대한물리의학회지 (Journal of the Korean Society of Physical Medicine)

  • 제13권1호
  • /
  • Pages.137-146
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  • 2018
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  • 1975-311X(pISSN)
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  • 2287-7215(eISSN)
대한물리의학회 (The Korean Society of Physical Medicine)
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지역사회 보행훈련이 만성 뇌졸중 환자의 보행 및 우울증, 자기효능감에 미치는 영향

The Effects of Community Ambulation Training on Gait, Depression and Self-efficacy in Chronic Stroke Patients

  • 김주형 (일산중심병원) ;
  • 심재훈 (백석대학교 보건학부 물리치료학과) ;
  • 오덕원 (청주대학교 보건의료대학 물리치료학과) ;
  • 유경훈 (백석대학교 보건학부 물리치료학과)
  • Kim, Ju-hyung (Dept. of Physical Therapy, Lisan Central Hospital) ;
  • Shim, Jae-Hun (Dept. of Physical Therapy, Division of Health Science Baekseok University) ;
  • Oh, Duck-Won (Dept. of Physical Therapy, College of Health Science Cheongju University) ;
  • Yu, Kyung-Hoon (Dept. of Physical Therapy, Division of Health Science Baekseok University)
  • 투고 : 2018.01.16
  • 심사 : 2018.02.08
  • 발행 : 2018.02.28
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초록

PURPOSE: This study examine the effect of community ambulation training on gait, depression and self - efficacy of stroke patients in order to develop more effective training methods of community rehabilitation. METHODS: In the experimental group, community ambulation training combined with indoor and outdoor walking was performed for 30 minutes three times a week for six weeks. In the control group, general indoor walking training was performed. The physical factors were assessed by a 10-meter walking test, six-minute walking test and community gait test. Psychological factors were assessed by the Korean version of the Epidemiology Center Depression Scale and Activity-Specific Balance Confidence Scale. RESULTS: In the 10-meter walking test, the normal walking speed was significantly improved after the intervention in both the experimental group and the control group (p<.05). However, the fast walking speed was significantly improved only in the experimental group (p <.05). ln the community gait test, the experimental group showed significant improvement (p<.05), but the control group did not. Depression and self-efficacy were significantly improved in the experimental group (p<.05) but not in the control group. CONCLUSION: Community ambulation training may improve the gait ability of stroke patients and reduce their depression and improve self-efficacy.

