농촌의학ㆍ지역보건 (Journal of agricultural medicine and community health)

한국농촌의학지역보건학회 (Korean Society for Rural Medicine and Community Health)
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뇌졸중 환자의 지팡이 높이에 따른 보행과 균형에 미치는 영향

The Effect of Cane Height on Walking and Balance for Stroke Patients

  • 서태화 (광주여자대학교 물리치료학과) ;
  • 두영택 (광주여자대학교 물리치료학과) ;
  • 정대인 (광주보건대학교 물리치료학과)
  • Seo, Tae-Hwa (Department of Physical Therapy, Kwangju Women's University) ;
  • Doo, Young-Taek (Department of Physical Therapy, Kwangju Women's University) ;
  • Jung, Dae-In (Department of Physical Therapy, Gwangju Health College University)
  • 투고 : 2018.11.26
  • 심사 : 2018.12.31
  • 발행 : 2018.12.31
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초록

본 연구는 성인 뇌졸중 환자의 보행기능을 향상시키기 위해 사용되고 있는 보행보조기의 가장 이상적인 길이를 제시함으로써 뇌졸중 환자만을 위한 전문화된 맞춤형 보행보조기 길이의 사용을 독려하기 위하여 실시하게 되었다. 그 결과, 지팡이 높이에 따른 성인 뇌졸중 환자의 보행균형, 보행분석에서 보행의 속도 증가를 위해서 몸통 굴곡을 통한 무게 중심이 아래쪽에 위치하고, 하지근육의 활성도 증가를 위해서 몸통 신전을 통한 무게 중심이 위쪽으로 이동하여 척추 기립근의 수축으로 뇌졸중 환자의 지팡이 높이에 따른 균형과 보행 변화의 근거를 제시한다.

Objecctives: This study investigates the effects of using customized walking aids individualized for stroke patients by measuring the effects of different cane lengths to determine the ideal length of walking aids for stroke patients. Methods: Cane lengths were determined from the greater trochanter with walking aids measured 5cm below, at the greater trochanter and 5cm above. All patients walked for ten meters with each cane length to measure speed. Then, we measured the opto gait, timed up go test, and electromyography three times each. Statistical analysis was performed using a linear mixed model, and in the case of significance, the p-value was corrected using the Bonferroni method. Results: There was a statistically significant differences in time up and go test(TUGT), 10m walking, stride and speed between the groups. Conclusions: Long cane length increases body symmetry, stride, increasing muscle activity, and short cane length increases balance and walking.

