디지털융복합연구 (Journal of Digital Convergence)

  • 제17권12호
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  • Pages.319-327
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  • 2019
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  • 2713-6434(pISSN)
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  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
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기능적 전기 자극을 이용한 생체되먹임 융합 자세조절 훈련이 뇌졸중 환자의 근활성도와 균형 능력에 미치는 영향

The Effects of Biofeedback Fusion Postural Control Training using Functional Electrical Stimulation on the Muscle Activity and Balance Ability of the Stroke Patient

  • 김제호 (세한대학교 물리치료학과) ;
  • 엄요한 (군장대학교 물리치료학과)
  • Kim, Je-Ho (Dept. of physical therapy, Sehan University) ;
  • Uhm, Yo-Han (Dept. of physical therapy, Kunjang University)
  • 투고 : 2019.09.18
  • 심사 : 2019.12.20
  • 발행 : 2019.12.28
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초록

본 연구에서는 기능적 전기 자극을 이용한 생체되먹임 융합 자세조절 훈련을 중재하여 급성기 뇌졸중 환자들의 다리 근활성도와 균형 능력에 미치는 효과에 대하여 알아보고자 하였다. 뇌졸중 환자는 기능적 전기 자극을 이용한 생체 되먹임 융합 자세조절 실험군 15명과 일반적인 생체되먹임 융합 자세조절 대조군 15명으로 나누어 8주간 주 5회, 30분간 시행하였고, 다리 근활성도를 평가하기 위해 근전도를 이용하여 가쪽넓은근, 안쪽넓은근, 넙다리곧은근, 넙다리두갈래근를 측정하였다. 균형 능력을 측정하기 위해 Biorecue를 이용하여 균형 능력을 측정하였다. 다리 근활성도 비교에서는 가쪽넓은근, 안쪽넓은근, 넙다리곧은근, 넙다리두갈래근에서 통계적으로 유의한 차이를 보였고, 균형 능력 비교에서는 신체 중심 이동면적, 총 궤적 길이, 안정선한계에서 통계적으로 유의한 차이를 보였다. 이에 따라 기능적 전지 자극을 이용한 생체되먹임 자세조절 훈련이 일반적인 생체되먹임 자세조절 훈련 보다 다리 근활성도와 균형 능력을 향상시키는데 효과적임을 알 수 있었다.

The muscle activity and balance ability of the acute stroke patient has been checked by the functional electrical stimulation using biofeedback fusion postural control training in this study. Functional electrical stimulation using biofeedback fusion postural control training have been implemented on 15 trainees and general biofeedback fusion postural control training have been implemented on another 15 trainees for 30 minutes at 5 times per week during 8 weeks, and vastus lateralis, vastus medialis, rectus femoris and biceps femoris have been measured using the biceps femoris to evaluate the muscle activity of the lower extremity. The moving surface area, whole path length and limited of stability have been measured using biorecue to measure the balance ability. There was statistically meaningful difference on the vastus lateralis, vastus medialis, rectus femoris and biceps femoris in the muscle activity of the lower extremity and there was statistically meaningful difference on surface area, whole path length and limited of stability in the balancing ability. Based on above, it is realized that the functional electrical stimulation using biofeedback fusion postural control training is more effective than the general biofeedback fusion postural control training on the improvement of the muscle activity of the lower extremity and the balance ability.

