본 연구는 테이핑 적용방법에 따른 근긴장도, 근경직도 및 악력의 변화를 알아보기 위해 실시하였다. 연구의 대상자는 20대 정상 성인 30명을 대상으로 하여 테이프를 늘리지 않고 붙이는 방법(non stretched taping)과 테이프를 늘려 붙이는 방법(stretched taping)을 통해 변인들을 측정하였다. 근긴장도와 근경직도는 Myoton pro 장비를 이용하여 측정하였으며, 악력계를 이용하여 악력을 측정하였다. 않은 자세에서 측정하였으며, 테이핑을 적용하기 전과 적용한 후를 대상자별로 임의로 순서를 정하여 측정하였고, 같은 동작에서 3번 측정하여 평균값을 사용하였다. 테이핑 적용에 따른 근긴장도, 근경직도 및 악력의 비교를 위하여 대응검정을 이용하여 분석하였으며, 중재 전·후에서 그룹간 차이를 보기 위하여 독립검정을 실시하였다. 본 연구의 결과 non stretched taping 적용과 stretched taping 적용 모두에서 근긴장도, 근경직도는 두 그룹 모두에서 통계적으로 유의한 감소를 보였으며, 악력은 두 그룹 모두에서 통계적으로 유의한 증가를 나타내었다. 그룹간 차이는 중재 전 근긴장도, 근경직도 및 악력은 차이가 나타나지 않았다. 중재 후 그룹간 차이는 근긴장도, 근경직도는 통계적으로 유의한 차이를 나타내지 않았으나, 악력의 경우 통계적으로 두 그룹간 유의한 차이가 나타났으며, stretched taping 그룹에서 더 높은 값을 나타내었다. 테이핑 적용 방법에 따른 근긴장도와 근경직도, 악력의 차이가 있기 때문에 테이핑 방법을 잘 적용하여 사용한다면 근육의 효과를 기대할 수 있을 것이다.

Muscle tone (stiffness/hardness) or muscle compliance changes during muscle contraction. The purposes of this study were to assess the intrarater and interrater reliabilities of the Myotonometer®, electronic device that quantifies muscle tone. Two raters used the Myotonometer to assess the right bicep brachia and quadriceps muscles of 30 voluntary persons without any orthopedic or neurological problems (age range, 18~21 yrs). Muscles were measured in a relaxed state and during brief sustained voluntary maximal isometric contraction. Intrarater correlation coefficients were calculated for each muscle and for each condition (relaxed and contracted). Intrarater reliabilities (intraclass correlation coefficients, ICCs) ranged from .778 to .954, relaxed, biceps brachia), .926 to .963 (contracted, biceps brachia), .935 to .990 (relaxed, quadriceps) and .679 to .952(contracted, quadriceps). Interrater reliabilities ranged from .652 to .790 (relaxed, biceps brachii), .813 to .907 (contracted, biceps brachii), .831 to .950 (relaxed, quadriceps) and .849 to .937 (contracted, quadriceps). Myotonometer measurements had high to very high intrarater and interrater reliability for measurements of the biceps brachia and quadriceps muscles.

The purpose of this study was to find any correlations among Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), Tone Assessment Scale (TAS), Motor Assessment Scale-Gait (MAS-G), Fugl Meyer-Balance (FM-B), and to predict MBI from subscales of the PASS. The subjects were 41 stroke patients of the Korea National Rehabilitation Center in Seoul. The main outcome measures were postural control (PASS), gait (MAS-G), Balance (FM-B), Tone (TAS), ADL (MBI). The data was analyzed using the Pearson product correlation. PASS scale was used between other clinical and instrumental indexes, multiple stepwise regression analyses were performed to identify prognostic factors for ADL incline, and Cronbach's alpha coefficient was used to identify internal consistency on PASS scale. The results of this study areas follows: 1. The highest level was sitting without support, the lowest level was standing on paretic leg on PASS scale. The highest level was chair/bed transfer, the lowest level was bathing on MBI. 2. All items of the PASS, except postural tone were significantly correlated with Gait, Balance, MBI (p<.01), 3. The Internal Consistency (Cronbach's alpha coefficient=.85) was very high, indicating that the PASS is homogeneous and is likely to produce consistent response. Furthermore, the sums of maintaining position items and of changing-position items were strongly correlated (r=.64, p<.05) and there were significant correlations between sums of PASS, sums of maintaining position items (r=.87, p<.01), and changing-position items (r=.93, p<.01). 4. The standing without support of the PASS items was the strongest variance (R²=.85) of the predicting ADL function. These findings provide strong evidence of the predictive value of the postural control on gait, Balance, ADL function in stroke patients and to can provide a reference for the successful therapeutic program and more improved functional recovery.

