[논문]The effects of functional electrical stimulation applied to the gluteus medius and tibialis anterior on stair climbing ability in persons with stroke

Jung, Jewon; Chung, Yijung

doi:10.14474/ptrs.2018.7.3.134

The effects of functional electrical stimulation applied to the gluteus medius and tibialis anterior on stair climbing ability in persons with stroke 원문보기

Physical therapy rehabilitation science, v.7 no.3, 2018년, pp.134 - 138

Jung, Jewon (Department of Physical Therapy, The Graduate School, Sahmyook University) , Chung, Yijung (Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University)

Abstract ▼ AI-Helper

Objective: The aim of this research was to investigate the effects of functional electrical stimulation (FES) applied to the gluteus medius (Gm) and tibialis anterior (TA) during stair climbing in persons with stroke compared to FES applied to the TA only during stair climbing, and during stair climbing without FES in persons with stroke. Design: Cross-sectional study. Methods: Twenty subjects with stroke participated in this study. Subjects were included if: 1) they were diagnosed as stroke at least 6 months before; 2) had Mini Mental State Examination- Korean score of 24 or higher; 3) were able to climb a flight of 10 stairs independently (with or without walking aid). The patients walked 10 stairs 3 times with FES applied to the Gm and TA, only TA, or no FES. There was a 1-minute rest period between each bout. The assessments were made using the Timed Up & Down Test and the Wii Balance Board. Results: Stair climbing with FES applied to the Gm and TA was significantly faster than stair climbing with FES applied to the TA only and without FES (p<0.05). Stair climbing with FES applied to the Gm and TA exhibited significantly greater sway velocity than stair climbing without FES (p<0.05). However, maximal sway distances were not significantly different between groups. Conclusions: Stair climbing with FES applied to the Gm and TA can be an important component of a rehabilitation program for improving stair climbing ability in persons with stroke.

주제어

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문제 정의

This study investigated how the ability of persons with stroke to perform stair climbing was affected by applying FES. Walking speeds and sway velocities were increased during stair climbing when FES was applied to the Gm and anterior tibialis muscles.

가설 설정

Based on the joint strategy (moving from the ankle to the hip joint) used to maintain balance [3], it was hypothesized that the degree of instability would decrease and the rate of instability would increase. This is because it was anticipated that the FES applied to the Gm and anterior tibialis muscle would assist with balance during walking.

제안 방법

Therefore, this study investigated the time it takes for persons with stroke to go up and down the stairs, how the center of gravity of the trunk moves, and whether there are quantitative or qualitative changes when applying FES to the Gm and tibialis anterior (TA).

대상 데이터

Twenty patients who were receiving treatment form the Guri K rehabilitation clinic in Gyeonggi-do were eligible for the study (Table 1). Stroke participants with a Korean version of the Mini Mental State Examination-Korea score of at least 24 points, those who can follow instructions, and those who can go up and down 10 steps with or without an assistive device were included in the study [20].

데이터처리

, Armonk, NY, USA) and descriptive statistics were used to describe the general characteristics of the subjects. The one-way repeated measures ANOVA was used to analyze the differences between the FES applied to the Gm and TA condition, FES applied only to the TA condition, and the no FES condition. The least significant difference was used for post hoc analyses, and the statistical significance level of all data was set at p<0.

성능/효과

This is because it was anticipated that the FES applied to the Gm and anterior tibialis muscle would assist with balance during walking. The experimental results showed that the rate of instability was higher than that of groups that did not have FES applied to the Gm and TA, but there was no significant difference in the degree of instability between the groups. A study by Marigold and Eng [27] showed that the greater the asymmetry of weight support, and that although the rate of instability increased, it did not increase as much as anticipated.

후속연구

Compared with previous studies in which the gait speed was increased in persons with stroke when FES was applied to the Gm and TA [28,29], it was anticipated that stair climbing speed would also increase with the same intervention. Therefore, in future studies, it is necessary to reaffirm the effect of FES on the Gm and TA muscles on left-right instability during stair climbing in persons with stroke. With stair climbing training, it is necessary to investigate the changes in the stair climbing speeds with FES applied to the Gm and anterior tibialis.

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