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Accelerometry of Unimanual and Bimanual Activities in Stroke Patients

뇌졸중 환자에서 한손 및 양손 활동 수행 시 가속도 분석

  • 이정은 ;
  • 김도영 (동서대학교 대학원 보건과학과) ;
  • 김태훈 (동서대학교 보건의료계열 작업치료학과)
  • Received : 2020.03.12
  • Accepted : 2020.04.08
  • Published : 2021.02.28

Abstract

Objective : This study evaluated the differences between the upper and lower arm activities of the affected and non-affected sides in stroke patients performing activities of daily living. It was intended to gather basic data for the measurement of daily activities. Methods : The participants in the study consisted of 20 patients, 10 had left hemiplegia and 10 had right hemiplegia. Between September and November 2017, they performed drinking and dressing as unimanual and bimanual tasks. The 3-axes accelerometers were placed 2cm below the lateral epicondyle on the upper arm and 2cm below the radial styloid on the lower arm. The data were collected at intervals of 1/32 Hz and analyzed. Results : In patients with right hemiplegia, the tendon activity was significantly higher in the lower arm when performing a bimanual activity (p<.05), for all the other activities, those of the lower arm were significantly higher than those of the upper arm (p<.01, p<.05). There was no significant difference between the unimanual and bimanual activities of the affected and tendon sides in patients with left hemiplegia (p>.05). In both hands, the activity of the lower arm was significantly higher than that of the activities of the upper and lower arms, except on the affected side (p<.05). In all patients, the activities of the upper and lower arms were significantly higher (p<.05), and the activity of the lower arm was significantly higher than that of the upper (p<.001, p<.05). Conclusion : The activity was higher on the non-affected side than the affected side during the dressing task, and the overall activity was higher in the lower arm than the upper arm.

목적 : 본 연구는 뇌졸중 환자가 한손 및 양손 활동을 수행하는 동안 가속도 측정을 통해 건측 및 환측, 위팔 및 아래팔의 활동량을 비교하여 일상생활활동의 정량적 측정도구로써 가속도계의 활용가능성을 제시하고자 한다. 연구방법 : 2017년 9월부터 11월까지 우측 편마비 환자 10명과 좌측 편마비 환자 10명을 대상으로 한손 활동과 양손 활동을 실시하였다. 한손 활동은 마시기로 건측과 환측을 따로 측정하였고, 양손 활동은 옷입기로 건측과 환측을 동시에 측정하였다. 삼축 가속도계를 위팔의 가쪽 위관절융기 아래 지점, 아래팔의 노뼈붓돌기 아래 지점에 착용하여 수행시간과 활동량을 측정하였다. 각 3회씩 반복 측정하여 평균값을 사용하였다. 결과 : 우측 편마비 환자에서는 양손 활동 수행 시 아래팔에서만 건측의 활동량이 유의하게 많았고(p<.05), 전체 활동에서 위팔보다 아래팔의 활동량이 유의하게 많았다(p<.01, p<.05). 좌측 편마비 환자에서 한손 활동과 양손 활동 수행 시 모두 환측과 건측의 활동량에 유의한 차이가 없었다(p>.05). 양손 활동 시 환측을 제외한 모든 활동에서 건측 및 환측의 위팔보다 아래팔의 활동량이 유의하게 많았다(p<.05). 전체 환자에서 양손 활동 수행 시 건측의 위팔과 아래팔의 활동량이 유의하게 많았고(p<.05), 전체 활동에서 위팔보다 아래팔의 활동량이 유의하게 많았다(p<.001, p<.05). 결론 : 삼축 가속도계로 위팔 및 아래팔의 활동량을 측정한 결과, 한손 및 양손 활동 수행 시 아래팔의 활동량이 위팔보다 많았고, 양손 활동 수행 시에는 건측의 활동량이 더 많았다.

