DOI QR코드

DOI QR Code

Kinematic Analysis in Reaching Depending on the Localized Vibration Duration in Persons With Hemiparetic Stroke

국소 진동자극이 편마비 뇌졸중 환자의 팔 뻗기 수행에 미치는 영향에 대한 운동학적 분석

  • Yoo, Eun-Young (Dept. of Occupational Therapy, College of Health Science, Yonsei University) ;
  • Park, Ji-Hyuk (Dept. of Occupational Therapy, College of Health Science, Yonsei University) ;
  • Kwon, Jae-Sung (Dept. of Occupational Therapy, Cheongju University) ;
  • Cho, Sang-Yoon (Dept. of Occupational Therapy, Seoul Metropolitan Children's Hospital) ;
  • Lee, Bo-Mi (Dept. of Long term care, National Health Insurance Corporation) ;
  • Kim, Yeong-Jo (Jechon Danyang Branch, Daejeon Local Headquarter, National Health Insurance Corporation) ;
  • Kim, Jae-Nam (Dept. of Rehabilitation Medicine, Seoul National University Hospital) ;
  • Kim, Sun-Ho (Dept. of Occupational Therapy, Youngkwang Hospital)
  • 유은영 (연세대학교 보건과학대학 작업치료학과) ;
  • 박지혁 (연세대학교 보건과학대학 작업치료학과) ;
  • 권재성 (청주대학교 보건의료대학 작업치료학과) ;
  • 조상윤 (서울특별시 어린이병원 작업치료실) ;
  • 이보미 (국민건강보험공단) ;
  • 김영조 (국민건강보험공단) ;
  • 김재남 (서울대학교병원 재활의학과) ;
  • 김선호 (영광병원 작업치료실)
  • Received : 2018.07.11
  • Accepted : 2018.08.14
  • Published : 2018.08.31

Abstract

Objective : Localized vibration has been shown to have a positive effect on recovery of upper-limb motor function in patients with hemiparetic stroke, but there has been little research on kinematic analysis for qualitative changes in movement. This study investigated kinematic changes in elbow motion during reaching after localized vibration in persons with hemiparetic stroke. Methods : This study used a one-group, cross-over trial design. Ten chronic stroke patients randomly received localized vibrations on the affected biceps brachii for 5, 10, or 20 min, at 70 Hz. Kinematic analysis of reaching was measured using a 3-D motion analysis system. Variables included peak angular velocity, time to peak angular velocity, and movement units during elbow motion. Result : Affected side elbow motion during reaching was faster, smoother, and more efficient after 20 min localized vibration. Peak angular velocity increased (p<0.05), and time to peak angular velocity (p<0.05) and the movement unit were significantly decreased (p<0.05) during elbow motion for reaching. Conclusion : Localized vibration can improve kinematic components during reaching motion in persons with hemiparetic stroke.

목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 환측 상지에 진동자극을 적용했을 때, 팔 뻗기 수행에서 나타나는 팔꿈치 움직임의 운동학적 변화를 관찰하기 위함이다. 연구방법 : 연구 설계는 단일집단 교차실험설계(one-group cross-over trial design)를 사용하였으며, 10명의 만성 뇌졸중 환자를 대상으로 하였다. 대상자의 환측 위팔두갈래근(biceps brachii)에 국소 진동자극을 5분, 10분, 20분 동안 무작위로 70Hz로 적용한 후, 3차원 동작분석 시스템을 통해 팔 뻗기 수행의 운동학적 움직임을 분석하였다. 종속변수에는 팔꿈치 움직임에서 나타나는 최대 각 속도, 최대 각속도까지의 시간, 움직임 단위를 포함하였다. 결과 : 팔 뻗기를 수행함에 있어서 팔꿈치의 움직임은 20분 동안 국소 진동자극을 적용하였을 때 보다 빠르고 부드러워졌으며, 효율적으로 나타났다. 팔꿈치 움직임의 최대 각속도는 증가하였고(p<0.05), 최대 각속도까지의 시간과 운동단위는 유의하게 감소하였다(p<0.05). 결론 : 국소 진동자극은 편마비 뇌졸중 환자가 팔 뻗기 움직임을 수행함에 있어 발생하는 운동학적 구성요소를 향상시킬 수 있는 효과적인 방법일 될 수 있다.

