Electromyographically Triggered Electrical Stimulation on Shoulder Subluxation in Hemiplegic Stroke Patients

Yang, Chung Yong; Joo, Min Cheol; Kil, Eun Young; Kim, Heon Soo; Shin, Yong Il

Original Article

Journal of the Korean Geriatrics Society 2006;10(1):36-42.
Published online March 31, 2006.

Electromyographically Triggered Electrical Stimulation on Shoulder Subluxation in Hemiplegic Stroke Patients

Chung Yong Yang, Min Cheol Joo, Eun Young Kil, Heon Soo Kim, Yong Il Shin

¹Department of Rehabilitation Medicine, Wonkwang Medical Science Research Center, Wonkwang University, Korea. cbrmshin@wonkwang.ac.kr
²Department of Rehabilitation Medicine, School of Medicine, Wonkwang University School of Oriental Medicine, Korea.

뇌졸중 후 견관절 아탈구에 대한 근전도 유발 전기자극 치료의 유용성

Abstract

BACKGROUND
The aim of this study is to evaluate the effect of electromyographically triggered electrical stimulation (ETES) on shoulder subluxation in stroke patients. METHOD: Twenty-three patients, who had hemiplegic shoulder subluxation within 3 months after stroke attack, were included. They were assigned randomly to either a control group (11 subjects) or a study group (12 subjects), and divided clinically to mild and severe subgroups by the degree in subluxation. Patients in both groups were received physical therapy and used an arm-sling. Subjects in the study group were taken ETES using biofeedback training on posterior deltoid and the supraspinatus muscle of hemiplegic subluxation side, daily 30 minutes a session, five days a week for 6 weeks. Electromyographic signals, which are derived from patient's voluntary muscle contraction, that exceeded a preset threshold trigger an immediate stimulation to force movement completion. The effect of ETES was assessed by the degree of subluxation using radiologic measurements at pre-treatment and 6 weeks post-treatment.
RESULTS
In the control group, the degree of subluxation was increased after 6 weeks (p>0.05). In the study group, the subluxation was significantly reduced (p<0.05). The significant difference after treatment 6 weeks in mild and severe subgroups implied similar improvement between subgroups.
CONCLUSION
The ETES may be the one of effective treatment methods for reducing the severity of hemiplegic shoulder subluxation in stroke patients.

Key Words: Electromyographically triggered, Shoulder, Subluxation, Hemiplegia, Biofeedback training

초 록

연구배경: 본 연구는 뇌졸중 환자에서 편마비측 견관절 아탈구에 대한 근전도 유발 전기자극(electromyographically trigge- red electrical stimulation, ETES)의 치료 효과를 규명하고자 하였다.

방법: 발병 후 3개월이 경과하지 않은 편마비측 견관절 아탈구를 갖는 23명의 초기 뇌졸중 환자를 대상으로 하였다. 대상환자를 실험군(12명)과 대조군(11명)으로 무작위 분류하였고, 임상적 아탈구 정도에 따라 경증과 중증의 소군으로 세분하였다. 두 군의 모든 환자는 물리 치료를 시행 받았고, 팔걸이를 사용하였다. 추가로 실험군은 편마비측 후삼각근과 극상근에 생체되먹이 훈련을 이용한 ETES를 하루 30분씩 1회, 매주 5일씩, 6주간 시행하였다. 미리 설정된 역치를 근전도 신호가 초과 할 때 견관절 운동이 유발하도록 고안하였다. ETES 효과는 치료 전과 치료 6주 후에 방사선학적 측정법을 이용하여 아탈구 정도를 평가하였다.

결과: 대조군의 견관절 아탈구 정도는 치료 6주 후 평가시 증가하였고(p>0.05), 실험군의 아탈구 정도는 통계적으로 의미있게 감소하였다(p<0.05). 경증과 중증의 소군에서 치료 후 모두 유의한 감소가 관찰되어 비슷한 아탈구 호전도를 보였다(p <0.05).

결론: ETES는 초기 뇌졸중 환자의 편마비측 견관절 아탈구 정도의 감소에 효과적인 치료 방법으로 생각된다.