Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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Clinical Feasibility of Otago Exercise Program to Improve the Balance and Gait Ability: In Chronic Stroke Patient, Randomized Controlled Trial

균형과 보행능력 향상을 위한 오타고 운동프로그램의 임상적 유용성: 만성 뇌졸중 환자를 대상으로, 무작위 배정 실험연구

  • 송현승 (첨단우암병원 재활센터) ;
  • 윤태원 (수완재활요양병원 재활센터)
  • Received : 2016.03.11
  • Accepted : 2016.04.21
  • Published : 2016.05.31
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Abstract

PURPOSE: The aim of this study was to conduct an Otago exercise program with stroke patients in a clinical setting and ascertain its effects on balance and walking ability. METHODS: The participating subjects were 45 people who had been diagnosed with stroke. They were assigned to two groups (Otago exercise; OE, n=22; balance exercise; BE, n=23), and the exercises were conducted for three sessions per week for eight weeks. The main balance outcomes were evaluated using the timed up and go test (TUG) and the four step square test (FSST), while walking ability was evaluated using the 10 m walk test (10MWT), direction change ability was measured using the figure 8 of walk test (F8WT), and the decrease of fear was evaluated using the modified falls efficacy scale (MFES). RESULTS: In the analysis results, the Otago exercise group showed significant increases in TUG, FSST, 10MWT, and F8WT within the both groups. There were significant differences in all variables between the OE group and the BE group at the post-intervention evaluation, but there was no significant difference between the groups with respect to the 10MWT. This study showed that conducting Otago exercise in stroke patients increased the main outcomes for TUG, FSST, F8WT scores, but not for 10MWT. CONCLUSION: The results of this study demonstrated that Otago exercise would be useful to improve balance and gait for stroke patients who want to improve their abilities and activities of daily living.

