전신진동운동 시 진동자극강도가 뇌졸중 편마비 환자의 가자미근 H-reflex에 미치는 영향 = Effects of Vibration Stimulation Intensity during Whole-body Vibration Exercise on Soleus H-reflex in Hemiplegic Stroke Patients

다국어 초록 (Multilingual Abstract)

[PURPOSE] The purpose of this study was to investigate the acute effects of vibration stimulation intensity during whole-body vibration exercise on the soleus H-reflex in hemiplegic stroke patients. [METHODS] Sixteen hemiplegic stroke patients participated in this study and performed whole-body vibration exercises in 4 different vibration stimulation conditions (0Hz 0 mm, 10Hz 4 mm, 20Hz 4 mm and 27Hz 4 mm). The soleus H-reflex was measured at hemiplegic side during the whole-body vibration exercise. The amplitude of H-reflex, M-wave and H/Mmax ratio, were compared with one-way repeated measurement analysis of ANOVA (p<0.05) among four different vibration stimulation intensity. [RESULTS] There were the significant differences in the amplitude of H-reflex according to vibration stimulation intensity (F=9.295, p=0.000). H-reflex was significantly lower at 20Hz (p=0.015) and the 27Hz (p=0.006) than at 0Hz. The amplitude of M-wave was similar in all vibration stimulation intensities (F=1.628, p=0.184). There were the significant differences in the amplitude of H/Mmax ratio according to vibration stimulation intensity (F=9.921, p=0.000). H/Mmax ratio was significantly lower at 20Hz (p=0.006) and the 27Hz (p=0.001) than at 0Hz. [CONCLUSIONS] The results of this study suggest that it might be effective to apply an the vibration stimulation intensity of at least 20Hz or more during whole-body vibration exercise for improvement of neural control ability in hemiplegic stroke patients. Whole-body vibration is most recommend to hemiplegic stroke patients exercise method which provide a positive effect on improvement of neural control ability.

국문 초록 (Abstract)

[목적] 본 연구의 목적은 뇌졸중 편마비 환자를 대상으로 진동운동 수행 시 다양한 진동자극강도에서 가자미근(soleus muscle)의 H-reflex(호프만반사)를 측정하여 뇌졸중 환자들의 신경활성화에 긍정적인 영향을 미치는 최적화된 진동 자극강도를 알아보는 것이다. [방법] 본 연구에 참가한 대상자는 진동운동 수행과 H-reflex 측정이 가능한 뇌졸중 환자 16명이다(남=12명: 49.3±11.3yrs, 168.1±7.8cm, 69.3±12kg; 여=4명: 54.8±8.2yrs, 156.4±4.4cm, 59.7±9.8kg). 모든 대상자들은 진동운동 수행 중 다양한 진동자극강도(0Hz 0 mm, 10Hz 4 mm, 20Hz 4 mm, 27Hz 4 mm)에서 가자미근의 H-reflex를 측정하였다. 4가지 다른 진동자극강도에서 H-reflex 최대 진폭, M-wave 최대 진폭 및 H/Mmax 비율을 비교하기 위하여 일원반복측정분산분석을 적용하였다. [결과] H-reflex의 최대 진폭은 진동강도에 따른 유의한 차이가 나타났다(F=9.295, p=0.000). H-reflex는 진동자극강도 20Hzz가 0Hz 보다 통계적으로 유의하게 낮았으며(p=0.015), 27Hz가 0Hz 보다 통계적으로 유의하게 낮았다(p=0.006). M-wave는 모든 진동자극강도에서 유의한 차이가 나타나지 않았다(F=1.628, p=0.184). H/Mmax 비율은 진동강도에 따른 유의한 차이가 나타났다(F=9.921, p=0.000). H/Mmax 비율은 진동자극강도 20Hz가 0Hz 보다 통계적으로 유의하게 낮았으며(p=0.006), 27Hz가 0Hz 보다 통계적으로 유의하게 낮았다(p=0.001). [결론] 본 연구의 결과를 통해 뇌졸중 편마비 환자들의 전신진동운동 시 20Hz 이상의 강도를 적용하는 것은 신경 조절 능력 개선에 효과적인 방안이 된다는 것을 제안한다. 결론적으로 전신진동운동은 뇌졸중 편마비 환자들의 신경조절 능력 개선에 효과적인 운동방안으로 권장된다.

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