뇌졸중 환자의 균형능력과 타이밍 기능평가의 신뢰도와 타당도 = Reliability and validity of timing-functional movement and balance ability in patients with stroke

다국어 초록 (Multilingual Abstract)

Background: Previous studies have shown that the use of auditory feedback to improve balance ability and the improvement of upper limb ability of stroke patients through RAS using IM have been actively studied. However, there are insufficient studies to evaluate the patient's balance ability including the ability to control the lower extremity and trunk. Therefore, the purpose of this study is to use as a basic data for the development of timing - functional evaluation for the balancing ability of patients considering the ceiling effect and fatigue which can be seen through the use of existing evaluation tool for stroke patients.

Method: The design of this study was a cross sectional study design, involving 30 adult stroke patients. Initial measurements were performed to determine the timing-functional movement test-retest reliability according to the physical ability assessment tool category. After 3 days, we revisited FIST, BBS, mPASS, 10MWT and TUG sequentially and then performed four timing-functional movement post tests.
Timing-Functional movement test-retest reliability was measured by intraclass correlation coefficients (ICCs) and Kappa values. The Pearson correlation coefficient was used to examine the linear relationship between measured variables. Absolute reliability was measured by standard error of measurement (SEM) [standard deviation of all test-retest scores × √(1-ICC)] for quantification of measurement errors.

Result: The results are as follows;
1. There was a statistically significant positive correlation between the button press and
wall touch.(r=.984, r=.364, r=.978).
2. Four timing measurements showed high test-retest reliability with ICC=.90 or better. Four timing measurements showed a reasonable level of reliability with ƙ=.45~.75. The SEM of the button press method and the wall touch method was less than 10% of the average value measured and was reliable.
3. The relationship between FIST score and wall touch was negatively correlated, Statistical significance was found in the measurements of the unaffected side, affected side, affected-unaffected side.(r=-.693, r=-.465, r=-.364).
4. The relationship between BBS score and step on the stool was negatively correlated, Statistical significance was found in the measurements of the affected side, affected-unaffected side.(r=-.511, r=-.492)
5. The relationship between mPASS score and step on the stool was negatively correlated, Statistical significance was found in the measurements of the affected side, affected-unaffected side(r=-.463, r=-.500).
6. The relationship between the 10MWT value and one step in front was positively correlated, Statistical significance was found in the measurements of the unaffected side, affected side(r=.376, r=.369).
7. The relationship between the TUG value and one step in front was positively correlated, Statistical significance was found in the measurements of the unaffected side, affected side, affected-unaffected side(r=.437, r=.471, r=.379).
Conclusion: In this study, we investigated the clinical usefulness of timing-functional movement using auditory feedback in evaluating the balance ability of stroke patients and found that it is useful for evaluating the balance ability of stroke patients with high reliability and validity.

목차 (Table of Contents)

• 제1장 서 론 1
• 제1절 연구의 배경 및 필요성 1
• 제2절 연구의 목적 3
• 제3절 연구의 가설 4
• 제4절 용어의 정의 5
• 4.1. 타이밍-기능적 움직임 5
• 4.2. 균형 능력 5
• 4.3. 앉기 균형능력 5
• 4.4. 동적 균형능력 5
• 4.5. 보행 균형능력 6
• 제5절 문헌 고찰 7
• 5.1. 상호작용식 메트로놈과 리듬 청각 자극 7
• 5.2. 연구 경향 8
• 제2장 연구 방법 12
• 제1절 연구 설계 12
• 제2절 연구의 대상 및 절차 13
• 2.1. 연구의 대상 13
• 2.2. 연구의 절차 14
• 제3절 실험 방법 16
• 제4절 측정 도구와 자료 수집 과정 21
• 4.1. 기능적 앉기 검사 21
• 4.2. 버그 균형 척도 21
• 4.3. 수정된 뇌졸중 자세 평가 척도 22
• 4.4. 10m 보행평가 22
• 4.5. 일어나 걸어가기 검사 23
• 4.6. 타이밍-기능적 움직임 검사 23
• 제5절 변수의 선정 24
• 제6절 분석 방법 25
• 제3장 연구 결과 26
• 제1절 연구 대상자의 특성 26
• 제2절 청지각 능력과 타이밍-기능적 움직임의 상관관계 27
• 제3절 타이밍-기능적 움직임 측정의 검사-재검사 신뢰도 28
• 제4절 측정 변수와 타이밍-기능적 움직임의 상관관계 29
• 제4장 고 찰 31
• 제5장 결론 및 제언 35
• 영 문 초 록 36
• 참 고 문 헌 39
• 그 림 목 록 49
• 표 목 록 50
• 감사의 말씀 51