• 제목/요약/키워드: muscle spasticity

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엉덩관절의 근력, 감각과 경직이 만성 뇌졸중 환자의 균형에 미치는 영향 (The Effect of Muscular strength, Sensation, and Spasticity of the Hip Joint on Balance in Chronic Stroke Patients)

  • 최유임;박은영
    • 한국산학기술학회논문지
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    • 제12권9호
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    • pp.4008-4014
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    • 2011
  • 이 연구는 뇌졸중 환자를 대상으로 임상척도를 이용하여 엉덩관절의 근력, 감각과 경직이 균형능력에 미치는 영향을 알아보기 위해 실시되었다. 32명의 뇌졸중 환자를 대상으로 도수근력검사를 사용하여 환측 다리의 가벼운 접촉감각과 엉덩관절굽힘근, 폄근, 모음근, 그리고 벌림근의 근력을 측정하였고, 수정 Ashworth 척도를 이용하여 넙다리근의 경직을 측정하였으며, 기능적 균형 척도를 이용하여 정적 및 동적균형능력을 측정하였다. 수집된 자료는 다중회귀분석을 이용하여 분석하였다. 연구결과 정적균형에 유의한 영향을 미치는 요인은 엉덩관절벌림근력, 넙다리 경직, 가벼운 접촉감각인 것으로 나타났으며(p<0.05), 설명력은 80.5%인 것으로 나타났다. 동적균형능력에 영향을 미치는 요인으로는 엉덩관절벌림근력과 가벼운 접촉감각인 것으로 나타났으며(p<0.05), 설명력은 77.9%인 것으로 나타났다. 엉덩관절벌림근력과 가벼운 접촉감각은 정적균형과 동적균형 모두에 영향을 미치는 것으로 나타나, 앞으로 균형에 대한 검사와 중재 프로그램 제공 시 엉덩관절벌림근력과 가벼운 접촉감각 요인을 고려하는 것이 필요할 것으로 여겨진다.

일상생활활동 수행능력에 따른 뇌졸중 환자의 신체 및 인지기능의 변화 (Changes in physical and cognitive functions according to the activities of daily living performance in stroke patients)

  • 김혜은;조기훈
    • 대한물리치료과학회지
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    • 제31권1호
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    • pp.98-109
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    • 2024
  • Background: The purpose of this study is to investigate changes in physical and cognitive function according to the level of independence in performing activities of daily living in stroke patients. Design: Retrospective study. Method: This study is a retrospective study analyzing medical records. This study utilized data collected from 123 stroke patients at admission in a local rehabilitation hospital between 2019 and 2022. Stroke patients were classified into 5 groups based on the scores of the Korean Modified Barthel index (K-MBI) evaluated at the time of hospitalization at a rehabilitation hospital, and investigated the change in physical (spasticity (modified Ashworth scale), muscle strength (manual muscle test), gait ability (functional ambulation category), upper extremity function (manual function test), and balance function (berg balance scale)) and cognitive function (Korean mini mental status examination) according to the level of independence in performing activities of daily living. Result:: As a results, significant differences were observed in the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive functions of stroke patients according to the level of independence in performing activities of daily living (p<0.05). However, there was no significant difference in upper and lower extremities spasticity. Conclusions: Through the results of this study, we found that the physical (muscle strength, gait ability, upper extremity and balance functions) and cognitive function were influenced by the level of independence in performing activities of daily living in stroke patients.

기능적 전기자극에 대한 고찰 (The Review of Functional Electrical Stimulation)

  • 박규현;김선규;정현애;박래준
    • The Journal of Korean Physical Therapy
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    • 제13권2호
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    • pp.399-405
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    • 2001
  • Attainment of the goals of functional electrical stimulation(FES) applications such as strengthening of muscle, increasing muscular endurance, improvement in joint range of motion or the reduction of spasticity does not insure that patients will be able to produce voluntary muscle contraction sufficient to maintain posture or produce purposeful movements. In many patients who have sustained CNS damage, the control exerted by higher nervous system center over muscle contraction may impaired. In Searched patients, a variety of advanced therapeutic exercise techniques have been employed traditionally to facilitate the return of controlled functional muscular activity or maintain postural alignment until recovery from dysfunction occurs Among the most common clinical applications of FES for functional muscle contraction is as a substitute for static or dynamic orthotic devices

