시각적 피드백을 이용한 전신 기울기 운동이 급성기 뇌졸중 환자의 체간 조절, 근력 및 균형에 미치는 효과: 무작위 대조군 예비연구 = Effects of Whole Body Tilt Exercise with Visual Feedback on Trunk Control, Strength, and Balance in Patients with Acute Stroke: a Randomized Controlled Pilot Study

다국어 초록 (Multilingual Abstract)

PURPOSE: This study was conducted to determine the effects of whole-body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke.
METHODS: The study included 18 patients with acute stroke who were randomly allocated to a Whole Body Tilt Exercise Group (WBTEG, N=9) and a General Trunk Exercise Group (GTEG, N=9). The WBTEG conducted whole-body tilt exercises with visual feedback, and the GTEG performed general trunk exercises. Both groups performed the exercises five times a week for 4 weeks. Outcomes were assessed using the trunk impairment scale (TIS), the trunk flexor and extensor strength test, the static balance test, and the Brunel Balance Assessment.
RESULTS: After 4 weeks of intervention, both groups showed significantly improved TIS scores, muscle strength, and balance components (p<.05 in both groups). However, the improvement in TIS, muscle strength, and static balance in the WBTEG was significantly better than that in the GTEG (p<.05).
CONCLUSION: Although both groups in this study showed post-intervention improvement, patients from the WBTEG who received visual feedback demonstrated more improvement. These findings indicate that whole-body tilt exercise with visual feedback may be effective at improving trunk control, trunk muscle strength, and balance in patients with acute stroke. Further studies are needed to gain a better understanding of the effectiveness of whole-body tilt exercise in patients with acute stroke.

참고문헌 (Reference)

1 김성호, "척추안정화 운동이 요통 환자의 요추부 심부근육의 근단면적, 요부근력, 주관적 통증지수에 미치는 영향" 한국사회체육학회 (40) : 527-536, 2010

2 김대훈, "요추추간판탈출증 환자의 최소침습 현미경수술 후 조기의 3차원 요부 안정화 운동의 단기 효과 연구" 대한스포츠의학회 27 (27): 47-52, 2009

3 최종덕, "앉은 자세에서 능동적 체간 훈련이 초기 뇌졸중 환자의 균형과 에너지 소모에 미치는 효과" 대한물리의학회 12 (12): 93-103, 2017

4 최지민, "아급성 뇌졸중 환자에서 Space Balance 3D와 Tinetti Mobility Test를 이용한 균형 능력 평가의 신뢰도 및 동시타당도 연구" 한국콘텐츠학회 12 (12): 264-273, 2012

5 장준영, "불안정한 지지면에서의 체간조절운동이 만성 뇌졸중 환자의 동적 균형에 미치는 효과" 대한물리의학회 11 (11): 1-9, 2016

6 송귀빈, "과제지향적 상지 운동과 가상현실 훈련이 뇌졸중 환자의 상지 기능과 균형, 우울감에 미치는 영향 비교" 대한물리의학회 11 (11): 115-125, 2016

7 Cabanas-Valdes R, "Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke : a systematic review" 33 (33): 575-592, 2013

8 Verheyden G, "Trunk performance after stroke and the relationship with balance, gait and functional ability" 20 (20): 451-458, 2006

9 Karatas M, "Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients" 83 (83): 81-87, 2004

10 Stevens VK, "Trunk muscle activity in healthy subjects during bridging stabilization exercises" 7 : 75-, 2006

11 Kang TW, "Treatment of hemispatial neglect in patients with post-hemiparesis : a single-subject experimental design study using a whole-body tilt exercise plus mental practice" 31 (31): 197-206, 2012

12 Verheyden G, "The trunk impairment scale : a new tool to measure motor impairment of the trunk after stroke" 18 (18): 326-334, 2004

13 Van Peppen RP, "The impact of physical therapy on functional outcomes after stroke : what’s the evidence?" 18 (18): 833-862, 2004

14 Kim CY, "The effects of a trunk stability exercise on trunk strengthening, dynamic balance and walking in the persons with chronic stroke" Sahmyook University 2008

15 Kim BH, "The effect of a task-oriented training on trunk control ability, balance and gait of stroke patients" 24 (24): 519-522, 2012

16 Yoo JS, "The Effect of trunk stabilization exercise using an unstable surface on the abdominal muscle structure and balance of stroke patients" 26 (26): 857-859, 2014

17 Prange GB, "Systematic review of the effect of robot-aided therapy on recovery of the hemiparetic arm after stroke" 43 (43): 171-184, 2006

18 Loughlin PJ, "Spectral characteristics of visually induced postural sway in healthy elderly and healthy young subjects" 9 (9): 24-30, 2001

19 Saeys W, "Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility" 26 (26): 231-238, 2012

20 Pollock A, "Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke : A systematic review" 21 (21): 395-410, 2007

21 Goljar N, "Improving balance in subacute stroke patients : a randomized controlled study" 33 (33): 205-210, 2010

22 Thorborg K, "Hip-and knee-strength assessments using a hand-held dynamometer with external belt-fixation are inter-tester reliable" 21 (21): 550-555, 2013

23 Knols RH, "Hand-held dynamometry in patients with haematological malignancies : Measurement error in the clinical assessment of knee extension strength" 10 : 31-, 2009

24 Anders C, "Gender specific activation patterns of trunk muscles during whole body tilt" 101 (101): 195-205, 2007

25 Anders C, "Evaluation of the EMG-force relationship of trunk muscles during whole body tilt" 41 (41): 333-339, 2008

26 Hasselbach-Heitzeg MM, "Egocentric body-centered coordinates modulate visuomotor performance" 40 (40): 1822-1833, 2002

27 Van Peppen RP, "Effects of visual feedback therapy on postural control in bilateral standing after stroke : a systematic review" 38 (38): 3-9, 2006

28 Yang YR, "Effects of interactive visual feedback training on post-stroke pusher syndrome : a pilot randomized controlled study" 29 (29): 987-993, 2015

29 Chen IC, "Effects of balance training on hemiplegic stroke patients" 25 (25): 583-590, 2002

30 Moon SJ, "Effect of three-dimensional spine stabilization exercise on trunk muscle strength and gait ability in chronic stroke patients : A randomized controlled trial" 41 (41): 151-159, 2017

31 Ko YJ, "Effect of space balance 3D training using visual feedback on balance and mobility in acute stroke patients" 27 (27): 1593-1596, 2015

32 Tyson SF, "Development of the Brunel Balance Assessment : a new measure of balance disability post stroke" 18 (18): 801-810, 2004

33 Akuthota V, "Core strengthening" 85 (85): 86-92, 2004

34 Verheyden G, "Clinical tools to measure trunk performance after stroke : a systematic review of the literature" 21 (21): 387-394, 2007

35 Bayouk JF, "Balance training following stroke : effects of task-oriented exercises with and without altered sensory input" 29 (29): 51-59, 2006

36 Dickstein R, "Anticipatory postural adjustment in selected trunk muscles in post stroke hemiparetic patients" 85 (85): 261-267, 2004

37 Verheyden G, "Additional exercises improve trunk performance after stroke : A pilot randomized controlled trial" 23 (23): 281-286, 2009

38 Dickstein R, "Activation of flexor and extensor trunk muscles in hemiparesis" 79 (79): 228-234, 2000

39 김규용, "3차원 요부안정화 운동이 20대 요통환자의 통증과 동적 및 정적 균형능력 향상에 미치는 효과" 대한물리의학회 6 (6): 235-246, 2011