목적 : 본 연구의 목적은 뇌졸중 환자의 얕은손가락굽힘근에 진동자극을 적용하는 것이 손의 기민성을 향상시키고 얕은손가락굽힘근의 개시와 종료 시간을 단축시키는데 도움이 되는지를 알아보는 것이었다.
연구방법 : 본 연구는 개별실험연구방법 중 ABA 연구 설계를 이용하였다. 총 실험회기는 24회로 기초선
과정, 중재 과정, 기초선 회기 과정으로 나누어 각 8회기씩 진행하였다. 중재기간 동안 진동자극은 환측의 얕은손가락굽힘근에 적용되었다. 상자와 블록 검사(Box and Block Test; BBT), 그리고 컵을 쥐기 및 놓기 과제를 수행하는 동안 얕은손가락굽힘근의 개시시간과 종료시간을 측정하였다.
결과 : BBT 점수는 기초선 과정에 비교하였을 때 중재기간 동안 유의하게 증가되었으며(p<.05), 과제
수행 동안 얕은손가락굽힘근의 개시시간과 종료시간은 중재 기간 동안 유의하게 단축되었다(p<.05). 이
러한 경향은 회귀 과정 동안에도 긍정적으로 유지되었다.
결론 : 이러한 결과는 진동자극이 이환된 손의 기민성을 향상시키고 물건을 쥐고 놓는 동안 손과 얕은손가락굽힘근의 활성 형태를 향상시키는데 긍정적으로 사용될 수 있다는 것을 의미한다.
To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were 0˚, 45˚, and 90˚. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was 0˚, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was 90˚, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.