Keywords

References

  1. Andrea, T., Mauro, D., Laura, V., Paolo, T., Michela, A., Carla, Z., ... Lamberto, P. (2013). Virtual reality for the rehabilitation of the upper limb motor function after stroke: A prospective controlled trial. Journal of NeuroEngineering and Rehabilitation, 10(85), 1-9. doi:10.1186/1743-0003-10-85
  2. Barbara, B., Fulvio, M., & Antonio, S. (2014, August). A public domain dataset for ADL recognition using wrist-placed accelerometers. The 23rd IEEE International Symposium on Robot and Human Interactive Communication, 738-743. doi:10.1109/ROMAN.2014.6926341
  3. Butler, E. E., Ladd, A. L., Louie, S. A., LaMont, L. E., Wong, W., & Rose, J. (2010). Three-dimensional kinematics of the upper limb during a reach and grasp cycle for children. Gait & Posture, 32(1), 72-77. doi:10.1016/j.gaitpost.2010.03.011
  4. Carolyn, L., Karen, J. D., & Kim, B. (2004). Outcomes of the bobath concept on upper limb recovery following stroke. Clinical Rehabilitation, 18(9), 888-898. doi:10.1191/0269215504cr793oa
  5. Chang, J. J., Tung, W. L., Wu, W. L., & Su, F. C. (2006). Effect of bilateral reaching on affected arm motor control in stroke-with and without loading on unaffected arm. Disability and Rehabilitation, 28(24), 1507-1516. doi:10.1080/09638280600646060
  6. de Kroon, J. R., IJzerman, M. J., Lankhorst, G. J., & Zilvold, G. (2004). Electrical stimulation of the upper limb in stroke: Stimulation of the extensors of the hand vs. alternate stimulation of flexors and extensors. American Journal of Physical Medicine & Rehabilitation, 83(8), 592-600. doi:10.1097/01.PHM.0000133435.61610.55
  7. de Niet, M., Bussmann, J. B., Ribbers, G. M., & Stam, H. J. (2007). The stroke upper-limb activity monitor: Its sensitivity to measure hemiplegic upper-limb activity during daily life. Archives of Physical Medicine and Rehabilitation, 88(9), 1121-1126. doi:10.1016/j.apmr.2007.06.005
  8. Francisco, G., Chae, J., Chawla, H., Kirshblum, S., Zorowitz, R., Lewis, G., & Pang, S. (1998). Electromyogram-triggered neuromuscular stimulation for improving the arm function of acute stroke survivors: A randomized pilot study. Archives of Physical Medicine and Rehabilitation, 79(5), 570-575. doi:10.1016/S0003-9993(98)90074-0
  9. Gardarsdottir, S., & Kaplan, S. (2002). Validity of the Arnadottir OT-ADL Neurobehavioral Evaluation (A-ONE): Performance in activities of daily living and neurobehavioral impairments of persons with left and right hemisphere damage. American Journal of Occupational Therapy, 56(5), 499-508. doi:10.5014/ajot.56.5.499
  10. Ham, M. Y., Choi, K. S., & Ryu, E. J. (2000). Analysis of nursing studies about stroke research in Korea. Korean Journal of Rehabilitation Nursing, 3(2), 141-153.
  11. Invernizzi, M., Negrini, S., Carda, S., Lanzotti, L., Cisari, C., & Baricich, A. (2013). The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients: A randomized controlled trial. European Journal of Physical and Rehabilitation Medicine, 49(3), 311-317.
  12. Jung, H. Y., Park, B. K., Shin, H. S., Kang, Y. K., Pyun, S. B., Paik, N. J., & Han, T. R. (2007). Development of the Korean version of Modified Barthel Index (K-MBI): Multi-center study for subjects with stroke. Journal of Korean Academy of Rehabilitation Medicine, 31(3), 283-297.
  13. Kang, J. W., & Park, J. H. (2017). A systematic review of assessment tools of activities of daily living for stroke patients. Therapeutic Science for Neurorehabilitation, 6(1), 11-28. doi:10.22683/tsnr.2017.6.2.011
  14. Kidd, D., Stewart, G., Baldry, J., Johnson, J., Rossiter, D., Petruckevitch, A., & Thompson, A. J. (1995). The Functional Independence Measure: A comparative validity and reliability study. Disability and Rehabilitation, 17(1), 10-14. doi:10.3109/09638289509166622
  15. Kim, D. Y., Hwang, I. H., Jeon, S. H., Bae, Y. H., & Kim, N. H. (2011). Estimating algorithm of physical activity energy expenditure and physical activity intensity using a tri-axial accelerometer. Rehabilitation Engineering and Assistive Technology Society of Korea, 5(1), 27-33.
  16. Kim, I. J., Im, S. M., Hong, E. N., Ahn, S. C., & Kim, H. G. (2007). ADL classification using triaxial accelerometers and RFID. International Conference on Ubiquitous Computing Convergence Technology. Retrieved from https://ieeexplore.ieee.org/xpl/conhome/4420216/proceeding
