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뇌졸중 편마비 환자에서 하지 근력강화운동이 상지 연합반응에 미치는 영향 KCI 등재

The Effects of Strengthening Exercise for the Lower Extremities on Associated Reaction of the Upper Extremities in Patients With Hemiparesis

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한국전문물리치료학회지 (Physical Therapy Korea)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
초록

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

저자
  • 박형기(연세의료원 세브란스 재활병원 물리치료팀) | Hyung-ki Park 통신저자
  • 김종만(서남대학교 물리치료학과) | Jong-man Kim
  • 김원호(울산과학대학 물리치료과) | Won-ho Kim