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Ko and You: Reliability and Responsiveness of the Korean Version of the Trunk Impairment Scale for Stroke Patients



The purposes of this study were to develop the Korean version of the trunk impairment scale (K-TIS) and to examine reliability and responsiveness of the K-TIS in patients with stroke.


Subjects of the study were 51 stroke patients (mean age: 57.78 years) recruited from two stroke clinics. For the interrater and test-retest reliability, two raters measured the K-TIS two times using video clips with an interval of 2 weeks. For the responsiveness, intensive physical therapy training was provided to all participants 2 times a day for one month or three months depending on the onset of the stroke and the admission rules of the two clinics. Inter-rater reliability and test-retest reliability of the K-TIS three subscales (static sitting balance, dynamic sitting balance, and coordination) scores and total scores were examined using intra-correlation coefficient (ICC3,1) and Pearsonโ€™s correlation coefficient (r). To examine responsiveness, the minimally important difference (MID) was calculated with effect size.


Inter-rater reliability of the K-TIS subscales and total scores were all high (ICC3,1=0.920-0.983 and r=0.924-0.984). For the test-retest reliability, ICC3,1=0.805-0.901 and r=0.806-0.903, and the MID for acute and post-acute as well as chronic stroke patients remained in the mean change range.


It is suggested that the K-TIS might be used for clinical and research purposes as a standardized tool for stroke patients. In addition, it can also be useful in establishment of treatment goal(s) and planning treatment program(s) for patients with stroke.


๋‡Œ์กธ์ค‘์€ ๋‡Œํ˜ˆ๊ด€์˜ ํ์‡„ ๋˜๋Š” ํŒŒ์—ด๋กœ ์ธํ•˜์—ฌ ๊ฐ‘์ž๊ธฐ ๊ตญ์†Œ์‹ ๊ฒฝํ•™์  ์žฅ์•  ๋˜๋Š” ์˜์‹์žฅ์• ๊ฐ€ ๋ฐœ์ƒํ•˜์—ฌ 24์‹œ๊ฐ„ ์ด์ƒ ์ง€์†๋˜๋Š” ์ž„์ƒ ์ฆ์ƒ์ด๋‹ค.1 ์šฐ๋ฆฌ๋‚˜๋ผ๋Š” ์•”์— ์ด์— ๋‡Œ์กธ์ค‘์œผ๋กœ ์ธํ•œ ์‚ฌ๋ง๋ฅ ์ด ๋‘ ๋ฒˆ์งธ๋กœ ๋†’์ง€๋งŒ, ๋‹จ์ผ ์žฅ๊ธฐ ์งˆํ™˜์œผ๋กœ๋Š” ์‚ฌ๋ง์›์ธ 1์œ„๋กœ,2 ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ 60*์—์„œ ์‹ฌ๊ฐํ•œ ์žฅ๊ธฐ์  ์‹ ์ฒด์žฅ์• ๋ฅผ ๊ฐ€์ ธ์˜จ๋‹ค.3
์—ฌ๋Ÿฌ ์š”์ธ๋“ค์ด ๋‡Œ์กธ์ค‘ ํ›„ ๊ธฐ๋ŠฅํšŒ๋ณต์— ์˜ํ–ฅ์„ ๋ฏธ์น˜์ง€๋งŒ,4 ๋งŽ์€ ์ „ํ–ฅ์  ์—ฐ๊ตฌ์—์„œ ์•‰์€ ์ž์„ธ์—์„œ ๊ท ํ˜•์กฐ์ ˆ๋Šฅ๋ ฅ๊ณผ ์„ ๋ณ„์  ๋ชธํ†ต์˜ ์›€์ง์ž„์„ ์ค‘์š”ํ•œ ์˜ˆ์ธก์ธ์ž๋กœ ๋ณด๊ณ ํ•˜์˜€๋‹ค.5,6,7 ์•‰์€ ์ž์„ธ์—์„œ ๊ท ํ˜•์กฐ์ ˆ์€ ์•‰๊ธฐ, ์•‰์€ ์ž์„ธ์—์„œ ์ผ์–ด์„œ๊ธฐ, ์•‰์€ ์ž์„ธ์—์„œ ์ผ์–ด์„œ์„œ ๊ฑท๊ธฐ ๋“ฑ์„ ๋น„๋กฏํ•˜์—ฌ ์ผ์ƒ์ƒํ™œ์— ํ•„์š”ํ•œ ๋‹ค์–‘ํ•œ ๊ธฐ๋Šฅ์  ํ™œ๋™์˜ ์ˆ˜ํ–‰์— ๋ฐ˜๋“œ์‹œ ํ•„์š”ํ•˜๋‹ค. ๋ชธํ†ต ๊ทผ์œก์€ ๊ณจ๋ฐ˜๊ณผ ์ฒ™์ถ”๋ฅผ ์•ˆ์ •ํ™”์‹œ์ผœ ๋‹ค์–‘ํ•œ ๊ท ํ˜•ํ™œ๋™์—์„œ ํŒ”ยท๋‹ค๋ฆฌ๋ฅผ ์กฐ์ ˆ๋œ ๋ฐฉ์‹์œผ๋กœ ํšจ์œจ์ ์œผ๋กœ ์›€์ง์ผ ์ˆ˜ ์žˆ๋Š” ํ† ๋Œ€๋ฅผ ์ œ๊ณตํ•œ๋‹ค.8,9 ์ตœ๊ทผ์˜ ํ•œ ์—ฐ๊ตฌ์—์„œ๋Š” ๋ชธํ†ต์กฐ์ ˆ๋Šฅ๋ ฅ ํšŒ๋ณต๊ณผ ๊ธฐ๋Šฅ์  ํšŒ๋ณต์ด ์ด๋ฃจ์–ด์ง€๋Š” ์‹œ๊ฐ„์€ ๋น„๋ก€ํ•œ๋‹ค๊ณ  ๋ณด๊ณ ํ•˜์˜€๋‹ค.10 ๊ทธ๋Ÿฌ๋ฏ€๋กœ ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜•๊ณผ ์„ ํƒ์  ๋ชธํ†ต์กฐ์ ˆ๋ ฅ์˜ ํšŒ๋ณต์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์—์„œ ์˜ˆํ›„์— ๋Œ€ํ•œ ์˜ˆ์ธก์ธ์ž๋ฟ ์•„๋‹ˆ๋ผ ์น˜๋ฃŒ๊ณ„ํš๊ณผ ์ˆ˜ํ–‰์—์„œ๋„ ๋งค์šฐ ์ค‘์š”ํ•œ ์˜๋ฏธ๊ฐ€ ์žˆ๋‹ค.
๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์•‰์€ ์ž์„ธ์—์„œ ๊ท ํ˜•์กฐ์ ˆ๊ณผ ๋ชธํ†ต์กฐ์ ˆ๋Šฅ๋ ฅ์„ ์ œ๋Œ€๋กœ ์ดํ•ดํ•˜๊ณ  ์ž„์ƒ์น˜๋ฃŒ์™€ ์—ฐ๊ตฌ์— ์ ์šฉํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ๊ตญ์ œ๊ธฐ๋Šฅ์žฅ์• ๋ถ„๋ฅ˜(International Classification of Functioning, Disability and Health, ICF)์— ๊ทผ๊ฑฐํ•œ ์ ํ•ฉํ•œ ํ‰๊ฐ€๋„๊ตฌ๊ฐ€ ํ•„์š”ํ•˜๋‹ค. ์ฆ‰, ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ํ‰๊ฐ€, ๊ธฐ๋Šฅ์  ๋ฌธ์ œ์  ์„ค์ •, ์น˜๋ฃŒ๋ชฉํ‘œ ์„ค์ •, ์น˜๋ฃŒ๊ณ„ํš ๋“ฑ ์ž„์ƒ์˜์‚ฌ๊ฒฐ์ •์„ ์ˆ˜ํ–‰ํ•˜๊ณ  ๊ฐ๊ด€์ ์ธ ์ž๋ฃŒ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ํ™˜์ž์˜ ์ƒํƒœ์™€ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์˜ ํšจ๊ณผ์— ๊ด€ํ•˜์—ฌ ํ™˜์ž ๋ฐ ๋ณดํ˜ธ์ž์™€์˜ ์ธํ„ฐ๋ทฐ๋ฅผ ์œ„ํ•˜์—ฌ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„๋ฅผ ๊ฐ–์ถ˜ ํ‰๊ฐ€๋„๊ตฌ๊ฐ€ ํ•„์š”ํ•˜๋‹ค.11 ๋ฌธํ—Œ์กฐ์‚ฌ์— ๋”ฐ๋ฅด๋ฉด, ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๋ชธํ†ต์กฐ์ ˆ๋Šฅ๋ ฅ ํ‰๊ฐ€๋„๊ตฌ๋กœ๋Š” Sitting Balance Scale๊ณผ12 Trunk Control Test13๊ฐ€ ์žˆ๋‹ค. ํ•˜์ง€๋งŒ ์ด ๋„๊ตฌ๋“ค์€ ์‹ ๋ขฐ๋„๊ฐ€ ๋‚ฎ๊ฑฐ๋‚˜ ๋ชธํ†ต์˜ ์งˆ์ ์ธ ์›€์ง์ž„๊ณผ ๊ทผ๋ ฅ์„ ๊ณ ๋ คํ•˜์ง€ ์•Š์•„ ์ž„์ƒ๊ณผ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์œผ๋กœ ์ ํ•ฉํ•˜์ง€ ๋ชปํ•˜๋‹ค.12,13 ์ด ์™ธ์—๋„ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ธฐ๋Šฅํ‰๊ฐ€์—์„œ ๋ชธํ†ตํ™œ๋™์„ ํ•œ ์š”์†Œ๋กœ ํ‰๊ฐ€ํ•˜๊ธฐ๋„ ํ•œ๋‹ค. ์˜ˆ๋ฅผ ๋“ค์ž๋ฉด, Rivermead Motor Assessment์˜ โ€˜๋‹ค๋ฆฌ์™€ ๋ชธํ†ตโ€™์˜์—ญ์—์„œ,14 Chedoke-McMaster Stroke Assessment์˜ โ€˜์ž์„ธ์กฐ์ ˆโ€™ ๋ถ€๋ถ„์—์„œ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๋ชธํ†ต์กฐ์ ˆ๋Šฅ๋ ฅ์„ ์ผ๋ถ€๋ถ„ ํ‰๊ฐ€ํ•œ๋‹ค.15
๋ชธํ†ต์†์ƒ์ฒ™๋„(Trunk Impairment Scale, TIS)๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์ •์  ๋ฐ ๋™์  ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜•๊ณผ ๋ชธํ†ต ์›€์ง์ž„์˜ ํ˜‘์‘๋ ฅ์„ ํ‰๊ฐ€ํ•ด์ฃผ๋Š” ์‹ ๋ขฐ๋„๊ฐ€ ๊ฒ€์ฆ๋œ ํ‰๊ฐ€๋„๊ตฌ๋กœ,16 ICF์˜ ์‹ ์ฒด๊ตฌ์กฐ ๋ฐ ๊ธฐ๋Šฅ๊ณผ ํ™œ๋™์˜์—ญ์„ ํ‰๊ฐ€ํ•œ๋‹ค.17 TIS๋Š” 2004๋…„ ๊ฐœ๋ฐœ๋œ ์ด๋ž˜ ํ˜„์žฌ ์—ฌ๋Ÿฌ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ธฐ๋ŠฅํšŒ๋ณต๊ณผ ์น˜๋ฃŒ๊ณ„ํš์— ๊ด€ํ•œ ์—ฐ๊ตฌ์—์„œ ๋„๋ฆฌ ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋‹ค.7,10,18 ๊ตญ๋‚ด์˜ ๊ฒฝ์šฐ, ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๋ฌผ๋ฆฌ์น˜๋ฃŒ ์ž„์ƒ์˜์‚ฌ๊ฒฐ์ •์˜ ์ „ ๊ณผ์ •์—์„œ ๊ธฐ๋ŠฅํšŒ๋ณต๊ณผ ๋†’์€ ์—ฐ๊ด€์„ฑ์„ ๊ฐ–๋Š” ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜•์กฐ์ ˆ๊ณผ ๋ชธํ†ต์กฐ์ ˆ๋Šฅ๋ ฅ์„ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋Š” ํ‘œ์ค€ํ™”๋œ ํ‰๊ฐ€๋„๊ตฌ๊ฐ€ ๊ฐœ๋ฐœ๋˜์–ด ์žˆ์ง€ ์•Š๋‹ค. ํ‘œ์ค€ํ™”๋œ ํ‰๊ฐ€๋„๊ตฌ๋ž€ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„๊ฐ€ ๋†’์€ ๋„๊ตฌ๋ฅผ ๋งํ•œ๋‹ค. ๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๊ตญ๋‚ด์˜ TIS์— ๋Œ€ํ•œ ๋†’์€ ๊ด€์‹ฌ๊ณผ ์ž„์ƒ ๋ฐ ์—ฐ๊ตฌ๋ชฉ์ ์œผ๋กœ์˜ ์ ์šฉ์„ ์œ„ํ•œ ์œ ์šฉํ•œ ์ž๋ฃŒ๋ฅผ ์ œ๊ณตํ•˜๊ธฐ ์œ„ํ•˜์—ฌ TIS์˜ ํ•œ๊ธ€ํ™”์™€ ์‹ ๋ขฐ๋„ ์กฐ์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค.๋ฅผ ํ•œ๊ธ€ํ™”๊ตญํŒ์œผ๋กœ ๊ฐœ๋ฐœํ•˜๊ณ ์ž ํ•œ๋‹ค. ๊ตฌ์ฒด์ ์ธ ๋ชฉ์ ์€ ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ฒซ์งธ, ์˜์–ด๋กœ ๋œ TIS๋ฅผ ํ•œ๊ตญ์–ด๋ฒˆ์—ญ, ์˜์–ด๋ฒˆ์—ญ, ํ•œ๊ตญ์–ด ์žฌ ๋ฒˆ์—ญ ๊ณผ์ •์„ ๊ฑฐ์ณ ํ•œ๊ธ€ํ™” ์‹œํ‚จ๋‹ค. ๋‘˜์งธ, ํ•œ๊ธ€ํ™”๋œ TIS์˜ ์ธก์ •์ž๊ฐ„ ๊ทธ๋ฆฌ๊ณ  ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„๋ฅผ ํ™•์ธํ•œ๋‹ค. ์…‹์งธ, ๋‡Œ์กธ์ค‘ ๋ฐœ๋ณ‘ 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„ ํ™˜์ž์™€ ๋ฐœ๋ณ‘ 6๊ฐœ์›” ์ด์ƒ ๋œ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์ง‘์ค‘์ ์ธ ๋ฌผ๋ฆฌ์น˜๋ฃŒ ํšจ๊ณผ๋ฅผ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด ํ•œ๊ธ€ํ™” ๋œ TIS์˜ ์ ์ˆ˜๋ณ€ํ™”์— ๋Œ€ํ•œ ๋ฏผ๊ฐ๋„๋ฅผ ํ™•์ธํ•œ๋‹ค.