References

  1. Albert, F., Bergenheim, M., Ribot-Ciscar, E., & Roll, J. P. (2006). The Ia afferent feedback of a given movement evokes the illusion of the same movement when returned to the subject via muscle tendon vibration. Experimental Brain Research, 172, 163-174. https://doi.org/10.1007/s00221-005-0325-2
  2. Aziz, Q., Thompson, D. G., Ng, V. W., Hamdy, S., Sarkar, S., Brammer, M. J., ... Williams, S. C. (2000). Cortical processing of human somatic and visceral sensation. Journal of Neuroscience, 20, 2657-2663. https://doi.org/10.1523/JNEUROSCI.20-07-02657.2000
  3. Bosco, C., Colli, R., Introini, E., Cardinale, M., Tsarpela, O., Madella, A., ... Viru, A. (1999). Adaptive responses of human skeletal muscle to vibration exposure. Clinical Physiology, 19, 183-187. doi:10.1046/j.1365-2281.1999.00155.x
  4. Caliandro, P., Celletti, C., Padua, L., Minciotti, I., Russo, G., Granata, G., ... Camerota, F. (2012). Focal muscle vibration in the treatment of upper limb spasticity: A pilot randomized controlled trial in patients with chronic stroke. Archives of Physical Medicine and Rehabilitation, 93, 1656-1661. doi:10.1016/j.apmr.2012.04.002
  5. Carr, J., & Shepherd, R. (2003). Stroke rehabilitation: Guidelines for exercise and training to optimize motor skill. Oxford, London: Butterworth Heinemann.
  6. Celik, O., O'Malley, M. K., Gillespie, R. B., Shewokis, P. A., & Contreras-Vidal, J. L. (2009). Compact and low-cost tendon vibrator for inducing proprioceptive illusions. The Third Joint Eurohaptics Conference and Symposium on Haptic Interfaces for Virtual Environment and Teleoperation Systems. Salt Lake City, UT: IEEE.
  7. Christova, M., Rafolt, D., Mayr, W., Wilfling, B., & Gallasch, E. (2010). Vibration stimulation during non-fatiguing tonic contractiion induces outlasting neuroplastic effects. Journal of Electromyography and Kinesiology, 20, 627-635. doi:10.1016/j.jelekin.2010.03.001
  8. Conrad, M., Scheidt, R., & Schmit, B. (2011). Effects of wrist tendon vibration on arm tracking in people poststroke. Journal of Neurophysiology, 106, 1480-1488. doi:10.1152/jn.00404.2010
  9. Forner-Cordero, A., Steyvers, M., Levin, O., Alaerts, K., & Swinnen, S. P. (2008). Changes in corticomotor excitability following prolonged muscle tendon vibration. Behavioural Brain Research, 190(1), 41-49. doi:10.1016/j.bbr.2008.02.019
  10. Gasser-Wieland, T. L., & Rice, M. S. (2002). Occupational embeddedness during a reaching and placing task with survivors of cerebral vascular accident. OTJR: Occupation, Participation and Health, 22, 153-160. https://doi.org/10.1177/153944920202200404
  11. Griffin, M. J. (2004). Minimum health and safety requirements for workers exposed to hand-transmitted vibration and whole-body vibration in the European Union: A review. Journal of Occupational Environmental Medicine, 61, 387-397. doi:10.1136/oem.2002.006304
  12. Heidi Mchugh, P., & Winifred, S. (2011). Pedretti's occupational therapy: Practice skills for physical dysfunction (7th ed). St. Louis, MO: Mosby.
  13. Kamper, D. G., George Hornby, T., & Rymer, W. Z. (2002). Extrinsic flexor muscles generate concurrent flexion of all three finger joints. Journal of Biomechanics, 35, 1581-1589. https://doi.org/10.1016/S0021-9290(02)00229-4
