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Relationship Between Pendulum Test Measurements of Post-Stroke Spasticity

뇌졸중 후 강직 평가를 위한 진자검사 측정값의 상관관계

  • 김용욱 (전주대학교 대체의학대학 물리치료학과)
  • Received : 2010.01.27
  • Accepted : 2010.04.13
  • Published : 2010.05.28

Abstract

The purpose of this study was to investigate the relationship between three quantitative measures of the pendulum test for spasticity in strokes: The relaxation index, the number of oscillations, and the duration of oscillations. Twenty-six stroke subjects participated in the study. Correlations among these measures of spasticity used Pearson's correlation coefficient. There was a statistically significant positive correlation between the relaxation index and number of oscillations in strokes (r=.881, p<.01). In addition there was significant positive correlation between the relaxation index and duration of oscillations (r=.896, p<.01), and between the number of oscillations and duration of oscillations (r=.938, p<.01). Thus, it is possible to use the number of oscillations and duration of oscillations as quantitative measures of spasticity, rather than the relaxation index, which is more complicated to obtain. According to the result of this study, the use of the simple and objective measurements of the number of oscillations and the duration of oscillations are required clinically in the quantitative measures of spasticity in the future.

본 연구의 목적은 뇌졸중 후 발생하는 강직을 평가하는데 사용되는 진자검사에서 세 가지 정량적 측정값 사이의 상관관계를 알아보는 것이다. 세 가지 측정값은 이완 지수, 진동 횟수, 그리고 진동 시간이다. 뇌졸중 환자 26명이 본 연구에 참여하였고, 측정값들 사이의 상관관계를 검증하기 위하여 피어슨 상관계수를 사용하였다. 본 연구의 결과 이완 지수와 진동 횟수 사이에서 통계적으로 유의한 양적 상관관계를 보였다(r=.881, p<.01). 또한 이완 지수와 진동 시간 사이에서도 유의한 양적 상관관계를 보였으며(r=.896, p<.01), 진동 횟수와 진동 시간 사이에서도 유의한 양적 상관관계를 보였다(r=.938, p<.01). 진자검사를 통한 강직의 정량적 측정치인 진동 횟수와 진동 시간은 복잡한 계산 과정을 통해 구해지는 이완 지수보다 비교적 쉽고 간단히 구할 수 있다. 따라서 간단하면서도 객관적인 측정값으로서 진자검사의 진동 횟수와 진동 시간의 사용이 향후 임상에서 강직의 정량적인 측정방법으로 유용할 것으로 사료된다.

