한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제20권2호
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  • Pages.694-703
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  • 2019
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  • 1975-4701(pISSN)
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  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
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전기자극치료를 동반한 운동치료가 전방십자인대 재건술 환자의 통증, 관절가동범위, 근력에 미치는 영향

The Effects of Therapeutic exercise with Electrical Stimulation on Pain, Range of motion, Muscle strength in patients after Anterior Cruciate Ligament Reconstruction

  • 투고 : 2018.10.11
  • 심사 : 2019.02.01
  • 발행 : 2019.02.28
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초록

본 연구는 전방십자인대 파열로 전방십자인대 재건술을 받은 환자를 대상으로 전기자극치료를 동반한 운동치료가 무릎관절 통증, 관절가동범위, 근력에 어떠한 영향을 미치는지 알아보고자 한다. 본 연구 대상자는 전방십자인대 파열로 진단받아 전방십자인대 재건술을 받은 환자 20명을 선정하여, 무작위 배분으로 운동치료을 수행할 대조군 10명, 전기자극치료를 동반한 운동치료를 수행할 실험군 10명으로 구성하였다. 운동치료방법은 선행 연구를 참고하여 구성한 3가지 운동을 총 3주간 실시하였다. 측정도구로 무릎관절 통증정도는 시각적 상사척도를 관절가동범위는 측각기를 근력은 휴대용역량계를 이용하였다. 통계학적 분석은 각 그룹 내 비교는 대응표본 t-검정, 각 그룹 간 비교는 독립표본 t-검정으로 분석하였다. 본 연구 결과 중재 후 실험군이 대조군에 비해 모든 측정 결과가 유의하게 향상되어 나타났다(p<.05). 이와 같은 결과를 바탕으로 전방십자인대 재건술 환자를 대상으로 무릎관절 치료와 함께 전기자극치료를 동반한 운동치료를 실시한다면 환자의 통증, 관절가동범위, 근력에 좀 더 효과적이라고 판단된다.

This study was to investigate the effect of therapeutic exercise with electrical stimulation on knee joint pain, range of motion and muscle strength in patients who underwent anterior cruciate ligament reconstruction. The subjects of this study were recruited who diagnosed with anterior cruciate ligament rupture and undergoing anterior cruciate ligament reconstruction, total of 20 patients were randomly divided to the 10 control groups and 10 experimental groups. The therapeutic exercise was carried out for 3 weeks with three exercises made by referring to the previous study. The measurement tools used were knee joint pain measurements were made using the visual analogue scale, range of motion was measured using a goniometer, and the muscle strength was measured using a handheld dynamometer. In the statistical analysis, to compare about pre and post test the difference in each same groups was accomplished by using the paired t-test, and compare the difference between the different each groups was accomplished by using the independent t-test. The results of the study showed that the experimental group showed significantly enhanced results than the control group(p<.05). Based on these results, it is concluded that it is effective for the recovery of the patient if the therapeutic exercise with electrical stimulation in parallel with knee joint therapy are performed for the patients with anterior cruciate ligament reconstruction.

키워드

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Fig. 1. quadriceps - setting exercise (start, finish)

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Fig. 2. prone knee flexion exercise (start, finish)

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Fig. 3. supine balance exercise

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Fig. 4. quadriceps - setting exercise with 20Hz electrical stimulation

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Fig. 5. prone knee flexion exercise with 20Hz electrical stimulation

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Fig. 6. supine balance exercise with 20Hz electrical stimulation

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Fig. 7. quadriceps femoris muscle strength measurement

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Fig. 8. hamstring muscle strength measurement

Table 1. General characteristics of subjects

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Table 2. Comparison of visual analogue scale score between each groups

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Table 3. Comparison of knee flexion range of motion each groups

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Table 4. Comparison of knee extension range of motion each groups

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Table 5. Comparison of quadriceps femoris muscle strength between each groups

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Table 6. Comparison of hamstring muscle strength between each groups

