DOI QR코드

DOI QR Code

The Effect of a Task-oriented Upper Arm Exercise on Stable and Unstable Surfaces on Dynamic Balance and Hand Function in Patient with Cerebral Palsy

  • Han, Yong-Gu (Daegu University Rehabilitation Clinic) ;
  • Yun, Chang-Kyo (Department of Physical therapy, College of Rehabilitation Science, Graduate School, Daegu University)
  • 투고 : 2017.02.19
  • 심사 : 2017.04.07
  • 발행 : 2017.04.30

초록

Purpose: The purpose of this study was to investigate the effects of a task-oriented upper arm exercise performed in a sitting position on either an unstable support surface or a stable support surface for children with cerebral palsy. Methods: We prospectively evaluated 18 children with cerebral palsy. Eight subjects were randomly assigned to each of the stable and unstable support surface groups. We performed the upper arm exercise three times a week for 6 weeks. To confirm the effects of the intervention, the berg balance scale test, modified functional reaching test (MFRT), timed up and go test (TUG), and Jebsen-Taylor hand function test were conducted before and after the study. Results: Significant differences were observed in MFRT and TUG between the experimental and control groups (p<0.05). In the Jebsen-Taylor hand function test, there were significant differences between the groups for the items picking up small objects, stacking checkers, lifting large light objects, and lifting large heavy objects (p<0.05), but not for writing and stimulation of feeding. Significant differences were observed between the groups in items of card turning, lifting large light objects, and lifting heavy objects. Conclusion: The purpose of this study was to evaluate the effectiveness of a task-oriented upper extremity exercise program for dynamic balance and hand function performed in a sitting position with either stable or unstable support by cerebral palsy patients. There were improvements in the two groups, but performing the exercise while sitting on an unstable support surface had a greater effect on dynamic balance and hand function than exercise while sitting on a stable supporting surface. The results of this study can be used to improve the daily lives of cerebral palsy patients.