키워드

참고문헌

  1. J. E. Harris, J. J. Eng & D. S. Marigold. (2005). Relationship of balance and mobility to fall incidence in people with chronic stroke. Phys Ther, 85(2), 150-158. DOI :https://doi.org/10.1093/ptj/85.2.150
  2. S. C. O. Martins et al. (2011). Thrombolytic therapy for acute stroke in the elderly: an emergent condition in developing countries. J Stroke Cerebrovas Dis, 20(5), 459-464. DOI :10.1016/j.jstrokecerebrovasdis.2010.02.019
  3. S. B. O'Sullivan & T. J. Schmitz. (2006). Physical rehabilitation, 5th ed, Philadelphia : F. A. Davis COMPANY.
  4. L. Lundy-Ekman. (2012). Neuroscience: Fundmentals for rehabilitation , 4th ed, Amsterdam : ELSEVIER Saunder.
  5. J. M. Gracies. (2005). Pathophysiology of spastic paresis. I : Paresis and soft tissue changes. MUS, 31(5), 535-551. DOI :doi.org/10.1002/mus.20284
  6. L. M. Snow, W. C. Low & L. V. Thompson. (2012). Skeletal muscle plasticity after hemorrhagic stroke in rats : influence of spontaneous physical activity. Am J Phys Med Rehabil, 91(11), 965-976. DOI :10.1097/phm.0b013e31825f18e1
  7. D. A. Winter. (2009). Biomechanics and motor control of human movement , 4th ed, New jersey : John Wiley & Sons Inc.
  8. S. Lin. (2005). Motor function and joint position sensein relation to gait performance in chronic stroke patients. Arch Phys Med Rehabil, 86(2), 197-202. DOI :10.1016/j.apmr.2004.05.009
  9. R. W. Bohannon. (2007). Muscle stength and muscle training after stroke. J Rehabil Med, 39(1), 14-20. DOI :10.2340/16501977-0018
  10. S. F. Tyson, M. Hanley & J. Chillala. (2006). Balance disability after stroke. Phys Ther, 86, 30-38. DOI :10.1093/ptj/86.1.30
  11. N. M. Salbach, N. E. Mayo & S. Wood-Dauphinee. (2004). A task orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial. Clin Rehabil, 18(5), 509-519. DOI :10.1191/0269215504cr763oa
  12. J. J. Eng & K. S. Chu. (2002). Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil, 83, 1138-1144. DOI :10.1053/apmr.2002.33644
  13. D. H. Kim & K. H. Kim. (2018). A convergence study on the effects of functional electrical stimulation with mirror therapy on balance and gait ability in chronic stroke patients. Journal of the Korea Convergence Society, 9(10), 109-120. DOI :10.15207/JKCS.2018.9.10.109
  14. K. H. Kim & S. H. Jang. (2018). A convergence study on effects of progressive proprioceptive motor program training on proprioception and balance ability in chronic stroke patients. Journal of the Korea Convergence Society, 9(10), 81-91. DOI :10.15207/JKCS.2018.9.10.081
  15. S. F. Tyson. (2004). Reliability and vadidity of functional balance tests post stroke. Clin Rehabil, 18, 916-923. DOI :10.1191/0269215504cr821oa
  16. S. K. Sabut, C. Sikdar & R. Kumar. (2011). Functional electrical stimulation of dorsiflexor muscle : effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation, 29(4), 393-400. DOI :10.3233/NRE-2011-0717.
  17. D. Soetanto, C. Kuo & D. Babic. (2001). Stabilization of human standing posture using functional neuromuscular stimulation. J Biomech, 34(12), 1590-1597. DOI :10.1016/s0021-9290(01)00144-0
  18. W. Rong, K. Y. Tong & X. L. Hu. (2015). Effects of electromyography-driven robot -aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke. Disabil Rehabil Assist Technol, 10(2), 149-159. DOI :10.3109/17483107.2013.873491
  19. N. M. Kapadia et al. (2014). Functional electrical stimulation therapy for recovery of reaching and grasping in severe chronic pediatric stroke patients. J Child Neurol, 29(4), 493-499. DOI :10.1177/0883073813484088
