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허리의 분절적 가동기법이 만성 허리통증 환자의 근육 특성과 안정성 한계에 미치는 영향
The Effect of the Lumbar Segmental Mobilization Technique on Chronic Low Back Pain Patients' the Characteristics of the Muscles, and Limited of Stability 원문보기

Journal of the Korean Society of Integrative Medicine = 대한통합의학회지, v.8 no.4, 2020년, pp.191 - 202  

양대중 (세한대학교 물리치료학과) ,  엄요한 (군장대학교 물리치료과)

Abstract AI-Helper 아이콘AI-Helper

Purpose : The purpose of this study is to examine the effect of the segmental mobilization technique of the lower back on the characteristics of the muscles and limited of stability of chronic backache patients. Methods : The subjects of the study were 30 chronic back pain patients who were divided ...

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표/그림 (6)

AI 본문요약
AI-Helper 아이콘 AI-Helper

제안 방법

  • 척추감압치료기(MID 4M Serise, WIZ medical, KOR)를 이용하여 실험자는 치료기 위에 바로 누운 자세로 눕고 air-grip extension을 이용하여 골반과 등뼈 부위에 air-belt를 채우고 head strap으로 머리를 고정하여 견착 부위 슬립을 방지시키고, 허리뼈의 앞굽음을 유지하기 위하여 sacrum extension 장치를 적용하여 견인력은 처음 4~5 strength setup에서 시작하여 점차 power level을 한 단계씩 일정 비율로 증가시키면서 견인치료 시간은 15분이며 유지 시간(hold time)과 휴지 시간(rest time)의 비율은 2:1로 설정하여 8주간 주 5회 15분간 적용하였다. 감압치료의 목표는 기능부전이 있는 척추에 대하여 가동범위를 증가시키고 통증을 경감시키기 위하여 사용된다.

대상 데이터

  • 본 연구는 2018년 5월부터 2018년 8월까지 3개월 간 군산 소재의 S 병원에서 입원과 외래 환자들 중 45세~55세의 환자를 대상으로 X-ray와 기타 영상학적 장비를 통해 의사로부터 만성 허리통증 진단을 받고 통증이 지속된지 12주 이상 된 환자들을 대상으로 하였고, 3개월 이내에 수술한 병력 없는 자, 다른 병원에서 치료 또는 재활 운동을 하지 않은 자, 실험기간 동안 외상이 발생하거나, 다른 수술을 실시하지 않은 자, 오스웨스트리 허리 통증 장애 지수가 21 %~40 % 정도의 경증 장애인 자, 본 연구의 취지를 이해하고 피험자의 동의서에 서명한 환자들을 대상으로 하며 선정기준과 제외 기준은 다음과 같다. 본 연구 기준에 적합한 환자 30명을 무작위 임의선정하여 도수치료 그룹 15명(실험군), 척추 감압치료 그룹 15명(실험군)으로 배정한다. 본 연구에서는 G-power 3.
  • 본 연구는 2018년 5월부터 2018년 8월까지 3개월 간 군산 소재의 S 병원에서 입원과 외래 환자들 중 45세~55세의 환자를 대상으로 X-ray와 기타 영상학적 장비를 통해 의사로부터 만성 허리통증 진단을 받고 통증이 지속된지 12주 이상 된 환자들을 대상으로 하였고, 3개월 이내에 수술한 병력 없는 자, 다른 병원에서 치료 또는 재활 운동을 하지 않은 자, 실험기간 동안 외상이 발생하거나, 다른 수술을 실시하지 않은 자, 오스웨스트리 허리 통증 장애 지수가 21 %~40 % 정도의 경증 장애인 자, 본 연구의 취지를 이해하고 피험자의 동의서에 서명한 환자들을 대상으로 하며 선정기준과 제외 기준은 다음과 같다. 본 연구 기준에 적합한 환자 30명을 무작위 임의선정하여 도수치료 그룹 15명(실험군), 척추 감압치료 그룹 15명(실험군)으로 배정한다.
  • 본 연구 기준에 적합한 환자 30명을 무작위 임의선정하여 도수치료 그룹 15명(실험군), 척추 감압치료 그룹 15명(실험군)으로 배정한다. 본 연구에서는 G-power 3.1.9.4를 이용한 공분산분석을 기준으로 하여 양측검정 유의수준 0.05, 검정력 0.80, 효과크기 0.50으로 계산하여 총 표본 크기는 28명으로 나왔으며, 탈락률을 고려하여 각 집단 당 15명, 총 30명으로 산출하였다. 연구기간 동안 모든 실험자들은 100 %의 참석률로 완료하였다(Table 1).

