DOI QR코드

DOI QR Code

점진적 앉은 자세에서의 PNF운동이 소뇌 손상환자의 동적 균형능력에 미치는 효과 -단일 사례 연구-

Effects of Using PNF in Progressive Sitting Position on Dynamic Balance in a Patient with a Cerebellar Injury -Single Subject Design-

  • 김대경 (대한고유수용성신경근촉진법학회 부산시회) ;
  • 나은진 (드림병원 물리치료실) ;
  • 문상현 (드림병원 물리치료실)
  • Kim, Dae-Kyeong (Korea Proprioceptive Neuromuscular Facilitation Association in Busan Branch) ;
  • Na, Eun-Jin (Department of Physical Therapy, Dream Hospital) ;
  • Moon, Sang-Hyun (Department of Physical Therapy, Dream Hospital)
  • 투고 : 2016.05.19
  • 심사 : 2016.08.11
  • 발행 : 2016.08.31

초록

Purpose: The purpose of this study was to investigate the effects of using proprioceptive neuromuscular facilitation (PNF) exercise in the progressive sitting position on the dynamic balance ability of a patient with a cerebellar injury. Methods: The subject had ataxia due to cerebellar injury. The subject participated in a PNF bilateral scapular pattern exercise with stabilizing reversal technique during a progressive sitting position session as well as baseline for 20 minutes a day for 4 weeks. In the first session, PNF exercises were performed at a height of 40 cm for 10 minutes, and in the second session they were performed at 50 cm for 10 minutes from a lower center of gravity (COG) to a higher COG sitting position. We used the Berg Balance Scale (BBS), Five-Times-Sit-to-Stand Test (FTSST), and the Timed Up and Go Test (TUGT) to measure the subject's dynamic balance ability every two days through the entire session. Results: After participating in the program, the subject's dynamic balance ability improved compared to the first baseline, as measured by BBS (2 points increased), FTSST (5.3 sec decreased), and TUGT (2 sec decreased). The increase was also maintained in the second baseline session. Conclusion: PNF exercise using bilateral scapula patterns with a stabilizing reversal technique helps to enhance the dynamic balance ability of a cerebellar injury patient.

키워드

참고문헌

  1. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide, 4th ed. Heidelberg. Springer. 2014.
  2. Berg K, Wood-Dauphinee S, Williams JI, et al. Measuring balance in the elderly: Validation of an instrument. Canadian journal of public health. 1992;83(2):7-11.
  3. Carr JH, Shepherd RB. Neurological Rehabilitation Optimizing Motor Performance. Butterworth-Heinemann. Oxford. 1998.
  4. Carr JH, Shepherd RB. Stroke Rehabilitation: Guidelines for Exercise and Training to Optimize Motor Skill. 1ed. Butterworth-Heinemann. Oxford. 2003.
  5. Chini G, Ranavolo A, Draicchio F, et al. Local stability of the trunk in patients with degenerative cerebellar ataxia during walking. Cerebellum. 2016;1(25):1-8.
  6. Freund JE, Stetts DM. Use of trunk stabilization and locomotor training in an adult with cerebellar ataxia: a single system design. Physiotherapy Theory and Practice. 2010;26(7):447-58. https://doi.org/10.3109/09593980903532234
  7. Folz T, Sinaki M. A nouveau aid for posture training in degenerative disorders of the central nervous system. Journal of Musculoskeletal Pain. 1995;3(4):59-70.
  8. Ghez C. Posture. Principles of Neural Science. 3rd ed. Appleton and Lange. Norwalk. 1991.
  9. Hwangbo PN, Kim KD. Effects of proprioceptive neuromuscular facilitation neck pattern exercise on the ability to control the trunk and maintain balance in chronic stroke patients. The Journal of Physical Therapy Science. 2016;28(3):850-853. https://doi.org/10.1589/jpts.28.850
  10. Joen HJ, Lee MH. The effects of PNF technique versus trunk exercise program on the pain, disability, and balance in chronic LBP patients. Korea Contents Association. 2009;9(12):665-673. https://doi.org/10.5392/JKCA.2009.9.12.665
  11. Jung DK. The effect of trunk stability exercises on trunk control ability and daily living activities on the osmotic demyelination syndrome of a patient with hyponatremia(a case study). Journal of Korea Proprioceptive Neuromuscular Facilitation Association. 2014;12(4):249-258.
  12. Kang TW, Ham KH. Effect of trunk stability exercises with stabilizing reversal and rhythmic stabilization of PNF for muscle strength and balance ability in stroke patients. Journal of Korea Proprioceptive Neuromuscular Facilitation Association. 2014;12(2):63-69.
  13. Kim SH, Kim KJ, Kim SY, et al. System physical rehabilitation (II) in nervous system and cardiopulmonary. Seoul. Hanulbook. 2007.
  14. Lee MK, Yoon TW, Kim YH, et al. Effect of gait training using PNF on balance and walking ability in person with chronic stroke(single subject design). Journal of Korea Proprioceptive Neuromuscular Facilitation Association. 2012;10(1):43-52.
  15. Mackinnon CD, Winter DA. Control of whole body balance in the frontal plane during human walking. Journal of Biomechanics. 1993;26(6):633-644. https://doi.org/10.1016/0021-9290(93)90027-C
  16. Podsiadlo D, Richardson S. The timed "Up and Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  17. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up and go test. Physical Therapy. 2000;80(9):896-903.
  18. Smeets CLM, Verbeek DS. Cerebellar ataxia and functional genomiscs: Identifying the routes to cerebellar neurodegeneration. Biochimica et Biophysica Acta. Molecular basis of disease. 2014; 1842(10);2030-2038. https://doi.org/10.1016/j.bbadis.2014.04.004
  19. Verheyden G, Vereeck L, Truijen S, et al. Additional exercise improve trunk performance after stroke: a pilot randomized controlled trial. Neurorehabilitation & Neural Repair. 2009;23(3):281-286. https://doi.org/10.1177/1545968308321776
  20. Whitney SL, Wrisley DM, Marchetti GF, et al. Clinical mearsurement of sit-to-stand performance in people with balance disorders; validity of data for the five-times-sit-to-stand test. Physical Therapy. 2005;85(10):1034-1045.