대한정형도수물리치료학회지 (The Journal of Korean Academy of Orthopedic Manual Physical Therapy)

  • 제30권1호
  • /
  • Pages.1-13
  • /
  • 2024
  • /
  • 1226-3680(pISSN)
  • /
  • 2508-7282(eISSN)
대한정형도수물리치료학회 (Korean Academy of Orthopedic Manual Physical Therapy)
권호 표지

압력 생체 되먹임 훈련을 이용한 복부 드로잉 운동이 산후 여성에서 통증, 배가로근 수행력, 요통장애지수, 삶의 질에 미치는 효과: 출산 후 1년 미만의 30대 여성을 대상으로

Effects of Abdominal Drawing-in using Pressure Biofeedback Training on Pain, Performance of Transverse Abdominis, Oswestry Disability Index, and Quality of Life in Postpartum Women: Targeted at Women in their 30s Less than One Year Postpartum

  • 송형봉 (아산사회복지재단 보성아산병원 물리치료실) ;
  • 박근홍 (첨단우암병원 물리치료실) ;
  • 김은비 (첨단우암병원 물리치료실) ;
  • 김태원 (우일신경외과 도수치료센터) ;
  • 박성두 (허리편한병원 물리치료실)
  • Hyoung-bong Song (Dept. of Physical Therapy, Boseong Asan Hospital, Asan Foundation) ;
  • Geun-hong Park (Dept. of Physical Therapy, Chumdan Wooam Hospital Rehabilitation Center) ;
  • Eun-bi Kim (Dept. of Physical Therapy, Chumdan Wooam Hospital Rehabilitation Center) ;
  • Tae-won Kim (Dept. of Physical Therapy, Wooil Neurosurgery Clinic) ;
  • Sung-doo Park (Dept. of Physical Therapy, Good Spine Hospital)
  • 투고 : 2023.12.11
  • 심사 : 2023.12.29
  • 발행 : 2024.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: The purpose of this study was to investigate the effects of stabilization exercise performed after abdominal drawing exercise using pressure biofeedback for 8 weeks on pain level, performance of transverse abdominis, back pain disability index, and quality of life in women in their 30s less than one year after giving birth. Methods: A total of 20 women who voluntarily participated less than one year after giving birth were randomly divided into a control group and an experimental group. The control group was subjected to abdominal drawing exercise before lumbar stabilization exercise, and the experimental group was subjected to abdominal drawing exercise using pressure biofeedback before lumbar stabilization exercise thrice a week for eight weeks. The quadruple visual analog scale (QVAS), the performance of transverse abdominis, the Korean version of the Oswestry disability index (KDOI), the inventory of functional status after childbirth (IFSAC), and the Short Form-12 item (SF-12) were evaluated before and after the intervention. Results: Except for the Physical Components Summary Scale of SF-12, after the intervention, the experimental group showed significant improvement in QVAS, performance of Transverse abdominis , KDOI, and Mental Components Summary Scale of SF-12 compared to the control group. Conclusion: Selective deep muscle activation through abdominal drawing exercises using pressure biofeedback can help rehabilitation for women after postpartum.