데이터처리

  • 0을 사용하였다. 연구대상자의 정규성 검증을 위해 샤피로-윌크 검정(shapiro-wilk test)을 시행하였고, 중재 방법에 따른 근육의 특성과 안정성 한계를 비교하기 위하여 공분산분석(analysis of covariance; ancova)을 실시하였다. 통계학적 유의 수준은 α=.
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참고문헌 (61)

  1. Abbott JH, Chapple CM, Fitzgerald GK, et al(2015). The incremental effects of manual therapy or booster sessions in addition to exercise therapy for knee osteoarthritis: a randomized clinical trial. JOSPT, 45(12), 975-983. https://doi.org/10.2519/jospt.2015.6015. 

  2. Alice BB, Ana CMAR, Giliane VMPL, et al(2012). Comparison of static postural balance between healthy subjects and those with low back pain. Acta Ortop Bras, 20(4), 210-212. https://doi.org/10.1590/S1413-78522012000400003. 

  3. Cao DY, Picker JG(2011). Lengthening but not shortening history of paraspinal muscle spindles in the low back alters their dynamic sensitivity. J Neurophysiol, 105(1), 434-441. https://doi.org/10.1152/jn.00498.2010. 

  4. Chang DC, Holt JA, Sklar M, et al(2016). Yoga as a treatment for chronic low back pain: A systematic review of the literature. J Orthop Rheumatol, 3(1), 1-8. 

  5. Choi JS(2015). The effect of thoracic spine mobilization passing through the sling on the static and dynamic balance of chronic low back pain patients. Graduate school of Dongshin University, Republic of Korea, Master's thesis. 

  6. Choi MS, Lee SY(2019). Effects of different lumbar stabilization exercise on the ratio of the thickness of deep and superficial muscle fibers of the multifidus stabilization exercise. Korea Soc Phys Med, 7(2), 121-131. https://doi.org/10.15268/ksim.2019.7.2.121. 

  7. Deyo RA(2017). The role of spinal manipulation in the treatment of low back pain. JAMA, 317(14), 1418-1419. https://doi.org/10.1001/jama.2017.3085. 

  8. Duray M, Yagci N, Ok N(2018). Determination of physical parameters associated with self-efficacy in patients with chronic mechanic low back pain. J Back Musculoskelet Rehabil, 31(4), 743-748. https://doi.org/10.3233/BMR-170993. 

  9. Faur C, Patrascu JM, Haragus H, et al(2019). Correlation between multifidus fatty atrophy and lumbar disc degeneration in low back pain. BMC Musculoskelet Disord, 20(1), Printed Online. https://doi.org/10.1186/s12891-019-2786-7. 

  10. Florence PS, Dino S, Jaro K, et al(2016). Modic changes of the lumbar spine: prevalence, risk factors, and association with disc degeneration and low back pain in a large-scale population-based cohort. Spine J, 16(1), 32-41. https://doi.org/10.1016/j.spinee.2015.09.060. 

  11. Franca FR, Burke TN, Hanada ES, et al(2010). Segmental stabilization and muscular strengthening in chronic low back pain - a comparative study. Clinics, 65(10), 1013-1017. https://doi.org/10.1590/S1807-59322010001000015. 

