DOI QR코드

DOI QR Code

뇌졸중 노인에게 PNF의 안정적 반전과 율동적 안정화 기법을 이용한 몸통 안정화 훈련이 몸통 근력과 호흡기능에 미치는 영향

The Effects of Trunk Stability Exercise Using Stabilizing Reversal and Rhythmic Stabilization Techniques of PNF on Trunk Strength and Respiratory Ability in the Elderly after Stroke

  • 이영훈 (동방문화대학원대학교 자연치유학과) ;
  • 조용호 (대구한의대학교 물리치료학과)
  • Lee, Young-Hun (Department of Naturopathy, Dongbang Culture University) ;
  • Cho, Yong-Ho (Department of Physical Therapy, Daegu Haany University)
  • 투고 : 2021.02.01
  • 심사 : 2021.03.03
  • 발행 : 2021.04.30

초록

Purpose: The purpose of this study was to investigate the effect of trunk-stabilization training using stabilizing reversal and rhythmic stabilization techniques of PNF on trunk muscle strength and respiratory function in elderly stroke patients. Methods: There were 26 stroke patients included in the study. Patients were divided into two groups, and all patients performed exercise 30 min five times per week for six weeks. The experimental group performed trunk stability exercise using stabilizing reversal and rhythmic stabilization techniques of PNF, and the control group performed flexibility and strength training. Trunk muscle strength, forced vital capacity, maximum inspiratory pressure, and maximum expiration pressure were measured to determine the changes after the intervention. For statistical processing, a paired t-test was performed within the group, and the value after intervention was performed as an independent t-test to find out the difference between the two groups. Results: In the experimental group, all of the trunk muscle strength, forced vital capacity, maximum inspiratory pressure, and maximum expiration pressure showed significant differences according to the intervention. In the control group, there were statistically significant differences in trunk muscle strength and forced vital capacity, but the maximum inspiratory pressure and the maximum expiration pressure did not show any statistical change. Conclusion: From these results, it can be seen that the trunk stability exercises that use the proprioceptive neuromuscular promotion method of stable reversal and rhythm stabilization can be a good intervention for the respiratory function of stroke patients.

