뇌졸중 환자의 유병기간 및 발 위치에 따른 일어서기 동작의 특성
Characteristics of Sit-to-stand Movements in Stroke Patients According to the Onset Time and Foot Position
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[서론] 이 연구의 목적은 뇌졸중 환자의 유병기간과 발의 위치에 따른 일어서기 동작의 특성을 분석하는 것이다. 뇌졸중 환자의 움직임과 관련된 선행연구들은 환자들의 유병기간을 고려하지 않은 채 그 결과를 일반적인 뇌졸중 환자의 움직임 특성으로 정의한다. 발 위치의 변화는 유병기간이 상이한 뇌졸중 환자들의 일어서기 동작에 어떤 영향을 줄 것인가 하는 의문에서 본 연구가 시작되었다. [방법] 압력측정 장비와 근전도 장비를 이용하여 일어서기 동작 수행 시 양 하지의 피크 압력, 힘, 대퇴직근, 대퇴이두근, 전경골근, 가자미근의 활동이 분석되었다. 대상자들은 세 가지 조건의 발 위치에서 일어서기 동작을 수행하였다. 조건1) 양발 나란히 놓고 일어서기, 조건2) 환측발을 건측발 뒤에 두고 일어서기, 조건3) 건측발을 환측발 뒤에 두고 일어서기 등이다. [결과] 뇌졸중 유병기간이 12개월 미만인 대상자들은 환측발을 건측발 뒤에 두고 일어서기 수행 시 양발의 최대 피크 압력이 크게 나타났고, 환측과 건측의 수직력 차이가 가장 작게 나타났다. 환측발을 건측발 뒤에 두고 일어서기 수행 시 환측 대퇴사두근의 활동이 감소하였다. [결론] 환측발을 건측발 뒤에 두고 일어서기 동작을 수행하는 것이 뇌졸중 유병기간이 짧은 대상자들에게 도움이 되는 전략으로 사료된다. 또한 유병기간 3년 전·후의 뇌졸중 환자들의 일어서기 동작 시 근육의 건측과 환측의 활동패턴이 다르게 나타났다. 따라서 뇌졸중 환자의 움직임 연구 수행 시 유병기간이 고려되어야 할 것이다.
Abstract
[INTRODUCTION] The purpose of this study was to investigate the characteristics of Sit-To-Stand(STS) movement in stroke patients according to the stroke onset time and foot positions, analyzing force, foot pressure, and muscle activities. Many studies which investigated the characteristics of movements have not considered stroke onset time in subjects. The foot positions may influence the STS in subjects who had different stroke onset time. [METHOD] Foot pressure, force, and the activities of four muscles(Rectus Femoris, Bicpes Femoris, Tibialis Anterior, & Soleus) were measured, using Novel emed-x systems and DELSYS Trigno Wireless system. Subjects performed STS movements in three foot conditions(con1: two foots are parallel, con2: paretic limb is placed posterior to non-paretic limb, & con3: non-pareitc limb is placed posterior to paretic limb). [RESULT] Subjects who suffered from stroke within 12 months showed the maximum value of peak pressure, the minimum value of difference in vertical force between paretic and non-pareatic limb, and decrease of Rectus Femoris at paretic limb in con2. [CONCLUSION] The strategy which is the paretic limb was placed posterior to the non-paretic limb might be a helpful method for acute stroke patients. Stroke onset time within/after three years had an effect on activities of muscles. Therefore, stroke onset time might be considered in the movement study.
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