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Park and Kim: Effects of Isokinetic Eccentric Training on Lower Extremity Muscle Activation and Walking Velocity in Stroke Patients

Abstract

Purpose:

The aim of this study was to determine the effects of isokinetic eccentric training (IET) on lower extremity muscle activation and walking velocity according to slow velocity and fast velocity of isokinetic eccentric training in stroke patients.

Methods:

Thirty subjects were randomly divided into three groups: experimental group I (n=10), group II (n=10), and control group III (n=10). Each group was provided intervention under three conditions, as follows: isokinetic eccentric training + slow velocity (group I), isokinetic eccentric training + fast velocity (group II), and sit to stand training (group III). The training program was conducted for eight weeks (five times per week; 30 minutes per day). Subjects were measured on lower extremity muscle (vastus lateralis, vastus medialis, gastrocnemius) activation and walking velocity. Analysis of covariance (ANCOVA) were performed for comparison of lower extremity muscle activation and walking velocity between different intervention methods.

Results:

Significant difference in lower extremity muscle activation and walking velocity was observed in experimental group I and group II compared with the control group III (p<0.01). Results of post-hoc analysis showed a significant in lower extremity muscle activation and walking velocity in group I compared with group II and group III.

Conclusion:

Findings of this study suggest that slow velocity and fast velocity using isokinetic eccentric training may have a beneficial effect on improvement of lower extremity muscle activation and walking velocity in stroke patients.