์—ฐ๊ตฌ ๋ฐฉ๋ฒ•

1. ์—ฐ๊ตฌ ๋Œ€์ƒ ๋ฐ ์‹œ๊ธฐ

๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ์‹ ๋ขฐ๋„์™€ ์ง‘์ค‘ ๋ฌผ๋ฆฌ์น˜๋ฃŒ ํšจ๊ณผ์˜ ๋ฏผ๊ฐ๋„๋ฅผ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•˜์—ฌ 2014๋…„ 1์›”๋ถ€ํ„ฐ 6์›”๊นŒ์ง€ ๊ฒฝ๊ธฐ๋„ ์†Œ์žฌ 2๊ฐœ์˜ ๊ธฐ๊ด€, ์ฆ‰ ์žฌํ™œ๋ณ‘์›์—์„œ ์น˜๋ฃŒ๋ฅผ ๋ฐ›๋Š” ๋งŒ์„ฑ๋‡Œ์กธ์ค‘ ํ™˜์ž 12๋ช…๊ณผ ์ผ๋ฐ˜๋ณ‘์›์—์„œ ์น˜๋ฃŒ๋ฅผ ๋ฐ›๋Š” ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„ ๋‡Œ์กธ์ค‘ ํ™˜์ž 39๋ช…, ์ด 51๋ช…์„ ํŽธ์˜ํ‘œ๋ณธ์ถ”์ถœํ•˜์˜€๋‹ค. ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ์žฌํ™œ๋ณ‘์›๊ณผ ์ผ๋ฐ˜๋ณ‘์›์˜ ๋‡Œ์กธ์ค‘ํ™˜์ž ์ž…์›๊ธฐ๊ฐ„์ด ๋‹ค๋ฅธ ์ ์„ ๊ณ ๋ คํ•  ๋•Œ ์žฌํ™œ๋ณ‘์›์˜ ํ‰๊ท ์ž…์›๊ธฐ๊ฐ„๊ณผ ์น˜๋ฃŒ๊ธฐ๊ฐ„์€ 6๊ฐœ์›” ์ด์ƒ ์ผ๋ฐ˜๋ณ‘์›์€ ํ‰๊ท  2๊ฐœ์›”์ด๋‹ค. ๋Œ€์ƒ์ž ์„ ์ •์กฐ๊ฑด์€ TIS ์›์ €์ž์˜ ๊ธฐ์ค€์— ๋”ฐ๋ผ ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ์‹œ์ž‘์ž์„ธ์ธ ์นจ๋Œ€ ๋˜๋Š” ์น˜๋ฃŒ ํ…Œ์ด๋ธ”์— ๊ธฐ๋Œ€๊ฑฐ๋‚˜ ์†์„ ์งš์ง€ ์•Š๊ณ  ์•‰์„ ์ˆ˜ ์žˆ๋Š” ์ž, ์น˜๋ฃŒ์‚ฌ์˜ ์ง€์‹œ๋ฅผ ๋“ฃ๊ณ  ์ดํ•ดํ•  ์ˆ˜ ์žˆ๋Š” MMSE-K 24์  ์ด์ƒ์ธ์ž, ํ•˜์ง€์— ์ •ํ˜•์™ธ๊ณผ์  ์งˆํ™˜์ด ์—†๋Š” ์ž, ๊ทธ๋ฆฌ๊ณ  ๋ณธ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์„ ๋“ฃ๊ณ  ์ž๋ฐœ์ ์œผ๋กœ ์‹คํ—˜์— ์ฐธ์—ฌ๋ฅผ ๋™์˜ํ•œ ์ž๋กœ ํ•˜์˜€๋‹ค(Table 1).
Tableย 1
General characteristics of the participant
Variables and category
Age (year)
โ€ƒ41-50 16 (31.37) 45.06ยฑ3.13
โ€ƒ51-60 11 (21.57) 53.00ยฑ1.67
โ€ƒ61-70 16 (31.37) 65.69ยฑ2.55
โ€ƒ71-80 8 (15.7) 74.00ยฑ3.30
โ€ƒTotal 51 (100) 57.78ยฑ12.06
โ€ƒMale 23 (45.10)
โ€ƒFemale 28 (57.90)
โ€ƒHemorrhage 27 (52.94)
โ€ƒInfarction 24 (47.06)
Affected side
โ€ƒRight 24 (47.06)
โ€ƒLeft 27 (52.94)
Duration of onset
โ€ƒ90 days > 39 (76.47)
โ€ƒ180 days โ‰ค 12 (23.53)

Values are No (*) and MeanยฑSD.

2. ์ธก์ •๋„๊ตฌ ๋ฐ ๋ฐฉ๋ฒ•

1) ๋ชธํ†ต์†์ƒ์ฒ™๋„(TIS)

๋ชธํ†ต์†์ƒ์ฒ™๋„๋Š” 2004๋…„ ์ฒ˜์Œ ์†Œ๊ฐœ๋œ ๋‡Œ์กธ์ค‘ํ™˜์ž์˜ ์•‰์€ ์ž์„ธ์—์„œ์˜ ์ •์  ๋ฐ ๋™์  ๊ท ํ˜•๊ณผ ๋ชธํ†ต์˜ ์„ ํƒ์  ์›€์ง์ž„์„ ํ‰๊ฐ€ํ•˜๋Š” ๋„๊ตฌ์ด๋‹ค. ๋ชธํ†ต์†์ƒ์ฒ™๋„๋Š” ์ •์ ์•‰๊ธฐ๊ท ํ˜•, ๋™์ ์•‰๊ธฐ๊ท ํ˜•, ๊ทธ๋ฆฌ๊ณ  ํ˜‘์‘๋ ฅ ๋“ฑ 3๊ฐœ์˜ ํ•˜์œ„์ฒ™๋„๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ๋‹ค. ์ •์ ์•‰๊ธฐ๊ท ํ˜• ํ•˜์œ„์ฒ™๋„์—์„œ๋Š” ํ™˜์ž๊ฐ€ ๊ธฐ๋Œ€๊ฑฐ๋‚˜ ์†์„ ์งš์ง€ ์•Š๊ณ  10์ดˆ ๋™์•ˆ ์•‰์€ ์ž์„ธ๋ฅผ ์œ ์ง€ํ•˜๋Š”์ง€, ๊ฒ€์‚ฌ์ž๊ฐ€ ๋น„๋งˆ๋น„์ธก ๋‹ค๋ฆฌ๋ฅผ ๋งˆ๋น„์ธก ๋‹ค๋ฆฌ ์œ„๋กœ ๊ต์ฐจ์‹œ์ผฐ์„ ๋•Œ ์ด ์ž์„ธ๋ฅผ ์œ ์ง€ํ•˜๋Š”์ง€, ํ™˜์ž๊ฐ€ ์Šค์Šค๋กœ ๋น„๋งˆ๋น„์ธก ๋‹ค๋ฆฌ๋ฅผ ๋งˆ๋น„์ธก ๋‹ค๋ฆฌ ์œ„๋กœ ๊ต์ฐจ์‹œ์ผฐ์„ ๋•Œ ๋ชธํ†ต์ด๋‚˜ ์ƒ์ง€์—์„œ ๋ณด์ƒ์  ์›€์ง์ž„์ด ๋‚˜ํƒ€๋‚˜๋Š”์ง€ ๋“ฑ์˜ 3๊ฐ€์ง€ ํ•ญ๋ชฉ์„ ํ‰๊ฐ€ํ•˜์—ฌ ๊ฐ๊ธฐ 0-2์ , 0-2์ , 0-3์ ์„ ๋ถ€์—ฌํ•˜์—ฌ ์ด 0-7์ ์˜ ์ ์ˆ˜๋ฒ”์œ„๋ฅผ ๊ฐ–๋Š”๋‹ค. ๋™์ ์•‰๊ธฐ๊ท ํ˜• ํ•˜์œ„์ฒ™๋„์—์„œ๋Š” ์ƒ๋ถ€๋ชธํ†ต๊ณผ ํ•˜๋ถ€๋ชธํ†ต์˜ ์„ ๋ณ„์  ์™ธ์ธก ๊ตฝํž˜์˜ ์ •๋„๋ฅผ ๊ฒ€์‚ฌํ•˜๋Š” 10๊ฐœ์˜ ํ•ญ๋ชฉ์œผ๋กœ ๊ตฌ์„ฑ๋˜๋ฉฐ ๊ฐ๊ธฐ 0-1์ ์„ ๋ถ€์—ฌํ•˜์—ฌ ์ด 0-10์ ์ด ๋ถ€์—ฌ๋œ๋‹ค. ํ˜‘์‘๋ ฅ ํ•˜๋ถ€์ฒ™๋„๋Š” ์ƒ๋ถ€๋ชธํ†ต๊ณผ ํ•˜๋ถ€๋ชธํ†ต์˜ ์„ ๋ณ„์  ํšŒ์ „๋Šฅ๋ ฅ์„ ์ธก์ •ํ•˜๋Š” 4๊ฐœ์˜ ํ•ญ๋ชฉ์œผ๋กœ ๊ตฌ์„ฑ๋˜๋ฉฐ ํ•ญ๋ชฉ์— ๋”ฐ๋ผ 0-1์  ๋˜๋Š” 0-2์ ์„ ๋ถ€์—ฌํ•˜์—ฌ ์ด 0-6์ ์ด ๋ถ€์—ฌ๋œ๋‹ค. ๋ชธํ†ต์†์ƒ์ฒ™๋„๋Š” 3๊ฐœ ํ•˜๋ถ€์ฒ™๋„, ์ด 17๊ฐœ ํ•ญ๋ชฉ, ์ด์  ๋ฒ”์œ„๋Š” 0-23์ ์ด๋‹ค. ๋ชธํ†ต์†์ƒ์ฒ™๋„๋Š” ๊ฐœ๋ฐœ ๋‹น์‹œ ํ‰๊ท ์—ฐ๋ น 63์„ธ, ๋ฐœ๋ณ‘๊ธฐ๊ฐ„ 21์ผ-78๊ฐœ์›” ๊ธ‰์„ฑ ๋ฐ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž 28๋ช…์„ ๋Œ€์ƒ์œผ๋กœ 2๋ช…์˜ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์‚ฌ๊ฐ€ ์‹ ๋ขฐ๋„๊ฐ€ ์กฐ์‚ฌ์— ์ฐธ์—ฌํ•˜์˜€์œผ๋ฉฐ, ๊ทธ ๊ฒฐ๊ณผ๋กœ ๊ฒ€์‚ฌ์ž ๊ฐ„ ๋ฐ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ๊ธ‰๋‚ด์ƒ๊ด€๊ณ„์ˆ˜๋Š” ICC=0.85-0.99 ๊ทธ๋ฆฌ๊ณ  ICC=0.96-0.99์˜€๋‹ค.17,19 K-TIS๋Š” Appendix 1์—์„œ ํ™•์ธํ•  ์ˆ˜ ์žˆ๋‹ค.

