• Title/Summary/Keyword: Gait balance

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고유수용성신경근촉진법을 적용한 상하지 협응 운동이 뇌졸중 환자의 균형 및 보행능력에 미치는 효과 (The Effects of PNF Upper- and Lower-Limb Coordinated Exercise on the Balancing and Walking-Abilities in Stroke Patients)

  • 조혁신;차현규;신효섭
    • PNF and Movement
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    • 제15권1호
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    • pp.27-33
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    • 2017
  • Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.

안뜰눈반사를 통한 노인 균형 연구 (Review of Balance in Elderly by Vestivulo-ocular Reflex)

  • 백수정
    • 대한지역사회작업치료학회지
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    • 제8권3호
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    • pp.91-106
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    • 2018
  • 이 논문은 노인의 균형문제를 해결하기 위해 안뜰눈반사와 안뜰재활운동에 대해 고찰하고자 한다. 낙상은 노화와 관련된 주요한 문제이다. 낙상과 결과적으로 일어나는 일은 가장 흔하면서 심각한 문제이다. 균형의 결함은 낙상의 가장 높은 위험 요소 중 하나이다. 균형을 조절하고 협응하는데 사용되고 통합되는데 세 가지 신경계가 필요하다. 정상적인 이동과 머리운동을 하는 동안, 안뜰눈반사는 주시를 안정화시키고 망막의 상을 유지하도록 돕는다. 안뜰눈반사의 결함과 낙상간에 직접적인 관계가 있다. 노인들은 안뜰눈반사를 억제하고 강화시키는 능력이 감소된다. 안뜰재활운동은 중추신경계 보상을 목적으로 시작한 운동에 근거한 단체 치료법이다. 안뜰재활운동은 머리와 눈의 반복적인 운동을 사용해서 안뜰눈반사의 이득을 회복시키고 오류를 줄인다. 많은 연구들이 안뜰재활운동을 한 단체가 균형과 보행 검사에서 월등함을 보였다. 이 논문은 노인의 낙상을 방지하기 위한 운동법으로 안뜰재활운동을이 도움이 될 것으로 사료된다.

뇌졸중 환자 재활 시 간병인 부담에 영향을 미치는 요인 (Factors Influencing Caregiver Burden During Rehabilitation of Stroke Patients)

  • 김유미;백승민;나영일;윤용순
    • 산업융합연구
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    • 제20권11호
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    • pp.27-34
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    • 2022
  • 본 연구에서는 뇌졸중 환자의 어떤 의학적 요인이 간병인 부담에 영향을 미치는지 알아보기 위해 8주간의 치료 전후 환자의 신경학적 상태, 인지, 일상생활수행능력, 보행, 균형 지표와 간병인의 부담감을 측정하여 그 변화를 비교하였습니다. 간병인은 8주간의 재활 치료 기간 동안 경도-중등도의 부담감을 느끼고 있었으며, 환자의 신경학적 상태, 인지 상태가 간병인 부담과 연관이 있었습니다. 전체 환자군 및 아급성기 뇌졸중 환자군의 의학적 지표와 간병인의 부담감을 다중회귀분석 하였을 때, 신경학적 상태와 균형 능력이 보호자 부담감에 영향을 주는 요소로 나타났습니다. 이에 입원한 뇌졸중 환자의 재활 치료 시 간병인 부담 경감을 위해 환자의 균형 능력 향상에 중점을 둘 것을 제안합니다.