์„œ๋ก 

๋‡Œ์กธ์ค‘(stroke)์€ ๊ฐ๊ฐ๊ณผ ์šด๋™ ๊ธฐ๋Šฅ์˜ ์†์ƒ์œผ๋กœ ์ธํ•ด ๊ฑท๊ธฐ์™€ ๊ฐ™์€ ๊ณผ์ œ ์ˆ˜ํ–‰๋ ฅ์˜ ๊ฐ์†Œ๋กœ ์ธํ•˜์—ฌ ๊ธฐ๋Šฅ์ ์ธ ํ™œ๋™์— ์ œํ•œ์„ ๋ณด์ด๊ณ , ์‚ฌํšŒ์  ์ฐธ์—ฌ(social participation)์— ์ œ์•ฝ์„ ๊ฐ€์ ธ์˜จ๋‹ค.1,2 ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์ฃผ๋œ ์ฆ์ƒ์ธ ๋ฐ˜์‹ ๋งˆ๋น„๋Š” ์‹ ์ฒด์˜ ํ•œ์ชฝ ๊ทผ๋ ฅ์˜ ์•ฝํ™”๋ฅผ ๊ฐ€์ ธ์˜ค๋ฉฐ, ์•ฝํ™”๋œ ๋งˆ๋น„์ธก ๊ทผ์œก์€ ๊ทผ์œก์„ฌ์œ ์˜ ํŠน์„ฑ์˜ ๋ณ€ํ™”๋กœ ์„ ํƒ์ ์ธ type II ์„ฌ์œ ์˜ ์œ„์ถ•๊ณผ ์šด๋™๋‹จ์œ„์˜ ๋™์›์œจ์— ๊ฐ์†Œ๋ฅผ ๋ณด์ธ๋‹ค.3 ์†์ƒ๋œ ์œ„์šด๋™์‹ ๊ฒฝ์›์€ ์ž‘์šฉ๊ทผ์˜ ๋™์›์œจ ๊ฐ์†Œ๋ฅผ ๋‚˜ํƒ€๋‚ด๋ฉฐ, ์ž‘์šฉ๊ทผ๊ณผ ๋Œ€ํ•ญ๊ทผ์˜ ์ˆ˜์ถ• ํƒ€์ด๋ฐ์˜ ์†์ƒ์œผ๋กœ ์ธํ•˜์—ฌ ๋™์ ์ธ ๊ณผ์ œ๋ฅผ ์‹œํ–‰ํ•˜๋Š” ๋™์•ˆ ๋™์‹œ์ˆ˜์ถ•์˜ ์•ฝํ™”๋ฅผ ๊ฐ€์ ธ์˜จ๋‹ค.4
๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์•ฝํ™”๋œ ๋‹ค๋ฆฌ ๊ทผ๋ ฅ์€ ๊ฐ์†Œ๋œ ํ•œ๋ฐœ์ง€์ง€์™€ ์กฐ์ ˆ๋˜์ง€ ์•Š์€ ์ „๋ฐฉ์œผ๋กœ์˜ ์›€์ง์ž„์€ ๊ฑธ์Œ์˜ ๋น„๋Œ€์นญ์„ฑ์„ ์ดˆ๋ž˜ํ•˜๋ฉฐ, ๊ฐ™์€ ์—ฐ๋ น๋Œ€์˜ ๊ฑด๊ฐ•ํ•œ ์‚ฌ๋žŒ๊ณผ ๋น„๊ตํ•˜์—ฌ ๋ฐœ๋””๋”ค๊ธฐ์™€ ํ•œ๊ฑธ์Œ๊ธธ์ด, ๊ฑท๊ธฐ์†๋„์˜ ๊ฐ์†Œ๋ฅผ ๋ณด์—ฌ, ๊ฑธ์Œ๋Šฅ๋ ฅ์˜ ์ €ํ•˜๋ฅผ ๊ฐ€์ ธ์˜จ๋‹ค.5 ๋‹ค๋ฆฌ ๊ทผ๋ ฅ์€ ๊ฑธ์Œ์ˆ˜ํ–‰๋ ฅ ๊ฒ€์‚ฌ์™€ ์œ ์˜ํ•œ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ณด์ด๋ฉฐ,6 ๊ฐ์†Œ๋œ ๊ด€์ ˆ๊ฐ๋„์™€ ๊ฑท๊ธฐ์†๋„๋ฅผ ์ฆ์ง„์‹œํ‚ค๊ธฐ ์œ„ํ•ด์„œ๋Š” ๋„™๋‹ค๋ฆฌ๋„ค๊ฐˆ๋ž˜๊ทผ, ๋„™๋‹ค๋ฆฌ๋‘๊ฐˆ๋ž˜๊ทผ, ์žฅ๋”ด์ง€๊ทผ์˜ ๊ทผ๋ ฅ๊ฐ•ํ™”์™€ ์œ ์‚ฐ์†Œ ๋Šฅ๋ ฅ์„ ํ–ฅ์ƒ์‹œํ‚ฌ ์ˆ˜ ์žˆ๋Š” ์ค‘์žฌ๊ฐ€ ํ•„์š”ํ•จ์„ ์ œ์‹œํ•˜์˜€๋‹ค.7
๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ทผ๋ ฅ๊ฐ•ํ™”๋ฅผ ์œ„ํ•œ ๋‹ค์–‘ํ•œ ์ค‘์žฌ๋ฐฉ๋ฒ•์ด ์ œ์‹œ๋˜๊ณ  ์žˆ์œผ๋ฉฐ ๊ทธ ์ค‘ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ์€ ๊ทผ์œก๋ผˆ๋Œ€๊ณ„ ์†์ƒ ํ™˜์ž์˜ ์žฌํ™œ์—์„œ ์˜ค๋žซ๋™์•ˆ ๊ด‘๋ฒ”์œ„ํ•˜๊ฒŒ ์ด์šฉ๋˜๊ณ  ์žˆ์œผ๋ฉฐ, ์ตœ๊ทผ ์ค‘์ถ”์‹ ๊ฒฝ๊ณ„ ์†์ƒ ํ™˜์ž์˜ ์žฌํ™œํ›ˆ๋ จ์— ์ž ์žฌ์ ์ด๋ฉฐ, ํฅ๋ฏธ๋กœ์šด ์ค‘์žฌ๋ฐฉ๋ฒ•์œผ๋กœ ์†Œ๊ฐœ๋˜๊ณ  ์žˆ๋‹ค.8 ๋“ฑ์†์„ฑ ํ›ˆ๋ จ์€ ์ผ์ •ํ•œ ์†๋„๋กœ ์›€์ง์ด๋Š” ๊ทผ์ˆ˜์ถ•์˜ ํ˜•ํƒœ๋กœ ๊ด€์ ˆ๊ฐ€๋™๋ฒ”์œ„์˜ ๋ชจ๋“  ๋ฒ”์œ„์—์„œ ์ตœ๋Œ€ ๊ทผ์ˆ˜์ถ•์„ ์ด๋ฃฐ ์ˆ˜ ์žˆ์œผ๋ฉฐ, ๋“ฑ์ฒ™์„ฑ ํ›ˆ๋ จ๊ณผ ๋“ฑ์žฅ์„ฑ ํ›ˆ๋ จ๊ณผ ๋น„๊ตํ•˜์—ฌ ๊ด€์ ˆ๊ฐ€๋™๋ฒ”์œ„์˜ ๋ณ€ํ™”์— ๋Œ€ํ•ด ๋™์ผํ•œ ํž˜์„ ์ƒ์‚ฐํ•œ๋‹ค.9 Bae ๋“ฑ10์€ ๋ฌด๋ฆŽ๊ด€์ ˆ ์ „์น˜ํ™˜์ˆ  ํ™˜์ž 21๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ๋“ฑ์†์„ฑ ํ›ˆ๋ จ ๊ทธ๋ฃน๊ณผ ๋“ฑ์ฒ™์„ฑ ํ›ˆ๋ จ ๊ทธ๋ฃน์˜ ๋น„๊ต์—์„œ ๋“ฑ์†์„ฑ ํ›ˆ๋ จ ๊ทธ๋ฃน์ด ๊ทผ๋ ฅ๊ณผ ๊ด€์ ˆ๊ฐ€๋™๋ฒ”์œ„์—์„œ ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์˜€๊ณ , Lee ๋“ฑ11์€ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž์—๊ฒŒ ๋“ฑ์†์„ฑ ๋™์‹ฌ์„ฑ ํ›ˆ๋ จ์„ ์ค‘์žฌํ•˜์—ฌ ๋ฌด๋ฆŽ๊ด€์ ˆ์˜ ํ„ ํ† ํฌ์˜ ์ฆ๊ฐ€์™€ ๊ท ํ˜•๋Šฅ๋ ฅ๊ณผ ๊ฑธ์Œ, ์‚ถ์˜ ์งˆ์— ํ–ฅ์ƒ์„ ๋ณด์˜€๋‹ค.
ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์€ ์ตœ๋Œ€ ํƒ„์„ฑ์œผ๋กœ ์ธํ•œ ์ตœ๋Œ€ ๊ทผ๋ ฅ์„ ์–ป์„ ์ˆ˜ ์žˆ์œผ๋ฉฐ ๊ทผ์œก๊ณผ ํž˜์ค„ ๊ณ„ํ†ต์— ์ฝœ๋ผ๊ฒ์„ ํ•ฉ์„ฑํ•˜์—ฌ ๊ทผ์„ธํฌ์˜ ์ƒ์„ฑ๊ณผ ์„ฑ์žฅ์˜ ํ™œ์„ฑํ™”๋ฅผ ์ผ์œผํ‚ค๋ฉฐ,12 ๋™์‹ฌ์„ฑ ํ›ˆ๋ จ๊ณผ ๋น„๊ตํ•˜์—ฌ ์—๋„ˆ์ง€๋ฅผ ์ ๊ฒŒ ์†Œ๋ชจํ•˜๊ณ  ์‹ฌํ˜ธํก๊ณ„์— ์ž‘์€ ๋ถ€ํ•˜๋ฅผ ์ผ์œผํ‚ค๊ธฐ ๋•Œ๋ฌธ์— ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์˜ ํ•„์š”์„ฑ์„ ์‹œ์‚ฌํ•˜์˜€๋‹ค.13 Dibble ๋“ฑ14์€ ํŒŒํ‚จ์Šจ ํ™˜์ž์—๊ฒŒ ๊ณ ๊ฐ•๋„์˜ ํŽธ์‹ฌ์„ฑ ์ €ํ•ญํ›ˆ๋ จ์„ ์ค‘์žฌํ•˜์—ฌ ๊ฑธ์Œ๋Šฅ๋ ฅ์˜ ํ–ฅ์ƒ๊ณผ ๊ท ํ˜•๋Šฅ๋ ฅ ๋ฐ ์‚ถ์˜ ์งˆ์˜ ํ–ฅ์ƒ์„ ๋ณด๊ณ ํ•˜์˜€์œผ๋ฉฐ, Marcus ๋“ฑ15์€ ๋‹น๋‡จ ํ™˜์ž์—๊ฒŒ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ณผ ๋“ฑ์†์„ฑ ๋™์‹ฌ์„ฑ ํ›ˆ๋ จ์„ ์ค‘์žฌํ•œ ํ›„ ์ง‘๋‹จ ๊ฐ„ ๋น„๊ต์—์„œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ ์ง‘๋‹จ์—์„œ ๊ท ํ˜•๊ณผ ๊ฑธ์Œ๋Šฅ๋ ฅ์˜ ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์˜€๋‹ค.
๊ทผ๋ ฅ์˜ ์ฆ๊ฐ€๋Š” ๊ทผ์œก ์ˆ˜์ถ•์˜ ํ˜•ํƒœ์™€ ๊ทผ์œก ์ˆ˜์ถ•์˜ ์†๋„์— ์˜ํ–ฅ์„ ๋ฐ›์œผ๋ฉฐ type II์„ฌ์œ ๋Š” type I์„ฌ์œ ์— ๋น„ํ•ด ์†๋„ ์˜์กด์ ์ด๋ฉฐ, ๋น ๋ฅธ ์†๋„๋ฅผ ์ด์šฉํ•œ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ์€ ๊ทผ์œก์˜ ๋‹จ๋ฉด์  ํฌ๊ธฐ๋ฅผ ์ฆ๊ฐ€์‹œํ‚ค๋ฉฐ, ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๊ทผ๋ ฅ๊ฐ•ํ™”๋Š” ๋งˆ์ด์˜ค์‹ ์˜ ๊ฒฐํ•ฉ๋ ฅ์„ ์ฆ๊ฐ€์‹œ์ผœ ํฐ ํž˜์„ ๋ฐœ์ƒํ•œ๋‹ค๊ณ  ํ•˜์˜€๋‹ค.16,17 Han๊ณผ Lee18๋Š” ์ €ํ•ญ์†๋„์— ๋”ฐ๋ผ ๋„™๋‹ค๋ฆฌ๋„ค๊ฐˆ๋ž˜๊ทผ์˜ ๊ทผ๋ ฅ๊ณผ ๊ทผ์œก์˜ ๋‘๊ป˜์— ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด๊ณ ํ•˜์˜€๊ณ  ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ์šด๋™ ์‹œ ์ €ํ•ญ์†๋„๋ฅผ ๊ณ ๋ คํ•ด์•ผ ํ•œ๋‹ค๊ณ  ํ•˜์˜€๋‹ค.
์ด์ฒ˜๋Ÿผ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ์„ ํ†ตํ•ด ๊ทผ๋ ฅ๊ณผ ๊ท ํ˜• ๋ฐ ๊ฑธ์Œ ํ–ฅ์ƒ์— ๋Œ€ํ•œ ์—ฐ๊ตฌ๋“ค์€ ํ™œ๋ฐœํ•˜๊ฒŒ ์ด๋ฃจ์–ด์ ธ ์™”์œผ๋‚˜ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์— ๋Œ€ํ•œ ์—ฐ๊ตฌ๋Š” ๋ถ€์กฑํ•œ ์‹ค์ •์ด๋ฉฐ, ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ ์†๋„์— ๋”ฐ๋ฅธ ํšจ๊ณผ๋ฅผ ๋ถ„์„ํ•œ ์—ฐ๊ตฌ ๋˜ํ•œ ๋ถ€์กฑํ•œ ์‹ค์ •์ด๋‹ค. ๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž์—๊ฒŒ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๋Œ€ํ•ด ์•Œ์•„๋ณด๊ณ  ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„๋ฅผ ๋ถ„์„ํ•˜์—ฌ ์น˜๋ฃŒ์  ๋ฐ˜์‘์„ ์ด๋Œ์–ด ๋‚ด๊ธฐ ์œ„ํ•œ ํšจ์œจ์ ์ธ ์†๋„๋ฅผ ๊ทœ๋ช…ํ•˜๊ณ ์ž ํ•œ๋‹ค.