2) TIS ํ•œ๊ธ€ํ™” ๊ณผ์ •

๋ชธํ†ต์†์ƒ์ฒ™๋„๊ฐ€ ์†Œ๊ฐœ๋œ ์ดํ›„ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ธฐ๋Šฅ์  ํšŒ๋ณต์„ ์œ„ํ•œ ์ž„์ƒ ๋ฐ ์—ฐ๊ตฌ๋ชฉ์ ์œผ๋กœ ๋„๋ฆฌ ์‚ฌ์šฉ๋˜๊ณ  ์žˆ์œผ๋ฉฐ, ํ•œ๊ตญํŒ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ๊ฐœ๋ฐœ์„ ์œ„ํ•˜์—ฌ ์—ฐ๊ตฌ์ž๋Š” ์›์ €์ž์ธ Geert Verheyden๋กœ ๋ถ€ํ„ฐ ํ•œ๊ตญํŒ๋ชธํ†ต์†์ƒ์ฒ™๋„ ๊ฐœ๋ฐœ์— ๋Œ€ํ•œ ์Šน์ธ๊ณผ ํŠธ๋ ˆ์ด๋‹ DVD๋ฅผ ํ†ตํ•ด ์ œ๊ณต๋ฐ›์•˜๋‹ค. ์™ธ๋ž˜์–ด๋กœ ๋œ ํ‰๊ฐ€๋„๊ตฌ์˜ ํ•œ๊ตญํŒ๊ฐœ๋ฐœ์„ ์œ„ํ•œ ๊ธฐ๋ณธ ์ ˆ์ฐจ์ธ ํ•œ๊ธ€๋ฒˆ์—ญ, ์˜๋ฌธ์œผ๋กœ ์žฌ ๋ฒˆ์—ญ, ์›์ €์ž์™€ ๋ฌธํ™”์  ๋ฐ ์–ธ์–ด์  ์ฐจ์ด์— ๋”ฐ๋ฅธ ๋‚ด์šฉ ์ˆ˜์ •, ๊ทธ๋ฆฌ๊ณ  ๋‹ค์‹œ ํ•œ๊ธ€๋ฒˆ์—ญ ๊ณผ์ •์„ ๊ฑฐ์ณ ํ•œ๊ธ€ํ™”๋œ ๋ชธํ†ต์†์ƒ์ฒ™๋„๋ฅผ ์ค€๋น„ํ•œ ๋‹ค์Œ ํ•œ๊ตญํŒ๋ชธํ†ต์†์ƒ์ฒ™๋„ ๊ฐœ๋ฐœ์„ ์œ„ํ•˜์—ฌ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„ ์กฐ์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค.

3. ํ†ต๊ณ„๋ถ„์„ ๋ฐ ์ž๋ฃŒ์ฒ˜๋ฆฌ

์—ฐ๊ตฌ๋Œ€์ƒ์ž์˜ ์ผ๋ฐ˜์  ํŠน์„ฑ์€ ๊ธฐ์ˆ ํ†ต๊ณ„๋Ÿ‰์„ ์ด์šฉํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค. ํ•œ๊ธ€ํ™”๋œ ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ์ •๊ทœ์„ฑ์„ ๊ฒ€์ •ํ•œ ํ›„ ๊ฒ€์‚ฌ์ž ๊ฐ„ ๋ฐ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„ ์กฐ์‚ฌ๋ฅผ ์œ„ํ•˜์—ฌ ๊ธ‰๋‚ด์ƒ๊ด€๊ณ„์ˆ˜(Intraclass correlation coefficient, ICC3,1) ๋ฐ ํ”ผ์–ด์Šจ์ƒ๊ด€๊ณ„์ˆ˜(Pearsonโ€™s correlation coefficient, r)๋ฅผ ๊ตฌํ•˜์˜€๋‹ค.20-23 โ€˜ICC โ‰ฅ 0.90โ€™, โ€˜ICC=0.75-0.90โ€™, โ€˜ICC=0.50-0.75โ€™, โ€˜ICC=โ‰ค0.50โ€™ ๋“ฑ์€ ๊ฐ๊ธฐ ์‹ ๋ขฐ๋„๊ฐ€ โ€˜๋†’์Œโ€™, โ€˜์–‘ํ˜ธํ•จโ€™, โ€˜๋ณดํ†ตโ€™, โ€˜์ข‹์ง€ ์•Š์Œโ€™์„ ๋‚˜ํƒ€๋‚ด๋ฉฐ, โ€˜r=0.00-0.25โ€™, โ€˜r=0.25-0.50โ€™, โ€˜r=0.50-0.75โ€™, โ€˜r=0.75 <โ€™ ๋“ฑ์€ โ€˜์ƒ๊ด€๊ด€๊ณ„ ์—†์Œโ€™, โ€˜์•ฝ๊ฐ„์˜ ์ƒ๊ด€๊ด€๊ณ„โ€, โ€˜์ค‘๊ฐ„์—์„œ ์ข‹์€ ์ƒ๊ด€๊ด€๊ณ„โ€™, โ€˜๋†’์€ ์ƒ๊ด€๊ด€๊ณ„โ€™๋ฅผ ๋‚˜ํƒ€๋‚ด๋Š” ๊ฒƒ์œผ๋กœ ํ•ด์„ํ•œ๋‹ค.24 ๋ฏผ๊ฐ๋„ ์กฐ์‚ฌ๋ฅผ ์œ„ํ•˜์—ฌ MID์™€ ๋Œ€์‘ํ‘œ๋ณธ T๊ฒ€์ •(paired t-test)๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค. Minimally important difference (MID)๋Š” effect size๋ฅผ ์ด์šฉํ•˜์—ฌ 0.3ร—baseline SD, 0.5ร—baseline SD๋กœ ๊ตฌํ•˜์˜€๋‹ค.25 ์ž๋ฃŒ์˜ ํ†ต๊ณ„์ฒ˜๋ฆฌ๋Š” Window SPSS ver 22.0 (IBM Inc., Armonk, NY, USA)๋ฅผ ์‚ฌ์šฉํ•˜์˜€๊ณ , ๋ชจ๋“  ํ†ต๊ณ„ํ•™์  ์œ ์˜์ˆ˜์ค€ ฮฑ=0.05๋กœ ์„ค์ •ํ•˜์˜€๋‹ค.