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참고문헌

  1. Andrews AW, Chinworth SA, Bourassa M, et al. Update on distance and velocity requirements for community ambulation. J Geriatr Phys Ther. 2010;33(3):128-34.
  2. Bonan IV, Yelnik AP, Colle FM, et al. Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2004;85(2):274-8. https://doi.org/10.1016/j.apmr.2003.06.016
  3. Carod-Artal FJ, Egido JA. Quality of life after stroke: the importance of a good recovery. Cerebrovasc Dis. 2009;27(1):204-14.
  4. Carr JH, Shepherd, R. B. Stroke rehabilitation: Guideline for exercise and training to optimal motor skill. In: heineman LB, editor. Oxford. 2003.
  5. Cha HG, JI SG. The effects of Community Ambulation Training on Muscle Activity of the Lower Extremities and Dynamic Balance Ability, Gait Scale in Stroke Patients. Institute of Special Education &Rehabitation Science, Daegu University. 2012;51(4):159-75.
  6. Chung JH KM, Lee JA. Effects of the group task-related program training on motor function and depression for patient with stroke. J Korean Soc Phys Med. 2010;5(1):25-34.
  7. Dobkin BH. Short-distance walking speed and timed walking distance; Redundant measures for clinical trial? Neurology. 2006;66(4):584-6. https://doi.org/10.1212/01.wnl.0000198502.88147.dd
  8. Eng JJ, Dawson AS, Chu KS. Submaximal exercise in persons with stroke: test-retest reilablility and concurrent validity with maximal oxygen consumption. Arch Phys Med Rehabil. 2004;85(1):113-8. https://doi.org/10.1016/S0003-9993(03)00436-2
  9. Filiatrault J, Gauvin L, Fournier M, et al. Evidence of the psychometric qualities of a simplified version of the activites-specific balance confidence scale for community-dwelling seniors. Arch Phys Med Rehabil. 2007;88(5):664-72. https://doi.org/10.1016/j.apmr.2007.02.003
  10. Gadidi V, Katz-Leurer M, Carmeli E, Bornstein NM. Long-term outcome poststroke: predictors of activity limitation and participation restriction. Arch Phys Med Rehabil. 2011;92(11):1802-8. https://doi.org/10.1016/j.apmr.2011.06.014
  11. Hackett ML, Yapa C, Parag V, et al. Frequency of depression after stroke: A systematic review of observational studies. Stroke 2005;36(6):1330-40. https://doi.org/10.1161/01.STR.0000165928.19135.35
  12. Ha MS, Park MC, Goo BO. The Effect of Recovery of disability on Post-stroke Depression. J Korean Soc Phys Med. 2010;5(4):623-32.
  13. Hwang EO, Oh DW, Kim SY, Choi JD. Effects of Community-based Adaptive Ambulation Training on Walking Function in Patients with Post-stroke Hemiparesis. Korean Journal of Health Promotion. 2010;10(2):78-85.
  14. Kelly-Hayes M, Beiser A, Kase CS, et al. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003;12(3):119-26. https://doi.org/10.1016/S1052-3057(03)00042-9
  15. Kim MK. Effects of community ambulation training on balance, gait and social participation in people with stroke. Department of Physical therapy Graduate School Sahmyook University. 2013.
  16. Kim SY, Oh DW. Effect of a weekly circuit-group exercise program on community-living individuals with chronic stroke. Korean Research Society of Physical Therapy. 2008;15(3):17-25.
  17. Lawton MP. The functional assessment of elderly people. J Am Soc Geriatr Dent. 1971;19:465-81. https://doi.org/10.1111/j.1532-5415.1971.tb01206.x
  18. Lee JA, Lee HM. The effect of dual task training based on the international classification of functioning, disability, and health on walking ability and self-efficacy in chronic stroke. J Korean Soc Phys Med. 2017;12(1):121-9 https://doi.org/10.13066/kspm.2017.12.1.121
  19. Lerner-Frankiel MB, Vargas S, Brown MB. Functional community ambulation: what are your criteria? Clin Manage PhysTher. 1986;6(2):12-15.
  20. Lord S, McPherson KM, McNaughton HK, et al. How feasible is the attainment of community ambulation after stroke? A pilot randomized controlled trial to evaluate community-based physiotherapy in subacute stroke. ClinRehabil. 2008;22(3):215-25.
  21. Lord SE, McPherson K, McNaughton HK, et al. Community ambulation after stroke: how important and obtainable is it and what measures appear predictive?. Arch Phys Med Rehabil. 2004;85(2):234-9. https://doi.org/10.1016/j.apmr.2003.05.002
  22. Lord SE, Rochester L. Measurement of community ambulation after stroke: Current status and future development. Stroke. 2005;36(7):1457-61. https://doi.org/10.1161/01.STR.0000170698.20376.2e
  23. Lynch EB, Butt Z, Heinemann A, et al. A qualitative study of quality of life after stroke: the importance of social relationships. J Rehabil Med. 2008;40(7):518-23. https://doi.org/10.2340/16501977-0203
  24. Marks R, Allegrante JP. A review and synthesisofresearch evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice(part II). Health promotion practic. 2005;6(2):148-56. https://doi.org/10.1177/1524839904266792
  25. Oh DW. Community Ambulation: Ultimate Goal for Therapeutic Planning and Clinical Decision-making in Stroke Rehabilitation. Kor J Neural Rehabil. 2013;3(1):48-56.
  26. Park HJ, Kim SY, Oh DW. Effectiveness of communitybased ambulation training for walking function of post-stroke hemiparesis: A randomized controlled pilot trial. ClinRehabil. 2011;25(5):451-9.
  27. Patla AE, Shumway-Cook A. Dimensions of mobility: Defining the complexity and difficulty associated with communiy mobility. J Aging Phys Activity. 1999;7(1):7-19. https://doi.org/10.1123/japa.7.1.7
  28. Radloff LS. The CES-D Scale : A Self-Report Depression Scale for Research in the General Population Applied psychological measurement. 1977:385-401.
  29. Rantakokko M, Manty M, Iwarsson S, et al. Fear of moving outdoors and development of outdoor walking difficulty in older people. J Am Geriatr Soc. 2009; 57(4):634-40. https://doi.org/10.1111/j.1532-5415.2009.02180.x
  30. Robinson-Smith G, Johnston MV, Allen J. Self-care selfefficacy, quality of life, and depression after stroke. Archives of physical medicine and rehabilitation. 2000;81(4):460-4. https://doi.org/10.1053/mr.2000.3863
  31. Salbach NM, Mayo NE, Wood-Dauphinee S, et al. A task-orientated intervention enhances walking distance and speed in the frist year post stroke: A randomized controlled trial. ClinRehabil. 2004;18(5): 509-19.
  32. Schepers VP, Visser-Meily AM, Ketelaar M, et al. Prediction of social activity 1 year poststroke. Arch Phys Med Rehabil. 2005;86(7):1472-6. https://doi.org/10.1016/j.apmr.2004.11.039
  33. Service KSi. www.kosis.kr. 2016.
  34. Shumway-Cook A, Patla AE, Stewart A, et al. Environmental demands associated with community mobility in older adults with and without mobility disabilities. PhysTher. 2002;82(7):670-81.
  35. Sin YH. Perceived exercise self-efficacy and exercise benefits/barriers of korean adults with chronic diseases. department of nursing. 2000;30(4):869-79.
  36. Singh A, Black SE, Herrman N, et al. Functional and neuroanatomic correlations in poststroke depression: Sunny brook stroke study. Stroke. 2000;31:637-44. https://doi.org/10.1161/01.STR.31.3.637
  37. Stuart M, Benvenuti F, Macko R, et al. Community-based adaptive physical activity program for chronic stroke: feasibility, safety, and efficacy of the Empoli model. Neurorehabil Neural Repair. 2009;23(7):726-34. https://doi.org/10.1177/1545968309332734
  38. Van de Port IG, Kwakkel G, van Wijk I, et al. Susceptibility to deterioration of mobility long-term after stroke: A prospective cohort study. Stroke. 2006;37(1): 167-71. https://doi.org/10.1161/01.STR.0000195180.69904.f2
  39. Van Vliet P, Lincoln N, Foxall A. Comparison of bobath based and movement science based treatment for stroke: a randomised controlled trial. Journal of Neurology, Neurosurgery & Psychiatry. 2005;76(4): 503-8. https://doi.org/10.1136/jnnp.2004.040436
  40. Winstein CJ, Rose DK, Tan SM, et al. A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke:a pilot study of immediate and long-term outcomes. Archives of physical medicine and rehabilitation. 2004;85(4):620-8. https://doi.org/10.1016/j.apmr.2003.06.027
  41. Yogev-Seligmann G, Hausdorff J, Giladi N. The role of executive function and attention in gait. Mov disord. 2008;23(3):329-42. https://doi.org/10.1002/mds.21720