์—ฐ๊ตฌ ๋ฐฉ๋ฒ•

1. ์—ฐ๊ตฌ ๋Œ€์ƒ

๋ณธ ์—ฐ๊ตฌ๋Š” ์ „๋‚จ ์†Œ์žฌ์˜ J ๋ณ‘์›์—์„œ ๋‡Œ์กธ์ค‘์œผ๋กœ ์ธํ•ด ๋ฐ˜๋งˆ๋น„ ์ง„๋‹จ์„ ๋ฐ›๊ณ  ๊ธฐ๋ŠฅํšŒ๋ณต์„ ์œ„ํ•ด ์น˜๋ฃŒ๋ฅผ ๋ฐ›๊ณ  ์žˆ๋Š” ์ž…์›ํ™˜์ž๋“ค ์ค‘ ์‹คํ—˜๋ฐฉ๋ฒ•์— ๋Œ€ํ•˜์—ฌ ์ถฉ๋ถ„ํ•œ ์„ค๋ช…์„ ๋“ฃ๊ณ  ์ž๋ฐœ์ ์œผ๋กœ ์ฐธ์—ฌํ•˜๊ธฐ๋กœ ๋™์˜ํ•œ 30๋ช…์„ ์„ ์ •ํ•˜์˜€๋‹ค. ์„ธ๋ถ€์ ์ธ ์„ ์ •๊ธฐ์ค€์€ ๋‡Œ์กธ์ค‘ ์ง„๋‹จ์„ ๋ฐ›๊ณ  1๋…„์„ ์ดˆ๊ณผํ•˜์ง€ ์•Š์€ ์ž, ํ•œ๊ตญํ˜• ๊ฐ„์ด ์ •์‹ ์ƒํƒœ ๊ฒ€์‚ฌ(MMSE-K) ์ ์ˆ˜๊ฐ€ 24์  ์ด์ƒ์œผ๋กœ ์˜์‚ฌ์†Œํ†ต์ด ๊ฐ€๋Šฅํ•œ ์ž, ๋…๋ฆฝ์ ์œผ๋กœ 10 m๋ฅผ ๊ฑธ์„ ์ˆ˜ ์žˆ๋Š” ์ž, ๋‹ค๋ฅธ ๋‚ดยท์™ธ๊ณผ์  ์˜ํ•™์  ์งˆํ™˜์„ ๊ฐ€์ง€๊ณ  ์žˆ์ง€ ์•Š์€ ์ž๋กœ ์„ ์ •ํ•˜์˜€๋‹ค(Table 1).
Tableย 1
General characteristic of subjects
Group I (n=10) MeanยฑSD Group II (n=10) MeanยฑSD Group III (n=10) MeanยฑSD
Height (cm) 166.5ยฑ6.1 165.5ยฑ5.9 166.3ยฑ5.9
Age (year) 59.0ยฑ4.1 58.4ยฑ4.2 58.7ยฑ3.8
Weight (kg) 64.9ยฑ5.2 64.7ยฑ7.2 65.0ยฑ7.1
Stroke duration (month) 5.4ยฑ1.4 5.3ยฑ1.2 5.3ยฑ0.8

Group I, isokinetic eccentric training+slow velocity (IET+SV); Group II, isokinetic eccentric training+fast velocity (IET+FV); Group III, sit to stand training (STST).

2. ์‹คํ—˜ ๋ฐฉ๋ฒ•

๋ณธ ์—ฐ๊ตฌ๋Š” ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ(Group I) 10๋ช…, ๋น ๋ฅธ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ(Group II) 10๋ช…, ์•‰์€์ž์„ธ์—์„œ ์„œ๊ธฐ ํ›ˆ๋ จ์„ ์ค‘์žฌํ•œ ๋Œ€์กฐ๊ตฐ(Group III) 10๋ช…์œผ๋กœ ๊ฐ๊ฐ ๋ฌด์ž‘์œ„ ์ž„์˜ ์„ ์ •ํ•˜์—ฌ ์ค‘์žฌ ์ „ยทํ›„ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„๋ฅผ ์ธก์ •ํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค.

1) ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ

๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์„ ์œ„ํ•ด ๊ทผ๋ ฅํ‰๊ฐ€์™€ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ์„ ํ•  ์ˆ˜ ์žˆ๋„๋ก ๊ณ ์•ˆ๋œ Eccentron (BTE Technologies Inc, USA)์„ ์ด์šฉํ•˜์˜€๋‹ค. Eccentron์€ ์Šคํฌ๋ฆฐ๊ณผ ์ธก๋ ฅ๊ณ„(ergometer)๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ๊ณ  ์ธก๋ ฅ๊ณ„๋Š” 3๋งˆ๋ ฅ์˜ ๋ชจํ„ฐ์™€ ํž˜ํŒ(forceplate)์ด ํƒ‘์žฌ๋œ ๋‘ ๊ฐœ์˜ ๋ฐœํŒ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ๊ทผ๋ ฅ์˜ ์ธก์ •๊ณผ ํ›ˆ๋ จ ์‹œ ๋˜๋จน์ž„์„ ์ œ๊ณตํ•œ๋‹ค. ํ›ˆ๋ จ์€ ๋‹ซํžŒ ์šด๋™ํ˜•์ƒํ•™์  ์‚ฌ์Šฌ์—์„œ ์ด๋ฃจ์–ด์ง€๋ฉฐ ์ €์†, ์ค‘์†, ๊ณ ์†์˜ ์†๋„๋กœ ์Œ์˜ ์ผ๋ฅ (negative work)์„ ์ˆ˜ํ–‰ํ•˜๋Š” ๋™์•ˆ ์—‰๋ฉ๊ด€์ ˆ, ๋ฌด๋ฆŽ๊ด€์ ˆ, ๋ฐœ๋ชฉ๊ด€์ ˆ์˜ ํŽธ์‹ฌ์„ฑ ์ˆ˜์ถ•์„ ์œ ๋ฐœํ•œ๋‹ค. ํ›ˆ๋ จ์†๋„๋Š” 1-40 RPM์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ์œผ๋ฉฐ, 1-13 RPM์€ ๋Š๋ฆฐ ์†๋„, 14-25 RPM์€ ์ค‘๊ฐ„ ์†๋„, 26-40 RPM์€ ๋น ๋ฅธ ์†๋„๋กœ ๋‚˜๋‰˜์–ด์ ธ ์žˆ๋‹ค. ํ›ˆ๋ จ์‹œ๊ฐ„์€ ์ด 30๋ถ„์œผ๋กœ 5 session์œผ๋กœ ๊ตฌ์„ฑ๋˜๋ฉฐ 1 session ๋‹น 5๋ถ„์˜ ํ›ˆ๋ จ๊ณผ 1๋ถ„์˜ ํœด์‹ ์‹œ๊ฐ„์„ ์ œ๊ณตํ•˜๋ฉฐ, 5๋ถ„์˜ ํ›ˆ๋ จ ์‹œ๊ฐ„ ์ค‘ ์•ž, ๋’ค 1๋ถ„์”ฉ 2๋ถ„์€ warm up๊ณผ cool down ๋‹จ๊ณ„๋กœ ํ›ˆ๋ จ๊ฐ•๋„์˜ 50%์˜ ํž˜์„ ๊ฐ€ํ•œ๋‹ค. ์‹คํ—˜๊ตฐ(GroupI, Group II)์€ 8์ฃผ ๋™์•ˆ ์ฃผ 5ํšŒ, 1์ผ 30๋ถ„์˜ ํ›ˆ๋ จ์„ ์ œ๊ณต๋ฐ›์•˜๋‹ค(Figure 1).
Figureย 1
Eccentron system.
JKPT_27_190_fig_1.tif

2) ์•‰์€์ž์„ธ์—์„œ ์„œ๊ธฐ ํ›ˆ๋ จ

์•‰์€์ž์„ธ์—์„œ ์„œ๊ธฐ ํ›ˆ๋ จ์€ Roy ๋“ฑ19์˜ ์—ฐ๊ตฌ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ๋Œ€์นญ์ , ๋น„๋Œ€์นญ์  ์ž์„ธ๋กœ ์ด๋ฃจ์–ด์ง„ 3๊ฐ€์ง€ ํ›ˆ๋ จ์ž์„ธ์—์„œ 8์ฃผ ๋™์•ˆ ์ฃผ 5ํšŒ ์‹œํ–‰๋˜๋ฉฐ, 1-4์ฃผ์—์„œ๋Š” ํ›ˆ๋ จ์ž์„ธ ๋‹น ๊ฐ๊ฐ 8-10ํšŒ์”ฉ 4 set๋ฅผ ์ˆ˜ํ–‰ํ•˜์˜€๊ณ  ์ ์ง„์ ์œผ๋กœ ์น˜๋ฃŒ์  ๊ฐ•๋„๋ฅผ ์ฆ๊ฐ€์‹œํ‚ค๊ธฐ ์œ„ํ•ด 5-8์ฃผ์—์„œ๋Š” ๊ฐ๊ฐ 12-15ํšŒ์”ฉ 4 set๋ฅผ ์ˆ˜ํ–‰ํ•˜์˜€๋‹ค. ๊ฐ set ํ›„ 1๋ถ„๊ฐ„์˜ ํœด์‹์‹œ๊ฐ„์„ ์ œ๊ณตํ•˜์˜€๋‹ค.

3. ์ธก์ •๋ฐฉ๋ฒ•

1) ํ‘œ๋ฉด๊ทผ์ „๋„์‹œ์Šคํ…œ

๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„๋ฅผ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด MP100 ํ‘œ๋ฉด๊ทผ์ „๋„ ์‹œ์Šคํ…œ(Biopac System Inc., USA)์„ ์ด์šฉํ•˜์˜€๊ณ , ๋””์ง€ํ„ธ ์‹ ํ˜ธ๋กœ ๋ณ€ํ™˜๋œ ์ž๋ฃŒ๋Š” ๊ฐœ์ธ์šฉ ์ปดํ“จํ„ฐ์—์„œ Acqknowledge 3.91 ์†Œํ”„ํŠธ์›จ์–ด๋ฅผ ์ด์šฉํ•˜์—ฌ ์ž๋ฃŒ ์ฒ˜๋ฆฌํ•˜์˜€๋‹ค. ํ‘œ๋ฉด๊ทผ์ „๋„ ์‹ ํ˜ธ์— ๋Œ€ํ•œ ํ”ผ๋ถ€์ €ํ•ญ์„ ์ตœ์†Œํ™”ํ•˜๊ธฐ ์œ„ํ•ด ๋ถ€์ฐฉ๋ถ€์œ„์˜ ํ„ธ์„ ์ œ๊ฑฐํ•˜๊ณ  ๊ฐ€๋Š” ์‚ฌํฌ๋กœ 3-4ํšŒ ๋ฌธ์งˆ๋Ÿฌ ํ”ผ๋ถ€๊ฐ์งˆ์ธต์„ ์ œ๊ฑฐํ•œ ํ›„, ์†Œ๋…์šฉ ์•Œ์ฝ”์˜ฌ ์†œ์œผ๋กœ ํ”ผ๋ถ€๋ฅผ ๊นจ๋—์ด ํ•˜์˜€๋‹ค. ๋ถ€์ฐฉ ๊ทผ์œก์€ ๊ฐ€์ชฝ๋„“์€๊ทผ, ์•ˆ์ชฝ๋„“์€๊ทผ, ์žฅ๋”ด์ง€๊ทผ์— ๋ถ€์ฐฉํ•˜์˜€๊ณ  ์ด๊ทน์ „๊ทน์€ ๊ฐ ๊ทผ์œก์˜ ๊ทผํž˜์‚ด(muscle belly)์— ๊ทผ์„ฌ์œ ์˜ ๋ฐฉํ–ฅ๊ณผ ํ‰ํ–‰ํ•˜๊ฒŒ ๋ถ€์ฐฉํ•˜์˜€๋‹ค. ํ‘œ๋ณธ์ถ”์ถœ๋ฅ (sampling rate)์€ 1,024 Hz๋กœ ์„ค์ •ํ•˜์˜€๊ณ , ์žก์Œ์„ ์ตœ์†Œํ™”ํ•˜๊ธฐ ์œ„ํ•ด ๋Œ€์—ญ ์—ฌ๊ณผ ํ•„ํ„ฐ(notch filter)๋Š” 60 Hz, ๋Œ€์—ญ ํ†ต๊ณผ ํ•„ํ„ฐ(band pass filter) 30-450 Hz๋กœ ์„ค์ •ํ•˜์˜€์œผ๋ฉฐ ์ˆ˜์ง‘๋œ ์‹ ํ˜ธ๋Š” RMS ์ฒ˜๋ฆฌํ•˜์˜€๋‹ค(Figure 2A).
Figureย 2
(A) sEMG. (B) Motion capture system.
JKPT_27_190_fig_2.tif

