만성 편마비 장애인의 보행속도와 동맥경직도와의 관련성
Association Between Gait Velocity and Arterial Stiffness in Individuals with Chronic Hemiplegia
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초록
동맥경직도의 증가는 심혈관계 질환의 위험성 증가와 관련이 높으며, 보행속도 또한 혈관의 죽상경화와 같은 심혈관계 질환의 위험요인과 관계한다. 최근 선행연구에서는 이와 같은 동맥경직도와 보행속도와의 관련성을 보고하고 있으나 동맥경직도가 높아져 있고, 보행에 문제가 있는 편마비 장애인을 대상으로 한 연구는 없다. 따라서 본 연구는 편마비 장애인을 대상으로 보행속도와 동맥경직도와의 관련성을 알아보는데 목적이 있다. 본 연구에서는 편마비 장애인 94명(남 68명, 여 26명, 평균 61세)을 대상으로 하였고, 보행속도는 10m 보행과 6분 걷기 검사로 측정하였으며 동맥경직도의 지표로서 경동맥-대퇴동맥 맥파전파속도를 측정하였다. 그 결과 10m 보행속도와 동맥경직도간에는 유의한 역 상관관계를 보였으며(r=-.34, p= .001), 6분 걷기에서도 역 상관관계가 나타났다(r=-.45, p= .001). 그리고 나이, 성별, 체질량지수, 체중, 유병기간, 혈압, 심박수, 약물복용을 보정한 후에도 보행속도는 동맥경직도와 관계하는 것으로 나타났다(10m 보행속도 β=-.19, p= .025; 6분 걷기 보행속도 β=-.27, p= .004). 또한 보행속도가 빠른 그룹이 느린 그룹에 비해 동맥경직도가 더 낮은 것으로 나타났다(8.6m/s vs. 11.4m/s, p= .001). 따라서 빠른 보행속도는 낮은 동맥경직도와 관계하는 것으로 사료된다.
Abstract
Increased arterial stiffness is a strong predictor of future cardiovascular events. Several studies have shown that gait velocity is associated with arterial stiffness, but it is unclear in individuals with chronic hemiplegia. We investigated the relationship between gait velocity and arterial stiffness in individuals with chronic hemiplegia. Ninety four patients with stroke(68 male , 26 female, mean age 61) were recruited in the study. We measured the 10 meter gait test and the six minutes walk test(6MWT) as indices of gait velocity. Arterial stiffness was assessed by carotid-femoral pulse wave velocity using applanation tonometry. There was a significant inversely association between gait velocity and pulse wave velocity(10m gait test r=-.34, p=.001; 6MWT r=-.45, p=.001). In separate multivariable linear regression models that adjusted for age, gender, body mass index, duration of stroke, systolic blood pressure, heart rate, and medication, gait velocity was an independent associated with pulse wave velocity(10m gait test β=-.19, p=.025; 6MWT β=-.27, p=.004). Subjects with fast gait velocity had significantly lower pulse wave velocity than subjects with low gait velocity(8.6m/s vs. 11.4m/s, p=.001). These findings demonstrate that high gait velocity was associated with low arterial stiffness independent of risk factors in individuals with chronic hemiplegia
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