Physical Therapy Rehabilitation Science

  • 제5권2호
  • /
  • Pages.106-112
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  • 2016
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  • 2287-7576(pISSN)
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  • 2287-7584(eISSN)
물리치료재활과학회 (korean Academy of Physical Therapy Rehabilitation Science)
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Effect of lower extremity resistance exercise on gait performance in a patient with systemic lupus erythematosus with cerebral infarction and lower extremity vasculitis: a case study

  • Oh, Yongseop (Department of Physical Therapy, Prime Rehabilitation and Pain Clinic) ;
  • Woo, Youngkeun (Department of Physical Therapy, College of Medical Science, Jeonju University)
  • 투고 : 2016.04.14
  • 심사 : 2016.06.09
  • 발행 : 2016.06.30
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초록

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

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참고문헌

  1. Grossman JM, Kalunian KC. Definition, classification, activity, and damage indices. In: Wallace DJ, Hahn BH, editors. Dubois' lupus erythematosus. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 19.
  2. Dall'Era M, Davis JC. Systemic lupus erythematosus. How to manage, when to refer. Postgrad Med 2003;114:31-7, 40.
  3. Fields RA, Sibbitt WL, Toubbeh H, Bankhurst AD. Neuropsychiatric lupus erythematosus, cerebral infarctions, and anticardiolipin antibodies. Ann Rheum Dis 1990;49:114-7. https://doi.org/10.1136/ard.49.2.114
  4. Denburg JA, Temesvari P. The pathogenesis of neuropsychiatric lupus. Can Med Assoc J 1983;128:257-60.
  5. Kaposi M. Neue beitrage zur kenntmiss des lupus erythematosus. Arch f Derm u Syph 1872;4:36-78. https://doi.org/10.1007/BF01921090
  6. Osler W. On the visceral complications of the erythema excudativum multiforme. Am J Med Sci 1895;110:629-46. https://doi.org/10.1097/00000441-189512000-00001
  7. Libman E, Sacks B. A hitherto undescribed form of valvular and mural endocarditis. Arch Intem Med 1924;33:701-37. https://doi.org/10.1001/archinte.1924.00110300044002
  8. Park JW, Kim MS, Lee SI, Jung YT, Kim SC, Sim JH. Systemic Lupus Erythematosus with Central Nervous System Involvement: Case Report. J Korean Neurosurg Soc 1998;27:268-73.
  9. Ainiala H, Loukkola J, Peltola J, Korpela M, Hietaharju A. The prevalence of neuropsychiatric syndromes in systemic lupus erythematosus. Neurology 2001;57:496-500. https://doi.org/10.1212/WNL.57.3.496
  10. West SG. Lupus and the central nervous system. Curr Opin Rheumatol 1996;8:408-14. https://doi.org/10.1097/00002281-199609000-00004
  11. Devinsky O, Petito CK, Alonso DR. Clinical and neuropathological findings in systemic lupus erythematosus: the role of vasculitis, heart emboli, and thrombotic thrombocytopenic purpura. Ann Neurol 1988;23:380-4. https://doi.org/10.1002/ana.410230411
  12. Karassa FB, Ioannidis JP, Touloumi G, Boki KA, Moutsopoulos HM. Risk factors for central nervous system involvement in systemic lupus erythematosus. QJM 2000;93:169-74. https://doi.org/10.1093/qjmed/93.3.169
  13. Park HD. Serologic characteristics in systemic lupus erythematosus patients with neurologic disorder [Master thesis]. Seoul: Hanyang University; 2004.
  14. Bohannon RW. Muscle strength and muscle training after stroke. J Rehabil Med 2007;39:14-20. https://doi.org/10.2340/16501977-0018
  15. Laufer Y, Dickstein R, Resnik S, Marcovitz E. Weight-bearing shifts of hemiparetic and healthy adults upon stepping on stairs of various heights. Clin Rehabil 2000;14:125-9. https://doi.org/10.1191/026921500674231381
