장애물 보행 훈련이 무릎관절 전치환술 환자의 균형 및 낙상효능감에 미치는 영향

The Effects of Obstacles Gait on Balance and Falls-efficacy in Patients With Total Knee Arthroplasty

  • 민동기 (대구보건대학교 물리치료학과) ;
  • 이상재 (대구 더열린병원 물리치료실)
  • Min, Dong-ki (Dept. of Physical Therapy, Daegu health college) ;
  • Lee, Sang-jae (Dept. of Physical Therapy, The Open Hospital)
  • 투고 : 2019.04.11
  • 심사 : 2019.06.15
  • 발행 : 2019.06.30

초록

Background: This study was conducted to investigate the effects of obstacles gait on balance and fall-efficacy in patients who underwent total knee arthroplasty. Methods: The 24 subjects of this study were recruited from individuals diagnoses with degenerative arthritis who had undergone total knee arthroplasty. The 24 patients were randomly divided into a control groups and experimental groups, obstacles gait exercise was conducted for 4 weeks three exercises. Balance and falls-efficacy were measured to compare the effects of the exercises. Results: The results of the balance ability and falls-efficacy showed that the experimental group showed significantly enhanced results than the control group(p<.05). Conclusions: Based on these results, Obstacles gait exercise effectively improves the recovery of patients with total knee arthroplasty.

