편마비 뇌졸중 환자에서 체간근 전기 자극이 체간 균형 향상에 미치는 영향
The Effect of Neuromuscular Electrical Stimulation on Trunk Control in Hemiparetic Stroke Patients
1
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Objective: To determine the effectiveness of electrical stimulation over the trunk in improving trunk control during early stroke rehabilitation. Method: Thirty-two acute and subacute hemiparetic stroke patients were enrolled in this study. All patients were randomly assigned to one of two groups, control group or electrical stimulation (ES) group. Both groups received the same physical therapy for 3 weeks. ES group received additional electrical stimulation over the posterior back muscles for 30 minutes a day, 5 days per week for 3 weeks. Outcome measurements included Korean version of Berg balance scale (K-BBS), total score of postural assessment scale for stroke patients (PASS), trunk control subscale of postural assessment scale for stroke patients (PASS-TC), trunk control test (TCT), Korean version of modified Barthel index (K-MBI), and motricity index (MI). These measurements were checked before and after treatment. Results: There were no significant differences in the baseline characteristics and initial values between two groups. Following 3 weeks therapy, the changes of TCT and PASS-TC scores in the ES group were significantly higher than those of the control group (p＜0.05). The changes of K-BBS, PASS, and K-MBI scores in the ES group tend to be higher than those in the control group. However the differences were not statistically significant. The changes of PASS-TC and TCT scores were significantly correlated with the changes of BBS and K-MBI scores at discharge. Conclusion: This study suggests that electrical stimulation over the trunk may be a beneficial therapeutic technique in improving trunk control in acute and subacute hemiparetic stroke patients.
Abstract
Objective: To determine the effectiveness of electrical stimulation over the trunk in improving trunk control during early stroke rehabilitation. Method: Thirty-two acute and subacute hemiparetic stroke patients were enrolled in this study. All patients were randomly assigned to one of two groups, control group or electrical stimulation (ES) group. Both groups received the same physical therapy for 3 weeks. ES group received additional electrical stimulation over the posterior back muscles for 30 minutes a day, 5 days per week for 3 weeks. Outcome measurements included Korean version of Berg balance scale (K-BBS), total score of postural assessment scale for stroke patients (PASS), trunk control subscale of postural assessment scale for stroke patients (PASS-TC), trunk control test (TCT), Korean version of modified Barthel index (K-MBI), and motricity index (MI). These measurements were checked before and after treatment. Results: There were no significant differences in the baseline characteristics and initial values between two groups. Following 3 weeks therapy, the changes of TCT and PASS-TC scores in the ES group were significantly higher than those of the control group (p＜0.05). The changes of K-BBS, PASS, and K-MBI scores in the ES group tend to be higher than those in the control group. However the differences were not statistically significant. The changes of PASS-TC and TCT scores were significantly correlated with the changes of BBS and K-MBI scores at discharge. Conclusion: This study suggests that electrical stimulation over the trunk may be a beneficial therapeutic technique in improving trunk control in acute and subacute hemiparetic stroke patients.
참고문헌 (29)
- Karatas M, "Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients", Am J Phys Med Rehabil, 83, pp.81~87 (2004)
- Kim YH, "Quantitative assessment of static and dynamic postural sway using COBETS in patients with balance problem", J Korean Acad Rehab Med, 21, pp.1~7 (1997)
- Dickstein R, "Activation of flexor and extensor trunk muscles in hemiparesis", Am J Phys Med Rehabil, 79, pp.228~234 (2000)
- 김대환, "편마비 환자에서 등속성 운동에 의한 체간근력 향상이 균형에 미치는 영향", Annals of Rehabilitation Medicine, 32(3), pp.280~284 (2008), 대한재활의학회
- Sheffler LR, "Neuromuscular electrical stimulation in neurorehabilitation", Muscle Nerve, 35, pp.562~590 (2007)
- O'Sullivan PB, "The effect of different standing and sitting postures on trunk muscle activity in a pain-free population", Spine, 27, pp.1238~1244 (2002)
- Nordin M, "Normal trunk muscle strength and endurance in women and the effect of exercises and electrical stimulation. Part 1: normal endurance and trunk muscle strength in 101 women", Spine, 12, pp.105~111 (1987)
- Park ES, "The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy", J Korean Med Sci, 16, pp.347~350 (2001)
- Wilkenfeld AJ, "Feasibility of functional electrical stimulation for control of seated posture after spinal cord injury: a simulation study", J Rehabil Res Dev, 43, pp.139~152 (2006)
- Axelgaard J, "Lateral electrical surface stimulation for the treatment of progressive idiopathic scoliosis", Spine, 8, pp.242~260 (1983)
- Dickstein R, "Anticipatory postural adjustment in selected trunk muscles in poststroke hemiparetic patients", Am J Phys Med Rehabil, 85, pp.261~267 (2004)
- Alon G, "Comparison of the effects of electrical stimulation and exercise on abdominal musculature", J Orthop Sports Phys Ther, 8, pp.567~573 (1987)
- Benaim C, "Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS)", Stroke, 30, pp.1862~1868 (1999)
- Verheyden G, "Clinical tools to measure trunk performance after stroke: a systematic review of the literature", Clin Rehabil, 21, pp.387~394 (2007)
- Liaw LJ, "The relative and absolute reliability of two balance performance measures in chronic stroke patients", Disabil Rehabil, 21, pp.1~6 (2007)
- 이재준, "뇌졸중 환자에서 보행관련 활동평가척도로서의 한글판 버그균형검사", Annals of Rehabilitation Medicine, 31(4), pp.400~403 (2007), 대한재활의학회
- Verheyden G, "Trunk performance after stroke and the relationship with balance, gait and functional ability", Clin Rehabil, 20, pp.451~458 (2006)
- Hsieh CL, "Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients", Stroke, 33, pp.2626~2630 (2002)
- Hama S, "Sitting balance as an early predictor of functional improvement in association with depressive symptoms in stroke patients", Psychiatry Clin Neurosci, 61, pp.543~551 (2007)
- Franchignoni FP, "Trunk control test as an early predictor of stroke rehabilitation outcome", Stroke, 28, pp.1382~1385 (1997)
- Geurts AC, "A review of standing balance recovery from stroke", Gait Posture, 22, pp.267~281 (2005)
- Spinazzola L, "Impairments of trunk movements following left or right hemisphere lesions: dissociation between apraxic errors and postural instability", Brain, 126, pp.2656~2666 (2003)
- Karnath HO, "The origin of contraversive pushing: evidence for a second graviceptive system in humans", Neurology, 55, pp.1298~1304 (2000)
- Niam S, "Balance and physical impairments after stroke", Arch Phys Med Rehabil, 80, pp.1227~1233 (1999)
- Sackley CM, "Single blind randomized controlled trial of visual feedback after stroke: effects on stance symmetry and function", Disabil Rehabil, 19, pp.536~546 (1997)
- Chen IC, "Balance evaluation in hemiplegic stroke patients", Chang Gung Med J, 23, pp.339~347 (2000)
- Perennou DA, "The polymodal sensory cortex is crucial for controlling lateral postural stability: evidence from stroke patients", Brain Res Bull, 53, pp.359~365 (2000)
- Bonan IV, "Reliance on visual information after stroke. Part II: effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial", Arch Phys Med Rehabil, 85, pp.274~278 (2004)
- Shin JB, "A clinical study of early rehabilitation in stroke", J Korean Acad Rehab Med, 12, pp.1~13 (1988)