뇌졸중 후 편마비 환자의 Global Synkinesis 수준이 보행능력에 미치는 영향

The Effects of Global Synkinesis Level on Gait Ability in Post-Stroke Hemiplegic Patients

  • 임재헌 (화순전남대학교병원 물리치료실) ;
  • 임영은 (동신대학교 대학원 물리치료) ;
  • 김수현 (동신대학교 대학원 물리치료) ;
  • 박경순 (충남대학교병원 물리치료실) ;
  • 김태열 (동신대학교 보건복지대학 물리치료학과)
  • Lim, Jae-Heon (Department of Physical Therapy, Chon nam National University Hawsun Hospital) ;
  • Lim, Young-Eun (Department of Physical Therapy, Graduate School of Donshin University) ;
  • Kim, Su-Hyon (Department of Physical Therapy, Graduate School of Donshin University) ;
  • Park, Kyeong-Soon (Department of Physical Therapy, Chungnam National University Hospital) ;
  • Kim, Tae-Youl (Department of Physical Therapy, College of Public Health and Welfare, Donshin University)
  • 발행 : 2008.09.25

초록

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

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