Korean Journal of Applied Biomechanics (한국운동역학회지)

Korean Society of Applied Biomechanics (한국운동역학회)
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Changes of Functional Performance Ability in Stroke Patients by Exercise Types I : Analysis of Lower Extremity Muscle Activity during Walking

운동유형별 뇌졸중 환자의 기능적 수행능력 변화 I : 보행시 하지근육 활성도 분석

  • Published : 2008.03.30
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Abstract

The purpose of this study was to compare and analyze the effects of exercise types on lower extremity muscle activity in stroke patients. For the purpose, the subjects of this study were classified into three groups such as therapeutic exercise group(n=7), elastic band group(n=7), and stretch reflex group(n=7). The three exercise programs were 5 times a week for 8 weeks. The stretch reflex group revealed higher in iliopsoas and biceps femoris %MVIC than the therapeutic exercise group and elastic band group, whereas elastic band group revealed lower in tibialis anterior %MVIC than therapeutic exercise group in the primary single-limb support. The stretch reflex group revealed higher in iliopsoas %MVIC than the therapeutic exercise group and elastic band group, whereas stretch reflex group revealed lower in medial gastrocnemius %MVIC than therapeutic exercise group in the secondary double support phase.

본 연구는 운동유형별 운동 전후 뇌졸중 환자의 보행시 하지근육 활성도의 차이를 비교 분석하여 임상에서 기능적 수행능력의 개선을 위한 효과적인 근력강화 방법을 제시하는데 그 목적이 있다. 이를 위하여 운동치료군, 탄성밴드군 및 신장반사군으로 구분하여 각각 7명씩 총 21명을 대상으로 하였고, 운동프로그램은 8주 동안 주 5회 실시하였다. 1차 단하지 지지기에서 장요근 및 대퇴이두근의 %MVIC는 신장반사군이 운동치료군과 탄성밴드군보다 높은 수준을 보였고, 반면 전경골근의 %MVIC는 탄성밴드군이 운동치료군보다 낮은 수준을 보였다. 2차 양하지 지지기에서 장요근의 %MVIC는 신장반사군이 운동치료군과 탄성밴드군보다 높은 수준을 보였고, 반면 내측 비복근의 %MVIC는 신장반사군이 운동치료군보다 낮은 수준을 보였다. 결론적으로 신장반사 운동은 운동치료와 탄성밴드를 이용한 근력강화 운동 보다 고관절의 안정성 및 하지 분절의 운동성을 제공하는 주요 근육의 활성도에 효과적인 영향을 미침으로써 임상에서 근 약화로 인한 운동 기능이 제한된 편마비 환자에게 실용적으로 접근할 수 있는 운동방법이라고 판단된다.

