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고관절 관절가동기법이 뇌졸중 환자의 고관절 가동성, 균형과 보행능력에 미치는 효과

Effect of Hip Joint Mobilization on Hip Mobility, Balance and Gait With Stroke Patients

한국전문물리치료학회지 2014년 21권 2호 p.8 ~ 17
김영훈, 장현정, 김선엽,
소속 상세정보
김영훈 ( Kim Young-Hoon ) - 대전 웰니스병원 물리치료실
장현정 ( Jang Hyun-Jeong ) - 대전대학교 자연과학대학 물리치료학과
김선엽 ( Kim Suhn-Yeop ) - 대전대학교 자연과학대학 물리치료학과

Abstract


The purpose of this study was to examine the effects of hip joint mobilization (HJM) on walking ability, balance ability, and the joint range of motion in stroke patients to minimize the problems of the musculoskeletal system in patients with central nervous system diseases. All volunteers were randomly assigned to the HJM group (n1=14) and the general neurodevelopment therapy (NDT) group (n2=16). The HJM procedure involved applying Maitland mobilization techniques (distraction, lateral gliding, inferior gliding, and anterior gliding) by grade 3 to both hip joint. The mobilization process included mobilization and NDT for 15 min/day, 3 days a week for 4 weeks. The outcome measures were evaluated, including the hip joint passive range of motion (ROM) test and femur head anterior glide test (FHAG) using prone figure four test, dynamic and static balance abilities [timed up and go (TUG) test and center of pressure (COP) analysis], and walking ability [10-meter walking test (10MWT) and 6-min walking test (6MWT)]. Both the groups showed significant post-training differences in the hip joint ROM (FHAG and degree of hip extension) and 10MWT. The post-training improvements in the TUG test were significantly greater in patients of the HJM group than in the NDT group; however, there were no post-training improvements in COP in both groups. Patients in the HJM group showed post-training improvement in the 6MWT; however, statistically significant differences were not observed. Patients in the NDT group showed post-training improvements in the 6MWT. These results suggest that HJM improves hip joint ROM, dynamic balance ability, and walking speed in stroke patients. However, further studies are required to evaluate the long-term therapeutic efficacy of HJM in stroke patients.

키워드

Balance; Gait; Hip Joint; Mobilization; Stroke

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