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A Convergence Study on the Effects of functional electrical stimulation with mirror therapy on balance and gait ability in chronic stroke patients.

기능적 전기자극을 병행한 거울치료가 만성 뇌졸중 환자의 균형 및 보행능력에 미치는 영향에 관한 융합적 연구

  • Kim, Dong Hoon (Department of Physcial Therapy, Bundang Jesaeng Hospital) ;
  • Kim, Kyung Hun (Department of Physcial Therapy, Gimcheon University)
  • Received : 2018.08.16
  • Accepted : 2018.10.20
  • Published : 2018.10.28

Abstract

The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with mirror therapy on balance and gait ability in chronic stroke patients. Thirty-five subjects who met the inclusion criteria were randomly allocated into three groups: the functional electrical stimulation with mirror therapy group(FMT group, n=11), mirror therapy group(MT group, n=12), and control group (n=12). The exercises were conducted for 30 min per day, five, per week for four weeks. Balance and gait ability were examined at baseline and after 4 weeks of intervention. After training, the FMT group showed significant improvement in berg balance scale (BBS), center of pressure (COP) length, affected step length (ASL), Cadence and average gait speed (AGS) compared MT group and control group(p<0.05). This findings show that FES and MT convergence can be an effective intervention for stroke patients balance and gait ability. Continued development of convergence interventions for stroke patients with balance and gait ability in practice, are suggested.

본 연구의 목적은 기능적 전기자극을 병행한 거울치료가 만성 뇌졸중 환자의 균형과 보행능력에 미치는 영향을 알아보기 위함이다. 선정기준에 따라 만성 뇌졸중 환자를 35명을 대상으로 세군으로 실시하였다. FMT군은 기능적 전기자극을 병행한 거울치료(n=11), MT군은 거울치료를 시행하였고(n=12), CON군(n=12)은 일반적인 물리치료를 시행하였다. 훈련은 1일 30분, 1주 5번, 총 4주간 시행하였다. 중재 전 훈련 4주 후에 균형과 보행능력을 검사실시하였다. 훈련결과 기능적 전기자극을 병행한 거울치료 훈련군이 버그균형척도, 신체의 이동거리, 활보장, 분속수, 그리고 평균보행속도에서는 거울치료군과 대조군에 비해 통계학적으로 유의한 차이를 보였다. 그러므로 기능적 전기자극 치료와 거울치료 융합은 뇌졸중 환자의 균형과 보행능력을 위한 효과적인 중재로 활용 될 수 있으며, 다양한 뇌졸중 환자를 위한 지속적인 융합중재개발이 요구된다.

