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

Abstract

Purpose:

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.

Methods:

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.

Results:

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.

Conclusion:

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.

์„œ๋ก 

๋‡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
Sex
โ€ƒMale 23 (45.10)
โ€ƒFemale 28 (57.90)
Diagnosis
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.

๊ฒฐ๊ณผ

์—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

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)
ํ•ญ๋ชฉ
1 Static sitting balance
์‹œ์ž‘์ž์„ธ
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
โ–ก
Total co-ordination 1 /6
Total Trunk Impairment Scale /23

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