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References

  1. Ahn MH, Park KD, You YY. The effect of feedback on somesthetic video game training for improving balance of stroke patients. J Korean Soc Phys Med. 2012;7(4):401-9. https://doi.org/10.13066/kspm.2012.7.4.401
  2. Ahn WH, Jeong MK, Kim CK. The Training effect of balance pad in stroke. Journal of Sport and Leisure Studies. 2008;32(2):803-11.
  3. Binns, Elizabeth. The otago exercise programme: do strength and balance improve? Diss. Auckland University of Technology. 2006.
  4. Campbell AJ, Robertson MC, Gardner MM et al. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ. 1997;315(7115):1065-9. https://doi.org/10.1136/bmj.315.7115.1065
  5. Danielli Coelho de Morais Faria C, Fuscaldi Teixeira-Salmela L, Nadeau S. Effects of the direction of turning on the timed up & go test with stroke subjects. Top Stroke Rehabil. 2009;16(3):196-206. https://doi.org/10.1310/tsr1603-196
  6. de Haart M, Geurts AC, Huidekoper SC et al. Recovery of standing balance in post-acute stroke patients: a rehabilitation cohort study. Arch Phys Med Rehabil. 2004;85(6):886-95. https://doi.org/10.1016/j.apmr.2003.05.012
  7. Dean CM, Richards CL, Malouin F. Walking speed over 10 metres overestimates locomotor capacity after stroke. Clin Rehabil. 2001;15(4):415-21. https://doi.org/10.1191/026921501678310216
  8. Dite W, Temple VA. A clinical test of stepping and change of direction to identify multiple falling older adults. Arch Phys Med Rehabil. 2002;83(11):1566-71. https://doi.org/10.1053/apmr.2002.35469
  9. Hess RJ, Brach JS, Piva SR et al. Walking skill can be assessed in older adults: validity of the Figure-of-8 Walk Test. Phys Ther. 2010;90(1):89-99. https://doi.org/10.2522/ptj.20080121
  10. Huh JY. The Effects of Fear of falling and sensory integration on balance and Postural Control in health Elderly. Korean Journal of Sport Psychology. 2001;12(2): 57-68.
  11. Karatas M, Cetin N, Bayramoglu M et al. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil. 2004;83(2):81-7. https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  12. Kerse N, Hayman KJ, Moyes SA et al. Home-based activity program for older people with depressive symptoms: DeLLITE-a randomized controlled trial. Ann Fam Med. 2010;8(3):214-23. https://doi.org/10.1370/afm.1093
  13. Kiriyama K, Warabi T, Kato M et al. Medial-lateral balance during stance phase of straight and circular walking of human subjects. Neurosci Lett. 2005;388(2):91-5. https://doi.org/10.1016/j.neulet.2005.06.041
  14. Lee YW, Shin DC, Lee KJ, et al. The Relation between asymmetric weight-supporting and gait symmetry in patients with stroke. J Korean Soc Phys Med. 2012; 7(2):205-12. https://doi.org/10.13066/kspm.2012.7.2.205
  15. Lin KC, Wu CY, Chen CL et al. Effects of object use on reaching and postural balance: a comparison of patients with unilateral stroke and healthy controls. Am J Phys Med Rehabil. 2007;86(10):791-9. https://doi.org/10.1097/PHM.0b013e318151fb81
  16. Liston MB, Alushi L, Bamiou DE et al. Feasibility and effect of supplementing a modified OTAGO intervention with multisensory balance exercises in older people who fall: a pilot randomized controlled trial. Clin Rehabil. 2014;28(8):784-93. https://doi.org/10.1177/0269215514521042
  17. Liu-Ambrose T, Donaldson MG, Ahamed Y et al. Otago homebased strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. J Am Geriatr Soc. 2008;56(10): 1821-30. https://doi.org/10.1111/j.1532-5415.2008.01931.x
  18. Michael KM, Allen JK, Macko RF. Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness. Arch Phys Med Rehabil. 2005;86(8):1552-6. https://doi.org/10.1016/j.apmr.2004.12.026
  19. Moon SH, Kim YM. Effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke. J Korean Soc Phys Med. 2014;(9(4):475-83. https://doi.org/10.13066/kspm.2014.9.4.475
  20. Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke Arch Phys Med Rehabil. 2005;86(8):1641-7. https://doi.org/10.1016/j.apmr.2005.01.011
  21. Orrell AJ, Eves FF, Masters RS. Motor learning of a dynamic balancing task after stroke: implicit implications for stroke rehabilitation. Phys Ther. 2006;86(3):369-80.
  22. Patterson SL, Forrester LW, Rodgers MM et al. Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil. 2007;88(1):115-9. https://doi.org/10.1016/j.apmr.2006.10.025
  23. Podsiadlo D, Richardson S. The timed up and go: a test of basic functional mobility for frail eldery person. J Am Geriatr Soc. 1991;39:142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  24. Roerdink M, Lamoth CJ, Kwakkel G et al. Gait coordination after stroke: benefits of acoustically paced treadmill walking. Phys Ther. 2007;87(8):1009-22. https://doi.org/10.2522/ptj.20050394
  25. School OM. Otago exercise programme to prevent falls in older adults. Otago: University of Otago. 2003.
  26. Shea SMoriello G. Feasibility and outcomes of a classical pilates program on lower extremity strength, posture, balance, gait, and quality of life in someone with impairments due to a stroke. J Bod Mov Ther. 2014; 18(3):332-60. https://doi.org/10.1016/j.jbmt.2013.11.017
  27. Song GB, Park EC. The effects of balance training on balance pad and sand on gait ability in stroke patients. J Korean Soc Phys Med. 2016;11(1):45-52. https://doi.org/10.13066/kspm.2016.11.1.45
  28. Steffen TM, Hacker TA, Mollinger L. Age-and gender-related test performance in community-dwelling elderly people: six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther. 2002;82(2): 128-37. https://doi.org/10.1093/ptj/82.2.128
  29. Thomas S, Mackintosh S, Halbert J. Does the 'Otago exercise programme'reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age Ageing. 2010;102.
  30. Tyson SF, Hanley M, Chillala J et al. Balance disability after stroke. Phys Ther. 2006;86(1):30-8. https://doi.org/10.1093/ptj/86.1.30
  31. Verheyden G, Vereeck L, Truijen S, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20(5): 451-8. https://doi.org/10.1191/0269215505cr955oa
  32. Yardley L, Donovan-Hall M, Francis K, et al. Older peolpe's views of advice about falls prevention: a qualitative study. Health Educ Res. 2006;21:508-17.

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