1) ์‹ ๋ขฐ๋„ ๋ฐ ๋ฏผ๊ฐ๋„ ์กฐ์‚ฌ

ํ•œ๊ธ€ํ™”๋œ ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ์‹ ๋ขฐ๋„ ๋ฐ ๋ฏผ๊ฐ๋„ ์กฐ์‚ฌ๋ฅผ ์œ„ํ•˜์—ฌ ๋‡Œ์กธ์ค‘ ํ‰๊ฐ€ ๋ฐ ์น˜๋ฃŒ๊ฒฝํ—˜์ด 3๋…„ ์ด์ƒ ๋œ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์‚ฌ 4๋ช…(A, B, C, D)์„ ๋Œ€์ƒ์œผ๋กœ TIS์˜ ๊ฐ ํ•ญ๋ชฉ์˜ ๋‚ด์šฉ์— ๋Œ€ํ•œ ์ด๋ก  ์ˆ™์ง€์™€ ํŠธ๋ ˆ์ด๋‹ DVD๋ฅผ ์ด์šฉํ•œ ์‚ฌ์ „ ๊ต์œก์„ ์‹ค์‹œํ•œ ํ›„ ์‹ค์ œ ์ธก์ •์„ ์‹œ์ž‘ํ•˜์˜€๋‹ค. ํŠธ๋ ˆ์ด๋‹ ๋œ ์ธก์ •์ž ์ค‘ 2๋ช…(A ๋ฐ B)๋Š” ์ธก์ •์ž ๊ฐ„ ๋ฐ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„ ์กฐ์‚ฌ๋ฅผ ์œ„ํ•˜์—ฌ ํ™˜์ž๋งˆ๋‹ค 2์ฃผ ๊ฐ„๊ฒฉ์œผ๋กœ 2ํšŒ์— ๊ฑธ์ณ ๋ชธํ†ต์†์ƒ์ฒ™๋„๋ฅผ ์‚ฌ์ •ํ•˜๊ณ  ๊ทธ ๋‚ด์šฉ์„ ๋น„๋””์˜ค๋กœ ๋ ˆ์ฝ”๋”ฉํ•˜์˜€๋‹ค. ๋ฏผ๊ฐ๋„ ์กฐ์‚ฌ๋ฅผ ์œ„ํ•˜์—ฌ ๋งŒ์„ฑ๋‡Œ์กธ์ค‘ํ™˜์ž์˜ ๊ฒฝ์šฐ ์ฒซ ์ธก์ •์„ ์‹ค์‹œํ•œ ์‹œ์ ์œผ๋กœ๋ถ€ํ„ฐ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์ธก์ •์„ ๋ชจ๋‘ ๋งˆ์นœ ํ›„ 3๊ฐœ์›” ํ›„์— ๊ทธ๋ฆฌ๊ณ  ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋Š” 1๊ฐœ์›” ์ดํ›„์— ๊ฐ๊ธฐ ์ถ”๊ฐ€๋กœ ๋ชธํ†ต์†์ƒ์ฒ™๋„๋ฅผ ์‚ฌ์ •ํ•˜๊ณ  ๋งˆ์ฐฌ๊ฐ€์ง€๋กœ ์ „ ํ‰๊ฐ€๊ณผ์ •์„ ๋น„๋””์˜ค๋ ˆ์ฝ”๋”ฉํ•˜์˜€๋‹ค. ๊ตญ๋‚ด์˜ ์‚ฌ์ •์„ ๊ณ ๋ คํ•˜์—ฌ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ฒฝ์šฐ ์ฃผ๋กœ ์žฌํ™œ๋ณ‘์›์—์„œ 6๊ฐœ์›” ์ด์ƒ์˜ ์ž…์›์น˜๋ฃŒ๋ฅผ ๋ฐ›๊ณ  ์žˆ์œผ๋ฉฐ ์น˜๋ฃŒ์— ๋Œ€ํ•œ ๊ธฐ๋Šฅ์  ๋ณ€ํ™”๋„ 12์ฃผ ์ด์ƒ์˜ ๊ธฐ๊ฐ„์ด ํ•„์š”ํ•˜๋ฏ€๋กœ 3๊ฐœ์›” ๊ฐ„์˜ ์น˜๋ฃŒ๊ธฐ๊ฐ„์„ ์„ค์ •ํ•˜์˜€๊ณ , ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„๋Š” 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ์‹œ๊ธฐ์— ํ•ด๋‹นํ•˜๋ฏ€๋กœ ์ผ๋ฐ˜๋ณ‘์›์— ์ฃผ๋กœ ์ž…์›ํ•˜๋Š” ํ™˜์ž๋“ค๊ณผ ์ด๋“ค์˜ ์ž…์›์‹œ๊ธฐ๋ฅผ ๊ณ ๋ คํ•˜์—ฌ 1๊ฐœ์›”๋กœ ์„ค์ •ํ•˜์˜€๋‹ค. ๋Œ€์ƒ์ž๋“ค์€ ๊ฐ๊ธฐ ์ž…์›ํ•œ ๋ณ‘์›์—์„œ 1์ผ 2ํšŒ, ์ฃผ 5ํšŒ์— ๊ฑธ์ณ ์ž…์›๊ธฐ๊ฐ„ ๋™์•ˆ ์ง‘์ค‘์ ์ธ ์šด๋™์น˜๋ฃŒ๋ฅผ ๋ฐ›์•˜๋‹ค. ๋‹ค๋ฅธ 2๋ช…์˜ ํ•œ๊ธ€ํ™”๋œ TIS ์‚ฌ์ •์„ ํ›ˆ๋ จ ๋ฐ›์€ ์ธก์ •์ž(C ๋ฐ D)๋Š” ์ค€๋น„๋œ ๋น„๋””์˜ค ํด๋ฆฝ์„ ๋ณด๋ฉด์„œ ํ•œ๊ธ€ํ™”๋œ TIS์˜ ํ•ญ๋ชฉ๋ณ„, 3๊ฐœ์˜ ํ•˜์œ„์ฒ™๋„, ๊ทธ๋ฆฌ๊ณ  ์ด์  ๋“ฑ์— ๋Œ€ํ•˜์—ฌ ์ ์ˆ˜๋ฅผ ๋ถ€์—ฌํ•˜์˜€๋‹ค. ์ด๋•Œ, ์ธก์ •์ž C์™€ D๋Š” ๋น„๋””์˜ค ํด๋ฆฝ์— ๋Œ€ํ•˜์—ฌ ์„œ๋กœ ์˜๊ฒฌ์„ ๋‚˜๋ˆ„์ง€ ๋ชปํ•˜๊ฒŒ ํ•˜๊ณ  ๋…๋ฆฝ์ ์œผ๋กœ ์ ์ˆ˜๋ฅผ ๋ถ€์—ฌํ•˜๋„๋ก ํ•˜์˜€๋‹ค.


์—ฐ๊ตฌ๋Œ€์ƒ์ž์˜ ์ผ๋ฐ˜์  ํŠน์„ฑ์€ Table 1 ๊ทธ๋ฆฌ๊ณ  ํ•œ๊ตญํŒ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ํ‰๊ท ๊ณผ ํ‘œ์ค€ํŽธ์ฐจ๋Š” Table 2์™€ ๊ฐ™๋‹ค. ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ์ดํ›„ 12๋ช…์˜ ํ™˜์ž๋“ค์˜ ํ‰๊ท  ๋ฐœ๋ณ‘์ผ์€ 12์ผ์ด์—ˆ๋‹ค.
Tableย 2
Mean and standard deviation of the K-TIS for reliabilities test (N=51)
TIS Rater A Rater B

First Second First Second

Mean (SD) Min-Max Mean (SD) Min-Max Mean (SD) Min-Max Mean (SD) Min-Max
SSB total 5.8 (1.5) 0-7 5.7 (1.7) 0-7 5.7 (1.7) 0-7 5.8 (1.7) 0-7
DSB total 5.2 (2.2) 0-9 6.3 (2.2) 0-10 5.0 (2.3) 0-9 6.2 (2.0) 0-10
COO total 1.6 (1.3) 0-6 1.6 (1.3) 0-6 1.3 (1.2) 0-6 1.6 (1.3) 0-6
Total 12.3 (4.0) 0-21 13.6 (4.2) 0-21 12.0 (4.1) 0-21 13.5 (4.1) 0-21

K-TIS, Korean version of trunk impairment scale; SSB, Static sitting balance; DSB, Dynamic sitting balance; COO, Coordinatio.

1. ํ•œ๊ตญํŒ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ์ธก์ •์ž ๊ฐ„ ๋ฐ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„

์ธก์ •์ž C์™€ ์ธก์ •์ž D ๊ฐ„์— 2์ฃผ ๊ฐ„๊ฒฉ์œผ๋กœ 2ํšŒ์— ๊ฑธ์ณ ์‹ค์‹œ๋œ ์ฒซ ๋ฒˆ์งธ ๊ฒ€์‚ฌ์ž ๊ฐ„ ์‹ ๋ขฐ๋„๋Š” ICC3,1=0.925-0.951, r=0.940-1.000, ๋‘ ๋ฒˆ์งธ ICC3,1=0.920-1.000, r=0.924-0.984์˜ ๋†’์€ ์‹ ๋ขฐ๋„๋ฅผ ๋‚˜ํƒ€๋ƒˆ๋‹ค(Table 3). ๊ฐ ์ธก์ •์ž์˜ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„๋Š” ICC3,1๊ณผ r๊ฐ’์ด 0.848, 0.849 (์ธก์ •์ž C) ๊ทธ๋ฆฌ๊ณ  0.856, 0.856 (์ธก์ •์ž D)๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค(Table 3).
Tableย 3
Inter-rater and test-retest reliability for the K-TIS (N=51)
Inter-rater 1st test 2nd test

ICC3,1 95* CI r ICC3,1 95* CI r
SSB total 0.951 0.911-0.974 0.958* 0.983 0.969-0.984 0.984*
DSB total 0.940 0.891-0.967 0.940* 0.920 0.857-0.956 0.924*
COO total 0.925 0.892-0.948 0.929* 0.939 0.889-0.966 0.939*
Total 0.938 0.922-0.969 0.976* 0.961 0.929-0.979 0.961*
Test-retest Rater A Rater B

ICC3,1 95* CI r ICC3,1 95* CI r
SSB total 0.896 0.815-0.943 0.903* 0.901 0.824-0.949 0.902*
DSB total 0.875 0.670-0.839 0.875* 0.873 0.667-0.810 0.877*
COO total 0.805 0.710-0.886 0.809* 0.814 0.670-0.865 0.806*
Total 0.889 0.735-0.915 0.879* 0.892 0.748-0.920 0.895*

* p<0.05.

K-TIS, Korean version of trunk impairment scale; SSB, Static sitting balance; DSB, Dynamic sitting balance; COO, Coordination.

2. ํ•œ๊ตญํŒ๋ชธํ†ต์†์ƒ์ฒ™๋„์˜ ๋ฏผ๊ฐ๋„

๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„ ๋‡Œ์กธ์ค‘ํ™˜์ž์˜ 1๊ฐœ์›”๊ฐ„์˜ ์ง‘์ค‘ ๋ฌผ๋ฆฌ์น˜๋ฃŒ ํ›„ ๋ฏผ๊ฐ๋„๋Š” ์ •์ ์•‰๊ธฐ๊ท ํ˜•, ๋™์ ์•‰๊ธฐ๊ท ํ˜•, ํ˜‘์‘๋ ฅ, ์ด์  ๋“ฑ์—์„œ ๊ฐ๊ธฐ MID=0.73-1.22, 0.84-1.41, 0.44-0.73, 1.78-2.97๋กœ 0.3ร—Sb- 0.5ร—Sb ๋ฒ”์œ„ ๋‚ด์—์„œ ๊ฒฐ๊ณผ๋ฅผ ๋ณด์—ฌ ๋ฏผ๊ฐ๋„๊ฐ€ ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๊ณ , 3๊ฐœ์˜ ํ•˜์œ„์ฒ™๋„์™€ ์ด์  ๋ชจ๋‘ ํ†ต๊ณ„์ ์œผ๋กœ๋„ ์œ ์˜ํ•œ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค(p<0.05) (Table 4).
Tableย 4
Minimally important difference for the K-TIS
Baseline MeanยฑSD After 1 mo. MeanยฑSD Changes MeanยฑSD 0.3ร—Sb 0.5ร—Sb

Acute and post-acute stroke patients (n=39)
SSB total 4.79ยฑ2.43 6.26ยฑ1.37 1.46ยฑ1.90* 0.73 1.22
DSB total 3.62ยฑ2.81 5.82ยฑ2.79 2.36ยฑ1.97* 0.84 1.41
COO total 1.56ยฑ1.45 2.38ยฑ1.89 0.82ยฑ1.19* 0.44 0.73
Total 10.03ยฑ5.94 14.46ยฑ5.29 4.44ยฑ3.31* 1.78 2.97
Baseline MeanยฑSD After 3 mo. MeanยฑSD Changes MeanยฑSD 0.3ร—Sb 0.5ร—Sb

Chronic stroke patients (n=12)
SSB total 6.08ยฑ0.29 6.67ยฑ0.49 0.58ยฑ0.51 0.09 0.15
DSB total 4.42ยฑ1.98 6.25ยฑ1.60 1.83ยฑ1.34 0.59 0.99
COO total 1.00ยฑ0.43 1.25ยฑ0.62 0.25ยฑ0.62 0.13 0.22
Total 11.50ยฑ2.35 14.17ยฑ2.04 2.67ยฑ1.30 0.71 1.18

* p<0.05.

K-TIS, Korean version of trunk impairment scale; SSB, Static sitting balance; DSB, Dynamic sitting balance; COO, Coordination; Sb, Standard deviation of baseline.

๋งŒ์„ฑ ๋‡Œ์กธ ์ค‘ํ™˜์ž์˜ ๊ฒฝ์šฐ ๋™์ ์•‰๊ธฐ๊ท ํ˜•๊ณผ ์ด์ ์—์„œ ๋ฏผ๊ฐ๋„๋ฅผ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ์ง€๋งŒ 3๊ฐœ์›” ์ „ํ›„์˜ ์ ์ˆ˜๋ณ€ํ™”๋Š” ํ†ต๊ณ„์ ์œผ๋กœ ์œ ์˜ํ•˜์ง€ ์•Š์•˜๋‹ค (pโ‰ฅ0.05) (Table 4).