Keywords

References

  1. G. Lamola, C. Fanciullacci, B. Rossi, & C. Chisari. (2014). Clinical evidences of brain plasticity in stroke patients. Archives italiennes de biologie, 152(4), 259-271. DOI: 10.12871/00039829201446.
  2. Y. Hara. (2015). Brain plasticity and rehabilitation in stroke patients. Journal of nippon medical school, 82(1), 4-13. DOI: 10.1272/jnms.82.4.
  3. E. K. Kim, D. K. Lee, & Y. M. Kim. (2015). Effects of auatic PNF lower extremity patterns on balacne and ADL of stroke patients. Journal of physical therapy science, 27(1), 213-215. DOI: 10.1589/jpts.27.213.
  4. E. Swinnen, D. Beckwee, R. Meeusen, J. P. Baeyens, & E. Kerckhofs. (2014). Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review. Topics in stroke rehabilitation, 21(2), 87-100. DOI: 10.1310/tsr2102-87
  5. S. Y. Kim, & Kim, I. Hong. (2018). Factors Convergent Influencing Rehabilitation Motivation among Stroke Patients. Journal of Digital Convergence. 15(9), 375-384. https://doi.org/10.14400/JDC.2017.15.9.375
  6. N. E. Fritz, F. M. Cheek, & D. S. Nichols- Larsen. (2015). Motor-Cognitive dual-task training in persons with neurological disorders: a systematic review. Journal of neurologic physical therapy, 39(3), 142-153. DOI: 10.1097/NPT.0000000000000090.
  7. X. Yang, P. Wang, C. Liu, C. He, & J. D. Reinhardt. (2015). The effects of whole body vibration on balance, gait performace and mobility in people with stroke: a systematic review and meta-analysis. Clinical rehabilitation, 29(7), 627-638. DOI: 10.1177/0269215514552829.
  8. A. Bhasin, M. V. Padam Srivastava, S. S. Kumaran, R. Bhatia, & S. Mohanty. (2012). Neural interface of mirror therapy in chronic stroke patients: A functional magnetic resonance imaging study. Neurology India, 60(6), 570-576. DOI: 10.4103/0028-3886.
  9. V. S. Ramachandran, & D. Rogers- Ramachandran. (1996). Synaesthesia in phantom limbs induced with mirrors. Proceedings. Bilological sciences/The Royal Society, 263(1369), 377-386. https://doi.org/10.1098/rspb.1996.0058
  10. S. Subeyaz, G. Yavuzer, N. Sezer, & F. Koseoglu. (2007). Mirror Theraphy Enhances Lower-Extremity Motor Recovery and Motor Functioning After Stroke: A randomized controlled trial. American Journal of Physical Medicine & Rehabilitation, 88(5), 555-559.
  11. D. Jack, R. Boian, A. S. Merians, M. Tremarine, G. C. Burdea, S. V. Adamovich, M. Recce, & H. Poizner. (2001). Virtual reality -enhanced stroke rehabilitation. IEEE transactions on neural systems and rehabiitaionl engineering, 9(3), 308-318. https://doi.org/10.1109/7333.948460
  12. M. Invernizzi, S. Negrini, S. Carda, L. Lanzotti, C. Cisari, & A. Baricich. (2013). The value of assing mirror therapy for upper limb motor recovery of subacute stroke patients: A randomized controlled trial. European journal of Physical Rehabilitation Medicine, 49(3), 311-317
  13. M. E. Michielsen, R. W. Selles, J. N. van det Geest, M. Eckhardt, G. Yavuzer, H. J. Stam, J. G. M. Ribbers & B. Bussmann. (2011). Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: A phase II randomized controlled trial. Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: A phase II randomized controlled trial. Neurorehabilitation and neural repair, 25(3), 223-233. DOI: 10.1177/1545968310385127.
  14. A. Radajewska, J. A. Opara, C. Kucio, M. Blaszczyszyn, K. Mehlich, & J. Szczygiel. (2013). The effects of mirror therapy on arm and hand function in subacute stroke in patients. Internationale journal of rehabilitation research, 36(3), 268-274. DOI: 10.1097/MRR.0b013e3283606 218.
  15. G. Yavuzer, R. Selles, N. Sezer, S. Sutbeyaz, J. B. Bussmann, F. Köseoglu, M. B. Atay, & H. J. Stam. (2008). Mirror Therapy Improves Hand Function in Subacute Stroke: A Randomized Controlled Trial. American Journal of Physical Medicine & Rehabilitation, 89(3), 393-398. DOI: 10.1016/j.apmr.2007.08.162
  16. J. Chae, & D. Yu. (2000). A critical review of neuromuscular electrical stimulation for treatment of motor dysfunction in hemiplegia. Assistive technology, 12(1), 33-49. https://doi.org/10.1080/10400435.2000.10132008
  17. A. J. Thompson, L. Jarrett, L. Lockley, J. Marsden, & V. L. Stevenson. (2005). Clinical management of spasticity. Neurology neurosurgery psychiatry, 76(4), 459-468. https://doi.org/10.1136/jnnp.2004.035972
  18. S. Combs, E. W. Miller, & E. Forsyth. (2007). Motor and functional outcomes of a patient post-stroke following combined activity and impairment level training. Physiotherapy theory and practice, 23(4), 219-229. https://doi.org/10.1080/09593980701209261
  19. S. K. Sabut, C. Sikdar, R. Kumar, & M. Mahadevappa. (2011). Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation, 29(4), 393-400. DOI: 10.3233/NRE-2011-0717.
  20. K. Berg, S. Wood-Dauphinee, & J. I. Williams. (1995). The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scandinavian Journal of Rehabilitation Medicine, 27(1), 27-36.