Evaluating the Reliability of Short-Form Berg Balance Scales and Short-Form Postural Assessment Scales in Chronic Stroke Survivors

  • Seung-Heon An;Dae-Sung Park
    • Physical Therapy Rehabilitation Science
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    • 제13권2호
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    • pp.143-151
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    • 2024
  • Objective: This study aims to assess the test-retest reproducibility of the Short Form Berg Balance Scale (SF-BBS) and the Short Form Postural Assessment Scale for Stroke (SF-PASS) among chronic stroke survivors, focusing on their reliability for consistent measurements over time. Design: A cross-sectional study design Methods: Thirty chronic stroke survivors participated in this study, undergoing evaluations with SF-BBS and SF-PASS scales at two different points, separated by a seven-day interval. The analysis focused on test-retest reliability, employing statistical measures such as the Intra-Class Coefficient (ICC2,1), Standard Error of Measurement (SEM), Minimal Detectable Change (MDC), and MDC%, the Bland-Altman plot to assess the limits of agreement and the extent of random measurement error. Results: The study found notable test-retest reproducibility for both SF-BBS and SF-PASS, with ICC values demonstrating strong reliability (0.932 to 0.941, with a confidence interval of 0.889 to 0.973). SEM values for SF-BBS and SF-PASS were reported as 1.34 and 0.61, respectively, indicating low measurement error. MDC values of 3.71 for SF-BBS and 1.69 for SF-PASS suggest that the scales have an acceptable level of sensitivity to change, with reliability metrics falling below 20% of the maximum possible score. Conclusions: The findings suggest that both SF-BBS and SF-PASS exhibit high intra-class correlation coefficients, indicating strong test-retest reliability. The SEM and MDC values further support the scales' reproducibility and reliability as tools for evaluating mobility and dynamic balance in chronic stroke survivors. Therefore, these scales are recommended for clinical use in this population, providing reliable measures for assessing progress in rehabilitation.

상상연습이 노인의 균형 능력과 낙상효능감에 미치는 영향 : 단일대상연구 (Effects of Mental Practice on Balance Ability and Fall Efficacy in Dwelling Elderly Population: Single Subject Design)

  • 정준철;정해윤;이창대;유은영
    • 대한지역사회작업치료학회지
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    • 제5권2호
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    • pp.31-42
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    • 2015
  • 목적 : 상상연습(mental practice)이 노인의 균형 능력에 미치는 효과를 규명하고 노인 낙상 예방을 위한 효과적인 중재 방법으로써 적용 가능성에 대해 알아보는 것이었다. 연구방법 : 본 연구는 2013년 7월부터 10월 까지 인지에 문제가 없고 낙상에 경험이 있지만 보조 도구 없이 자립보행이 가능한 65세 이상 노인 3명에게 상상연습을 제공하였다. 개별 사례 실험 연구 중 ABA' 설계를 사용하여 기초선 과정 4회기, 중재 과정 5회기, 재 기초선 과정 4회, 총 13회기로 진행되었다. 독립변수는 노인의 균형 능력 및 낙상 효능감 증진을 위해 상상연습을 사용하였고, 종속변수로는 전반적 균형능력의 변화를 알아보기 위해 버그 균형 척도(Berg Blance Scale; BBS), 낙상효능감에 변화를 알아보기 위해 낙상효능감척도(Fall Efficacy Scale: FES), 정적, 동적 균형에 변화를 측정하기 위해 각각 외다리기립검사(One-Leg Standing test; OLS), 일어나 걸어가기 검사(Timed Up & Go test : TUG)를 실시하였다. 결과 분석은 평균값과 시각적 그래프를 통해 제시하였다. 결과 : 상상연습 기법 적용 후 모든 대상자의 낙상효능감이 기초선 과정에서 측정된 수치 보다 증가된 결과를 보였으며 또한 전반적 균형 능력과 정적 동적 균형 능력 또한 증진 또는 유지 되었다. 결론 : 본 연구는 상상연습이 노인의 낙상효능감과 균형능력의 향상과 유지에 효과가 있는 것으로 나타났음으로 노인의 낙상 예방 활동으로 상상연습의 적용을 추천한다.