๊ณ ์ฐฐ

๋ณธ ์—ฐ๊ตฌ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์ •์  ๋ฐ ๋™์  ์•‰๊ธฐ์—์„œ ๊ท ํ˜•์กฐ์ ˆ๊ณผ ๋ชธํ†ต์˜ ์„ ํƒ์  ์กฐ์ ˆ๋Šฅ๋ ฅ์„ ํ‰๊ฐ€๋„๊ตฌ์ธ TIS๋ฅผ ํ•œ๊ธ€ํ™”ํ•˜๊ณ , ํ•œ๊ธ€ํ™”๋œ TIS์˜ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„๋ฅผ ์กฐ์‚ฌํ•ด K-TIS๋กœ ํ‘œ์ค€ํ™”ํ•˜๊ณ ์ž ํ•˜์˜€๋‹ค.
TIS์˜ ํ•œ๊ธ€ํ™” ์ž‘์—…์—์„œ ๋ฌธํ™”์  ์ฐจ์ด์—์„œ ๋ฐœ์ƒํ•  ์ˆ˜ ์žˆ๋Š” ์˜ค์—ญ์„ ์—†์• ๊ธฐ ์œ„ํ•˜์—ฌ26 ์›์ €์ž์™€ ๋…ผ์˜๋ฅผ ํ†ตํ•ด ์—„๊ฒฉํ•œ ๋‹จ์–ด์˜ ์„ ๋ณ„๊ณผ์ •์„ ๊ฑฐ์ณค๋‹ค. ๋ชจ๊ตญ์–ด๊ฐ€ ์•„๋‹Œ ์™ธ๋ž˜์–ด๋กœ ๋œ ํ‰๊ฐ€๋„๊ตฌ์˜ ํ•œ๊ธ€ํ™” ๋ฐ ํ‘œ์ค€ํ™” ์ž‘์—…์„ ์œ„ํ•˜์—ฌ ์ฒซ์งธ, ํ•ด๋‹น ๋ถ„์•ผ์˜ 2์ธ ์ด์ƒ์˜ ์ „๋ฌธ๊ฐ€์— ์˜ํ•œ ๋ฒˆ์—ญ๊ณผ ์™ธ๋ž˜์–ด๋กœ์˜ ์žฌ ๋ฒˆ์—ญ์ด ํ•„์š”ํ•˜๋‹ค. ์žฌ ๋ฒˆ์—ญ๋œ ๋‚ด์šฉ์„ ๋ฐ”ํƒ•์œผ๋กœ ์›์ €์ž์™€์˜ ๋…ผ์˜๋ฅผ ํ†ตํ•˜์—ฌ ํ‰๊ฐ€ํ•ญ๋ชฉ์˜ ๋‚ด์šฉ์„ ์œ ์ง€ํ•˜๋ฉด์„œ ๊ตญ๋‚ด์—์„œ ์ดํ•ดํ•˜๋Š”๋ฐ ๊ฐ€์žฅ ์ ํ•ฉํ•œ ๋‚ด์šฉ์œผ๋กœ ์ „ํ™˜ํ•˜๋Š” ๊ณผ์ •์„ ๊ฑฐ์ณ์•ผ ํ•œ๋‹ค. ๋‘˜์งธ, ํ‰๊ฐ€๋„๊ตฌ๋ฅผ ํ•œ๊ธ€ํ™” ํ•œ ๊ฒƒ์œผ๋กœ ํ•œ๊ตญํŒํ‰๊ฐ€๋„๊ตฌ๊ฐ€ ๊ฐœ๋ฐœ๋˜๋Š” ๊ฒƒ์ด ์•„๋‹ˆ๋ฏ€๋กœ, ์‹ค์ œ๋กœ ์ž„์ƒํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„๋ฅผ ์กฐ์‚ฌํ•ด์•ผ ํ•œ๋‹ค.27 ๋ณธ ์—ฐ๊ตฌ์—์„œ ์กฐ์‚ฌํ•œ ์ธก์ •์ž ๊ฐ„ ์‹ ๋ขฐ๋„๋Š” 2๋ช… ์ด์ƒ์˜ ์ธก์ •์ž๊ฐ€ ๋™์ผํ•œ ์ธก์ •๋Œ€์ƒ 1๋ช…์—๊ฒŒ ๊ฐ™์€ ์ธก์ •๊ฐ’์„ ๋ถ€์—ฌํ•˜๋Š” ์ •๋„๋ฅผ ๋งํ•˜๋ฉฐ, ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„๋Š” ๋ฐ˜๋ณต ์ธก์ •ํ•œ ๊ฐ’์ด ์–ด๋Š ์ •๋„ ์ผ์น˜ํ•˜๋Š”์ง€ ๊ฒ€์‚ฌํ•˜๋Š” ๊ฒƒ์œผ๋กœ ์‹ ๋ขฐ๋„ ๊ฐ’์ด โ€˜1โ€™์ผ ๊ฒฝ์šฐ ์ธก์ •์ž ๊ฐ„์— ๊ทธ๋ฆฌ๊ณ  ๋ฐ˜๋ณต ๊ฒ€์‚ฌ์—์„œ ์ธก์ •๊ฐ’์ด ์™„์ „ํžˆ ์ผ์น˜ํ•œ๋‹ค๋Š” ๋œป์ด๋‹ค.
ํ•œ๊ธ€ํ™”ํ•œ TIS์˜ ์ •์ ์•‰๊ธฐ๊ท ํ˜•, ๋™์ ์•‰๊ธฐ๊ท ํ˜•, ๊ทธ๋ฆฌ๊ณ  ํ˜‘์‘๋ ฅ ๋“ฑ์˜ 3๊ฐœ ํ•˜์œ„ ์˜์—ญ์˜ ์ธก์ •์ž ๊ฐ„ ์‹ ๋ขฐ๋„๋Š” ๊ธ‰๋‚ด์ƒ๊ด€๊ณ„์ˆ˜ ICC์™€ ํ”ผ์–ด์Šจ์ƒ๊ด€๊ณ„์ˆ˜ r์—์„œ ๋ชจ๋‘ 0.9์ด์ƒ์˜ ๋†’์€ ์‹ ๋ขฐ๋„๋ฅผ ๋‚˜ํƒ€๋ƒˆ๋‹ค. ์ด ๊ฒฐ๊ณผ๋Š” Verheyden ๋“ฑ16์ด TIS๋ฅผ ๊ฐœ๋ฐœํ•  ๋•Œ ๋ฐœ๋ณ‘์ผ 21์ผ์—์„œ 2,341์ผ์˜ ๋ฒ”์œ„๋ฅผ ๊ฐ–๋Š” 28๋ช…์˜ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์กฐ์‚ฌํ•œ ์ธก์ •์ž ๊ฐ„ ์‹ ๋ขฐ๋„ ICC =0.87-0.96๊ณผ ์œ ์‚ฌํ•˜๋‹ค. ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„์˜ ๊ฒฝ์šฐ, ์ธก์ •์ž A์™€ B์˜ ์‹ ๋ขฐ๋„ ๊ฐ’์ด ICC=0.805-0.896, ICC=0.814-0.901๋กœ Verheyden ๋“ฑ16์˜ ๊ฒฐ๊ณผ์™€ ์•ฝ๊ฐ„ ๋‚ฎ๊ฑฐ๋‚˜ ์œ ์‚ฌํ•˜๋‹ค.
๋ณธ ์—ฐ๊ตฌ์˜ ์ธก์ •์ž ๊ฐ„ ์‹ ๋ขฐ๋„๊ฐ’๊ณผ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ์‹ ๋ขฐ๋„ ๊ฐ’์„ ๋น„๊ตํ–ˆ์„ ๋•Œ ์ธก์ •์ž๊ฐ„ ์‹ ๋ขฐ๋„ ๊ฐ’์ด ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„ ๋ณด๋‹ค ๋†’๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด์™€ ๊ฐ™์€ ๊ฒฐ๊ณผ๊ฐ€ ๋‚˜ํƒ€๋‚œ ๊ฒƒ์€ ์ธก์ •์ž ๊ฐ„ ์‹ ๋ขฐ๋„์˜ ๊ฒฝ์šฐ 2๋ช…์˜ ์ธก์ •์ž๊ฐ€ ๊ฐ™์€ ์‹œ๊ฐ„์— ๋™์ผํ•œ ๋น„๋””์˜ค๋ฅผ ๋ณด๋ฉด์„œ ์ ์ˆ˜๋ฅผ ์ธก์ •ํ•˜๊ธฐ ๋•Œ๋ฌธ์— ์˜ํ–ฅ์„ ๋ฏธ์น  ์ˆ˜ ์žˆ๋Š” ์—ฌ๋Ÿฌ ์š”์ธ๋“ค์˜ ์ž‘์šฉ์ด ์ตœ์†Œํ™”๋œ๋‹ค. ํ•˜์ง€๋งŒ, ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„์—์„œ๋Š” ํ™˜์ž์˜ ์ˆ˜ํ–‰๋Šฅ๋ ฅ ๋‚ด์—์„œ ๋ณ€์ด๊ฐ€ ์ž‘์šฉํ–ˆ์„ ์ˆ˜ ์žˆ๋‹ค. ํŠนํžˆ, ๋ณธ ์—ฐ๊ตฌ์˜ ๋Œ€์ƒ์ž์˜ ๊ฒฝ์šฐ ๋‡Œ์กธ์ค‘ ๋ฐœ๋ณ‘๊ธฐ๊ฐ„์ด 3๊ฐœ์›” ๋ฏธ๋งŒ์ธ ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„ ํ™˜์ž๊ฐ€ 76* ์ด์ƒ์ด๊ธฐ ๋•Œ๋ฌธ์— 2์ฃผ ๊ฐ„๊ฒฉ์˜ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ๊ธฐ๊ฐ„ ์‚ฌ์ด์— ์•‰๊ธฐ ๊ท ํ˜• ๋ฐ ๋ชธํ†ต์กฐ์ ˆ๋ ฅ์— ๋ณ€ํ™”๊ฐ€ ์ƒ๊ธธ ์ˆ˜๋„ ์žˆ์—ˆ์„ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค. ๋‡Œ์กธ์ค‘ ๋ฐœ๋ณ‘ 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ํ™˜์ž์˜ K-TIS์˜ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ์‹ ๋ขฐ๋„๋ฅผ ์กฐ์‚ฌํ•  ๊ฒฝ์šฐ ๊ฒ€์‚ฌ ๊ฐ„ ์‹œ๊ธฐ๋ฅผ 2์ฃผ ์ด๋‚ด๋กœ ๋ณด๋‹ค ์งง๊ฒŒ ์‹œ๊ฐ„ ๊ฐ„๊ฒฉ์„ ๋‘˜ ํ•„์š”๊ฐ€ ์žˆ์„ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค.
๋ฏผ๊ฐ๋„๋ž€, ์‹œ๊ฐ„์˜ ๊ฒฝ๊ณผ ๋˜๋Š” ์น˜๋ฃŒ ์ „ยทํ›„์— ์ž„์ƒ์ ์œผ๋กœ ์ค‘์š”ํ•œ ๋ณ€ํ™”๊ฐ€ ์žˆ์„ ๋•Œ ์ธก์ •ํ•œ ์ ์ˆ˜๋ณ€ํ™”๋กœ ์‹ค์ œ์  ๊ธฐ๋Šฅ์  ๋ณ€ํ™”๋ฅผ ์„ค๋ช…ํ•  ์ˆ˜ ์žˆ๋Š” ํ‰๊ฐ€๋„๊ตฌ์˜ ํŠน์„ฑ์„ ๋œปํ•œ๋‹ค.28 ๋ฌผ๋ฆฌ์น˜๋ฃŒ๋ถ„์•ผ์—์„œ ํ‘œ์ค€ํ™” ๋˜๋Š” ๊ฐ๊ด€ํ™”๋œ ํ‰๊ฐ€๋„๊ตฌ๋ผ๊ณ  ํ•œ๋‹ค๋ฉด ์น˜๋ฃŒ์˜ ๊ฒฐ๊ณผ๋ฅผ ์ˆซ์žํ™” ๋œ ๋ฐ์ดํ„ฐ๋กœ ์ œ๊ณตํ•˜์—ฌ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์˜ ํšจ๊ณผ๋ฅผ ์ž˜ ์ž…์ฆํ•ด ์ค„ ์ˆ˜ ์žˆ์–ด์•ผ ํ•œ๋‹ค. TIS์˜ ๊ฒฝ์šฐ ์•„์ง ์น˜๋ฃŒ ๋ฐ ์‹œ๊ฐ„์˜ ๊ฒฝ๊ณผ์— ๋”ฐ๋ฅธ ๋ฏผ๊ฐ๋„๊ฐ€ ๋ฐœํ‘œ๋œ ์—ฐ๊ตฌ๋Š” ์—†๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๊ตญ๋‚ด์˜ ๋‡Œ์กธ์ค‘ ํ™˜์ž ์น˜๋ฃŒ ๋ฐ ์ž…์›๊ธฐ๊ฐ„ ๋“ฑ์˜ ์—ฌ๊ฑด์„ ๊ณ ๋ คํ•˜์—ฌ ๋ฐœ๋ณ‘๊ธฐ๊ฐ„ 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ํ™˜์ž๋“ค์€ 1๊ฐœ์›”์˜ ์ž…์›๊ธฐ๊ฐ„ ๋™์•ˆ ๊ทธ๋ฆฌ๊ณ  6๊ฐœ์›” ์ด์ƒ ๋œ ํ™˜์ž๋“ค์€ 3๊ฐœ์›”์˜ ์ž…์›๊ธฐ๊ฐ„ ๋™์•ˆ ์ง‘์ค‘์šด๋™์น˜๋ฃŒ ์ „ํ›„์˜ K-TIS์˜ ์ ์ˆ˜๋ณ€ํ™”๋ฅผ ์ด์šฉํ•˜์—ฌ ๋ฏผ๊ฐ๋„๋ฅผ ์ธก์ •ํ•˜์˜€๋‹ค.
