요추 안정화 운동과 결합된 신경역동학기법이 요추 추간판 탈출증 환자의 요부근력과 오스웨스트리 장애지수에 미치는 영향

The Effect of Lumbar Stabilization Exercises with Neurodynamic Techniques on Lumbar Muscular Strength and Oswestry Disability Index in Lumbar Disc Herniation Patient's

  • 모민상 (한림대학교성심병원 물리치료실) ;
  • 박현식 (국제나은병원 물리치료실)
  • Mo, Min-sang (Dept. of Physical Therapy, Hallym University Hospital) ;
  • Park, Hyun-sik (Dept. of Physical Therapy, International Na-Eun Hospital)
  • 투고 : 2016.04.15
  • 심사 : 2016.05.30
  • 발행 : 2016.06.30

초록

Background: The purpose of this study was to investigate the effects of lumbar stabilization exercise with neurodynamic techniques on lumbar muscular strength and Oswestry index in lumbar disc herniation patient. Method: The Lumbar stabilization exercise with neurodynamic techniques was performed by 30 pt's in G hospital. The subjects were randomly organized into a study group 15 and control group 15. The exercises and neurodynamic technique were conducted for 40 minutes and, 3 times a week (total 24 times for 8 weeks). General characteristics of the Lumbar muscular strength and Oswestry disability index (ODI) were measured before the training and at 4 weeks and 8 weeks after the intervention. Comparison of the time dependent variable for each group was Calculated by a one way repeated analysis of variance (ANOVA). Comparison between the two groups was Calculated by an analysis of covariance (ANCOVA). Result: There was a significant difference in the Lumbar muscular strength and ODI (p<.05). Similarly in the inter-group analysis, significant differences (p<.05) occurred. Conclusion: In this study, we demonstrated that lumbar stabilization exercises with neurodynamic techniques are an effective therapy for Lumbar muscular strength and ODI in lumbar disc herniation patient's.