키워드

참고문헌

  1. American College of Obstetricians and Gynecologists. Exercise during pregnancy and the postpartum period: ACOG technical bulletin number 189-February 1994. Int J Gynecol Obstet. 1994;45(1):65-70. https://doi.org/10.1016/0020-7292(94)90773-0. 
  2. Andersen TB, Essendrop M, Schibye B. Movement of the upper body and muscle activity patterns following a rapidly applied load: The influence of pre-load alterations. Eur J appl physiol. 2004;91(4):488-492. https://doi.org/10.1007/s00421-004-1040-6. 
  3. Batt MM, Duffy KA, Novick AM, et al. Is postpartum depression different from depression occurring outside of the perinatal period? A review of the evidence. Focus. 2020;18(2):106-119. https://doi.org/10.1176/appi.focus.20190045. 
  4. Beninato M, Portney LG, Sullivan PE. Using the international classification of functioning, disability and health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys ther. 2009;89(8):816-825. https://doi.org/10.2522/ptj.20080160. 
  5. Chiarello CM, Falzone LA, McCaslin KE, et al. The effects of an exercise program on diastasis recti abdominis in pregnant women. The Journal of Women's & Pelvic Health Physical Therapy. 2005:29(1);11-16. 
  6. Cresswell AG, Grundstrom H, Thorstensson A. Observations on intra -abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand. 1992;144(4)409-418. https://doi.org/10.1111/j.1748-1716.1992.tb09314.x. 
  7. Di Mascio D, Magro-Malosso ER, Saccone G, et al. Exercise during pregnancy in normal-weight women and risk of preterm birth: A systematic review and meta-analysis of randomized controlled trials. Am J obst gynecol. 2016;215(5):561-571. https://doi.org/10.1016/j.ajog.2016.06.014 
  8. Fawcett J, Tulman L, Myers ST. Development of the inventory of functional status after childbirth. J Nurse Midwifery. 1988;33(6):252-260. https://doi.org/10.1016/0091-2182(88)90080-8. 
  9. Franca FR, Burke TN, Hanada ES, et al. Segmental stabilization and muscular strengthening in chronic low back pain-a comparative study. Clinics. 2010;65(10):1013-1017. https://doi.org/10.1590/S1807-59322010001000015. 
  10. Gill PK, Callaghan JM. The measurement of lumbar proprioception in individuals with and without low back pain. spine. 1998;23(3):371-377. https://doi.org/10.1097/00007632-199802010-00017. 
  11. Goldby LJ, Moore AP, Doust J, et al. A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine. 2006;31(10):1083-1093. https://doi.org/10.1097/01.brs.0000216464.37504.64. 
  12. Gutke A, Lundberg M, Ostgaard HC, et al. Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms. Eur Spine J. 2011;20(30):440-448. https://doi.org/10.1007/s00586-010-1487-6. 
  13. Hides J, Wilson S, Stanton W, et al. An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine. 2006;31(6):E175-E178. http://doi.org/10.1097/01.brs.0000202740.86338.df. 
  14. Hoder A, Stenbeck J, Fernando M, et al. Pelvic floor muscle training with biofeedback or feedback from a physiotherapist for urinary and anal incontinence after childbirth - A systematic review. BMC Womens Health. 2023;23(1):618. https://doi.org/10.1186/s12905-023-02765-7. 
  15. Hodges PW, Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys ther. 1997:77(2);132-142. https://doi.org/10.1093/ptj/77.2.132 
  16. Jeon CH, Kim DJ, Kim DJ, et al. Cross-cultural adaptation of the Korean version of the Oswestry disability index (ODI). J Korean Soc Spine Surg. 2005;12(2):146-152. https://doi.org/10.4184/jkss.2005.12.2.146. 
  17. Jung DE, Kim K, Lee SK. Comparison of muscle activities using a pressure biofeedback unit during abdominal muscle training performed by normal adults in the standing and supine positions. J phys ther sci. 2014;26(2):191-193. https://doi.org/10.1589/jpts.26.191. 
  18. Kendall FP, McCreary EK, Provance PG, et al. Muscles: Testing and Function with Posture and Pain. 5th edition. Lippincott Williams & Wilkins. Philadelphia. USA. 1-100, 2005. 
