JU 동작치료가 뇌졸중 편마비환자의 운동기능, 관절가동범위, 통증, 균형 및 보행에 미치는 영향

Abstract

This study is to suggest a new movement therapy that makes patients take rehab exercise with a will and interest. It was applied to patients with hemiparalysis caused by stroke, and during this study, they took rehab exercise by using tools in accordance with the therapeutic program. Then, an analysis was made of changes in motor skill, range of motion, pain degree, sense of balance and ambulatory ability. This study was carried out on 35 patients who were diagnosed with hemiparalysis and undergoing physical rehab treatments at a hospital located in Gyeonggi Province, Korea. All of them understood this study, and they were divided into 2 groups, an experimental group and a control group by 16 to 19, 35 in all. Prior to the study, preliminary data were collected on the general characteristics and subjective symptoms. Patients, who complained of pains, underwent physical examinations. The experimental group underwent JU movement therapy 40 minutes at a time, 3 times a week for 12 weeks, 36 sessions in all. With the repeated measures ANOVA (RMANOVA), analyses were made of changes in the motor assessment scale (MAS), the range of motion (ROM) and the visual analogue scale (VAS) previously to the therapy and in the 4th week, 8th week and 12th week respectively. In addition, the Dunnett test as a post-hoc test was conducted to ascertain when intergroup differences arose in MAS, ROM and VAS. The paired t-test was conducted on changes in the Berg balance scale (BBS) and timed up and go (TUG) along with the independent t-test on intergroup changes. The results are as in the following: First, in MAS, there was no significant intergroup difference, but with time, significant differences arose (p<.001). Moreover, there were significant interaction effects between groups and points in time when MAS was measured (p<.001). Second, in ROM measured at all the joints in both affected and sound sides, there were significant intergroup differences. Likewise, there were significant interaction effects between groups and time points; especially, it was more significant in the experimental group. Third, in VAS, there was no significant intergroup difference, but with time, significant differences arose (p<.001). As in the foregoing, a significant interaction effect was between groups and time points (p<.001). Fourth, BBS remarkably rose in the experimental group. It was measured at 37.9±11.4 before the therapy but at 48.2±6.5 after its completion (p<.001). In BBS measured previously to the therapy, there was no significant intergroup difference, but after the completion of therapy, two groups showed a significant difference (p<.01). Thus, the 12-week JU movement therapy was found to be effective for the sense of balance. Fifth, TUG remarkably changed in the experimental group. It was measured at 32.9±9.5 before the therapy but at 21.5±7.0 after its completion (p<.001). In TUG measured previously to the therapy, there was no significant intergroup difference, but after the completion of therapy, two groups showed a significant difference (p<.05). Thus, the 12-week JU movement therapy was found to be effective for ambulatory ability.