였다. 대조군과 실험군으로 분류하여 대조군은 일반적 물리치료를 30분간 시행하였고, 실험군은 일반적 물리치료 20분과 후방보행훈련 10분을 시행하여, 주 5회, 총 4주간 실시한 후 보행능력과 양측 족저압의 차이를 정량적으로 측정하여 비교하였다. 연구결과, 후방보행훈련이 마비측 입각기시 체중지지(발 전체, 발 앞쪽, 발 뒤쪽)에 통계적으로 유의한 차이가 있었다(p<.05). 양측 족저압 차이에서도 대조군에 비해 실험군이 통계적으로 유의한 차이가 있었다(p<.05). 따라서 향후 뇌졸중으로 인한 편마비 환자의 보행능력 향상을 위한 재활 프로그램에 후방보행훈련이 도움이 될 것으로 판단된다.

Keywords

References

  1. H. C. Dijkerman, M. Ietswaart, M. Johnston, R. S. Macwalter, "Does motor imagery training improve hand function in chronic stroke patients", A pilot study. Clin Rehabil. Vol.18, No.5, pp. 538-549. 2004. DOI: http://dx.doi.org/10.1191/0269215504cr769oa
  2. A. C. Geurts, M. de Haart, I. J. van Nes, J. Duysens. "A review of standing balance recovery from stroke", Gait Posture, Vol.22, No.3, pp. 267-281. 2005. DOI: http://dx.doi.org/10.1016/j.gaitpost.2004.10.002
  3. K. H. Mauritz, "Gait training in hemiplegia", European Journal of Neurology, Vol.9, No.S1, pp. 23-29, 2002. DOI: http://dx.doi.org/10.1046/j.1468-1331.2002.0090s1023.x
  4. G. D. Caty, C. Arnould, G. G. Stoquart, J. L. Thonnard, T. M. Lejeune, "ABILOCO: a Rasch=built 13-item questionnaire to assess locomotion ability in stroke patients", Archives of Physical Medicine Rehabilitation, Vol.89, No.2, pp.284-290, 2008. DOI: http://dx.doi.org/10.1016/j.apmr.2007.08.155
  5. R. Ferber, L. R. Osternig, M. H. Woollacott, N. J. Wasielewski, J. H. Lee, "Reactive balance adjustments to unexpected perturbations during human walking", Gait Posture, Vol.16, No.3, pp.238-248, 2002. DOI: http://dx.doi.org/10.1016/S0966-6362(02)00010-3
  6. H. J. Eich, H. Mach C. Werner, S. Hesse, "Aerobic treadmill plus Bobath walking training improves walking in subacute stroke: a randomized controlled trial", Clinical Rehabiltation, Vol.18, No.6, pp.640-651, 2004. DOI: http://dx.doi.org/10.1191/0269215504cr779oa
  7. M. F. Ng, R. K. Tong, L. S. Li, "A pilot study of randomized clinical controlled trial of gait training in subacute stroke patients with partial body-weight support electromechanical gait trainer and functional electrical stimulation: six-month follow-up", Stroke, Vol. 39, No. 1, pp.154-160, 2007. DOI: http://dx.doi.org/10.1161/STROKEAHA.107.495705
  8. A. J. Threlkeld, T. S. Horn, G. Wojtowicz, J. G. Rooney, R. Shapiro, "Kinematics, ground reaction force, and muscle balance produced by backward running", Journal of Orthopedic and Sports Physical Therapy, Vol.11, pp.56-63, 1989. DOI: http://dx.doi.org/10.2519/jospt.1989.11.2.56
  9. S. J. Kong, "After ACL reconstruction the effect of backward walking training on knee joint muscle function", Graduate School of Korea University master's thesis, 2007.
  10. Y. S. Kim, D. H. Kim, K. K. Cho, "The effects of aquatic backward locomotion training frequency on lumbar extension strength, pain, and functional disability in lumbar diskectomy patients-24week short term training-", Koean Society for wellness, Vol.8, No.3, pp.276-289, 2013.
  11. C. H. Chang, S. W. Han, "Effects of inclined backward and forward walking on pain sacle and muscle function for patients with patellofemoral pain syndrome", Journal of coaching development, Vol.15, No.3, pp.179-185, 2013.
