DOI QR코드

DOI QR Code

The Effect of Types of Weight-Bearing Surfaces on Muscle Activities of Lower Limbs and Weight Distribution During Semi-Squat Movement of Patients With Hemiplegia

편마비 환자의 반 쪼그려 앉기(semi-squat)동작 시 양하지 지지면의 형태가 하지 근활성도와 체중분포에 미치는 영향

  • Yang, Yong-Pil (Dept. of Physical Therapy, The Graduate School, Hanseo University) ;
  • Roh, Jung-Suk (Dept. of Physical Therapy, Hanseo University)
  • 양용필 (한서대학교 대학원 물리치료학과) ;
  • 노정석 (한서대학교 물리치료학과)
  • Received : 2011.11.17
  • Accepted : 2012.01.02
  • Published : 2012.02.19

Abstract

This study used an unstable platform to change the support surface type and position of both lower limbs in order to determine changes in weight distribution and muscle including the vastus medialis, tibialis anterior, lateral hamstring, and lateral gastrocnemius of both lower limbs were evaluated during knee joint flexing and extending in a semi-squat movement in 32 hemiplegic patients. The support surface conditions applied to the lower limbs were divided into four categories: condition 1 had a stable platform for both lower limbs; condition 2 had an unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side; condition 3 had a stable platform for the non-hemiplegic side and an unstable platform for the hemiplegic side; and condition 4 had an unstable platform for both sides. The normalized EMG activity levels of muscles and weight bearing ratio of both sides in the four surface conditions were compared using repeated measures ANOVA. A significant increase was found in the weight support distribution for the hemiplegic side in flexing and extending sessions in condition 2 compared to the other conditions (p<.05). A statistically significant decrease in significant decrease in asymmetrical weight bearing in flexing and extending sessions was observed for condition 2 compared to the other conditions (p<.05). A similar significant decrease was found in differences in muscular activity for both lower limbs in condition 2 (p<.05). The muscular activity of the hemiplegic side, based on the support surface for each muscle showed a significantly greater increase in condition 2 (p<.05). An unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side therefore increased symmetry in terms of the weight support distribution rate and muscle activity of lower limbs in hemiplegic patients. The problem of postural control due to asymmetry in hemiplegic patients should be further studied with the aim of developing continuous effects of functional training based on the type and position of the support surfaces and functional improvement.

