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요부안정화운동이 요부불안정성을 가진 산업체 만성요통환자의 통증관련 기능에 미치는 효과

The Effects of Lumbar Stabilization Exercise on Pain-related Functions of Industrial Workers with Chronic Low Back Pain and Lumbar Instability

  • 정대인 (광주보건대학교 물리치료학과) ;
  • 고대식 (호남대학교 응급구조학과)
  • Jung, Dae-In (Dept. of Physical Therapy, Gwangju Health College University) ;
  • Ko, Dae-Sik (Dept. of Emergency medical Service, Honam University)
  • 투고 : 2017.03.15
  • 심사 : 2017.05.20
  • 발행 : 2017.05.28

초록

본 연구의 목적은 요부안정화운동이 요부 불안정성을 가진 산업체 만성요통환자의 통증관련 기능에 미치는 효과를 알아보고자 하였다. 산업체 만성요통환자 20명을 대상으로 대조군과 실험군으로 10명씩 할당하여 신체기능은 배근력, 유연성, 균형능력을 측정하였고, 통증은 visual analog scale(VAS)를 이용하였다. 연구결과 두군 모두 운동 후 배근력과 균형능력은 유의하게 향상되었고, 통증은 유의하게 감소되었다. 군간 비교에서는 실험군이 대조군에 비해 균형능력이 유의하게 향상되었고, 통증은 유의하게 감소되었다. 결론적으로 요부안정화운동은 요부 불안정성을 가진 산업체 만성요통환자의 균형능력을 향상시키고 통증 감소에 긍정적인 영향을 미친다.

The purpose of this study is to investigate the effects of lumbar stabilization exercise on pain-related function of industrial workers with chronic low back pain and lumbar instability. 20 industrial workers with chronic low back pain were divided into two groups, control group(n=10) and experimental group(n=10). Back muscle strength, flexibility, and balance ability were measured to assess physical functions, and visual analog scale(VAS) was used to evaluate pain levels. In both groups, back muscle strength and balance ability increased significantly, and pain levels decreased significantly. In comparison between the groups, the experimental group compared to the control group showed significant improvement in balance ability and significant diminishment in pain levels. In conclusion, the lumbar stabilization exercise has positive effects on industrial workers with lumbar instability and chronic low back pain by improving balance ability and reducing pain.