키워드

참고문헌

  1. Bae WS, Moon HJ, Lee KC. Effects of abdominal exercise methods on breathing ability. Journal of the Korean Society of Integrative Medicine. 2020;8(1):137-146.
  2. Cameron MH, Monroe LG. Physical rehabilitation: evidencebased examination, evaluation, and intervention. Philadelphia. Elsevier Health Sciences. 2007.
  3. Cerniauskaite M, Quintas R, Koutsogeorgou E, et al. Quality-of-life and disability in patients with stroke. American Journal of Physical Medicine & Rehabilitation. 2012; 91(13):S39-S47. https://doi.org/10.1097/PHM.0b013e31823d4df7
  4. Cho YH, Lee SB. Impact of respiratory muscle exercises on pulmonary function and quality of sleep among stroke patients. Journal of the Korean Society of Physcical Medicine. 2015;10(4):123-131. https://doi.org/10.13066/kspm.2015.10.4.123
  5. Choi HS, Kwon OY, Yi CH, et al. The comparison of trunk muscle activities during sling and mat exercise. Physical Therapy Korea. 2005;12(1):1-10.
  6. Dimitriadis Z, Kapreli E, Konstantinidou I, et al. Test/retest reliability of maximum mouth pressure measurements with the MicroRPM in healthy volunteers. Respiratory care. 2011;56(6):776-782. https://doi.org/10.4187/respcare.00783
  7. Dimitriadis Z, Kapreli E, Strimpakos N, et al. Respiratory weakness in patients with chronic neck pain. Manual therapy. 2013;18(3):248-253. https://doi.org/10.1016/j.math.2012.10.014
  8. Frownfelter D, Dean E. Cardiovascular and pulmonary physical therapy: evidence and practice, 4th ed. Philadelphia. Mosby. 2006.
  9. HACMON RR, Krasovsky T, Lamontagne A, et al. Deficits in intersegmental trunk coordination during walking are related to clinical balance and gait function in chronic stroke. Journal of neurologic physical therapy. 2012;36(4):173-181. https://doi.org/10.1097/NPT.0b013e31827374c1
  10. Jandt SR, Caballero RM, Junior LA, et al. Correlation between trunk control, respiratory muscle strength and spirometry in patients with stroke: an observational study. Physiotherapy Research International. 2011;16(4):218-224. https://doi.org/10.1002/pri.495
  11. Jung KM. Effects of whole body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke: a randomized controlled pilot study. Journal of the Korean Society of Physcical Medicine. 2018;13(4):75-84. https://doi.org/10.13066/kspm.2018.13.4.75
  12. Kang JI, Kim BR, Park SK, et al. Effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients. Journal of Korean Physical Therapy. 2015;27(4):258-263. https://doi.org/10.18857/jkpt.2015.27.4.258
  13. Kang TW, Ham KH. Effect of trunk stability exercises with stabilizing reversal and rhythmic stabilization of PNF for muscle strength and balance ability in stroke patients. Journal of Korea Proprioceptive Neuromuscular Facilitation Association. 2014;12(2):63-69.
  14. Kang TW, Kim BR. Effect of proprioceptive neuromuscular facilitation chopping pattern on neglect, balance, and activity of daily living of stroke patients with hemi-spatial neglect: a randomized clinical trial. Journal of the Korean Society of Physcical Medicine. 2019;14(2):107-115. https://doi.org/10.13066/kspm.2019.14.2.107
  15. Karthikbabu S, Chakrapani M, Ganeshan S, et al. A review on assessment and treatment of the trunk in stroke: A need or luxury. Neural regeneration research. 2012;7(25):1974. https://doi.org/10.3969/j.issn.1673-5374.2012.25.008
  16. Khedr EM, EI Shinway O, Khedr T, et al. Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. European Journal of Neurology. 2000;7(3):323-30. https://doi.org/10.1046/j.1468-1331.2000.00078.x
  17. Kim JH, Hong WS, Bae SS. The effect of chest physical therapy on improvement of pulmonary function in the patients with stroke. The Journal of Korean Physical Therpay. 2000;12(2):133-144.
  18. Kim KS, Kwon OY, Yi CH. Effect of abdominal drawing-in maneuver on peak expiratory flow, forced expiratory volume in 1 second and pain during forced expiratory pulmonary function test in patients with chronic low back pain. Physical Therapy Korea. 2015;16(1):10-17.
  19. Knols RH, Aufdemkampe G, De Bruin ED, et al. Hand-held dynamometry in patients with haematological malignancies: measurement error in the clinical assessment of knee extension strength. BMC Musculoskeletal Disorders. 2009;10(1):1-11. https://doi.org/10.1186/1471-2474-10-1
  20. Korea Proprioceptive Nueromuscular Facilitation Association (KPNFA). http://www.pnf.or.kr. 2021.
  21. Kwon GI. Effects of arm exercise using PNF chopping and lifting pattern on the respiratory function, respiratory muscle strength and trunk control ability of a chronic stroke. Daegu Haany University. Dissertation of Master's Degree. 2020.
  22. Lee BK. The effect of the forced pulmonary function of young female, by changes in lung function related to postures and by transverse abdominis activation in standing position. Journal of Korean Society of Physical Medicine. 2012;7(3):267-274. https://doi.org/10.13066/kspm.2012.7.3.267
  23. Lee JH, Kwon YJ, Kim K. The effect of chest expansion and pulmonary function of stroke patients after breathing exercise. The Journal Korean Society of Physical Therapy. 2009;21(3):25-32.
  24. Lee JW. The effect of depending on the location of applying chest expansion resistance exercise on respiratory muscle strength and function stroke patient. Daegu Haany University. Dissertation of Master's Degree. 2019.
  25. Lee WH, Lee YM. The effect of hormone and pulmonary function in the scoliosis patients after trunk stabilization exercise. Journal of the Korean Society of Integrative Medicine. 2018;6(1):43-74.
  26. Menezes KK, Nascimento LR, Ada L, et al. Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review. Journal of physiotherapy. 2016;62(3):138-144. https://doi.org/10.1016/j.jphys.2016.05.014
  27. Menezes KK, Nascimento LR, Avelino PR, et al. Efficacy of interventions to improve respiratory function after stroke. Respiratory care. 2018;63(7):920-933. https://doi.org/10.4187/respcare.06000
  28. Skinner JS. Exercise testing & exercise prescription for special cases: theoretical basis & clinical application, 3rd ed. Philadelphia. Lippincott Williams & Wilkins. 2005.
  29. Spinazzola L, Cubelli R, Della Sala S. Impairments of trunk movements following left or right hemisphere lesions: dissociation between apraxic errors and postural instability. Brain. 2003;126(12):2656-2666. https://doi.org/10.1093/brain/awg266
  30. Thorborg K, Bandholm T, Holmich P. Hip-and knee-strength assessments using a hand-held dynamometer with external belt-fixation are inter-tester reliable. Knee Surgery, Sports Traumatology, Arthroscopy. 2013;21(3):550-555. https://doi.org/10.1007/s00167-012-2115-2
  31. van der Palen J, Rea TD, Manolio TA, et al. Respiratory muscle strength and the risk of incident cardiovascular events. Thorax. 2004;59(12):1063-1067. https://doi.org/10.1136/thx.2004.021915