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

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

A Study on Muscle Architectural and Tissue Compliance of Biceps Brachii in Stroke Patient Based on Elbow Joint Angle

뇌졸중 환자에서 주관절 각도 변화에 따른 상완이두근의 근구조 및 탄성 변화에 관한 연구

  • Received : 2012.09.07
  • Accepted : 2012.12.06
  • Published : 2012.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of this study was to find on muscle architectural and tissue compliance of biceps brachii in stroke patient based on elbow joint angle. The subjects of this study were twelve hemiplegic adults after stroke with passive range of motion in the elbow from $10^{\circ}$ to $90^{\circ}$ and Modified Ashworth Scale score 1 to 3 were recruited. Ultrasonography and Myotonometer was used to measure biceps brachii muscle pennation angle, fascicle length, and tissue compliance at the rest condition and pennation angle, fascicle length, and tissue compliance of the biceps brachii muscle were measured in the affected and unaffected sides of people after stroke at 9 different elbow angles ranging from $10^{\circ}$ to $90^{\circ}$ at the rest condition. The results of this study, comparisons found that the pennation angles of the affected biceps brachii muscle were significantly larger(p<.05) than the unaffected muscle in the most extended positions($<40^{\circ}$), whereas the affected fascicle lengths were significantly shorter(p<.05) than the unaffected muscle in most flexed positions($>20^{\circ}$), and the affected tissue compliance were significantly lower(p<.05) than the unaffected muscle in most extended positions($<50^{\circ}$) Therefore, pennation angles, fascicle lengths, and tissue compliance were found to be joint-angle-dependent in both the affected and unaffected sides at the rest condition. Suggest that, the results data can be used as a muscle architectural changes and clinical treatment research in stroke patients.

본 연구의 목적은 뇌졸중 환자에서 주관절 각도 변화에 따른 상완이두근(biceps brachii)의 근구조 및 탄성 변화에 관하여 알아보고자 하였다. 연구대상은 주관절 수동 ROM범위가 $10^{\circ}{\sim}90^{\circ}$ 가능하며 MAS(modified Ashworth scale) 1~3등급인 뇌졸중 환자 12명을 대상으로 하였다. 이완(resting) 상태의 건측과 환측 상완이두근의 우모각, 근섬유속길이, 근탄성의 측정은 초음파 영상 촬영장치와 근긴장도 측정기(myotonometer)를 이용하여 주관절을 $10^{\circ}{\sim}90^{\circ}$로 변화시키면서 측정하였다. 본 연구 결과, 환측 상완이두근을 건측과 비교 시 우모각은 신전위치($<40^{\circ}$)에서 큰 값을 나타냈으며(p<.05), 근섬유속길이는 굴곡위치($>20^{\circ}$)에서 짧은 길이를 나타냈으며(p<.05), 근긴장은 신전위치($<50^{\circ}$)에서 전위 값이 낮게 나타나 근긴장이 높아짐을 나타냈다(p<.05). 이렇듯 이완 시 상완이두근의 근구조 및 탄성은 주관절 각도에 의해 영향을 받는다는 것을 알 수 있었다. 본 결과를 뇌졸중 환자의 근구조 변화 및 임상치료의 연구 자료로 사용할 수 있을 것으로 생각된다.

