스트레칭 운동이 만성 뇌졸중 편마비 환자의동맥경직도에 미치는 영향
Effect of stretching exercise on arterial stiffness in patients with chronic hemiparesis.
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이용희, 박수현, 윤은선, 제세영. 스트레칭 운동이 만성 뇌졸중 편마비 환자의 동맥경직도에 미치는 영향. 운동과학, 제22권 제1호, 53-59, 2013. 동맥경직도의 증가는 심혈관계 질환 및 사망과 관련이 높다. 건강한 사람에 있어 심폐체력의 증가는 동맥경직도를 개선시킨다. 하지만 유연성이 동맥경직도에 미치는 영향에 대한 연구는 부족하다. 따라서 본 연구는 만성 뇌졸중 편마비 환자를 대상으로(운동집단 10명, 통제집단 10명) 스트레칭 운동이 심폐체력과는 독립적으로 동맥경직도에 영향을 미치는지를 알아보는데 목적이 있다. 스트레칭 운동은 운동집단에서 16주, 주 3회, 회당 약 40-60분 간 실시하였다. 유연성은 앉아서 윗몸 앞으로 굽히기를 측정하였고, 심폐체력은 6분 걷기 검사를 실시하였다. 동맥경직도는 경동맥-대퇴동맥 맥파전파속도(PWV)와 대동맥 맥압증폭지수를 측정하였다. 실험중재 후 운동집단은 통제집단에 비해 유연성과 심폐체력이 유의하게 개선되었다(p=.003；p=.002). 동맥경직도에서는 PWV에서 집단 간 상호작용 효과가 나타났다(p=.001). 실험중재 후 심폐체력과 혈압의 변화를 통제변인으로 설정한 후 유연성의 변화와 동맥경직도의 변화 간에는 역 상관관계를 보였다(r=-.47, p=.049). 따라서 스트레칭 운동에 따른 유연성 증가는 심폐체력과는 독립적으로 만성 뇌졸중 편마비 환자의 동맥경직도를 감소시킬 수 있는 것으로 사료된다. 추후 본 연구의 결과를 확인할 수 있는 후속연구가 필요하겠다.
Abstract
Lee, Yong-Hee., Park, Soo-Hyun., Yoon, Eun-Sun., Jae, Sae-Young. Effect of stretching exercise on arterial stiffness in patients with chronic hemiparesis. Exercise Science, 22(1): 53-59. 2013. Increased arterial stiffness is a strong predictor of future cardiovascular events and mortality. Increased cardiorespiratory fitness(CRF) improves arterial stiffness in healthy population. However, it is unclear whether stretching exercise improves arterial stiffness. We investigate the effect of stretching exercise independent of CRF on arterial stiffness in adults with chronic stroke hemiparesis. Twenty outpatients with chronic hemiparesis after stroke participated in the study. The exercise group(n=10) received stretching exercise program 3 times a week for 16 weeks and the control group(n=10) received usual care for 16 weeks. We measured a modified sit and reach test on chair as an index of flexibility and 6 minutes walk test as an index of CRF. Arterial stiffness was assessed by carotid-femoral pulse wave velocity(PWV) and augmentation index(Aix) using applanation tonometry. After intervention period, flexibility and CRF were significantly improved in the exercise group compared with the control group(p=.003；p=.002, respectively). A significant group by time interaction was detected for PWV(p=.001). After intervention there was a significant inversely association between change in flexibility and change in pulse wave velocity after adjusted for the change in CRF and systolic blood pressure(r=-.47, p=.049). These findings suggested that increased flexibility improved arterial stiffness independent of CRF in adults with chronic stroke hemiparesis. But additional research is needed to confirm this finding with a larger sample.
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