Exercise Science (운동과학)

korean Society of Exercise Physiology (한국운동생리학회)
권호 표지

Effect of Nordic walking and Aquatic exercise on Oxidative stress and Pain in women with Degenerative Arthritis

노르딕 걷기와 수중 운동이 퇴행성 슬관절염 환자의 산화적 스트레스와 통증 반응에 미치는 영향

Kim, Jeong-Gyu;No, Seong-Gyu
김정규;노성규

  • Published : 20090000
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate the effect of Nordic walking and aquatic exercise on oxidative stress and pain in women with degenerative Arthritis. 28 women with degenerative Arthritis completed three different experimental conditions: (1) Nordic walking 4 times a week for 8 weeks; (2) Aquatic exercise 4 times a week for 8 weeks; (3) control group. Blood was sampled before and after experimentation. Visual analog scale(VAS) score was obtained at the same time point. Plasma was analyzed for free oxygen radical and total antioxidant capacity. Nordic walking exercise was more effective on body composition factors, weight and fat free mass, than aquatic exercise program. However, these changes of body composition factors were not related to pain in this study. Blood free oxygen radical concentration was more effective on pain in women with degenerative Arthritis than total antioxidant level. In conclusion, there is a preponderance of evidence that both land-based exercise program and aquatic exercise in combination including decreases of ROS, are safe and moderately effective for individuals with degenerative Arthritis.

본 연구에서는 여성 퇴행성 슬관절염 환자들을 대상으로 노르딕 걷기 운동의 치료적 효과를 입증함과 동시에 산화적 스트레스 및 인체 내 총항산화력이 통증 반응에 미치는 영향에 대해서 고찰하였다. 28명의 피험자들을 세 개의 그룹(노르딕/수중/통제)으로 무작위 배정하였다. 운동 그룹(노르딕/수중)에 배정된 피험자들은 주 4회 1시간씩 총 8주간 각각의 운동 프로그램에 참여하였다. 체구성 요인들과 혈중 활성산소 유리기, 총항산화력, 그리고 통증 척도는 실험 참가 전과 후에 각각 2회 측정 분석하였다. 본 연구에서 체구성 요인인 체중과 제지방 체중의 경우 노르딕 걷기 그룹에서 훨씬 더 긍정적인 효과를 유도했다고 볼 수 있지만, 이러한 변화가 직접적으로 통증 반응에도 영향을 미쳤다고는 볼 수 없다. 퇴행성 슬관절염 환자들의 주요 증후군인 통증 유발과 관련이 있는 생화학적 요인들로는 총항산화력 수준 보다는 활성 산소 유리기 농도에 더 의존적이라고 본다. 결론적으로, 퇴행성 슬관절염 환자들의 통증 감소와 기능적 역량 강화를 위해서는 수중 운동과 더불어 지상에서 수행될 수 있는 다양한 신체활동 프로그램의 병행과 이를 통해 발생하는 산화적 스트레스 수준의 감소 유도가 병행되어야 한다고 사료된다.

