DOI QR코드

DOI QR Code

깊은목굽힘근 강화운동과 등뼈 관절가동운동이 뇌졸중 환자의 전방머리자세와 목통증에 미치는 영향

The Effect of Deep Neck Flexor Exercise and Thoracic Mobilization Exercise on Forward Head Posture and Neck Pain in Chronic Stroke

  • Yang, Sun-ah (Department of Physical Therapy, Daejeon Boram hospital) ;
  • Seo, Dong-Kwon (Department of Physical Therapy, Konyang University) ;
  • Lee, Byoung-Kwon (Department of Physical Therapy, Konyang University)
  • 투고 : 2019.10.28
  • 심사 : 2019.12.20
  • 발행 : 2019.12.28

초록

본 연구는 깊은목굽힘근운동과 등뼈 관절가동운동이 뇌졸중 환자의 통증, 전방머리자세에 미치는 영향을 알아보고자 한다. 연구대상자는 36명은 사전측정 후 무작위로 깊은목굽힘근군(DNFE), 등뼈 관절가동운동군(TROM), 대조군으로 각각 12명씩 배정되었다. 중재 전후에 통증(VAS), 두개척추각도(CVA), 두개회전각도(CRA), 전방머리내밈자세(FHP), 등뼈관절가동범위(TROM)를 측정하였다. 그 결과. DNFE 군과 TROM 군은 중재 전후 VAS, CVA, CRA, FHP, TROM에서 유의한 차이를 보였으며(p<.05), 두 군은 대조군에 비해 VAS, CVA, CRA, FHP, TROM에서 보였다(p<.05). 결론적으로 깊은목굽힘근운동과 등뼈 가동범위운동이 뇌졸중 환자의 전방머리자세와 목통증 회복에 효과적이었다. 그러므로 임상에서 뇌졸중 환자 중재프로그램에 깊은목굽힘근운동과 등뼈 가동범위운동을 적극적으로 활용되기를 바란다.

The purpose of this study was to investigate the effects of deep neck flexion exercise(DNFE) and thoracic range of motion exerecise(TROM) on the pain and forward head position(FHP) in stroke patients. Thirty-six patients were randomly assigned to DNFE group, TROM group, and control group. pre and post intervention, pain(VAS), Craniovertebral angle(CVA), cranial rotation angle(CRA), FHP, and TROM were measured. As a result. The DNFE group and the TROM group showed significant differences in VAS, CVA, CRA, FHP, and TROM pre and post intervention(p <.05), and the two groups showed VAS, CVA, CRA, FHP, and TROM compared to the control group (p <.05). In conclusion, in patients with stroke, DNFE and TROM were effective in restoring FHP and neck pain. We hope that they will be used in the interventional program for stroke patients in clinical practice.