Table 4์—์„œ ๋ฐœ๋ณ‘๊ธฐ๊ฐ„ 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ฒฝ์šฐ 1๊ฐœ์›” ๊ฐ„์˜ ์ •์ ์•‰๊ธฐ๊ท ํ˜•์—์„œ์˜ ์ ์ˆ˜๋ณ€ํ™”๋Š” 4.79์ ์—์„œ 6.26์ ์œผ๋กœ 1.46์  ์ฆ๊ฐ€ํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  Table 4์—์„œ ์ œ์‹œํ•˜๊ณ  ์žˆ๋Š” 0.3ร—Sb=0.73๊ณผ 0.5ร—Sb=1.22์˜ ์˜๋ฏธ๋Š” 1๊ฐœ์›”๊ฐ„์˜ ์น˜๋ฃŒ ํ›„์— ์ ์ˆ˜๋ณ€ํ™”๊ฐ€ 0.73-1.22์ ์˜ ์ ์ˆ˜ ๋ฒ”์œ„์— ํ•ด๋‹น๋˜๊ฑฐ๋‚˜ ๋˜๋Š” 1.22์  ๋ณด๋‹ค ํด ๊ฒฝ์šฐ ์ •์ ์•‰๊ธฐ๊ท ํ˜•์—์„œ ์˜๋ฏธ ์žˆ๋Š” ๋ณ€ํ™”๊ฐ€ ์ผ์–ด๋‚œ ๊ฒƒ์œผ๋กœ ํ•ด์„ํ•œ๋‹ค. ๋™์ ์•‰๊ธฐ๊ท ํ˜•๊ณผ ํ˜‘์‘๋ ฅ์—์„œ๋„ ๊ฐ๊ธฐ 1.41์ ๊ณผ 0.73์  ๋ณด๋‹ค ํฐ ์ ์ˆ˜๋ณ€ํ™”๋ฅผ ๋‚˜ํƒ€๋‚ด์–ด ๋ฐœ๋ณ‘ 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ๋‡Œ์กธ์ค‘ ํ™˜์ž์—๊ฒŒ 1๊ฐœ์›” ๊ฐ„์˜ ์ง‘์ค‘์น˜๋ฃŒ๊ฐ€ ํšจ๊ณผ์ ์ด์—ˆ๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. Harley์™€ Fragara-Pinkham29์€ ์น˜๋ฃŒ ์ „ํ›„์˜ ํ‰๊ฐ€์ ์ˆ˜์˜ ๋ณ€ํ™”๋Ÿ‰์ด 0.3ร—Sb๊ฐ’๊ณผ 0.5ร—Sb๊ฐ’์˜ ์ ์ˆ˜ ๋ฒ”์œ„์— ํฌํ•จ๋  ๋•Œ ํ•ด๋‹น ํ‰๊ฐ€๋„๊ตฌ์˜ ๋ฏผ๊ฐ๋„๊ฐ€ ๋†’๋‹ค๊ณ  ํ•˜์˜€๋‹ค.
๋ฐœ๋ณ‘ 6๊ฐœ์›” ์ด์ƒ์˜ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ฒฝ์šฐ, K-TIS์˜ 3๊ฐœ ํ•˜์œ„์˜์—ญ์—์„œ ๋ชจ๋‘ ๋ฏผ๊ฐ๋„๋ฅผ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. ํ•˜์ง€๋งŒ, ์ •์ ์•‰๊ธฐ๊ท ํ˜•, ๋™์ ์•‰๊ธฐ๊ท ํ˜•, ํ˜‘์‘๋ ฅ์—์„œ์˜ ์ ์ˆ˜๋ณ€ํ™”๊ฐ€ 3๊ฐœ์›”๊ฐ„์˜ ์ง‘์ค‘์น˜๋ฃŒ ํ›„์—๋„ ๋ฐœ๋ณ‘ 3๊ฐœ์›” ๋ฏธ๋งŒ์˜ ๊ธ‰์„ฑ ๋ฐ ๊ธ‰์„ฑ๊ธฐ ์ดํ›„ ๋‡Œ์กธ์ค‘ ํ™˜์ž์— ๋น„ํ•ด ๋‚ฎ๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋ฌธํ—Œ๋ณด๊ณ ์— ์˜ํ•˜๋ฉด, ๋‡Œ์กธ์ค‘ ๋ฐœ๋ณ‘ ํ›„ ๋‡Œ์˜ ๊ฐ€์†Œ์„ฑ ๋ฐ ๋ฌผ๋ฆฌ์น˜๋ฃŒ๋ฅผ ํ†ตํ•œ ๊ธฐ๋Šฅ์˜ ํšŒ๋ณต์€ ๋ฐœ๋ณ‘ ํ›„ 3๊ฐœ์›” ๋‚ด์— ๊ฐ€์žฅ ๊ทน๋Œ€ํ™” ๋œ๋‹ค๊ณ  ํ•œ๋‹ค.30 ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋„ ์ด๋Ÿฌํ•œ ๋‚ด์šฉ์„ ๋’ท๋ฐ›์นจํ•˜๊ณ  ์žˆ๋‹ค. ๋‡Œ์กธ์ค‘ ํ™˜์ž์—๊ฒŒ K-TIS๋ฅผ ์ ์šฉํ•  ๋•Œ๋Š” ๋‡Œ์กธ์ค‘ ๋ฐœ๋ณ‘ ์‹œ๊ธฐ์— ๋”ฐ๋ฅธ ์šด๋™ํšŒ๋ณต ๋Šฅ๋ ฅ์„ ๊ณ ๋ คํ•˜์—ฌ ๋งŒ์„ฑ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ผ๋ฉด 3๊ฐœ์›” ์ด์ƒ์˜ ์šด๋™๊ธฐ๊ฐ„์„ ๊ณ„ํšํ•˜๋Š” ๊ฒƒ์ด K-TIS๋ฅผ ์ด์šฉํ•œ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์˜ ํšจ๊ณผ๋ฅผ ํ™•์ธํ•˜๋Š”๋ฐ ์ ํ•ฉํ•  ๊ฒƒ์œผ๋กœ ์ƒ๊ฐํ•œ๋‹ค.
๋ณธ ์—ฐ๊ตฌ์˜ ์ œํ•œ์ ์œผ๋กœ๋Š” ๋งŒ์„ฑ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์ˆ˜๊ฐ€ ๋น„๊ต์  ์ ์—ˆ๋‹ค๋Š” ๊ฒƒ๊ณผ 2๊ฐœ ๊ธฐ๊ด€์˜ ํ™˜์ž๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๊ธฐ ๋•Œ๋ฌธ์— ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋ฅผ ์ผ๋ฐ˜ํ™” ํ•˜๊ธฐ ์–ด๋ ต๋‹ค๋Š” ๊ฒƒ์ด๋‹ค. ํ–ฅํ›„ K-TIS๋ฅผ ์ด์šฉํ•œ ์—ฐ๊ตฌ๊ฐ€ ์ด๋ฃจ์–ด์ง„๋‹ค๋ฉด ์ฒซ์งธ, ๋‹ค์ˆ˜์˜ ๊ธฐ๊ด€์ด ์ฐธ์—ฌํ•˜๋Š” ํฐ ๊ทœ๋ชจ์˜ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„ ์กฐ์‚ฌ๊ฐ€ ์ด๋ฃจ์–ด์ ธ์•ผ ํ•  ๊ฒƒ์ด๋ฉฐ, K-TIS๋ฅผ ์‚ฌ์šฉํ•˜๋Š” ๊ธฐ๊ด€๋ณ„๋กœ ์‹ ๋ขฐ๋„์™€ ๋ฏผ๊ฐ๋„๋ฅผ ์กฐ์‚ฌํ•˜๋Š” ๊ฒƒ๋„ ๋ณด๋‹ค ์‹ค์ œ์ ์ธ ๋ฐฉ๋ฒ•์ด ๋  ๊ฒƒ์ด๋‹ค. ๋‘˜์งธ, ๋‹ค์–‘ํ•œ ๋‡Œ์กธ์ค‘ ํ™˜์ž ๋ฌผ๋ฆฌ์น˜๋ฃŒ ์ค‘์žฌ๋ฒ•์— ๋Œ€ํ•œ K-TIS์˜ ๋ฏผ๊ฐ๋„๋ฅผ ์กฐ์‚ฌํ•˜์—ฌ ์ค‘์žฌ๋ฒ•์— ๋”ฐ๋ฅธ K-TIS์˜ ์ ์šฉ์„ ํ™•์ธ ํ›„ ํ™˜์ž์‚ฌ๋ก€ ๋ฐ ์น˜๋ฃŒ์ ‘๊ทผ๋ฒ•์— ๋”ฐ๋ฅธ ์ ์šฉ์„ ์—ฐ๊ตฌํ•ด์•ผ ํ•  ๊ฒƒ์ด๋‹ค. ๋งˆ์ง€๋ง‰์œผ๋กœ, K-TIS์˜ 17๊ฐœ ํ•ญ๋ชฉ์€ ์ผ์ƒ์ƒํ™œ์—์„œ ์ฃผ๋กœ ์ทจํ•˜๋Š” ๊ธฐ๋Šฅ์  ์ž์„ธ์™€ ์›€์ง์ž„์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ๋‹ค. ์˜ˆ๋ฅผ ๋“ค์–ด์„œ K-TIS์˜ ํ˜‘์‘๋ ฅ ๋ถ€๋ถ„์—๋Š” ๋ฌด๋ฆŽ์„ ์•ž์œผ๋กœ 6ํšŒ ์›€์ง์ด๋Š” ํ•ญ๋ชฉ์ด ์žˆ๊ณ  6์ดˆ ์•ˆ์— ์ˆ˜ํ–‰ํ•ด์•ผ ํ•œ๋‹ค. ์ด ํ•ญ๋ชฉ๋“ค์—์„œ๋Š” ์ผ์ƒ์ƒํ™œ์—์„œ ๋‹ค๋ฆฌ์˜ ์›€์ง์ž„์ด ํฌํ•จ๋˜๋Š” ๋Œ€๋ถ€๋ถ„์˜ ๊ธฐ๋Šฅ์  ๋™์ž‘์— ํ•„์ˆ˜์ ์ธ ํ•˜๋ถ€๋ชธํ†ต์˜ ์„ ํƒ์  ํšŒ์ „๋™์ž‘์„ ํ‰๊ฐ€ํ•˜๋Š” ๊ฒƒ์ด๋ฉฐ ์ •์ƒ์ธ์ฒ˜๋Ÿผ ์ ์ ˆํ•œ ์‹œ๊ฐ„ ์•ˆ์— ์ˆ˜ํ–‰ํ•˜๋Š”์ง€ ํ‰๊ฐ€ํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ๋•Œ๋ฌธ์— ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์˜ ๋ชฉํ‘œ์™€ ์น˜๋ฃŒํ”„๋กœ๊ทธ๋žจ์„ ๊ณ„ํšํ•  ๋•Œ TIS์˜ 17๊ฐœ ํ•ญ๋ชฉ์„ ์ด์šฉํ•˜์—ฌ ๊ฐœ๊ฐœ์ธ์˜ ํ™˜์ž์—๊ฒŒ ์ ํ•ฉํ•œ ํ•ญ๋ชฉ์ด๋‚˜ ํ•ญ๋ชฉ๋“ค์„ ๋‹จ๊ธฐ์  ์น˜๋ฃŒ๋ชฉํ‘œ๋กœ ์„ค์ •ํ•ด ์น˜๋ฃŒ์‹œ๊ฐ„์— ์ง‘์ค‘์ ์œผ๋กœ ๋ฐ˜๋ณต ์—ฐ์Šต์‹œํ‚จ๋‹ค๋ฉด ๊ธฐ๋Šฅ์  ํšŒ๋ณต์— ๋„์›€์ด ๋  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋‹ค.
๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋ฅผ ์ข…ํ•ฉํ•ด ๋ณผ ๋•Œ, K-TIS๋Š” ์‹ ๋ขฐ๋„์™€ ์‹œ๊ฐ„์˜ ๊ฒฝ๊ณผ์— ๋”ฐ๋ฅธ ๋ฏผ๊ฐ๋„๋ฅผ ๊ฐ–์ถ˜ ์ž„์ƒ๊ณผ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์œผ๋กœ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์•‰์€ ์ž์„ธ์—์„œ ๊ท ํ˜•์กฐ์ ˆ๊ณผ ๋ชธํ†ต์กฐ์ ˆ๋ ฅ์„ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋Š” ์œ ์šฉํ•œ ํ‰๊ฐ€๋„๊ตฌ๋ผ๊ณ  ์ƒ๊ฐ๋œ๋‹ค.