  12. K. P. Na, "Effects of gait training with applied posterior traction on gait, balance, energy consumption in patients with stroke", Graduate School of Sahmyook University, master's thesis, 2012.
  13. J. J. Bae, J. C. Lee, S. W. Han, "The effect of backward walking on respiratory factor and VAS in the rehabilitation training for knee injury", The Korean Journal of physical education, Vol.44, No.4, pp.347-355, 2005.
  14. M. A. Thomas, A. Fast, "One step forward and two step back: the dangers of walking backwards in therapy". American Journal of Physical Medicine & Rehabilitation, Vol.79, No.5, pp.459-461, 2002. DOI: http://dx.doi.org/10.1097/00002060-200009000-00011
  15. K. I. Ki, S. Y. Kim, D. W. Oh, K. H. Kim, "The effect of back ward walking training in the walking speed and balance capability of patients with hemiplegia", The journal of Korean Academy of physical therapy science, Vol. 16, No.2, pp. 1-9, 2009.
  16. S. Alder, D. Beckers, M. Buck, "PNF in Practice", 3rd ed. Springer, 2008.
  17. C. Kisner, L. A. Colby, "Therapeutic Exercise: Foundations and Techniques", 5th ed. Philadephia. FA Davis. 2007.
  18. S. J. Park, "The Analysis the Changes of Foot Pressure by Various Carrying a Pack Methods during Walking", Graduate School of Daegu University, master's thesis, 2008
  19. C. K. Kim, B. H. Lee, "Gait analysis According to the changes of the carrying type and weight of bag", Journal of the korea Academia- industrial cooperation Society, Vol.14, No.1, pp.199-205, 2013. DOI: http://dx.doi.org/10.5762/KAIS.2013.14.1.199
  20. C. Werner, S. Von Frankenberg, T. Treig, "Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke paients: a randomized cross over study", Stroke, Vol.33, No.12, pp.2895-2901, 2002. DOI: http://dx.doi.org/10.1161/01.STR.0000035734.61539.F6
  21. S. I. Yoon, "The effect of energy consumption during walking with arm sling in adult hemiplegic patients", Graduate School of Hanyang University, master's thesis, 2004.
  22. R. Dickstein, Y. Yoeli, S. Holtzman, A. Faust, E. Markoviz, "Weight bearing on the affected lower limb in residents of a geriatric rehabilitation hospital", American Journal of Physical Medicine and Rehabilitation, Vol.89, No.4, pp.287-292, 2010. DOI: http://dx.doi.org/10.1097/PHM.0b013e3181c9d86e
  23. H. W. Yoon, S. Y. Lee, H. M. Lee, "The comparison of plantar foot pressure in normal side of normal people, affected side and less affected side of hemiplegic patients during stance phase", Journal of the korean Society of physical medicine, Vol.4, No.2, pp.87-96, 2009.
  24. E. J. Kim, B. G. Hwang, H. C. Kwon, "The effects of gait component and foot plantar pressure on gait training way in stroke patients", The journal of rehabilitation science research, Vol.27, No.2, pp.41-54, 2009.
  25. S. J. Kim, "The effect of backward walking which influences forward walking in patient with stroke", Graduate School of Daegu University master's thesis, 2009.
  26. E. Y. Kim, S. B. Lee, B. S Jeon, H. S. Kwon, D. Y. Yu, "Comparison between rectus femoris and tibialis anterior in terms of the levels of activity varying depending on walking patterns and varied treadmill slopes", Korean journal of orthopedic manual therapy, Vol.16, No.2, pp.76-81, 2010.