Journal of Korean Physical Therapy Science (대한물리치료과학회지)

Korean Physical Therapy Science (대한물리치료과학회)
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The effect and feasibility of knee extension assist orthosis on balance and gait in subacute stroke patients : case study

아급성 뇌졸중 환자에게 무릎 신전 보조기기가 균형과 보행에 미치는 효과 및 유용성 : 사례 연구

  • Received : 2020.09.01
  • Accepted : 2020.10.23
  • Published : 2020.12.31
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Abstract

Background: This study was to confirm the effect and feasibility of knee extension assist orthosis (KEAO) on balance and gait in subacute stroke patients. Design: Case study. Methods: The subjects of the study were 4 subacute stroke patients, who had an onset period of less than 6 months. The limit of stability (LOS) and berg balance scale (BBS), timed up and go test (TUG) were used to verify the dynamic balance ability, static balance ability, and gait ability pre and post and after wearing the knee extension assist orthosis (KEAO). In addition, the satisfaction survey was to confirm the feasibility of the knee extension assist orthosis (KEAO) through the to Korean quebec user evaluation of satisfaction assistive technology 2.0 (K-QUEST 2.0). Results: After the wearing on KEAO, the distance for the limit of stability decreased by mean 541.25±240.46 mm2, and the score on the berg balance scale improved by mean 5±2.71 point, and the time for the timed up and go test deceased by mean 3.75±1.71 second. The stability and durability were found to be full score, and the control, ease, effectiveness were some high score, and the size, weight, comfort were some low score in the satisfaction and feasibility. Conclusion: The knee extension assist orthosis (KEAO) produce in this study was improved the static balance ability, dynamic balance ability and gait ability of subacute stroke patients, and the satisfaction and feasibility were high in the stability, durability and effectiveness of the user.