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참고문헌

  1. W. S. Cho, "The Results of Sports Rehabilitation after Anterior cruciate ligament reconstruction." Korean Society of Sports Medicine, Vol. 23, No. 3 pp. 241-245, 2005.
  2. S. J. Park, "The Effects of Electrical Stimulation Method on Muscle Strength, Pain, Range of Motion, Fear Avoidance-Belief in Patients with Anterior Cruciate Ligament Reconstruction." Journal of the Korea Academia-Industrial cooperation Society, Vol. 18, No. 6 pp. 538-546, 2017. https://doi.org/10.5762/KAIS.2017.18.6.538
  3. Y. J. Kim, "Exercise Treatment of Knee Joint after Anterior Cruciate Ligament Reconstruction Operation." Journal of the Korean Society of Physical Medicine, Vol. 3, No.1 pp. 27-37, 2008.
  4. Meier, W., Mizner, R., Marcus, R., Dibble., Peter, C., & Lastayo, P. C. "Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. journal of orthopaedic & sports physical therapy, Vol. 38, No.5 pp. 246-256, 2008. https://doi.org/10.2519/jospt.2008.2715
  5. Wylde, V., Rooker, J., Halliday, L., & Blom, A. "Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep." journal of orthopaedics & Traumatology: Surgery & Research, Vol. 97, No.2 pp. 139-144, 2011. https://doi.org/10.1016/j.otsr.2010.12.003
  6. Mizner, R. L., Petterson, S. C., & Snyder-Mackler, L. "Quadriceps strength and the time course of functional recovery after total knee arthroplasty." journal of orthopaedic & sports physical therapy, Vol. 35, No.7 pp. 424-436, 2005. https://doi.org/10.2519/jospt.2005.35.7.424
  7. Bade, M. J., Kohrt, W. M., & Stevens-Lapsley, J. E. "Outcomes before and after total knee arthroplasty compared to healthy adults." journal of orthopaedic & sports physical therapy, Vol. 40, No.9 pp, 559-567, 2010. https://doi.org/10.2519/jospt.2010.3317
  8. Andrea Biscarinin, Samuele Contemori, Daniele Busti, Fabio M Botti, Vito E.Pettorossi "Knee flexion with quadricpes cocontraction : A new therapeutic exercise for the early stage of ACL rehabilitation" Journal of Biomechanics 49, pp. 3855-3860, 2016. https://doi.org/10.1016/j.jbiomech.2016.10.026
  9. Y. S. Jin, T. G. Jeong, "Effects of Neuromuscular Electrical Stimulation of the Vastus Medialis on Pain and Muscle Function in Patients with Knee Osteoarthritis" The Korea Contents Society, Vol. 12, No. 1 pp. 329-337, 2012.
  10. E. A. Lee, J. C. Byun. "The effects of accelerated rehabilitation, exercise program after anterior cruciate ligament reconstruction." The Korean Journal of Growth and Development, Vol. 14, No. 1 pp. 61-69, 2006.
  11. Huber, E. O., Roos, E. M., Meichtry, A., de Bie, R. A., & Bischoff-Ferrari, H. A. "Effect of preoperative neuromuscular training on functional outcome after total knee replacement : an assessor-blinded rancomized controlled trial. BMC musculoskeletal disorders, Vol. 16, No. 1, 2015.
  12. Qin, L., Appell, H.-J., Chan, K., & Maffulli, N. "Electrical stimulation prevents immobilization atrophy in skeletal muscle of rabbits." Archives of Physical Medicine and Rehabilitation, Vol. 78, No. 5 pp 512-517, 1997. https://doi.org/10.1016/S0003-9993(97)90166-0
  13. Delitto, A., Mckowen, J. M., McCarthy, J. A., Shively, R. A., & Rose, S. J. "Electrically elicited co-contraction of thigh musculature after anterior cruciate ligament surgery." Physical Therapy, Vol. 68, No. 1 pp. 45-50, 1988. https://doi.org/10.1093/ptj/68.1.45