Keywords

References

  1. P. S. Smith, "Berg balance scale and functional reach: determining the best clinical tool for individuals post acute stroke," Clin Rehabil, Vol.18, pp.811-818, 2004. https://doi.org/10.1191/0269215504cr817oa
  2. S. Reyerson, “Hemiplegia resulting from vascular insult or disease," Neurological Rehabilitation, Mosby, pp.474-514, 1985.
  3. C. L. Watkins, M. J. Leathley, J. M. Gregson, A. P. Moore, T. L. Smith, and A. K. Sharmal, "Prevalence of spasticity post stroke," Clin Rehabi,. Vol.16, No.5, pp.515-522, 2002. https://doi.org/10.1191/0269215502cr512oa
  4. 김종만, 최흥식, “강직의 최신 지견과 물리치료와의 관련성”, 한국전문물리치료학회지, 제2호, pp.73-84, 1995.
  5. W. S. Pease, "Therapeutic electrical stimulation for spasticity: quantitative gait analysis," Am J Phys Med Rehabil. Vol.77, No.4, pp.351-355, 1998. https://doi.org/10.1097/00002060-199807000-00021
  6. J. J. Daly, E. B. Marsolais, L. M. Mendell, W. Z. Rymer, A. Stefanovska, and J. R. Wolpaw, "Therapeutic neural effects of electrical stimulation," IEEE Trans Rehabil Eng, Vol.4, pp.218-230, 1996. https://doi.org/10.1109/86.547922
  7. J. W. Lance, "Spasticity : disordered motor control," Symposium synopsis, Year Book Medical Pub, pp.485-494, 1980.
  8. C. W. Y. Hui-Chen, S. S. M. Ng, and M. K. Y. Mak, “Effectiveness of a home-based rehabilitation programme on lower limb functions after stroke,” Hong Kong Med J, Vol.15, No.3, pp.S42-S46, 2009.
  9. H. C. Lo, K. H. Tsai, F. C. Su, G. L. Chang, and C. Y. Yeh. "Effects of a functional electrical stimulation-assisted leg-cycling wheelchair on reducing spasticity of patients after stroke," J Rehalil Med, Vol.41, No.4, pp.242-246, 2009. https://doi.org/10.2340/16501977-0320
  10. J. E. Gallichio, "Pharmacological risks following stroke," Phys Ther, Vol.84 No.10, pp.973-981, 2004.
  11. L. Shaw and H. Rodgers, "Botulinum toxin type A for upper limb spasticity after stroke,"Expert Rev Neurother, Vol.9, No.12, pp.1713-1725, 2009. https://doi.org/10.1586/ern.09.121
  12. C. G. Canning, "Constraint-induced movement therapy after injection of Botulinum toxin improves spasticity and motor function in chronic stroke patients," Aust J Physiother Vol.55, No.4, pp.286, 2009. https://doi.org/10.1016/S0004-9514(09)70012-1
  13. M. Rousseaux, N. Buisset, W. Daveluy, O. Kozlowski, and S. Blond, "Long-term effect of tibial nerve neurotomy in stroke patients with lower limb spasticity," J Neurol Sci, Vol.278, No.1-2, pp.71-76, 2009. https://doi.org/10.1016/j.jns.2008.11.024
  14. 전중선, “상지의 경직을 평가하는데 있어 진자검사의 유용성에 대한 연구”, 대한재활의학회지, 제16호, pp.418-422, 1992.
  15. M. Syczewska, M. K. Lebiedowska, and A. D. Dandyan, "Quantifying repeatability of the Wartenberg pendulum test parameters in children with spasticity," J Neurosci Methods, Vol.178, No.2, pp.340-344, 2009. https://doi.org/10.1016/j.jneumeth.2008.12.031
  16. 김용욱, 감각신경 경로의 치료적 전기자극이 뇌병변 환자의 경직에 미치는 영향, 연세대학교 석사학위논문, 2001.
  17. T. Bajd, and B. Bowman, "Testing and modelling of spasticity," J Biomed Eng, Vol.4, No.2, pp.90-96, 1982. https://doi.org/10.1016/0141-5425(82)90067-X
  18. T. Bajd, and L. Vodovnik, "Pendulum testing of spasticity," J Biomed Eng, Vol.6, No.1, pp.9-16, 1984. https://doi.org/10.1016/0141-5425(84)90003-7
  19. R. W. Bohannon, "Variability and reliability of the pendulum test for spasticity using a cybex II isokinetic dynamometer," Phys Ther, Vol.67, No.5, pp.659-661, 1987.
  20. A. W. Smith, C. Kirtley, and M. Jamshidi, “Intrarater reliability of manual passive movement velocity in the clinical evaluation of knee extensor muscle tone," Arch Phys Med Rehabil, Vol.81, No.10, pp.1428-1431, 2000. https://doi.org/10.1053/apmr.2000.9399
  21. H. White, T. L. Uhl, S. Augsburger, and C. Tylkowski, "Reliability of the three-dimensional pendulum test for able-bodied children and children diagnosed with cerebral palsy," Gait & Posture, Vol.26, No.1, pp.97-150, 2007. https://doi.org/10.1016/j.gaitpost.2006.07.012
  22. T, Bajd, and B. Bowman, “Testing and modelling of spasticity,“ J Biomed Eng, Vol.4, pp.90-96, 1982. https://doi.org/10.1016/0141-5425(82)90067-X
  23. J. A. Bauer, J. H. Cauraugh, and M. D. Tillman, "An insole pressure measurement system:repeatability of postural data," Foot Ankle Int, Vol.21, No.3, pp.221-226, 2000.
  24. 김용욱, 원종혁, “정상 성인에 대한 정량적 무릎힘줄반사 검사의 측정자간 신뢰도”, 한국전문물리치료학회지, 제14권, 제3호, pp.57-63, 2007.
  25. B. M. Haas and J. L. Crow, "Towards a clinical measurement of spasticity?," Physiotherapy, Vol.81, No.8, pp.474-479, 1995. https://doi.org/10.1016/S0031-9406(05)66743-0
  26. J Fung and H. Barbeau, "Effects of conditioning cutaneomuscular stimulation on the soleus H-reflex in normal and spastic paretic subjects during walking and standing," J Neurophysiol, Vol.72, No.5, pp.2090-2104, 1994.
  27. M. Jamshidi and A. W. Smith, "Clinical measurement of spasticity using the pendulum test: Comparison of electrogoniometric and videotape analyses," Arch Phys Med Rehabil, Vol.77, No.11, pp.1129-1132, 1996. https://doi.org/10.1016/S0003-9993(96)90134-3
  28. R. Wartenberg, "Pendulousness of the legs as a diagnostic test," Neurology, Vol.1, No.1, pp.18-24, 1951. https://doi.org/10.1212/WNL.1.1.18
  29. B. Stillmann and J. McMeeken, "A video-based version of the pendulum test: Technique and normal response," Arch Phys Med Rehabil, Vol.76, No.2, pp.166-176, 1995. https://doi.org/10.1016/S0003-9993(95)80026-3
  30. E. G. Fowler, T. W. Ho, A. I. Nwigwe, and F. J. Dorey, "The eddect of quadriceps femoris muscle strengthening exercises on spasticity in children with cerebral palsy," Phys Ther, Vol.81, No.6, pp.1215-1223. 2001.