The aim of this study was to investigate effects of reaching distance on movement time and trunk kinematics in hemiplegic patients. Eight hemiplegic patients participated in this study. The independent variables were side (sound side vs. affected side) and target distance (70%, 90%, 110%, and 130% of upper limb). The dependent variables were movement time measured by pressure switch and trunk kinematics measured by motion analysis device. Two-way analysis of variance with repeated measures was used with Bonferroni post-hoc test. (1) There were significant main effects in side and reaching distance for movement time (p=.01, p=.02). Post-hoc test revealed that there was a significant difference between 110% and 130% of reaching distance (p=.01). (2) There was a significant main effect in side and reaching distance for trunk flexion (p=.01, p=.00). Post-hoc test revealed that there were significant differences in all pair-wise reaching distance comparison. (3) There was a significant side by target distance interaction for trunk rotation (p=.04). There was a significant main effect in target distance (p=.00). Post-hoc test revealed that there were significant differences between 70% and 110%, 70% and 130%, 90% and 110%, 90% and 130% of target distance. It was known that trunk flexion is used more than trunk rotation during reaching task in hemiplegic patients from the findings of this study. It is also recommended that reaching training is performed with limiting trunk movement within 90% of target distance whereas reaching training is performed incorporating with trunk movement beyond 90% of target distance in patients with hemiplegia.

Anticipatory postural adjustments is an example of the ability of the central nervous system to predict the consequence of the mechanical effect of movement on posture and helps minimize a forth coming disturbance. The aim of this study was to evaluate the sequence of activation of the trunk muscles during the performance of hip and shoulder movement and to determine the relationship between anticipatory activity and subjects' motor and functional status in subjects with hemiplegia post stroke. Twenty-four poststroke hemiparetic patients enrolled in this study. Electromyographic activity of the lumbar erector spinae, latissimus dorsi, and of the obliquus internus muscles was recorded bilaterally during flexion of both arm and from the rectus abdominis, obliquus externus, and obliquus internus muscles during flexion of both hip. Onset latencies of trunk muscles were partially delayed in the subjects with hemiplegia post stroke (p<.05). With upper limb flexion, the onset of erector spinae muscle and latissimus dorsi muscle activity preceded the onset of deltoid on both side respectively (p<.05). A similar sequence of activation occurred with lower limb flexion. Also the onset of external oblique muscle and rectus abdominis muscle activity preceded the onset of rectus femoris muscle on both side (p<.05). Major impairments in the activity of trunk muscles in hemiparetic subjects were manifested in delayed onset between activation of pertinent muscular pairs. These problems were associated with motor and functional deficits and warrant specific consideration during physical rehabilitation of post stroke hemiparetic patients.

Anticipatory postural adjustments are pre-planned by the central nervous system (CNS) before the activation of agonist muscles in the limbs, and minimize postural sway. Most previous studies on this topic have focused on upper-limb movement, and little research has been conducted on lower-limb movement. The purpose of this study was to investigate the recruitment order of left and right trunk muscles during limb movement. Fifteen healthy subjects (10 male, 5 female) were enrolled. Electro-myographic signals were recorded on the muscles of: (1) deltoid, lumbar erector spinae, latissimus dorsi and internal oblique during shoulder flexion, (2) rectus femoris, rectus abdominis, external oblique and internal oblique during hip flexion. During right upper limb flexion, the onset of left erector spinae muscle and left internal oblique muscle activity preceded the onset of right deltoid by 8.09 ms and 19.83 ms, respectively. But these differences were not significant (p>.05). A similar sequence of activation occurred with lower limb flexion. The onset of left internal oblique muscle activity preceded the onset of right rectus femoris muscle by 28.29 ms (p<.05). The onset of right internal oblique muscle activity preceded the onset of left rectus femoris muscles by 23.24 ms (p<.05). The internal oblique muscle was the first activated during limb movement. Our study established the recruitment order of trunk muscles during limb movement, and explained the postural control strategy of the trunk muscles in healthy people. We expect that this study will be used to evaluate patients with an asymmetric recruitment order of muscle activation due to impaired CNS.

목적 : 본 연구는 뻗기 과제를 수행하는 동안 팔과 체간의 움직임에 있어서의 차이를 알아보고자 실시하였다. 정상 성인을 대상으로 책상 위에서의 팔뻗기 과제 수행시 거리에 따른 팔의 움직임에 대한 체간의 움직임을 알아보기 위하여 대상자의 팔의 길이에 비례하여 다양한 거리에서의 팔뻗기 과제를 실시하였다. 연구방법 : 연구대상자는 상지에 선천적인 기형, 심각한 외과적 혹은 신경학적 질환이나 지난 1년 동안 상지의 외상이나 통증을 경험했던 사람은 제외한, 우세 손이 오른손인 건강한 성인 20명을 대상으로 실시하였다. 상지움직임의 변화는 실시간 삼차원 동작분석 장치인 CMS-HS를 사용하였다. 팔길이에 대한 50%, 70%, 90%, 110%, 130% 거리의 작업수행시 체간의 움직임이 측정되었고, 단일 표식자에서 얻어진 속도와 움직인 거리 그리고 체간과 상지의 최대속도시간을 나누어 처리하였다. 결과 : 거리가 증가하는 동안 체간의 움직임은 팔의 길이의 90%의 거리에서부터 체간의 움직임이 유의하게 증가됨을 보였다(p.<05). 팔의 움직임에 대한 체간의 회전은 팔길이의 70% 거리에서부터 유의한 회전을 나타내기 시작했다(p.<05). 팔과 체간의 최대속도 도달시간은 팔길이의 70%, 90% 110%의 거리에서는 팔의 최대속도 도달시간이 먼저 나타났고, 팔길이의 130%의 거리에서는 체간의 최대속도 도달시간이 팔보다 먼저 나타남을 보였다. 결론 : 본 연구의 결과 거리에 따라 팔의 움직임에 대한 체간의 회전과 굴곡이 유의하게 일어나는 거리를 알 수 있었고, 거리에 따른 체간의 운동속도에 있어서의 움직임 패턴을 예측할 수 있었다. 따라서 상지 손상이 있는 환자들의 책상 위에서의 작업 수행이나 작업치료시 작업이 일어나는 거리에 따라 체간의 올바른 움직임을 위한 더 많은 연구가 필요할 것이다.