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수중운동이 경련성 뇌성마비인의 신체구성, 체력 및 폐기능에 미치는 영향 (Effect of Aquatic Exercise on Body Composition, Fitness and Pulmonary Function of Spasticity Cerebral Palsy)

  • 고영호;윤영복;김선호
    • 한국콘텐츠학회논문지
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    • 제5권3호
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    • pp.37-44
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    • 2005
  • 수중운동이 경련성 뇌성마비인의 신체구성, 체력 및 폐기능에 미치는 효과를 규명하기 위하여 경련성 뇌성마비 남자 7명을 대상으로 11개 동작으로 구성된 수중운동 프로그램을 주 4회(월, 화, 목, 금)의 빈도로 1일 30$\~$40분씩 12주간 실시하여 변인들의 측정치를 비교 분석한 결과 신체구성 성분(체중, 체지방율, 지방량)은 각각 유의하게 감소되었으며(P< .05), 체력요소는 근 지구력(p< .01), 유연성(p< .05), 평형성(p< .01)에서만 각각 유의하게 증가하였다. 또한, 폐활량도 12주 수중운동 후 유의하게 증가하였다(p<.05).

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기능적 전기자극을 적용한 트레드밀 보행훈련에 통합한 경피신경 전기자극이 뇌졸중환자의 경직도 균형, 보행 능력에 미치는 영향 (Effects of Integrating Transcutaneous Electrical Nerve Stimulation into Treadmill Gait Training Applying Functional Electrical Stimulation on Spasticity, Balance and Gait Ability in Stroke Patients: A Randomized Controlled Trial)

  • 이문수;이명모
    • 대한물리의학회지
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    • 제15권2호
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    • pp.39-48
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    • 2020
  • PURPOSE: This study examined the effects of integrating transcutaneous electrical nerve stimulation into treadmill gait training by applying functional electrical stimulation on the spasticity, balance, and gait ability of chronic stroke patients METHODS: Twenty participants were assigned randomly to two groups: the treadmill gait training group with applied functional electrical stimulation (FES) with integrated transcutaneous electricalstimulation (TENS) (experimental group, EG, n = 10) and the treadmill gait training group with FES (control group, CG, n = 10). Both groups received treadmill gait training with FES for 30 minutes a time, four times a week, during five weeks. The experimental group received additional TENS on their L3, L5, and S2 dermatome for 30 minutes before the interventions. The spasticity, balance, and gait ability were evaluated before and after the training to compare the intergroup and intragroup changes. RESULTS: Both groups showed significant improvements in the static, dynamic balance, and gait ability (p < .05), but did not show any significant changes in the muscle tone. The EG showed significant improvements in the static balance ability and gait cycle compared to the CG (p < .05). CONCLUSION: Treadmill gait training combined with FES with integrated TENS is an effective method for improving the static balance and gait cycle. On the other hand, the effects of treadmill gait training with FES on spasticity need to be studied further.

편마비 환자에서 트레드밀 보행훈련이 보행에 미치는 효과 - 지면 보행훈련과의 비교 - (Effects of Treadmill Gait Training on Gait Patterns in Hemiplegic Patients comparison with conventional gait training)

  • 김현희;허진강;양영애
    • 대한물리치료과학회지
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    • 제10권2호
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    • pp.17-28
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    • 2003
  • The aim of this study was to investigate the effects of treadmill gait training on the functional characteristics and the temporal-distance parameters of gait in hemiplegic patients, as compared with conventional gait training. The subjects of this study were 32 hemiplegic patients who had been admitted or were visited out-patients at Kangdong Sacred Heart Hospital, Hallym University, from March 3 through April 25, 2003. These subjects were randomly divided into treadmill gait training group or conventional gait training group. We evaluated the gait ability, motor functions, muscle strength, spasticity, physiological cost index, and temporal-distance parameters. We analyzed the changes between pre and post training in each groups, and the difference between two groups. Temporal-distance parameters were obtained using the ink footprint method and then energy consumption using physiological cost index. The results were as follows: 1. After a six-week training, treadmill gait training group significantly improved, as. compared to pre-training, in gait ability, motor functions for the leg and trunk and gross function, muscle strength of the lower limb, gait speed, cadence, step length both on the affected and on the unaffected side, step length symmetry, and energy consumption(p<0.05). 2. After a six-week training, conventional gait training group significantly improved, as compared to pretraining, in gait ability, motor functions for the leg and trunk, muscle strength of the lower limb, spasticity the upper limb, gait speed, cadence, step length both on the affected and on the unaffected side, and energy consumption(p<0.05). 3. After a six-week training, the treadmill gait training group significantly improved, as compared to the conventional gait, training, in gait speed and step length on the unaffected side. These results show that treadmill gait training was improved gait speed and step length on the unaffected side of hemiplegic patients, as compared with conventional gait training. Further research is needed to confirm the generalization of these findings and to identify which hemiplegic patients might benefit from treadmill gait training.

