The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
권호 표지

The Immediate Effect of Thoracic Self-Mobilization on Balance and Gait of Acute Stroke Patients

자가 흉추관절가동술이 급성기 뇌졸중 환자의 균형과 보행에 미치는 즉각적 영향

  • Park, Si-hyun (Dept. of Physical Therapy, Soon Cheon An University Hospital) ;
  • Jeong, Eui-young (Dept. of Physical Therapy, Asan Chungmu Hospital)
  • 박시현 (순천향대학교 천안병원 물리치료실) ;
  • 정의용 (아산충무병원 물리치료실)
  • Received : 2019.06.10
  • Accepted : 2019.11.01
  • Published : 2019.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The purpose of this study was to investigate the immediate effect of thoracic self mobilization on balance and gait of acute stroke patients. Methods: Patients (n=10) with acute stroke applied to thoracic self mobilization. There are two thoracic self mobilization of both extension and rotation. Each thoracic self mobilization was performed ten times per direction in a total of three sets and the total time required for two thoracic self mobilization was twenty minutes. The break time between sets was one minute. Balance ability was measured using the timed up and go test and the five times sit to stand test for patients. The 10 meter walk test and the functional gait assessment were used for measurement of gait ability for patients. Results: Significant improvements were observed on balance ability (p<.05) and gait ability (p<.05). Conclusion: These results show that thoracic self mobilization is immediate effective on balance and gait ability. Thus, thoracic self mobilization will help recovery of balance and gait ability in acute stroke patients.