  20. L. R. Sheffler, M. T. Hennessey & G. G. Naples. (2006). Peroneal nerve stimulation versus an ankle foot orthosis for correction of foot drop in stroke : impact on functional ambulation. Neurorehabil Neural Repair, 20(3), 355-360. DOI :10.1097/00002060-200603000-00090
  21. R. K. Tong, M. F. Ng & L. S Li (2006). Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke : a randomized controlled trial. Arch Phys Med Rehabil, 8710), 1298-304. DOI :10.1016/j.apmr.2006.06.016
  22. A. I. Kottink et al. (2007). A randomized controled trial of an implantable 2-channel peroneal nerve stimulatory on walking speed and activity in post stroke hemiplegia. Arch Phys Med Rehabil, 88(8), 452-479. DOI :10.3990/1.9789036529594
  23. G. Y. Ng, A. Q., Zhang & C. K. Li. (2008). Biofeedback exercise improved the emg activity ratio of the medial and lateral vasti muscles in subjects with patellofemoral pain syndrome. J Electromyogr Kinesiol, 18(1), 128-133. DOI :10.1016/j.jelekin.2006.08.010
  24. O. M. Bazanova, E. M. Mernaya & M. B. Shtark. (2009). Biofeedback in psychomotor training: electrophy siological basis. Neurosci Behav Physiol, 39(5), 437-447. DOI :10.1007/s11055-009-9157-z
  25. D. Rosenberg et al. (2010). Exergames for subsyndromal depression in older adults : a pilot study of a novel intervention. Am J Geriatr Psychiatry, 18(3), 221-226. DOI :10.1097/jgp.0b013e3181c534b5
  26. A. S. Merians, H. Poizner & R. Boian. (2006). Sensorimotor training in a virtual reality environment: does it improve functional recovery poststroke?. Neurorehabil Neural Repair, 20, 252-267. DOI :10.1177/1545968306286914
  27. B. Lange, B. Physio & S. Flynn. (2010). Development of interactive game based rehabilitation tool for dynamic balance training. Top Stroke Rehabil, 17(5), 345-352. DOI :10.3138/physio.62.2.114
  28. B. M. Doucet. (2012). Neurorehabilitation: are we doing all that we can?. AJOT, 66(4), 488-493. DOI :10.5014/ajot.2012.002790.
  29. J. A. Robertson, J. J. Eng & C. Hung. (2010). The effect of functional electrical stimulation on balance function and balance confidence in community-dwelling individuals with stroke. Physiother Can, 62(2), 114-119. DOI :10.5014/ajot.2012.002790
  30. Y. H. Uhm, D. J. Yang & S. K. Park. (2012). Effect of Computerized Feedback Postural Training on Balance and Muscle Activity in Stroke Patients. J Kor Soc Phys Ther, 24(5), 348-354. DOI :G704-SER000001656.2012.24.5.008
  31. G. B. Song & E. C. Park. (2016). The effects of balance training on balance pad and sand on balance and gait ability in stroke patients. Korea Soc Phys Med, 11(1), 45-52. DOI : 10.13066/kspm.2016.11.1.45
  32. A. Forster & K. Szabo. (2008). Mechanisms of Disease: Pathophysiological Concepts of stroke in hemodynamic risk zones do hypoperfusion and embolism interact?. nature clinical practice neurolog, 4(4), 216-225. DOI :10.1038/ncpneuro0752
  33. D. Anaby, T. Jarus & C. L. Backman. (2010). The role of occupational characteristics and occupational imbalance in explaining wellbeing. Applied Research in Quality of Life, 5(2), 81-104. DOI :10.1007/s11482-010-9094-6
  34. E. De Vlugt, J. de Groot & K. Schenkeveld. (2010). The relation between neuromechanical parameters and Ashworth score in stroke patients. Journal of Neuroengineering and Rehabilitation, 7(1), 35. DOI :10.1186/1743-0003-7-35
  35. J. Hendrickson, K. K. Patterson & E. L. Inness. (2014). Relationship between asymmetry of quiet standing balance control and walking post-stroke. Gait & Posture, 39(1), 177-181. DOI :10.1016/j.gaitpost.2013.06.022