  14. Kwon, J. S. (2013). Effects of wrist tendon vibration on upper limb function during performance task post-stroke (Doctoral dissertation). Yonsei University, Korea.
  15. Luke, C., Dodd, K., & Brock, K. (2004). Outcomes of the Bobath concept on upper limb recovery following stroke. Clinical Rehabilitation, 18, 888-898. doi:10.1191/0269215504cr793oa
  16. Maitra, A., Adsay, N. V., Argani, P., Iacovuzio-Donahue, C., De Marzo, A., Cameron, J. L., ... Hruban, R. H. (2003). Multicomponent analysis of the pancreatic adenocarcinoma progression model using a pancreatic intraepithelial neoplasia tissue microarray. Modern Pathology, 16, 902-912. https://doi.org/10.1097/01.MP.0000086072.56290.FB
  17. Maldian, J. A., Gottschalk, A., Patel, R. S., Detre, J. A., & Alsop, D. C. (1999). The sensory somatotopic map of the human hand demonstrated at 4 Tesla. NeuroImage, 10, 55-62. https://doi.org/10.1006/nimg.1999.0448
  18. Marconi, B., Filippi, G. M., Koch, G., Giacobbe, V., Pecchioli, C., Versace, V., ... Caltagirone, C. (2011). Long-term effects on cortical excitability and motor recovery induced by repeated muscle vibration in chronic stroke patients. Neurorehabilitation and Neural Repair, 25, 48-60. doi:10.1177/1545968310376757
  19. Noma, T., Matsumoto, S., Etoh, S., Shimodozono, M., & Kawahira, K. (2009). Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscle of hemiplegic limbs in post-stroke patients. Brain Injury, 23, 623-631. doi:10.1080/02699050902997896
  20. Park, J. H., Yoo, E. Y., Chung, B. I., & Jung, M. Y. (2009). Effects of vocalization on elbow motion during reaching in persons with hemiparetic stroke. NeuroRehabilitation, 25, 123-128. doi:10.3233/NRE-2009-0507
  21. Rice, M., Alaimo, A., & Cook, J. (1999). Movement dynamics and occupational embeddedness in a grasping and placing task. Occupational Therapy International, 6, 298-310. doi:10.1002/oti.103
  22. Roelants, M., Verschueren, S., Delecluse, C., Levin, O., & Stijnen, V. (2006). Whole-body-vibration-induced increase in leg muscle activity during different squat exercises. Journal of Strength and Conditioning Research, 20, 124-129.
  23. Roll, J. P., Albert, F., Thyrion, C., Ribot-Ciscar, E., Bergenheim, M., & Mattei, B. (2009). Inducing any virtual two-dimensional movement in humans by applying muscle tendon vibration. Journal of Neurophysiology, 101, 816-823. doi:10.1152/jn.91075.2008
  24. Roll, J. P., Vedel, J. P., Ribot, E. (1989). Alteration of proprioceptive messages induced by tendon vibration in man: A microneurographic study. Experimental Brain Research, 76, 213-222. doi:10.1007/BF00253639
  25. Tavernese, E., Paoloni, M., Mangone, M., Mandic, V., Sale, P., Franceschini, M., & Santilli, V. (2013). Segmental muscle vibration improves reaching movement in patients with chronic stroke: A randomized controlled trial. NeuroRehabilitation, 32, 591-599. doi:10.3233/NRE-130881
  26. Zwecker, M., Levenkrohn, S., Fleisig, Y., Zeilig, G., Ohry, A., & Adunsky, A. (2002). Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: Relation to functional outcome of stroke patients. Archives of Physical Medicine and Rehabilitation, 83, 342-345. https://doi.org/10.1053/apmr.2002.29641