Keywords

References

  1. Alstermark B, Lundberg A, Sasaki S. Integration in descending motor pathways controlling the forelimb in the cat. 11. Inhibitory pathways from higher motor centres and forelimb afferents to C3-C4 propriospinal neurones. Exp. Brain Res. 1984;56:293-307. https://doi.org/10.1007/bf00236285
  2. Ballion B, Morin D, Viala D. Forelimb locomotor generators and quadru-pedal locomotion in the neonatal rat. Eur. J. Neurosci. 2001;14(10):1727-1738 https://doi.org/10.1046/j.0953-816x.2001.01794.x
  3. Bogduck N, Engel R. The menisci of the lumbar zygapophyseal joints: A review of their anatomy and clinical significance. Spine. 1984;9(5):454-460. https://doi.org/10.1097/00007632-198407000-00006
  4. Canning CG, Ada L, Adams R, et al. Loss of strength contributes more to physical disability after stroke than loss of dexterity. Clin Rehabi. 2004;18(3):200-308. https://doi.org/10.1191/0269215504cr715oa
  5. Chei SJ, Oh DW. The effects of intensive chestmobility exercise on increasing pulmonary function and gait in stroke patients. J Spec Educ & Rehabi Sci. 2012;51(2);221-239.
  6. Cowley KC, Zaporozhets E, Schmidt BJ. Propriospinal neurons are sufficient for bulbospinal transmission of the locomotor command signal in the neonatal rat spinal cord. J. Physiol. 2008;586(6):1623-1635. https://doi.org/10.1113/jphysiol.2007.148361
  7. Dabholkar A, Mehta D, Yardi S, et al. Assessment of scapular behaviour in stroke patients. International Journal of Health and Rehabilitation Sciences. 2015;4(2):95-102. https://doi.org/10.5455/ijhrs.000000079
  8. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: A randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;8(4):409-417. https://doi.org/10.1053/mr.2000.3839
  9. De Almeida IC, Clementino AC, Rocha EH, et al. Effects of hemiplegy on pulmonary function and diaphragmatic dome displacement. Resp Physiol Neurobi. 2011;178(2);196-201. https://doi.org/10.1016/j.resp.2011.05.017
  10. Duncan PW, Horner RD, Reker DM, et al. Adherence to postacute rehabilitation guidelines is associated with functional recovery in stroke. Stroke. 2002;33(1):167-177. https://doi.org/10.1161/hs0102.101014
  11. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's disease. Arch Phys Med Rehabil. 2011;92(9):1431-1436. https://doi.org/10.1016/j.apmr.2011.04.008
  12. Edmondston SJ, Singer KP. Thoracic spine: Anatomical and biomechanical considerations for manual therapy. Man Ther. 1997;2(3):132-143. https://doi.org/10.1054/math.1997.0293
  13. Frownfelter D, Dean E. Cardiovascular and pulmonary physical therapy: Evidence and Practice, 4ed. Philadelphia: Mosby. 2006.
  14. Geiger RA, Allen JB, O'Keefe J, et al. Balance and mobility following stroke: Effects of physical therapy interventions with and without biofeedback/forceplate training. Phys Ther. 2001;81(4):995-1005. https://doi.org/10.1093/ptj/81.4.995
  15. Godges JJ, Mattson-Bell M, Thorpe D, et al. The immediate effects of soft tissue mobilization with proprioceptive neuromuscular facilitation on glenohumeral external rotation and overhead reach. J Orthop Sports Phys Ther. 2003;33(12):713-718. https://doi.org/10.2519/jospt.2003.33.12.713
  16. Hans RW. The effect of an exercise program on vital capacity and rib mobility in patients with idiopathic scoliosis. Spine. 1991;16(1):88-93. https://doi.org/10.1097/00007632-199101000-00016
  17. Hoeksma HL, Dekker J, Ronday HK, et al. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial. Arthritis Rheum. 2004;51(5):722-729. https://doi.org/10.1002/art.20685
  18. Illert M, Lundberg A, Tanaka, R. Integration in descending motor pathways controlling the forelimb in the cat. 3. Convergence on propriospinal neurones transmitting disynaptic excitation from the corticospinal tract and other descending tracts. Exp. Brain Res. 1977;29:323-346. https://doi.org/10.1007/bf00236174
  19. Illert M, Lundberg A, Padel Y, et al. Integration in descending motor pathways controlling the forelimb in the cat. 5. Properties of and monosynaptic excitatory convergence on C3-C4 propriospinal neurones. Exp. Brain Res. 1978;33:101-130. https://doi.org/10.1007/bf00238798
  20. Jamie R Flynn, Brett A Graham, Mary P Galea, et al. The role of propriospinal interneurons in recovery from spinal cord injury. Neuropharmacology. 2011;60(5):809-822. https://doi.org/10.1016/j.neuropharm.2011. 01.016
  21. Jung KM, Jung YJ. The effect of scapula setting intervention on the function of upper extremity and walking in the patients with stroke. J Korean Soc Neur Ther. 2013;17(1):39-44.
  22. Juvin L, Simmers J, Morin D. Propriospinal circuitry underlying interlimb coordination in mammalian quadrupedal locomotion. J. Neurosci. 2005;25(25):6025-6035. https://doi.org/10.1523/JNEUROSCI.0696-05.2005
  23. Kaltenborn FM, Evjenth O, Kaltenborn TB, et al. The Spine: Basic Evaluation and Mobilization Techniques: Olaf Norlis Bokhandel. 1993.
  24. Karatas M, Cetin N, Bayramoglu M, et al. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil. 2004;83:213-224. https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  25. Kim DK. The Effects of Joint Mobilization Treatment on Dynamic standing Balance and Gait Balance for the Patients with Spinal Movement. Dankook University. Master Thesis. 2014.
  26. Kim GH, Choe HS, Lee HI, et al. The effects of scapular stabilization exercising on dynamic standing balance in stroke patients. J Korean Soc Phys Ther. 2014;26(1):15-20.
  27. Kim JH, Han TR. Seoul National University College of Medicine. Rehabilitaion medicine. Samhwa publisher. 1996.
  28. Kim NY, Cha YJ. Effect of gait training with constrained- induced movement therapy (CIMT) on the balance of stroke patients. J PHYS THER SCI. 2015;27:611-613. https://doi.org/10.1589/jpts.27.611
  29. Kisner C, Colby LA. Therapeutic exercise. foundation and techniques. FA Davis. Philadelphia. 2002:183-232.
  30. Lynch. Bobath concept: Theory and Clinical Practice in Neurological Rehabilitation. John Wiley & SONS Ltd. United Kingdom. 102-162, 2009.
  31. Magarey ME, Jones MA. Dynamic evaluation and early management of altered motor control around the shoulder complex. Man Ther. 2003;8(4):195-206. https://doi.org/10.1016/S1356-689X(03)00094-8
  32. Ma JS. The effect of arm swing exercise on gait and balance in stroke patients. American Journal of Clinical and Experimental Medicine. 2014;2(6):151. https://doi.org/10.11648/j.ajcem.20140206.16
  33. Mehrholz J, Wagner K, Rutte K, et al. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88 (10):1314-1319. https://doi.org/10.1016/j.apmr.2007.06.764
  34. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: Reliability and validity. Arch Phys Med Rehabil. 2010;91(3):407-413. https://doi.org/10.1016/j.apmr.2009.10.030
  35. Neumann DA. Kinesiology of the Musculoskeletal System: Foundation for Rehabilitation. 2nd edition. Mosby Elsevier. 2002.
  36. Paris SV. Mobilization of the spine. Phys Ther. 1979;59(8):988-995. https://doi.org/10.1093/ptj/59.8.988
  37. Podsiadlo D, Richardson S. The time up & go: A test of basic functional mobility for trail elderly persons. J Am Geriatr SOC. 1991;39(2):142-50. https://doi.org/10.1111/ j.1532-5415.1991.tb01616.x
  38. Rothwel JC, Thompson PD, Day BL, et al. Motor cortex stimulation in intact man: 1. general characteristics of EMG responses in different muscles. Brain. 1987;110(5):1173-1190. https://doi.org/10.1093/brain/110.5.1173
  39. Shim JH, Oh DW, Lee GW. The effects of thoracic flexibility exercise on vital capacity and chest expansion in patients with idiopathic scoliosis. Phys Ther Korea. 2002;12:145-156.
  40. Shumway-Cook A, Woollacott MH. Motor Control: Translating Research into Clinical Practice, 4th edition. Lippincott Williams & Wilkins. 2011.
  41. Statistics Korea. National Health Statistics. Korea Centers for Disease Control and Prevention. 2013.
  42. Stephenson JL, De Serres SJ, Lamontagne A. The effect of arm movements on the lower limb during gait after a stroke. Gait Posture. 2010;31(1):109-115. https://doi.org/10.1016/j.gaitpost.2009.09.008
  43. Thieme H, Ritschel C, Zange C. Reliability and validity of the functional gait assessment (German version) in subacute stroke patients. Arch Phys Med Rehabil. 2009;90(9):1565-1570. https://doi.org/10.1016/j.apmr.2009.03.007
  44. Umberger BR. Effects of suppressing arm swing on kinematics, kinetics, and energetics of human walking. J Biomech. 2008;41(11):2575-2580. https://doi.org/ 10.1016/j.jbiomech.2008.05.024
  45. Umphred DA, Burton GU, Lazaro RT, et al. Umphred's Neurological Rehabilitation. 6th edition. Elsevier Mosby. 2014.
  46. Zaporozhets E, Cowley KC, Schmidt BJ. Propriospinal neurons contribute to bulbospinal transmission of the locomotor command signal in the neonatal rat spinal cord. J. Physiol. 2006;572:443-458. https://doi.org/10.1113/jphysiol.2005.102376