PNF and Movement

  • 제17권3호
  • /
  • Pages.339-351
  • /
  • 2019
  • /
  • 2508-6227(pISSN)
  • /
  • 2508-6472(eISSN)
대한고유수용성신경근촉진법학회 (Korea Proprioceptive Neuromuscular Facilitation Association)
권호 표지
DOI QR코드

DOI QR Code

이중과제 보행훈련이 파킨슨병 환자의 균형, 보행능력 및 일상생활동작에 미치는 효과 -단일사례연구-

The Effect of Dual-task Gait Training on Balance, Gait, and Activities of Daily Living for Patients with Parkinson's Disease -A Single-subject Experimental Design-

  • 박현주 (굿데이케어센터 물리치료실) ;
  • 이언주 (대전대학교 보건의료과학대학 물리치료학과) ;
  • 나규민 (대전대학교 보건의료과학대학 물리치료학과) ;
  • 강태우 (우석대학교 보건복지대학 물리치료학과)
  • Park, Hyun-Ju (Physical Therapy Section, Good-daycare Center) ;
  • Lee, Eon-Ju (Department of Physical Therapy, College of Health and Medical Science, Daejeon University) ;
  • Na, Gyu-Min (Department of Physical Therapy, College of Health and Medical Science, Daejeon University) ;
  • Kang, Tae-Woo (Department of Physical Therapy, College of health and Welfare, Woosuk University)
  • 투고 : 2019.07.25
  • 심사 : 2019.09.05
  • 발행 : 2019.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study identified the effects of dual-task gait training on balance, gait function, and activity of daily living in patients with Parkinson's disease. Methods: This study used a single-subject design. Two patients with Parkinson's disease participated in this study. Dual-task gait training was performed 1 hour per day 8 times during intervention phase. The subjects were measured 8 times in the baseline phase, 8 times in the intervention phase, and 8 times in the follow-up phase. The outcome measurements included a timed up and go test (TUG), a Berg balance scale (BBS), a 10 meter walk test (10MWT), a 6 minute walk test (6MWT), a dynamic gait index (DGI) and a Korean modified Barthel index (K-MBI). Results: When compared to the average of the baseline process, the data collected during the intervention period showed that the TUG and 10MWT results improved and the tendency line was above the baseline. In addition, BBS, 6MWT, DGI, and K-MBI values for both patients increased remarkably after the training. Conclusion: The results of this study revealed that dual-task gait training may be helpful to improve balance, walking function, and activity of daily living for patients with Parkinson's disease. Further studies need to confirm our findings.