Keywords

References

  1. 김은희(1998). 율동적 운동과 수중운동의 원리 및 효과. 류마티스건강학회지. 4(2): 320-325
  2. 김종임, 강현숙, 최희정, 김인자(1997). 수중운동프로그램이 퇴행성관절염 환자의 통증, 신체지수, 자기 효능 및 삶의 질에 미치는 영향. 류마티스건강학회지. 4(1): 15-25
  3. 나영무, 석현, 박윤길, 서정훈, 성연재, 박종률, 문재호(2000). 슬관절골관절염 환자에서 운동치료의 효과. 대한재활의학회지. 24(5): 966-971
  4. 박종숙, 박수연, 이상민(2002). 수중운동이 골관절염 환자의 통증, 유연성, 관절각도, 수면에 미치는 영향. 경희대학교 체육대학 한국체육과학연구소. 30: 145-156
  5. 지용석, 변재종, 김만겸(2000). 퇴행성 슬관절염 노인여성에 있어 12주운동프로그램 적용 후 근기능과 신체조성 및 통증정도의 변화. 한국사회체육학회지. 13: 377-392
  6. 진행미, 박은정(2006). 수중재활운동 후 퇴행성 슬관절염 노인환자의 대퇴사두근력, 정적균형, 신체구성의 변화. 한국여성체육학회지. 20(4): 169-179
  7. 홍선경, 강혜영(1999). 퇴행성관절염 노인의 유연성운동과 온열요법이 통증과 일상활동장애 정도 및 생활만족도에 미치는 영향. 류마티스건강학회지. 6(2): 197-210
  8. 홍은정(2007). 8주간의 운동프로그램이 퇴행성슬관절염 고령 여성의 관절의 기능상태, 근력, 유연성 및 평형성에 미치는 효과. 건양대학교 보건복지대학원 석사학위논문
  9. Bosomworth, N. J.(2009). Exercise and knee osteoarthritis: benefit or hazard?. Can. Fam. Physician. 55(9): 871-8
  10. Callahan, L. F.(2009). Physical activity programs for chronic arthritis. Curr. Opin. Rheumatol. 21(2): 177-82 https://doi.org/10.1097/BOR.0b013e328324f8a8
  11. Church, T. S., Earnest, C. P & Morss, M.(2002). Field testing of physio-logical responses associated with Nordic Walking. Res. Q. Exerc. Sport. 73: 296-300
  12. Danneskiold - Samsoe, B., Lyngber K., Risum T., & Telling, M.(1987). The effect of exercise therapy given to patients with rheumatoid arthritis. Scand. J. Rehabili. Med., 19: 31-35
  13. Davies, C. M., Guilak, F., Weinberg, B. J., & Fermor, B.(2008). Reactive nitrogen and oxygen species in interleukin-1-mediated DNA damage associated with osteoarthritis. Osteoarthritis Cartilage. 16(5): 624-630 https://doi.org/10.1016/j.joca.2007.09.012
  14. Deberg, M., Labasse, A., Christgau, S., Cloos, P,. Bang Henriksen, D., Chapelle, J. P., Zegels, B., Reginster, J. Y., & Henrotin, Y.(2005) Osteoarthr. Cartil. 13(3), 258-65 https://doi.org/10.1016/j.joca.2004.12.002
  15. Del Carlo, M., Jr. & Loeser, R. F.(2002) Arthritis Rheum., 46(2), 394-403 https://doi.org/10.1002/art.10056
  16. Ettinger, W. H., & Afble, R. F.(1994). Physical disability from knee osteoarthritis: The role of exercise as on intervention. Med Sci Sports Exerc, 26(12), 1435-1440
  17. Felson D. T., Naimark, A., Anderson, J., Kazis, L., Castelli, W., & Meenan, R. F.(1987). The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis study. Arthritis Rheum 8(30): 914-918.Fisher, N. M. & Pendergast, D. R. (1994). Effects of muscle exercise program of exercise capacity in subjects with osteoarthritis. Archives of Phys Med & Rehab, 75: 792-797
  18. Gehlsen, G. M., & whaley M. H.(1990). Falls in the elderly: part Ⅱ, Balance, strength & flexibility. Arch Phys Med Tehabil, 71(10), 739-741
  19. Gerig, U.(2005). Nordic Walking. BLV Buchverlag, Germany. auflage 3, 34pp
  20. Hall, J., Swinkels, A., Briddon, J., & McCabe, C. S.(2008). Does aquatic exercise relieve pain in adults with neurologic or musculoskeletal disease? A systematic review & meta-analysis of randomized controlled trials. Archives of Physical Medicine & Rehabilitation. 89(5), p873-883 https://doi.org/10.1016/j.apmr.2007.09.054
  21. Hansen, L., Henriksen, M., Larsen, P., & Alkjaer, T.(2008). Nordic Walking does not reduce the loading of the knee joint. Scand. Med. Sci. Sports. 18: 436-441 https://doi.org/10.1111/j.1600-0838.2007.00699.x