키워드

참고문헌

  1. 국윤진, 김창원, 임종훈, 등. 체간근력운동과 심부근 안정화운동이 요통장애, 요부근력 및 심부근 활성화에 미치는 영향. 한국체육학회지. 2013;52(2):471-481.
  2. 김현희. 만성요통 환자에서 척추 안정화운동이 요추주위근과 복근의 운동기증에 미치는 효과. 한국스포츠리서치. 2007;18(4):135-146.
  3. 남혜주, 노호성. 8주간의 변형 하지거상 운동프로그램이 고관절의 등속성 근력 및 근활성도에 미치는 영향. 체육과학연구. 2011;22(4):2296-2307.
  4. 박동식, 허진강, 송재철, 등. 흉추의 운동성 증가가 요추 안정성에 미치는 효과. 대한재활의학회지. 2005; 29(1):102-108.
  5. 박현식. 신경역동적 기법과 자가 신경 운동법이 수근관 증후군 환자에게 미치는 영향. 대한정형도수물리치료학회지. 2010;16(2):48-52.
  6. 변숙희. PNF 운동과 안정화 운동이 요부 안정성에 미치는 효과. 대구대학교 재활보건대학원, 박사학위논문. 2010.
  7. 오덕원. 좌골신경통 환자에서 통증 및 기능 장애에 대한 신경가동화 기법의 효과. 보건의료과학연구. 2015;3(2):21-28.
  8. 오원택, 허진강, 정신호. 슬링 운동과 시각적 되먹임을 이용한 안정화 운동이 만성요통환자의 통증, 근 기능 및 척추운동성에 미치는 효과 비교. 대한치료과학회지. 2013;5(2):72-85.
  9. 이광규. 탄력밴드, Swiss ball, 요부 안정화운동이 만성요통 중년여성의 체중 분배, 요부 근력 및 요통에 미치는 영향. 세종대학교 대학원, 석사학위논문. 2009.
  10. 이동진, 이한주, 한상완 등. 요통환자의 운동프로그램에 따른 체간 근 두께와 최대근력 및 통증에 미치는 영향. 한국사회체육학회지. 2012;49:811-819.
  11. 장기룡. 신경가동술이 요추간판탈출증 수술 후 환자의 통증 및 이상감각에 미치는 영향. 대구가톨릭대학교 보건의료과학 대학원, 석사학위논문. 2013.
  12. 장정훈, 정동혁. Effectiveness of Therapeutic Sports Massage in Delayed Onset Muscle Soreness. 대한물리치료학회지. 2001;13(2):359-371.
  13. 허진강. 매트운동과 볼 운동이 만성요통환자의 오스웨스트리 장애지수, 균형 및 다열근의 단면적에 미치는 영향. 한국스포츠학회지. 2011;9(3):525-534.
  14. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 suppl 1):S86-92.
  15. Butler DS. Mobilization of the Nervous System. Edinburgh. Churchill Livingston. 1991;1-2.
  16. Butler DS. Adverse mechanical tension: A model for assessment and treatment: Commentary: Adverse neural tension reconsidered. Australian Journal of Physiotherapy Monograph. 1998;3:13-17.
  17. Coppieters MW, Butler DS. Do 'sliders' slide and 'tensioners' tension? An analysis of neurodynamic technique sand considerations regarding their application. Man Ther. 2008;13(3):213-221. https://doi.org/10.1016/j.math.2006.12.008
  18. Chad E, Cook. Orthopedic Manual Therapy. 2nd Edition. Pearson Education, Inc. 2012;459.
  19. Davidson M. Rasch analysis of three versions of the Oswestry disability Questionnaire. Man Ther. 2008;13(3):222-231. https://doi.org/10.1016/j.math.2007.01.008
  20. Deyo RA, Walsh NE, Martin DC. A controlled trial of transcutaneuous electrical nerve stimulation (TENS) and exercise for chronic low back pain. The New England Journal of Medicine. 1990; 322b:1596-1634.
  21. Dos Santos Alves VL. Impact of a physical rehabilitation program on the respiratory function of adolescent with idiopathic scoliosis. Chest. 2006;130(2).
  22. Fairbank JC, Couper J, Davies JB, et al. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-273.
  23. Granacher U, Gollhofer A, Stras D. Training induced adaptations in characteristics of postural reflexes in elderly men. Gait posture. 2006;24(4):459-466. https://doi.org/10.1016/j.gaitpost.2005.12.007
  24. Jemmett R. Spinal Stabilization: The New Science of Back Pain (2nd. ed.). Canada: Novont Health Publishing. 2003.
  25. Jeon CH, Kim KJ, Kim SK, et al. Validation in the cross-cultural adaptation of the Korean version of the Oswestry Disability Index. J Korean Med Sci. 2006;21(6):1092-1097. https://doi.org/10.3346/jkms.2006.21.6.1092
  26. McKenzie RA. Treat Your Own Neck. New Zealand: Spinal Publications. 1983.
  27. Maitland GD. The slump test: Examination and treatment. Aust J Physiother. 1985;31(6):215-219. https://doi.org/10.1016/S0004-9514(14)60634-6
  28. Mcgill SM. Low back stability from formal description to issues for performance and rehabilitation. Sport Sci. Rev. 2001;29(1):26-31. https://doi.org/10.1097/00003677-200101000-00006
  29. Michael J, Andre NP. The Great Body Ball Handbook. Productive Fitness Publishing Inc. 2000.
  30. Nee RJ, Butler DS. Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamics and clinical evidence. Phys Ther in sport. 2006;7(1):36-49. https://doi.org/10.1016/j.ptsp.2005.10.002
  31. Saliba SA, Croy T, Guthrie R, et al. Differences in transverse abdominis activation with stable and unstable bridging exercises in individuals with low back pain. N Am J Sports Phys Ther. 2010;5(2):63-73.
  32. Shacklock M. Clinical Neurodynamics: A New System of Musculoskeletal Treatment. Elsevier. Oxford. 2005;12-36.
  33. Simoes A, Dias J, Marinho K, et al. Relationship between functional capacity assessed by walking test and respiratory and lower limb muscle function in community-dwelling elders. Rev Bras Fisioter, Sao Carlos. 2010;14(1):24-30. https://doi.org/10.1590/S1413-35552010000100005
  34. Standaert CJ, Weinstein SM, Rumpeltes J. Evidenceinformed management of chronic low back pain with lumbar stabilization exercises. Spine. 2008;8(1):114-120. https://doi.org/10.1016/j.spinee.2007.10.015
  35. Turl SE, George KP. Adverse neural tension:A factorin repetitive hamstring strain? J Orthop Sports Phys Ther. 1998;27(1):16-21. https://doi.org/10.2519/jospt.1998.27.1.16
  36. Vera-Garcia FJ, Grenier SG, et al. Abdominal muscle response during curl-ups on both stable and labile surfaces. Phys Ther. 2000;80(6):564-569.
  37. Vera-Garcia FJ, Brown HM, Gray R, et al. Effects of different level of torso coactivation on trunk muscular and kinematic response to posteriorly applied sudden loads. Clin Biomech(Bristol, Avon). 2006;21(5):443-455. https://doi.org/10.1016/j.clinbiomech.2005.12.006