DOI QR코드

DOI QR Code

Comparing the Effects of Underwater and Ground-Based Diagonal Pattern Exercises on the Balance Confidence and Respiratory Functions of Chronic Stroke Patients

수중과 지상에서 대각선 패턴 운동이 만성 뇌졸중 환자의 균형 자신감과 호흡 기능에 미치는 효과 비교

  • Park, Jae-Cheol (Department of Physical Therapy, Chunnam Techno University) ;
  • Lee, Dong-Kyu (Department of Physical Therapy, Chunnam Techno University)
  • 박재철 (전남과학대학교 물리치료과) ;
  • 이동규 (전남과학대학교 물리치료과)
  • Received : 2021.05.13
  • Accepted : 2021.06.02
  • Published : 2021.08.31

Abstract

Purpose: The purpose of this study was to compare the effects of underwater and ground-based diagonal pattern exercises on the balance confidence and respiratory functions of chronic stroke patients. Methods: Thirty chronic stroke patients were assigned randomly to an experimental (n = 15) or control (n = 15) group. The experimental group performed an underwater diagonal pattern exercise. The control group performed a ground-based diagonal pattern exercise. Training was conducted once a day for 30 minutes, five days per week for six weeks. Balance confidence was measured using the Activities-Specific Balance Confidence Scale-Korea version. Respiratory function was measured using a spirometer. Results: In a comparison within groups, the experimental and control groups showed significant differences in balance confidence after the experiment (p < 0.05). In a comparison between the two groups, the experimental group showed a more significant difference in balance confidence than the control group (p < 0.05). In a comparison within groups, the experimental group showed a significant difference in respiratory functions after the experiment (p < 0.05). In a comparison between the two groups, the experimental group showed a more significant difference in respiratory functions than the control group (p < 0.05). Conclusion: Based on these results, underwater diagonal pattern exercises effectively improved the balance confidence and respiratory functions of chronic stroke patients.