Appendix 1

Korean version of Trunk Impairment Scale (K-TIS)

ํ•ญ๋ชฉ๋งˆ๋‹ค ์‹œ์ž‘ ์ž์„ธ๋Š” ๋™์ผํ•˜๋‹ค. ํ™˜์ž๋Š” ์นจ๋Œ€ ๋˜๋Š” ์น˜๋ฃŒ ํ…Œ์ด๋ธ” ๊ฐ€์žฅ์ž๋ฆฌ์— ๊ธฐ๋Œ€๊ฑฐ๋‚˜ ์†์„ ์งš์ง€ ์•Š๊ณ  ์•‰๋Š”๋‹ค. ํ—ˆ๋ฒ…์ง€๋Š” ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ์™„์ „ํžˆ ๋‹ฟ์•„์•ผ ํ•˜๊ณ , ๋ฐœ์€ ์—‰๋ฉ์ด ๋„ˆ๋น„๋งŒํผ ๋ฒŒ๋ ค ๋ฐ”๋‹ฅ์— ํŽธํ‰ํ•˜๊ฒŒ ๋‹ฟ๊ฒŒ ํ•œ๋‹ค. ๋ฌด๋ฆŽ์€ 90ยฐ ๊ตด๊ณก์‹œํ‚จ๋‹ค. ์–‘ ํŒ”์€ ๋‹ค๋ฆฌ ์œ„์— ์˜ฌ๋ ค ๋†“๋Š”๋‹ค. ํ‰๊ฐ€ ์ค‘ ๋งˆ๋น„์ธก ํŒ”์— ๊ธด์žฅ๋„๊ฐ€ ๋†’์•„์ง€๋ฉด ๋‹ค์‹œ ์‹œ์ž‘์ž์„ธ๋กœ ์ทจํ•˜๊ฒŒ ํ•œ๋‹ค. ๋จธ๋ฆฌ์™€ ๋ชธํ†ต์€ ๊ฐ€์šด๋ฐ๋กœ ์ •๋ ฌ ์‹œํ‚จ๋‹ค.
ํ™˜์ž๊ฐ€ ์ฒซ ํ•ญ๋ชฉ์—์„œ 0์ ์ด๋ฉด โ€˜TIS ์ด์ โ€™์€ 0์ ์ด๋‹ค.
ํ•ญ๋ชฉ๋งˆ๋‹ค 3ํšŒ ์ˆ˜ํ–‰์‹œํ‚จ ํ›„ ๊ฐ€์žฅ ๋†’์€ ์ ์ˆ˜๋ฅผ ์„ ํƒํ•œ๋‹ค. ํ™˜์ž๊ฐ€ ํ‰๊ฐ€ํ•ญ๋ชฉ์„ ๋ณ„๋„๋กœ ์—ฐ์Šตํ•˜์ง€ ์•Š๋„๋ก ํ•œ๋‹ค. ์น˜๋ฃŒ์‚ฌ๋Š” ํ™˜์ž๊ฐ€ ํ•ญ๋ชฉ์„ ์ˆ˜ํ–‰ํ•  ๋•Œ โ€˜๊ตฌ๋‘(verbal)โ€™๋กœ ํ”ผ๋“œ๋ฐฑ์„ ์ค„ ์ˆ˜ ์žˆ๋‹ค.
๋ง๋กœ ํ•ญ๋ชฉ์ˆ˜ํ–‰์— ๊ด€ํ•ด ์„ค๋ช…ํ•˜๊ฑฐ๋‚˜ ํ•„์š”ํ•˜๋‹ค๋ฉด ์ง์ ‘ ์‹œ๋ฒ”์„ ๋ณด์—ฌ์ฃผ์–ด๋„ ๋œ๋‹ค.
Korean version of Trunk Impairment Scale (K-TIS)
1 Static sitting balance
โ€ขํ™˜์ž๊ฐ€ ํŒ”๋กœ ์ง€์ง€ํ•˜์ง€ ์•Š์œผ๋ฉด ๋„˜์–ด์ง€๊ฑฐ๋‚˜ 10์ดˆ ๋™์•ˆ ์‹œ์ž‘์ž์„ธ๋ฅผ ์œ ์ง€ํ•˜์ง€ ๋ชป ํ•œ๋‹ค.
โ€ข10์ดˆ ๋™์•ˆ ์‹œ์ž‘์ž์„ธ๋ฅผ ์œ ์ง€ํ•œ๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ TIS์˜ ์ด์ ์€ โ€˜0์ โ€™
โ–ก 0
โ–ก 2
2 ์‹œ์ž‘์ž์„ธ์—์„œ ์น˜๋ฃŒ์‚ฌ๊ฐ€ ๋น„๋งˆ๋น„์ธก ๋‹ค๋ฆฌ๋ฅผ ๋งˆ๋น„์ธก ๋‹ค๋ฆฌ ์œ„๋กœ ๊ต์ฐจ์‹œํ‚จ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ํŒ”๋กœ ์ง€์ง€ํ•˜์ง€ ์•Š์œผ๋ฉด ๋„˜์–ด์ง€๊ฑฐ๋‚˜ 10์ดˆ ๋™์•ˆ ์‹œ์ž‘์ž์„ธ๋ฅผ ์œ ์ง€ํ•˜์ง€ ๋ชป ํ•œ๋‹ค.
โ€ขํ•œ์ž๊ฐ€ ์•‰์€ ์ž์„ธ๋ฅผ 10์ดˆ ๋™์•ˆ ์œ ์ง€ํ•œ๋‹ค.
โ–ก 0
โ–ก 2
3 ์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž๊ฐ€ ๋น„๋งˆ์ธก ๋‹ค๋ฆฌ๋ฅผ ๋งˆ๋น„์ธก ๋‹ค๋ฆฌ ์œ„๋กœ ๊ต์ฐจ์‹œํ‚จ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ๋„˜์–ด์ง„๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ํŒ”์˜ ์ง€์ง€ ์—†์ด ๋‹ค๋ฆฌ๋ฅผ ๊ต์ฐจ์‹œํ‚ค์ง€ ๋ชป ํ•œ๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ๋‹ค๋ฆฌ๋ฅผ ๊ต์ฐจ์‹œํ‚ค์ง€๋งŒ ๋ชธํ†ต์ด 10 cm ์ด์ƒ ๋’ค๋กœ ๊ธฐ์šธ์–ด์ง€๊ฑฐ๋‚˜ ์†์œผ๋กœ ๋‹ค๋ฆฌ๋ฅผ ๋„˜๊ธด๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ๋ชธํ†ต์„ ๋’ค๋กœ ๊ธฐ์šธ์ด๊ฑฐ๋‚˜ ์†์„ ์“ฐ์ง€ ์•Š๊ณ  ๋‹ค๋ฆฌ๋ฅผ ๊ต์ฐจ์‹œํ‚จ๋‹ค.
โ–ก 0
โ–ก 1
โ–ก 2
โ–ก 3
Total static sitting balance /7
1 Dynamic sitting balance
์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž์—๊ฒŒ ๋งˆ๋น„์ธก ํŒ”๊ฟˆ์น˜๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ๋‹ฟ๊ฒŒ(๋งˆ๋น„์ธก ์ฒด๊ฐ„์€ ์งง๊ฒŒ ํ•˜๊ณ  ๋น„๋งˆ๋น„์ธก์€ ๊ธธ๊ฒŒ ํ•จ์œผ๋กœ์„œ) ํ•œ ํ›„ ์‹œ์ž‘์ž์„ธ๋กœ ๋Œ์•„์˜ค๊ฒŒ ํ•œ๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ๋„˜์–ด์ง€๊ฑฐ๋‚˜, ์ƒ์ง€๋กœ ๊ธฐ๋Œ€๊ฑฐ๋‚˜, ํŒ”๊ฟˆ์น˜๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ๋‹ฟ์ง€ ์•Š๋Š”๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ๋„์›€ ์—†์ด ๋Šฅ๋™์ ์œผ๋กœ ์›€์ง์ด๊ณ , ํŒ”๊ฟˆ์น˜๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ๋‹ฟ๋Š”๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 2๋ฒˆ ๋ฐ 3๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
2 1๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ์น˜๋ฃŒ์‚ฌ์˜ ์ง€์‹œ๋Œ€๋กœ ์ˆ˜ํ–‰ํ•˜์ง€ ๋ชปํ•˜๊ฑฐ๋‚˜ ๋งˆ๋น„์ธก ์ฒด๊ฐ„์ด ๊ธธ์–ด์ง€๊ณ  ๋น„๋งˆ๋น„์ธก์ด ์งง์•„ ์ง„๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ์ ์ ˆํžˆ ๋งˆ๋น„์ธก ์ฒด๊ฐ„์„ ์งง๊ฒŒ ํ•˜๊ณ  ๋น„๋งˆ๋น„์ธก์€ ๊ธธ๊ฒŒ ํ•œ๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 3๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
3 1๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๋ณด์ƒ์ž‘์šฉ์„ ํ•œ๋‹ค: (1) ์ƒ์ง€์˜ ์‚ฌ์šฉ, (2) ๋ฐ˜๋Œ€์ชฝ ๊ณ ๊ด€์ ˆ ์™ธ์ „, (3) ๊ณ ๊ด€์ ˆ ๊ตด๊ณก(ํŒ”๊ฟˆ์น˜๊ฐ€ ๋Œ€ํ‡ด๊ณจ ๊ทผ์œ„๋ถ€ 1/2์„ ์ง€๋‚˜์„œ ํ…Œ์ด๋ธ”์ด๋‚˜ ์นจ๋Œ€์— ๋‹ฟ๋Š” ๊ฒฝ์šฐ), (4) ์Šฌ๊ด€์ ˆ ๊ตด๊ณก, (5) ๋ฐœ์˜ ๋ฏธ๋„๋Ÿฌ์ง
โ€ขํ™˜์ž๊ฐ€ ๋ณด์ƒ์ž‘์šฉ ์—†์ด ์›€์ง์ธ๋‹ค.
โ–ก 0
โ–ก 1
4 ์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž์—๊ฒŒ ๋น„๋งˆ๋น„์ธก ํŒ”๊ฟˆ์น˜๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ๋‹ฟ๊ฒŒ(๋น„๋งˆ๋น„์ธก ์ฒด๊ฐ„์„ ์งง๊ฒŒ ํ•˜๊ณ  ๋งˆ๋น„์ธก์€ ๊ธธ๊ฒŒ ํ•จ์œผ๋กœ์„œ) ํ•œ ํ›„ ์‹œ์ž‘์ž์„ธ๋กœ ๋Œ์•„์˜ค๊ฒŒ ํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ๋„˜์–ด์ง€๊ฑฐ๋‚˜, ์ƒ์ง€๋กœ ๊ธฐ๋Œ€๊ฑฐ๋‚˜, ํŒ”๊ฟˆ์น˜๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ๋‹ฟ์ง€ ์•Š๋Š”๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ๋„์›€ ์—†์ด ๋Šฅ๋™์ ์œผ๋กœ ์›€์ง์ด๊ณ , ํŒ”๊ฟˆ์น˜๊ฐ€ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์— ๋‹ฟ๋Š”๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 5๋ฒˆ ๋ฐ 6๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
