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Effect of the increased sympathetic outflow on the changes of muscle tone and central nervous system excitability in chronic stroke patients

만성 편마비 환자에 대한 교감신경 활동 강화가 근 긴장도와 중추신경흥분성 변화에 미치는 영향

  • Kang, Byeong-Kil (Dept. of Rehabilitation Medicine, Presbyterian Medical Center) ;
  • Nam, Ki-Won (Dept. of Physical Therapy, Dongshin University)
  • 강병길 (전주예수병원 재활의학과) ;
  • 남기원 (동신대학교 물리치료학과)
  • Received : 2011.10.11
  • Accepted : 2011.11.10
  • Published : 2011.11.30

Abstract

The purpose of this study was to investigate the effect of the increased sympathetic outflow on the changes of muscle tone and central nervous system excitability in the chronic stroke patients. This study was conducted from October 12th 2009 to December 4th 2009. 30 patients with chronic hemiplegia for at least 6 months were participated. Before and during the mental arithmetic, static handgrip and post-handgrip ischemia tasks, the central nervous system action potentials and global synkinesis level were compared. The central nerve action potentials were measured with H/Mmax ratio and V/Mmax ratio. To obtain global synkinesis level, surface electromyography data were digitized, processed to root mean square. In our study, The global synkinesis level during knee flexion and extension was decreased in the mental arithmetic and in the post-handgrip ischemia task(p<.05) but not in the grip task. Also, V/Mmax ratio was decreased all in the three task(p<.05). In conclusion, we know that the central nervous system excitability and the muscle tone in chronic hemiplegic patients were decreased by the increased sympathetic outflow.

본 연구는 만성 편마비 환자의 교감신경 활동 강화가 근 긴장도 및 중추신경 흥분성 변화에 미치는 영향을 알아보기 위해 시행하였다. 연구기간은 2009년 10월 12일부터 12월 4일까지 실시하였으며, 연구대상자는 발병 후 6개월 이상 된 만성 편마비 환자 30명을 대상으로 하였다. 실험은 교감신경 활동을 강화하는 세 가지 과제(암산, 정적인 상태에서 쥐기운동, 쥐기운동 후 허혈)를 실시하였으며 측정은 과제를 수행하기 전과 중의 global synkinesis 수준과 중추신경원 활동전위을 각각 측정하였다. 중추신경원 활동전위는 H/Mmax비, V/Mmax비를 측정하였고, global synkinesis 수준은 근전도 활동전위의 실효치 값을 측정하여 분석하였다. 본 연구에서, global synkinesis 수준은 정적인 상태에서 쥐기 과제를 제외한 나머지 과제(암산, 쥐기 후 허혈)에서 슬관절 굴곡, 신전 시 감소했다(p<.05). 또한 V/Mmax비에서는 세 가지 과제 모두에서 감소하였다(p<.05). 결론적으로, 교감신경 활동 강화는 만성 편마비 환자의 중추신경 흥분성과 근 긴장도를 감소시킴을 알 수 있었다.

Keywords

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