목적 : 본 연구는 만성 뇌졸중 환자를 대상으로 자세 조절이 일상생활동작 수행능력과 근 긴장도 변화 및 상지기 능 수행에 어떠한 영향을 미치는지 알아보고자 하였다． 연구방법 : 본 연구를 위하여 국립재활원에 입원한 41명의 뇌졸중 환자를 대상으로 모든 환자들은 자세조절 평가 척도(Postural Assessment Scale stroke, PASS), 일상생활동작 수행능력 측정 도구(Modified Barthel Index, MBI), 긴장도 사정 척도(Tone Assessment scale, TAS), Fugl-Meyer 평가 척도(Fugl-Meyer Assessment scale－upper extremity) 등을 이용하였고 자료 분석은 피어슨 상관분석(pearson correlation coefficient), 단계적 다중 회귀분석(stepwise multiple regression）을 실시하였으며 내적 일치도를 알아보기 위하여 Cronbach's alpha Coefficient를 구하였다． 결과 : PASS항목에서 가장 기능이 좋은 것은 지지하여 서기로 나타났으며，가장 기능이 낮은 것은 환측으로 서기였고，MBI항목에서 가장 기능이 좋은 것은 의자／침상 이동이며， 가장 기능이 낮은 것은 목욕하기로 나타났다．PASS의 모든 항목은 MBI, FM-UE, TAS와 유의한 상관관계(r=-33~91, p<.05~01）가 있으며，FM-U/E와 MBI(r=.35, p<.05), TAS- 안정(r=.-40, p,<．0.1), 연합항목(r=-.39,p<.05)에서 유의한 상관관계가 있는 것으로 나타났다．내적 일치도는 Cronbach's a=.86로 높게 나타났으며，PASS의 합과 자세유지 항목 (r=.90 p<.01)의 합，자세변화 항목(r=.93,p<.01)의 합은 유의한 상관관계가 있었으며，자세유지 항목의 합과 자세변화 항목의 합 간에는 유의한 상관관계(r=.69,p<.01)가 있었다．PASS 항목 중 누운자세에서 건측으로 돌기와 바닥에서 볼펜집어 올리기가 각각 ADL과 상지 기능을 예견하는데 가장 중요한 변수(R2=.95, R2=.56)임을 알 수 있었다． 결론 : PASS는 일상생활동작 수행 능력과 근 긴장도 및 상지기능수행 간에 유의한 상관관계가 있는 것으로 나타나 뇌졸중 환자의 기능적 독립성을 예측할 수 있는 지표가 될 수 있을 것이다．

The purpose of this study was to investigate the effect of submerged relaxation therapy for the spasticity on the affected side in three subjects with post-stroke hemiparesis. A single-subject alternating design with multiple baselines across individuals was employed in this study. Each subject alternately participated in a range of motion exercises on the mat and in the pool, and relaxation exercises in the pool. The muscle tone of the affected side was measured using the tone assessment scale (TAS). Measurements were made immediately and one hour following the intervention. The findings showed a therapeutic effect of submerged relaxation exercise on reducing spasticity for all subjects. The effect of submerged relaxation exercise on decreasing muscle tone was maintained for one hour measurements after the submerged relaxation exercise, although the mean TAS score assessed one hour after intervention was higher than that assessed immediately. The results of this study suggest that submerged relaxation exercise has a positive effect on decreasing spasticity on the affected side in persons suffering from post-stroke hemiparesis. Future research on submerged relaxation exercise should focus on objective evaluation and functional the aspects relevant to activities of daily living.

The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) approach on the spasticity of affected side in patients with hemiplegia. Three subjects with hemiplegia participated in this study. In single-subject research design (a multiple baseline across individuals) was employed in this study. The intervention program including PNF to the unaffected side was introduced for 30 minutes each day during each intervention phase. Muscle tone of affected side was measured with Tone Assessment Scale, and active hip abduction distance of affected side was taken with the subject supine. And then the muscle tone and the hip abduction distance were measured again 30 minutes later following the intervention. The results showed that the PNF application had some beneficial effects on both muscle tone and active hip abduction. This result suggest that PNF application to non-paretic limb can be effective in reducing muscle tone and improving hip abduction range on paretic limb in persons with hemiplegia. However, further research is needed to prove the effect of PNF application on functional improvement.