2) ๊ทผํ™œ์„ฑ๋„์˜ ํ‘œ์ค€ํ™”

๋ณธ ์—ฐ๊ตฌ์—์„œ ๊ทผํ™œ์„ฑ๋„๋ฅผ ํ‘œ์ค€ํ™”ํ•˜๊ธฐ ์œ„ํ•ด ํŠน์ • ๋™์ž‘์˜ ๊ทผ์ˆ˜์ถ•์„ ๊ธฐ์ค€ ์ˆ˜์ถ•(reference voluntary contraction, RVC)์œผ๋กœ ํ•˜์—ฌ ์ด๋ฅผ ํ‘œ์ค€ํ™”ํ•˜๋Š” %๊ธฐ์ค€์ˆ˜์ถ•(%RVC)๋ฐฉ๋ฒ•์„ ์ด์šฉํ•˜์˜€๋‹ค. ๋ฐ˜์›…ํฌ๋ฆฌ๊ธฐ ์ž์„ธ(semi-squat position)๋ฅผ 5์ดˆ ์œ ์ง€ํ•˜๋Š” ๋™์•ˆ ์ธก์ • ๊ทผ์œก๋“ค์˜ ๊ทผํ™œ์„ฑ๋„๋ฅผ ์ธก์ •ํ•œ ๋’ค ์ฒ˜์Œ๊ณผ ๋งˆ์ง€๋ง‰ 1์ดˆ์”ฉ์„ ์ œ์™ธํ•œ 3์ดˆ์˜ ์‹ ํ˜ธ๋ฅผ ๋ถ„์„ํ•˜์—ฌ RVC๊ฐ’์„ ์‚ฐ์ถœํ•˜์˜€๊ณ , ๊ฑธ์Œ์ฃผ๊ธฐ์˜ ๋””๋”ค๊ธฐ ๋™์•ˆ ๊ทผํ™œ์„ฑ๋„ ๊ฐ’๊ณผ ๋น„๊ตํ•˜์—ฌ %RVC๊ฐ’์„ ์‚ฐ์ถœํ•˜์˜€๋‹ค. ๊ทผํ™œ์„ฑ๋„์˜ ์ž๋ฃŒ๋Š” 3ํšŒ ์ธก์ •ํ•˜์—ฌ ์–ป์€ ๊ฒฐ๊ณผ์˜ ํ‰๊ท ๊ฐ’์„ ์ด์šฉํ•˜์˜€๋‹ค.

3) ๊ฑท๊ธฐ์†๋„ ์ธก์ •

๊ฑธ์Œ์˜ ์šด๋™ํ˜•์ƒํ•™์  ๋ณ€์ธ(kinematics variance)๊ณผ ์‹œ๊ฐ„์ , ๊ณต๊ฐ„์  ๋ณ€์ธ(temporal & spatial variance)์„ ๋ถ„์„ํ•˜๊ธฐ ์œ„ํ•ด LUKOtronic (Lutz-Kovacs Electronic, Austria) ๋™์ž‘๋ถ„์„์‹œ์Šคํ…œ์„ ์ด์šฉํ•˜์˜€๋‹ค. ๊ตฌ์„ฑ์š”์†Œ๋Š” ๋™์ž‘๋ถ„์„์„ ์œ„ํ•œ ์นด๋ฉ”๋ผ, ์ ์™ธ์„  ๋งˆ์ปค, ๋ถ„์„์šฉ ์†Œํ”„ํŠธ์›จ์–ด๊ฐ€ ๋‚ด์žฅ๋œ ๊ฐœ์ธ์šฉ ์ปดํ“จํ„ฐ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ์œผ๋ฉฐ, ์ˆ˜์ง‘๋œ ๋ฐ์ดํ„ฐ๋Š” GaitLab์„ ์ด์šฉํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค(Figure 2B).

4. ์ž๋ฃŒ๋ถ„์„

์ธก์ •๋œ ์ž๋ฃŒ๋Š” SPSS 19.0์„ ์ด์šฉํ•˜์—ฌ ํ†ต๊ณ„์ฒ˜๋ฆฌ ํ•˜์˜€์œผ๋ฉฐ, ์„ธ ์ง‘๋‹จ ๊ฐ„์˜ ๋™์งˆ์„ฑ ๊ฒ€์ฆ์„ ์œ„ํ•ด ์ผ์š”์ธ ๋ถ„์‚ฐ๋ถ„์„(one-way ANOVA)์„ ์‹œํ–‰ํ•˜์˜€๊ณ , ์ค‘์žฌ๋ฐฉ๋ฒ•์— ๋”ฐ๋ฅธ ๊ทธ๋ฃน ๊ฐ„ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„ ์ฐจ์ด๋ฅผ ๊ฒ€์ฆํ•˜๊ธฐ ์œ„ํ•ด ๊ณต๋ถ„์‚ฐ๋ถ„์„์„ ์ด์šฉํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค. ์‚ฌํ›„๊ฒ€์ •์œผ๋กœ Bonferroni ๊ฒ€์ •์„ ์‹ค์‹œํ•˜์˜€๋‹ค. ํ†ต๊ณ„ํ•™์  ์œ ์˜์ˆ˜์ค€์€ ฮฑ=0.05๋กœ ํ•˜์˜€๋‹ค.

๊ฒฐ๊ณผ

1. ๊ทธ๋ฃน ๊ฐ„ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„ ๋น„๊ต

๊ทธ๋ฃน ๊ฐ„ ์ค‘์žฌ ์ „ํ›„ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„ ๋น„๊ต ๊ฒฐ๊ณผ, ๊ทธ๋ฃน I๊ณผ ๊ทธ๋ฃน II๋Š” ๊ทธ๋ฃน III์™€ ๋น„๊ตํ•˜์—ฌ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์˜ ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์˜€๋‹ค(p<0.01). ์‚ฌํ›„๊ฒ€์ • ๊ฒฐ๊ณผ ๊ทธ๋ฃน I์€ ๊ทธ๋ฃน II, ๊ทธ๋ฃน III์™€ ๋น„๊ตํ•˜์—ฌ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„ ํ–ฅ์ƒ์— ํšจ๊ณผ์ ์ด์—ˆ๋‹ค(Table 2).
Tableย 2
Comparison of lower extremity muscle activation between groups (Unit: %)
Group I (n=10) Group II (n=10) Group III (n=10) F p Post-Hoc



Pre Post Pre Post Pre Post
VL 31.93ยฑ2.51 39.94ยฑ3.52 31.41ยฑ3.59 37.44ยฑ3.49 31.55ยฑ3.46 35.74ยฑ2.51 17.98 <0.001* III<I
III<II
II<I
VM 29.49ยฑ3.91 37.50ยฑ4.96 29.77ยฑ4.65 35.79ยฑ4.62 29.93ยฑ4.50 33.95ยฑ5.42 22.62 <0.001% III<I
III<II
II<I
GCM 27.20ยฑ4.67 35.22ยฑ5.32 26.98ยฑ5.74 33.09ยฑ4.73 27.15ยฑ5.62 31.17ยฑ4.30 19.27 <0.001% III<I
III<II
II<I

* p<0.01.

