한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제18권12호
  • /
  • Pages.597-604
  • /
  • 2017
  • /
  • 1975-4701(pISSN)
  • /
  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
권호 표지
DOI QR코드

DOI QR Code

전정자극 훈련이 만성 뇌졸중 환자의 균형에 미치는 영향

The Effect of the Vestibular Stimulation Training on the Balance of Patient with Chronic Stroke

  • 남기원 (동신대학교 물리치료학과) ;
  • 오채은 (동신대학교 대학원 물리치료학과) ;
  • 서동열 (동신대학교 물리치료학과)
  • Nam, Ki-Won (Department of Physical Therapy, Dongshin University) ;
  • Oh, Chae-Eun (Department of Physical Therapy, Graduate School of Dongshin University) ;
  • Seo, Dong-Yel (Department of Physical Therapy, Dongshin University)
  • 투고 : 2017.11.15
  • 심사 : 2017.12.08
  • 발행 : 2017.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구의 목적은 만성 뇌졸중 환자를 대상으로 전정자극훈련 프로그램이 정적 균형 및 동적 균형에 미치는 영향을 알아보는 것이다. 본 연구는 2014년 7월 15일부터 9월 6일까지 진행하였으며, 대상자는 뇌졸중 진단을 받은 환자 20명이 본 연구에 참여하였고, 무작위로 Group I(일반운동치료, n=10)과 Group II(전정자극훈련, n=10)로 나누었다. 두 군 모두 주 3회, 회당 40분씩 6주간 치료적 중재를 실시하였다. 균형 능력은 Good Balance System을 이용하여 정적 균형 및 동적 균형을 측정하였으며, 중재 전과 후를 비교하였다. 연구 결과, 전정자극 훈련군에서는 눈감고 선자세의 좌우 및 전후 균형, 눈뜨고 선자세의 좌우 및 전후 균형, 이동시간, 이동거리에서 통계학적으로 유의한 차이를 보였고, 일반운동 치료군에서는 눈뜨고 선자세의 좌우 균형을 제외한 모든 항목에서 통계학적으로 유의한 차이는 보이지 않았다. 결론적으로, 본 연구에서는 전정자극 훈련은 만성 뇌졸중 환자의 정적 균형 능력과 동적 균형 능력 향상에 긍정적인 영향을 미쳤으며, 이러한 뇌졸중 환자의 균형능력 향상을 위한 치료프로그램에 다양한 방법으로 활용될 수 있을 것이다.

This study examined the effects of vestibular stimulation training on the static and dynamic balance of patients with chronic stroke. This study was conducted from July 15th to September 6th, 2014 and 20 subjects diagnosed with stroke participated in this study. The subjects were divided randomly into Group I (general therapeutic exercise, n=10) and Group II (vestibular stimulation training, n=10). Both groups were trained for 40 minutes, 3 times a week, for 6 weeks. The balance ability, static balance and dynamic balance, were evaluated using a Good Balance System and compared before-and-after intervention. In the vestibular training group, there were statistically significant differences in the left-right and anterior-posterior balance with the eyes closed and standing posture, in the left-right and anterior-posterior balance with the eyes open and standing posture, and moving time and distance. In the general therapeutic exercise group, there was no significant difference except in the left-right balance with the eyes open and standing posture. In conclusion, vestibular stimulation training had positive effects on the static and dynamic balance of chronic stroke patients, and this training can be effective in a treatment program to improve the balance ability of stroke patients.