  14. K. M. Kim, Croy. T, Hertel. J, Saliba. S, "Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadricpes Strength, Function, and Patient-Oriented Outcomes: A Systematic Review", J Orthop Sports Phys Ther, Vol. 40, No. 7 pp. 383-391, 2010. https://doi.org/10.2519/jospt.2010.3184
  15. W. H. Choi, W. T. Shin, "The Effect of the application of electrical stimuli and Ultrasound on Muscle Performance and Pain in Patient with Chronic Low Back Pain" Korean journal of sport science, Vol. 18, No. 4 pp. 911-918, 2009.
  16. Moritani T, Muro M, Kijima A. "Electromechanical changes during electrically induced and maximal voluntary contractions: electrophysiologic responses of different muscle fiber types during stimulated contractions." Exp Neurol. Jun;88(3):471-83, 1985. https://doi.org/10.1016/0014-4886(85)90064-0
  17. T. S. Suh, S. Y. Jo, B. M. Kwon, "The Effects of the Resistant Isometric Quadriceps femoris muscle strengthening exercise on Degenerative Knee Arthritis Patients" Journal of the Korean Academy of Health and Welfare for Elderly, Vol. 1, No. 2 pp. 123-136, 2010.
  18. C. Park, "The Effects of Balance Exercise Accompanied by Muscle Strengthening on Balance, Muscular Strength, WOMAC, Pain and Depression Index of the Elderly who Received Total Knee Arthroplasty." Daegu University Dissertation of Master Degree, 2016.
  19. H. C. Nam, Y. H. Cho, "The Effects of Extension Exercise program in LBP Patients when Using Kinesio Taping." Korean journal of physical education, Vol. 49, No. 4 pp. 429-436, 2010.
  20. D. H. Moon, D. H. Oh, S. A. Zhang, J. K. Lee, "Effects of Backward walking Exercise on ROM, VAS score and Proprioception in Anterior Cruciate Ligament Reconstruction Patients." Journal of the Korea Academia-Industrial cooperation Society Vol. 17, No. 5 pp. 522-529, 2016. https://doi.org/10.5762/KAIS.2016.17.5.522
  21. Y. T. Hwang, K. O. Hwang, "The Effect of Isometric Exercise and Active Stretching on Joint Function in Patient with Osteoarthritis." The journal of Korean society of physical therapy, Vol. 18, No. 2 pp. 35-45, 2006.
  22. Y. I. Kim, J. S. Park, "Development and Evaluation of a Joint Health Self-management Program for the Elderly with Knee Osteoarthritis in Communities : Applying the IMB Model." Korean Academy of Community Health Nursing, Vol. 28, No. 1 pp. 55-68, 2017. https://doi.org/10.12799/jkachn.2017.28.1.55
  23. Arnold, C. M., et al., "The reliability and validity of handheld dynamometry for the measurement of lower-extremity muscle strength in older adults." J Strength Cond Res, 24(3):p. 815-24, 2010. https://doi.org/10.1519/JSC.0b013e3181aa36b8
  24. S. Y. Kim, "Muscle Strength Ratio and Q-angle in Patients With Osteoarthritis of The Knee:A Comparative Study With Healthy Persons." Korean Research Society of Physical Therapy, Vol. 12, No. 1 pp. 45-53, 2005.
  25. S. H. Lee, "The Effects of physical therapy intervention methods on range of motion, muscular strength, and balance after total knee replacement" Kwangju women's University Dissertation of Master Degree, 2014.
  26. Palmieri-Smith. R. M, Thomas. A. C, Wojtys. E. M, "Maximizing Quadriceps Strength after ACL Reconstruction", Clin Sports Med, Vol. 27, No. 3 pp. 405-424, 2008. https://doi.org/10.1016/j.csm.2008.02.001
  27. Secrist. E. S, Freedman. K. B, Ciccotti. M. G, Mazur. D.W, Hammoud. S, "Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction A Systematic Review of Randomized Controlled Trials", Am J Sports Med, Vol. 44, No. 9 pp. 2435-2447, 2016. https://doi.org/10.1177/0363546515617737