  17. Kim, T. H., & Park, K. H. (2014). Accelerometry of upper extremity during activities of daily living in healthy adults. Journal of Korean Society of Community Based Occupational Therapy, 4(1), 23-31.
  18. Law, M., Baptiste, S., McColl, M., Opzoomer, A., Polatajko, H., & Pollock, N. (1990). The Canadian Occupational Performance Measure: An outcome measure for occupational therapy. Canadian Journal of Occupational Therapy, 57(2), 82-87. doi:10.1177/000841749005700207
  19. Lee, C. Y., & Chang, M. Y. (2014). A survey on the activities of daily living training for occupational therapy in Korea. Journal of Korean Society of Occupational Therapy, 22(2), 35-46. doi:10.14519/jksot.2014.22.2.03
  20. Lee, J. H., Park, J. H., Kim, Y. J., Park, H. Y., & Park, J. H. (2016). A systematic review on accelerometer to measure activity of daily living of patients with stroke. Therapeutic Science for Neurorehabilitation, 5(2), 57-69. doi:10.22683/tsnr.2016.5.2.057
  21. Levine, P., & Page, S. J. (2004). Modified constraint-induced therapy: A promising restorative outpatient therapy. Topics in Stroke Rehabilitation, 11(4), 1-10. doi:10.1310/R4HN-51MW-JFYK-2JAN
  22. Liepert, J., Bauder, H., Miltner, W. H., Taub, E., & Weiller, C. (2000). Treatment-induced cortical reorganization after stroke in humans. Stroke, 31(6), 1210-1216. doi:10.1161/01.STR.31.6.1210
  23. Marco, F., Maria, G., Maurizio, A., Paola, C., Stefano, B., Valentina, D. A., ... Patrizio, S. (2012). Clinical relevance of action observation in upper-limb stroke rehabilitation: A possible role in recovery of functional dexterity. A randomized clinical trial. Neurorehabilitation and Neural Repair, 26(5), 456-462. doi:10.1177/1545968311427406
  24. Merritt. B. K. (2011). Validity of using the assessment of motor and process skills to determine the need for assistance. American Journal of Occupational Therapy, 65, 643-650. doi:19.5014/ajot.2011.000547 https://doi.org/10.5014/ajot.2011.000547
  25. Miller, E. L., Murray, L., Richards, L., Zorowitz, R. D., Bakas, T., Clark, P., & Billinger, S. A. (2010). Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient. Stroke, 41(10), 2402-2448. doi:10.1161/STR.0b013e3181e7512b
  26. Noorkoiv, M., Rodgers, H., & Price, C. I. (2014). Accelerometer measurement of upper extremity movement after stroke: A systematic review of clinical studies. Journal of Neuroengineering and Rehabilitation, 11(1), 1-11. doi:10.1186/1743-0003-11-144
  27. Pan, P., Lynch, K. M., Peshkin, M. A., & Colgate, J. E. (2004). Static single-arm force generation with kinematic constraints. Journal of Neurophysiology, 93, 2752-2765. doi:10.1152/jn.00799.2004
  28. Plamondon, R. (1995). A kinematic theory of rapid human movements. Biological Cybernetics, 72(4), 295-307. doi:10.1007/BF00202785
  29. Potgieser, A. R. E., & de Jong, B. M. (2011). Different distalproximal movement balances in right-and left-hand writing may hint at differential premotor cortex involvement. Human Movement Science, 30(6), 1072-1078. doi:10.1016/j.humov.2011.02.005
  30. Shumway-Cook, A., & Woollacott, M. H. (2007). Abnormal reach, grasp, and manipulation. In A., Shumway-Cook, & M. H. Woollacott (Eds.), Motor control: Translating research into clinical practice (3rd ed., pp. 468-492). Philadelphia, PA: Lippincott Williams & Wilkins.
  31. Taub, E., Miller, N. E., Novack, T. A., Cook, E. W., Fleming, W. C., Nepomuceno, C. S., ... Cargo, J. E. (1993). Technique to improve chronic motor deficit after stroke. Archives of Physical Medicine and Rehabilitation, 74(4), 347-354.
  32. Wijnroks, A., & Vermeer, A. (2002). Bimanual circle drawing in children with spastic hemiparesis: Effect of coupling modes on the performance of the impaired and unimpaired arms. Acta Psychologica, 110(2), 339-356. doi:10.1016/S0001-6918(02)00041-0
  33. Wu, C. Y., Yang, C. L., Lin, K. C., & Wu, L. L. (2013). Unilateral versus bilateral robot-assisted rehabilitation on arm-trunk control and functions post stroke: A randomized controlledtrial. Journal of Neuroengineering and Rehabilitation, 10(1), 1-10. doi:10.1186/1743-0003-10-35
  34. Wu, G., Van der Helm, F. C., Veeger, H. E., Makhsous, M., Van Roy, P., Anglin, C., & Werner, F. W. (2005). ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion-part II: Shoulder, elbow, wrist and hand. Journal of Biomechanics, 38(5), 981-992. doi:10.1016/j.jbiomech.2004.05.042