키워드

참고문헌

  1. Y. M. Kang, H. J. Kim, T. Y. Lee, B. J. Ku, "The relationship between death and clinical risk factors in korean: Community Cohort Study", Korean Public Health Research, vol. 43, no. 3, pp. 81-90, 2017.
  2. M. K. Aaslund, R. Moe-Nilssen, B. B. Gjelsvik, B. Bogen, H. Naess, H. Hofstad, J. S. Skouen, "A longitudinal study investigating how stroke severity, disability, and physical function the first week post-stroke are associated with walking speed si months post-stroke", Physiother Theory Pract, vol. 33, no. 12, pp. 932-942, 2017. DOl: https://doi.org/10.1080/09593985.2017.1360424
  3. M. Starosta, J. Redlicka, M. Brzezianski, M. Niwald, E. Miller, "Brain stroke - risk of disability and possibilities of improvment in motor and cognitive functioning", Pol Merkur Lekarski, vol. 41, no. 241, pp. 39-42, 2016.
  4. S. A. Sharp, B. J. Brouwer, "lsokinetic strength training of the hemiparetic knee: effects on function and spasticity", Arch Phys Med Rehabil, vol. 78, no. 11, pp. 1231-1236, 1997. https://doi.org/10.1016/S0003-9993(97)90337-3
  5. F. Mauguiere, J. E. Desmedt, J. Courjon, "Astereognosis and dissociated loss frontal or parietal components of somatosensory evoked potentials in hemiparetic lesions", Brain. vol. 106, no. 2, pp. 271-311, 1983. DOl: https://doi.org/10.1093/brain/106.2.271
  6. Y. S. Kim, H. Y. Kang, T. Y. Kim, "The effect of balance training using force platform on postural control and somatosensory pathway in adults with C.N.S. Disorders", J Korean Soci Phys Ther, vol. 11, no. 3, pp. 71-79, 1999. https://doi.org/10.1589/jpts.11.71
  7. S. F. Tyson, M. Hanley, J. Chillala, A. Selley, R. C. Tallis, "Balance disability after stroke", Phys Ther, vol. 86, no. 1, pp. 30-38. 2006. DOl: https://doi.org/10.1093/ptj/86.1.30
  8. B. J. Brouwer, E. G. Culham, R. A. Liston, T Grant, "Normal variability of postural measures: implications for the reliability of relative balance performance outcomes", Scan J Rehabil Med, vol. 30, no. 3, pp. 131-137, 1998. DOl: https://doi.org/10.1080/003655098444048
  9. S. L. Patterson, L. W. Forrester, M. M. Rodgers, A. S. Ryan, F. M. lvey, J. D. Sorkin, R. F. Macko, "Determinants of walking function after stroke: differences by deficit severity", Arch Phys Med Rehabil, vol. 88, no. 1, pp. 115-119, 2007. DOl: https://doi.org/10.1016/j.apmr.2006.10.025
  10. F. B. Horak, C. L. Shupert, V. Dietz, G. Horstmann, "Vestibular and somatosensory contributions to responses to head and body displacements in stance", Exp Brain Res, vol. 100, no. 1, pp. 93-106, 1994. DOl: https://doi.org/10.1007/BF00227282
  11. A. C. Geurts, G. M. Ribbers, J. A. Knoop, J. van Limbeek, "ldentification of static and dynamic postural instability following traumatic brain injury", Arch Phys Med Rehabil, vol. 77, no. 7, pp. 639-644, 1996. DOl: https://doi.org/10.1016/S0003-9993(96)90001-5
  12. L. K. Huon, T. C. Wang, T. Y. Fang, L. J. Chuang, P. C. Wang, "Vertigo and stroke: a national database survey", Otol Neurotol, vol. 33, no. 7, pp. 1131-1135, 2012. DOl: https://doi.org/10.1097/MAO.0b013e31826426ee
  13. V. Sharma, J. Kaur, "Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke", J Exerc Rehabil, vol. 13, no. 2, pp. 200-205, 2017. DOl: https://doi.org/10.12965/jer.1734892.446
  14. L. J. Janssen, L. L. Verhoeff, C. G. Horlings, J. H. Allum, "Directional effects of biofeedback on trunk sway during gait tasks in healthy young subjects", Gait Posture, vol. 29, no. 4, pp. 575-581, 2009. DOl: https://doi.org/10.1016/j.gaitpost.2008.12.009
  15. R. W. Bohannon, "Gait performance of hemiparetic stroke patients: selected variables", Arch Phys Med Rehabil, vol. 68, no. 11, pp. 777-781, 1987.
  16. D. S. Nichols, "Balance retraining after stroke using force platform biofeedback", Phys Ther, vol. 77, no. 5, pp. 553-558, 1997. DOl: https://doi.org/10.1093/ptj/77.5.553
  17. R. A. Geiger, J. B. Allen, J. O'Keefe, R. R Hicks, "Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/force plate training", Phys Ther, vol. 81, no. 4, pp. 995-1005, 2001.
  18. S. H. Nam, K. W. Kang, J. W. Kwon, Y. W. Choi, C. S. Kim, "The effects of handrails during treadmill gait training in stroke pateints", J Korean Soc Phys Ther, vol. 25, no. 1, pp. 23-28, 2013.
  19. S. S. Hwang, "The effects of vestibular stimulation on balance and fundamental phychological process of children with central nervous system dysfunction", Doctor's Degree, Dankook University, 1998.
