[논문]주파수에 따른 전기치료가 만성 뇌졸중 환자의 보행 및 발목 관절가동범위에 즉각적으로 미치는 영향

조균희; 김태현; 박신준

doi:10.22156/cs4smb.2019.9.10.220

주파수에 따른 전기치료가 만성 뇌졸중 환자의 보행 및 발목 관절가동범위에 즉각적으로 미치는 영향
Immediate Effects of Frequency-dependent Electrotherapy on the Gait and Ankle Range of Motion of Chronic Stroke Patients 원문보기

융합정보논문지 = Journal of Convergence for Information Technology, v.9 no.10, 2019년, pp.220 - 226

조균희 (아벤스병원) , 김태현 (늘봄병원) , 박신준 (강동대학교 물리치료과)

초록
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본 연구는 발바닥 굽힘근에 저주파 치료인 경피신경전기자극과 중주파 치료인 간섭전류가 뇌졸중 환자의 보행 및 발목 관절가동범위에 즉각적인 영향을 미치는지 알고자 한다. 30명의 연구대상자는 경피신경전기자극군과 간섭전류군으로 동일하게 나누어 마비측 장딴지근에 각각 통전하였다. 60분 통전 직후 스마트폰을 이용한 보행 평가와 발등 굽힘 관절가동범위를 측정하였다. 연구결과 두 전기치료 방법 모두 보행속도, 분속수, 발목 관절가동범위에 유의한 증가를 보였다. 두 전기치료 방법 모두 뇌졸중 환자의 보행 및 발목 관절가동범위를 증가시킬 수 있는 중재 방법이었지만 두 전기치료방법 간의 차이는 더 많은 대상자 모집을 통해 확인되어야 할 것이다.

Abstract ▼ AI-Helper

Transcutaneous electrical nerve stimulation and interferential current therapy were applied to the plantar flexor of the stroke patients, and the immediately effects on gait and ankle ROM were investigated. TENS group (n=15) and ICT group (n=15) were applied to the paretic side plantar flexor, respectively. After 60 minutes of application, evaluation of the gait and passive ankle dorsiflexion range of motion (ROM) using smartphone. After 60 minutes of application, immediate post evaluation was carried out. Two electrotherapy methods showed a significant increase in gait speed, cadence, and ankle ROM. Two electrotherapy methods were intervention methods that could increase the gait and ankle ROM of stroke patients. More subjects will be needed to pinpoint differences between the two electrotherapy methods.

주제어

표/그림 (2)

표 Table 1. General characteristics of subjects
표 Table 2. Change of gait and ROM

AI 본문요약
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문제 정의

However, there are few studies confirming gait changes following TENS and ICT treatment, and no comparison between the two interventions. The aim of this study was to determine which electrotherapy method was more effective for improvement in gait and ankle range of motion.
Despite previous studies showing that electrotherapy reduces spasticity and thus enhances gait ability [11,14], there have been not enough studies comparing the effects of low frequency treatment and intermediate frequency treatment. The purpose of this study is to compare the effects of gait ability and range of joint motion after applying TENS and ICT in stroke patients.

가설 설정

This resulted in an increase in ankle dorsiflexion mobility, which contributed to improving balance ability, leading to increase in Berg balance scale (BBS) scores. In this study, we think that the improvement in gait velocity was due to the improvement in ankle dorsiflexion mobility.

제안 방법

The 30 stroke patients in this study were divided into two groups, TENS and ICT groups. An occupational therapist who was not part of this study randomly assigned 15 people each to the two groups by drawing lots. Assessments were conducted by another occupational therapist who was unrelated to the study, after learning the assessment method.
Assessments were conducted by another occupational therapist who was unrelated to the study, after learning the assessment method. Both groups underwent a preliminary evaluation and a post- evaluation was conducted immediately after receiving 60 minutes of electrotherapy.
In this study, TENS and ICT were applied to the plantar flexor muscles to identify effective intervention methods to improve gait and ankle range of motion in stroke patients. Both electrotherapy methods had an immediate effect in terms of improving gait and ankle range of motion.
41) [15]. In this study, gait speed and cadence were selected as the outcome measures.
The inclusion criteria for participants were chronic stroke (of more than six months’ duration) diagnosed by a specialist using computerized tomography or magnetic resonance imaging; ability to walk 10 m or more without neurological, orthopedic, or cardiopulmonary problems that may affect gait, other than stroke[15]; no skin disease; and score of at least 24 points on K-MMSEs (Korea version of Mini-Mental State Examination).
However, the improvements in balance ability confirmed in previous studies were measured by simply assessing time for a 10 m walk. This study has clinical significance in that it utilized a smartphone with a built-in gyroscope and accelerometers that can be easily used clinically. In this study, there was no significant difference between TENS and ICT, but the effect sizes in the outcome measures were larger in the ICT group.
This study was designed to determine the immediate effect of electrotherapy while excluding the effect of other modes of therapy; thus, we were unable to confirm long-term effects like effectiveness when combined with continuous exercise therapy. A limitation of this study was the small sample size.

대상 데이터

The 30 stroke patients in this study were divided into two groups, TENS and ICT groups. An occupational therapist who was not part of this study randomly assigned 15 people each to the two groups by drawing lots.
In this study, the slope of the paretic heel in contact with the floor was measured from the ground at the lunge position. The smartphone was placed with its base 1 cm above the Achilles tendon. The measurement was conducted on a flat surface.
This study was carried out on 30 stroke patients admitted to A, J Rehabilitation Hospital in Gyeonggi-do. The inclusion criteria for participants were chronic stroke (of more than six months’ duration) diagnosed by a specialist using computerized tomography or magnetic resonance imaging; ability to walk 10 m or more without neurological, orthopedic, or cardiopulmonary problems that may affect gait, other than stroke[15]; no skin disease; and score of at least 24 points on K-MMSEs (Korea version of Mini-Mental State Examination).

데이터처리

To verify the effect of applying ICT or TENS, effect sizes using mean difference from one constant sample were obtained. A paired t-test was used for pre- and post-comparisons within each group, and an independent t-test was used for comparing the different values between groups (post-pre). The statistical significance level was set as α = .
0 and G power. All participant data were tested for normality of variables using Shapiro-Wilk test, descriptive statistics and chi-squared test were used for subject homogeneity test. To verify the effect of applying ICT or TENS, effect sizes using mean difference from one constant sample were obtained.

성능/효과

This study has clinical significance in that it utilized a smartphone with a built-in gyroscope and accelerometers that can be easily used clinically. In this study, there was no significant difference between TENS and ICT, but the effect sizes in the outcome measures were larger in the ICT group.
The results showed that both TENS and ICT significantly increased ankle dorsiflexion range of motion and gait. However, there was no significant difference between the two intervention methods.

참고문헌 (24)

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원문보기 상세보기
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