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게임 기반의 자세수직 훈련이 급성 뇌졸중 환자의 밀기행동, 자세조절, 그리고 일상생활동작에 미치는 영향: 사전연구

Effects of Game-based Postural Vertical Training on Pusher Behavior, Postural Control, and Activity of Daily Living in Patients With Acute Stroke: A Pilot Study

한국전문물리치료학회지 2019년 26권 3호 p.57 ~ 66
안창만 ( An Chang-Man ) - 전북대학교병원 물리치료실

노정석 ( Roh Jung-Suk ) - 한서대학교 물리치료학과
김택훈 ( Kim Tack-Hoon ) - 한서대학교 물리치료학과
최흥식 ( Choi Houng-Sik ) - 한서대학교 물리치료학과
최규환 ( Choi Kyu-Hwan ) - 안산대학교 물리치료과
김경모 ( Kim Gyoung-Mo ) - 대전보건대학교 물리치료과


Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke.

Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients.

Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group (n1=7) and conventional postural vertical training (CPVT) group (n2=7). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject’s postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention.

Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively).

Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.


Game-based postural vertical training; Postural control; Pusher behavior; Stroke
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