다운증후군 아동의 보행 향상을 위한 근육활동 규명
Analysis of Lower Extremity Muscle Activity onthe Gait in Children with Down Syndrome
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초록
다운증후군 아이들은 근육의 약화와 불균형으로 인하여 걸을 때 여러 가지 문제점을 가지고 있다. 본 연구는 다운증후군을 가진 아동(9～13세) 7명을 대상으로 걸을 때 작용하는 하지 근육의 역할을 규명하기 위해서 수행되었다. 보행 중에 중요하게 작용하는 근육들(장내전근, 중둔근, 대둔근, 대퇴이두근, 대퇴직근, 비복근, 전경골근)의 활동을 기록하기 위하여 7쌍의 표면 전극을 하지의 해당부위에 부착한 후 근전도 자료를 기록하였다. 실험을 통해서 얻은 근전도를 필터링하고 정류하였다. 부드러운 근전도를 얻기 위해서 정류된 근전도를 3㎐의 차단주파수로 다시 필터링하였다. 표준화된 근전도는 보행주기 동안 나타난 최대 값(100%)의 백분율로 구하였다. 다운증후군 아동들의 전경골근, 대퇴이두근, 장내전근의 근력 활동의 비율이 낮게 나타나서 이러한 근육들의 강화와 불균형 조절 훈련을 통해서 보행 패턴을 향상 시킬 필요가 있다. 따라서 이러한 근육들의 강화를 위한 발 앞꿈치 들기, 레크 컬, 엉덩 내전 강화 훈련이 포함되어야 할 것이다. 또한 위 근육들의 불균형을 조절하기 위한 발 뒤꿈치 들기, 레그 익스텐션, 엉덩 외전 강화 훈련도 포함되어야 할 것으로 판단된다. 정상인은 걸을 때 대체로 일정한 패턴을 보였으나, 다운증후군은 지지기와 체공기 전반에 걸쳐 다양한 패턴이 나타났다. 따라서 다운증후군 개개인별로 보행 동작 및 근육의 활동을 진단하고 평가하여 개개인별 맞춤형 근력 향상 훈련과 보행 향상 훈련을 실시해야 할 것으로 판단된다.
Abstract
The purpose of this study were to investigate the muscle activities of adductor longus, gluteus medius, gluteus maximus, biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior using noraxon 8 channels EMG system during walking in children with trisomy-21 Down syndrome. Seven children (9~13 years old) with Down syndrome and one normal adult participated in this study. The results indicated that the Down syndrome's tibialis anterior showed lower muscle activity than normal ones from foot contact to foot stance phase. This means that most of Down syndrome contacted ground by foot flat without heel contacted. While the normal's rectus femoris showed activity in swing-stance transition period, the Down syndrome showed activity in stance-swing transition period. The Down syndrome's adductor longus showed higher muscle activity in swing phase than normal ones. This means that the Down syndrome walked with sway thigh. The tibialis anterior, biceps femoris, and adductor longus showed lower muscle activity during walking. So, it needs to strength these muscles(ex, toe-taps, leg curl, and inner thigh). The Down syndrome's EMG pattern showed intra-individual and inter-individual variabilities. Therefore it needs to training related muscle each other.
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