키워드

Table 1. General characteristics of subjects

NCOHBS_2018_v43n4_250_t0001.png 이미지

Table 2. The comparison of walking and balance in each height

NCOHBS_2018_v43n4_250_t0002.png 이미지

Table 3. The comparison of muscle activity in each height

NCOHBS_2018_v43n4_250_t0003.png 이미지

참고문헌

  1. Fatahzadeh M, Glick M. Stroke: epidemiology, classification, risk factors, complications, diagnosis, prevention, and medical and dental management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(2):180-191 https://doi.org/10.1016/j.tripleo.2005.07.031
  2. Lee DW, Kwak KH, Bae SS. Influence of standing balance with external rotation angle of the hemiplegia leg. J Kor Phys Ther 2003;15(3):173-188 (Korean)
  3. Yoon JG, Kim MH, Yook DW. The effects of selfcontrolled learning on balance in hemiplegics. Phys Ther Korea 2005;12(1): 36-44 (Korean)
  4. Holt RR, Simpson D, Jenner JR, Kirker SG, Wing AM. Ground reaction force after a sideways push as a measure of balance in recovery from stroke. Clin Rehabil 2000;14(1):88-95 https://doi.org/10.1191/026921500668655351
  5. Laufer Y, Dickstein R, Resnik S, Marcovitz E. Weightbearing shifts of hemiparetic and healthy adults upon ste pping on stairs of various heights. Clin Rehabil 2000;14(2):125-129 https://doi.org/10.1191/026921500674231381
  6. Rodriguez GM, Aruin AS. The effect of shoe wedges and lifts on symmetry of stance and weight bearing in hemiparetic individuals. Arch Phys Med Rehabil 2002;83(4):478-482 https://doi.org/10.1053/apmr.2002.31197
  7. Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil 1999;80(7):777-784 https://doi.org/10.1016/S0003-9993(99)90227-7
  8. Aminzadeh F, Edwards N. Exploring seniors' views on the use of assistive devices in fall prevention. Public Health Nurs 1998;15(4):297-304 https://doi.org/10.1111/j.1525-1446.1998.tb00353.x
  9. Tinetti ME, Powell L. Fear of falling and low selfefficacy: a case of dependence in elderly persons. J Gerontol 1993;48:35-38 https://doi.org/10.1093/geronj/48.Special_Issue.35
  10. Dean E, Ross J. Relationships among cane fitting, function, and falls. Phys Ther 1993;73(8):494-500 https://doi.org/10.1093/ptj/73.8.494
  11. Hass U, Persson J, Brodin H, Freden-Karlsson I, Olsson JE, Berg I. Assessment of rehabilitation technologies in stroke. Outcomes and costs. Int J Technol Assess Health Care 1995;11(2):245-261 https://doi.org/10.1017/S0266462300006863
  12. Park KJ. The effects of methods of using assist devices on weight bearing, balance, ambulation in hemiplegic patients [dissertation]. Seoul, Korea University, 2013 (Korean)
  13. Allet L, Leemann B, Guyen E, Murphy L, Monnin D, Herrmann FR, Schnider A. Effect of different walking aids on walking capacity of patients with post stroke hemiparesis. Arch Phys Med Rehabil 2009;90(8):1408-1413 https://doi.org/10.1016/j.apmr.2009.02.010
  14. Cha YJ. The effect of cane height on foot pressure of affected side in adult hemiplegia [dissertation]. Daegu, Daegu University, 2009 (Korean)
  15. Ok JY, Kim JW, Han WS, Han JD,And DH. Influence of cane length on the weight distribution. Phys Ther Korea 2000;7(1):91-100 (Korean)
  16. Kumar R, Roe MC, Scremin OU. Methods for estimating the proper length of a cane. Arch Phys Med Rehabil 1995;76:1173-1175 https://doi.org/10.1016/S0003-9993(95)80129-4
  17. Yi CH, ,Kim JM.(1996). A Comparison of methods for estimating the proper cane length for hemiplegic patients. Physical Therapy Korea 1996;3(2):1-7 (Korean)
  18. Jang JH, Kim KY, Kim HD, et al. Principles & techniques of patient care. 4th ed, Korea, E PUBLIC, 2008, pp.215-273 (Korean)
  19. Yi CH, Kim JM. A comparison of methods estimating the proper cane lenth for hemiplegic patients. Phys Ther Korea 1996;3(2):1-7 (Korean)
  20. Kim JH, Park SC, Jang MH, Kim CJ. A study on anthropometric survey in korea. J Ergon Soc Korea 1989;8(1):19-29 (Korean)
  21. Park SC, Kim JH, Kim CJ. A study on the physical growth and development of korean based on the '92 national anthropometric survey. Korean J Phys Anthropol 1993;6(2):177-189 (Korean) https://doi.org/10.11637/kjpa.1993.6.2.177
  22. Podsiadlo D, Richardson S. The timed "Up and Go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39(2):142-148 https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  23. Dean CM, Richards CL, Malouin F. Walking speed over 10meter overestimates locomotor capacity after stroke. Clin Rehabil 2001;15(4):415-421 https://doi.org/10.1191/026921501678310216
  24. Lienhard K, Schneider D, Maffiuletti NA. Validity of the Optogait photoelectric system for the assessment of spatiotemporal gait parameters. Med Eng Phys 2013;35(4):500-504 https://doi.org/10.1016/j.medengphy.2012.06.015
  25. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placment procedures. J Electomyogr Kinesiol 2000;10(5):361-374 https://doi.org/10.1016/S1050-6411(00)00027-4
  26. Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J. Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil 2001;82(2):183-189 https://doi.org/10.1053/apmr.2001.19022
  27. DeVita P, Stribling J. Lower extremity joint kinetics and energetics during backward running. Med Sci Sports Exerc 1991;23(5):602-610
  28. Ok JY, Kim JW, Han WS, Han JD, Ahn DH. Influence of cane length on the weight distribution. Phys Ther Korea 2000;7(1):91-100 (Korean)
  29. Kumar R, Roe MC, Scremin OU. Methods for estimating the proper length of a cane. Arch Phys Med Rehabil 1995;76(12):1173-1175 https://doi.org/10.1016/S0003-9993(95)80129-4
  30. Cha YJ. Kinetic analysis of adult hemiplegia walking at different walking aid lengths [dissertation]. Daegu, Daegu University, 2011 (Korean)
  31. Buurke JH, Hermens HJ, Erren-Wolers CV, Nene AV. The effect of walking aid 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
  32. Choi YW, Jeong DG, Han JT, Lee MH, Kweon OH, Bae SS. A review of falls in the elderly and exercise intervention. J Korean Soc Phys Med 2007;2(2):125-134(Korean)
  33. Choi YW. The effect of cane-shape on gait in stroke patients [dissertation]. Daegu, Daegu University, 2007 (Korean)