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경추성 두통 환자의 근육 특성과 자세 및 근활성도의 융복합적 분석

An Convergence Analysis of Muscle Characteristics, Muscle Activity and Posture in Patients with Cervicogenic Headache

  • 윤종혁 (원광대학교 장흥통합의료병원)
  • Yoon, Jong-Hyuk (Wonkwang University Jangheung Intergrated Medicine Hospital)
  • 투고 : 2021.03.31
  • 심사 : 2021.06.20
  • 발행 : 2021.06.28

초록

본 연구는 경추성 두통 환자의 진단 기준을 정립하고, 임상평가와 운동치료 시 효율적 방법 제공을 목적으로 경추성 두통환자들을 15명을 실험군으로 건강한 대상자 15명을 대조군으로 설정하여 그룹 간, 근육의 특성과 자세, 근활성도를 비교 분석하고, 실험군의 각 변수들 간 상관관계를 분석하였다. 연구결과 뒤통수밑근 경도와 위등세모근의 긴장도, 경도에서 통계적으로 유의한 차이를 보였다p<.001). 자세 변화 비교에서는 목 기울기 각도와 첫 번째 등뼈 경사각이 통계적으로 유의한 차이를 보였으며p<.05), 목빗근의 근활성도 변화 비교에서도 통계적으로 유의한 차이를 보였다(p<.001). 실험군에서 근육의 특성, 자세, 목빗근의 근활성도 간 상관관계를 분석한 결과, 뒤통수밑근의 긴장도가 증가할수록 뒤통수밑근의 경도가 증가함을 나타내 양의 상관관계를 보였고(p<.001), 위등세모근의 긴장도가 증가할수록 위등세모근의 경도도 증가하여 양의 상관관계를 보였다(p<.001). 경추성 두통환자의 평가와 치료 시 본 연구의 결과를 참고한다면, 보다 효율적으로 접근할 수 있을 것으로 기대된다. 향후 연구를 발전시켜 더 많은 연구대상자들을 평가하고 차이를 비교하는 연구와 다양한 직업군을 대상으로 하는 연구들이 필요할 것으로 생각된다.

This study aimed to define the diagnostic criteria for cervicogenic headache and propose an efficient method of clinical evaluation and physical therapy. Fifteen patients with cervicogenic headache and 15 healthy individuals were recruited and categorized into the test group and the control group, respectively. The groups were compared in terms of muscle characteristics, muscle activity and posture, and the intervariable correlations were analyzed for the test group. A significant between-group difference was found in the stiffness of the suboccipital muscle and the tone and stiffness of the upper trapezius muscle (p<.001). In posture comparison, a significant difference was noted in neck tilt angle and the T1 slope angle (p<.05). The activity of the sternocleidomastoid muscle was also significantly different between the groups (p<.001). When the correlations among the muscle characteristics, the posture, and the activity of the sternocleidomastoid muscle were analyzed for the test group, a positive correlation was found between the tone and the stiffness of the suboccipital muscle (p<.001) and between the tone and the stiffness of the upper trapezius muscle (p<.001). The findings of this study suggest a more efficient approach for the assessment and treatment of cervicogenic headache patients. It is considered that, further studies including more subjects of various job categories and comparing the outcomes.

