The Journal of Korean Physical Therapy

  • 제21권2호
  • /
  • Pages.1-8
  • /
  • 2009
  • /
  • 1229-0475(pISSN)
  • /
  • 2287-156X(eISSN)
대한물리치료학회 (The Korean Society of Physical Therapy)
권호 표지

근전도 유발 신경근 전기자극치료가 뇌졸중 환자의 상지기능에 미치는 효과

The Effect of EMG-stim on Upper Limb Function in Chronic Stroke Patients

  • 조인술 (대구대학교 대학원 재활과학과) ;
  • 장종성 (대구대학교 대학원 재활과학과) ;
  • 김경 (대구대학교 재활과학대학 물리치료학과) ;
  • 김욱로 (영남대학교 의과대학 재활의학교실) ;
  • 박래준 (대구대학교 대학원 재활과학과)
  • Cho, In-Sul (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Chang, Jong-Sung (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kim, Kyoung (Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University) ;
  • Kim, Wook-Ro (Department of Rehabilitation Medicine, College of Medicine, Yeungnam University) ;
  • Park, Rae-Joon (Department of Rehabilitation Science, Graduate School, Daegu University)
  • 투고 : 2009.04.27
  • 심사 : 2009.05.29
  • 발행 : 2009.06.25
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study examined the effect of EMG-stim related to the functional recovery of the upper extremity in chronic stroke patients with an intensive massed practice protocol. Methods: The subjects were assigned randomly to either the EMG-stim group (n=10) or sham treatment group (n=10). Both groups received conventional physical therapy, occupational therapy and FES, five times per week over a four week period. In the EMG-stim group, EMG-stim was applied to the hemiplegic wrist and finger extensors for 2 sessions for 30 minutes per day, 5 times per week over a 4 week period. As the pre- and the post-test, the following four motor tests were assessed as the function of the upper extremity clinical functional test: extensor digitorum strength test, Box and Block test, Fugl-Mayer Assessment, and Jebson-Taylor Hand Function Test. Results: In the Box and Block test and Fugl-Mayer Assessment, there were statistically significant differences between both groups as well as between pre- and post-test. The extensor digitorum and wrist extensor strength were similar in both groups. In the Jebson-Taylor Hand Function Test, there was a significant difference in simulated page turning but not in the other subtests. Conclusion: Intensive massed practice with EMG-stim intervention applied to the hemiplegic upper extremity is an effective therapeutic method for chronic stroke patients. However, a variety of intervention methods designed for stroke patients in clinical settings are needed.