  12. Gomes-Neto M, Lopes JM, Conceicao CS, et al(2017). Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis. Phys Ther Sport, 23, 136-142. https://doi.org/10.1016/j.ptsp.2016.08.004. 

  13. Gong WT, Jung YW, Bae SS(2005). The effects of sacroiliac joint mobilization and lumbopelvic stabilizing exercises on the equilibrium ability. J Korean Soc Phys Med, 17(3), 285-295. 

  14. Hallur SS, Brismee JM, Sizer PS, et al(2020). Three-dimensional spinal position with and without manual distraction load increases spinal height. JMPT, 43(4), 267-275. https://doi.org/10.1016/j.jmpt.2019.04.007. 

  15. Hyong IH, Ha MS(2009). Effect of immediate dynamic balance ability of chronic low back pain on Maitland's manual therapy. J KoCon A, 9(6), 207-215. https://doi.org/10.5392/JKC A.2009.9.6.207. 

  16. Jadhav AV(2016). Comparative cross-sectional study for understanding the burden of low back pain among public bus transport drivers. Indian J Occup Environ Med, 20(1), 26-30. https://doi.org/10.4103/0019-5278.183833. 

  17. James S, Stewart BL, Dave S, et al(2020). Isolated lumbar extension resistance training improves strength, pain, and disability, but not spinal height or shrinkage("Creep") in participants with chronic low back pain. Cartilage, 11(2), 160-168. https://doi.org/10.1177/1947603517695614. 

  18. Jason HR, Kyndall B(2013). The role of prism glass and postural restoration in managing a collegiate baseball player with bilateral sacroiliac joint dysfunction: A case report. Int J Sports Phys Ther, 8(5), 716-728. 

  19. Javadian Y, Akbari M, Talebi G, et al(2015). Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial. Caspian J Intern Med, 6(2), 98-102. 

  20. Jeong HJ(2018). The effect of thoracic joint mobilization on the changes of the thoracic kyphosis angle and static and dynamic balance. Graduate school of Dong-eui University, Republic of Korea, Master's thesis. 

  21. Jorge F, Susan AO, Martha F, et al(2014). Enhanced therapeutic alliance modulates pain intensity and muscle pain sensitivity in patients with chronic low back pain : An experimental controlled study. Phys Ther, 94(4), 477-489. https://doi.org/10.2522/ptj.20130118. 

  22. Kaltenborn FM, Evjenth O, Kaltenborn TB(2012). Manual mobilization of the joints: the spine. 6th ed, Minneapolis, Orthopedic Physical Therapy Products, pp.183-192. 

  23. Kang DY(2011). The effects of spinal decompression therapy and manual therapy on the pain, flexability and muscle activity in patient with herniated intervertebral lumbar disc. Graduate school of Korea University, Republic of Korea, Master's thesis. 

  24. Kim DH, Kim SK, Jung YJ, et al(2015). Measurement of low back muscle characteristic change using MyotonPRO in a long-term driving; pilot study. Ergonomics Soc Korea, 4, 592-598. 

  25. Kim GY, Ahn CS, Kim SS(2011). The effects of 3-dimensional lumbar stabilization exercise have an effect on the improvement of pain and static or dynamic balance ability in 20's age group with low back pain. J Korean Soc Phys Med, 6(2), 235-246. 

  26. Kim HS, Yun DH, Huh KY(2008). Effect of spinal decompression therapy compared with intermittent mechanical traction in lumbosacral disc herniation. J Korean Acad Rehabil Med, 32(3), 319-323. 

  27. Kim SJ, Park DS, Jung SH, et al(2014). The impacts of muscle energy technique and transcutaneous electrical nerve stimulation performed on elector spinae muscle of acute low back pain patients on pain and meridian electromyography. J Korean Med Rehabil, 24(1), 83-92. 

  28. Ko TS, Jung HB, Kim JA(2009). The effects of thoracic mobilization on pain, disability index and spinal mobility in chronic low back pain patients. J Special Edu Rehabil Sci, 48(2), 1156-1137. 