5 4๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ์น˜๋ฃŒ์‚ฌ์˜ ์ง€์‹œ๋Œ€๋กœ ์ˆ˜ํ–‰ํ•˜์ง€ ๋ชปํ•˜๊ฑฐ๋‚˜ ๋งˆ๋น„์ธก ์ฒด๊ฐ„์ด ์งง์•„์ง€๊ณ  ๋น„๋งˆ๋น„์ธก์ด ๊ธธ์–ด์ง„๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ์ ์ ˆํžˆ ๋น„๋งˆ๋น„์ธก ์ฒด๊ฐ„์„ ์งง๊ฒŒ ํ•˜๊ณ  ๋งˆ๋น„์ธก์€ ๊ธธ๊ฒŒ ํ•œ๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 6๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
6 4๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๋ณด์ƒ์ž‘์šฉ์„ ํ•œ๋‹ค: (1) ์ƒ์ง€์˜ ์‚ฌ์šฉ, (2) ๋ฐ˜๋Œ€์ชฝ ๊ณ ๊ด€์ ˆ ์™ธ์ „, (3) ๊ณ ๊ด€์ ˆ ๊ตด๊ณก(ํŒ”๊ฟˆ์น˜๊ฐ€ ๋Œ€ํ‡ด๊ณจ ๊ทผ์œ„๋ถ€ 1/2 ์„ ์ง€๋‚˜์„œ ํ…Œ์ด๋ธ”์ด๋‚˜ ์นจ๋Œ€์— ๋‹ฟ๋Š” ๊ฒฝ์šฐ), (4) ์Šฌ๊ด€์ ˆ ๊ตด๊ณก, (5) ๋ฐœ์˜ ๋ฏธ๋„๋Ÿฌ์ง
โ€ขํ™˜์ž๊ฐ€ ๋ณด์ƒ์ž‘์šฉ ์—†์ด ์›€์ง์ธ๋‹ค.
โ–ก 0
โ–ก 1
7 ์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž์—๊ฒŒ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์—์„œ ๋งˆ๋น„์ธก ๊ณจ๋ฐ˜์„ ๋“ค์–ด์˜ฌ๋ฆฌ๊ณ (๋งˆ๋น„์ธก ์ฒด๊ฐ„์€ ์งง๊ฒŒ ํ•˜๊ณ  ๋น„๋งˆ๋น„์ธก์„ ๊ธธ๊ฒŒ ํ•จ์œผ๋กœ์„œ) ๋‹ค์‹œ ์‹œ์ž‘์ž์„ธ๋กœ ๋Œ์•„์˜จ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ์น˜๋ฃŒ์‚ฌ์˜ ์ง€์‹œ๋Œ€๋กœ ์ˆ˜ํ–‰ํ•˜์ง€ ๋ชปํ•˜๊ฑฐ๋‚˜ ๋งˆ๋น„์ธก ์ฒด๊ฐ„์ด ๊ธธ์–ด์ง€๊ณ  ๋น„๋งˆ๋น„์ธก์ด ์งง์•„ ์ง„๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ์ ์ ˆํžˆ ๋งˆ๋น„์ธก ์ฒด๊ฐ„์„ ์งง๊ฒŒ ํ•˜๊ณ  ๋น„๋งˆ๋น„์ธก์€ ๊ธธ๊ฒŒ ํ•œ๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 8๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค.
โ–ก 0
โ–ก 1
8 7๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๋ณด์ƒ์ž‘์šฉ์„ ํ•œ๋‹ค: (1) ์ƒ์ง€์˜ ์‚ฌ์šฉ, (2) ๋งˆ๋น„์ธก ๋ฐœ๊ฟˆ์น˜ ๋“ค๊ธฐ (push off: ๋ฐœ๋’ค๊ฟˆ์น˜๊ฐ€ ๋ฐ”๋‹ฅ์—์„œ ๋–จ์–ด์ง„๋‹ค)
โ€ขํ™˜์ž๊ฐ€ ๋ณด์ƒ์ž‘์šฉ ์—†์ด ์›€์ง์ธ๋‹ค.
โ–ก 0
โ–ก 1
9 ์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž์—๊ฒŒ ์นจ๋Œ€๋‚˜ ํ…Œ์ด๋ธ”์—์„œ ๋น„๋งˆ๋น„์ธก ๊ณจ๋ฐ˜์„ ๋“ค์–ด์˜ฌ๋ฆฌ๊ณ (๋น„๋งˆ๋น„์ธก ์ฒด๊ฐ„์€ ์งง๊ฒŒ ํ•˜๊ณ  ๋งˆ๋น„์ธก์„ ๊ธธ๊ฒŒ ํ•จ์œผ๋กœ์„œ) ๋‹ค์‹œ ์‹œ์ž‘์ž์„ธ๋กœ ๋Œ์•„์˜จ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ์น˜๋ฃŒ์‚ฌ์˜ ์ง€์‹œ๋Œ€๋กœ ์ˆ˜ํ–‰ํ•˜์ง€ ๋ชปํ•˜๊ฑฐ๋‚˜ ๋น„๋งˆ๋น„์ธก ์ฒด๊ฐ„์ด ๊ธธ์–ด์ง€๊ณ  ๋งˆ๋น„์ธก์ด ์งง์•„ ์ง„๋‹ค.
โ€ขํ™˜์ž๊ฐ€ ์ ์ ˆํžˆ ๋น„๋งˆ๋น„์ธก ์ฒด๊ฐ„์„ ์งง๊ฒŒ ํ•˜๊ณ  ๋งˆ๋น„์ธก์€ ๊ธธ๊ฒŒ ํ•œ๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 10๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
10 9๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํ™˜์ž๊ฐ€ ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๋ณด์ƒ์ž‘์šฉ์„ ํ•œ๋‹ค: (1) ์ƒ์ง€์˜ ์‚ฌ์šฉ, (2) ๋น„๋งˆ๋น„์ธก ๋ฐœ๋’ค๊ฟˆ์น˜ ๋“ค๊ธฐ (push off: ๋ฐœ๋’ค๊ฟˆ์น˜๊ฐ€ ๋ฐ”๋‹ฅ์—์„œ ๋–จ์–ด์ง„๋‹ค)
โ€ขํ™˜์ž๊ฐ€ ๋ณด์ƒ์ž‘์šฉ ์—†์ด ์›€์ง์ธ๋‹ค.
โ–ก 0
โ–ก 1
Total dynamic sitting balance /10
1 Co-ordination
์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž์—๊ฒŒ ์ƒ๋ถ€์ฒด๊ฐ„์„ 6ํšŒ ํšŒ์ „์‹œํ‚ค๋Š”๋ฐ(์–‘์ชฝ ์–ด๊นจ๊ฐ€ ์•ž์œผ๋กœ 3ํšŒ ์›€์ง์—ฌ์•ผ ํ•จ), ๋งˆ๋น„์ธก๋ถ€ํ„ฐ ์›€์ง์—ฌ์•ผ ํ•˜๊ณ  ๋จธ๋ฆฌ๋Š” ์‹œ์ž‘์ž์„ธ๋กœ ์œ ์ง€ํ•ด์•ผ ํ•œ๋‹ค.
โ€ข๋งˆ๋น„์ธก์ด 3ํšŒ ์›€์ง์ด์ง€ ์•Š๋Š”๋‹ค.
โ€ขํšŒ์ „์ด ๋น„๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ€ขํšŒ์ „์ด ๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ€˜0์ โ€™์ธ ๊ฒฝ์šฐ 2๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
โ–ก 2
2 6์ดˆ ๋‚ด์— 1๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํšŒ์ „์ด ๋น„๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ€ขํšŒ์ „์ด ๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ–ก 0
โ–ก 1
3 ์‹œ์ž‘์ž์„ธ์—์„œ ํ™˜์ž์—๊ฒŒ ํ•˜๋ถ€ ์ฒด๊ฐ„์„ 6ํšŒ ํšŒ์ „์‹œํ‚ค๋Š”๋ฐ(์–‘์ชฝ ๋ฌด๋ฆŽ์ด ์•ž์œผ๋กœ 3ํšŒ ์›€์ง์—ฌ์•ผ ํ•จ), ๋งˆ๋น„์ธก๋ถ€ํ„ฐ ์›€์ง์—ฌ์•ผ ํ•˜๊ณ , ์ƒ๋ถ€ ์ฒด๊ฐ„์€ ์‹œ์ž‘์ž์„ธ๋กœ ์œ ์ง€ํ•ด์•ผ ํ•œ๋‹ค. โ€ข๋งˆ๋น„์ธก์ด 3ํšŒ ์›€์ง์ด์ง€ ์•Š๋Š”๋‹ค.
โ€ขํšŒ์ „์ด ๋น„๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ€ขํšŒ์ „์ด ๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ€˜0โ€™์ ์ธ ๊ฒฝ์šฐ 4๋ฒˆ ํ•ญ๋ชฉ๋„ โ€˜0์ โ€™ ์ฒ˜๋ฆฌํ•œ๋‹ค
โ–ก 0
โ–ก 1
โ–ก 2
4 6์ดˆ ๋‚ด์— 1๋ฒˆ ํ•ญ๋ชฉ์„ ๋ฐ˜๋ณตํ•œ๋‹ค. โ€ขํšŒ์ „์ด ๋น„๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ€ขํšŒ์ „์ด ๋Œ€์นญ์ ์œผ๋กœ ์ผ์–ด๋‚œ๋‹ค.
โ–ก 0
Total co-ordination 1 /6
Total Trunk Impairment Scale /23


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