  20. H. Y. Yu, "The effect of the vestibular- and proprioceptive sensory program on the posture balance and occupational performance", Master's Degree, lnje University, 2013.
  21. P. M. Kennedy, J. T lnglis, "Modulation of the soleus H-refle in prone human subjects using galvanic vestibular stimulation", Clin Neurophysiol, vol. 112, no. 11, pp. 2159-2163, 2001. DOl: https://doi.org/10.1016/S1388-2457(01)00665-4
  22. l. V. Bonan, F. M. .Colle, J. P. Guichard, E. Vicaut, M. Eisenfisz, P. Tran Ba Huy, A. P. Yelnik, "Reliance on visual information after stroke. Part l: Balance on dynamic posturography", Arch PhysMed Rehabil, vol. 85, no. 2, pp. 268-273, 2004. DOl: https://doi.org/10.1016/j.apmr.2003.06.017
  23. C. D. Wolfe, "The impact of stroke", Br Med Bull, vol. 56, no. 2, pp. 275-286, 2000. DOl: https://doi.org/10.1258/0007142001903120
  24. M. Kararas, N. Cetin, M. Bayramoglu, A. Dilek, "Truck Muscle strength in relation to balance and functional disability in unihemispheric stroke patients", Am J Phys Med Rehabil, vol. 83, no. 2, pp. 81-87, 2004. DOl: https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  25. Y. K. Park, J. H. Kim, "Effects of kinetic chain e ercise using EMG-biofeedback on balance and lower e tremity muscle activation in stroke patients", J Phys Ther Sci, vol. 29, no. 8, pp. 1390-1393, 2017. DOl: https://doi.org/10.1589/jpts.29.1390
  26. K. W. Lau, M. K. Mak, "Speed-dependent treadmill training is effective to improve gait and balance performance in patients with sub-acute stroke", J Rehabil Med, vol. 43, no. 8, pp. 709-713, 2011. DOl: https://doi.org/10.2340/16501977-0838
  27. G. S. Sim, H. S. Jeon, "Comparison of the effects of Wii games and mirror self-balancing e ercises on knee joint proprioception and balance in chronic stroke patients", Phys Ther Korea, vol. 24, no. 1, pp. 30-40, 2016. DOl: https://doi.org/10.12674/ptk.2016.24.1.030
  28. H. C. Lee, C. L. Huang, S. H. Ho, W. H. Sung, "The effect of a virtual reality game intervention on balance for patients with stroke: A randomized controlled trial", Games Health, vol. 6, no. 5, pp. 303-311, 2017. DOl: https://doi.org/10.1089/g4h.2016.0109
  29. J. C. Montagna, B. C. Santos, C. R. Battistuzzo, A. P. Loureiro, "Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors", Int J Clin Exp Med, vol. 4, no. 4, pp. 1182-1187, 2014.
  30. M. Yasuhiro, D. Kazuya, Y. Toru, S. Eiji, M. Kouichi, S. Youichi, K. Tetsuhiko, "Effect of e ercise using a Horse-Riding Simulator on physical ability of frail seniors", J Phys Ther Sci, vol. 20, pp. 177-183, 2008. DOl: https://doi.org/10.1589/jpts.20.177
  31. A P. Mulavara, l. S. Kofman, Y. E. De Dios, C. Miller, B. T. Peters, R. Goel, R. Galvan-Garza, J. J. Bloomberg, "Using low levels of stochastic vestibular stimulation to improve locomotor stability", Front Syst Neurosci, 2015. DOl: https://doi.org/10.3389/fnsys.2015.00117
  32. S. l. An, "The effects of vestibular stimulation on a child with hypotonic cerebral palsy", J Phys Ther Sci, vol. 27, no. 4, pp. 1279-1282, 2015. DOl: https://doi.org/10.1589/jpts.27.1279
  33. E. S. Kim, H. K. Lee, R. J. Park, "Effects of aqua e ercise program on the improvement of static balance in child with mental retardation", J Korean Phys Ther, vol. 16, no. 1, pp. 139-152, 2004.
  34. J. C. Montagna, B. C. Santos BC, C. R. Battistuzzo, A. P. Loureiro, "Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors", Int J Clin Exp Med, vol. 7, no. 4, pp. 1182-1187, 2014.
  35. H. C. Nam, "Effect of aquatic therapy for functional restoration in the persons with chronic stroke", Master's Degree, Daegu University, 2006.
  36. D. J. Lee, "Effect of the aquatic training on balance and walking in stroke patients", J Spec Educ Rehabil, vol. 47, no. 2, pp. 21-41, 2008.
  37. J. Y. Han, J. M. Kim, S. K. Kim, J. S. Chung, H. C. Lee, J. K. Lim, J. Lee, K. Y. Park, "Therapeutic effects of mechanical horseback riding on gait and balance ability in stroke patients", Ann Rehabil Med, vol. 36, no. 6, pp. 762-769, 2012. DOl: https://doi.org/10.5535/arm.2012.36.6.762
  38. H. Y. Jung, J. D. Choi, "The effects of vestibular sensory stimulation training on balance and gait in the patients with stroke", J Korean Phys Ther, vol. 26, no. 5, pp. 365-371. 2014.