Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Effects of Vibration Stimulation Method on Upper Limbs Spasticity in Patients with Brain Lesion

진동자극 방식이 뇌병변 환자의 상지경직에 미치는 영향

  • 배세현 (광주희망병원 물리치료실) ;
  • 김경윤 (동신대학교 물리치료학과)
  • Received : 2011.05.24
  • Accepted : 2011.07.07
  • Published : 2011.07.31
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Abstract

We studied the effects of vibration stimulation method on upper limbs spasticity in patients with brain lesion. 21 patients with spasticity of the upper limbs selected and divided randomly 3 groups. And then vibratory stimulation was applied to the triceps brachii muscle in group I(n=7), to biceps brachii muscle in group II (n=7), and to both muscles in group III (n=7). Using Neuro-EMG_Micro to investigate the changes in spinal neuronal excitability, F-waves were measured at before and directly after stimulation, and 10 minutes later and 20 minutes later after stimulation especially. MAS(Modified Ashworth Scale) test for muscle tone and MFT(Manual Function Test) for the upper extremity motor function were performed before stimulation and 20 minutes later after stimulation for the purpose of clinical evaluation. In our study, MAS was significant decreased in all groups, F wave and F/M ratio parameters were decreased in all groups and more decreased specially in group III. MFT was increased in group II and III, and more increased specially in group III. Vibration stimulation reduced the neuronal excitability of spinal cord and also muscle tone, and improved the motor function of the upper extremity. These results suggested that vibration stimulation giving to both muscles(triceps and biceps brachii muscle) at the same time was more efficiency in reducing the neuronal excitability of spinal cord and improving the motor function of the upper limbs.

본 연구는 뇌병변으로 상지경직이 관찰되는 환자를 대상으로 자극방식에 따른 진동자극이 경직에 미치는 영향에 대하여 알아보고자 하였다. 뇌병변으로 인해 상지경직이 있는 21명의 환자가 연구에 참여하였고, 실험군 I: 길항근(상완삼두근)자극, 실험군II: 주동근(상완이두근)자극, 실험군III: 동시(상완삼두근 및 상완이두근)자극에 각 7명씩을 배정하여 진동자극을 실시하였다. 척수운동신경원 흥분성을 알아보기 위해 Neuro-EMG_Micro를 이용한 F파를 자극전, 자극 직후, 자극 10분 후, 자극 20분 후에 측정하였고, 임상적 평가로는 MAS(Modified Ashworth Scale)와 MFT(Manual Function Test)를 자극 전, 자극 20분 후에 평가하였다. 본 연구의 결과, MAS는 세군 모두 유의한 감소를 나타냈고, F파 진폭 및 F/M비에서는 세군 모두에서 자극 직후에서부터 유의한 감소를 나타냈으며, 실험군III에서 시간 경과상 변화량이 가장 크게 나타났다. MFT에서는 실험군II와 III에서 유의한 증가를 나타냈으며 특히, 실험군III에서 기능적 변화량이 가장 크게 나타났다. 이러한 결과는 경직근에 대한 진동자극시 경직 주동근이나 길항근에 대한 단일 자극 방식보다는 동시자극 방식이 척수운동신경원의 흥분성 감소 및 상지 운동 기능 향상에 더 효과적임을 확인할 수 있었다.

Keywords

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