Journal of rehabilitation welfare engineering & assistive technology (재활복지공학회논문지)

Rehabilitation Engineering And Assistive Technology Society of Korea (한국재활복지공학회)
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Effect of Aquatic Ramp Exercise on Gait And Activity Of Daily Living In Child With Spinal Muscular Atrophy Type II: Single Subject Research

수중 경사로 보행 훈련이 제2형 척수성근위축증 아동의 보행 및 일상생활동작에 미치는 효과: 개별실험연구

  • 성윤희 (경남대학교 물리치료학과)
  • Received : 2016.03.17
  • Accepted : 2016.05.31
  • Published : 2016.05.31
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Abstract

The purpose of this study was to determine the effect of aquatic ramp walking exercise on the activity of the quadriceps, gait and activity of daily living in child with Spinal Muscular Atrophy (SMA) type II. A 5 years-old girl with SMA type II participated in this study. This study used single-subject reverse(A-B-A) design study. There are 12 sessions(4weeks 3 times a week) each during the baseline phase(A), the intervention phase(B), the follow up phase(A). During the baseline phase and the follow up phase performed general aquatic therapy, the intervention phase additional performed walking activity on ramp in pool (60m). Surface electromyogram, Timed Up and Go (TUG) test, ACTIVLIM were used as outcome. During the intervention phase, there were decrease on the activity of the quadriceps. In modified TUG test, gait time reduced during the intervention phase. The ACTIVLIM logit score increased during intervention phase by comparison with the baseline phase. These findings suggest that an aquatic ramp walking exercise activities have the therapeutic possibility on the quadriceps activity and gait ability for child with SMA type II.

본 연구는 수중 경사로 보행 훈련이 제2형 척수성근위축증(spinal muscular atrophy type II) 아동의 넙다리네갈래근 활성화와 보행 및 일상생활동작에 미치는 영향을 알아보고자 하였다. 본 연구의 대상자는 만 5세의 제2형 척수성근위축증으로 진단받은 아동이었다. 본 연구는 단일 대상자 반전 연구 설계(A-B-A)를 이용하여 일주일에 3번 12회기 실행하였고 기초선 설정기간(A), 실험 적용기간(B), 관찰기간(A)으로 나누어 진행하였다. 기초선 설정기간, 관찰기간에서는 일반적인 수중 치료가 적용되었고 실험 적용기간에는 일반적인 수중 치료와 수중 경사로 보행훈련(60m 경사로 걷기)이 추가되었다. 제2형 척수성근위축증 환자의 보행에 큰 영향을 끼치는 넙다리네갈래근 활성화 측정을 위해 표면 근전도 검사가 실시되었고, 동적인 기능평가를 위해 일어나 걷기 검사와 일상생활 기능평가(ACTIVLIM)를 실시하였다. 그 결과 기초선 설정기간에 비해 실험 적용기간에서 넙다리네갈래근의 활성화가 감소하였고 보행 시간도 감소하였다. 일상생활 기능은 변화가 나타나지 않았다. 하지만, 관찰기간동안 다시 넙다리네갈래근의 활성화 증가, 보행시간 증가, 일상생활 기능 감소가 나타난 것으로 보아 수중 경사로 보행 훈련이 본 아동에게 기능적으로 영향을 끼쳤음을 알 수 있었다.

Keywords

References

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