지면 경사도에 따른 후방 낙상 시 소뇌성 운동실조증 환자의 자세제어 특성 연구

다국어 초록 (Multilingual Abstract)

The Cerebellar damage leads to falls due to the impairments in balance control, and secondary damage is a terrifying factor that may cause injuries. Concerning the fear of falls in patients with cerebellar disease (CD), this study examined the kinematic characteristics on body control abilities such as the movements of the upper and lower limbs and the motion of stepping to recover the balance when a back fall is occurred with increased ground inclination. Eight patients diagnosed with CD and 8 age-matched normal controls (NC) participated in the study. We evaluated the ability to recover the balance independently through stepping movements by causing the situation of a backward fall with the lean-and-release method and four different ground inclination conditions. The results demonstrated that there were no differences between two groups in overall stepping characteristics such as total steps, initiation time and step distance. However, the distance between the foot and body COM was shorter and velocity of COM movement at landing of first step was higher in CD than NC as the ground inclination increased. These findings indicate that patients with cerebellar disease used an inefficient movement strategy that does not help to recover their trunk motion from falling when fear of falling is elevated.

목차 (Table of Contents)

• Abstract
• Ⅰ. 서론
• Ⅱ. 연구방법
• Ⅲ. 결과
• Ⅳ. 논의
• Ⅴ. 결론 및 제언
• 참고문헌

참고문헌 (Reference)

1 임창하, "소뇌성 운동실조증 환자의 후방 낙상 시 운동학적 특성" 한국체육과학회 26 (26): 493-508, 2017

2 Klockgether, T., "Update on degenerative ataxias" 24 (24): 339-345, 2011

3 Tinetti, M. E., "The effect of falls and fall injuries on functioning in community-dwelling older persons" 53 (53): M112-M119, 1998

4 Wu, G., "The control of body orientation and center of mass location under asymmetrical loading" 13 (13): 95-101, 2001

5 B³aszczyk, J. W., "Sway ratio a new measure for quantifying postural stability" 68 : 51-57, 2008

6 Serrao, M., "Sudden stopping in patients with cerebellar ataxia" 12 (12): 607-616, 2013

7 Gillen, G., "Stroke rehabilitation: a function-based approach" Elsevier Health Sciences 2015

8 Luchies, C. W., "Stepping responses of young and old adults to postural disturbances : kinematics" 42 (42): 506-512, 1994

9 Rogers, M. W., "Step training improves the speed of voluntary step initiation in aging" 58 (58): 46-51, 2003

10 Okubo, Y., "Step training improves reaction time, gait and balance and reduces falls in older people : a systematic review and meta-analysis" 51 (51): 586-593, 2017

11 Pai, Y. C., "Static versus dynamic predictions of protective stepping following waist-pull perturbations in young and older adults" 31 (31): 1111-1118, 1998

12 Baloh, R. W., "Static and dynamic posturography in patients with vestibular and cerebellar lesions" 55 (55): 649-654, 1998

13 Earhart, G. M., "Selection and coordination of human locomotor forms following cerebellar damage" 85 (85): 759-769, 2001

14 Fletcher, P. C., "Restriction in activity associated with fear of falling among community-based seniors using home care services" 33 (33): 273-279, 2004

15 Fonteyn, E. M., "Prospective analysis of falls in dominant ataxias" 69 (69): 53-57, 2013

16 Maki, B. E., "Preventing falls in older adults : new interventions to promote more effective change-in-support balance reactions" 18 (18): 243-254, 2008

17 Alexander, N. B., "Postural control in older adults" 42 (42): 93-108, 1994

18 Fonteyn, E. M., "Physiotherapy in degenerative cerebellar ataxias : utilisation, patient satisfaction, and professional expertise" 12 (12): 841-847, 2013

19 Murphy, S., "Participation in daily living tasks among older adults with fear of falling" 55 (55): 538-544, 2001

20 Troy, K. L., "Modifiable performance domain risk-factors associated with slip-related falls" 28 (28): 461-465, 2008

21 Morton, S. M., "Mecha-nisms of cerebellar gait ataxia" 6 (6): 79-, 2007

22 Morton, S. M., "Longitudinal tracking of gait and balance impairments in cerebellar disease" 25 (25): 1944-1952, 2010

23 Lafond, D., "Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people1" 85 (85): 896-901, 2004

24 Trouillas, P., "International Coopera-tive Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome" 145 (145): 205-211, 1997

25 Gomez-Esteban, J. C., "Influence of motor symptoms upon the quality of life of patients with Parkinson’s disease" 57 (57): 161-165, 2007

26 Winter, D. A., "Human balance and posture control during standing and walking" 3 (3): 193-214, 1995

27 Paulsen, E. K., "Health-related quality of life in children with Friedreich ataxia" 42 (42): 335-337, 2010

28 McCollum, G., "Form and exploration of mechanical stability limits in erect stance" 21 (21): 225-244, 1989

29 van de Warrenburg, B. P., "Falls in degenerative cerebellar ataxias" 20 (20): 497-500, 2005

30 Kim, Y. H., "Effects of task constraints on obstacle avoidance strategies in patients with cerebellar disease" 37 (37): 521-525, 2013

31 Brown, S. H., "Disturbances in human arm movement trajectory due to mild cerebellar dysfunction" 53 (53): 306-313, 1990

32 Maki, B. E., "Control of compensatory stepping reactions : age-related impairment and the potential for remedial intervention" 15 (15): 69-90, 1999

33 Schulz, B. W., "Compensatory stepping in response to waist pulls in balance-impaired and unimpaired women" 22 (22): 198-209, 2005

34 Berard, J. R., "Characteri-stics of single and double obstacle avoidance strategies : a comparison between adults and children" 175 (175): 21-31, 2006

35 Miyai, I., "Challenge of neurorehabilitation for cerebellar degenerative diseases" 11 (11): 436-437, 2012

36 Morton, S. M., "Cerebellar control of balance and locomotion" 10 (10): 247-259, 2004

37 Bastian, A. J., "Cerebellar ataxia : abnormal control of interaction torques across multiple joints" 76 (76): 492-509, 1996

38 Rietdyk, S., "Balance recovery from medio-lateral perturbations of the upper body during standing" 32 (32): 1149-1158, 1999

39 Laessoe, U., "Anticipatory postural control strategies related to predictive perturbations" 28 (28): 62-68, 2008

40 Bonner, A., "A student-led demonstration project on fall prevention in a long-term care facility" 28 (28): 312-318, 2007