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The Effects of Convergent Stimulation on tDCS during Mirror Therapy to Improve the Muscle Strength and Gait Ability in Chronic Stroke Patients

만성 뇌졸중 환자에서 거울 치료 시 tDCS의 융합 자극이 다리근력 및 보행능력에 미치는 효과

  • 이승태 (순천희망병원 물리치료실) ;
  • 김경윤 (동신대학교 물리치료학과)
  • Received : 2020.07.11
  • Accepted : 2020.08.21
  • Published : 2020.08.31

Abstract

The purpose of this study was to investigate the improvement of muscle strength and gait ability of paralyzed lower extremity through convergent stimulation of tDCS(transcranial direct current stimulation) during mirror therapy with resistance exercise in chronic stroke patients. 12 patients with stroke were randomly assigned and divided into groupI(n=6) and groupII(n=6). GroupI provided NDT(neurodevelopmental treatment) and mirror therapy with sham tDCS, and groupII provided NDT and mirror therapy with tDCS. Each convergent stimulation was conducted 5 times a week, 30 minutes per session for a total of 4 weeks. All evaluation was conducted before intervention and performed after 4 weeks. Lower extremity strength showed a significant improvement in groupII compared to groupI(p<.05), and in comparison between groups by variance, significant difference in the quadriceps(p<.01) and tibialis anterior(p<.01). Gait ability showed a significant improvement in both groupI(p<.05) and groupII(p<.05), and significant difference in comparison between groups by variance(p<.01). In conclusion, mirror therapy with tDCS convergent stimulation had a positive improvement effect on paralyzed lower extremity to strength and gait ability through the overlapping interaction.

본 연구는 만성 뇌졸중 환자를 대상으로 저항운동이 포함된 거울치료 시 tDCS(transcranial direct current stimulation)의 융합 자극을 통해 마비측 다리의 근력과 보행 능력의 개선을 알아보고자 하였다. 12명의 뇌졸중 환자는 실험군 당 6명씩 무작위로 할당하였다. 실험군I(n=6)은 NDT(neurodevelopmental treatment)와 거울치료 시 sham tDCS의 융합자극군, 실험군II는 NDT와 거울치료 시 tDCS의 융합자극군으로 나누어 각각 30분씩, 주5회, 총4주 동안 실험을 실시하였다. 모든 평가는 중재 전과 중재 4주 후에 실시하였다. 다리근력은 측정한 모든 근육에서 실험군I에 비해 실험군II에서 유의한 차이를 나타냈고(p<.05), 변화량을 통한 군 간 비교에서는 quadriceps(p<.01)와 tibialis anterior(p<.01)에서 유의한 차이를 나타냈다. 보행능력은 실험군I과 실험군II 모두에서 유의한 차이를 나타냈고(p<.05), 변화량을 통한 군 간 비교에서 유의한 차이를 나타냈다(p<.01). 거울치료와 tDCS의 융합자극은 마비측 다리 근력 및 보행능력 향상에 중첩효과를 통한 긍정적인 개선 효과를 주는 것을 알 수 있었다.

Keywords

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