Keywords

References

  1. L. Li, K. Y. Tong, X. Hu. "The effect of poststroke impairments on brachialis muscle architecture as measured by ultrasound", Arch Phys Med Rehabil, Vol.88, No.2, pp. 243-250, 2007, Article(CrossRefLink) https://doi.org/10.1016/j.apmr.2006.11.013
  2. N. Metoki, Y. Sato, K. Satoh, K. Okumura, J. Iwamoto. "Muscular atrophy in the hemiplegic thigh in patients after stroke", Am J Phys Med Rehabil, Vol.82, No.11, pp. 862-865, 2003, Article(CrossRefLink) https://doi.org/10.1097/01.PHM.0000091988.20916.EF
  3. C. Patten, J. Lexell, H. E. Brown. "Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy", J Rehabil Res Dev, Vol.41, pp. 293-312, 2004, Article(CrossRefLink) https://doi.org/10.1682/JRRD.2004.03.0293
  4. S. J. Lee, T. R. Han. "A quantitative assessment of spasticity in hemiplegic patients using isokinetic dynamometer", J Korean Acad Rehab Med, Vol.22, No.4, pp.784-792, 1998.
  5. G. Chi-Fishman, J. E. Hicks, H. M. Cintas, B. C. Sonies, L. H. Gerber. "Ultrasound imaging distinguishes between normal And weak muscle", Arch Phys Med Rehabil, Vol.85, No.6, pp. 980-986, 2004, Article(CrossRefLink) https://doi.org/10.1016/j.apmr.2003.07.008
  6. N. M. Maurits, E. A. Beenakker, D. E. van Schair, J. M. Fock, J. H. van der Hoeven. "Muscle ultrasound in children: normal values and application to neuromuscular disorders", Ultrasound Med Biol, Vol.30, No.8, pp. 1077-1027, 2004, Article(CrossRefLink)
  7. R. L. Lieber, J. Friden. "Functional and clinical significance of skeletal muscle architecture", Muscle Nerve, Vol. 23(11), pp. 1647-1666, 2000, Article(CrossRefLink) https://doi.org/10.1002/1097-4598(200011)23:11<1647::AID-MUS1>3.0.CO;2-M
  8. L. Li, K. Y. Tong, X. Hu. "The effect of poststroke impairments on brachialis muscle architecture as measured by ultrasound", Arch Phys Med Rehabil, Vol.88, No.2, pp. 243-250, 2007, Article(CrossRefLink) https://doi.org/10.1016/j.apmr.2006.11.013
  9. C. T. Leonard, J. S. Brown, T. R. Price, S. A. Queen, E. L. Mikhailenok. "Comparison of surface electromyography and myotonometer measurements during voluntary isometric contractions", J Electromyogr Kinesiol, Vol.14, No.6, pp. 709-714, 2004, Article(CrossRefLink) https://doi.org/10.1016/j.jelekin.2004.06.001
  10. C. T. Leonard, W. P. Deshner, J. W. Romo, E. S. Suoja, S. C. Fehrer, E. L. Mikhailenok. "Myotonometer intra-and interrater reliabilities", Arch Phys Med Rehabil, Vol.84, No.6, pp. 928-932, 2003, Article(CrossRefLink) https://doi.org/10.1016/S0003-9993(03)00006-6
  11. M. V. Marici. "Human skeletal muscle architecture studied in vivo by non-invasive imaging techniques: functional significance and applications", J Electromyogr Kinesiol Vol.9, No.2, pp. 97-103, 1999, Article(CrossRefLink) https://doi.org/10.1016/S1050-6411(98)00041-8
  12. M. R. Gossman, S. A. Sahrmann, S. J. Rose. "Review of length-associated changes in muscle. Experimental evidence and clinical implications", Phys Ther, Vol.62, No.12, pp. 1799-1808, 1982. https://doi.org/10.1093/ptj/62.12.1799
  13. B. O. Kim, T. M. K, J. M. Chae, K. H. Cho. "Kinetic characteristics during initiation of gait in stroke patients", J Korean Acad Rehab Med, Vol.25, No.2, pp. 227-235, 2001.
