PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
권호 표지
DOI QR코드

DOI QR Code

A Comparison of Lower Limb Muscle Activity Affecting Sit-to-Stand Movement of Stroke Patients

뇌졸중 환자의 앉은 자세에서 일어서기 동작 수행에 영향을 주는 다리 근 활성 비교

  • Park, In-Seok (Department of Physical Therapy, College of Health and Welfare, Silla University) ;
  • Ju, Sung-Kwang (Department of Physical Therapy, Keunsol Hospital)
  • 박인석 (신라대학교 물리치료학과) ;
  • 주성광 (큰솔병원 물리치료실)
  • Received : 2017.11.13
  • Accepted : 2018.02.20
  • Published : 2018.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aimed (1) to identify asymmetry observed in electromyography (EMG) activity patterns of lower limb muscles between affected and unaffected sides of stroke patients during sit to stand (STS) movement and (2) to identify the muscles of the paretic lower limb that affected STS performance in stroke patients. Methods: This study consisted of 27 patients (15 males and 12 females) with poststroke hemiparesis. The activation of the rectus femoris (RF), tibialis anterior (TA), and gastrocnemius (GCM) of the affected side and unaffected side during STS movement were recorded using surface EMG. In addition, EMG lower limb muscle activation patterns were measured in the all section, pre-thigh off (pre-TO), and post-thigh off (post-TO) section. All measurements were obtained during five repetitions of the STS (FTSTS) movement. An independent t-test was performed to compare the affected side and unaffected side of the lower limb during the STS movement. A stepwise linear regression analysis was conducted to identify the muscles that affected STS performance. Results: Activation of both the RF and TA significantly affected the lower limb during the STS movement (p<0.05). Two muscles showed a difference on the post-TO section. The results of the stepwise multiple regression analysis showed that the RF and TA muscles of the affected lower limb were affected in FTSTS. Conclusion: These results provide a basis for reinforcement training, focusing on the RF and TA muscles of the affected side of stroke patients to improve asymmetric movement and performance in STS movement.

