근력훈련이 다운증후군 청년의 발목 관절에 작용하는 회전력에 미치는 영향
The Effects of Strength Training on Ankle Kinetics During Walking in an Adolescent with Down Syndrome: A Single Case Study
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다운증후군을 가지고 있는 사람들은 근육의 약화와 불균형으로 인해 걸을 때 여러 가지 문제점을 가지고 있다. 본 연구의 목적은 다운증후군 아동의 보행에 영향을 주는 근력 훈련이 보행과 자세를 조절하는데 중요한 부위인 발목 관절에 작용하는 회전력에 미치는 영향을 규명하는 것이다. 21세의 다운증후군을 가진 남자청년 1명과 발목 관절에 작용하는 회전력을 비교하기 위해서 12세의 정상인 여자 1명이 본 연구에 참가하였다. 보행과 관련된 8가지 운동(스쿼트, 레그 컬, 레그 익스텐션, 토 레이즈, 대퇴 내전 및 외전, 백 익스텐션 및 윗몸일으키기)이 1주일에 3회, 1회에 3세트씩, 총 12주간 점증부하의 원리에 의해 실시되었다. 근력 훈련 전․후에 등속성 근력과 발목 회전력을 측정하여 비교하였다. 12주간의 근력훈련을 통해서 최대회전력과 평균 파워가 점증적으로 증가하였다. 이것은 일반인과 마찬가지로 다운증후군에게도 충분한 훈련을 통해 근력을 향상시킬 가능성이 있다는 것을 의미한다. 또한, 12주간의 근력훈련은 배측굴곡/저측굴곡 모멘트에는 영향을 미치지 않았으나, 내측 회전근에서 외측 회전근으로 바뀌는 타이밍과 외측 회전근의 최대값이 나타나는 타이밍이 정상보행에 가까워졌다. 결론적으로 12주간의 근력훈련은 다운증후군의 근력을 향상시키고 보행 패턴의 타이밍을 향상시켰다.
Abstract
The purpose of this study were to investigate the effects of strength training on ankle kinetics during walking in an adolescent with trisomy-21 Down syndrome. One adolescent with Down syndrome and one normal child participated in this study. Strength training consisted of eight exercises: squat, hamstring curl, hip adduction, hip abduction, knee extension, toe raise, sit-ups, and hyperextension of the waist. The participant with Down syndrome participated in strength training for 12 weeks, three times a week, three sets, 10-15 RM; resistance was adjusted according to the principle of progressive overload. To measure the effect of strength training, isokinetic strength variables and ankle kinetics were measured before training and after 12 weeks of training. The participant with Down syndrome had some abnormalities in controlling ankle motion during walking due to muscle hypotonia, ligament laxity, and weakness of plantar flexor muscles. Post-training isokinetic strength increased compared to pre-training measurements. Strength training did not affect dorsiflexion/plantarflexion moments but did have an effect on adduction and internal/external moments in timing.
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