The Effects of Hippotherapy for Physical, Cognitive and Psychological Factors in Children with Intellectual Disabilities

  • Bae, Myung-Soo;Yun, Chang-Kyo;Han, Yong-Gu
    • 대한물리의학회지
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    • 제12권3호
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    • pp.119-130
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    • 2017
  • PURPOSE: The purpose of this study is to determine, by conducting a 10 week hippotherapy, the effects on the physical, cognitive and psychological factors of children with intellectual disabilities. METHODS: As an intervention method, intervention was based on a program from the American Hippotherapy Association and was modified and enhanced. 16 children with intellectual disabilities was conducted horse riding intervention program and Intervention was conducted once a week for a total of 10 weeks with each session lasting 30 minutes. A doctor of rehabilitation medical treatment of D rehabilitation center, physical therapist and occupational therapist evaluated the upper limbs test, balance, gait function, Korea-mini mental state examination (MMSE) before and after hippotherapy intervention. Self-esteem scale and aggression scale was evaluated by Psychology Counseling of C psychological clinic before and after hippotherapy intervention. RESULTS: The results of this study reveal that first, there was a positive effect. Second, statistically significant differences were found in BBS, TUG, K-MMSE, 10m walking test, 6 min walking test, self-esteem scale and aggression scale (p<.05). However no statistically significant differences were found in upper limbs function and good balance analysis before and after intervention. CONCLUSION: The hippotherapy is effective way to improve the physical, cognitive and psychological factors of children with intellectual disability.

회전효과를 고려한 이족 로봇의 정밀 원형 경로 보행 (Precision Circular-path Walking of a Biped Robot with Consideration of Rotational Effects)

  • 임승철;곽병문;임주영;손영익
    • 한국소음진동공학회논문집
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    • 제24권4호
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    • pp.299-309
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    • 2014
  • When biped robots make turns, the ability to walk stably and precisely along any circular path is crucial. In this context, inverse kinematics solutions are found for accurate gait realization, and new zero moment point(ZMP) equations are derived with respect to the cyclindrical coordinate system to facilitate generation of stable walking patterns. Then, appropriate steady and transitional walking patterns are both proposed in form of time functons. Subsequently, walking patterns for a path but of different speeds are generated using the functions and associated formulas, and preliminarily checked for stability based on the ZMP equations. Upon comparison of those cases, one can see how and when robots may fall down during circular walking. Finally, those patterns are put to test on the sample robot by ADAMS(R) along with the inverse kinematics solutions and a new balance control scheme compensating for insufficient stability particulary during the initial transition period. Test results show that the robot can walk along the circular path as predicted at a resonably high speed despite the distributed mass and ground contact effects, validating effectiveness of the suggested approach.

보행 시 부하의 위치에 따른 발의 안정성 및 운동학적 분석에 관한 연구 (The Studies on the Foot Stability and Kinesiology by Direction of Carry a Load during Gait)

  • 이상열;배성수
    • The Journal of Korean Physical Therapy
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    • 제21권2호
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    • pp.97-101
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    • 2009
  • Purpose: This study examined how the direction of carrying a load affects the foot stability and kinesiology while walking. Methods: The heel rotation, Hallux stiffness, foot balance, metatarsal load, toe out angle, subtalar joint flexibility were measured in 40 adults (men and women) who carried a load back and forth, walking on a 2-meter-long board. The measurement was carried out three times and the mean of the measurements was used to compare the difference between the front, back and the condition without a load. Results: While walking, heel rotation and hallux stiffness occurred most when a front load was applied compared to a back load or no load condition (p<0.05). A metatarsal load also appeared to be the highest with the frond load, but there was no significant difference in the balance of the whole foot. Both the toe out angle and subtalar joint flexibility appeared to increase significantly (p<0.05). Conclusion: Applying the front load causes subtalar joint instability and increases the plantar foot pressure imbalance during walking.

