Journal of the Korea Convergence Society (한국융합학회논문지)

Korea Convergence Society (한국융합학회)
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Convergence Effects of Treadmill Training on Plantar Pressure, Lower Limb Muscle Function, and Balance in Chronic Stroke : A Meta-Analysis

만성 뇌졸중 환자의 트레드밀 훈련이 족저압, 하지 근 기능, 균형에 미치는 융복합적 효과 : 메타분석

  • Choi, Ki-Bok (Team of Rehabilitation Therapy, Chosun University Hospital) ;
  • Cho, Sung-Hyoun (Department of Physical Therapy, Nambu University)
  • 최기복 (조선대학교병원 재활치료팀) ;
  • 조성현 (남부대학교 물리치료학과)
  • Received : 2020.04.10
  • Accepted : 2020.05.20
  • Published : 2020.05.28
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Abstract

The purpose of this study is to evaluate the convergence effectiveness of treadmill training in patients with chronic stroke through a meta-analysis. After searching the literature based on the patients, intervention, comparison, outcome criteria, and study desigan, a total of 22 studies related to "stroke" and "treadmill" were eligible for inclusion. Effect size was calculated using the comprehensive meta-analysis program for the meta-analysis. Based on the forest plot results, the overall effect size of treadmill training was 0.661 (95% confidence interval: 0.456-0.865), which was statistically significant with a medium effect size (p < 0.05). The effects of treadmill training on patients with stroke were separated by dependent variables of interest-plantar pressure (1.147), lower limb muscle function (0.875), and balance (0.664). The effect sizes were evaluated for the subdomains of timed up and go test (0.553), Berg Balance Scale (0.760), and static balance index (0.654) for balance. Therefore, treadmill training can be expected to have a positive impact on improving the quality of life of patients with chronic stroke. This meta-analysis of treadmill training may the lead to an industry paradigm shift toward healthcare convergence of information, communication, and medical technology.

만성 뇌졸중 환자를 대상으로 메타분석 기법을 활용하여 트레드밀 훈련의 융복합적 효과성을 평가하고자 한다. PICOS 기준에 의거하여 문헌을 검색한 후 총 22편의 국내 '뇌졸중', '트레드밀' 관련 연구물을 선정하였다. 메타분석을 위해 CMA 프로그램을 이용하여 효과크기를 산출하였으며, 국내 트레드밀 훈련의 전체 효과크기는 0.661(95%CI: 0.456~0.865)로 중간크기로 유의한 차이가 있었다(p<.05). 트레드밀 훈련의 효과를 족저압(1.147), 하지 근 기능(0.875), 균형(0.664)으로 나누어 효과크기를 비교한 결과, 족저압의 효과크기가 가장 크게 나타났다. 추가로 균형은 하위항목들을 나누어 분석하였고, 균형은 TUG(0.553), BBS(0.760), 정적균형지수(0.654)의 효과크기가 나타났다. 따라서 트레드밀 훈련이 만성 뇌졸중 환자의 삶의 질 향상에 긍정적인 영향을 제공한다. 트레드밀 훈련에 대한 메타분석 연구는 정보, 통신 및 의료기술의 헬스케어 융합을 향한 업계 패러다임의 전환으로 이어질 수 있을 것이다.

