DOI QR코드

DOI QR Code

The effects of functional electrical stimulation applied to the gluteus medius and tibialis anterior on stair climbing ability in persons with stroke

  • Jung, Jewon (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Chung, Yijung (Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University)
  • 투고 : 2018.08.24
  • 심사 : 2018.09.13
  • 발행 : 2018.09.30

초록

Objective: The aim of this research was to investigate the effects of functional electrical stimulation (FES) applied to the gluteus medius (Gm) and tibialis anterior (TA) during stair climbing in persons with stroke compared to FES applied to the TA only during stair climbing, and during stair climbing without FES in persons with stroke. Design: Cross-sectional study. Methods: Twenty subjects with stroke participated in this study. Subjects were included if: 1) they were diagnosed as stroke at least 6 months before; 2) had Mini Mental State Examination- Korean score of 24 or higher; 3) were able to climb a flight of 10 stairs independently (with or without walking aid). The patients walked 10 stairs 3 times with FES applied to the Gm and TA, only TA, or no FES. There was a 1-minute rest period between each bout. The assessments were made using the Timed Up & Down Test and the Wii Balance Board. Results: Stair climbing with FES applied to the Gm and TA was significantly faster than stair climbing with FES applied to the TA only and without FES (p<0.05). Stair climbing with FES applied to the Gm and TA exhibited significantly greater sway velocity than stair climbing without FES (p<0.05). However, maximal sway distances were not significantly different between groups. Conclusions: Stair climbing with FES applied to the Gm and TA can be an important component of a rehabilitation program for improving stair climbing ability in persons with stroke.

