Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Treadmill Gait Training in an Adjusted Position from Functional Training System on Chronic Stroke Patients' Walking and Balance Ability

기능적 훈련 시스템을 이용한 조절된 자세에서의 트레드밀 보행훈련이 만성 뇌졸중 환자의 보행 기능과 균형에 미치는 효과

  • Park, Ji-Eung (Dept. of Physical Therapy, Iksan Wonkwang Hyodo Hospital) ;
  • Lee, Jun-Ho (Dept. of Emergency Medicine, College of Health and Medical Science, Daejeon University) ;
  • Cha, Yong-Jun (Dept. of Physical Therapy, College of Health and Medical Science, Daejeon University)
  • 박지응 (익산원광효도요양병원 물리치료실) ;
  • 이준호 (대전대학교 보건의료과학대학 응급구조학과) ;
  • 차용준 (대전대학교 보건의료과학대학 물리치료학과)
  • Received : 2016.09.21
  • Accepted : 2016.10.10
  • Published : 2017.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE: The purpose of this study was to examine the effects of treadmill gait training in an adjusted position from the functional training system on the gait and balance of chronic stroke patients. METHODS: Thirty chronic stroke patients were randomly assigned to either the experimental group, who received treadmill gait training in an adjusted position, or the control group, who received regular treadmill gait training. Both groups underwent a 30-minute comprehensive rehabilitation treatment before receiving an additional 20-minute treadmill gait training. This routine was repeated five times a week for four weeks. To measure the difference before and after training in walking and balance, patients were scored on the following: 10 m walking test (10 MWT), 6 minute walking distance (6 MWD), timed up and go test (TUG), and static standing balance test (stability index). RESULTS: While post-training scores of 10 MWT, 6 MWD, TUG, and stability index for both groups increased significantly compared with pre-training (p<.05), the experimental group showed greater improvement than the control group (p<.05). The scores of the experimental group increased significantly by 9% in the 10 MWT, 11% in 6 MWD, 13% in the TUG, 8% in the stability Index (eye opened), and 10% in the stability index (eye closed). CONCLUSION: Treadmill gait training in an adjusted position from the functional training system would be a useful gait training method to improve walking and balance of chronic stroke patients.

