The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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Change in Gait Parameters by Arm Sling Types in Healthy Adults

팔걸이 형태에 따른 정상인의 보행변수 변화

  • 이옥경 (좋은강안병원 물리치료실) ;
  • 안덕현 (인제대학교 의생명공학대학 물리치료학과)
  • Received : 2010.02.03
  • Accepted : 2010.04.19
  • Published : 2010.05.28
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Abstract

The purpose of this study was to investigate the variations in gait parameters according to arm slings used in healthy adults. Twenty healthy adults (9 males, 11 females) participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. They were randomly assigned conditions: without an arm sling, a care sling, a Harris hemi arm sling, a CVA sling, and a Rolyan humeral cuff sling. The following gait parameters were analyzed: the temporo-spatial parameters of gait velocity, swing phase, single support, cadence. In the comparison of parameters in each trial, step length was statistically significantly changed(p=.002). The right step length was significantly decreased in the Harris hemi arm sling and increased in the Rolyan humeral cuff sling when compared with no sling. This study found that several different types arm slings varied gait pattern in healthy adults.

본 연구의 목적은 4가지의 다른 형태의 팔걸이를 이용하여 상지의 움직임을 제한하였을 때, 보행양상에 미치는 영향을 알아보고, 기능적인 보행을 획득하기 위한 기초자료를 제공하는 것이다. 건강한 성인 남녀20명을 대상으로 미착용 상태와 단일 끈형, 해리스 편측형, 뇌졸중용, 로리안 상완 커프형 팔걸이를 착용한 상태에서 무작위 순으로 GAITRite system을 통해 보행평가를 시행하였다. 팔걸이를 착용한 동측 하지의 보장에서 유의한 결과를 나타냈다(p=.002). 팔걸이를 착용하지 않았을 때보다 해리스 편측형 착용시에 팔걸이를 착용한 동측 하지의 보장이 감소되었다(p=.001). 신전형 팔걸이인 로리안 상완 커프형 착용시에 해리스 편측형 착용 시에 비해 동측 하지의 보장이 증가되었다(p=.01). 보행속도, 유각기, 단하지 지지기, 분속수에서는 통계적으로 유의한 변화가 없었다. 앞으로의 연구에서는 팔걸이를 착용하는 환자들에게 나타나는 보행변화에 대한 연구와 기능적인 보행패턴을 획득하기 위한 운동학적 측면의 연구가 이루어 져야 할 것이다.

