전정감각 자극훈련이 뇌졸중 환자의 균형과 보행에 미치는 영향 = The Effects of Vestibular Sensory Stimulation Training on Balance and Gait in the Patients with Stroke

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study is to examine the effects of training in vestibular sensory stimulation on balance and gait of stroke patients. Methods: Twenty patients were randomly assigned to either the experimental group (n=10) or the control group (n=10). Patients in the experimental group received rotational stimulation training, vertical-horizontal stimulation training, gait training on a flat surface with vestibular sensory stimulation, and gait training on soft ground with vestibular sensory stimulation. Patients in the control group received general treadmill gait training. The intervention was applied four times per week, 25 minutes each time, for a period of four weeks. We measured Berg Balance Scale (BBS), Biodex Balance System, Timed up to Go (TUG) test and Dynamic Gait Index (DGI) to evaluate balance and gait ability. Results: BBS differed significantly in both groups between before and after the intervention (p<0.05) and changes in BBS after the intervention differed between the two groups (p<0.05). According to the Biodex Balance System test result, only the experimental group showed significant changes in balance in the conditions of static eyes open (SEC), dynamic eyes open (DEO), and dynamic eyes closed (DEC) (p<0.05). TUG test results differed significantly between prior to and after the training in both the experimental group and the control group (p<0.05) and changes in TUG after the intervention differed significantly between the two groups (p<0.05). DGI results showed significant change after the intervention in the experimental group only (P<0.05). Conclusion: Training in vestibular sensory stimulation was effective in improving static-dynamic balance and gait ability of stroke patients.

참고문헌 (Reference)

1 이민석, "편마비 환자의 발목관절에 테이핑 적용이 보행속도와 관절각도에 미치는 영향" 대한물리치료학회 24 (24): 157-162, 2012

2 박지원, "지역 거주 노인의 균형 능력과 낙상 공포감의 관계" 대한물리치료학회 24 (24): 23-28, 2012

3 이근호, "전정재활운동이 파킨슨병 환자들의 자세조절 및 감각구성에 미치는 영향" 대한운동학회 15 (15): 129-140, 2013

4 이정구, "전정장애 재활치료" 한국청각언어재활학회 6 (6): 1-9, 2010

5 강태우, "뇌졸중 후 편마비 환자들의 보행 수행 평가에 대한 문헌 고찰" 한국신경재활학회 3 (3): 28-43, 2013

6 김중휘, "뇌졸중 환자의 정적, 동적 선자세 균형 대칭성과 보행 기능의 상관관계 연구" 대한물리치료학회 24 (24): 73-81, 2012

7 정지훈, "뇌졸중 환자의 양하지 교차밀기 근력 검사와 균형의 상관관계 연구" 대한물리치료학회 25 (25): 180-186, 2013

8 송보경, "뇌졸중 환자의 상지 체감각 자극을 통한 감각, 손 기능, 자세조절 및 일상생활수행력의 변화" 대한물리치료학회 24 (24): 291-299, 2012

9 김중휘, "뇌졸중 환자의 보행 대칭성과 기능적 균형 및 보행과의 상관관계 연구" 대한물리치료학회 26 (26): 1-8, 2014

10 안승헌, "뇌졸중 환자들을 위한 한국어판 Dynamic Gait Index의 신뢰도와 타당도" 특수교육재활과학연구소 50 (50): 289-306, 2011

11 한병인, "Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises" 대한신경과학회 7 (7): 184-196, 2011

12 Beninato M, "Using the international classification of functioning, disability and health as a framework to examine the association between falls and clinical assessment tools in people with stroke" 89 (89): 816-825, 2009

13 Perennou DA, "Understanding the pusher behavior of some stroke patients spatial deficits : a pliot study" 83 (83): 570-575, 2002

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

15 Park MO, "The effects of vestibular stimulation training on balance for the children with cerebral palsy" Dankook University 2009

16 Hirsch MA, "The effects of balance training and high-intensity resistance training on persons with idiopathic parkinson's disease" 84 (84): 1109-1117, 2003

17 Yu HY, "The effect of vestibular- and proprioceptive sensory program on the posture balance and occupational performance" Inje university 2013

18 Lim JH, "The effect of mechanical horsebackriding training velocity on vestibular functions and static postural balance in healthy adults" 25 (25): 288-296, 2013

19 Kwon HM, "The effect of balance control and vestibular function by an aquatic rotation control and the obstacle avoidance underwater with hemiplegia patients" Dongshin University 2010

20 Hwang SS, "The Effects of vestibular stimulation on balance and fundamental psychological process of children with central nervous system dysfunction" Dankook University 1998

21 Bonan IV, "Sensory reweighting in controls and stroke patients" 124 (124): 713-722, 2013

22 Ayres AJ, "Sensory integration dysfunction: test score constellations. part II of a final project report" sensory integration international 1986

23 Ayres, Jean A, "Sensory integration and the child" koonja 115-, 2006

24 Bonan IV, "Reliance on visual information after stroke. part I: balance on dynamic posturography" 85 (85): 268-273, 2004

25 Smania N, "Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis" 29 (29): 313-319, 2009

26 Maurer C, "Pronounced over estimation of support surface tilt during stance" 168 (168): 4150-, 2006

27 Yelnik AP, "Post Korean Academy of Audiology ural visual dependence after recent stroke : Assessment by optokinetic stimulation" 24 (24): 262-269, 2006

28 Shumway-Cook A, "Motor control: theory and practical applications" Williams & Wilkins 1995

29 Keenan MA, "Factors affecting balance and ambulation following stroke" 182 : 165-171, 1984

30 Herdman SJ, "Exercise strategies in vestibular disorder" 68 (68): 961-964, 1990

31 Arnold BL, "Examination of balance measures produced by the biodex stability system" 33 (33): 323-327, 1998

32 Badke MB, "Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap" 114 (114): 48-54, 2005

33 Niewboer A, "Cueing training in the home improves gait-related mobility in Parkinson’s disease : the rescue trial" 78 (78): 134-140, 2007

34 Szturm T, "Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction" 4 (4): 461-469, 1994

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

36 Nashner LM, "Adapting reflexes controlling the human posture" 26 (26): 59-72, 1976

37 Nashner LM, "Adaptation to altered support and visual conditions during stance : patients with vestibular deficits" 2 (2): 536-544, 1982

38 Noh SL, "A restructured vestibular·proprioceptive sensation training program for cerebral palsied gait function and its effects" Daegu University 1999

39 김미간, "8자 모양 트랙을 이용한 방향전환 훈련이 뇌졸중 환자의 균형 및 보행에 미치는 영향" 대한물리치료학회 24 (24): 143-150, 2012