  19. Keeler J, Albrecht M, Eberhardt L, et al. Diastasis recti abdominis: A survey of women's health specialists for current physical therapy clinical practice for postpartum women. J Womens Health Phys Therap. 2012;36(3):131-142. https://doi.org/10.1097/JWH.0b013e318276f35f. 
  20. Kim DY, Lee SH, Lee HY, et al. Validation of the Korean version of the Oswestry disability index. Spine. 2005;30(5):123-127. https://doi.org/10.1097/01.brs.0000157172.00635.3a. 
  21. Kim GJ, Kong KW, Kwon SO, et al. The study of stability exercise using pressure biofeedback unit for low back pain. Journal of Korean Physical Therapy Science. 2012;19(2):63-71. 
  22. Kim SA. The Effects of a Pelvic Correction Ballet Floor Program using Elastic Band on Pelvis and Posture for Women having Childbirth Experience. Ehwa Woman University. Master Thesis. 2018. 
  23. Kim SC, Kim SG, Kim CS. Effect of abdominal draw in maneuver in sitting position. Journal of Rehabilitation Welfare Engineering & Assistive Technology. 2017;11(3):207-214. https://doi.org/10.21288/resko.2017.11.3.207 
  24. Kim SY, Kim KS. Prevalence of back pain in pregnancy. J Korean Acad Orthop Man Physi Ther. 1998;4(1):71-82. 
  25. Kim SY, Kwon JH. Lumbar stabilization exercises using the sling system. J Korean Acad Orthop Man Physi Ther. 2001;7(2): 23-39. 
  26. Kim TH, Oh DB, Kim DY. Usability testing of digital pressure bio-feedback for spinal rehabilitation exercise. Journal of Rehabilitation Welfare Engineering & Assistive Technology. 2017;11(3):119-126. https://doi.org/10.21288/resko.2017.11.3.119. 
  27. Kim TW, Kim YW. Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis. J Phys Ther Sci. 2015;27(2):383-386. https://doi.org/10.1589/jpts.27.383. 
  28. Kisner C, Colby LA. Therapeutic Exercise: Foundation and techniques. 6th ed. FA Davis Company. Philadelphia. USA. 2012. 
  29. Koes BW, Van TM, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-1434. https://doi.org/10.1136/bmj.332.7555.1430. 
  30. Korea Statistics. Major Surgery Statistics by Age. Korea of Ministry of Health and Welfare. Seoul. Korea. 
  31. Kwon NH, Lee HO, Park DJ. The use of real-time ultrasound imaging for feedback during abdominal hollowing. J Korean Soc Phys Med. 2011;6(3):303-310. 
  32. Leonard SA, Petito LC, Stephansson O, et al. Weight gain during pregnancy and the black-white disparity in preterm birth. Ann Epidemiol. 2017;27(5):323-328.e1. https://doi.org/10.1016/j.annepidem.2017.05.001. 
  33. Lee HJ, Kim SY. Comparison of the effects of abdominal draw-in and expansion maneuvers on trunk stabilization in patients with low back pain and lumbar spine instability. Physical Therapy Korea. 2015;22(1):37-48. https://doi.org/10.12674/ptk.2015.22.1.037. 
  34. Lee JM, Yi CH, Kwon OY, et al. The effect of lumbar stabilization exercise for caregivers with chronic low back pain. Physical Therapy Korea. 2011;18(2):9-17. 
  35. Lee MJ, Kwon OK, Song HS. The effects of pelvic floor stabilization exercise on pain, function, psychosocial, EMG activity on the lower back pain with postpartum women. J Korean Acad Orthop Man Physi Ther. 2018:24(2);17-27. 
  36. Lee SH, Lee SY. The effect of abdominal drawing-in maneuver with pressure biofeedback unit in various postures on abdominal muscle contraction. Phys Ther Rehabil Sci. 2022;11(2):136-144. https://doi.org/10.14474/ptrs.2022.11.2.136. 
  37. Lim HJ, Seo SH, Lim JE, et al. Effects of physical activity levels on impaired glucose tolerance and blood inflammatory markers during pregnancy. Exercise Science. 2009;18(3):409-418. https://doi.org/10.15857/ksep.2009.18.3.409. 
  38. Macedo LG, Maher CG, Latimer J, et al. Motor control exercise for persistent, nonspecific low back pain: A systematic review. Physi Ther. 2009;89(1):9-25. https://doi.org/10.2522/ptj.20080103. 
  39. Magnusson ML, Chow DH, Diamandopoulos Z, et al. Motor control learning in chronic low back pain. Spine. 2008;33(16):532-553. https://doi.org/10.1097/BRS.0b013e31817dfd9a. 
  40. Mayer RE. Educational Psychology: A Cognitive Approach. Scott Foresman and Company. Northbrook. USA. 1987. 