키워드

참고문헌

  1. B. S. Levy, D. H. Wegman, "Occupational Health: Recognizing and preventing work-related disease and injury, 4th ed. Lippincott, Williams & Wilkins. 1999.
  2. G. Waddell, "The problem. In the back pain revolution, 2nd edition. Edinburgh. Churchill Livingston. 2004.
  3. S. B. Tamrin, K. Yokoyama, J. Jalaludin J, N. A. Aziz, N. Jemoin, R. Nordin, A. Li Naing, Y. Abdullah, and M. Abdullah, “The associations between risk factors and low back pain among commercial vehicle drivers in Peninsular Malaysia,” Ind Health, Vol. 45, No. 2, pp. 268-278, 2007. https://doi.org/10.2486/indhealth.45.268
  4. H. Miranda, E. Viikari-Juntura, L. Punnett, and H. Riihimaki, “Occupational loading, health behavior and sleep disturbance as predictor of low-back pain,” Scand J Work Environ Health, Vol. 34, No. 6, pp. 411-419, 2008. https://doi.org/10.5271/sjweh.1290
  5. R. Grant. "Physical therapy of cervical and thoracic spine, 3re ed, Churchill Living stone, New York, 2002.
  6. M. Erdil, O. B. Dickerson, and E. Glackin, "Diagnosis and medical management of work related low back pain. In Erdil M, Dickerson OB, ed. Cumulative trauma disorders; Prevention, evaluation and treatment. New York, Van Nostrand Reinhold, 1997.
  7. S. J. Linton, "The socioeconomic impact of chronic back pain: is anyone benefiting?," Pain, Vol. 75, pp. 163-168, 1998. https://doi.org/10.1016/S0304-3959(97)00222-4
  8. P. B. O’Sullivan, A. Burnett, A. N. Floyd, K. Gadsdon, J. Logindice, D. Miller and H. Quirke, “Lumbar repositioning deficit in a specific low back pain population,” Spine, Vol. 28, No. 10, pp. 1074-1079, 2003. https://doi.org/10.1097/00007632-200305150-00022
  9. M.Wallden, “The neutral spine principle,” J Bodyw Mov Ther, Vol. 13, No. 4, pp. 350-361, 2009. https://doi.org/10.1016/j.jbmt.2009.07.006
  10. J. K. Jeon, “The effects of combination patterns exercise of proprioceptive neuromuscular facilitation on balance in chronic low back pain elderly patients,” Journal of Digital Convergence, Vol. 11, No. 4, pp. 361-368, 2013. https://doi.org/10.14400/JDPM.2013.11.12.361
  11. J. McConnell, “Recalcitrant chronic low back and leg pain-A new theory and different approach to management,” Man Ther, Vol. 7, No. 4, pp. 183-192, 2002. https://doi.org/10.1054/math.2002.0478
  12. A. Akbari, S. Khorashadizadeh, and G. Abdi, "The effect of motor control exercise versus general exercise on lumbar local stabilization muscles thickness: Randomized controlled trail of patients with chronic low back pain," J Back Musculoskelet Rehabil, Vol. 21, pp. 105-112, 2008. https://doi.org/10.3233/BMR-2008-21206
  13. F. R. Franca, T. N. Burke, E. S. Hanada, and A. P. Marques, “Segmental stabilization and muscular strengthening in chronic low back pain: A comparative study,” Clinics, Vol. 65, No. 10, pp. 1013-1017, 2010. https://doi.org/10.1590/S1807-59322010001000015
  14. O. Sokunbi, V. Cross, P. Watt, and A. Moore, “Experiences of individuals with chronic low back pain during and after their participation in a spinal stabilization exercise programme-A pilot qualitative study,” Man Ther, Vol. 15, No. 2, pp. 179-184, 2010. https://doi.org/10.1016/j.math.2009.10.006
  15. M. C. Cairns, N. E. Foster, and C. Wright, “Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain,” Spine, Vol. 31, No. 19, pp. 670-681, 2006. https://doi.org/10.1097/01.brs.0000232787.71938.5d
  16. G. A. Koumantakis, P. J. Watson, and J. A. Oldham, “Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain,” Phys Ther, Vol. 85, No. 3, pp. 209-225, 2005.
  17. S. G. Baek, “The Effect of Sling Lumbar Stabilization Exercise to Muscle Body Type and Subjective Pain Degree of Men Who Have Sacroiliac Joint Syndrome,” Journal of Digital Convergence, Vol. 12, No. 12, pp. 651-658, 2014. https://doi.org/10.14400/JDC.2014.12.12.651
  18. J. I. Kang, D. K. Jeong "The Effect of Lumbosacral Stabilization Exercise on Oswestry Disability Index and Gait Velocity of Patients with Chronic Low Back Pain," Journal of Digital Convergence, Vol. 11, No. 8, pp. 243-250, 2013. https://doi.org/10.14400/JDPM.2013.11.11.243
  19. D. J. Critchley, J. Ratcliffe, S. Noonan, R. H. Jones, M. V. Hurley, “Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: a pragmatic randomized trial with economic evaluation,” Spine, Vol. 32, No. 14, pp. 1474-1481, 2007. https://doi.org/10.1097/BRS.0b013e318067dc26