Keywords

References

  1. O. D. Adebayo & G. Culpan. (2019). Diagnostic accuracy of computed tomography perfusion in the prediction of haemorrhagic transformation and patient outcome in acute ischaemic stroke: a systematic review and meta-analysis. European Stroke Journal, 5(1), 4-16. DOI : 10.1177/2396987319883461
  2. R. W. Bohannon. (2007). Muscle strength and muscle training after stroke. Journal of rehabilitation Medicine, 39(1), 14-20. DOI : 10.2340/16501977-0018
  3. F. Khan, H. Anjamparuthikal & M. F. Chevidikunnan. (2019). The comparison between isokinetic knee muscles strength in the ipsilateral and contralateral limbs and correlating with function of patients with stroke. Journal of Neurosciences in Rural Practice, 10(4), 683-689. DOI : 10.1055/s-0039-1700612
  4. A. S. Ryan, C. L. Dobrovolny, G. V. Smith, K. H. Silver & R. F. Macko. (2002). Hemiparetic muscle atrophy and increased intramuscular fat in stroke patients. Archives of Physical Medicine and Rehabilitation, 83(12), 1703-1707. DOI : 10.1053/apmr.2002.36399
  5. T. Tanaka, Y. Kariya & Y Hoshino. (2004). Histochemical study on the changes in muscle fibers in relation to the effects of aging on recovery from muscular atrophy caused by disuse in rats. Journal of Orthopedic Science, 9(1), 76-85. DOI : 10.1007/s00776-003-0734-7
  6. T. Hortobagyi et al. (2000). Changes in muscle strength, muscle fibre size and myofibrillar gene expression after immobilization and retraining in humans. The Journal of physiology, 524(1), 293-304. DOI : 10.1111/j.1469-7793.2000.00293.x
  7. M. Kivimaki et al. (2019). Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis. BMJ, 365, I1495. DOI : 10.1136/bmj.l1495
  8. A. S. Aruin, T. Hanke, G. Chaudhuri, R. Harvey & N. Rao. (2000). Compelled weight bearing in persons with hemiparesis following stroke: the effect of a lift insert and goal-directed balance exercise. Journal of Rehabilitation Research and Development, 37(1), 65-72.
  9. J. S. Roh & T. H. Kim. (2001). Reliability of plantar pressure meaures using the parotec system. Physical Therapy Korea, 8(3), 35-41.
  10. H. W. Yoon, S. Y. Lee & H. M. Lee. (2009). The comparison of plantar foot pressure in normal side of normal people, affected side and less affected side of hemiplegic patients during stance phase. Journal of the Korean Society of Physical Medicine, 4(2), 87-92.
  11. S. B. O'Sullivan & T. J. Schmitz. (2007). Physical rehabilitation. ed. Philadelphia : FA Davis Company.
  12. A. Shumway-Cook & M. H. Woollacott. (2007). Motor control: Translating research into clinical practice. Lippincoot Williams & Wilkins, 108-105.
  13. R. A. Geiger, J. B. Allen, J. O'Keefe & R. R. Hicks. (2001). Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Physical Therapy, 81(4), 995-1005. DOI : 10.1093/ptj/81.4.995
  14. J. J. Eng & K. S. Chu. (2002). Reliability and comparison of weigh-bearing ability during standing tasks for individuals with chronic stroke. Archives of Physical Medicine and Rehabilitation, 83(8), 1138-1144. DOI : 10.1053/apmr.2002.33644
  15. V. Dietz. (2009). Body weight supported gait training : from laboratory to clinical setting. Brain Research Bulletin, 78(1), 1-6. DOI : 10.1016/S0361-9230(08)00410-3
  16. E. W. Miller, M. E. Quinn & P. G. Seddon. (2002). Body weight support treadmill and overground ambulation training for two patients with chronic disability secondary to stroke. Physical Therapy, 82(1), 53-61. DOI : 10.1093/ptj/82.1.53
  17. J. S. Kim, J. H. An, H. H. Lee, H. J. Park & K. I. Ki. (2017). The effect of treadmill gait training accompanied by visual feedback on the gait and balance of chronic stroke patients. PNF and Movement, 15(2), 133-140. DOI : 10.21598/JKPNFA.2017.15.2.133
  18. Y. J. Kim. (2018). Effects of underwater and ground treadmill walking training on the foot pressure and the walking ability in chronic stroke patients. Master's thesis, Youngsan University, Busan.
  19. J. Park, B. R. Kim & T. H. Kim. (2018). Effects of visual feedback and rhythmic auditory stimulation on walking of stroke patients induced by treadmill walking training. Physical Therapy Korea, 25(2), 53-61. DOI : 10.12674/ptk.2018.25.2.053
  20. K. J. Kim & K. H. Kim. (2018). Progressive treadmill cognitive dual-task gait training on the gait ability in patients with chronic stroke. Journal of exercise rehabilitation, 14(5), 821-828. DOI : 10.12965/jer.1836370.185
  21. S. Y. Park & I. S. Shin. (2012). Meta-analysis of constraint-induced movement therapy in hemiplegic stroke patient in korea. Physical Therapy Korea, 19(2), 59-68. DOI : 10.12674/ptk.2012.19.2.059
  22. M. Borenstein, L. V. Hedges, J. P. Higgins & H. R. Rothstein. (2009). Introduction to meta-analysis . UK : John Wiley & Sons, Ltd.
  23. S. Hesse, C. Werner, T. Paul, A. Bardeleben & J. Chaler. (2001). Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. Archives of physical medicine and rehabilitation, 82(11), 1547-1550. DOI : 10.1053/apmr.2001.26607
  24. N. M. Salbach, N. E. Mayo, S. Wood- Dauphinee, J. A. Hanley, C. L. Richards & R. Cote. (2004). A task-orientated intervention enhances walking distance and speed in the first year post stroke: A randomized controlled trial. Clinical rehabilitation, 18(5), 509-519. DOI : 10.1191/0269215504cr763oa
  25. H. S. Shin. (2015). Effects of inclination tread mill training for dynamic stretching on the spasticity and gait of chronic stroke patients. Master's thesis, Daejeon University, Daejeon.