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The Effects of Mechanical Stimulation using Graston on Changing Trigger Point Pressure Pain Threshold and Muscle Tone of the Same Spinal Segment in Neck Disk Patient

목 디스크 환자에게 그라스톤을 이용한 기계적 자극 시 동일 척수 분절의 통증 유발점 압통 역치 및 근 긴장도에 미치는 영향

  • 김도형 (여주대학교 의료재활과학과) ;
  • 이병희 (삼육대학교 물리치료학과)
  • Received : 2019.08.28
  • Accepted : 2019.10.10
  • Published : 2019.10.28

Abstract

The purpose of this study was to identify whether cutaneous sensory (CS) changes induced by mechanical intervention(MI) increases the trigger point threshold and muscle tone of the same spinal segment to neck disc patients. Thirty persons with Neck disc patients were recruited in this experiment. The subjects consisted of 10 men and 20 women. The mechanical stimulus group induced CS changes for 5 minutes using the Graston instrument and the control group received no action. The CS changes were estimated by using the Von Frey Filament, PPT changes were measured by using the pressure threshold meter and msucle tone changes were measured by using Myotone pro. CS threshold increased significantly when MI was applied (p<0.05). On the same spinal segment, increases in the right infraspinatus PPT and muscle tone was observed (p<0.05) and decreases in the right trapezius PPT was observed(p<0.05). However, the PPT and muscle tone changes in other muscles were not significantly different. Furthermore, the control group CS, PPT and muscle tone were not significantly different. As a result, CS changes induced by MI make to change PPT and muscle tone on the same spinal segment. Therefore, application of MI to the same spinal segment may be of clinical significance as a new rehabilitation method for increasing pain threshold, muscle tone and pain control in neck disc patients.

본 연구의 목적은 목 디스크 환자에게 기계적 자극을 적용하여 피부 감각의 변화를 유도하고 동일한 척수분절의 통증 역치와 근 긴장도 전-후 변화를 확인하고자 하였다. 이에 목 디스크 질환을 가지고 있는 남성 10명, 여성 20명으로 구성된 대상자를 총 30명 선정하고 실험을 진행하였다. 기계적 자극 그룹은 Graston 장비를 이용하여 5분간 피부 감각 변화를 유도하였고, 대조군은 아무런 조치를 받지 않았다. 피부 감각 변화는 Von Frey filament를 통해 검사를 진행하였고, 압통 역치의 변화는 압통 역치 측정기를 통해 측정하였고, 근 긴장도의 변화는 Myotone pro를 사용하여 측정하였다. 기계적 자극 적용 시 피부 감각의 역치는 통계적으로 유의하게 증가하였다(p<0.05). 동일한 척수 분절의 신경 지배를 받는 오른쪽 가시아래근의 압통 역치와 근 긴장도는 통계적으로 유의하게 증가하였고(p<0.05), 오른쪽 등세모근의 압통 역치는 통계적으로 유의하게 감소하였다(p<0.05). 하지만 다른 근육들의 압통 역치와 근 긴장도는 통계적으로 유의한 변화가 나타나지 않았다. 또한, 대조군에서는 피부 감각, 압통 역치, 근 긴장도의 변화가 통계적으로 유의하게 나타나지 않았다. 결과적으로 기계적 자극에 의해 유도된 피부 감각 변화는 동일 척수 분절의 압통 역치와 근 긴장도의 변화시켰다. 따라서 동일 척수 분절에 대한 기계적 자극의 적용을 통해 목 디스크 환자의 압통 역치, 근 긴장도의 증가와 통증 조절을 위한 새로운 재활 방법으로 임상적 의의가 있다고 판단된다.

Keywords

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