키워드

참고문헌

  1. Aarsland D, Larsen JP, Lim NG, et al. Range of neuropsychiatric disturbances in patients with Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry. 1999;67(4):492-496. https://doi.org/10.1136/jnnp.67.4.492
  2. Abbud GAC, Li KZH, DeMont RG. Attentional requirements of walking according to the gait phase and onset of auditory stimuli. Gait & posture. 2009;30(2):227-232. https://doi.org/10.1016/j.gaitpost.2009.05.013
  3. Beauchet O, Annweiler C, Allali G, et al. Recurrent falls and dual task-related decrease in walking speed: Is there a relationship? Journal of the American Geriatrics Society. 2008;56(7):1265-1269. https://doi.org/10.1111/j.1532-5415.2008.01766.x
  4. Benecke R, Rothwell JC, Dick JPR, et al. Disturbance of sequential movements in patients with Parkinson's disease. Brain. 1987;110(2):361-379. https://doi.org/10.1093/brain/110.2.361
  5. Berardelli A, Dick JP, Rothwell JC, et al. Scaling of the size of the first agonist EMG burst during rapid wrist movements in patients with Parkinson's disease. Brain. 1986;49(11):1273-1279.
  6. Berg K, Wood-Dauphinee S, Williams JI. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scandinavian journal of rehabilitation medicine. 1995;27(1):27-36.
  7. Borg G. Perceived exertion as an indicator of somatic stess. Scandinavian journal of rehabilitation medicine. 1970;2(2):92-98.
  8. Bowen A, Wenman R, Mickelborough J, et al. Dual-task effects of talking while walking on velocity and balance following a stroke. Age and ageing. 2001;30(4):319-323. https://doi.org/10.1093/ageing/30.4.319
  9. Canning CG. The effect of directing attention during walking under dual-task conditions in Parkinson's disease. Parkinsonism & related disorders. 2005;11(2):95-99. https://doi.org/10.1016/j.parkreldis.2004.09.006
  10. Canning CG, Ada L, Woodhouse E. Multiple-task walking training in people with mild to moderate Parkinson's disease: a pilot study. Clinical rehabilitation. 2008;22(3):226-233. https://doi.org/10.1177/0269215507082341
  11. Choi SS. The effect of dual tasks on gait and static standing in stroke patients. Daegu University. Dissertation of Doctorate Degree. 2009.
  12. Dobkin BH. Short-distance walking speed and timed walking distance: redundant measures for clinical trials? Neurology. 2006;66(4):584-586. https://doi.org/10.1212/01.wnl.0000198502.88147.dd
  13. Eng JJ, Dawson AS, Chu KS. Submaximal exercise in persons with stroke: test-retest reliability and concurrent validity with maximal oxygen consumption. Archives of physical medicine and rehabilitation. 2004;85(1):113-118. https://doi.org/10.1016/S0003-9993(03)00436-2
  14. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975;12(3):189-198. https://doi.org/10.1016/0022-3956(75)90026-6
  15. Hiengkaew V, Jitaree K, Chaiyawat P. Minimal detectable changes of the Berg balance scale, Fugl-Meyer assessment scale, timed "up & go" test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Archives of physical medicine and rehabilitation. 2012;93(7):1201-1208. https://doi.org/10.1016/j.apmr.2012.01.014
  16. Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology. 1967;17(5):427-427. https://doi.org/10.1212/WNL.17.5.427
  17. Huxham FE, Goldie PA, Patla AE. Theoretical considerations in balance assessment. Australian Journal of Physiotherapy. 2001;47(2):89-100. https://doi.org/10.1016/S0004-9514(14)60300-7
  18. Hong SK, Park KW, Cha JK, et al. Quality of life in patients with Parkinson's disease. Journal of the Korean Neurological Association. 2002;20(3):227-233.
  19. Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Archives of physical medicine and rehabilitation. 2007;88(11):1410-1415. https://doi.org/10.1016/j.apmr.2007.08.109
  20. Jung HY, Park BK, Shin HS, et al. Development of the Korean version of modified Barthel index (K-MBI): multi-center study for subjects with stroke. Journal of the Korean Academy of Rehabilitation Medicine. 2007;31(3):283-297.
  21. Kim YJ, Son HH, Oh JL, et al. Effects of dual task balance training on balance and activities of daily living in stroke patient. Journal of the Korean Society of Physical Medicine, 2011;6(1):19-29.
  22. Kisner C, Colby LA. Therapeutic Exercise, 4th ed. Philadelphia. Foundations and Techniques. 2002.
  23. Kramer AF, Larish JF, Strayer DL, et al. Training for attentional control in dual task settings: a comparison of young and old adults. Journal of experimental psychology: Applied. 1995;1(1):50. https://doi.org/10.1037/1076-898X.1.1.50