  28. Mintken. P. E, Carpenter. K. J, Eckhoff. D, Kohrt. W. M, Stevens. J. E, "Early Neuromuscular Electrical Stimulation to Optimize Quadriceps Muscle Function Following Total Knee Arthroplasty: A Case Report", J Orthop Sports Phys Ther, Vol. 37, No. 7 pp. 364-371, 2007. https://doi.org/10.2519/jospt.2007.2541
  29. Ward, A. R., & Shkuratova, N. "Russian electrical stimulation: the early experiments," Journal of Physical Therapy, vol. 82, no. 10, pp. 1019-1030, 2002. https://doi.org/10.1093/ptj/82.10.1019
  30. Y. H. Lee, "Functional Electrical Stimulation to Ankle Dorsiflexor and Plantarflexor Using Single Foot Switch in Patients With Hemiplegia from Hemorrhagic Stroke." Annal of Rehabilitation Medicine, Vol. 38, No. 3 pp. 310-316, 2014. https://doi.org/10.5535/arm.2014.38.3.310
  31. Y. H. Kim, K. W. Kim, H. J. Min, U. S. Yoon, K. H. Cho, D. Y. Kim, S. R. Kim, "Analysis of the Factors that Influence the Range of Motion after Total Knee Arthroplasty." Knee Surgery and Related Research, Vol. 11, No. 1 pp. 20-25, 1999.
  32. Kisner, C., & Colby, L. A. "Therapeutic exercise. foundations and techniques." philadelphia, pp. 61-108, 109-112, 1996.
  33. S. Y. Kang, "General Conceptions of Physical Therapy." Vol. 8. No, 12 pp. 23-30, 1984.
  34. Thorstensson, A. "How is the normal locomotor program modified to produce backward walking?" Experimental brain Research, Vol. 61 No. 3 pp. 664-668, 1986. https://doi.org/10.1007/BF00237595
  35. Winter, D.A., Pluck, N. & Yang, J. F. "Backward walking, A simple reversal of forward walking?" Journal of Motor Behavior, Vol. 21 No. 3 pp. 291-305, 1989. https://doi.org/10.1080/00222895.1989.10735483
  36. H. J. Yeon, "Effect of Exercise Program on Thigh Muscle Area and Lower Extremity Muscle Strength of Patients Undergoing Anterior Cruciate Ligament Reconstruction." Seoul National University, Department of Nursing, 2006.
  37. C. H. Bae, "The Effects of Strengthening the knee Muscles, Balance, and Ambulation by Using Registive Exercises Combined with Vibration Stimuli in Patients with Post ACL Surgery." Daegu University Dissertation of Master Degree, 2013.
  38. B. G. Pietrosimone, J. M. Hart, S. A. Saliba, J. Hertel, C. D. Ingersoll. "Immediate effects of transcutaneous electrical nerve stimulation and focal knee joint cooling on quadriceps activation," Journal of Medicine & Science in Sport & Exercise, vol. 41, no. 6 pp. 1175-1181, 2009. https://doi.org/10.1249/MSS.0b013e3181982557
  39. D. K. Kim, W. H. Park, " Clinical Measurement of Muscle Strength and Laxity in Relation to Dynamic Postural Stability in Anterior Cruciate Ligament Deficient Knees." Korean Society of sport Medicine, Vol. 25, No. 1 pp. 92-97, 2007.
  40. Triston Shaw, Marie T Wiliams and Lucy S Chipchase, "Do early quadriceps exercises affect the outcome of ACL reconstruction?" School of Health Sciences, University of South Australia, 2005.
  41. Risberg, M. A., Holm, I., Tjomsland, O., Ljunggren, E., & Ekeland, A. "Prospective study of changes in impairments and disabilities after anterior cruciate ligament reconstruction." J Orthop Sports Phys Ther, Vol. 29, No. 7, 1999.
  42. Pollock, R. D., Provan, S., Martin, F. C., & Newham, D. J. "The effects of whole body vibration on balance, joint position sense and cutaneous sensation. Eur J Appl physiol, Vol. 111, No. 12 pp. 3069-3077, 2011. https://doi.org/10.1007/s00421-011-1943-y
  43. Kasai, T., Kawanishi, M., & Yahagi, S. "The effects of wrist muscle vibration on human voluntary elbow flexion-extension movements." Exp Brain Res, Vol. 90, No. 1 pp. 217-220, 1992.