CAJ | 학술논문

目的：探讨脑卒中偏瘫患者在不同足位下完成坐-站转移时躯干运动及下肢负重。方法选取脑卒中偏瘫患者32例(实验组)和健康人32名(对照组)，在双足踝背屈10°(BF)、健侧(优势侧)踝背屈10°时患足置后(PFP)或非优势足置后(UFDP)、患侧(非优势侧)踝背屈10°时健足置后(NPFP)或优势足置后(DFP)3种足位下完成坐-站转移测试；采用平衡功能训练评估系统对受试者坐-站转移时下肢负重、下肢负重的不对称性(WBasym)以及臀部压力中心点(CoP)在冠状面和矢状面上的摆动幅度(CoPx, CoPy)进行测量。结果对照组在BF时，双下肢负重基本对称，躯干几乎无侧方移动，与DFP或UDFP时比较均有显著性差异(P<0.05)。实验组双下肢负重对称性较差，躯干偏向健侧；与NPFP比较，除CoPy外，均有显著性差异(P<0.05)；与PFP比较，除CoPx及CoPy外，均有显著性差异(P<0.05)。PFP时，躯干先偏向患侧，再向健侧移动；与NPFP比较，除CoPy外，均有显著性差异(P<0.05)。实验组BF与对照组BF以及实验组NPFP与对照组DFP比较，所有指标均有非常显著性差异(P<0.01)；实验组PFP与对照组UDFP比较，CoPx及CoPy均增大(P<0.05)。实验组CoPx与WBasym之间呈中度负相关(r=-0.626, P<0.001)，而在对照组呈高度负相关(r=-0.776, P<0.001)。结论脑卒中偏瘫患者坐-站转移时，躯干侧方运动影响下肢负重的对称性；足位可以调节躯干运动及下肢负重。
목적：탐토뇌졸중편탄환자재불동족위하완성좌-참전이시구간운동급하지부중。방법선취뇌졸중편탄환자32례(실험조)화건강인32명(대조조)，재쌍족과배굴10°(BF)、건측(우세측)과배굴10°시환족치후(PFP)혹비우세족치후(UFDP)、환측(비우세측)과배굴10°시건족치후(NPFP)혹우세족치후(DFP)3충족위하완성좌-참전이측시；채용평형공능훈련평고계통대수시자좌-참전이시하지부중、하지부중적불대칭성(WBasym)이급둔부압력중심점(CoP)재관상면화시상면상적파동폭도(CoPx, CoPy)진행측량。결과대조조재BF시，쌍하지부중기본대칭，구간궤호무측방이동，여DFP혹UDFP시비교균유현저성차이(P<0.05)。실험조쌍하지부중대칭성교차，구간편향건측；여NPFP비교，제CoPy외，균유현저성차이(P<0.05)；여PFP비교，제CoPx급CoPy외，균유현저성차이(P<0.05)。PFP시，구간선편향환측，재향건측이동；여NPFP비교，제CoPy외，균유현저성차이(P<0.05)。실험조BF여대조조BF이급실험조NPFP여대조조DFP비교，소유지표균유비상현저성차이(P<0.01)；실험조PFP여대조조UDFP비교，CoPx급CoPy균증대(P<0.05)。실험조CoPx여WBasym지간정중도부상관(r=-0.626, P<0.001)，이재대조조정고도부상관(r=-0.776, P<0.001)。결론뇌졸중편탄환자좌-참전이시，구간측방운동영향하지부중적대칭성；족위가이조절구간운동급하지부중。
Objective To explore the interaction of foot placement, trunk control and weight-bearing (WB) during sit-to-stand (STS) movement. Methods 32 hemiplegic stroke patients (experimental group) and 32 healthy people (control group) were recruited and complet-ed STS movement with 3 different foot positions:ankle dorsiflexed 10° of both feet (BF), with the paretic foot posterior (PFP) or the undom-inant foot posterior (UDFP), with the non-paretic foot posterior (NPFP) or the dominant foot posterior (DFP). Balance function assessment system (model AL-080) was used for collecting the WB, WB asymmetry (WBasym), and the center of pressure of the buttocks in medial-lat-eral (CoPx) and anterior-posterior (CoPy) sway during STS movement. Results The control group had the mostly WB symmetry, and little trunk side movement in BF, and there was significant difference in all indicators compared with in DFP or UDFP. For the experiment group, the WB, WBasym and CoPx were different as BF from as NPFP (P<0.05);while all the indicators except CoPx were different from PFP. When PFP, the trunk moved to the non-paretic side, and then to paretic side, all the indicators were different from NPFP. When BF and NPFP of the experiment group compared with BF and DFP of the control group, all the indicators were different (P<0.05). CoPx and CoPy increased in the experiment group compared with the control group. CoPx negatively correlate with WBasym in the experiment group (r=-0.626, P<0.001) and in the control group (r=-0.776, P<0.001). Conclusion The trunk side movement affects weight-bearing symmetry, and foot placement can modify weight-bearing distribution during the STS movement in hemiplegic stroke patients.