  24. Lord SE, Rochester L. Measurement of community ambulation after stroke: current status and future developments. Stroke. 2005;36(7):1457-1461. https://doi.org/10.1161/01.STR.0000170698.20376.2e
  25. Mak MK, Wong-Yu IS, Shen X, et al. Long-term effects of exercise and physical therapy in people with Parkinson disease. Nature Reviews Neurology. 2017;13(11):689. https://doi.org/10.1038/nrneurol.2017.128
  26. Marsden CD, Parkes JD. "On-off effects" in patients with Parkinson's disease on chronic levodopa therapy. The Lancet. 1976;307(7954):292-296. https://doi.org/10.1016/S0140-6736(76)91416-1
  27. Marsden CD. Slowness of movement in Parkinson's disease. Movement disorders: official journal of the Movement Disorder Society. 1989;4(S1):26-37. https://doi.org/10.1002/mds.870040505
  28. Martin M, Shinberg M, Kuchibhatla M, et al. Gait initiation in community-dwelling adults with Parkinson disease: comparison with older and younger adults without the disease. Physical therapy. 2002;82(6):566-577. https://doi.org/10.1093/ptj/82.6.566
  29. Musselman KE. Clinical significance testing in rehabilitation research: what, why, and how? Physical Therapy Reviews. 2007;12(4):287-296. https://doi.org/10.1179/108331907X223128
  30. Olanow CW, Stern MB, Sethi K. The scientific and clinical basis for the treatment of Parkinson disease. Neurology. 2009;72(21 Suppl 4):1-136. https://doi.org/10.1212/01.wnl.0000339408.96493.fe
  31. Park HJ, Lim SH, Lee HJ. The effect of dual-task training on cognitive function and physical performance in patients with dementia: a single-subject experimental design. Korean Journal of Neuromuscular Rehabilitation. 2019;9(1):7-18.
  32. Perez de la Cruz S. Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson's disease: a randomized clinical trial. European journal of physical and rehabilitation medicine. 2017;53(6):825-832. https://doi.org/10.23736/S1973-9087.17.04647-0
  33. Plummer-D'Amato P, Altmann LJ, Saracino D, et al. Interactions between cognitive tasks and gait after stroke: a dual task study. Gait & posture. 2008;27(4):683-688. https://doi.org/10.1016/j.gaitpost.2007.09.001
  34. Podsiadlo D, Richardson S. The timed "up & go": a test of basic functional mobility for frail elderly persons. Journal of the American geriatrics Society. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  35. Redelmeier DA, Bayoumi AM, Goldstein RS, et al. Interpreting small differences in functional status: the six minute walk test in chronic lung disease patients. American journal of respiratory and critical care medicine. 1997;155(4):1278-1282. https://doi.org/10.1164/ajrccm.155.4.9105067
  36. Rijk MC, Tzourio C, Breteler MMB, et al. Prevalence of parkinsonism and Parkinson's disease in Europe: the EUROPARKINSON collaborative study. European community concerted action on the epidemiology of Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry. 1997;62(1):10-15. https://doi.org/10.1136/jnnp.62.1.10
  37. Rochester L, Nieuwboer A, Baker K, et al. Walking speed during single and dual tasks in Parkinson's disease: which characteristics are important?. Movement disorders : official journal of the Movement Disorder Society. 2008;23(16):2312-2318. https://doi.org/10.1002/mds.22219
  38. Seo YG, Jung MS, Lee JH, et al. The effect of diaphragmatic breathing exercise on back pain of an elementary schoolchild. Journal of the Korean Proprioceptive Neuromuscular Facilitation Association. 2012;10(3):39-44.
  39. Silsupadol P, Shumway-Cook A, Lugade V, et al. Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial. Archives of physical medicine and rehabilitation. 2009;90(3):381-387. https://doi.org/10.1016/j.apmr.2008.09.559
  40. Silsupadol P, Lugade V, Shumway-Cook A. Training-related changes in dual-task walking performance of elderly persons with balance impairment: a double-blind, randomized controlled trial. Gait & posture. 2009;9(4):634-639. https://doi.org/10.1016/j.gaitpost.2009.01.006
  41. Trail M, Protas EJ, Lai EC. Neurorehabilitation in Parkinson's disease: an evidence-based treatment model. New Jersey. Slack Incorporated. 2008.
  42. Victor M, Ropper AH. Adams and Victor's principles of neurology, 7th ed. New York. McGraw Hill Professional. 2001.
  43. Yang YR, Chen YC, Lee CS, et al. Dual-task-related gait changes in individuals with stroke. Gait Posture. 2007;25(2):185-190. https://doi.org/10.1016/j.gaitpost.2006.03.007
  44. Yogev-Seligmann G, Hausdorff JM, Giladi N. The role of executive function and attention in gait. Movement disorders. 2008;15;23(3):329-342. https://doi.org/10.1002/mds.21720