키워드

참고문헌

  1. B. H. Kang. (2000). The Relationship between Family Support and Activities of Daily Living Abilities for the Hemiplegic Patients(after stroke). The Korean Journal of Rehabilitation Nursing, 3(1), 5-14.
  2. D. H. Bang, T. W. Kang & D. W. Oh. (2012). Comparison of the effect of Action Observational training and Task-oriented training on Upper Limb Function and activities of daily living in People with Chronic stroke. Journal of Digital Convergence, 10(9), 409-416. https://doi.org/10.14400/JDPM.2012.10.9.409
  3. P. W. Duncan, R. D. Horner, D. M., Reker, G. P. Samsa, H. Hoenig, B, Hamilton, B. J, LaClair & T. K. Dudley. (2002). Adherence to post acute rehabilitation guidelines is associated with functional recovery in stroke. Stroke, 33(1), 167-177. https://doi.org/10.1161/hs0102.101014
  4. B. Braun & L, Amundson. (1989). Quantitative assessment of head and shoulder posture. Archives Physical Medicine and Rehabilitation, 70, 322-329.
  5. J. Dvorak, L. Valach & S. Schmid. (1987). Injuries of the cervical spine in Switzerland. Der Orthopade, 16(1), 2-12.
  6. M. Vijanen, A. Malmivaara, J, Uitti, M. Rinne, P. Palmroos, & P. Laippala. (2003). Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: Randomised controlled trial. BMJ, 327(7413), 475-485. https://doi.org/10.1136/bmj.327.7413.475
  7. K. H. Lee & K. C. Hwang. (2016). Virtual Reality-based Training Program Using Computer-human Interface gor Recovery of Upper Extremity Use in Stroke Patients. Journal of Digital Convergence, 14(1), 285-290. https://doi.org/10.14400/JDC.2016.14.1.285
  8. D. Falla. (2004). Unravelling the complexity of muscle impairment in chronic neck pain. Manual Therapy, 9(3), 125-133. https://doi.org/10.1016/j.math.2004.05.003
  9. C. Y. Cho. (2008). Survey of faulty postures and associated factors among chinese adolescents. Journal of Manipulative Physiological Therapeutics, 31(3), 224-229. https://doi.org/10.1016/j.jmpt.2008.02.003
  10. R. Harrison & J. Kessels. (2008). Human Resource Development in A Knowledge Economy: An Organisational View. Bingley: Industrial and Commercial Training, 36(4), 178-178.
  11. Y. A. Yang. (2004). The Efficacy of Active Exercise Program for Work-related Chronic Low Back Pain. Korean Industrial Hygiene Association Journal, 14(3), 301-310.
  12. H. Katherine, L. Cheryl & B. Heather. (2005). Effectiveness of an exercise program to improve forward head posture in normal adults: A randomized, controlled 10-week trial. Journal of Manual & Manipulative Therapy, 3(3), 163-176.
  13. E. Kapreli, E, Vourazanis E, Billis, J. A. Oldham & N Strimpakos, (2009). Respiratory dysfunction in chronic neck pain patients. A pilot study. Cephalalgia, 29(7), 701-710. https://doi.org/10.1111/j.1468-2982.2008.01787.x
  14. S. W. Han & J. Y. Kim. (2007). The Effects of sling and mat exercise during 6 weeks on cervical coordination, muscle strength and muscle endurance. Korean Society of Sports Physical Therapy, 3(1), 37-46.
  15. T. Chiu, T. H. Lam & A. Hedley. (2005). A Randomized Controlled Trial on the Efficacy of Exercise for Patients with Chronic Neck Pain. Spine, 30(1), E1-E7. https://doi.org/10.1097/01.brs.0000149082.68262.b1
  16. C. Griffiths, K. Dziedzic, J. Waterfield & J. Sim. (2009). Effectiveness of specific neck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. The Journal of Rheumatology, 36(2), 390-397. https://doi.org/10.3899/jrheum.080376
  17. J. Siebenga, V. J. M. Leferink, M. J. Elzinga, F. C. bakker, Duie H. J. ten, P. M. Rommens & P. Patka. (2008). A prospective cohort study comparing the VAS spine score and Roland-Morris disability questionnaire in patients with a type A traumatic thoracolumbar spinal fracture. European Spine Journal, 17(8), 1096-1100. https://doi.org/10.1007/s00586-008-0705-y
  18. Y. W. Chae. (2002). The measurement of gorward head posture and pressure pain threshold in neck muscle. The journal of Korean society of physical therapy, 14(1), 117-124.
  19. J. A. Saal. (1992). The new back school prescription: Stabilization training part II. Occupational Medicine, 7(1), 33-42.
  20. C. Femandez-de-las-Penas, M, Perez-de-Heredia, A, Molero-Sanchez, J. C. Miangolarra-Page & (2007). Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: a pilot study. Journal of Orthopaedic & Sports Physical Therapy, 37(2), 33-39. https://doi.org/10.2519/jospt.2007.2401
  21. M. H. Kwon. (2004). Comparing of strenth and cervical posture between people with and without cervical pain. Unpublished master's Thesis. Graduate School of Dankook University.
  22. Y. W. Jung. (2006). Effects of McKenzie Exercise on the Functional Recovery and Forward Head Posture of Chronic Neck Pain Patients. Journal of the Korean Society of Physical Medicine, 1(1), 93-108.
  23. D. Y. Won, S. Y. Kim, Y. S. Kim, J. H. Park, Y. K. An, M. K. Lee, E. Y. Jang, S. J. Jung, S. H. Choi & I. H. Whang. (2011). The Effects of the neck extensor strength exercise and the thoracic extensor strength exercise on the forward head posture and the cervical range of motion. Journal of Korean Physical Therapy Science, 18(2), 41-49.
  24. J. H. Youn & D. J. Sung. (1998). The Influence of Mckenzie Approach in Head Shoulder Posture of the Patients with Chronic Neck Pain. The Rescarch Institute of Physical Education & Sports Science, 17(1), 79-90.
  25. M. M. Panzabi. (1992). The Stabilizing System of the Spine. Part I. Function Dysfunction, Adaptation, and Enhancement. Journal of Spinal Disorders, 5(4), 383-389. https://doi.org/10.1097/00002517-199212000-00001
  26. D. A. Neumann. (2002). Kinesiology of the musculoskeletal system, Singapore: Mosby.
  27. K. Harman, L. Cheryl & H. Butler. (2005). Effectiveness of an Exercise program to Improve Forward Head Posture in Normal Adults. The Journal of Manual & Manipulative Therapy, 13(3), 163-176. https://doi.org/10.1179/106698105790824888
  28. W. Chansirinukor, D. Wilson, K. Grmmer & B. Dansie. (2001). Effets of backpacks on students:Measurement of cervical and shoulder posture, Australian Journal of Pgysiotherapy, 47(2), 110-116. https://doi.org/10.1016/S0004-9514(14)60302-0
  29. G. A. Jull, S. P. O'Leary & D. L. Falla. (2008). Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test. Journal of Manipulative and Physiological Therapeutics. 31(7), 525-533. https://doi.org/10.1016/j.jmpt.2008.08.003