  22. Harrison, K. M.(1992). Therapeutic pool programs(abstract). Arthritis Rheum., 25(suppl), S11
  23. Henrotin, Y., Sanchez, C., & Reginster, J. Y.(2002) Exper. Opin. Ther. patents, 12(1), 29-43. https://doi.org/10.1517/13543776.12.1.29
  24. Henrotin, Y.E., Bruckner, P. & Pujol, J.P.(2003) Osteoarthr. Cartil., 11(10), 747-55 https://doi.org/10.1016/S1063-4584(03)00150-X
  25. Henrotin, Y., & Kurz, B.(2007). Antioxidant to Treat Osteoarthritis: Dream or Reality?. Current Drug Targets, 8, 347-357 https://doi.org/10.2174/138945007779940151
  26. http://www.nordicwalking.com/portal/nordic_walking/english/health_facts/.September (2006)
  27. Jordan, K. M., Arden, N. K., Doherty, M., Bannwarth, B., & et al. EULAR Recommendations(2003): an evidence based approach to the management of knee osteoarthritis : report of a task force of the Standing Committee of International Clinical Studies Inducing Therapeutic Trials(ESCISIT) Ann Rheum Dis, 62: 1145-55 https://doi.org/10.1136/ard.2003.011742
  28. Kazuo, Y., Nguyen van, T., Hiroshi, N., Kayo hongo, M., Tomohiro, K., & Kusuki, N.(2005). Potential involvement of oxidative stress in cartilage senescence and development of osteoarthritis : oxidative stress induces chondrocyte telomere instability and downregulation of chondrocyte function. Arthritis Res. Ther. 7:R380-R391 https://doi.org/10.1186/ar1499
  29. Kreuzriegler, F., Gollner, E., & Fichtner, H.(2002) Das ist Nordic Walking. Ausrustung, Technic, Training. Munchen-Jena. l.: Urban & Fischer Verlag, auflage, 98pp
  30. Kieindienst, F. L, Michel, K. J., Schwartz, J., & Krabbe, B.(2006). Comparison of kinematic and kinetic parameters between the locomotion patterns in Nordic Walking, walking and running. Sportverletz Sportschaden. 20: 25-30 (In German). https://doi.org/10.1055/s-2006-926592
  31. Leena Sharma., Dorothy, D., Dunlop, Septenber., Cahue, B.S., & et al.(2003). Quadriceps Strength and Osteoarthritis Progression in Malaligned and Lax Knees. Ann Intern Med, 138, 613-619
  32. Leight, R., Bowman, J., & Barlow., A.(2008). Pain measurement : Long term stability of VAS pain intensity ratings assessed by means of pain scale calibration exercise. The Journal of Pain 9:(4). suppl. 2
  33. Masakazu, I., Kuniharu, M., Dai, S., Masato, K., Kazumi, I., Tomoko, K., Takayuki, N., Kazunori, S., Yasuhito, S., Takahiko, Y., Shuji, K., Naoaki, S., & Chihiro, Y., Y. N.(2008). Reactive Oxygen Species Derived from NOX1/NADPH Oxidase Enhance Inflammatory Pain. The Journal of Neuroscience. 28(38): 9486-9494 https://doi.org/10.1523/JNEUROSCI.1857-08.2008
  34. Maurer, B. T., Stern, A. G., Kinossian, B., Cook, D., & Schumacher, H. R. Jr.(2000). Osteoarthritis of the knee; isokinetic quadriceps exercise versus an educational intervention. Arch Phys Med Rehabil, 1(4), 535-536
  35. Messier, S. P.(1994). Osteoarthritis of the knee and associated factors of age and obesity. Effects on gait. MSSE 26: 1446-1452
  36. Meyer, C. L., & Hawley, D. J.(1994). Characteristics of participants in water exercise program compared to patients seen in a rheumatic disease clinics. Arthitis Care and Research, 7(2), 85-89 https://doi.org/10.1002/art.1790070207
  37. Minor, M. A., & Lane, N. E.(1996). Recreational exercise in arthritis. Rheumatic Disease Clinics of North Am., 22(3), 563-577 https://doi.org/10.1016/S0889-857X(05)70288-X