키워드

참고문헌

  1. H.V. Suijlekom, J.V. Zundert, S Narouze et al. (2010). Cervicogenic Headache. Pain Practice. 10(2), 124-130. DOI:10.1111/j.1533-2500.2009.00354.x
  2. E. Ramezani, & A.M. Arab (2017). The Effect of Suboccipital Myofascial Release Technique on Cervical Muscle Strength of Patients With Cervicogenic Headache. physical treatments. 7(1), 19-28. DOI: 10.29252/nrip.ptj.7.1.19
  3. G. Zito, G Jull, & I Story. (2006). Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Manual Therapy. 11, 118-129. DOI: 10.1016/j.math.2005.04.007
  4. B.E.B. Gjelsvik. (2008). The Bobath concept in adult neurology. Thieme. New York. 11-12.
  5. L. Bailey, D. Samuel, M. Warner et al., (2003). Parameters Representing Muscle Tone, Elasticity and Stiffness of Biceps Brachii in Healthy Older Males. J Neurol Disord. 1. 116. DOI: 10.4172/jnd.1000116
  6. J. H. Carr & R.B. Shepherd. (2004). Stroke Rehabilitation: Guidelines for Exercise and Training to Optimize Motor Skill. Elsevier limited Oxford United Kingdom. 169-170.
  7. S.K Park, D.J Yang, J.H Kim et al., (2017). Analysis of mechanical properties of cervical muscles in patients with cervicogenic headache. The Journal of Physical Therapy Science. 29, 332-335. DOI: 10.1589/jpts.29.332
  8. D.H Watson, & P.H Trott. (1993). Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia. 13(1), 272-284. DOI: 10.1046/j.1468-2982.1993.1304272.x
  9. S Racicki, S Gerwin, S.D Claudio et al., (2013). Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. Journal of Manual and Manipulative Therapy. 21(2), 113-124. DOI: 10.1179/2042618612Y.0000000025
  10. P Page. (2011). Cervicogenic headache: An evidence approach to clinical management. The International Journal of Sports Physical Therapy. 6(3), 254-266.
  11. S.K Park, D.J Yang, J.H Kim et al., (2017). Effects of cervical stretching and cranio-cervical flexion exercises on cervical muscle characteristics and posture of patients with cervicogenic headache. The Journal of Physical Therapy Science. 29, 1836-1840. DOI: 10.1589/jpts.29.1836
  12. D.M Biondi. (2005). Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies. The Journal of the American Osteopathic Association. 105. 16-22. DOI: 10.1007/s11916-001-0026-x
  13. L Hamilton, C Boswell, G Fryer. (2007). The effects of high-velocity, low-amplitude manipulation and muscle energy technique on suboccipital tenderness. International Journal of Osteopathic Medicine. 10. 42-49. DOI.org/10.1016/j.ijosm.2007.08.002
  14. R Virr, K Laiho et al., (2006). Repeatability of trapezius muscle tone assessment by a myometric method. Journal of Mechanics in Medicine and Biology. 6, 215-228. DOI.org/10.1142/S0219519406001856
  15. W Singhatanadgige, D.G Kang, P Luksanapruksa et al., (2015). Correlation and Reliability of Cervical Sagittal Alignment Parameters between Lateral Cervical Radiograph and Lateral Whole-Body EOS Stereoradiograph. Global Spine Journal. 6(5), 548-554.
  16. G Jull, D Falla, B Vicenzino, P.W Hodges. (2009). The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Manual Therapy. 14 696-701. DOi.org/10.1016/j.math.2009.05.004
  17. D.J Yang, & D.H Kang. (2017). Comparison of muscular fatigue and tone of neck according to craniocervical flexion exercise and suboccipital relaxation in cervicogenic headache patients. J. Phys. Ther. Sci. 29, 869-873. DOI.org/10.1589/jpts.29.869
  18. H.Y. Cho. (2011). Effects of cervical stabilization exercise type on muscle strength and endurance, cross sectional area of cervical in patients with chronic cervical pain. Doctoral dissertation. Korea University, seoul.
  19. E.M. Seo. (2012). The analysis of Sagittal Balance between Cranium, Cervical Spine, and Thoracic Inlet in Asymptomatic Adult. Doctoral dissertation. Kangwon University, Chuncheon.
  20. J.H Park, C.B Cho, J.H Song et al., (2013). T1 Slope and Cervical Sagittal Alignment on Cervical CT Radiographs of Asymptomatic Persons. J Korean Neurosurg Soc. 53, 356-359. DOI: 10.3340/jkns.2013.53.6.356
  21. A.H Peggy. (2001). Therapeutic Exercise for Athletic Injury Hougum. U.S.A, Human Kinetkcs, Inc.
  22. D Falla, G Jull, P.W Hodges. (2004). Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 29(19), 2108-2114. DOI: 10.1097/01.brs.0000141170.89317.0e
  23. C Kisner, L.A Colby. (2007). Therapeutic Exercise Foundations and Techniques. The F.A, Davis Company Philadelphia Pennsylvania. 518-519.
  24. D.H. Kim et al., (2015). Measurement of Low Back Muscle Characteristic Change using MyotonPRO in a Long-term Driving. Ergonomics Society of Korea. 592-598.
  25. Shumway-Cook A, Woollacott M.H. (2000). Motor control translating reserch into clinical practice. Lippincott Williams & Wilkins. 169-170.