뇌졸중 환자에서 한손 및 양손 활동 수행 시 가속도 분석
Accelerometry of Unimanual and Bimanual Activities in Stroke Patients
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목적 : 본 연구는 뇌졸중 환자가 한손 및 양손 활동을 수행하는 동안 가속도 측정을 통해 건측 및 환측, 위팔 및 아래팔의 활동량을 비교하여 일상생활활동의 정량적 측정도구로써 가속도계의 활용가능성을제시하고자 한다. 연구방법 : 2017년 9월부터 11월까지 우측 편마비 환자 10명과 좌측 편마비 환자 10명을 대상으로 한손활동과 양손 활동을 실시하였다. 한손 활동은 마시기로 건측과 환측을 따로 측정하였고, 양손 활동은옷입기로 건측과 환측을 동시에 측정하였다. 삼축 가속도계를 위팔의 가쪽 위관절융기 아래 지점, 아래팔의 노뼈붓돌기 아래 지점에 착용하여 수행시간과 활동량을 측정하였다. 각 3회씩 반복 측정하여 평균값을사용하였다. 결과 : 우측 편마비 환자에서는 양손 활동 수행 시 아래팔에서만 건측의 활동량이 유의하게 많았고(p<.05), 전체 활동에서 위팔보다 아래팔의 활동량이 유의하게 많았다(p<.01, p<.05). 좌측 편마비 환자에서 한손활동과 양손 활동 수행 시 모두 환측과 건측의 활동량에 유의한 차이가 없었다(p>.05). 양손 활동 시환측을 제외한 모든 활동에서 건측 및 환측의 위팔보다 아래팔의 활동량이 유의하게 많았다(p<.05). 전체 환자에서 양손 활동 수행 시 건측의 위팔과 아래팔의 활동량이 유의하게 많았고(p<.05), 전체 활동에서 위팔보다 아래팔의 활동량이 유의하게 많았다(p<.001, p<.05). 결론 : 삼축 가속도계로 위팔 및 아래팔의 활동량을 측정한 결과, 한손 및 양손 활동 수행 시 아래팔의활동량이 위팔보다 많았고, 양손 활동 수행 시에는 건측의 활동량이 더 많았다.
Abstract
Objective : This study evaluated the differences between the upper and lower arm activities of the affected and non-affected sides in stroke patients performing activities of daily living. It was intended to gather basic data for the measurement of daily activities. Methods : The participants in the study consisted of 20 patients, 10 had left hemiplegia and 10 had right hemiplegia. Between September and November 2017, they performed drinking and dressing as unimanual and bimanual tasks. The 3-axes accelerometers were placed 2cm below the lateral epicondyle on the upper arm and 2cm below the radial styloid on the lower arm. The data were collected at intervals of 1/32 Hz and analyzed. Results : In patients with right hemiplegia, the tendon activity was significantly higher in the lower arm when performing a bimanual activity (p<.05), for all the other activities, those of the lower arm were significantly higher than those of the upper arm (p<.01, p<.05). There was no significant difference between the unimanual and bimanual activities of the affected and tendon sides in patients with left hemiplegia (p>.05). In both hands, the activity of the lower arm was significantly higher than that of the activities of the upper and lower arms, except on the affected side (p<.05). In all patients, the activities of the upper and lower arms were significantly higher (p<.05), and the activity of the lower arm was significantly higher than that of the upper (p<.001, p<.05). Conclusion : The activity was higher on the non-affected side than the affected side during the dressing task, and the overall activity was higher in the lower arm than the upper arm.
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