  38. Oakley, C., Zwierska, I., Tew, G., Beard, J. D., & Saxton, J. M.(2008). Nordic Poles Immediately Improve Walking Distance in Patients with Intermittent Claudication. Eur. J. Vasc. Endovasc. Surg. 36, 689-694 https://doi.org/10.1016/j.ejvs.2008.06.036
  39. Pelletier, J. P., Jovanovic, D., Fernandes, J. C., Manning, P., Con-nor, J. R., Currie, M.. G., Di Battista, J. A., & Martel-Pelletier, J.(2000). Arthritis Rheum., 43(6), 1290-9 https://doi.org/10.1002/1529-0131(200006)43:6<1290::AID-ANR11>3.0.CO;2-R
  40. Porcari, J. P., Hendrickson, T. L., Walter, P. R., Terry, L, & Walsko, G.(1997). The physiological responses to walking with and without Power PolesTM on treadmill exercise. Res. Q. Exerc. Sport. 68: 161-166
  41. Regan, E. A., Bowler, R. P., & Crapo, J. D.(2008). Joint fluid antioxidants are decreased in osteoarthritic joints compared to joints with macroscopically intact cartilage and subacute injury. Osteoarthritis and Carilage. 16, 515-521 https://doi.org/10.1016/j.joca.2007.09.001
  42. Roddy, E., Zhang, M., & Doherty, M.(2005). Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis, 64, 544-548 https://doi.org/10.1136/ard.2004.028746
  43. Rodgers, C. D., Vanheest, J. L., & Schachter, C. L(1995). Energy expendi-ture during submaximal walking with Exerstriders. Med. Sci. Sports. Exerc. 27: 607-611
  44. Schiffer, T., Knicker, A., Hoffman, U., Harwig, B., Hollmann., S., & Str$\ddot{u}$der, H. K.(2006). Physiological responses to nordic walking, walking and jogging. Eur. J. Appl. ysiol. 98: 56-61 https://doi.org/10.1007/s00421-006-0242-5
  45. Taylor, P., Hallett, M., & Flaherty, L.(1981). Treatment of osteoarthritis of the knee with transcutaneous electrical nerve stimulation. Pain, 11, 233-240 https://doi.org/10.1016/0304-3959(81)90008-7
  46. Templeton, M. S., Booth, D. L., & O'kelly, W. D.(1996). Effects of aquatic therapy on joint flexibility and functional ability in subject with rheumatic disease. Journal Sports Phys Thcr, 23(6), 376-381
  47. Tork, S. S., & Douglas, V.(1989). Arthritis water exercise program evaluation. Arthritis Care and Research, 2(1): 28-30 https://doi.org/10.1002/anr.1790020108
  48. Verbrugge, L. M.(1995). Women and osteoarthritis. Arthritis Care Res 8: 212-220 https://doi.org/10.1002/art.1790080404
  49. Weile, U., Lund, H., Rostock, B., Downey, A., Bartels, E. M., Fredriksen, B., Danneskiold, B. S., Bliddal, H., & Christensen, B.(2005). A Randomized, controlled trial of sand based compared with aquatic exercises for knee osteoarthritis. Osteoarthritis and Cartilage. 13, Supplement 1 S79
  50. Wider, R. P., & Brennan, D. K.(1993). Physiological response to deep water running in athletes. Sports Medicine, 16: 374-380 https://doi.org/10.2165/00007256-199316060-00003
  51. Willson, J. R., Torry, M. R., Decker, M. J., Kernozer, T., & Steadman, J. R (2001). Effects of walking poles on lower extremity gait mechanics. Med. Sci. Sports. Exerc., Vol. 33(1), 142-147
  52. Yudoh, K., Trieu, N. V., Nakamura, H., Masuko, K. H., Kato, T., & Nishioka, K.(2005). Potential involvement of oxidative stress in cartilage senescence and development of osteoarthritis: oxidative stress induces chondrocyte telomere instability and down-regulation of chondrocyte function. Arthritis. Res. Ther. 7:R380-R391 https://doi.org/10.1186/ar1499