DOI QR코드

DOI QR Code

PNF를 이용한 체중지지훈련이 아급성 뇌졸중 환자의 체중지지, 낙상에 대한 두려움 및 계단보행 기능에 미치는 영향 -증례보고-

The Effect of PNF-Based Weight Support Exercise on Weight-Supporting Ability, Fear of Falling, and Stair-Walking Ability of Subacute Stroke Patients

  • 투고 : 2016.11.26
  • 심사 : 2016.11.30
  • 발행 : 2017.04.30

초록

Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

키워드

참고문헌

  1. Ada L, Dean CM, Hall JM, et al. A treadmill and overground walking program improves walking in persons residing in the community after stroke: a placebo-controlled, randomized trial. Archives of Physical Medicine and Rehabilitation. 2003; 84(10):1486-1491. https://doi.org/10.1016/S0003-9993(03)00349-6
  2. Alexander LD, Black SE, Patterson KK, et al. Association between gait asymmetry and brain lesion location in stroke patients. Stroke. 2009;40(2):537-544. https://doi.org/10.1161/STROKEAHA.108.527374
  3. Bae SS. Gait training strategy by CPG in PNF with brain injured patients. The Korean Society of Physical Therapy. 2005;17(1):13-24.
  4. Bassett DR, Vachon JA, Kirkland AO, et al. Eenergy cost of stair climbing and descending on the college alumnus questionnaire. Medicine and Science in Sports and Exercise. 1997;29(9):1250-1254. https://doi.org/10.1097/00005768-199709000-00019
  5. Belgen B, Beninato M, Sulivan PE, et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Archives of Physical Medicine and Rehabilitation. 2006;87(4):554-561. https://doi.org/10.1016/j.apmr.2005.12.027
  6. Bohannon RW, Diane TW. Accuracy of weight bearing estimation by stroke versus healthy subjects. Perceptual and Motor Skills. 1991;72(3):935-941. https://doi.org/10.2466/pms.1991.72.3.935
  7. Bohannon RW, Walsh S. Association of paretic lower extremity muscle strength and balance with stair climbing ability in patients with stroke. Journal of Stroke and Cerebrovascular Diseases. 1991;1(3):129-133. https://doi.org/10.1016/S1052-3057(10)80004-7
  8. Buurke JH, Hermens HJ, Erren-Wolters CV, et al. The effect of walking aids on muscle activation patterns during walking in stroke patients. Gait & Posture. 2005;22:164-170. https://doi.org/10.1016/j.gaitpost.2004.09.003
  9. Dean CM, Ada L, Bampton J, et al. Treadmill walking with body weight support in subacute non-ambulatory stroke improves walking capacity more than overground walking: a randomised trial. Journal of Physiotherapy. 2010;56(2):97-103. https://doi.org/10.1016/S1836-9553(10)70039-4
  10. Eich HJ, Mach H, Werner C, et al. Aerobic treadmill plus Bobath walking training improves walking in subacute stroke: a randomized controlled trial. Clinical Rehabilitation. 2004;18(6):640-651. https://doi.org/10.1191/0269215504cr779oa
  11. Eun SD. Biomechanical effect of the stair heights on the lower extremity joints in stair-ascent activity of elderly persons. Seoul University. Dissertation of Doctorate Degree. 2003.
  12. Ferber R, Ostering LR, Gravells DC. Effect of PNF stretch technique on knee flexormuscle EMG activity in older adults. Journal of Electromyography and Kinesiology. 2002;12(5):391-397. https://doi.org/10.1016/S1050-6411(02)00047-0
  13. Flansbjer UB, Holmbäck AM, Downham D, et al. Reliability of gait performance tests in men and women with hemiparesis after stroke. Journal of Rehabilitation Medicine. 2005;37(2):75-82. https://doi.org/10.1080/16501970410017215
  14. Geurts, Alexander CH, Haart M, et al. A review of standing balance recovery from stroke. Gait & Posture. 2005;22(3):267-281. https://doi.org/10.1016/j.gaitpost.2004.10.002
  15. Harvey RL, Roth EJ, Yu D. Rehabilitation in stroke syndromes. Physical medicine and rehabilitation, 3rd ed. Philadelphia. Saunders. 2007.
  16. Kim DK. Change of walking and stair up in hemiplegia by proprioceptive neuromuscular facilitation techniques. The Korean Society of Physical Therapy. 1991; 11(3):57-64.
  17. Kim K, Lee JD, Seo KC. The effect of gait quality, accuracy in the stroke patients after stair gait exercise by proprioceptive neuromuscular facilitation techniques. Journal of Special Education & Rehabilitation Science. 2011;50(2):271-287.
  18. Klein DA, Stone WJ, Phillips WT, et al. PNF training and physical function in assisted-living older adults. Journal of Aging and Physical Activity. 2002;41(10): 476-488.
  19. Ko BO, Kim EY, Park MH, et al. The effect on functional recovery of self exercise program in stroke. Journal of Special Education & Rehabilitation Science. 2008;47(1):331-347.
  20. Lamontagne A, De Serres SJ, Fung J, et al. Stroke affects the coordination and stabilization of head, thorax and pelvis during voluntary horizontal head motions performed in walking. Clinical Neurophysiology. 2005;116(1):101-111. https://doi.org/10.1016/j.clinph.2004.07.027
  21. Lee JR, Ahn DH, Kim YM. The difference of EEI through the slope of stairs. Physical Therapy Korea. 1999; 6(2):67-76.
  22. Lord SR, Sherrington C, Menz HB, et al. Falls in older people: risk factors and strategies for prevention. Cambridge University Press. 2007.
  23. Maupas E, Paysant J, Datie AM, et al. Functional asymmetries of the lower limbs. A comparison between clinical assessment of laterality, isokinetic evaluation and electrogoniometric monitoring of knees during walking. Gait & posture. 2002;16(3):304-312. https://doi.org/10.1016/S0966-6362(02)00020-6
  24. O'Sullivan SB, Schmitz TJ. Physical rehabilitation: Assessment and treatment, 4th ed. Philadelphia. F.A. Davis Co. 2001.
  25. Riener R, Rabuffetti M, Frigo C. Stair ascent and descent at different inclinations. Gait & posture. 2002; 15(1):32-44. https://doi.org/10.1016/S0966-6362(01)00162-X
  26. Sriwatanakul K, Kelvie W, Lasagna L, et al. Studies with different types of visual analog scales for measurement of pain. Clinical Pharmacology and Therapeutics. 1983;34(2):234-239. https://doi.org/10.1038/clpt.1983.159
  27. Susan SA, Dominiek B, Math B. PNF in practice: an illustrated guide, 3rd ed. Berlin. Springer-Verlag. 2008.