키워드

참고문헌

  1. Akagi M, Nakamura T, Matsusue Y, et al. The bisurface total knee replacement: A unique design for flexion. Four-to-nine-year follow-up study. J Bone Joint Surg Am. 2000;82:1626-1633. https://doi.org/10.2106/00004623-200011000-00017
  2. Benedetti MG, Catani F, Bilotta TW, et al. Muscle activation pattern and gait biomechanics after total knee replacement. Clinical Biomechanics. 2003;18(9): 871-876. https://doi.org/10.1016/S0268-0033(03)00146-3
  3. Carr JH, Shepherd RB. Stroke Rehabilitation. London: Butter Worth-Heinemann. 2003.
  4. Choi HK. Effects of Water Exercise on Physical Fitness, Pain and Quality of Life in Patients with Osteoarthritis. Seoul National University, Master Thesis. 2009.
  5. Cromwell RL, Newton RA, Forrest G. Influence of vision on head stabilization strategies in older adults during walking. J Gerontol A Biol Sci Med Sci, 2002;57(7):442-448. https://doi.org/10.1093/gerona/57.7.M442
  6. Crowninshield, Roy D, Rosenberg, et al. Changing demographics of patients with total joint replacement. Clinical Orthopaedics and Related Research. 2006;443:266-272. https://doi.org/10.1097/01.blo.0000188066.01833.4f
  7. Dennis DA. Evaluation of painful total knee arthroplasty. J Arthroplasty, 2004;19(4 Supple 1):35-40. https://doi.org/10.1016/j.arth.2004.03.003
  8. Felson DT, Lawrence RC, Dieppe PA, et al. Osteoarthritis. new insights. Part 1. the disease and its risk factors. Ann Intern Med, 2002;133(8):635-646. https://doi.org/10.7326/0003-4819-133-8-200010170-00016
  9. Fletcher PC, Hirdes JP. Restriction in activity associated with fear of falling among community- based seniors using home care services. Age Ageing. 2004;33(3):273-279. https://doi.org/10.1093/ageing/afh077
  10. Gidwani S, Tauro B, Whitehouse S, et al. Do patients need to earn total knee arthroplasty? J Arthroplasty. 2003;18(2):199-203. https://doi.org/10.1054/arth.2003.50021
  11. Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: A review. Neurobiol Aging. 1989;10:727-738. https://doi.org/10.1016/0197-4580(89)90010-9
  12. Hwang HC. The Effect of Obstacle Training in Aqua and Land for Chronic Stroke Patients for Balance and Muscle Activation. Daegu University, Master Thesis. 2015.
  13. Jeon BJ, Lee JS, Lee Oj, et al. A study on the factors affecting falls of the elderly in rural areas. Journal of Korean Society of Occupational Therapy. 2009;17(4):99-111.
  14. Kerrigan DC, Todd BA, Mary K, et al. Biomechanical gait alterations independent of speed in the healthy elderly: Evidence for specific limiting impairments. Arch Phys Med Rehabil. 1998;79(3):317-322. https://doi.org/10.1016/S0003-9993(98)90013-2
  15. Kim EJ, Hwang BY, Kim MS. The effect of a virtual reality program on static balance control and fall efficacy of elderly people. Journal of the Korean Gerontological Society. 2010;30(4):1107-1116.
  16. Kim HS. The Effect of Therapeutic Taping on The Active Knee Extension and Knee pain during Going up and Down the stairs With Knee Osteoarthritis. Dankook University, Master Thesis. 2002.
  17. Kim JH, Yang YH, An SY, et al. Gerontological Nursing. HyunMoon. 1998;61-66.
  18. Kwon HM. The Effect of Balance Control And Vestibular Function by an Aquatic Rotation Control and The Obstacle Avoidance Underwater With Hemiplegia Patients. Dongshin University, Master Thesis. 2010.
  19. Lay AN, Hass CJ, Richard Nichols T, et al. The effects of sloped surfaces on locomotion: An electromyographic analysis. J Biomech, 2007;40(6):1276-1285. https://doi.org/10.1016/j.jbiomech.2006.05.023
  20. Lee HJ. The Effects of Obstacles Gait on Balance and Gait in Patients with Parkinson's Disease. Daegu University, Master Thesis. 2017.
  21. Lee JH, Min DK, Lee SJ. The effects of trunk stability exercise onf knee function, balance, gait in patients after total knee arthroplasty. Journal of Korea Academia-Industrial cooperation Society. 2018;19(2):422-428. https://doi.org/10.5762/KAIS.2018.19.2.422
  22. Lee SJ. The Effects of Early Exercise Therapeutic Program with Hip Joint Exercise on Muscle Strength, Balance and Gait in Early Patients after Total Knee Arthroplasty. Daegu Universty, Master Thesis. 2017.
  23. Lin MR, Hwang HF, Hu MH, et al. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and tinetti balance measures in community-dwelling older people. Journal of the American Geriatrics Society. 2004;52(8):1343-1348. https://doi.org/10.1111/j.1532-5415.2004.52366.x
  24. Lu TW, Yen HC, Chen HL. Comparisons of the inter- joint coordination between leading and trailing limbs when crossing obstacles of different heights. Gait Posture. 2007;27(2):309-315. https://doi.org/10.1016/j.gaitpost.2007.04.007
  25. Means KM. The obstacle course: A tool for the assessment of functional balance and mobility in the elderly. Journal of Rehabilitation Research & Development. 1996;33(4):413-429.
  26. Park KT. Effects of The Task circuit training program using the obstacles on Gait, Balance, Falls-efficacy and Self-efficacy in Stroke Patients. Korea National University of Transportation. 2015.
  27. Park SY. The effect of adjuvant cold therapy before Continuous Passive Motion on pain management in elderly total knee replacement patients. Pusan Catholic University, Master Thesis. 2011.
  28. Posiadlo D, Richardson S. The Timed "Up & Go": A test of basic functional mobility for frail elderly persons, J Am Geriatr Soc. 1991;39:142-148. DOI: http://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  29. Pryde KM, Roy EA, Patla AE. Age-related trends in locomotor ability and obstacle avoidance. Human movement science. 1997;16(4):507-516. https://doi.org/10.1016/S0167-9457(96)00064-4
  30. Rahmann AE, Brauer SG, Nitz JC. A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: A randomized controlled trial. Phys Med Rehabil. 2009;90:744-755.
  31. Said CM, Goldie PA, Patla AE, et al. Effect of stroke on step characteristics of obstacle crossing. Archives of Physical Medicine and Rehabilitation. 2001;82(12):1712-1719. https://doi.org/10.1053/apmr.2001.26247
  32. Shumway-cook A, Woollacott MH. Motor control: Translating research in to clinical practice. 3rd ed. Lippincott Williams & Wilkins. 2007;157-186.
  33. Silsupado lP, Siu KC, Shumway-Cook A, et al. Training of balance under single and dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86:269-281. https://doi.org/10.1093/ptj/86.2.269
  34. Skelton DA, Dinan SM. Exercise for falls management : rational for an exercise programme aimed at reducing postural instability. Physiother Theory Pract. 1999;15:105-120. https://doi.org/10.1080/095939899307801
  35. Son JH, Kang MS. Total knee arthroplasty without patellar resurfacing in moderate to severe patellofemoral arthritis. Knee Surgery & Related Research. 2006;18(2):140.
  36. Stitik TP, Kaplan RJ, Kamen LB, et al. Rehabilitation of orthopedic and rheumatologic disorder. osteoarthritis assessment treatment and rehabilitation. Arch Phy Med Rehabil. 2005;86(1):48-55. https://doi.org/10.1016/j.apmr.2004.07.346
  37. Tinetti ME. Multi factorial fall-prevention strategies: Time to retreat or advance. Journal of the American Geriatrics Society. 2008;(8)1563-1565.