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The Effect of Muscle Activity on Muscle Architectural of Medial Gastrocnemius in Chronic Stroke Patient Based on Ankle Joint Degree

만성 뇌졸중 환자에서 발목관절 각도에 따른 근 수축이 내측 비복근의 근 구조에 미치는 영향

  • 김태곤 (동인요양병원 물리치료실) ;
  • 배세현 (광주희망병원 물리치료실) ;
  • 김경윤 (동신대학교 물리치료학과)
  • Received : 2012.06.27
  • Accepted : 2012.09.06
  • Published : 2012.09.30

Abstract

The aim of this study was to effect of muscle activity on muscle architectural of medial gastrocnemius in chronic stroke patient based on ankle joint degree. The subjects of this study were 10 chronic stroke patients modified Ashworth scale(MAS) 2. Ultrasonographic and dynamometer was measured during resting and maximum voluntary isometric contraction(MVIC) on muscle thickness, pennation angle, fascicle length, MVIC. Result from analysis showed that muscle thickness was thinner in the paretic side than in the non-paretic side(p<.001) and the more plantarflexion increased, the thinner muscle thickness became. And at the time of resting rather than of MVIC significant(p<.001). Result from analysis showed that penneation angle was smaller in the paretic side than in the non-paretic side(p<.001) and the more plantarflexion increased, the larger pennation became. And at the time of resting rather than of MVIC significant(p<.001). Result from analysis showed that fascicle was shorter in the paretic side than in the non-paretic side(p<.001) and the more plantarflexion increased, the shorter fascicle length became. And at the time of resting rather than of MVIC significant(p<.001). The results of this study showed that effect of muscle activity on muscle architectural of medial gastrocnemius in chronic stroke patient based on ankle joint degree. Therefore, Ultrasonographic evaluation of chronic stroke patients according ankle joint degree and muscle activity in the clinical diagnosis and therapy is considered a very useful data.

본 연구의 목적은 만성 뇌졸중 환자에서 발목관절 각도에 따른 근 수축이 내측 비복근의 근 구조에 미치는 영향에 대해 알아보고자 하였다. 연구대상은 MAS(modified Ashworth scale) 2등급인 만성 뇌졸중 환자 10명을 대상으로 하였다. 근육 두께, 우모각, 근섬유속 길이, 최대 수의적 등척성 수축력(MVIC) 측정은 초음파 영상 촬영장치와 동력계로 이완 시(resting)와 최대 수의적 등척성 수축 시를 측정하였다. 측정결과, 근육 두께는 마비측이 정상측에 비해 유의하게 얇은 것으로 나타났고(p<.001), 발목이 저측굴곡 될수록 얇아짐을 알 수 있었다. MVIC에서는 이완 시보다 근육 두께가 유의하게 얇아지는 것을 알 수 있었다(p<.001). 우모각은 마비측이 정상측에 비해 유의하게 작은 것으로 나타났고(p<.001), 발목이 저측굴곡 될수록 커짐을 알 수 있었다. MVIC에는 이완 시보다 우모각이 유의하게 커짐을 알 수 있었다(p<.001). 근섬유속 길이는 마비측이 정상측보다 유의하게 짧은 것으로 나타났고(p<.001), 발목이 저측굴곡 될수록 짧아짐을 알 수 있었다. MVIC에는 이완 시보다 근섬유속 길이가 유의하게 짧아지는 것을 알 수 있었다(p<.001). 본 연구를 통해 만성 뇌졸중 환자에서 발목 각도에 따른 근 수축이 내측 비복근의 근 구조에 영향을 미치는 것을 알 수 있었다. 따라서, 만성 뇌졸중 환자의 영상구조적 특성을 평가하는 것은 임상적 진단과 치료에 매우 유용한 자료라 생각된다.

Keywords

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