이중운동과제 훈련이 만성 뇌졸중 환자의 균형 및 보행에 미치는 효과 = The Effects of Two Motor Dual Task Training on Balance and Gait in Patients with Chronic Stroke

다국어 초록 (Multilingual Abstract)

Purpose: The goal of this study was to investigate the effect of balance and gait ability through two motor dual task training in chronic stroke subjects. Methods: A group of twenty-five subjects who were six months post stroke participated in this study, where they were designated into pretest-posttest control The subjects were randomly allocated into two groups: experimental (n=13) and control (n=12). Both groups received physical therapy for 5 session 30 minutes per week during 6 weeks. Experimental group practiced additional two motor dual task training programs for thirty minutes a day, three days a week during six weeks. Evaluation of results was obtained through analyzing static balance, dynamic balance and gait function. Results: There was significant improvement among the group that practiced the additional two motor dual task training in that the postural sway area with open eye and close eye on the foam surface, the dynamic balance (p<0.05), and the gait function (p<0.05). Conclusion: Two motor dual task training improved static balance on the foam, dynamic balance, gait function. These results suggest that two motor dual task training is a feasible and suitable treatment for individuals with chronic stroke.

참고문헌 (Reference)

1 김은자, "뇌졸중 환자의 체간하부 안정성 강화운동이 균형과 보행에 미치는 영향" 대한물리치료학회 21 (21): 17-22, 2009

2 이한숙, "뇌졸중 환자의 균형 향상 과제 중심 순환 훈련의 효과" 대한물리치료학회 21 (21): 23-30, 2009

3 신원섭, "가상현실을 이용한 재활 운동이 뇌졸중 환자의 정적 균형 및 보행에 미치는 효과" 대한물리치료학회 21 (21): 33-40, 2009

4 Walker C, "Use of visual feedback in retraining balance following acute stroke" 80 (80): 886-895, 2000

5 McDonough AL, "The validity and reliability of the gaitrite system's measurements: A preliminary evaluation" 82 (82): 419-425, 2001

6 Ng SS, "The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke" 86 (86): 1641-16747, 2005

7 Brauer SG, "The influence of a concurrent cognitive task on the compensatory stepping response to a perturbation in balance-impaired and healthy elders" 15 (15): 83-93, 2002

8 Yavuzer G, "The effects of balance training on gait late after stroke: a randomized controlled trial" 20 (20): 960-969, 2006

9 Canning CG, "The effect of directing attention during walking under dual-task conditions in parkinson's disease" 11 (11): 95-99, 2005

10 Berg K, "The Balance Scale:reliability assessment with elderly residents and patients with an acute stroke" 27 (27): 27-36, 1995

11 Leroux A, "Task-oriented intervention in chronic stroke: changes in clinical and laboratory measures of balance and mobility" 85 (85): 820-830, 2006

12 Duncan PW, "Similar motor recovery of upper and lower extremities after stroke" 25 (25): 1181-1188, 1994

13 Smania N, "Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: a before/after pilot study" 29 (29): 313-319, 2008

14 de Seze M, "Rehabilitation of postural disturbances of hemiplegic patients by using trunk control retraining during exploratory exercises" 82 (82): 793-800, 2001

15 Michael KM, "Reduced ambulatory activity after stroke: The role of balance, gait, and cardiovascular fitness" 86 (86): 1552-1556, 2005

16 Beauchet O, "Recurrent falls and dual task-related decrease in walking speed: is there a relationship?" 56 (56): 1265-1269, 2008

17 Rogind H, "Posturographic description of the regaining of postural stability following stroke" 25 (25): 1-9, 2005

18 Shumway-Cook A, "Postural sway biofeedback: Its effect on reestablishing stance stability in hemiplegic patients" 69 (69): 395-400, 1988

19 Horak FB, "Postural perturbations: new insights for treatment of balance disorders" 77 (77): 517-533, 1997

20 Era P, "Postural balance in a random sample of 7,979 subjects aged 30 years and over" 52 (52): 204-213, 2006

21 Bohannon RW, "Nature, reliability, and predictive value of muscle performance measures in patients with hemiparesis following stroke" 73 (73): 721-725, 1992

22 Rietdyk S, "NACOB presentation CSB new investigator award. balance recovery from medio-lateral perturbations of the upper body during standing. North American Congress on Biomechanics" 32 (32): 1149-1158, 1999

23 Lord SE, "Measurement of community ambulation after stroke: current status and future developments" 36 (36): 1457-1461, 2005

24 Goldie PA, "Maximum voluntary weight-bearing by the affected and unaffected legs in standing following stroke" 11 (11): 333-342, 1996

25 Sharp SA, "Isokinetic strength training of the hemiparetic knee: effects on function and spasticity" 78 (78): 1231-1236, 1997

26 Carr JH, "Investigation of a new motor assessment scale for stroke patients" 65 (65): 175-180, 1985

27 Plummer-D'Amato P, "Interactions between cognitive tasks and gait after stroke:a dual task study" 27 (27): 683-688, 2008

28 Kim JH, "Effects of virtual reality program on balance, gait and brain activation patterns in stroke patients" Daegu University 2005

29 Springer S, "Dual-tasking effects on gait variability: The role of aging, falls, and executive function" 21 (21): 950-957, 2006

30 Yang YR, "Dual-task-related gait changes in individuals with stroke" 25 (25): 185-190, 2007

31 Yang YR, "Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial" 88 (88): 1236-1240, 2007

32 Bowen A, "Dual-task effects of talking while walking on velocity and balance following a stroke" 30 (30): 319-323, 2001

33 Lord SE, "Community ambulation after stroke: how important and obtainable is it and what measures appear predictive?" 85 (85): 234-239, 2004

34 Horak FB, "Clinicalmeasurement of postural control in adults" 67 (67): 1881-1885, 1987

35 Bayouk JF, "Balance training following stroke: effects of task-oriented exercises with and without altered sensory input" 29 (29): 51-59, 2006

36 Tyson SF, "Balance disability after stroke" 86 (86): 30-38, 2006

37 Geiger RA, "Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training" 81 (81): 995-1005, 2001

38 Coppin AK, "Association of executive function and performance of dual-task physical tests among older adults: analyses from the inchianti study" 35 (35): 619-624, 2006

39 Eich HJ, "Aerobic treadmill plus bobath walking training improves walking in subacute stroke:a randomized controlled trial" 18 (18): 640-651, 2004