  36. S. Combs, E. W. Miller & E. Forsyth. (2007). Motor and functional outcomes of a patient post-stroke following combined activity and impairment level training. Physiother Theory Pract, 23(4), 219-229. DOI :10.1080/09593980701209261
  37. A. R. Lindquist, C. L. Prado & R. M. Barros. (2007). Gait training combining partial body-weight support, a treadmill, and functional electrical stimulation : effects on post stroke gait. Phys Ther, 87(9), 1144-1154. DOI : https://doi.org/10.2522/ptj.20050384
  38. D. Kunkel et al. (2013). Functional electrical stimulation with exercises for standing balance and weight transfer in acute stroke patients: a feasibility randomized controlled trial. Neuromodulation : Technology at the Neural Interface, 16(2), 168-177. DOI :10.1111/j.1525-1403.2012.00488.x
  39. C. A. O. Bethel, W. Leslie & F. Mathew. (2016). Rehabiliation of hand in subacute tetraplegic patients based on brain computer interface and functional electrical stimulation: a randomised pilot study. Journal of Neural Engineering, 13(6). DOI :10.5220/0005650500150023
  40. A. I. F. Spooren, Y. J. M. Janssen-Potten & E. Kerckhofs. (2011). A task-oriented client -centered training module to improve upper extremity skilled performance in cervical spinal cord-injured persons. Spinal Cord, 49(10), 1042-1048. DOI :10.1038/sc.2011.52
  41. C. Bustamante, F. Brevis & S. Canales. (2016). Effect of functional electrical stimulation on the proprioception, motor function of paretic upper limb, and patient quality of life: a case report. Journal of hand therapy, 29(4), 507-514. DOI :10.1016/j.jht.2016.06.012
  42. R. B. Stein et al. (2002). Electrical stimulation for therapy and mobility spinal cord injury. Prog Brain Res, 137, 27-34. DOI :10.1016/j.pmr.2014.05.001
  43. J. H. Cauraugh, & S. B. Kim. (2003). Stroke motor recovery : active neuromuscular stimulation and repetitive practice schedules. J Neurol Neurosurg Psychiatry, 74(11), 1562-1566. DOI :10.1136/jnnp.74.11.1562
  44. A. Boyaci, O. Topuz & H. Alkan. (2013). Comparison of the effectiveness of active and passive neuromuscular electrical stimulation of hemiplegic upper extremities: a randomized, controlled trial. Int J Rehabil Res, 36(4), 315-322. DOI :10.1097/mrr.0b013e328360e541
  45. F. L. Alan, G. Alon & P. A. McCARTHY. (2007). Functional electrical stimulation enhancement of upper extermity functional recovery during stroke rehabilitation: A pilot study. Neuro rehabilitation and Neural Repair, 21(3), 207-215. DOI :https://doi.org/10.1177/1545968306297871
  46. S. A. Hosseini, M. Fallahpour & M. Sayadi. (2012). The impact of mentalpractice on stroke patients' postural balance. J Neurol Sci, 322(1-2), 263-267. DOI :10.1016/j.jns.2012.07.030
  47. M. K. Cho, J. H. Kim & Y. CHung. (2015). Treadmill gait training combined with functional electrical stimulation on hip abductor and ankle dorsiflexor muscles for chronic hemiparesis. Gait Posture, 42(1), 73-78. DOI : doi: 10.1016/j.gaitpost.2015.04.009
  48. C. Y. Yang, T. J. Kim & J. H. Lee. (2009). The Effect of Functional Electrical Stimulation on the Motor Function of Lower Limb in Hemiplegic Patients. Journal of the Korean Academy of Rehabilitation Medicine, 33(1), 29-35. DOI :G704-000430.2009.33.1.012
  49. J. Y. Hong. (2019). The Effect of FES with Adominal Muscle Contraction before Virtual Reality Training on Balance and Gait of Stroke Patient dissertation. Masteral dissertation. Korea national university of transportation. Chungju-si. DOI :I804:43010-200000172138