[논문]The Effects of Sitting Questionmark Exercise and Brugger's Relief Exercise on Pain, ROM, Proprioception, NDI in Patients with Chronic Cervical Pain

Suh, Kwanchul; Lee, Byoungkwon; Lee, Yeonseop; Seo, Dongkwon

doi:10.15268/ksim.2019.7.4.151

The Effects of Sitting Questionmark Exercise and Brugger's Relief Exercise on Pain, ROM, Proprioception, NDI in Patients with Chronic Cervical Pain 원문보기

Journal of the Korean Society of Integrative Medicine = 대한통합의학회지, v.7 no.4, 2019년, pp.151 - 159

Suh, Kwanchul (Dept. of Physical Therapy, Konyang University Undergraduate) , Lee, Byoungkwon (Dept. of Physical Therapy, Konyang University) , Lee, Yeonseop (Dept. of Physical Therapy, Daewon college University) , Seo, Dongkwon (Dept. of Physical Therapy, Konyang University)

Abstract ▼ AI-Helper

Purpose : This study aimed to evaluate the effects of sitting questionmark exercise (SQE) and brugger's relief exercise (BRE) on pain, ROM, proprioception, NDI in 60 Patients with Chronic Cervical Pain (CCP). Methods : In this study the VAS and NDI were used to investigate changes in pain and disability with SQE and BRE. The pre and post intervention intra group differences were analysed with a paired t-test for mean values, and the inter group differences were analyzed with an independent t-test for mean values. Results : The pain of both of groups was lowered with statistical significance. Pain of SQE group is lower than that of BRE group with statistical significance. ROM in both groups was improved, but there is no significant difference between two groups. NDI in both of groups were significantly decreased after the intervention, but there was no significant difference between groups. there was NDI ratio (%) significant difference between each groups. Conclusion : SQE intervention may be considered a more effective clinical approach for reducing pain and restoring proprioception in patients with CCP.

주제어

표/그림 (2)

표 Table 1. Comparison of the pain between the two groups
표 Table 2. Comparison of the proprioception between the two groups

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문제 정의

However, no study has been conducted yet to compare the exercises for total and partial thoracic extensions. Therefore, this study aimed to determine the effects of SQE and BRE as intervention exercises for partial and total thoracic extensions, respectively, on pain, ROM, proprioception, and NDI in randomly assigned patients with CCP and to provide clinical evidence on this topic.

제안 방법

The electro-goniometer was also used to measure the reposition errors for the TL joints. In the standing and resting positions, the electro-goniometer was set to 0, and the blinded subjects were instructed to perceive a position for 3 seconds at 30 %, 60 %, and 90 % positions, preset between the resting position and the maximum ROM positions and to repeat it five times. The subjects were provided a 5-minute rest period to eliminate the learning effects, and joint reposition sense was measured.
In this study, the reposition errors were used to assess proprioception. Similarly, Humphreys and Irgens (2002) used a craniocervical movement training program to induce the eye-head-cervical coordination in patients with CCP and the consequent improvement in cervical coordination.
Sitting questionmark exercise is to perform the SQE easily without the risk for pelvic deformity, the subjects were instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45° of abduction.
A total of 60 subjects participated in this study. Sixty subjects underwent tests to measure the pain intensity, ROM, proprioception, and NDI before the experiment and were randomly assigned to the following two groups: the SQE group (n=30) and the BRE group (n=30). Before the experiment, all the subjects received a full explanation of the experimental method based on the contents of the Helsinki Declaration, and conducted the subjects who fully understood and voluntarily agreed the contents and purpose of the experiment.
The aim of this study was to compare the effects of SQE and BRE on pain, ROM, proprioception, and NDI in patients with CCP and to suggest effective exercise options for clinical purposes. In conclusion, I suggest to use SQE to clinically because SQE may be considered a more effective clinical approach for reducing pain, ROM, restoring proprioception and NDI in patients with CCP.
Before the experiment, all the subjects received a full explanation of the experimental method based on the contents of the Helsinki Declaration, and conducted the subjects who fully understood and voluntarily agreed the contents and purpose of the experiment. The subjects completed four sets of 12 reps for each exercise and underwent the measurement tests again after the experiment.
Brugger’s relief exercise is to perform the BRE easily without the risk for pelvic deformity, the subjects were instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45 ° of abduction. The subjects sat hitting their ischial tuberosity on the chair and maintained their physiological curvature for the TL spine. Following external rotation of the glenohumeral joints, tension was relaxed with each inhalation, and depression and retraction of the shoulder girdle were performed with each exhalation (Liebenson, 2002).
Sitting questionmark exercise is to perform the SQE easily without the risk for pelvic deformity, the subjects were instructed to place their feet on the floor completely and keep their knee joints 10 ㎝ below the hip joints in 45° of abduction. The subjects sat with their ischial tuberosity touching the chair, maintained their physiological curvature for the TL spine, and then placed both forearms tightly against the stool bars. While holding that position, SQE was performed by breathing in between the medial borders of the scapula on both sides and breathing out while still maintaining the physiological TL curvature and creating thoracic kyphosis (Lehnert-Schroth & Christ, 2007).
In the standing and resting positions, the electro-goniometer was set to 0, and the blinded subjects were instructed to perceive a position for 3 seconds at 30 %, 60 %, and 90 % positions, preset between the resting position and the maximum ROM positions and to repeat it five times. The subjects were provided a 5-minute rest period to eliminate the learning effects, and joint reposition sense was measured. Each target angle was measured three times (Yang et al.
An electro-goniometer (Mobee med, SportMed, Germany) was used to measure the ROM. This instrument is used to measure angle of joint and ROM, such as flexion, extension, and right and left side bending, through a computer-aided analysis.
Proprioception plays an essential role in normal motor control by distinguishing between joint movement and joint position based on sensory input and feedback (Riemann & Lephart, 2002). This test was used in this study to measure the control of TL joint movement.