  41. Mason L, Roe B, Wong H, et al. The role of antenatal pelvic floor muscle exercises in prevention of postpartum stress incontinence: A randomised controlled trial. J clin nurs. 2010;19(19-20):2777-2786. https://doi.org/10.1111/j.1365-2702.2010.03297.x. 
  42. McGill SM, Grenier S, Kavcic N, et al. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003;13(4):353-359. https://doi.org/10.1016/S1050-6411(03)00043-9. 
  43. OECD. Korea Development Institute. 2022.
  44. Park DJ, Lee SK. What is a suitable pressure for the abdominal drawing-in maneuver in the supine position using a pressure biofeedback unit?. J Phys Ther Sci. 2013;25(5):527-530. https://doi.org/10.1589/jpts.25.527. 
  45. Park HJ. Effects of Equipment Pilates Exercise on Thoracic & Hip Joint Range of Motion, Lumbar Stabilization and Pain Level of Childbirth Women with Low Back Pain in Sacroiliac Joint Instability. Korean National Sport University. Master Thesis. 2019. 
  46. Park JH. The Effects of Unstable Surfaces Training Exercise on the Pain, Dysfunction Index and Transverse abdominal Muscle Performance of Women with Low Back Pain after Childbirth. Deagu University. Master Thesis. 2018. 
  47. Pruett MD, Caputo JL. Exercise guidelines for pregnant and postpartum women. Strength & Conditioning Journal. 2011;33(3):100-103. https://doi.org/10.1519/SSC.0b013e31821c3261 
  48. Ryu SH. The Effect of Biofeedback Walking Exercise on the Lumbar Muscle Strengthening, Muscle Activation and Lumbar Functional Disability Index with Chronic Back Pain Patients. Korea University. Master Thesis. 2011. 
  49. Sampselle CM, Burns PA, Dougherty MC, et al. Continence for women: Evidence-based practice. J Obstet Gynecol Neonatal Nurs. 1999;28(6):25-33. 
  50. Seo KC, Park KY. The effect of trunk stabilization circuit exercise using a rubber mat on the thickness and white area index of transverse abdominis in healthy young adults. J Phys Ther Sci, 2018;30(6):892-895. https://doi.org/10.1589/jpts.30.892. 
  51. Siedentop D. Developing Teaching Skills in Physical Education, 2nd ed. Houghton Mifflin. Boston. USA. 1983. 
  52. Son MJ, Lee MH, Kim MK. Effects of the gluteus muscle exercise combined with the lumbar stabilization exercise on pain, ODI, and postpartum depression in women with chronic back pain after C-section delivery. Kor Acad Ortho Man Phys Ther. 2023;29(3):31-42. https://doi.org/10.23101/kaompt.2023.29.3.31. 
  53. Teyhen DS, Miltenberger CE, Deiters HM, et al. The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. J Orthop Sports Phys Ther. 2005;35(6):346-355. https://doi.org/10.2519/jospt.2005.35.6.346. 
  54. Urquhart DM, Hodges PW. Differential activity of regions of transversus abdominis during trunk rotation. Eur Spine J. 2005;14:393-400. https://doi.org/10.1007/s00586-004-0799-9. 
  55. Vera-Garcia FJ, Elvira JL, Brown SH, et al. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. 2007;17(5):556-567. https://doi.org/10.1016/j.jelekin.2006.07.004. 
  56. Von Korff M, Deyo RA, Cherkin D, et al. Back pain inprimary care. Outcomes at 1 year. Spine. 1993;18(7):855-862.  https://doi.org/10.1097/00007632-199306000-00008
  57. Walton LM, Costa A, LaVanture D, et al. The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI) and pelvic floor disability index scores (PFDI). Phys Ther Rehabil. 2016;3(1):3. https://doi.org/10.7243/2055- 2386-3-3. 
  58. Wang SM, Dezinno P, Lin EC, et al. Auricular acupuncture as a treatment for pregnant women who have low back and posterior pelvic pain: A pilot study. Am J Obstet Gynecol. 2009;201(3):271-279. https://doi.org/10.1016/j.ajog.2009.04.028. 
  59. Ware JE, Kosinski M, Keller SD. A 12-Item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-233. https://doi.org/10.1097/00005650-199603000-00003. 
  60. Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in US women. Obstet Gynecol. 2014:123(1);141-148. https://10.1097/AOG.0000000000000057. 
  61. Yang SH, Jung ET. The design of a biofeedback stabilizer for back pain prevention and treatment. Archives of Design Research. 2013;26:379-92. https://10.15187/adr.2013.08.26.3.379.