Keywords

References

  1. S. F. Donker, P. J. Beek, R. C. Wagenaar, and T. Mulder, "Coordination between arm and leg movements during locomotion," J. of Motor Behavior, Vol.33, No.1, pp.86-102, 2001. https://doi.org/10.1080/00222890109601905
  2. M. P. Ford, R. C. Wagenaar, and K. M. Newell, "Arm constraint and walking in healthy adults,"Gait Posture, Vol.26, No.1, pp.135-141, 2007. https://doi.org/10.1016/j.gaitpost.2006.08.008
  3. R. C. Wagenaar and R. E. van Emmerik, "Resonant frequencies of arms and legs identify different walking patterns," J. of Biomechanics, Vol.33, No.7, pp.853-861, 2000. https://doi.org/10.1016/S0021-9290(00)00020-8
  4. J. Perry, Gait Analysis: Normal and pathological function, New Jersey, Slack, 1992.
  5. J. R. Gage, Gait Analysis in Cerebral Palsy, London, Cambridge University Press, 1991.
  6. B. R. Umberger, "Effects of suppressing arm swing on kinematics, kinetics, and energetics of human walking," J. of Biomechanics, Vol.41, No.11, pp.2575-2580, 2008. https://doi.org/10.1016/j.jbiomech.2008.05.024
  7. S. Grillner and P. Zangger, "How detailed is the central pattern generation for locomotion?"Brain Research, Vol.88, No.2, pp.367-371, 1975. https://doi.org/10.1016/0006-8993(75)90401-1
  8. K. I. Ustinova, A. G. Feldman, and M. F. Levin, "Central resetting of neuromuscular steady states may underlie rhythmical arm movements," J. of Neurophysiology, Vol.96, No.3, pp.1124-1134, 2006. https://doi.org/10.1152/jn.01152.2005
  9. E. P. Zehr and C. Haridas, "Modulation of cutaneous reflexes in arm muscles during walking: further evidence of similar control mechanisms for rhythmic arm and leg movements," Experimental Brain Research, Vol.149, No.2, pp.260-266, 2003.
  10. E. P. Zehr, K. L. Hesketh, and R. Chua, "Differential regulation of cutaneous and H-reflexes during leg cycling in humans," J. of Neurophysiology, Vol.85, No.3, pp.1178-1184, 2001.
  11. J. Duysens and T. Tax, Interlimb reflexes during gait in cat and human. In: S.P. Swimmen, H. Heuer, J. Massion, P. Casaer(eds), Interlimb Coordination: neural, dynamic, and cognitive constraints. Academic Press, pp.97-126, 1994.
  12. D. P. Ferris, H. J. Huang, and P. C. Kao, "Moving the arms to activate the legs,"Exercise and Sport Science Reviews, Vol.34, No.3, pp.113-120, 2006. https://doi.org/10.1249/00003677-200607000-00005
  13. K. M. Jackson, J. Joseph, and S. J. Wyard, "The upper limbs during human walking, Part2: Function," Electromyography Clinical Neurophysiology, Vol.23, No.6, pp.435-446, 1983.
  14. M. Kubo, R. C. Wagenaar, E. Saltzman, and K. G. Holt, "Biomechanical mechanism for transitions in phase and frequency of arm and leg during walking," Biological Cybernetics, Vol.91, No.2, pp.91-98, 2004.
  15. R. W. Bohannon, "Gait performance of hemiplegic stroke patient: Selected variables,"Archives of Physical Medicine and Rehabilitation, Vol.68, No.11, pp.777-781, 1987.
  16. L. K. Smith, E .I. Weiss, and L. D. Lehmkuhl, Brunnstrom's Clinical Kinesiology. 5th Ed, Philadelphia, FA Davis Company, 1996.
  17. S. V. Fisher and G. Gullickson Jr, "Energy cost of ambulation in health and disability: A literature review," Archives of Physical Medicine and Rehabilitation, Vol.59, No.3, pp.124-133, 1978.
  18. J. Park, "Synthesis of natural arm swing motion in human bipedal walking," J. of Biomechanics, Vol.41, No.7, pp.1417-1426, 2008. https://doi.org/10.1016/j.jbiomech.2008.02.031
  19. S. T. Eke-Okoro, M. Gregoric, and L. E. Larsson, "Alterations in gait resulting from deliberate changes of arm-swing amplitude and phase," Clinical Biomechanics, Vol.12, No.7, pp.516-521, 1997. https://doi.org/10.1016/S0268-0033(97)00050-8
  20. R. D. Zorowitz, D. Idank, T. Ikai, M. B. Hughes, and M. V. Johnston, "Shoulder subluxation after stroke: a comparison of four supports," Archives of Physical Medicine and Rehabilitation, Vol.76, No.8, pp.763-771, 1995. https://doi.org/10.1016/S0003-9993(95)80532-X
  21. M. M. Brooke, B. J. de Lateur, G. C. Diana-Rigby, and K. A. Questad, "Shoulder subluxation in hemiplegia: effects of three different supports," Archives of Physical Medicine and Rehabilitation, Vol.72, No.8, pp.582-586, 1991.
  22. 한경희, 김경덕, 장기언, "팔걸이의 4가지 유형에 따른 견관절 아탈구 교정효과의 방사선학적 비교 ", 대한재활의학회지, 제18권, 제1호, pp.118-124, 1994.
  23. G. Yavuzer and S. Ergin, "Effect of an arm sling on gait pattern in patients with hemiplegia," Archives of Physical Medicine and Rehabilitation, Vol.83, No.7, pp.960-963, 2002. https://doi.org/10.1053/apmr.2002.33098
  24. 김정태, 박성현, "팔걸이 착용이 편마비 환자의 보행지지기 동안 하지 근육의 활성도에 미치는 영향", 한국체육학회지, 제46권, 제1호, pp.713-722, 2007.
  25. 윤성익, "성인편마비환자에서 팔걸이가 보행 중 에너지 소모량에 미치는 영향", 한양대학교 대학원 석사학위논문, 2004.
  26. 이도경, 한승진, 윤성익, 김미정, 이규훈, “팔걸이가 편마비환자의 기립자세 균형에 미치는 영향”, 대한재활의학회지, 제28권, 제6호, pp.532-536, 2004.
  27. R. W. Kressing, R. J. Gregor, A. Oliver, D. Waddell, W. Smith, M. O'Grady, A. T. Curns, and M Kutner, "Temporal and spatial features of gait in older adults transitioning to frailty," Gait Posture, Vol.20, No.1, pp.30-35, 2004. https://doi.org/10.1016/S0966-6362(03)00089-4
  28. B. Bilney, M Morris, and K. Webster, "Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait," Gait Posture, Vol.17, No.1, pp.68-74, 2003. https://doi.org/10.1016/S0966-6362(02)00053-X
  29. H. B. Menz, M. D. Latt, A. Tiedemann A, M. Mun San Kwan, and S. R. Lord, "Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people," Gait Posture, Vol.20, No.1, pp.20-25, 2004. https://doi.org/10.1016/S0966-6362(03)00068-7
  30. A. L. McDonough, M. Batavia, P. C. Chen, S. Kwon, and J. Ziai, "The validity and reliability of the GAITRite system's measurements: A preliminary evaluation," Archives of Physical Medicine and Rehabilitation, Vol.82, No.3, pp.419-425, 2001. https://doi.org/10.1053/apmr.2001.19778
  31. R. W. Bohannon, "Gait performance of hemiplegic stroke patient: Selected variables,"Archives of Physical Medicine and Rehabilitation, Vol.68, No.11, pp.777-781, 1987.
  32. D. Webb, R. H. Tuttle, and M. Baksh, "Pendular activity of human upper limbs during slow and normal walking," American J. of Physical Anthropology, Vol.93, No.4, pp.477-489, 1994. https://doi.org/10.1002/ajpa.1330930407
  33. M. LaFiandra, R. C. Wagenaar, K. G. Holt, and J. P. Obusek, "How do load carriage and walking speed influence trunk coordination and stride parameters," J. of Biomechanics, Vol.36, No.1, pp.87?.95, 2003. https://doi.org/10.1016/S0021-9290(02)00243-9
  34. M. Kubo, K. G. Holt, E. Saltzman, and R. C. Wagenaar, "Changes in axial stiffness of the trunk as a function of walking speed," J. of Biomechanics, Vol.39, No.4, pp.750-757, 2006. https://doi.org/10.1016/j.jbiomech.2004.12.024
  35. R .C. Wagenaar and W. J. Beek, "Hemiplegic gait: a kinematic analysis using walking speed as a basis," J. of Biomechanics, Vol.25, No.9, pp.1007-1015, 1992. https://doi.org/10.1016/0021-9290(92)90036-Z
  36. J. D. Ortega, L. A. Fehlman, and C. T. Farley, "Effects of aging and arm swing on the metabolic cost of stability in human walking," J. of Biomechanics, Vol.41, No.16, pp.3303-3308, 2008. https://doi.org/10.1016/j.jbiomech.2008.06.039

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