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References

  1. 김정태, 박성현 (2007). 팔걸이 착용시 편마비 환자의 보행 지지기 동안 하지 근육의 활성도에 미치는 영향. 한국체육학회지, 46(1), 713-722.
  2. 김현수, 김남정 (2003). 고무밴드 운동이 뇌졸중 환자의 일상활동체력에 미치는 효과. 한국체육학회지, 42(5), 649-655.
  3. 이재학, 함용운, 장수경 (1996). 측정 및 평가. 서울: 도서출판 대학서림.
  4. 채정병 (2006). 고유수용성 운동조절이 뇌졸중 환자의 균형 및 보행에 미치는 영향. 박사학위논문, 대구대학교 대학원.
  5. Baechle, T. R., & Earle, R. W. (1995). Fitness weight training. Champaign. IL: Human Kinetics.
  6. Baechle, T. R., & Earle, R. W. (2000). Essentials of strength training and conditioning, 2nd edition. Champaign, IL: Human Kinetics.
  7. Baechle, T. R., & Groves, B. R. (1998). Weight training steps to success, 2nd edition. Champaign, IL: Human Kinetics
  8. Bohannon, R. W., & Smith, M. B. (1987). Interrator reliability of modification ashworth scale of muscle spasticity. Physical Therapy, 67, 206-207.
  9. Bohannon, R. W., & Andrews, A. W. (1990). Correlation of knee extensor muscle torque and spasticity with gait speed in patients with stroke. Archives of Physical Medicine and Rehabilitation, 71, 330-333.
  10. Buchner, D. M., Larson, E. B., & Wagner, E. H. (1996). Evidence for a non-linear relationship between leg strength and gait speed. Age and Ageing, 25, 38-391.
  11. Burke, D., Hagbarth, K. E., & Lofstedt, L. (1978). Muscle spindle activity in man during shortening and lengthening contractions. The Journal of Physiology, 277, 131-142. https://doi.org/10.1113/jphysiol.1978.sp012265
  12. Carr, J. H., & Shepherd, R. B. (1985). Investigation of a new motor assessment scale for stroke patients, Physical Therapy, 65, 175-180.
  13. Carr, J. H., & Shepherd, R. B. (2004). Stroke rehabilitation: guidelines for exercise and training to optimize motor skill. Singapore, Elsevier.
  14. Edward, F. D., & Aldo, P. (1981). Anatomic guide for the electromyograph, 2nd edition. Springfield, Charles C Tomas.
  15. Fiatarone, M. A., Marks, E. C., & Ryan, N. D. (1990). High-intensity strength training in nonagenarians. The Journal of the American Medical Association, 263, 3029-3034. https://doi.org/10.1001/jama.263.22.3029
  16. Hakkinen, K., & Komi, P. V. (1981). Effect of different combined concentric and eccentric muscle work regimens on maximal strength development. Journal of Human Movement Study, 7, 33-44.
  17. Miller, G. J. T., & Light, K. E. (1997). Strength training in spastic hemiparesis: Should it be avoided?. Neurology and Rehabilitation, 9, 17-28.
  18. Olney, S. J., & Richard, C. (1996). Hemiplegic gait following stroke. Part I: Characteristics. Gait & Posture, 4, 134-148.
  19. Peat, M., Dubo, H. I., & Winter, D. A. (1976). Electromyographic temporal analysis of gait:Hemiplegic locomotion. Archives of Physical Medicine and Rehabilitation, 57, 421-425.
  20. Sackley, C. M., & Baguly, B. I. (1993). Visual feedback after stroke with balance performance monitor: Two single case studies. Clinical Rehabilitation, 7, 189-195. https://doi.org/10.1177/026921559300700302
  21. Scarborough, D. M., Krebs, D. E., & Harris, B. A. (1999). Quadriceps muscle strength and dynamic stability in elderly persons. Gait & Posture, 10, 10-20. https://doi.org/10.1016/S0966-6362(99)00018-1
  22. Sharp, S. A., & Brouwer, B. J. (1997). Isokinetic strength training of the hemiplegic knee:effects on function and spasticity. Archives of Physical Medicine and Rehabilitation, 78, 1231-1236. https://doi.org/10.1016/S0003-9993(97)90337-3
  23. Smith, G. V., Silver, K. H. C., & Goldberg, A. P. (1999). Task-oriented exercise improves hamstring strength and spastic reflexes in chronic stroke patients. Stroke, 30, 2112-2118 https://doi.org/10.1161/01.STR.30.10.2112
  24. Teixeira-Salmela, L. F., Olney, S. J., Nadeau, S., & Brouwer, B. B. (1999). Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors. Archives of Physical Medicine and Rehabilitation, 80, 1211-1218. https://doi.org/10.1016/S0003-9993(99)90018-7
  25. Teixeira-Salmela, L. F., Nadeau, S., McBride, I. & Olney, S. J. (2001). Effects of muscle strengthening and physical conditioning training on temporal, kinematic and kinetic variables during gait in chronic stroke survivors. Journal of Rehabilitation Medicine, 33, 53-60. https://doi.org/10.1080/165019701750098867