  29. Koppenhaver SL, Walker MJ, Su J, et al(2015). Changes in lumbar multifidus muscle function and nociceptive sensitivity in low back pain patient responders versus non-responders after dry needling treatment. Man Ther, 20(6), 769-776. https://doi.org/10.1016/j.math.2015.03.003. 

  30. .Lee HS(2001). A study of standing balance control between normal subjects and subjects with low back pain. Graduate school of Dankook University, Republic of Korea, Doctoral dissertation. 

  31. Lee JG(2015). The effect of dynamic balance training on flexibility and function of chronic low back pain patients. Graduate school of Kwangju Women's University, Republic of Korea, Master's thesis. 

  32. Lopes S, Correia C, Felix G, et al(2017). Immediate effects of Pilates based therapeutic exercise on postural control of young individuals with non-specific low back pain: A randomized controlled trial. Complement Ther Med, 10(34), 104-110, https://doi.org/10.1016/j.ctim.2017.08.006. 

  33. Ma SY, Kwon WA, Lee JH, et al(2013). The effects of spinal decompression combined with therapeutic modalities for patients with lumbar radiculopathy. J Korean Data Information Sci Soc, 14(1), 336-343. https://doi.org/10.5762/KAIS.2013.14.1.336. 

  34. McFarland C, Wang-Price S, Richard S(2015). Clinical measurements of cervical lordosis using flexirule and inclinometer methods in individuals with and without cervical spine dysfunction: A reliability and validity study. J Back Musculoskelet Rehabil, 28(2), 295-302. https://doi.org/10.3233/BMR-140517. 

  35. Mirbagheri SS, Amir RR, Nikoo MR, et al(2015). Evaluating kyphosis and lordosis in students by using a flexible ruler and their relationship with severity and frequency of thoracic and lumbar pain. J Asian Spine, 9(3), 416-422. https://doi.org/10.4184/asj.2015.9.3.416. 

  36. Mordecai SC, Dabke HV(2012). Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: a review of the literature. Eur Spine J, 21(3), 382-389. https://doi.org/10.1007/s00586-011-2063-4. 

  37. Nashner LM(2014). Balance function assessment and management: practical biomechanics and physiology of balance. 2nd ed, San Diego, Plural publishing, pp.431. 

  38. Neumann DA(2010). Kinesiology of the musculoskeletal system: Foundations for physical rehabilitation. 2nd ed, Milwaukee, Mosby Publication, pp.89-91. 

  39. Newcomer K, Laskowski ER, Yu B, et al(2001). The effects of a lumbar support on repositioning error in subjects with low back pain. Arch Phys Med Rehahil, 82(7), 906-910. https://doi.org/10.1053/apmr.2001.2328. 

  40. Oh HJ, Jeon CB, Jeong MG, et al(2017). The effects of spinal decompression therapy on pain and disability in patients with chronic low back pain. J Kor Phys Ther, 29(6), 299-302. https://doi.org/10.18857/jkpt.2017.29.6.299. 

  41. Olson KA(2015). Manual physical therapy of the spine. 2nd ed, Amsterdam, Elsevier Health Sciences, pp.84-87. 

  42. Ombregt L, Bisschop P, terVeer HJ(2013). A system of orthopedic medicine. 3rd ed, London, Churchill Livingstone, pp.623-635. 

  43. Park BJ(2017). The effects of thickness of trunk muscles, balance, and subjective quality of life by applying therapeutic climbing in chronic lower back pain. Graduate school of Catholic University, Republic of Korea, Doctoral dissertation. 

  44. Park DH, Lee EH, Lee KS(2019). Effects of thoracic flexibility exercise program on pain, heart rate variability, and depression in patients with chronic low back pain. Korea Soc Phys Med, 7(4), 161-170. https://doi.org/10.15268/ksim.2019.7.4.161. 