키워드

참고문헌

  1. Shamsoddini A, Amirsalari S, Hollisaz MT et al. Management of spasticity in children with cerebral palsy. Iran J Pediatr. 2014;24(4):345-51.
  2. Bass N. Cerebral palsy and neurodegenerative disease. Curr Opin Pediatr. 1999;11(6):504-7. https://doi.org/10.1097/00008480-199912000-00005
  3. Braun KVN, Doernberg N, Schieve L et al. Birth prevalence of cerebral palsy: a population-based study. Pediatrics. 2016;137:1-9. https://doi.org/10.1542/peds.2015-4450
  4. James S, Ziviani J, Boyd R. A systematic review of activities of daily living measures for children and adolescents with cerebral palsy. Dev Med Child Neurol. 2014;56(3):233-44. https://doi.org/10.1111/dmcn.12226
  5. Arnould C, Bleyenheuft Y, Thonnard J. Hand functioning in children with cerebral palsy. Front Neurol. 2014;5:48.
  6. Taub E. Movement in nonhuman primates deprived of somatosensory feedback. Exerc Sports Sci Rev. 1976;4:335-74.
  7. Sung IY, Park JM. A pilot evaluation of cast immobilization of intact upper extremity: a new therapeutic approach for spastic hemiplegic cerebral palsy. J Korean Acad Rehabil Med. 1998;22(4):828-32.
  8. Taub E, Crago JE, Burgio T et al. An operant approach to rehabilitation medicine: overcoming learned non use by shaping. J Exp Anal Behav. 1994;61:281-93. https://doi.org/10.1901/jeab.1994.61-281
  9. Taub E. Somatosensory deafferentation research with monkeys: implications for rehabilitation medicine. In: Ince LP, eds. Behavioral Psychology in Rehabilitation Medicine: Clinical Applications, New York, Williams & Wilkins Co., 1980:371-401.
  10. Winstein CJ, Wolf SL, Dromerick AW et al. Effect of a task-oriented rehabilitation program on upper extremity recovery following motor stroke the ICARE randomized clinical trial. Jama. 2016;315(6):571-81. https://doi.org/10.1001/jama.2016.0276
  11. Almhdawi, Khader. Effects of occupational therapy task-oriented approach in upper extremity post-stroke rehabilitation. Minnesota University. Dissertation of Docter's Degree. 2011.
  12. DeLuca SC, Case-Smith J, Stevenson R et al. Constraint-induced movement therapy (CIMT) for young children with cerebral palsy: effects of therapeutic dosage. J Pediatr Rehabil Med. 2012;5(2):133-42.
  13. Ko MS, Jeon HS, Kwon OY et al. The effects of modified constraint induced therapy on upper extremity functions of children with hemiparesis. Phys Ther Korea. 2005;12:81-9.
  14. Yu EY. The effects of single and dual task balance training on stable and unstable surfaces on balance and walking ability in stroke patients. Yongin University. Dissertation of Master's Degree. 2016.
  15. Jung JH. The effect of task-oriented movement therapy on upper extremity, upper extremity function and activities of daily living for stroke patients. Daegu University. Dissertation of Master's Degree. 2009.
  16. Lee HS, Choi JH. Correlation between BBS, FRT, STI, TUG, MBI, and falling in stroke patients. J Kor Soc Phys Ther. 2008;20(4):1-6. https://doi.org/10.1589/jpts.20.1
  17. Jones EG, Powell TPS. An anatomical study of converging sensory pathways within the cerebral cortex of the monkey. Brain. 2016;93(4):793-820. https://doi.org/10.1093/brain/93.4.793
  18. Martin K, Jacobs S, Frey SH. Handedness-dependent and independent cerebral asymmetries in the anterior intraparietal sulcus and ventral premotor cortex during grasp planning. Neuroimage. 2011;57(2):502-12. https://doi.org/10.1016/j.neuroimage.2011.04.036
  19. Nudo RJ, Milliken GW, Jenkins WM et al. Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. J Neurosci. 1996;16(2):785-807. https://doi.org/10.1523/JNEUROSCI.16-02-00785.1996
  20. Park. RJ. Task oriented approach of hemiparetic patients. J Kor Soc Phys Ther. 2004;16(2):54-62.
  21. Bosch J, Donnell MJ, Barreca S et al. Does task-oriented practice improve upper extremity motor recovery after stroke? a systematic review. ISRN Stroke. 2014:1-10.
  22. Lowe A, Dorich J, Warnken B et al. Using virtual reality upper-extremity training combined with task practice to improve functional performance. AJOT. 2015;69(suppl 1):6911515055p1. https://doi.org/10.5014/ajot.2015.69S1-PO1100
  23. Kim SH, Park SH. The clinical art therapy program for concentration and cognitive development-based on action feedback. Society for Art Education of Korea. 2011;41:23-44.
  24. Kohler, JM, Flanagan SP, Whiting WC. Muscle activation patterns while lifting stable and unstable loads on stable and unstable surfaces. J Strength Cond Res. 2010;24(2):313-21. https://doi.org/10.1519/JSC.0b013e3181c8655a
  25. Tuna Z, Oska D, Onbulak D et al. Analysis of the effects of hospitalization on fine hand functions compared to gross grip in patients with rheumatoid arthritis. JCEI. 2015;6(3):228-32.
  26. Chen YP, Pope S, Tyler D et al. Effectiveness of constraint-induced movement therapy on upper extremity function in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2014;28(10):939-53. https://doi.org/10.1177/0269215514544982
  27. Hwang BY, Kim JH, Chung SM. The effects of constraint-induced movement therapy on improvement of hand function in hemiplegic side. J Kor Soc Phys Ther. 2009;21(2):9-14.
  28. Hoare BJ, Imms C, Carey L et al. Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy: a cochrane systematic review. Clin Rehabil. 2007;21:675-85. https://doi.org/10.1177/0269215507080783
  29. Chiu HC, Ada L. Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. Journal of Physiotherapy. 2016;62(3):130-7. https://doi.org/10.1016/j.jphys.2016.05.013
  30. Taub E, Ramey SL, DeLuca SC et al. Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics. 2004;113(2):305-12. https://doi.org/10.1542/peds.113.2.305
  31. Oskoui M, Coutinho F, Dykeman J et al. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013;55(6):509-19. https://doi.org/10.1111/dmcn.12080
  32. Lee WJ, Kong YS, Ko YM et al. Effect of unstable surface exercise on trunk posture and balance ability in patients with scoliosis: after six months follow-up. J Korean Soc Phys Ther. 2013;25(5):232-8.
  33. Kim SJ, Jong HW, Oh JS et al. Comparison of abdominal oblique muscle activity during leg raising in hook-lying position according to surface conditions. Phys Ther Korea. 2006;13(3):102-10.
  34. Yoo JS, Jeong JR, Lee WH. The effect of trunk stabilization exercise using an unstable surface on the abdominal muscle structure and balance of stroke patients. J Phys Ther Sci. 2014;26(6):857-9. https://doi.org/10.1589/jpts.26.857
  35. Shin JW, Song GB. The effects of neck and trunk stabilization exercises on upper limb and visuoperceptual function in children with cerebral palsy. J Phys Ther Sci. 2016;28(11):3232-5. https://doi.org/10.1589/jpts.28.3232
  36. Jang SH, Ann JH, Kim JS. Effect of trunk control training on labile surface on relative impulse in the persons with stroke. J Kor Soc Phys Ther. 2012;24(2):163-9.