Keywords

References

  1. Ada L, Dean CM, Hall JM, et al. A treadmill and over ground walking program improves walking in persons residing in the community after stroke: a placebocontrolled, randomized trial. Arch Phys Med Rehabil. 2003;84(10):1486-91. https://doi.org/10.1016/S0003-9993(03)00349-6
  2. Baer HR, Wolf SL. Modified emory functional ambulation profile: An outcome measure for the rehabilitation of poststroke gait dysfunction. Stroke. 2001;32(2): 973-9. https://doi.org/10.1161/01.STR.32.4.973
  3. Dean CM, Richards CL, Malouin F, et al. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-17. https://doi.org/10.1053/mr.2000.3839
  4. Dietz V. Human neuronal control of automatic functional movement: Interaction between central programs and afferent input. Physiological Reviews. 1992;72(1): 33-69. https://doi.org/10.1152/physrev.1992.72.1.33
  5. Geiger RA, Allen JB, O'Keefe J, et al. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/force plate training. Phys Ther. 2001;81(4):995-1005.
  6. Goldie PA, Matyas TA, Evans OM, et al. Maximum voluntary weight bearing by the affected and unaffected legs in standing following stroke. Clin Biomech. 1996; 53(11):333-42.
  7. Hesse S, Helm B, Krajnik J, et al. Treadmill training with partial body weight support: influence of body weight release on the gait of hemiparetic patients, J Neurol Rehabil. 1997;11(1):15-20.
  8. Ikai T, Kamikubo T, Takehara I, et al. Dynamic postural control in patients with hemiparesis. AM J Phys Med Rehabil. 2003;82(6):463-9.
  9. Jang JY, Kim SY. Effects of trunk control exercise performed on an unstable surface on dynamic balance in chronic stroke patients. J Korean Soc Phys Med. 2016;11(1): 1-9. https://doi.org/10.13066/kspm.2016.11.1.1
  10. Johansson R, Maqnusson M. Human postural dynamics. Crit Rev Biomed Eng. 1991;18(6):413-37.
  11. Kim EJ, Jung JM, Kim TH, et al. The effects of plantar foot pressure and muscular activity on treadmill gait training in stroke patients. J Korean Soc Phys Med. 2009;4(3):165-74.
  12. Kim SG. Effect of treadmill gradient training on lower limb muscle activity in chronic stroke patient. Journal of the Korea Academia-Industrial cooperation Society. 2012;13(1):220-6. https://doi.org/10.5762/KAIS.2012.13.1.220
  13. Kohen-Raz R. Application of tetra-ataxiametric posturography in clinical and developmental diagnosis. Perceptual and motor skills. 1991;73(2):635-56. https://doi.org/10.2466/pms.1991.73.2.635
  14. Laufer Y, Dickstein R, Resnik S, et al. Weight-bearing shifts of hemiparetic and healthy adults upon stepping on stairs of various heights. Clin Rehabil. 2000;14(2): 125-9. https://doi.org/10.1191/026921500674231381
  15. Lee HS. The effect of gait pattern in hemiplegia patients through progressive speed increase treadmill training. Journal of The Korean Society of Integrative Medicine. 2014;2(1):23-34. https://doi.org/10.15268/KSIM.2014.2.1.023
  16. Massion J. Postural control system. Current Opinion in Neurobiology. 1994;4(6):977-87.
  17. Mossberg KA. Reliability of a timed walk test in persons with acquired brain injury. Am J Phys Med Rehabil. 2003;82(5):385-90. https://doi.org/10.1097/01.PHM.0000052589.96202.BE
  18. Myklebust BM, Gottlieb GL. Spinal reflex organization in early developments: Electro physiological measures and proposed motor path ways. Ment Retard Dev Disa bil Res Rev. 1997;3(2):175-83. https://doi.org/10.1002/(SICI)1098-2779(1997)3:2<175::AID-MRDD9>3.0.CO;2-Q
  19. Nyberg L, Gustafson Y. Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies. Stroke. 1995;26(5):838-942. https://doi.org/10.1161/01.STR.26.5.838
  20. Patterson KK, Parafianowicz I, Danells CJ, et al. Gait asymmetry in community-ambulating stroke survivors. Arch Phys Med Rehabil. 2008;89(2):304-10. https://doi.org/10.1016/j.apmr.2007.08.142
  21. Podsiadlo D, Richardson S. The timed Up & Go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  22. Runge M, Rehfeld G, Resnicek E, et al. Balance Training and Exercise in Geriatric Patients. J Musculoskelet Neuronal Interact. 2000;1:54-8.
  23. Semenova K. The basis for application of the method of dynamic proprioceptive correction in the restorative therapy of patients with infantile cerebral paralysis in the residual stage. Korsakov's J Neurol Psychiatr. 1996; 96(3):47-50.
  24. Shumway-Cook A, Woollacott M. Motor Control Translating Research into Clinical Practice. Maryland. Lippincott Williams & Wilkins. 2007.
  25. Shumway-Cook A, Brauer S, Woollacott M, et al. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
  26. Song GB, Park EC. The effects of balance training on balance pad and sand on balance and 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
  27. Van Loo MA, Moseley AM, Bosman JM, et al. Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: A pilot study. Brain Inj. 2004;18(10):1041-8. https://doi.org/10.1080/02699050410001672314
  28. Visintin M, Barbeau H, Korner-Bitensky N, et al. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke. 1998;29(6):1122-8. https://doi.org/10.1161/01.STR.29.6.1122
  29. Winstein CJ, Gardner ER, McNeal DR, et al. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil. 1989;70(10):755-62.
  30. Winter DA. Biomechanics of normal and pathological gait: implication for understanding human locomotor control. J Mot Behav. 1989;21:337-56. https://doi.org/10.1080/00222895.1989.10735488

Cited by

  1. The Effects of Underwater Treadmill Walking Training with Aquatic Cuff Weights on Balance and Walking Abilities in Stroke Patients vol.13, pp.1, 2018, https://doi.org/10.13066/kspm.2018.13.1.89
  2. Effects of a Vestibular Stimulation Training Program on the Gait of Chronic Stroke Patients vol.14, pp.1, 2017, https://doi.org/10.13066/kspm.2019.14.1.35
  3. 뇌졸중 환자에게 하지 근력강화 프로그램이 균형, 보행과 상지 기능에 미치는 효과 vol.20, pp.6, 2017, https://doi.org/10.5392/jkca.2020.20.06.114
  4. 트레드밀 운동이 뇌졸중 환자의 폐기능과 보행능력에 미치는 효과 : 메타분석 vol.8, pp.2, 2017, https://doi.org/10.15268/ksim.2020.8.2.169
  5. 뇌졸중환자에게 적용된 트레드밀훈련의 효과 및 방법에 대한 체계적 고찰 vol.27, pp.2, 2017, https://doi.org/10.26862/jkpts.2020.09.27.2.63