  45. Park JH, Kim GJ, Kim DD(2012). The physical therapy of musculoskeletal diseases. Seoul, Hyunmoonsa, pp.289-291. 

  46. Patel DR, Kinsella E(2017). Evaluation and management of lower back pain in young athletes. Transl Pediatr, 6(3), 225-235. https://doi.org/10.21037/tp.2017.06.01. 

  47. Salavati M, Akhbari B, Takamjani IE, et al(2016). Effect of spinal stabilization exercise on dynamic postural control and visual dependency in subjects with chronic non-specific low back pain. JBMT, 20(2), 441-448. https://doi.org/10.1016/j.jbmt.2015.10.003. 

  48. Schmid AB, Dyer L, Boni T, et al(2010). Paraspinal muscle activity during symmetrical and asymmetrical weight training in idiopathic scoliosis. J Sport Rehabil, 19(3), 315-327. https://doi.org/10.1123/jsr.19.3.315. 

  49. Schneider S, Peipsi A, Stokes M, et al(2015). Feasibility of monitoring muscle health in microgravity environments using myoton technology. Med Biol Eng Comput, 53(1), 57-66. https://doi.org/10.1007/s11517-014-1211-5. 

  50. Seval T, Muzeyyen O, Ozlem U(2017). The effect of visceral osteopathic manual therapy applications on pain, quality of life and function in patients with chronic nonspecific low back pain. J Back Musculoskelet Rehabil, 30(3), 419-425. https://doi.org/10.3233/BMR-150424. 

  51. Shin DC(2008). The effects of a deep cervical flexion exercise on neck-shoulder pain, muscle strengthening, and cervical alignment in sedentary workers. Graduate school of Sahmyook University, Republic of Korea, Master's thesis. 

  52. Shamsi MB, Sarrafzadeh J, Jamshidi A, et al(2016). The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging. Physiother Theory Pract, 32(4), 277-283. https://doi.org/10.3109/09593985.2016.1138559. 

  53. Shum GL, Tsung BY, Lee RY, et al(2013). The immediate effect of posteroanterior mobilization on reducing back pain and the stiffness of the lumbar spine. Arch Phys Med Rehabil, 94(4), 673-679. https://doi.org/10.1016/j.apmr.2012.11.020. 

  54. Song GB, Park EC(2016). The effects of balance training on balance pad and sand on balance and gait ability in stroke patients. J Korean Soc Phys Med, 11(1), 45-52. https://doi.org/10.13066/kspm.2016.11.1.45. 

  55. Urits I, Burshtein A, Sharma M, et al(2019). Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep, 23(23), 1-10. https://doi.org/10.1007/s11916-019-0757-1. 

  56. Wallden M(2009). The neutral spine principle. J Bodyw Mov Ther, 13(4), 350-361. https://doi.org/10.1016/j.jbmt.2009.07.006. 

  57. Wayne H, Henry P(2010). The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial. BMC Musculoskelet Disord, 11(64), 1-11. https://doi.org/10.1186/1471-2474-12-200. 

  58. Xia T, Ankruma JA, Spratt KF, et al(2008). Seated human response to simple and complex impacts: Paraspinal muscle activity. Int J Ind Ergonom, 38(9), 767-774. https://doi.org/10.1016/j.erg on.2007.11.003. 

  59. Yang JM(2016). The effect of thoracic joint mobilization on pain, disability, spine curvature, static balance, range of motion and proprioception in back pain patients with thoracic hypomobility. Graduate school of Daejeon University, Republic of Korea, Doctoral dissertation. 

  60. Yoon JS(2014). The effect of manual therapy and lumbar stabilization exercise with chronic low back pain patients flexibility, functional activity and trunk muscle thickness. Graduate school of Daegu University, Republic of Korea, Doctoral dissertation. 

  61. Zakeri F, Taghian VF(2020). Comparing the effect of 8 weeks of total body resistance exercise and core stability training on selected common abnormalities and postural control in deaf adolescents. JRSR, 7(2), 87-95. https://doi.org/10.30476/JRSR.2020.81562.1004. 

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