DOI QR코드

DOI QR Code

Effect of Olfactory Stimulation on Balance, Spasticity and Quality of Life in Chronic Stroke Patients

후각자극이 만성 뇌졸중 환자의 균형, 경직 및 삶의 질에 미치는 효과

  • In, Tae-Sung (Department of Physical Therapy, Gimcheon University) ;
  • Kim, Kyung-Hun (Department of Physical Therapy, Gimcheon University)
  • 인태성 (김천대학교 물리치료학과) ;
  • 김경훈 (김천대학교 물리치료학과)
  • Received : 2020.03.19
  • Accepted : 2020.04.27
  • Published : 2020.04.30

Abstract

The purpose of this study was to determine whether olfactory stimulation would improve spasticity, balance ability and quality of life in stroke patients. Twenty-one stroke patients were recruited and were randomly divided into two groups: olfactory stimulation group (n=10) and sham stimulation group (n=11). Participants in both groups received conventional physical therapy for 30 minutes before the intervention. Additionally, subject in the olfactory stimulation group performed olfactory stimulation using lavender oil for 6 minutes (2 minx3 set), five times a week for two weeks, while the sham stimulation group conducted olfactory stimulation using water for the same amount of time. Composite-Spasticity-Score was used to assess spasticity level of ankle plantar-flexors. Dynamic balance was measured using a TUG. Postural-sway distance was measured using a force platform. Quality of life were measured by SF-36. There was no significant difference within group and between the groups in the spasticity. Significant improvement in postural-sway and TUG were observed in the olfactory stimulation group compared to the sham stimulation group (p<0.05). The Mental Componnt Summary of the SF 36 in the olfactory stimulation group improved significantly greater than the sham stimulation group (p<0.05). Our findings indicate that olfactory stimulation is beneficial and effective to improve balance ability and quality of life in stroke patients.

본 연구는 만성 뇌졸중 환자를 대상으로 2주간 후각 자극이 균형, 경직 및 삶의 질에 미치는 효과를 규명하기 위하여 실시되었다. 단일맹검 및 사전 무작위 임상시험으로 진행되었으며, 21명의 만성 뇌줄중 환자는 무작위로 후각자극군(n=10)과 속임 후각자극군(n=11)으로 배정되었다. 후각자극 군은 라벤더 오일을 2주간 주 5회, 총 10회 시행하였고, 속임 후각자극 군은 물을 적용하였다. 경직은 Composite Spasticity Score (CSS)를 사용하여 측정하였고, 정적 균형은 힘판(force plate), 동적균형은 Timed up and go test(TUG), 삶의 질은 Short-Form 36 items(SF-36)를 사용하였다. 훈련 후 후각자극 군이 속임 후각자극 군에 비해 정적균형이 유의하게 개선되었으며(p<.05), 경직과 동적균형은 집단 간 유의한 차이가 없었다. 또한, 후각자극 군에서 SF 36의 정신적 건강요약과 총점이 속임 후각자극 군에 비해 유의하게 개선되었다. 본 연구는 후각자극이 만성 뇌졸중 환자의 정적균형과 삶의 질을 효과적으로 향상시킴을 증명하였다.

Keywords

Acknowledgement

본 논문은 김천대학교의 2018학년도 교내학술 연구비 지원에 의한 것임.

