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Effects of Game-based Postural Vertical Training on Pusher Behavior, Postural Control, and Activity of Daily Living in Patients With Acute Stroke: A Pilot Study

게임 기반의 자세수직 훈련이 급성 뇌졸중 환자의 밀기행동, 자세조절, 그리고 일상생활동작에 미치는 영향: 사전연구

  • An, Chang-man (Department of Physical Therapy, Chonbuk National University Hospital) ;
  • Roh, Jung-suk (Department of Physical Therapy, Hanseo University) ;
  • Kim, Tack-hoon (Department of Physical Therapy, Hanseo University) ;
  • Choi, Houng-sik (Department of Physical Therapy, Hanseo University) ;
  • Choi, Kyu-hwan (Department of Physical Therapy, Ansan University) ;
  • Kim, Gyoung-mo (Department of Physical Therapy, Daejeon Health Institute of Technology)
  • 안창만 (전북대학교병원 물리치료실) ;
  • 노정석 (한서대학교 물리치료학과) ;
  • 김택훈 (한서대학교 물리치료학과) ;
  • 최흥식 (한서대학교 물리치료학과) ;
  • 최규환 (안산대학교 물리치료과) ;
  • 김경모 (대전보건대학교 물리치료과)
  • Received : 2019.06.17
  • Accepted : 2019.07.19
  • Published : 2019.09.17

Abstract

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

Keywords

References

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