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편마비 환자의 건측에 적용한 고유수용성 신경근 촉진법이 환측 근 긴장도에 미치는 영향 (Effect of PNF Applied to the Unaffected Side on Muscle Tone of Affected Side in Patients With Hemiplegia)

  • 우영근;조규행;유은영
    • 한국전문물리치료학회지
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    • 제9권2호
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    • pp.157-168
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    • 2002
  • The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) approach on the spasticity of affected side in patients with hemiplegia. Three subjects with hemiplegia participated in this study. In single-subject research design (a multiple baseline across individuals) was employed in this study. The intervention program including PNF to the unaffected side was introduced for 30 minutes each day during each intervention phase. Muscle tone of affected side was measured with Tone Assessment Scale, and active hip abduction distance of affected side was taken with the subject supine. And then the muscle tone and the hip abduction distance were measured again 30 minutes later following the intervention. The results showed that the PNF application had some beneficial effects on both muscle tone and active hip abduction. This result suggest that PNF application to non-paretic limb can be effective in reducing muscle tone and improving hip abduction range on paretic limb in persons with hemiplegia. However, further research is needed to prove the effect of PNF application on functional improvement.

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국내·외 문헌적 비교를 통한 뇌졸중 환자에 대한 근력강화 운동의 고찰연구 (A Study on Strengthening Exercise for Stroke Patients through Comparison of Literature between Domestic and Foreign)

  • 오태영
    • 대한통합의학회지
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    • 제7권1호
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    • pp.113-124
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    • 2019
  • Purpose : The purpose of this study is to investigate the effect of strengthening program for improving the muscle strength and body function in rehabilitation of patients with stroke Methods : We found the 15 precedent studies at online portal site of "Korea education and Research information service" and found 5 precedent studies at "Pubmed". We analyzed and describe the total 19 studies involving national and international research. Results : The strengthening exercise was adapted to lower extremities and trunk muscle of participants and the isokinetic (concentric and eccentric) exercise was most of exercise type and then manual isometric exercise, functional activities, progressive task oriented resistance exercise, PNF pattern exercise was following. The studies reported that the strengthening program increased target muscle strength and improved balance capacity and walking function for the participants positively. Conclusion : Conclusionally the several strengthening program can be the intervention to increase the muscle strength without increasing spasticity for patients with stroke. We think that the strengthening of lower extremities an improve balance capacity and walking ability and it can use the intervention to change the quality of life in patients with stroke. More than 3weeks strength program might be effectiveness, in case of acute patients with stroke, the improving of muscle strength is available but need to study for improving balance and walking capacity more in the future.

기능적 전기 자극에 대한 고찰 (A Study on the Functional Electrical Stimulation)

  • 임종수;김순희;송영화
    • 대한물리치료과학회지
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    • 제6권4호
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    • pp.187-199
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    • 1999
  • Functional Electrical Stimulation (FES) is used for muscle reeducation, reduction of spasticity, delay of atrophy, and muscle strengthening. FES stronger stimulation than other forms of electrical stimulation. The efficacy of FES in improving function has been substantiated in the literature. Treatment programs employing FES - activation of muscular tissue through the intact peripheral nervous system - can be broken into five major categories, according to the goal of treatment. These broad areas would include the use of FES to: (1) a direct excitation onto the alpha motoneuron, through peripheral stimulation of the Ia myotatic sensory system and ascending afferent information, which will be integrated at conscious and subconscious level of the CNS. (2) The quality of a stimulated muscle contraction is determined by combination of many parameters, including stimulus amplitude, pulse duration, stimulus frequency, and duty cycle. (3) A unit that has a pulse duration between 200 and $400{\mu}sec$ will be more than adequate for FES applications. (4) The neuromuscular plasticity is critically important to return of function using muscle re-education and facilitation applications. (5) Prior to using FES as an electrical orthosis, the patient should build up endurance in the muscles to be stimu1ated during the gait cycle.

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