  20. R. Muthukrishnan, D. D. Shenoy, S. S. Jaspal, S. Nellikunja, and S. Fernandes, "The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain," Sports Med Arthrosc Rehabil Ther Technol, Vol. 2, pp. 13, 2010.
  21. J. M. Fritz, S. R. Piva, and J. D. Childs, “Accuracy of the clinical examination to predict radiographic instability of the lumbar spine,” Eur Spine J, Vol. 14, No. 8, pp. 743-750, 2005. https://doi.org/10.1007/s00586-004-0803-4
  22. Y. Kasai, K. Morishita, E. Kawakita, T. Kondo, and A. Uchida, “A new evaluation method for lumbar spinal instability: passive lumbar extension test,” Phys Ther, Vol. 86, No. 12, pp. 1661-1667, 2006. https://doi.org/10.2522/ptj.20050281
  23. A. Imai, K. Kaneoka, Y. Okubo, I. Shiina, M. Tatsumura, S. Izumi, and H. Shiraki, “Trunk muscle activity during lumbar stabilization exercises on both a stable and unstable surface,” J Orthop Sports Phys Ther, Vol. 40, No. 6, pp. 369-375, 2010. https://doi.org/10.2519/jospt.2010.3211
  24. V. Akuthota, A. Ferreiro, T. Moore, and M. Fredericson, “Core stability exercise principles,” Curr Sports Med Rep, Vol. 7, No. 1, pp. 39-44, 2008. https://doi.org/10.1097/01.CSMR.0000308663.13278.69
  25. R. Landel, K. Kulig, M. Fredericson, B. Li, and C. M. "Powers, Intertester reliability and validity of motion assessments during lumbar spine accessory motion testing," Phys Ther, Vol. 88, No. 1, pp. 43-49, 2008. https://doi.org/10.2522/ptj.20060179
  26. M. Ogon, B. R. Bender, D. M. Hooper, K. F. Spratt, V. K. Goel, D. G. Wilder, and M. H. Pope, “A dynamic approach to spinal instability. Part I: Sensitization of intersegmental motion profiles to motion direction and load condition by instability,” Spine, Vol. 22, No. 24, pp. 2841-2858, 1997. https://doi.org/10.1097/00007632-199712150-00007
  27. M. M. Panjabi, “The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement,” J Spinal Disord, Vol. 5, No. 4, pp. 383-389, 1992. https://doi.org/10.1097/00002517-199212000-00001
  28. I. C. Baek, J. H. Shim, “Pelvic Compression Belt Convergence Impact on the Thickness of Multifidus and Erector Spinae Muscles,” Journal of the Korea Convergence Society, Vol. 7, No. 5, pp. 51-57, 2016. https://doi.org/10.15207/JKCS.2016.7.5.051
  29. K. P. Gill, and M. J. Callaghan, “The measurement of lumbar proprioception in individuals with and without low pack pain,” Spine, Vol. 23, No. 3, pp. 371-377, 1998. https://doi.org/10.1097/00007632-199802010-00017
  30. P. Boucher, N. Teasdale, R. Courtemanche, C. Bard, and M. Fleury, “Postural stability in diabetic polyneuropathy,” Diabetes Care, Vol. 18, No. 5, pp. 638-645, 1995. https://doi.org/10.2337/diacare.18.5.638
  31. S. E. Kang, J. H. Shim, S. D. Choung, "The Convergence Study on the Effects of Three Pelvic Floor Muscle Excercise on Thickness of Pelvic Floor Muscle and Abdominal Muscles". Journal of the Korea Convergence Society, Vol. 7, No. 1, pp. 105-111, 2016. https://doi.org/10.15207/JKCS.2016.7.1.105
  32. R. G. Cooper, W. St Clair Forbes, and M. I. Jayson, "Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain". Br J Rheumatol, Vol. 31, No. 6, pp. 389-394, 1992. https://doi.org/10.1093/rheumatology/31.6.389
  33. S. Louto, H. Aalto, S. Taimela, H. Hurri, I. Pyykko, and H. Alaranta, “One-footed and externally disturbed two-footed posture control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up,” Spine, Vol. 23, No. 19, pp. 2081-2089, 1998. https://doi.org/10.1097/00007632-199810010-00008
  34. D. H. Kim, J. K. Park, Y. J. Park, D. I. Jung, S. S. Kim, “Characteristic of Cross-sectional Area of Lumbar Paraspinal Muscle in Patients of Acute and Chronic LBP,” The journal of the Korea Contents Association, Vol. 11, No. 6, pp. 270-278, 2011. https://doi.org/10.5392/JKCA.2011.11.6.270
  35. D. K. Jeong, “A Qualitative Analysis on Paraspinal Muscles in Patients with Acute Low Back Pain and Chronic Low Back Pain,” The Journal of Digital Policy & Management, Vol. 11, No. 11, pp. 613-620, 2013.
  36. W. S. Marras, M. Parnianpour, S. A. Ferguson, J. Y. Kim, R. R. Crowell, S. Bose, and S. R. Simon, “The Classification of Anatomic and Symptom Based Low Back Disorders Using Motion Measure Models,” Spine, Vol. 20, No. 23, pp. 2531-2546, 1995. https://doi.org/10.1097/00007632-199512000-00013