Keywords

References

  1. 김종만, 이충휘. 신경계물리치료학. 정담미디어, 2004:473-474.
  2. Brunnstrom S. Movement Therapy in Hemiplegia. New York, Harper & Row, 1970:162-165.
  3. Barra J, Oujamaa L, Chauvineau V, et al. Asymmetric standing posture after stroke is related to a biased egocentric coordinate system. Neurology. 2009;72(18):1582-1587. https://doi.org/10.1212/WNL.0b013e3181a4123a
  4. Carr JH, Shepherd RB. Physiotherapy in Disorders of the Brain: A clinical guide. London, William Heinemann Medical Books, 1980:325-326.
  5. Carr JH, Shepherd RB, Nordholm L, et al. Investigation of a new motor assessment scale for stroke patients. Phys Ther. 1985;65(2):175-180. https://doi.org/10.1093/ptj/65.2.175
  6. Chaudhuri S, Aruin AS. The effect of shoe lifts on static and dynamic postural control in individuals with hemiparesis. Arch Phys Med Rehabil. 2000;81(11):1498-1503. https://doi.org/10.1053/apmr.2000.17827
  7. Cheng PT, Liaw MY, Wong MK, et al. The sit-to-stand movement in stroke patients and its correlation with falling. Arch Phys Med Rehabil. 1998;79(9):1043-1046. https://doi.org/10.1016/S0003-9993(98)90168-X
  8. Chiang J-H, Wu G. The influence of foam surfaces on biomechanical variables contributing to postural control. Gait Posture. 1997;5(3):239-245. https://doi.org/10.1016/S0966-6362(96)01091-0
  9. Di Fabio RP. Sensitivity and specificity of platform posturography for identifying patients with vestibular dysfunction. Phys Ther. 1995;75(4):290-305. https://doi.org/10.1093/ptj/75.4.290
  10. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: A randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-417. https://doi.org/10.1053/mr.2000.3839
  11. Dettmann MA, Linder MT, Sepic SB. Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient. Am J Phys Med. 1987;66(2):77-90.
  12. Dickstein R, Nissan M, Pillar T, et al. Foot-ground pressure pattern of standing hemiplegic patients. Major characteristics and patterns of impairment. Phys Ther. 1984;64(1):19-23. https://doi.org/10.1093/ptj/64.1.19
  13. Dixon J, Howe TE. Activation of vastus medialis oblique is not delayed in patients with osteoarthritis of the knee compared to asymptomatic participants during open kinetic chain activities. Man Ther. 2007;12(3):219-225. https://doi.org/10.1016/j.math.2006.06.012
  14. Hughes MA, Duncan PW, Rose DK, et al. The relationship of postural sway to sensorimotor function, functional performance, and disability in the elderly. Arch Phys Med Rehabil. 1996;77(6):567-572. https://doi.org/10.1016/S0003-9993(96)90296-8
  15. Jørgensen 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):406-412. https://doi.org/10.1016/S0003-9993(95)80568-0
  16. Katsuo F, Hiroshi T, Takeo K et al. Postural muscle activity patterns during standing at rest and on an oscillating floor. J Electromyogr kinesiol. 2006;16(5):448-457. https://doi.org/10.1016/j.jelekin.2005.08.008
  17. Kirker SG, Simpson DS, Jenner JR, et al. Stepping before standing: Hip muscle function in stepping and standing balance after stroke. J Neurol Neurosurg Psychiatry. 2000;68(4):458-464. https://doi.org/10.1136/jnnp.68.4.458
  18. Lee MY, Wong MK, Tang FT, et al. New quantitative and qualitative measures on functional mobility prediction for stroke patients. J Med Eng Technol. 1998;22(1):14-24. https://doi.org/10.3109/03091909809009994
  19. Liepert J, Hamzei F, Weiller C. Motor cortex disinhibition of the unaffected hemisphere after acute stroke. Muscle Nerve. 2000;23(11):1761-1763. https://doi.org/10.1002/1097-4598(200011)23:11<1761::AID-MUS14>3.0.CO;2-M
  20. Mizrahi J, Solzi P, Ring H, et al. Postural stability in stroke patients: Vectorial expression of asymmetry, sway activity and relative sequence of reactive forces. Med Biol Eng Comput. 1989;27(2):181-190. https://doi.org/10.1007/BF02446228
  21. Olney SJ, Richards C. Hemiparetic gait following stroke. Part I: Characteristics. Gait Posture. 1996;4(2):136-148. https://doi.org/10.1016/0966-6362(96)01063-6
  22. Sackley CM, Baguley BI, Gent S, et al. The use of a balance performance monitor in the treatment of weight-bearing and weight-transference problems after stroke. Physiotherapy. 1992;78(12):907-913. https://doi.org/10.1016/S0031-9406(10)60498-1
  23. Sackley CM. The relationships between weight-bearing asymmetry after stroke, motor function and activities of daily living. Physiother Theory Pract. 1990;6(4):179-185. https://doi.org/10.3109/09593989009048293
  24. Shumway-Cook A, Anson D, Haller S. Postural sway biofeedback: Its effect on reestablishing stance stability in hemiplegic patients. Arch Phys Med Rehabil. 1988;69(6):395-400.
  25. Shumway-Cook A, Woollacott M. Attentional demands and postural control: The effect of sensory context. J Gerontol A Biol Sci Med Sci. 2000;55(1):M10-16. https://doi.org/10.1093/gerona/55.1.M10
  26. Smith LK, Weiss E, Lehmkuhl LD. Brunnstrom's Clinical Kinesiology. 5th ed. F.A. Davis, Philadelphia, 1996:309-311.
  27. Taube W, Gruber M, Beck S, et al. Cortical and spinal adaptations induced by balance training: Correlation between stance stability and corticospinal activation. Acta Physiol Oxf. 2007;189(4):347-358. https://doi.org/10.1111/j.1748-1716.2007.01665.x
  28. Taube W, Gruber M, Gollhofer A. Spinal and supraspinal adaptations associated with balance training and their functional relevance. Acta Physiologica. 2008;193(2):101-116. https://doi.org/10.1111/j.1748-1716.2008.01850.x
  29. Yavuzer G, Eser F, Karakus D, et al. The effects of balance training on gait late after stroke: A randomized controlled trial. Clin Rehabil. 2006;20(11):960-969. https://doi.org/10.1177/0269215506070315

Cited by

  1. Effects of fast and slow squat exercises on the muscle activity of the paretic lower extremity in patients with chronic stroke vol.27, pp.8, 2015, https://doi.org/10.1589/jpts.27.2597
  2. Effects of Balance Training on Different Support Surface on Balance and Gait in Patients with Chronic Stroke vol.10, pp.3, 2012, https://doi.org/10.13066/kspm.2015.10.3.57