Keywords

References

  1. Andersen LL, Magnusson SP, Nielsen M, et al. Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: implications for rehabilitation. Physical therapy. 2006;86(5):683-697. https://doi.org/10.1093/ptj/86.5.683
  2. Bang DH, Shin WS. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke: a randomized controlled pilot trial. NeuroRehabilitation. 2016;38(4):343-349. https://doi.org/10.3233/NRE-161325
  3. Carr JH, Shepherd RB. Stroke rehabilitation: guidelines for exercise and training to optimize motor skill. Butterworth-Heineman. Oxford. 2011.
  4. Dean E, Frownfelter DL. Cardiovascular and pulmonary physical therapy: evidence and practice. Missouri. Mosby. 2006.
  5. Driver S, O'connor J, Lox C, et al. Evaluation of an aquatics programme on fitness parameters of individuals with a brain injury. Brain Injury. 2004;18(9):847-859. https://doi.org/10.1080/02699050410001671856
  6. Dubey L, Karthikbabu S. Trunk proprioceptive neuromuscular facilitation influences pulmonary function and respiratory muscle strength in a patient with pontine bleed. Neurology India. 2017;65(1):183-184.
  7. Duncan PW, Zorowitz R, Bates B, et al. Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke. 2005;36(9):100-143.
  8. Estenne M, Gevenois PA, Kinnear W, et al. Lung volume restriction in patients with chronic respiratory muscle weakness: the role of microatelectasis. Thorax. 1993;48(7):698-701. https://doi.org/10.1136/thx.48.7.698
  9. Ferreira M, Lopes AA, Silva F, et al. Effect of an aquatic therapy program on pulmonary function in ankylosing spondylitis. Journal of Aquatic Physical Therapy. 2013;21(1):2-7.
  10. Geiger RA, Allen JB, O'Keefe J, et al. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Physical therapy. 2001;81(4):995-1005. https://doi.org/10.1093/ptj/81.4.995
  11. Houglum PA. Therapeutic exercise for athletic injuries. Champaign. Human kinetics. 2001.
  12. Howard R, Rudd A, Wolfe C, et al. Pathophysiological and clinical aspects of breathing after stroke. Postgraduate medical journal. 2001;77(913):700-702. https://doi.org/10.1136/pmj.77.913.700
  13. Hurkmans E, van der Giesen FJ, Vlieland TPV, et al. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database of Systematic Reviews(online). 2009;7(4):212-220.
  14. Ikai T, Kamikubo T, Takehara I, et al. Dynamic postural control in patients with hemiparesis. American Journaal Physical Medicine & Rehabilitation. 2003;82(6):463-469.
  15. Jang SN, Cho SI, Ou SW, et al. The validity and reliability of Korean fall efficacy scale (FES) and activities-specific balance confidence scale (ABC). Journal of the Korean Geriatrics Society. 2003;7(4):255-268.
  16. Jette DU, Latham NK, Smout RJ, et al. Physical therapy interventions for patients with stroke in inpatient rehabilitation facilities. Physical therapy. 2005;85(3):238-248. https://doi.org/10.1093/ptj/85.3.238
  17. Jung J, Chung E, Kim K, et al. The effects of aquatic exercise on pulmonary function in patients with spinal cord injury. Journal of physical therapy science. 2014;26(5):707-709. https://doi.org/10.1589/jpts.26.707
  18. Khedr E, El Shinawy O, Khedr T, et al. Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. European journal of neurology. 2000;7(3):323-330. https://doi.org/10.1046/j.1468-1331.2000.00078.x
  19. Kim BR, Kang TW. Effect of progressive task-oriented lower extremity strength exercise on pulmonary function, gait endurance, and activities of daily living in chronic stroke patients. Korean Academy of Cardiorrespiratory Physical Therapy. 2020;8(1): 41-47. https://doi.org/10.32337/KACPT.2020.8.1.41
  20. Kim EK, Lee DK, Kim YM. Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients. Journal of physical therapy science. 2015;27(1):213-215. https://doi.org/10.1589/jpts.27.213
  21. Kim SH, Lee DK, Kim EK. Effect of aquatic exercise on balance and depression of stroke patients. Journal of Korean Physical Therapy. 2014;26(2):104-109.
  22. Kim YN, Lee DK. Comparison between aquatic and ground environments of rhythmic initiation for postural control. Journal of Physical Therapy Science. 2012;24(12):1269-1271. https://doi.org/10.1589/jpts.24.1269
  23. Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques. Philadelphia. Fa Davis. 2017.
  24. Klein DA, Stone WJ, Phillips WT, et al. PNF training and physical function in assisted-living older adults. Journal of aging and physical activity. 2002;10(4):476-488. https://doi.org/10.1123/japa.10.4.476
  25. Koury JM. Aquatic therapy programming: guidelines for orthopedic rehabilitation. Champaign. Human Kinetics. 1996.
  26. Lanini B, Bianchi R, Romagnoli I, et al. Chest wall kinematics in patients with hemiplegia. American journal of respiratory and critical care medicine. 2003;168(1):109-113. https://doi.org/10.1164/rccm.200207-745OC