  16. Geurts AC, de Haart M, van Nes IJ, Duysens J. A review of standing balance recovery from stroke. Gait Posture 2005;22:267-81. https://doi.org/10.1016/j.gaitpost.2004.10.002
  17. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002;16:1-14.
  18. An MJ, Park IH. Effect of stretching exercise on depression, pain, and fatigue in patients with systemic lupus erythematosus. J Muscle Jt Health 2006;13:43-52.
  19. Tench C, Bentley D, Vleck V, McCurdie I, White P, D'Cruz D. Aerobic fitness, fatigue, and physical disability in systemic lupus erythematosus. J Rheumatol 2002;29:474-81.
  20. Ramsey-Goldman R, Schilling EM, Dunlop D, Langman C, Greenland P, Thomas RJ, et al. A pilot study on the effects of exercise in patients with systemic lupus erythematosus. Arthritis Care Res 2000;13:262-9. https://doi.org/10.1002/1529-0131(200010)13:5<262::AID-ANR4>3.0.CO;2-8
  21. Kim MJ. Lupus; self-management and exercise. J Muscle Jt Health 1999;6:360-9.
  22. Weiss A, Suzuki T, Bean J, Fielding RA. High intensity strength training improves strength and functional performance after stroke. Am J Phys Med Rehabil 2000;79:369-76; quiz 391-4. https://doi.org/10.1097/00002060-200007000-00009
  23. Kim NJ, Kim HS, Oh JK, Lee BH. Effects of elastic band exercise on upper and lower electromyographic activity in stroke. Exerc Sci 2006;15:329-35.
  24. Prentice WE. Rehabilitation techniques in sports medicine. 5th ed. New York: McGraw-Hill Higher Education; 2010.
  25. Meretta BM, Whitney SL, Marchetti GF, Sparto PJ, Muirhead RJ. The five times sit to stand test: responsiveness to change and concurrent validity in adults undergoing vestibular rehabilitation. J Vestib Res 2006;16:233-43.
  26. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Arch Phys Med Rehabil 2010;91:407-13. https://doi.org/10.1016/j.apmr.2009.10.030
  27. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  28. Dean CM, Richards CL, Malouin F. Walking speed over 10 meters overestimates locomotor capacity after stroke. Clin Rehabil 2001;15:415-21. https://doi.org/10.1191/026921501678310216
  29. Caty GD, Arould C, Stoquart GG, Thonnard JL, Lejeune TM. ABILOCO: a Rash-built 13-item questionnaire to assess locomotion ability in stroke patients. Arch Phys Med Rehabil 2008;89:284-90. https://doi.org/10.1016/j.apmr.2007.08.155
  30. Kim HS, Lee SC, Hong HI, Han KH, Lee SK, Kim SS. A case of neuropsychiatric lupus presenting as guillain-barre syndrome and cerebral infarction. J Korean Rheum Assoc 2004;11:411-6.
  31. Kim MJ, Sohng KY. Nursing interventions of the lupus patient. J Muscle Jt Health 1995;2:197-208.
  32. Clarke-Jenssen AC, Fredriksen PM, Lilleby V, Mengshoel AM. Effects of supervised aerobic exercise in patients with systemic lupus erythematosus: a pilot study. Arthritis Rheum 2005;53:308-12. https://doi.org/10.1002/art.21082
  33. Ramsey-Goldman R, Schilling EM, Dunlop D, Langman C, Greenland P, Thomas RJ, et al. A pilot study on the effects of exercise in patients with systemic lupus erythematosus. Arthritis Care Res 2000;13:262-9. https://doi.org/10.1002/1529-0131(200010)13:5<262::AID-ANR4>3.0.CO;2-8
  34. Tench CM, McCarthy J, McCurdie I, White PD, D'Cruz DP. Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. Rheumatology (Oxford) 2003;42:1050-4. https://doi.org/10.1093/rheumatology/keg289
  35. van de Port IG, Kwakkel G, Lindeman E. Community ambulation in patients with chronic stroke: how is it related to gait speed? J Rehabil Med 2008;40:23-7. https://doi.org/10.2340/16501977-0114
  36. Kirschbaum JB, Axelson PW, Longmuir PE, Mispagel KM, Stein JA, Yamada DA. Designing sidewalks and trails for access: part II of II: best practices design guide. Washington DC: Federal Highway Administration; 2001.