  14. C. Tardieu, J. C. Tabary, C. Tardieu. "Adaptation of sarcomere numbers to the length imposed on muscle In: F. Guba, G. Marechal, O. Takacs, editors. Mechanism of muscle adaptation to functional requirements", Elmsford: Pergamon Pr; pp. 99-114, 1981.
  15. M. V. Narici, T. Binzoni, E. Hiltbrand, J. Fasel, F. Terrier, P. Cerretelli. "In vivo human gastrocnemius architecture with changing joint angle at rest and during graded isometric contraction", J Physiol, Vol.496, pp. 287-297, 1996. https://doi.org/10.1113/jphysiol.1996.sp021685
  16. G. S. Chleboun, A. R. France, M. T. Crill, H. K. Braddock, J. N. Howell. "In vivo measurement of fascicle length and pennation angle of the human biceps femoris muscle", Cells Tissues Organs, Vol.169, No.4, pp. 401-409, 2001, Article(CrossRefLink) https://doi.org/10.1159/000047908
  17. T. Fukunaga, Y. Kawakami, S. Kuno, K. Funato, S. Fukashiro. "Muscle architecture and function in humans", J Biomech. Vol.30, No.5, pp. 457-63, 1997, Article(CrossRefLink) https://doi.org/10.1016/S0021-9290(96)00171-6
  18. Y. Kawakami, Y. Ichinose, T. Fukunaga. "Architectural and functional features of human triceps surae muscles during contraction", J Appl Physiol, Vol.85, No.2, pp. 398-404, 1998. https://doi.org/10.1152/jappl.1998.85.2.398
  19. A. P. Shortland, C. A. Harris, M. Gough, R. O. Robinson. "Architecture of the medial gastrocnemius in children with spastic diplegia", Dev Med Child Neurol, Vol.44, No.3, pp. 158-163, 2002, Article(CrossRefLink) https://doi.org/10.1017/S0012162201001864
  20. R. D. Woittiez, P. A. Huijing, H. B. Boom, R. H. Rozendal. "A three-dimensional muscle model: a quantified relation between form and function of skeletal muscles", J Morphol, Vol.182, No.1, pp. 95-113, 1984, Article(CrossRefLink) https://doi.org/10.1002/jmor.1051820107
  21. E. M. Halar, W. C. Stolov, B. Venkatesh, F. V. Brozovich, J. D. Harley. "Gastrocnemius muscle belly and tendon length in stroke patients and able-bodied persons", Arch Phys Med Rehabil, Vol.59, No.10, pp. 476-484, 1978.
  22. J. Harlaar, J. G. Becher, C. J. Snijders, G. J. Lankhorst. "Passive stiffness characteristics of ankle plantar flexors in hemiplegia", Clin Biomech (Bristol, Avon), Vol.15, No.4, pp. 261-270, 2000, Article(CrossRefLink) https://doi.org/10.1016/S0268-0033(99)00069-8
  23. R. L. Lieber, J. Friden. "Spasticity causes a fundamental rearrangement of muscle-joint interaction", Muscle Nerve, Vol.25, No.2, pp. 265-270, 2002, Article(CrossRefLink) https://doi.org/10.1002/mus.10036
  24. C. Tardieu, E. Huet de la Tour, M. D. Bret, G. Tardieu. "Muscle hypoextensibility in children with cerebral palsy: I. Clinical and experimental observations", Arch Phys Med Rehabil, Vol.63, No.3, pp. 97-102, 1982.
  25. W. M. Murray, T. S. Buchanan, S. L. Delp. "The isometric functional capacity of muscles that cross the elbow", J Biomech, Vol.33, No.8, pp. 943-952, 2000, Article(CrossRefLink) https://doi.org/10.1016/S0021-9290(00)00051-8
  26. T. K. Koo, A. F. Mak, L. K. Hung. "In vivo determination of subject-specific musculotendon parameters: applications to the prime elbow flexors in normal and hemiparetic subjects", Clin Biomech (Bristol, Avon), Vol.17, No.5, pp. 390-399, 2002, Article(CrossRefLink) https://doi.org/10.1016/S0268-0033(02)00031-1
  27. F. E. Zajac. "Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control", Crit Rev Biomed Eng, Vol.17, No.4, pp. 359-411, 1989.