역동적 정중신경가동기법이 뇌졸중 환자의 손 근활성도 및 악력에 미치는 영향
The Effect of Dynamic Median Neural Mobilization on Hand Muscle Activity and Grip Strength in Stroke Patients
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뇌졸중 환자들의 마비측 악력을 더 효율적으로 증가시키기 위해 본 연구는 뇌졸중 환자들에게 역동적 정중신경가동기법을 적용함으로써 손 주위 근 활성도와 악력의 변화를 규명하고, 이를 통해 뇌졸중 환자들의 팔 기능 회복 정도를 예측할 수 있는 임상적 기초자료를 제공하기 위해 시행하였다. 뇌졸중 환자를 대상으로 각 집단에 10명씩 무작위 배치하고 사전 검사로 마비측 손 주위 근활성도와 악력을 측정하였으며, 총 4주 간, 주 4회, 1일 1회, 1회 3세트, 세트당 10회 중재를 시행하였다. 그리고 사후 검사는 사전 검사와 동일하게 재측정하여 변화를 분석하였다. 각 집단 내 손 근활성도를 측정한 결과, 실험군Ⅰ은 노쪽손목굽힘근과 노쪽손목폄근에서만 유의한 차이가 있었고(p<0.05)(p<0.01), 실험군Ⅱ에서도 모든 근육에서 유의한 차이가 있으며, 악력에서도 모든 집단에서 유의한 차이가 있었다(p<0.01)(p<0.001). 두 집단 간 손 근활성도를 비교한 결과에서는, 모든 근육과(p<0.05)(p<0.01) 악력에서 유의한 차이가 있었다(p<0.05). 뇌졸중 환자들에게 역동적 정중신경가동기법은 더 넓은 손 주변 조직들이 자극되어 근활성도와 악력 변화에 있어서 효과적으로 향상시킬 수 있는 운동프로그램임을 알 수 있었다. 따라서 뇌졸중 환자들의 팔 기능 회복 정도를 알 수 있는 악력과 같은 기능을 더 효과적으로 증가시키기 위해 역동적 정중신경가동기법을 적극적으로 활용할 필요성이 있다.
Abstract
This study was conducted to examine the changes in hand muscle activity and grip strength and provide clinical basic data for predicting the degree of the upper limb function recovery of stroke patients by applying dynamic median neural mobilization to stroke patients for a more efficient increase in grip strength of the affected side. 10 of stroke patients were randomly placed in each group and for a pre-test, hand muscle activity and grip strength of the affected side were measured. A total of 10 interventions were conducted per set (3 sets at a time, once per day, 4 times per week, for 4 weeks). Then a post-test was carried out the same way as the pre-test to analyze the changes. When measuring hand muscle activity of each group, Experimental groupⅠ only showed significant differences in flexor carpi radialis and extensor carpi radialis(p<0.05)(p<0.01). Experimental groupⅡ showed significant differences in all of muscles, and all the groups showed significant differences in grip strength(p<0.01)(p<0.001). When comparing hand muscle activity between the two groups, there were significant differences in all of muscles(p<0.05)(p<0.01) and grip strength(p<0.05). It was revealed that dynamic median neural mobilization was an effective exercise program for stroke patients to improve muscle activity and grip strength by stimulating broader surrounding tissues of the hand. This result demonstrates that in order to increase grip strength, which refers to the degree of the upper limb function recovery of stroke patients, in a more effective way, there is a need to make full use of dynamic median neural mobilization.
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