References

  1. Y. Yano, Y. Murata, M. Taniguchi, F. Okutani, M. Yamaguchi, and H. Kaba, Olfactory Stimulation with Japanese Soy Sauce Improves Upper Limb Performance, Occup Ther Int, 2748721 2019.
  2. K-N. Fong, C-C Chan, and D-K. Au, Relationship of motor and cognitive abilities to functional performance in stroke rehabilitation, Brain Inj, Vol. (15), No. (5), pp. 443-453, 2001 https://doi.org/10.1080/02699050118772
  3. M. Woollacott, and A. Shumway-Cook, Attention and the control of posture and gait: a review of an emerging area of research, Gait Posture, Vol. 16, No. 1, pp. 1-14, 2002. https://doi.org/10.1016/S0966-6362(01)00156-4
  4. J-J. Kim, D-H. Kim, J-H. Kim, J-S. Bae, J-J. Seo, Y-A. Song, H-J. Jang, The immediately effects of PNF combined pattern movement on balance, propriocetion and flexibility using 3D newton box, JKEIA, Vol. 14, No. 1, pp. 159-166, 2020.
  5. B. Ping Ho Chung and B. Kam Kwan Cheng, Immediate effect of transcutaneous electrical nerve stimulation on spasticity in patients with spinal cord injury, Clin Rehabil, Vol. 24, No. 3, pp. 202-210, 2010. https://doi.org/10.1177/0269215509343235
  6. D. Laddha, G-S. Ganesh, M. Pattnaik, P. Mohanty and C. Mishra, Effect of Transcutaneous Electrical Nerve Stimulation on Plantar Flexor Muscle Spasticity and Walking Speed in Stroke Patients, Physiother Res Int, Vol. 21, No. 4, pp. 247-256, 2016. https://doi.org/10.1002/pri.1638
  7. P-R. Rougier and S. Boudrahem, Visual feedback of force platform displacements for balance control training: what postural ability do healthy subjects have to develop to decrease the difference between center of pressure and center of gravity movements?, Motor Control, Vol. 14, No. 2, pp. 277-297, 2010. https://doi.org/10.1123/mcj.14.2.277
  8. H-C. Boshuizen, L. Stemmerik, M-H. Westhoff and M. Hopman-Rock, The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly. J Aging Phys Act, Vol. 13, No. 1, pp. 5-22, 2005. https://doi.org/10.1123/japa.13.1.5
  9. K. Delbaere, J. Bourgois, N. Van Den Noortgate, G. Vanderstraeten, T. Willems and D. Cambier, A home-based multidimensional exercise program reduced physical impairment and fear of falling, Acta Clin Belg, Vol. 61, No. 6, pp. 340-350, 2006. https://doi.org/10.1179/acb.2006.054
  10. Q. Tian, S. M. Resnick and S. A. Studenski, Olfaction Is Related to Motor Function in Older Adults, J Gerontol A Biol Sci Med Sci, Vol. 72, No. 8, pp. 1067-1071, 2017.
  11. C-L. Marvel, B-L. Schwartz and R. B. Rosse, A quantitative measure of postural sway deficits in schizophrenia, Schizophr Res, Vol. 68, No. 2-3, pp. 363-372, 2004. https://doi.org/10.1016/j.schres.2003.09.003
  12. T. Nakamura, K. Meguro, H. Yamazaki, H. Okuzumi, A. Tanaka, A. Horikawa and H. Sasaki, Postural and gait disturbance correlated with decreased frontal cerebral blood flow in Alzheimer disease, Alzheimer Dis Assoc Disord, Vol. 11, No. 3, pp. 132-139, 1997. https://doi.org/10.1097/00002093-199709000-00005
  13. J-D. Mainland, B-N. Johnson, R. Khan, R-B. Ivry, and N. Sobel, Olfactory impairments in patients with unilateral cerebellar lesions are selective to inputs from the contralesional nostril. J Neurosci, Vol. 25, No. 27, pp. 6362-6371, 2005. https://doi.org/10.1523/JNEUROSCI.0920-05.2005
  14. K-H. Lee, J-Y. Kim, J-H. Y, The anlaysis of the health related physical fitness and mental health in individuals with intellectual idsabilities on virtual reality exercise program by game bike- a pilot study, JKEIA, Vol. 14, No. 2, pp. 119-129, 2020. https://doi.org/10.21184/jkeia.2020.2.14.2.119
  15. I-E. de Araujo, E-T. Roll, M-I. Velazco, C. Margot and I. Cayeux, Cognitive modulation of olfactory processing, Neuron, Vol. 19;46, No. 4, pp. 671-9, 2005. https://doi.org/10.1016/j.neuron.2005.04.021
