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)

The 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 Rhythmic auditory stimulation using Interactivity metronome have been actively studied. However, there are insufficient studies to evaluate the patient's balance ability including control of lower extremity and trunk. Therefore, the purpose of this study is to provide basic data for the development of Timing-functional movement test tool to evaluate the balance ability of stroke patients. The design of this study was a cross sectional design, involving 30 patients with stroke. 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). Timing-functional movement test methods showed high test-retest reliability with ICC=.986 or better. The Function in sitting test and Wall touch was significantly negative correlated(r=-.693, r=-.465, r=-.364). The Berg balance scale and Step on the stool was significantly negative correlated(r=-.511, r=-.492). The modified Postural assessment scale for stroke and Step on the stool was significantly negative correlated(r=-.463, r=-.500). The 10 Meter walk test and One step in front was significantly positive correlated(r=.376, r=.369). The Timed up & go and One step in front was significantly positive correlated(r=.437, r=.471, r=.379). 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.

참고문헌 (Reference)

1 이정아, "한국판 버그 균형척도 평가도구의 라쉬분석" 한국전문물리치료학회 13 (13): 49-56, 2006

2 전현주, "청각적 생체 되먹임 훈련과 공차기 훈련이 뇌졸중 환자의 체중지지율에 미치는 영향" 대한물리의학회 9 (9): 363-373, 2014

3 김경미, "성인지적장애인에 대한 상호작용식 메트로놈(Interactive Metronome) 중재가 타이밍과 집중력, 양측 협응, 균형능력에 미치는 영향: 단일사례연구" 특수교육재활과학연구소 54 (54): 349-364, 2015

4 정지혜, "상호작용식 메트로놈(Interactive Metronome; IM) 훈련이 편마비 뇌성마비 아동의 신체 양측 협응과 균형능력, 상지기능에 미치는 효과: 개별 실험 연구" 대한작업치료학회 21 (21): 37-48, 2013

5 안승헌, "보행에 제한이 있는 뇌졸중 환자들의 한국어 번안 기능적 앉기 검사의 신뢰도와 타당도" 특수교육재활과학연구소 55 (55): 471-486, 2016

6 현동수, "리듬청각자극을 이용한 후방 보행 훈련이 뇌졸중 환자의 보행과 균형에 미치는 영향" 한국산학기술학회 14 (14): 6237-6245, 2013

7 김정두, "뇌졸중 환자의 초기 접지기를 강조한 청각적-피드백 보행훈련이 균형능력과 보행기능에 미치는 영향" 대한물리의학회 10 (10): 49-57, 2015

8 권혜림, "뇌졸중 환자의 시선 방향 조절이 균형과 보행에 미치는 영향" 대한물리의학회 8 (8): 425-431, 2013

9 안명환, "뇌졸중 환자의 균형 증진을 위한 체감형 전자게임 훈련에 적용되는 되먹임 방식에 따른 효과" 대한물리의학회 7 (7): 401-409, 2012

10 Morice, A., "Two-, six-, and 12-minute walking test in respiratory disease" 285 (285): 295-, 1982

11 Robertson, J. V., "The trunk as a part of the kinematic chain for reaching movements in healthy subjects and hemiparetic patients" 1382 : 137-146, 2011

12 Podsiadlo D, "The timed "Up & Go": a test of basic functional mobility for frail elderly persons" 39 (39): 142-148, 1991

13 Ahmed, S., "The Stroke Rehabilitation Assessment of Movement (STREAM): a comparison with other measures used to evaluate effects of stroke and rehabilitation" 83 (83): 617-630, 2003

14 이규영, "The Effects of Closed Kinetic and Open Kinetic Chain Exercises Using Knee Reposition Sense in Chronic Stroke Patients" 대한물리치료학회 26 (26): 182-190, 2014

15 Dean, C. M., "Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial" 81 (81): 409-417, 2000

16 Beckerman, H., "Smallest real difference, a link between reproducibility and responsiveness" 10 (10): 571-578, 2001

17 Thaut, M. H., "Rhythmic auditory stimulation improves gait more than NDT/Bobath training in near-ambulatory patients early poststroke: a single-blind, randomized trial" 21 (21): 455-459, 2007

18 Richman, J., "Research methodology and applied statistics, part 3: measurement procedures in research" 32 (32): 253-257, 1980

19 Bonan, I. V., "Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial" 85 (85): 274-278, 2004

20 Morris S, "Reliability of measurements obtained with the Timed “Up & Go” test in people with Parkinson disease" 81 (81): 810-818, 2001

21 Liston, R. A., "Reliability and validity of measures obtained from stroke patients using the balance master" 77 (77): 425-430, 1996

22 Trombly CA, "Occupational therapy for physical dysfunction" Lippincott 2002

23 Asanuma, H., "Neuronal mechanisms of motor learning in mammals" 2 : 217-224, 1991

24 Kim SJ., "Motor learning and control" Daehan Media 2010

25 Berg, K. O., "Measuring balance in the elderly: preliminary development of an instrument" 41 (41): 304-311, 1989

26 Bartscherer, M. L., "Interactive Metronome training for a 9-year-old boy with attention and motor coordination difficulties" 21 : 257-269, 2005

27 Beaton, D. E., "Guidelines for the process of cross-cultural adaptation of self-report measures" 25 (25): 3186-3191, 2000

28 Gorman, S. L., "Examining the function in sitting test for validity, responsiveness, and minimal clinically important difference in inpatient rehabilitation" 95 (95): 2304-2311, 2014

29 Jeong, S., "Effects of a theory-driven music and movement program for stroke survivors in a community setting" 20 (20): 125-131, 2007

30 Shahraki, M., "Effect of rhythmic auditory stimulation on gait kinematic parameters of patients with multiple sclerosis" 10 (10): 33-, 2017

31 Suh, J. H., "Effect of rhythmic auditory stimulation on gait and balance in hemiplegic stroke patients" 34 (34): 193-199, 2014

32 Thaut, M. H., "Distinct cortico-cerebellar activations in rhythmic auditory motor synchronization" 45 (45): 44-53, 2009

33 Gorman, S. L., "Development and validation of the Function In Sitting Test in adults with acute stroke" 34 (34): 150-160, 2010

34 Beckelhimer, S. C., "Computer-based rhythm and timing training in severe, stroke-induced arm hemiparesis" 65 (65): 96-100, 2011

35 Debaere, F., "Brain areas involved in interlimb coordination: a distributed network" 14 (14): 947-958, 2001

36 Mirelman, A., "Audio-biofeedback training for posture and balance in patients with Parkinson's disease" 8 (8): 35-, 2011

37 Halsaa, K. E., "Assessments of interrater reliability and internal consistency of the Norwegian version of the Berg Balance Scale" 88 (88): 94-98, 2007

38 Persson, C. U., "A validation study using a modified version of Postural Assessment Scale for Stroke Patients:Postural Stroke Study in Gothenburg (POSTGOT)" 8 : 57-, 2011

39 Shank, T. M., "A Retrospective outcomes study examining the effect of interactive metronome on hand function" 28 (28): 396-402, 2015