대상 데이터

Subjects were excluded if they had a medical history in orthopedics or neurology, infection, car accident over the last year, and surgical procedure in the spine and extremity joints and if they were pregnant. A total of 60 subjects participated in this study. Sixty subjects underwent tests to measure the pain intensity, ROM, proprioception, and NDI before the experiment and were randomly assigned to the following two groups: the SQE group (n=30) and the BRE group (n=30).

데이터처리

0 for windows. A paired t-test was used to compare the difference before and after the interventions in each group, and an independent t-test was used to compare the differences between the groups. A statistically significant level was set at p<.

성능/효과

After the interventions, the extension reposition error in the SQE group (30 % and 90 %) significantly decreased (p < .05); only the extension reposition error of the SQE group at 60 % had no significant difference (p > .05).
After the interventions, the flexion reposition errors in the SQE group (flexion 30 %, 60 %, and 90 %) and BRE group (flexion 30 % and 60 %) significantly decreased (both p<.05).
After the interventions, the left side bending reposition error in the SQE group (30%, 60 %, and 90 %) significantly decreased (p<.05).
Concerning the effects of SQE and BRE on ROM, SQE group demonstrated statistically significant increase in flexion 3 %, extension 9 %, right side bending 5 %, and left side bending 6% after the intervention. and BRE group demonstrated statistically significant increase in flexion 4 %, extension 9 %, right side bending 5 %, and left side bending 5 % after the intervention.
In extension measurements, the SQE group showed statistically significant changes after the intervention at 30 %, 90 %, the extension reposition error of the SQE group at 60 % had no significant difference. However, the BRE group showed a statistically significant post-intervention change at 30 % only, and the changes at 60 % and 90 % were not statistically significant. The post-intervention changes in right side bending were statistically significant at all preset angles.
The aim of this study was to compare the effects of SQE and BRE on pain, ROM, proprioception, and NDI in patients with CCP and to suggest effective exercise options for clinical purposes. In conclusion, I suggest to use SQE to clinically because SQE may be considered a more effective clinical approach for reducing pain, ROM, restoring proprioception and NDI in patients with CCP.
With respect to the effects of SQE and BRE on proprioception the changes in the flexion of the BRE group varied, showing a statistically significant difference at 30 % and 60 % and a statistically insignificant difference at 90 %; the post-intervention changes in flexion in the SQE group were statistically significant. In extension measurements, the SQE group showed statistically significant changes after the intervention at 30 %, 90 %, the extension reposition error of the SQE group at 60 % had no significant difference. However, the BRE group showed a statistically significant post-intervention change at 30 % only, and the changes at 60 % and 90 % were not statistically significant.
, 2007). In this study, the difference in the VAS scores was statistically significant before and after the interventions (SQE : -55 % and BRE : -42 %). In particular, the 13% decrease in the VAS scores was prominent in the SQE group compared with in the BRE group.
With respect to the effects of SQE and BRE on proprioception the changes in the flexion of the BRE group varied, showing a statistically significant difference at 30 % and 60 % and a statistically insignificant difference at 90 %; the post-intervention changes in flexion in the SQE group were statistically significant. In extension measurements, the SQE group showed statistically significant changes after the intervention at 30 %, 90 %, the extension reposition error of the SQE group at 60 % had no significant difference.
Concerning the effects of SQE and BRE on ROM, SQE group demonstrated statistically significant increase in flexion 3 %, extension 9 %, right side bending 5 %, and left side bending 6% after the intervention. and BRE group demonstrated statistically significant increase in flexion 4 %, extension 9 %, right side bending 5 %, and left side bending 5 % after the intervention.

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