Horticultural Science & Technology (원예과학기술지)

Korean Society of Horticultural Science (한국원예학회)
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Measuring Range of Motion and Muscle Activation of Flower Arrangement Tasks and Application for Improving Upper Limb Function

꽃꽂이 작업의 관절가동범위와 근육활성도 측정 및 상지기능 향상을 위한 적용사례

  • Lee, Son-Sun (Department of Environmental Sciences, Konkuk University) ;
  • Park, Sin-Ae (Department of Environmental Sciences, Konkuk University) ;
  • Kwon, Oh-Yun (Department of Physical Therapy, Yonsei University) ;
  • Song, Jong-Eun (Department of Environmental Sciences, Konkuk University) ;
  • Son, Ki-Cheol (Department of Environmental Sciences, Konkuk University)
  • 이손선 (건국대학교 환경과학과) ;
  • 박신애 (건국대학교 환경과학과) ;
  • 권오윤 (연세대학교 물리치료학과) ;
  • 송종은 (건국대학교 환경과학과) ;
  • 손기철 (건국대학교 환경과학과)
  • Received : 2012.04.09
  • Accepted : 2012.06.04
  • Published : 2012.08.30
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Abstract

The objectives of this study were to measure the range of motion for joints and muscle activation of upper limb for flower arrangement tasks for physical rehabilitation and to test horticultural therapy programs using flower arrangement tasks for improving upper limb function of the patients with stroke. Major flower arrangement tasks were classified with eight tasks (cutting 1, thick stem; cutting 2, thin stem; fixing 1, long stem; fixing 2, short stem; rolling a leaf; bending 1, thick stem; bending 2, thin stem; and winding, using a wire) based on the occupational analysis. When eight male university students (mean age $24.1{\pm}2.5$ years) conducted the eight flower arrangement tasks, range of motion for joints and muscle activation of upper limb were measured by a 3D motion analyzer and electromyography, respectively. Based on the results of the range of motion and muscle activation of upper limb, horticultural therapy programs using flower arrangement tasks (total 33 sessions) for improving upper limb function of the patients with stroke was conducted at a rehabilitation hospital, Seoul, South Korea and then the range of motion, grip strength, and upper limb function of the patients were tested. Among the eight flower arrangement tasks, cutting 1, winding, and bending 1 induced the highest value for the range of motion in joints of shoulder, elbow, and wrist, respectively (P < 0.001). In terms of muscle activation, eight flower arrangement tasks performed in this study showed various patterns of muscle activation and several muscles were simultaneously used for each task (P < 0.001). In addition, thickness and length of the materials used in a task had a prominent effect on the range of motion for joints and muscle activation of upper limb (P < 0.001). The stroke patients had positive effects for their range of motion of upper limb (shoulder, forearm, and elbow), grip strength, and overall upper limb function through the horticultural therapy program. Thus, this study suggested that flower arrangement tasks would be a potential horticultural activity for physical rehabilitation program. It would be interesting to apply a customized horticultural therapy program using flower arrangement tasks according to the symptoms of patient for physical rehabilitation.

본 연구는 신체재활을 위해 다양한 꽃꽂이 작업들을 이용하기 위해서 꽃꽂이 작업 시 주로 사용되는 작업들을 분류하고, 각 작업 수행 시 사용되는 상지의 관절가동범위와 근육 활성도를 측정하였다. 또한 꽃꽂이 작업 시 상지의 관절 가동범위와 근육활성도 측정결과를 근거로 뇌졸중 환자의 상지기능 향상을 위한 꽃꽂이 프로그램을 개발하여, 실제 임상현장에서 적용하여 그 효과를 조사하였다. 상지 움직임을 정량적으로 분석하기 위해 주요한 꽃꽂이 작업을 분류한 다음, 작업 분석을 토대로 8가지 꽃꽂이 기본 작업(자르기 1, 굵은 줄기; 자르기 2, 가는 줄기; 꽂기 1, 긴 줄기; 꽂기 2, 짧은 줄기; 말기; 관엽 이용; 휘기 1, 굵은 줄기; 휘기 2, 가는 줄기; 감기, 절화용 와이어 이용)을 재분류하였다. 강원도 소재 대학의 8명의 남학생(평균 연령 $24.1{\pm}2.5$세)들이 8가지 꽃꽂이 작업을 수행하는 동안 삼차원 실시간 동작 분석 시스템과 근 전도 측정기를 이용하여 상지의 관절가동범위와 각 근육부위별 활성도를 각각 측정하였다. 이 측정결과를 토대로 상지기능 향상을 위한 꽃꽃이 프로그램을 개발하여, 서울시 소재 재활병원에 입원한 뇌졸중 환자들을 대상으로 실시하였다. 참여대상자들의 의사에 따라 4명은 원예치료군에 나머지 4명은 작업치료군에 배정되었다. 원예치료는 1일 2회(총 33회기)로 실시되었으며, 프로그램 전과 후에 뇌졸중 환자들의 상지기능 평가를 위해서 관절가동범위와 장악력 및 전반적인 상지기능평가가 수행되었다. 꽃꽂이 작업 수행 시 어깨관절은 자르기 1 작업에서 관절가동범위의 변화가 가장 큰 것으로 나타났고, 팔꿈치 관절은 감기 작업에서, 손목부위 관절은 휘기 1 작업에서 가장 큰 관절가동 범위를 나타냈다(P < 0.001). 수행된 꽃꽂이 작업에 따라 상지 근육의 부위별 근육 활성도는 다양한 변화를 보였으며, 한 가지 작업에 대해 여러 부위의 근육들이 동시에 사용되었다(P < 0.001). 또한 같은 방법으로 수행하는 작업일지라도 재료의 굵기나 길이에 따라 관절가동범위와 근수축의 차이가 나타났다(P < 0.001). 뇌졸중 환자의 상지기능 향상을 위해 실시된 꽃꽂이 작업을 이용한 원예치료 프로그램은 뇌졸중 환자들의 상지(어깨, 팔꿈치, 손목관절)의 가동범위와 장악력 및 전반적인 상지 기능에 긍정적인 영향을 미치는 것으로 나타났다. 따라서 본 연구는 꽃꽂이의 주요 작업을 이용하여 특정 신체부위의 기능향상이 필요한 대상자의 재활치료를 위한 프로그램 개발에 유용한 기초자료를 제시하였다. 추가적으로 실제 재활환자의 상태에 따라 효율적인 맞춤형 원예치료 프로그램을 개발하여 그 효과를 규명하는 연구가 필요할 것이다.

Keywords

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