키워드

참고문헌

  1. Handzic I, Reed KB. Perception of gait patterns that deviate from normal and symmetric biped locomotion. Front Psychol 2015;6:199. https://doi.org/10.3389/fpsyg.2015.00199
  2. Kim MK, Kim SG. Analysis of the correlation between the differences in muscle strengths between the bilateral lower extremities and postural stability in healthy adults. J Phys Ther Sci 2015;27:3103-4. https://doi.org/10.1589/jpts.27.3103
  3. Dickstein R, Abulaffio N. Postural sway of the affected and nonaffected pelvis and leg in stance of hemiparetic patients. Arch Phys Med Rehabil 2000;81:364-7. https://doi.org/10.1016/S0003-9993(00)90085-6
  4. Lee SW, Verghese J, Holtzer R, Mahoney JR, Oh-Park M. Trunk sway during walking among older adults: norms and correlation with gait velocity. Gait Posture 2014;40:676-81. https://doi.org/10.1016/j.gaitpost.2014.07.023
  5. Schmidt H, Werner C, Bernhardt R, Hesse S, Kruger J. Gait rehabilitation machines based on programmable footplates. J Neuroeng Rehabil 2007;4:2. https://doi.org/10.1186/1743-0003-4-2
  6. Lord SE, McPherson K, McNaughton HK, Rochester L, Weatherall M. Community ambulation after stroke: how important and obtainable is it and what measures appear predictive? Arch Phys Med Rehabil 2004;85:234-9. https://doi.org/10.1016/j.apmr.2003.05.002
  7. Seo K, Kim J, Wi G. The effects of stair gait exercise on static balance ability of stroke patients. J Phys Ther Sci 2014;26:1835-8. https://doi.org/10.1589/jpts.26.1835
  8. Park KH, Kim DY, Kim TH. The effect of step climbing exercise on balance and step length in chronic stroke patients. J Phys Ther Sci 2015;27:3515-8. https://doi.org/10.1589/jpts.27.3515
  9. Alzahrani MA, Dean CM, Ada L. Ability to negotiate stairs predicts free-living physical activity in community-dwelling people with stroke: an observational study. Aust J Physiother 2009;55:277-81. https://doi.org/10.1016/S0004-9514(09)70008-X
  10. Lyons K, Perry J, Gronley JK, Barnes L, Antonelli D. Timing and relative intensity of hip extensor and abductor muscle action during level and stair ambulation An EMG study. Phys Ther 1983;63:1597-605. https://doi.org/10.1093/ptj/63.10.1597
  11. Hase K, Stein RB. Turning strategies during human walking. J Neurophysiol 1999;81:2914-22. https://doi.org/10.1152/jn.1999.81.6.2914
  12. Kubinski SN, McQueen CA, Sittloh KA, Dean JC. Walking with wider steps increases stance phase gluteus medius activity. Gait Posture 2015;41:130-5. https://doi.org/10.1016/j.gaitpost.2014.09.013
  13. Duval K, Luttin K, Lam T. Neuromuscular strategies in the paretic leg during curved walking in individuals post-stroke. J Neurophysiol 2011;106:280-90. https://doi.org/10.1152/jn.00657.2010
  14. Maeda Y, Tanaka T, Nakajima Y, Shimizu K. Analysis of postural adjustment responses to perturbation stimulus by surface tilts in the feet-together position. J Med Biol Eng 2010;31:301-5.
  15. Mercer VS, Gross MT, Sharma S, Weeks E. Comparison of gluteus medius muscle electromyographic activity during forward and lateral step-up exercises in older adults. Phys Ther 2009;89:1205-14. https://doi.org/10.2522/ptj.20080229
  16. Tan Z, Liu H, Yan T, Jin D, He X, Zheng X, et al. The effectiveness of functional electrical stimulation based on a normal gait pattern on subjects with early stroke: a randomized controlled trial. Biomed Res Int 2014 Jul 10. doi: 10.1155/2014/545408. [Epub ahead of print].
  17. Kesar TM, Perumal R, Jancosko A, Reisman DS, Rudolph KS, Higginson JS, et al. Novel patterns of functional electrical stimulation have an immediate effect on dorsiflexor muscle function during gait for people poststroke. Phys Ther 2010;90:55-66. https://doi.org/10.2522/ptj.20090140
  18. Mun BM, Kim TH, Lee JH, Lim JY, Seo DK, Lee DJ. Comparison of gait aspects according to FES stimulation position applied to stroke patients. J Phys Ther Sci 2014;26:563-6. https://doi.org/10.1589/jpts.26.563
  19. Kamphuis JF, de Kam D, Geurts AC, Weerdesteyn V. Is weightbearing asymmetry associated with postural instability after stroke? a systematic review. Stroke Res Treat 2013 Apr 28. doi: 10.1155/2013/692137. [Epub ahead of print]
  20. Ng SS, Ng HH, Chan KM, Lai JC, To AK, Yeung CW. Reliability of the 12-step ascend and descend test and its correlation with motor function in people with chronic stroke. J Rehabil Med 2013;45:123-9. https://doi.org/10.2340/16501977-1086
  21. Kirker SG, Simpson DS, Jenner JR, Wing AM. Stepping before standing: hip muscle function in stepping and standing balance after stroke. J Neurol Neurosurg Psychiatry 2000;68:458-64. https://doi.org/10.1136/jnnp.68.4.458
  22. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med 2005;37:75-82. https://doi.org/10.1080/16501970410017215
  23. Abujaber S, Gillispie G, Marmon A, Zeni J Jr. Validity of the Nintendo Wii Balance Board to assess weight bearing asymmetry during sit-to-stand and return-to-sit task. Gait Posture 2015;41:676-82. https://doi.org/10.1016/j.gaitpost.2015.01.023
  24. Cote KP, Brunet ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J Athl Train 2005;40:41-6.
  25. Mei Z, Zhao G, Ivanov K, Guo Y, Zhu Q, Zhou Y, et al. Sample entropy characteristics of movement for four foot types based on plantar centre of pressure during stance phase. Biomed Eng Online 2013;12:101. https://doi.org/10.1186/1475-925X-12-101
  26. Kim JH, Chung Y, Kim Y, Hwang S. Functional electrical stimulation applied to gluteus medius and tibialis anterior corresponding gait cycle for stroke. Gait Posture 2012;36:65-7. https://doi.org/10.1016/j.gaitpost.2012.01.006
  27. Marigold DS, Eng JJ. The relationship of asymmetric weightbearing with postural sway and visual reliance in stroke. Gait Posture 2006;23:249-55. https://doi.org/10.1016/j.gaitpost.2005.03.001
  28. Chung Y, Kim JH, Cha Y, Hwang S. Therapeutic effect of functional electrical stimulation-triggered gait training corresponding gait cycle for stroke. Gait Posture 2014;40:471-5. https://doi.org/10.1016/j.gaitpost.2014.06.002
  29. Cho MK, Kim JH, ChungY, Hwang S. Treadmill gait training combined with functional electrical stimulation on hip abductor and ankle dorsiflexor muscles for chronic hemiparesis. Gait Posture 2015;42:73-8. https://doi.org/10.1016/j.gaitpost.2015.04.009