한국전문물리치료학회지 (Physical Therapy Korea)

  • 제20권4호
  • /
  • Pages.47-54
  • /
  • 2013
  • /
  • 1225-8962(pISSN)
  • /
  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
권호 표지
DOI QR코드

DOI QR Code

Effects on Ankle Dorsiflexor Activity to Active and Passive Perturbation Condition in Patients With Stroke

  • Yuk, Ji-Hyun (Dept. of Physical Therapy, The Health and Sports Graduated School, Daejeon University) ;
  • Choi, Jong-Duk (Dept. of Physical Therapy, College of Natural Science, Daejeon University)
  • 투고 : 2013.10.01
  • 심사 : 2013.11.12
  • 발행 : 2013.11.19
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The purpose of this study was to investigate the effects of active and passive postural perturbation on ankle dorsiflexor responses in stroke patients. The subjects consisted of 13 stroke patients. Using wireless electromyography, the patients' ankle dorsiflexor muscle responses were measured under the following conditions: active dorsiflexion (AD), active perturbation (AP), and passive perturbation (PP). Tibialis anterior muscle activity increased most significantly during PP of the affected side ($118.64{\pm}56.28$). The most significant increase for the non-affected side was in AD ($72.64{\pm}24.56$). Tibialis anterior muscle activity was compared under each condition. The affected side showed significant differences between PP and AD and between PP and AP (p<.05). The non-affected side showed not significant differences between each condition. The ratios of tibialis anterior muscle activity under AP to that under AD were 1.00 on the affected side and .75 on the non-affected side and the difference was not significant (p>.05). The ratios of tibialis anterior muscle activity under PP to that under AD were 3.30 on the affected side and 1.14 on the non-affected side and the difference was significant (p<.05). Passive perturbation improved tibialis anterior muscle activity on the affected side, and training based on this approach may have the potential to improve the ankle dorsiflexion of people with stroke.

키워드

참고문헌

  1. Blanchette A, Lambert S, Richards CL, et al. Walking while resisting a perturbation: Effects on ankle dorsiflexor activation during swing and potential for rehabilitation. Gait posture. 2011; 34(3):358-363. https://doi.org/10.1016/j.gaitpost.2011.06.001
  2. Bolgla LA, Uhl TL. Reliability of electromyographic normalization methods for evaluating the hip musculature. J Electromyogr Kinesiol. 2007;17(1): 102-111. https://doi.org/10.1016/j.jelekin.2005.11.007
  3. Ferber R, Osternig LR, Woollacott MH, et al. Reactive balance adjustments to unexpected perturbations during human walking. Gait posture. 2002;16(3):238-248. https://doi.org/10.1016/S0966-6362(02)00010-3
  4. Fortin K, Blanchette A, McFadyen BJ, et al. Effects of walking in a force field for varying durations on aftereffects and on next day performance. Exp Brain Res. 2009;199(2):145-155. https://doi.org/10.1007/s00221-009-1989-9
  5. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for semg sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-374. https://doi.org/10.1016/S1050-6411(00)00027-4
  6. Kaminski TW, Hartsell HD. Factors contributing to chronic ankle instability: A strength perspective. J Athl Train. 2002;37(4):394-405.
  7. Kao PC, Ferris DP. Motor adaptation during dorsiflexion-assisted walking with a powered orthosis. Gait posture. 2009;29(2):230-236. https://doi.org/10.1016/j.gaitpost.2008.08.014
  8. Kesar TM, Perumal R, Jancosko A, et al. Novel patterns of functional electrical stimulation have an immediate effect on dorsiflexor muscle function during gait for people poststroke. Phys Ther. 2010;90(1):55-66. https://doi.org/10.2522/ptj.20090140
  9. Kim SG. Effect of treadmill gradient training on lower limb muscle activity in chronic stroke patient. J Korea Acad Industr Coop Soc. 2012;13(1):220-226. https://doi.org/10.5762/KAIS.2012.13.1.220
  10. Kottink AI, Oostendorp LJ, Buurke JH, et al. The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: A systematic review. Artif Organs. 2004;28(6):577-586. https://doi.org/10.1111/j.1525-1594.2004.07310.x
  11. Lam T, Pauhl K, Krassioukov A, et al. Using robot-applied resistance to augment body-weight -supported treadmill training in an individual with incomplete spinal cord injury. Phys Ther. 2011;91(1):143-151. https://doi.org/10.2522/ptj.20100026
  12. Lamontagne A, Malouin F, Richards CL, et al. Mechanisms of disturbed motor control in ankle weakness during gait after stroke. Gait posture. 2002;15(3):244-255. https://doi.org/10.1016/S0966-6362(01)00190-4
  13. Lamontagne A, Stephenson JL, Fung J. Physiological evaluation of gait disturbances post stroke. Clin Neurophysiol. 2007;118(4):717-729. https://doi.org/10.1016/j.clinph.2006.12.013
  14. Lawrence ES, Coshall C, Dundas R, et al. Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001;32(6):1279-1284. https://doi.org/10.1161/01.STR.32.6.1279
  15. Lehmann JF, Condon SM, Price R, et al. Gait abnormalities in hemiplegia: Their correction by ankle-foot orthoses. Arch Phys Med Rehabil. 1987;68(11):763-771.
  16. Lyons GM, Sinkjaer T, Burridge JH, et al. A review of portable FES-based neural orthoses for the correction of drop foot. IEEE Trans Neural Syst Rehabil Eng. 2002;10(4):260-279. https://doi.org/10.1109/TNSRE.2002.806832
  17. Noble JW, Prentice SD. Adaptation to unilateral change in lower limb mechanical properties during human walking. Exp Brain Res. 2006;169(4): 482-495. https://doi.org/10.1007/s00221-005-0162-3
  18. Noel M, Fortin K, Bouyer LJ. Using an electrohydraulic ankle foot orthosis to study modifications in feedforward control during locomotor adaptation to force fields applied in stance. J Neuroeng Rehabil. 2009;6:16. https://doi.org/10.1186/1743-0003-6-16
  19. Perry J, Burnfield JM. Gait Analysis: Normal and pathological function. 2nd ed. Thorofare, NJ, Slack Inc., 2010;304-314.
  20. Reisman DS, McLean H, Bastian AJ. Split-belt treadmill training poststroke: A case study. J Neurol Phys Ther. 2010;34(4):202-207. https://doi.org/10.1097/NPT.0b013e3181fd5eab
  21. Richards CL, Malouin F, Dumas F, et al. The relationship of gait speed to clinical measures of function and muscle activations during recovery post-stroke. J Biomech. 1993;26(3):324.
  22. Rose KJ, Burns J, Wheeler DM, et al. Interventions for increasing ankle range of motion in patients with neuromuscular disease. Cochrane Database Syst Rev. 2010;17(2):CD006973.
  23. Sorensen KL, Hollands M, Patla E. The effects of human ankle muscle vibration on posture and balance during adaptive locomotion. Exp Brain Res. 2002;143(1):24-34. https://doi.org/10.1007/s00221-001-0962-z
  24. Teasell RW, Bhogal SK, Foley NC, et al. Gait retraining post stroke. Top Stroke Rehabil. 2003; 10(2):34-65.
  25. van Swigchem R, Weerdesteyn V, van Duijnhoven HJ, et al. Near-normal gait pattern with peroneal electrical stimulation as a neuroprosthesis in the chronic phase of stroke: A case report. Arch Phys Med Rehabil. 2011;92(2):320-324. https://doi.org/10.1016/j.apmr.2010.10.038