Keywords

References

  1. Belgen B, Beninato M, Sullivan PE, et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Archives of Physical Medicine and Rehabilitation. 2006;87(4):554-561. https://doi.org/10.1016/j.apmr.2005.12.027
  2. Bohannon RW. Knee extension strength and body weight determine sit-to-stand independence after stroke. Physiotherapy Theory and Practice. 2007;23(5):291-297. https://doi.org/10.1080/09593980701209428
  3. Brunt D, Liu S-M, Trimble M, et al. Principles underlying the organization of movement initiation from quiet stance. Gait and Posture. 1999;10(2):121-128. https://doi.org/10.1016/S0966-6362(99)00020-X
  4. Cameron DM, Bohannon RW, Garrett GE, et al. Physical impairments related to kinetic energy during sit-to-stand and curb-climbing following stroke. Clinical Biomechanics. 2003;18(4):332-340. https://doi.org/10.1016/S0268-0033(03)00023-8
  5. Carr JH, Shepherd RB. Stroke rehabilitation: guidelines for exercise and training to optimize motor skill. Edinburgh. Butterworth-Heinemann Medical. 2003.
  6. Cheng PT, Chen CL, Wang CM, et al. Leg muscle activation patterns of sit-to-stand movement in stroke patients. American Journal of Physical Medicine & Rehabilitation. 2004;83(1):10-16. https://doi.org/10.1097/01.PHM.0000104665.34557.56
  7. Chou SW, Wong AM, Leong CP, et al. Postural control during sit-to stand and gait in stroke patients. American Journal of Physical Medicine & Rehabilitation. 2003;82(1):42-47. https://doi.org/10.1097/00002060-200301000-00007
  8. Csuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strength. The American Journal of Medicine. 1985;78(1):77-81.
  9. Demura S, Sato S, Minami M, et al. Gender and age differences in basic ADL ability on the elderly: comparison between the independent and the dependent elderly. Journal of Physiological Anthropology and Applied Human Science. 2003;22(1):19-27. https://doi.org/10.2114/jpa.22.19
  10. Dickstein R, Shefi S, Marcovitz E, et al. Electromyographic activity of voluntarily activated trunk flexor and extensor muscles in post-stroke hemiparetic subjects. Clinical Neurophysiology. 2004; 115(4):790-796. https://doi.org/10.1016/j.clinph.2003.11.018
  11. Eriksrud O, Bohannon RW. Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. Physical Therapy. 2003;83(6):544-551.
  12. Goulart F, Valls-Sole J. Patterned electromyographic activity in the sit-to-stand movement. Clinical Neurophysiology. 1999;110(9):1634-1640. https://doi.org/10.1016/S1388-2457(99)00109-1
  13. Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology. 1994;49(2):M85-94. https://doi.org/10.1093/geronj/49.2.M85
  14. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for SEMG sensors and sensor placement procedures. Journal of Electromyography and Kinesiology. 2000;10(5):361-374. https://doi.org/10.1016/S1050-6411(00)00027-4
  15. Lee M, Wong M, Tang F, et al. Comparison of balance responses and motor patterns during sit-to-stand task with functional mobility in stroke patients1. American Journal of Physical Medicine & Rehabilitation. 1997;76(5):401-410. https://doi.org/10.1097/00002060-199709000-00011
  16. Lee MY, Wong MK, Tang FT, et al. Comparison of balance responses and motor patterns during sit-to-stand task with functional mobility in stroke patients. American Journal of Physical Medicine & Rehabilitation. 1997;76(5):401-410. https://doi.org/10.1097/00002060-199709000-00011
  17. Lee SH, Yoo WG. Comparison of the tibialis anterior and soleus muscles isolation ratios during the sit-to-stand movement in elderly people. Journal of Physical Therapy Science. 2017;29(6):1019-1020. https://doi.org/10.1589/jpts.29.1019
  18. Lomaglio MJ, Eng JJ. Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke. Gait and posture. 2005;22(2):126-131. https://doi.org/10.1016/j.gaitpost.2004.08.002
  19. Millington PJ, Myklebust BM, Shambes GM. Biomechanical analysis of the sit-to-stand motion in elderly persons. Archives of Physical Medicine and Rehabilitation. 1992;73(7):609-617.
  20. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Archives of Physical Medicine and Rehabilitation. 2010;91(3):407-413. https://doi.org/10.1016/j.apmr.2009.10.030
  21. Ouellette MM, LeBrasseur NK, Bean JF, et al. High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors. Stroke. 2004;35(6):1404-1409. https://doi.org/10.1161/01.STR.0000127785.73065.34
  22. Park HJ, Oh DW, Choi SJ, et al. Study on asymmetrical EMG activation pattern of selected trunk and thigh muscles on gait velocity of individuals with post-stroke hemiparesis during sit-to-stand movement. Physical Therapy Korea. 2012:19(2);29-38. https://doi.org/10.12674/ptk.2012.19.2.029
  23. Patterson KK, Parafianowicz I, Danells CJ, et al. Gait asymmetry in community-ambulating stroke survivors. Archives of Physical Medicine and Rehabilitation. 2008;89(2):304-310. https://doi.org/10.1016/j.apmr.2007.08.142
  24. Prudente C, Rodrigues-de-Paula F, Faria CD. Lower limb muscle activation during the sit-to-stand task in subjects who have had a stroke. American Journal of Physical Medicine & Rehabilitation. 2013;92(8):666-675. https://doi.org/10.1097/PHM.0b013e318282c87a
  25. Schenkman M, Berger RA, Riley PO, et al. Whole-body movements during to standing from sitting. Physical Therapy. 1990;70(10):638-648. https://doi.org/10.1093/ptj/70.10.638
  26. Thielman G, Kaminski T, Gentile AM. Rehabilitation of reaching after stroke: comparing 2 training protocols utilizing trunk restraint. Neurorehabilitation and Neural Repair. 2008;22(6):697-705. https://doi.org/10.1177/1545968308315998