  21. J. F. Glatthorn, S. Gouge, S. Nussbaumer, S. Stauffacher, F. M. Impellizzeri, & N. A. Maffiuletti. (2011). Validity and reliability of Optojump photoelectric cells for estimating vertical jump height. Journal of strength and conditioning research, 25(2), 556-560. DOI: 10.1519/JSC.0b013e3181ccb18d
  22. E. L. Altschuler, S. B. Wisdom, L. Stone, C. Foster, D. Galasko, D. M. Llewellyn, & V. S. Ramachandran. (1999). Rehabilitation of hemiparesis after stroke with a miirror. Lance, 2035-2036.
  23. J. Wang, C. Fritzsch, J. Bernarding, T. Krause, K. H. Mauritz, M. Brunetti, & C. Dohle. (2013). Cerebral activation evoked by the mirror illusion of the hand in stroke patietns compared to normal subjects. Neurorehabilitation, 33(4), 593-603. DOI: 10.3233/NRE-130999.
  24. A. Shumway-Cook, & M. H. Woollacott. (2006). Motor Control: Translating Research into Clinical Practice. Philadelphia, Lippincott Williams & Wilkins, 3rded.
  25. Y. Laufer, R. Dickstein, Y. Chefez, & E. Marcovitz. (2001). The effect of treadmill training on the ambulation of stroke survivors in the early stages of rehabilitation: a randomized study. Journal of rehabilitation research and development, 38(1), 69-78.
  26. S. F. Tyson, M. Hanley, J. Chillala, A. Selley, & R. C. Tallis. (2006). Balance disability after stroke. Physical therapy, 86(1), 30-38. https://doi.org/10.1093/ptj/86.1.30
  27. S. Sutbeyaz, G. Yavuzer, N. Sezer, & B. F. Koseoglu. (2007). Miiror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. American Journal of Physical Medicine & Rehabilitation, 88(5), 555-559.
  28. N. E. Kim, Y. L. Kim, S. C. Moon, D. H. Lee, H. J. Lim, E. K. Jang, J. E. Hung, & J. H. Kang. (2018). The Effect of Dynamic Balance on Cyber Motion Sickness of Full Immersion Virtual Reality. Journal of Convergence for Information Technology, 8(1), 131-138. https://doi.org/10.22156/CS4SMB.2018.8.1.131
  29. J. H. Cauraugh, N. Lodha, S. K. Naik, & J. J. Summers. (2010). Bilateral movement training and stroke motor recovery progress: a review and meta-analysis. Human movement science, 29(5), 853-870. https://doi.org/10.1016/j.humov.2009.09.004
  30. G. M. Galeazzi, D. Monzani, C. Gherpelli, R. Covezzi, & G. P. Guaraldi. (2006). Posturographic stabilisation of healthy participants exposed to full-length mirror image is inversely related to body-image preoccupations. Neuroscience Letters, 410, 71-75. https://doi.org/10.1016/j.neulet.2006.09.077
  31. D. Lee, G. Lee, & J. Jeong. (2016). Mirror Therapy with Neuromuscular Electrical Stimulation for improving motor function of stroke survivors: A pilot randomized clinical study. Technology and health care, 27(4), 503-511. DOI: 10.3233/THC-161144.
  32. M. DeHaart, A. C. Geurts, S. Huidekoper, C. FasottiL, & J. van Limbeek. (2004). Recovery of standing balance in post acute stroke patients: a rehabilitation cohort study.
  33. S. J Park, T. H. Kim, J. H. Go, P. S. Youn. (2017). The impact of convergence balance training and taping on spasticity and balance ability in patients with chronic stroke. Journal of Digital Convergence. 15(7), 297-306. https://doi.org/10.14400/JDC.2017.15.7.297
  34. T. G. Nam, & J. H. Lee. (2017). The effect of unstable plate on the ankle joint displacement and dynamic balance ability of female college students wearing high-heeled shoes. Journal of Convergence for Information Technology, 7(5), 31-38. https://doi.org/10.22156/CS4SMB.2017.7.5.031
  35. R. B. Huitema, A. L. Hof, T. Mulder, W. H. Brouwer, R. Dekker, & K. Postema. (2004). Functional recovery of gait and joint kinematics after right hemispheric stroke. American Journal of Physical Medicine & Rehabilitation, 85(12), 1982-1988.
  36. F. Caillet, P. Mertens, S. Rabaseda, & D. Boisson. (2003). [Three dimensional gait analysis and controlling spastic foot on stroke patients]. Annales de readaptionn et de medecine physique, 46(3), 119-131. https://doi.org/10.1016/S0168-6054(03)00015-1
  37. R. E. Kelley, & A. P. Borazanci. (2009). Stroke rehabilitation. Neurological research, 31(8), 832-840. https://doi.org/10.1179/016164109X12445505689689
  38. S. G. Ji, & M. K. Kim. (2014). The effects of mirror therapy on the gait of subacute stroke patient; a randomized controlled trial. Clinical rehabilitation, 29(4), 348-354. DOI: 10.1177/0269215514542356.
  39. S. Sütbeyaz, G. Yavuzer, N. Sezer, & B. F. Koseoglu. (2007). Mirror Therapy Enhances Lower-Extremity Motor Recovery and Motor Functioning After Stroke: A Randomized Controlled Trial. American Journal of Physical Medicine & Rehabilitation, 88(5), 555-559.
  40. G. Bellelli, G. Buccino, B. Bernardini, A. Padovani, & M. Trabocci. (2010). Action observation treatment improves recovery of postsurgical orthopedic patient: Evidence for a top-down effect? American Journal of Physical Medicine & Rehabilitation, 91(10), 1489-1494. DOI: 10.1016/j.apmr.2010.07.013.
  41. Y. R. Kim, Y. I Kim & M. J. Kim. (2017). A convergent study of the physcial related quality of life using SF-8 of stroke patient's caregiver. Journal of the korea convergence society, 8(12), 119-127. DOI: org/10.15207/JKCS.2017.8.12.119