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NTIS 바로가기대한물리의학회지 = Journal of the korean society of physical medicine, v.12 no.2, 2017년, pp.43 - 52
박신준 (강동대학교 물리치료과) , 조균희 (용인대학교 재활복지대학원 물리치료학전공) , 조용훈 (아벤스병원)
PURPOSE: This study aimed to compare the impact of exercise with that of functional electrical stimulation (FES) and transcutaneous electrical nerve stimulation (TENS) on muscle tone, calf muscle stiffness, and balance ability in patients with stroke. METHODS: Thirty patients with stroke were random...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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근긴장에 기여하는 기전에는 무엇이 있나? | 경직은 근육이 정적 신장 반사에 항진된 반응과 빠른 수동 신장에 저항하는 증가된 근긴장 상태를 뜻한다(Sheean과 McGuire, 2009). 근긴장에 기여하는 기전에는 항진된 반사, 근육힘줄 단위의 점탄성 성질, 수축 성분의 내재성 성질이 포함된다(De Vlugt 등, 2010; Mirbagheri 등, 2007; Sheean과 McGuire, 2009). 이러한 경직이 발목에 발생하게 되면 발바닥 처짐, 구축, 뒤침 변형이 발생하게 되고 이차적으로 자세흔들림이 증가하는 균형장애와 빠른 보행 시 뻣뻣함이 증가되는 비정상적 보행패턴을 야기한다(Lin 등, 2006; Niam 등, 1999; Park 등, 2010; Vattanasilp 등, 2000). | |
과긴장증 및 경직이란 무엇인가? | 과긴장증 및 경직은 조직의 뻣뻣함과 점탄성이 증가된 현상으로 뇌졸중 환자가 경험하는 일반적인 증상이다(De Vlugt 등, 2010; Sheean과 McGuire, 2009). 경직은 근육이 정적 신장 반사에 항진된 반응과 빠른 수동 신장에 저항하는 증가된 근긴장 상태를 뜻한다(Sheean과 McGuire, 2009). | |
TENS의 적용이 힘든 환자군은 무엇인가? | 장딴지근 근피로가 균형능력 감소 및 근력감소를 야기하는데, TENS의 적용은 이러한 근피로, 근력, 균형 능력 개선에 효과를 보인다(Cho 등, 2011). 반면 뇌졸중 환자는 발바닥 부위에 피부감각 장애가 발생하기도 하여(Jeon, 2014), 심각한 감각결손이 있는 자라면 TENS의 자극을 인식하지 못하게 된다. 따라서 피부에 전기자극을 느낄 수 있는 뇌졸중 환자라면, 발등굽힘의 약화가 주된 문제로 균형능력 감소가 나타난 환자의 경우에는 기능적전기자극을 선택할 수 있지만, 퇴원 후 가정에서 치료를 할 경우, 경피신경전 기자극기는 금기사항이 적고 쉽게 적용할 수 있는 방법 이므로(Sluka와 Walsh, 2003), 기능적 전기자극치료를 대안 할 수 있는 방법으로 사용될 수 있을 것이다. |
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