  27. Lee DW, Kim TH. The effects of breathing methods for spirometry tests on the parameters of pulmonary function with healthy subjects. Korean Academy of Cardiorrespiratory Physical Therapy. 2018;6(1):9-13. https://doi.org/10.32337/KACPT.2018.6.1.9
  28. Lee YH, Cho YH. The Effects of trunk stability exercise using stabilizing reversal and rhythmic stabilization techniques of PNF on trunk strength and respiratory ability in thee elderly after stroke. PNF and Movement. 2021; 19(1):105-113. https://doi.org/10.21598/JKPNFA.2021.19.1.105
  29. Lee DK, Kim YN. The effects of proprioceptive neuromuscular facilitation lower extremity pattern on muscular strength and flexibility in an aquatic environment. Journal of Korean Physical Therapy. 2013;25(2):49-55.
  30. Lephart SM, Pincivero DM, Giraido JL, et al. The role of proprioception in the management and rehabilitation of athletic injuries. The American journal of sports medicine. 1997;25(1):130-137. https://doi.org/10.1177/036354659702500126
  31. Liao LR, Ng GY, Jones AY, et al. Whole-body vibration intensities in chronic stroke: a randomized controlled trial. Medicine & Science in Sports & Exercise. 2016;48(7):1227-1238. https://doi.org/10.1249/MSS.0000000000000909
  32. Lord SE, McPherson K, McNaughton HK, et al. Community ambulation after stroke: how important and obtainable is it and what measures appear predictive? Archives of physical medicine and rehabilitation. 2004;85(2):234-239. https://doi.org/10.1016/j.apmr.2003.05.002
  33. Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36(10):2206-2211. https://doi.org/10.1161/01.str.0000181076.91805.89
  34. Masumoto K, Shono T, Hotta N, et al. Muscle activation, cardiorespiratory response, and rating of perceived exertion in older subjects while walking in water and on dry land. Journal of Electromyography and Kinesiology. 2008;18(4):581-590. https://doi.org/10.1016/j.jelekin.2006.12.009
  35. Matsumoto S, Uema T, Ikeda K, et al. Effect of underwater exercise on lower-extremity function and quality of life in post-stroke patients: a pilot controlled clinical trial. Journal of Alternative and Complementary Medicine. 2016;22(8):635-641. https://doi.org/10.1089/acm.2015.0387
  36. Osman E, Pala K. Occupational exposure to wood dust and health effects on the respiratory system in a minor industrial estate in Bursa/Turkey. International journal of occupational medicine and environmental health. 2009;22(1):43.
  37. Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1995;50(1):M28-M34. https://doi.org/10.1093/gerona/50A.1.M28
  38. Prange G, Jannink M, Groothuis-Oudshoorn C, et al. Systematic review of the effect of robot-aided therapy on recovery of the hemiparetic arm after stroke. Journal of rehabilitation research and development. 2009;43(2):171-184. https://doi.org/10.1682/JRRD.2005.04.0076
  39. Ribeiro TS, Silva WHS, de Alencar Caldas VV, et al. Effects of a training program based on the proprioceptive neuromuscular facilitation method on post-stroke motor recovery: a preliminary study. Journal of bodywork and movement therapies. 2014;18(4):526-532. https://doi.org/10.1016/j.jbmt.2013.12.004
  40. Seo K, Cho M. The effects on the pulmonary function of normal adults proprioceptive neuromuscular facilitation respiration pattern exercise. Journal of physical therapy science. 2014;26(10):1579-1582. https://doi.org/10.1589/jpts.26.1579
  41. Sharma V, Kaur J. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke. Journal of exercise rehabilitation. 2017;13(2):200. https://doi.org/10.12965/jer.1734892.446
  42. Silsupadol P, Siu K-C, Shumway-Cook A, et al. Training of balance under single-and dual-task conditions in older adults with balance impairment. Physical therapy. 2006;86(2):269-281. https://doi.org/10.1093/ptj/86.2.269
  43. Sjogren T, Long N, Story I, et al. Group hydrotherapy versus group land-based treatment for chronic low back pain. Physiotherapy Research International. 1997;2(4):212-222. https://doi.org/10.1002/pri.107
  44. Smania N, Picelli A, Gandolfi M, et al. Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: a before/after pilot study. Neurological Sciences. 2008;29(5):313-319. https://doi.org/10.1007/s10072-008-0988-0
  45. Song JM, Kim SM. The effect of aquatic exercise applied PNF patterns on body composition and balance performance in stroke patients. PNF and Movement. 2008;6(2):1-10.
  46. Verheyden G, Nieuwboer A, Van de Winckel A, et al. Clinical tools to measure trunk performance after stroke: a systematic review of the literature. Clinical rehabilitation. 2007;21(5):387-394. https://doi.org/10.1177/0269215507074055