VL, vastus lateralis; VM, vastus medialis; GCM, gastrocnemius.

Group I, isokinetic eccentric training+slow velocity (IET+SV); Group II, isokinetic eccentric training+fast velocity (IET+FV); Group III, sit to stand training (STST).

2. ๊ทธ๋ฃน ๊ฐ„ ๊ฑท๊ธฐ์†๋„ ๋น„๊ต

๊ทธ๋ฃน ๊ฐ„ ์ค‘์žฌ ์ „ยทํ›„ ๊ฑท๊ธฐ์†๋„ ๋น„๊ต ๊ฒฐ๊ณผ, ๊ทธ๋ฃน I๊ณผ ๊ทธ๋ฃน II๋Š”๊ทธ๋ฃน III์™€ ๋น„๊ตํ•˜์—ฌ ๊ฑท๊ธฐ์†๋„์˜ ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์˜€๋‹ค(p<0.01). ์‚ฌํ›„๊ฒ€์ • ๊ฒฐ๊ณผ ๊ทธ๋ฃน I์€ ๊ทธ๋ฃน II, ๊ทธ๋ฃน III๊ณผ ๋น„๊ตํ•˜์—ฌ ๊ฑท๊ธฐ์†๋„ ํ–ฅ์ƒ์— ํšจ๊ณผ์ ์ด์—ˆ๋‹ค(Table 3).
Tableย 3
Comparison of walking velocity between groups (Unit: m/s)
Group I (n=10) Group II (n=10) Group III (n=10) F p Post-Hoc



Pre Post Pre Post Pre Post
WV 0.34ยฑ0.04 0.54ยฑ0.07 0.33ยฑ0.05 0.52ยฑ0.06 0.34ยฑ0.05 0.48ยฑ0.05 21.44 <0.001* III<I
III<II
II<I

* p<0.01.

WV, walking velocity.

Group I, isokinetic eccentric training+slow velocity (IET+SV); Group II, isokinetic eccentric training+fast velocity (IET+FV); Group III, sit to stand training (STST).