  16. N. Motomura, A. Sakurai and Y. Yotsuya, Reduction of mental stress with lavender odorant, Percept Mot Skills, Vol. 93, No. 3, pp. 713-718, 2001. https://doi.org/10.2466/pms.2001.93.3.713
  17. S. Freeman, S. Ebihara, T. Ebihara, K. Niu, M. Kohzuki, H. Arai and J. P. Butler, Olfactory stimuli and enhanced postural stability in older adults, Gait Posture, Vol. 29, No. 4, pp. 658-660, 2009. https://doi.org/10.1016/j.gaitpost.2009.02.005
  18. S. Ebihara, E. Nikkuni, T. Ebihara, Y. Sakamoto, S. Freeman and M. Kohzuki, Effects of olfactory stimulation on gait performance in frail older adults, Geriatr Gerontol Int, Vol. 12, No. 3, pp. 567-568, 2012. https://doi.org/10.1111/j.1447-0594.2011.00801.x
  19. M-N. Gim, S-B. Lee, K-T. Yoo, J-Y. Bae, M-K. Kim and J-H. Choi, The effect of olfactory stimuli on the balance ability of stroke patients, J Phys Ther Sci, Vol. 27, No. 1, pp. 109-113, 2015. https://doi.org/10.1589/jpts.27.109
  20. K. Suzuki, R. Nakamura, Y. Yamada and T. Handa, Determinants of maximum walking speed in hemiparetic stroke patients, Tohoku J Exp Med, Vol. 162, No. 4, pp. 337-344, 1990. https://doi.org/10.1620/tjem.162.337
  21. T-J. Ware, M. Kosinski and B. Gandek, SF-36 health survey manual & interpretation guide, Lincoln, RI Quality Metric Incorporated, 2000.
  22. M. Dieterich, M and T. Brandt, Vestibular system: anatomy and functional magnetic resonance imaging. Neuroimaging Clin N Am, Vol. 11, No. 2, pp. 263-273, 2001.
  23. R. Holtzer, N. Epstein J. R. Mahoney, M. Izzetoglu and H. M. Blumen, Neuroimaging of mobility in aging: a targeted review, J Gerontol A Biol Sci Med Sci, Vol. 69, No. 11, pp. 1375-1388, 2014. https://doi.org/10.1093/gerona/glu052
  24. Y. Sakamoto, S. Ebihara, T. Ebihara, N. Tomita, K. Toba, S. Freeman and M. Kohzuki, Fall prevention using olfactory stimulation with lavender odor in elderly nursing home residents: a randomized controlled trial, J Am Geriatr Soc, Vol. 60, No. 6, pp. 1005-1011, 2012. https://doi.org/10.1111/j.1532-5415.2012.03977.x
  25. A. Miyanari, Y. Kaneoke, Y. Noguchi, M. Honda, N. Sadato, Y. Sagara and R. Kakigi, Human brain activation in response to olfactory stimulation by intravenous administration of odorants, Neurosci Lett, Vol. 423, No. 1, pp. 6-11, 2007. https://doi.org/10.1016/j.neulet.2007.06.039
  26. A. Qureshy, R. Kawashima, M-B. Imran, M. Sugiura, R. Goto, K. Okada, K. Inouse, M. Itoh, T. Schomann, K. Zilles and H. Fukuda, Functional mapping of human brain in olfactory processing: a PET study, J Neurophysiol, Vol. 84, No. 3, pp. 1656-66, 2000. https://doi.org/10.1152/jn.2000.84.3.1656
  27. J-V. Jacob and F-B. Horak, Cortical control of postural responses, J Neural Transm, Vol. 114, No. 10, pp. 1339-48, 2007. https://doi.org/10.1007/s00702-007-0657-0
  28. T. Ebihara, S. Ebihara, M. Maruyama, M. Kobayashi, A. Itou, H. Arai and H. Sasaki, A randomized trial of olfactory stimulation using black pepper oil in older people with swallowing dysfunction, J Am Geriatr Soc, Vol. 54, No. 9, pp. 1401-6, 2006. https://doi.org/10.1111/j.1532-5415.2006.00840.x
  29. C-A. Laughton, M. Slavin, K. Katdare, L. Nolan, J-F. Bean, D-C. Kerrigan, E. Phillips, L-A, Lipsitz and J-J. Collons, Aging, muscle activity, and balance control: physiologic changes associated with balance impairment, Gait Posture, Vol. 18, No. 2, pp. 101-8, 2003. https://doi.org/10.1016/S0966-6362(02)00200-X
  30. P-W. Lin, W-C. Chan, B-F. Ng and L-C. Lam, Efficacy of aromatherapy(Lavandula angustifolia)as an intervention for agitated behaviours in Chinese older persons with dementi: a cross-over randomized trial, Int J Geriatr Psychiatry, Vol. 22, No. 5, pp. 405-10, 2007. https://doi.org/10.1002/gps.1688