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성인 편마비환자의 계단 높이에 따른 보행훈련시 균형 및 근활성도 분석 (The Analysis of Balance and muscle Activity according to Stair Height Gait Training in Adult Hemiplegia)

  • 최윤희;김경
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2012년도 춘계 종합학술대회 논문집
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    • pp.181-182
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    • 2012
  • 본 연구는 뇌졸중으로 인한 성인 편마비 환자의 계단 높이에 따른 보행 훈련을 통하여 균형과 근활성도 변화를 분석하는데 목적이 있다. 뇌졸중으로 진단받은 편마비 환자 30명을 대상으로 5cm, 10cm, 15cm 높이의 계단 보행 훈련군으로 나누어 계단 보행 훈련을 실시하였으며, 임상적 균형능력 측정도구인 Berg Balance Scale(BBS), Timed up and go(TUG), Functional Reach Test(FRT)와 근활성도를 측정하였다. 연구결과 균형변화에서는 세 군간 계단 보행 훈련 전과 후의 균형 변화량이 통계학적으로 유의한 차이가 나타나지 않았으나(p>.05), 10cm 높이 계단 보행 훈련군에서 가장 큰 변화량을 보였다. 근활성도변화에서는 계단 오르기시 10cm 높이 계단 보행 훈련군에서 넙다리곧은근, 넙다리두갈래근, 장딴지근, 15cm 높이 계단 보행 훈련군에서 모든 근육들이 통계학적으로 유의한 차이를 보였으며(p<.05), 계단 내리기시 근활성도 변화에서는 5cm 높이계단 보행 훈련군에서 앞정강근와 장딴지근, 10cm 높이 계단 보행 훈련군에서 모든 근육들이, 15cm 높이 계단 보행 훈련군에서 넙다리두갈래근, 앞정강근, 장딴지근이 통계학으로 유의한 차이를 나타내었다(p<.05). 따라서, 높이에 따른 계단 보행 훈련은 편마비 환자의 임상적 균형 능력과 근활성도를 변화시키는데 영향을 줄 수 있으며, 특히 10cm 높이 계단 보행 훈련군에서는 다른 높이의 계단 보행 훈련군에서 보다 약간 상대적인 증가를 보였다.

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The Effects of Pilates Exercise on Static and Dynamic Balance in the Elderly

  • Park, Ji-Hye;Lee, Joong-Sook;Yang, Jeong-Ok;Lee, Bom-Jin;Bae, Kang-Ho;Shin, Jin-Hyung
    • 한국운동역학회지
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    • 제26권4호
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    • pp.397-405
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    • 2016
  • Objective: Pilates is a low/mid-intensity exercise that can be easily performed by elderly individuals as it is an individual body-oriented exercise. It is also a cardio workout that can be performed anywhere to develop strength and flexibility. Therefore, we investigated the effects of 8 week Pilates program on the balancing ability of elderly individuals. Method: The research participants were selected from elderly residents in B city. Ten individuals voluntarily signed an agreement to undergo free measurements as well as to participate in the workout program. (Height: $157.1{\pm}11.9cm$, Weight: $61.7{\pm}8.0kg$). The Pilates exercise was performed 60 minutes a day, three times a week for a total of eight weeks. The measurement variables used to test balance were the vestibular test, 5 m habitual and maximum walk test and 3 m tandem walk test. A series of paired t-test were conducted using IBM SPSS Statistics 23.0 to analyze all the research data collected in order to determine the balance ability of the participants before and after the Pilates program. Additionally, the statistically significant level for all analysis was set to ${\alpha}=.05$. Results: In the vestibular test, some meaningful changes were observed in the length envelope area (ENV) while standing on one foot, but there were no significant differences in the ENV, rectangle(REC), root mean square, and total length. Results also revealed that statistically significant differences existed in the 5 m habitual and maximum walk test, as well as the 3 m tandem walk test. Conclusion: To summarize the findings, the 8 week Pilates program employed in this study significantly improved the dynamic balance of the elderly participants. Thus, elderly individuals that frequent perform Pilates are expected to enjoy positive benefits such as increased balance and fewer falling accidents.