๊ณ ์ฐฐ

ํŽธ์‹ฌ์„ฑ ์ˆ˜์ถ•์€ ์™ธ์ ์ธ ํ† ํฌ๊ฐ€ ๋‚ด์ ์ธ ํ† ํฌ๋ณด๋‹ค ํด ๋•Œ ๋ฐœ์ƒํ•˜๋ฉฐ ๊ทผ์œก์˜ ๊ธธ์ด๊ฐ€ ๊ธธ์–ด์ง€๋Š” ์ˆ˜์ถ•์œผ๋กœ ๋™์‹ฌ์„ฑ ์ˆ˜์ถ•๊ณผ ๋น„๊ตํ•˜์—ฌ ๋” ํฐ ํž˜์„ ์ƒ์‚ฐํ•˜๊ณ  ์‚ฐ์†Œ์š”๊ตฌ๋Ÿ‰์ด ์ ๊ธฐ ๋•Œ๋ฌธ์— ์•ˆ์ „ํ•˜๊ณ  ํšจ์œจ์ ์ธ ํ›ˆ๋ จ๋ฐฉ๋ฒ•์ด๋‹ค.20 ๋ณธ ์—ฐ๊ตฌ๋Š” ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์„ ํ™•์ธํ•˜๊ณ  ์น˜๋ฃŒ์  ๋ฐ˜์‘์„ ์ด๋Œ์–ด ๋‚ด๊ธฐ ์œ„ํ•œ ํšจ์œจ์ ์ธ ์†๋„๋ฅผ ๊ทœ๋ช…ํ•˜๊ธฐ ์œ„ํ•ด ์—ฐ๊ตฌํ•œ ๊ฒฐ๊ณผ, ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋Œ€์กฐ๊ตฐ๊ณผ ๋น„๊ตํ•˜์—ฌ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„์— ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์˜€๊ณ , ์‚ฌํ›„๊ฒ€์ • ๊ฒฐ๊ณผ ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„ ํ–ฅ์ƒ์— ํšจ๊ณผ์ ์ž„์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค.
Clark์™€ Patten21๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž 34๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ๊ณผ ๋“ฑ์†์„ฑ ๋™์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ์œผ๋กœ ๋‚˜๋ˆ„์–ด 5์ฃผ ๋™์•ˆ ์ฃผ 3ํšŒ ์ค‘์žฌํ•œ ํ›„ ์ง‘๋‹จ ๊ฐ„ ๋น„๊ต ๊ฒฐ๊ณผ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ์—์„œ ๋„™๋‹ค๋ฆฌ๊ณง์€๊ทผ, ์•ˆ์ชฝ๋„“์€๊ทผ์˜ ๊ทผํ™œ์„ฑ๋„๊ฐ€ ์œ ์˜ํ•œ ์ฆ๊ฐ€๋ฅผ ๋ณด์˜€๋‹ค. Jegu ๋“ฑ22์€ ๋ฌด๋ฆŽ๊ด€์ ˆ์˜ ๊ณจ๊ด€์ ˆ์—ผ์„ ๊ฐ€์ง„ 80๋ช…์˜ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ๊ณผ ๋“ฑ์†์„ฑ ๋™์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ์œผ๋กœ ๋‚˜๋ˆ„์–ด 6์ฃผ ๋™์•ˆ ์ฃผ 2ํšŒ, 1์ผ 12 session์˜ ๋ฌด๋ฆŽ๊ด€์ ˆ ๊ตฝํž˜๊ณผ ํ„์„ ์ค‘์žฌํ•œ ๊ฒฐ๊ณผ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ์˜ ๋„™๋‹ค๋ฆฌ๋„ค๊ฐˆ๋ž˜๊ทผ๊ณผ ๋’ค๋„™๋‹ค๋ฆฌ๊ทผ์˜ ๊ทผ๋ ฅ์ด ๋™์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ๊ณผ ๋น„๊ตํ•˜์—ฌ ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€๋‹ค.
๋ณธ ์—ฐ๊ตฌ์—์„œ๋„ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์„ ์ค‘์žฌํ•œ ๊ทธ๋ฃน I, II๊ฐ€ ์•‰์€์ž์„ธ์—์„œ ์„œ๊ธฐ ํ›ˆ๋ จ์„ ์ค‘์žฌํ•œ ๋Œ€์กฐ๊ตฐ๊ณผ ๋น„๊ตํ•˜์—ฌ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์— ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€๋‹ค. ์„ ํ–‰์—ฐ๊ตฌ์™€ ๋น„๊ตํ•˜์—ฌ ํ›ˆ๋ จ์†๋„์™€ ์ค‘์žฌ๊ธฐ๊ฐ„์— ์ฐจ์ด๋Š” ์žˆ์ง€๋งŒ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„๋ฅผ ํ–ฅ์ƒ์‹œํ‚ค๋Š” ๋™์ผํ•œ ๊ฒฐ๊ณผ๋Š” ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ทผ๋ ฅ ํ–ฅ์ƒ์„ ์œ„ํ•ด ํ•„์š”ํ•˜๋‹ค๋Š” ๊ฒƒ์„ ๋’ท๋ฐ›์นจ ํ•ด์ค„ ์ˆ˜ ์žˆ๋‹ค.
Paul ๋“ฑ23์€ ํŒŒํ‚จ์Šจ ํ™˜์ž 40๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ๋Š๋ฆฐ์†๋„๋ฅผ ์ด์šฉํ•œ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ๊ณผ ์ผ๋ฐ˜์ ์ธ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ์œผ๋กœ ๋‚˜๋ˆ„์–ด 12์ฃผ ๋™์•ˆ ์ฃผ 2ํšŒ 1์ผ 40๋ถ„์— ์ค‘์žฌํ•œ ๊ฒฐ๊ณผ ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ์ด ๋ฌด๋ฆŽ๊ด€์ ˆ ๊ทผ๋ ฅ์—์„œ ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์˜€๊ณ , Van ๋“ฑ24์€ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ์€ ํž˜-์†๋„(force-velocity) ๊ด€๊ณ„์— ์˜ํ•ด ๋™์‹ฌ์„ฑ ์ˆ˜์ถ•์—์„œ๋Š” ๋Š๋ฆฐ ์†๋„๊ฐ€ ํŽธ์‹ฌ์„ฑ ์ˆ˜์ถ•์—์„œ๋Š” ๋น ๋ฅธ ์†๋„๊ฐ€ ๊ทผ๋ ฅ๊ฐ•ํ™”์— ํšจ๊ณผ์ ์ด๋ผ๊ณ  ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„ ํ–ฅ์ƒ์— ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์—ฌ ์„ ํ–‰์—ฐ๊ตฌ์™€ ๋ถ€๋ถ„ ์ผ์น˜ํ•˜์˜€๋‹ค.
๋‡Œ์กธ์ค‘ ํ™˜์ž๋Š” ํฌ๋„๋‹น๊ณผ ๋‹จ๋ฐฑ์งˆ์˜ ๋Œ€์‚ฌ์ž‘์šฉ์˜ ์†์ƒ๊ณผ ๊ทผ์›์„ฌ์œ ์˜ ๋ณ€์„ฑ์œผ๋กœ ๊ทผ์œก ๋ฉ์–ด๋ฆฌ(mass)์˜ ์†์‹ค๋กœ ์ธํ•ด ๊ฐ€๋กœ๋‹จ๋ฉด์ ์˜ ๊ฐ์†Œ๋ฅผ ๊ฐ€์ ธ์˜ค๋ฉฐ,25 Cadore ๋“ฑ26์€ ๋น ๋ฅธ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์€ ์†๋„์— ๋” ์˜์กด์ ์ธ type II ์„ฌ์œ ๋ฅผ ์ž๊ทนํ•˜์—ฌ ๊ทผ๋ ฅ์„ ํšŒ๋ณต์‹œํ‚ค๊ณ  ๊ฐ€๋กœ๋‹จ๋ฉด์ ์„ ์ฆ๊ฐ€์‹œ์ผœ ๊ทผํ™œ์„ฑ๋„์˜ ์ฆ๊ฐ€๋ฅผ ๋ณด์˜€๋‹ค. ํ•˜์ง€๋งŒ ๋น ๋ฅธ ์†๋„๋Š” ์กฐ์ง์— ๊ณผ๋ถ€ํ•˜๋ฅผ ์ผ์œผ์ผœ ์•กํ‹ด๊ณผ ๋ฏธ์˜ค์‹ ์˜ ๊ต์ฐจ์—ฐ๊ฒฐ์ด ๊ฐ์†Œ๋˜์–ด ๊ทผ์ˆ˜์ถ•๋ ฅ์˜ ๊ฐ์†Œ๋ฅผ ๋‚˜ํƒ€๋‚ด๊ธฐ ๋•Œ๋ฌธ์—,27 ๋ฏธ์˜ค์‹ ์˜ ๊ฒฐํ•ฉ๋ ฅ ์ฆ๊ฐ€์™€ type I์„ฌ์œ ์™€ type II์„ฌ์œ ์˜ ๋™์‹œ์ˆ˜์ถ•์„ ์œ ๋ฐœํ•˜๋Š” ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„ ํ–ฅ์ƒ์— ํšจ์œจ์ ์ด๋ผ๊ณ  ์ƒ๊ฐ๋œ๋‹ค.