키워드

참고문헌

  1. Jorgensen HS, Nakayama H, Raaschou HO et al. Outcome and time course of recovery in stroke. Part II: Time course of recovery. The copenhagen stroke study. Arch Phys Med Rehabil. 1995;76(5):406-12. https://doi.org/10.1016/S0003-9993(95)80568-0
  2. Feys HM, De Weerdt WJ, Selz BE et al. Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: A single‐blind, randomized, controlled multicenter trial. Stroke. 1998;29(4):785-92. https://doi.org/10.1161/01.STR.29.4.785
  3. Cooper BY, Glendinning DS, Vierck CJ. Finger movement deficits in the stumptail macaque following lesions of the fasciculus cuneatus. Somatosens Mot Res. 1993;10(1):17-29. https://doi.org/10.3109/08990229309028820
  4. Chollet F, DiPiero V, Wise RJ et al. The functional anatomy of motor recovery after stroke in humans: A study with positron emission tomography. Ann Neurol. 1991;29(1):63-71. https://doi.org/10.1002/ana.410290112
  5. Armagan O, Tascioglu F, Oner C. Electromyographic biofeedback in the treatment of the hemiplegic hand: A placebo-controlled study. Am J Phys Med Rehabil. 2003;82(11):856-61. https://doi.org/10.1097/01.PHM.0000091984.72486.E0
  6. Chung YJ, Cho SH, Lee YH. Effect of the knee joint tracking training in closed kinetic chain condition for stroke patients. Restor Neurol Neurosci. 2006;24(3):173-80.
  7. Lee MK, Kim JM, Kim WH. The effects of pnf leg patterns on activation of biceps and triceps in stroke patients. J Kor Soc Phys Ther. 2009;21(1):1-7. https://doi.org/10.1589/jpts.21.1
  8. Szaflarski JP, Page SJ, Kissela BM et al. Cortical reorganization following modified constraint‐induced movement therapy: A study of 4 patients with chronic stroke. Arch Phys Med Rehabil. 2006;87(8):1052-8. https://doi.org/10.1016/j.apmr.2006.04.018
  9. Bolton DA, Cauraugh JH, Hausenblas HA. Electromyogramtriggered neuromuscular stimulation and stroke motor recovery of arm/hand functions: A meta‐analysis. J Neurol Sci. 2004;223(2):121-7. https://doi.org/10.1016/j.jns.2004.05.005
  10. Park RJ, Oh JR. The effect of functional electrical stimulation on sitting balance in cerebral palsy. J Kor Soc Phys Ther. 2002;14(4):204-13.
  11. Ghez C, Gordon J, Ghilardi M et al. Contribution of vision and proprioception to accuracy in limb movement In: Gazzaniga M, eds, The cognitive neuroscience Boston, Massachusetts Institute of Technology, 1995.
  12. Chae J, Yu DT. Neuromuscular electrical stimulation for motor restoration in hemiparesis. Top Stroke Rehabil. 2002;8(4):24-39. https://doi.org/10.1310/REXB-AKV9-2XBE-U5QA
  13. Powell J, Pandyan AD, Granat M et al. Electrical stimulation of wrist extensors in poststroke hemiplegia. Stroke. 1999;30(7):1384-9. https://doi.org/10.1161/01.STR.30.7.1384
  14. Cauraugh J, Light K, Kim S et al. Chronic motor dysfunction after stroke: Recovering wrist and finger extension by electromyography-triggered neuromuscular stimulation. Stroke. 2000;31(6):1360-4. https://doi.org/10.1161/01.STR.31.6.1360
  15. de Kroon JR, MJ IJ. Electrical stimulation of the upper extremity in stroke: Cyclic versus emg-triggered stimulation. Clin Rehabil. 2008;22(8):690-7. https://doi.org/10.1177/0269215508088984
  16. Gregson JM, Leathley MJ, Moore AP et al. Reliability of measurements of muscle tone and muscle power in stroke patients. Age Ageing. 2000;29(3):223-8. https://doi.org/10.1093/ageing/29.3.223
  17. Cromwell FS. Occupational therapist's manual for basic skill assessment: Primary prevocational evaluation. CA, Fair Oaks printing, 1976.
  18. Mathiowetz V, Volland G, Kashman N et al. Adult norms for the box and block test of manual dexterity. Am J Occup Ther. 1985;39(6):386-91. https://doi.org/10.5014/ajot.39.6.386
  19. Chai KJ, Lee HS. Assessment of upper extremity function in normal korean adults by manual function test. J Kor Soc Occup Ther. 1997;5(1):52-7.
  20. Fugl-Meyer AR, Jaasko L, Leyman I et al. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31. https://doi.org/10.3109/03009746109165143
  21. Duncan PW, Propst M, Nelson SG. Reliability of the fuglmeyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther. 1983;63(10):1606-10.
  22. Jebsen RH, Taylor N, Trieschmann RB et al. An objective and standardized test of hand function. Arch Phys Med Rehabil. 1969;50(6):311-9.
  23. Carey JR, Anderson KM, Kimberley TJ et al. Fmri analysis of ankle movement tracking training in subject with stroke. Exp Brain Res. 2004;154(3):281-90. https://doi.org/10.1007/s00221-003-1662-7
  24. Francisco G, Chae J, Chawla H et al. Electromyogramtriggered neuromuscular stimulation for improving the arm function of acute stroke survivors: A randomized pilot study. Arch Phys Med Rehabil. 1998;79(5):570-5. https://doi.org/10.1016/S0003-9993(98)90074-0
  25. Sheffler LR, Chae J. Neuromuscular electrical stimulation in neurorehabilitation. Muscle Nerve. 2007;35(5):562-90. https://doi.org/10.1002/mus.20758
  26. Inglis J, Donald MW, Monga TN et al. Electromyographic biofeedback and physical therapy of the hemiplegic upper limb. Arch Phys Med Rehabil. 1984;65(12):755-9.
  27. Jang SH, Kim YH, Cho SH et al. Cortical reorganization associated with motor recovery in hemiparetic stroke patients. Neuroreport. 2003;14(10):1305-10. https://doi.org/10.1097/00001756-200307180-00004
  28. Kwon YH, Lee MY, Park JW et al. Differences of cortical activation pattern between cortical and corona radiata infarct. Neurosci Lett. 2007;417(2):138-42. https://doi.org/10.1016/j.neulet.2007.01.084
  29. Bonifer NM, Anderson KM, Arciniegas DB. Constraintinduced therapy for moderate chronic upper extremity impairment after stroke. Brain Inj. 2005;19(5):323-30. https://doi.org/10.1080/02699050400004302
  30. Tarkka IM, Pitkanen K, Sivenius J. Paretic hand rehabilitation with constraint-induced movement therapy after stroke. Am J Phys Med Rehabil. 2005;84(7):501-5. https://doi.org/10.1097/01.phm.0000166881.71097.9d
  31. Shin HK, Cho SH, Jeon HS et al. Cortical effect and functional recovery by the electromyography-triggered neuromuscular stimulation in chronic stroke patients. Neurosci Lett. 2008;442(3):174-9. https://doi.org/10.1016/j.neulet.2008.07.026