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References

  1. 김성철, 허영구. 편마비 환자의 트레드밀과 체중지지의 트레드밀 훈련이 균형능력 및 보행능력에 미치는 영향. 대한물리치료과학회지 2018;25(1):31-43. https://doi.org/10.26862/jkpts.2018.06.25.1.31
  2. 윤현식, 한규범, 오승인, 등. 오타고운동 기반 낙상예방교육활동이 아급성 뇌졸중 환자의 균형, 낙상 효능감 및 일상생활동작능력에 미치는 영향: 무작위 대조군 임상 연구. 대한물리치료과학회지 : . 2020;27(1):1-8. https://doi.org/10.26862/jkpts.2020.06.27.1.1
  3. 이상헌, 정봉근, 박소연. QUEST 2.0의 한국어 번안 및 심리측정학적 특징. 한국산학기술학회 논문지 2013;14(7):3284-92.
  4. 이진, 김도형, 인태성. 간섭전류전기자극이 만성요통 노인 환자의 통증, 균형 및 보행능력에 미치는 즉각적인 효과. 대한물리치료과학회지 . 2018;25(2):15-23. https://doi.org/10.26862/jkpts.2018.09.25.2.15
  5. 조준행, 김로빈. 무릎 움직임의 제한이 보행 기전에 미치는 영향. 한국사회체육학회지 2018;72:429-36.
  6. 최동성, 손민균. 발목관절 보조기 착용이 뇌졸중 편마비 환자의 균형에 미치는 영향. 한국생활환경학회지 2014;21(5):837-44.
  7. Bedoya-Belmonte JJ, Rodriguez-Gonzalez MDM, Gonzalez-Sanchez M, et al. Inter-rater and intra-rater reliability of the extended TUG test in elderly participants. BMC Geriatr 2020;20(1):56. https://doi.org/10.1186/s12877-020-1460-0
  8. Berg KO, Maki BE, Williams JI, et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992;73(11):1073-80.
  9. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New York: Lawrence Erlbaum Associates; 1988.
  10. Crossley K, Cowan SM, Bennell KL, et al. Patellar taping: is clinical success supported by scientific evidence? Man Ther 2000;5(3):142-50. https://doi.org/10.1054/math.2000.0354
  11. de Haart M, Geurts AC, Huidekoper SC, et al Recovery of standing balance in postacute 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
  12. Devan MR, Pescatello LS, Faghri P, et al. A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities. J Athl Train 2004;39(3):263-7.
  13. Ernst GP, Kawaguchi J, Saliba E. Effect of patellar taping on knee kinetics of patients with patellofemoral pain syndrome. J Orthop Sports Phys Ther 1999;29(11):661-7. https://doi.org/10.2519/jospt.1999.29.11.661
  14. Fang J. Computer modelling and experimental design of a gait orthosis for early rehabilitation of walking. University of Glasgow; 2013.
  15. Filho JM, Valderramas S, Vojciechowski AS, et al. The Brazilian version of the Home Falls and Accidents Screening Tool (HOME FAST): translation, cross-cultural adaptation, validation and reliability. Rev Bras Geriatr Gerontol 2020;23(1):e190180. https://doi.org/10.1590/1981-22562020023.190180
  16. Harris ML, Polkey MI, Bath PM, et al. Quadriceps muscle weakness following acute hemiplegic stroke. Clin Rehabil 2001;15(3):274-81. https://doi.org/10.1191/026921501669958740
  17. Horstman AM, Gerrits KH, Beltman MJ, et al. Intrinsic properties of the knee extensor muscles after subacute stroke. Arch Phys Med Rehabil 2010;91(1):123-8. https://doi.org/10.1016/j.apmr.2009.09.008
  18. Horton MG, Hall TL. Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures. Phys Ther 1989;69(11):897-901. https://doi.org/10.1093/ptj/69.11.897
  19. Hoy MG, Zajac FE, Gordon ME. A musculoskeletal model of the human lower extremity: the effect of muscle, tendon, and moment arm on the moment-angle relationship of musculotendon actuators at the hip, knee, and ankle. J Biomech 1990;23(2):157-69. https://doi.org/10.1016/0021-9290(90)90349-8
  20. Hyun CW, Han EY, Im SH, et al. Hemiparetic Knee Extensor Strength and Balance Function Are Predictors of Ambulatory Function in Subacute Stroke Patients. Ann Rehabil Med 2015;39(4):577-85. https://doi.org/10.5535/arm.2015.39.4.577
  21. Hwang YI, An DH, Yoo WG. Effects of the Dual AFO on gait parameters in stroke patients. NeuroRehabilitation 2012;31(4):387-93. https://doi.org/10.3233/nre-2012-00808
  22. Jorgensen HS, Nakayama H, Raaschou HO, et al. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil 1995;76(1):27-32. https://doi.org/10.1016/S0003-9993(95)80038-7
  23. Kim SG, Lee JH. The effects of horse riding simulation exercise on muscle activation and limits of stability in the elderly. Arch Gerontol Geriat. 2015;60(1):62-5. https://doi.org/10.1016/j.archger.2014.10.018
  24. Lange B, Flynn S, Chang C, et al. Development of an interactive rehabilitation game using the Nintendo® WiiFit™ balance board for people with neurological injury. Proceedings of ICDVRAT Chile 2010;249-54.
  25. Laufer Y, Dickstein R, Chefez Y, et al. The effect of treadmill training on the ambulation of stroke survivors in the early stages of rehabilitation: a randomized study. J Rehabil Res Dev 2001;38(1):69-78.
  26. Li L, Tong KY, Hu X. The effect of poststroke impairments on brachialis muscle architecture as measured by ultrasound. Arch Phys Med Rehabil 2007;88(2):243-50. https://doi.org/10.1016/j.apmr.2006.11.013
  27. Lieb FJ, Perry J. Quadriceps function. An anatomical and mechanical study using amputated limbs. J Bone Joint Surg Am 1968;50(8):1535-48. https://doi.org/10.2106/00004623-196850080-00003
  28. Loudon JK. Biomechanics and pathomechanics of the patellofemoral joint. Int J Sports Phys Ther 2016;11(6):820.
  29. Mojica JA, Nakamura R, Kobayashi T, et al. Effect of ankle-foot orthosis (AFO) on body sway and walking capacity of hemiparetic stroke patients. Tohoku J Exp Med 1988;156(4):395-401. https://doi.org/10.1620/tjem.156.395
  30. Mulroy SJ, Eberly VJ, Gronely JK, et al. Effect of AFO design on walking after stroke: impact of ankle plantar flexion contracture. Prosthet Orthot Int 2010;34(3):277-92. https://doi.org/10.3109/03093646.2010.501512
  31. Ohata K, Yasui T, Tsuboyama T, et al. Effects of an ankle-foot orthosis with oil damper on muscle activity in adults after stroke. Gait Posture 2011;33(1):102-7. https://doi.org/10.1016/j.gaitpost.2010.10.083
  32. Page SJ, Gater DR, Bach-Y-Rita P. Reconsidering the motor recovery plateau in stroke rehabilitation. Arch Phys Med Rehabil 2004;85(8):1377-81. https://doi.org/10.1016/j.apmr.2003.12.031
  33. Perry J, Davids JR. Gait analysis: normal and pathological function. J Pediatr Orthop 1992;12(6):815. https://doi.org/10.1097/01241398-199211000-00023
  34. 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
  35. Portnoy S, Frechtel A, Raveh E, et al. Prevention of Genu Recurvatum in Poststroke Patients Using a Hinged Soft Knee Orthosis. PM R 2015;7(10):1042-51. https://doi.org/10.1016/j.pmrj.2015.04.007
  36. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 2003;33(11):639-46. https://doi.org/10.2519/jospt.2003.33.11.639
  37. Requier B, Bensoussan L, Mancini J, et al. Knee-ankle-foot orthoses for treating posterior knee pain resulting from genu recurvatum: Efficiency, patients' tolerance and satisfaction. J Rehabil Med 2018;50(5):451-6. https://doi.org/10.2340/16501977-2333
  38. Saeys W, Vereeck L, Truijen S, et al. Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility. Neurorehabil Neural Repair 2012;26(3):231-8. https://doi.org/10.1177/1545968311416822
  39. Silver-Thorn B, Herrmann A, Current T, et al. Effect of ankle orientation on heel loading and knee stability for post-stroke individuals wearing ankle-foot orthoses. Prosthet Orthot Int 2011;35(2):150-62. https://doi.org/10.1177/0309364611399146
  40. Winstein CJ, Miller JP, Blanton S, et al. Methods for a multisite randomized trial to investigate the effect of constraint-induced movement therapy in improving upper extremity function among adults recovering from a cerebrovascular stroke. Neurorehabil Neural Repair 2003;17(3):137-52. https://doi.org/10.1177/0888439003255511
  41. Yamamoto M, Shimatani K, Hasegawa M, et al. Effect of an ankle-foot orthosis on gait kinematics and kinetics: case study of post-stroke gait using a musculoskeletal model and an orthosis model. ROBOMECH J 2019;6(1):9. https://doi.org/10.1186/s40648-019-0137-y
  42. Yazdani S, Alizadeh F, Dizaji E, et al. Postural sway changes in genu recurvatum deformity during standing with manipulation of visual and proprioceptive systems. J Bodyw Mov Ther 2020;24(4):147-151. https://doi.org/10.1016/j.jbmt.2020.06.018