๋Œ€๋ถ€๋ถ„์˜ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋Š” ํ‰๊ท ์ ์œผ๋กœ 0.2 m/s-0.7 m/s์˜ ๊ฑท๊ธฐ์†๋„์™€ 81.5 cm์˜ ํ•œ๊ฑธ์Œ ๊ธธ์ด, 79.7 step/min์˜ ๋ถ„์†์ˆ˜(cadence)๋กœ ์‹œยท๊ณต๊ฐ„์  ๊ฑธ์Œ ์š”์†Œ์— ๊ฐ์†Œ๋ฅผ ๋ณด์ด๋ฉฐ, ๊ฐ์†Œ๋œ ๋””๋”ค๊ธฐ์™€ ํ”๋“ฆ๊ธฐ, ์กฐ์ ˆ๋˜์ง€ ์•Š์€ ๋ถ„์ ˆ์˜ ์›€์ง์ž„์€ ๊ฐ™์€ ์—ฐ๋ น๋Œ€์˜ ๊ฑด๊ฐ•ํ•œ ๋Œ€์ƒ์ž์™€ ๋น„๊ตํ•˜์—ฌ ๊ฑธ์Œ๋Šฅ๋ ฅ์˜ ๊ฐ์†Œ๋ฅผ ๋ณด์˜€๊ณ ,28 Flansbjer ๋“ฑ29์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž 50๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ๋ฌด๋ฆŽ๊ด€์ ˆ์˜ ๊ตฝํž˜๊ทผ๊ณผ ํ„๊ทผ์˜ ๊ทผ๋ ฅ๊ณผ ๊ฑธ์Œ๋Šฅ๋ ฅ์˜ ์ƒ๊ด€๊ด€๊ณ„ ์—ฐ๊ตฌ์—์„œ ๊ทผ๋ ฅ๊ณผ ๊ฑท๊ธฐ์†๋„, TUG, ๊ณ„๋‹จ์˜ค๋ฅด๋‚ด๋ฆฌ๊ธฐ์™€ ์œ ์˜ํ•œ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋ณด๊ณ ํ•˜์˜€๋‹ค.
Lee์™€ Kang30์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž 20๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ์„ ์ค‘์žฌํ•œ ์‹คํ—˜๊ตฐ๊ณผ ์ „ํ†ต์ ์ธ ๋ฌผ๋ฆฌ์น˜๋ฃŒ๋ฅผ ์ค‘์žฌํ•œ ๋Œ€์กฐ๊ตฐ์œผ๋กœ ๋‚˜๋ˆ„์–ด 6์ฃผ ๋™์•ˆ ์ฃผ 3ํšŒ 1์ผ 40๋ถ„์”ฉ ์ค‘์žฌํ•œ ํ›„ ์ง‘๋‹จ ๊ฐ„ ๋น„๊ต ๊ฒฐ๊ณผ ์‹คํ—˜๊ตฐ์ด ๊ฑท๊ธฐ์†๋„, ๊ณ„๋‹จ์˜ค๋ฅด๋‚ด๋ฆฌ๊ธฐ ๊ฒ€์‚ฌ, TUG ๊ฒ€์‚ฌ์—์„œ ๋Œ€์กฐ๊ตฐ๊ณผ ๋น„๊ตํ•˜์—ฌ ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€๋‹ค. Cha ๋“ฑ31์€ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž 14๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ๋Š๋ฆฐ ์†๋„(60ยฐ/sec)๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ๊ณผ ๋น ๋ฅธ ์†๋„(180ยฐ/sec)๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ์œผ๋กœ ๋‚˜๋ˆ„์–ด 6์ฃผ ๋™์•ˆ ์ฃผ 3ํšŒ ์ค‘์žฌํ•œ ํ›„ ์ง‘๋‹จ ๊ฐ„ ๋น„๊ต ๊ฒฐ๊ณผ ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ์ด 10 m ๊ฑท๊ธฐ ๊ฒ€์‚ฌ์—์„œ ๋น ๋ฅธ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ๊ทผ๋ ฅ๊ฐ•ํ™” ํ›ˆ๋ จ๊ตฐ๊ณผ ๋น„๊ตํ•˜์—ฌ ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋„ ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๊ฑท๊ธฐ์†๋„ ํ–ฅ์ƒ์— ์œ ์˜ํ•œ ํ–ฅ์ƒ์„ ๋ณด์—ฌ ์„ ํ–‰์—ฐ๊ตฌ์™€ ์ผ์น˜ํ•˜์˜€๋‹ค.
Kobayashi ๋“ฑ32์€ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์€ ๊ทผ์œก, ํž˜์ค„, ์ธ๋Œ€์˜ ๋ปฃ๋ปฃํ•จ(stiffness)๊ณผ ๊ทผ์œก์˜ ํฌ๊ธฐ์™€ ๊ทผ๋ ฅ์„ ์ฆ๊ฐ€์‹œ์ผœ ๋””๋”ค๊ธฐ ๋™์•ˆ ๋ฌด๋ฆŽ๊ด€์ ˆ ๊ทผ์œก์˜ ๊ธ‰๊ฒฉํ•œ ๋Š˜์–ด๋‚จ(elongation)์„ ์–ต์ œํ•˜์—ฌ ๋ฌด๋ฆŽ๊ด€์ ˆ์— ์•ˆ์ •์„ฑ์„ ์ œ๊ณตํ•˜๊ณ  ๊ฑธ์Œ ๋™์•ˆ ์ •๊ฐ•๋ผˆ์˜ ์›€์ง์ž„์— ์˜ํ–ฅ์„ ์ฃผ์–ด ์ตœ๋Œ€ ๋ฌด๋ฆŽ ๊ตฝํž˜๊ฐ๋„์˜ ์ฆ๊ฐ€๋ฅผ ๋ณด์˜€๋‹ค. ์ฆ๊ฐ€๋œ ์ตœ๋Œ€๋ฌด๋ฆŽ๊ตฝํž˜๊ฐ์€ ๋น ๋ฅธ ๋ฌด๋ฆŽํ„์„ ๋ฐฉ์ง€ํ•˜์—ฌ ์ฒด์ค‘์ง€์ง€์˜ ์ฆ๊ฐ€๋ฅผ ํ†ตํ•ด ๋””๋”ค๊ธฐ์˜ ์‹œ๊ฐ„์ด ํ–ฅ์ƒ๋˜์–ด ๊ฑท๊ธฐ์†๋„๊ฐ€ ํ–ฅ์ƒ๋œ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค.
๋ณธ ์—ฐ๊ตฌ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์„ ์ค‘์žฌํ•˜์—ฌ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„์˜ ๋ณ€ํ™”๋ฅผ ๋น„๊ตํ•˜์˜€๊ณ , ์น˜๋ฃŒ์  ๋ฐ˜์‘์„ ์ด๋Œ์–ด๋‚ด๊ธฐ ์œ„ํ•œ ํšจ์œจ์ ์ธ ์†๋„๋ฅผ ์•Œ์•„๋ณธ ๊ฒฐ๊ณผ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์ด ๋Œ€์กฐ๊ตฐ๊ณผ ๋น„๊ตํ•˜์—ฌ ๋‹ค๋ฆฌ ๊ทผํ™œ์„ฑ๋„์™€ ๊ฑท๊ธฐ์†๋„์— ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์˜€์œผ๋ฉฐ, ์‚ฌํ›„๊ฒ€์ • ๊ฒฐ๊ณผ ๋Š๋ฆฐ ์†๋„๋ฅผ ์ด์šฉํ•œ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ๊ตฐ์ด ํšจ์œจ์ ์ž„์„ ์ฆ๋ช…ํ•˜์˜€๋‹ค.
๋ณธ ์—ฐ๊ตฌ์˜ ์ œํ•œ์ ์€ ํŠน์ • ์ง€์—ญ์—์„œ ๋Œ€์ƒ์ž๋ฅผ ์„ ๋ฐœํ•˜์˜€๊ณ , ๋Œ€์ƒ์ž์˜ ์ˆ˜๊ฐ€ ์ ๊ธฐ ๋•Œ๋ฌธ์— ์ผ๋ฐ˜ํ™” ํ•˜๊ธฐ ์–ด๋ ค์›€์ด ์žˆ์—ˆ์œผ๋ฉฐ, ํ–ฅํ›„ ๋ณธ ์—ฐ๊ตฌ๋ฅผ ๋ฐ”ํƒ•์œผ๋กœ ๋‡Œ์กธ์ค‘ ํ™˜์ž์—๊ฒŒ ๋“ฑ์†์„ฑ ํŽธ์‹ฌ์„ฑ ํ›ˆ๋ จ์„ ํ†ตํ•œ ๊ทผ๋ ฅ๊ฐ•ํ™”๊ฐ€ ์‹ฌํ˜ธํก๊ณ„ํ†ต์˜ ๊ธฐ๋Šฅ๊ณผ ์‚ถ์˜ ์งˆ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๋Œ€ํ•œ ์ถ”๊ฐ€์ ์ธ ์ž„์ƒ์  ์—ฐ๊ตฌ๊ฐ€ ํ•„์š”ํ•  ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค.

ACKNOWLEDGEMENTS

๋ณธ ์—ฐ๊ตฌ๋Š” 2015๋…„ ์„ธํ•œ๋Œ€ํ•™๊ต์˜ ์—ฐ๊ตฌ๋น„ ์ง€์›์„ ๋ฐ›์•˜์Œ.

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