슬링운동과 분절안정화운동이 요추추간판탈출증 수술환자의 통증과 국소근육 활성도에 미치는 영향
Effects of Sling Exercise and Segmental Stabilizing Exercise on the Pain and Activation of the Deep Muscle after Lumbar Discectomy
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[서론] 이 연구의 목적은 요추추간판탈출증 수술환자를 대상으로 슬링운동과 분절안정화운동을 적용하여 국소근육 활성도와 통증에 미치는 영향을 분석하는 것에 있다. [방법] 이 연구의 피험자는 추간판 절제술(discectomy)을 받은 환자 24명중 슬링운동군 12명(30.2±4.6세) 및 분절안정화운동군 12명(31.0±4.2세)으로 하였다. 운동처치는 수술 후 3주부터 11주까지 8주 동안 진행되었다. 사전·사후 검사는 3회 측정하였고 측정시기는 다음과 같다 : 운동전, 운동 후 4주, 운동 후 8주. 통증은 시각상사척도를 이용하여 측정하였고, 복횡근과 다열근은 초음파를 사용하여 두께의 변화를 측정하였다. [결과] 이 연구의 실험결과는 다음과 같다. 첫째, 복횡근의 활성도는 기간과 집단에서 유의한 차이가 나타났고, 상호작용 효과는 없는 것으로 나타났다. 둘째, 다열근의 활성도는 기간, 집단, 상호작용 효과가 없는 것으로 나타났다. 셋째, 시각상사척도(VAS)는 기간에서 유의한 차이가 나타났고, 집단과 상호작용에서는 유의한 차이가 없는 것으로 나타났다. [결론] 결론적으로 요추추간판 절제술 후 환자의 국소근육 재활 운동 프로그램은 국소근육회복과 통증감소에 효과적인 것으로 사료된다.
Abstract
[INTRODUCTION] The purpose of this study is to examine the relative efficacy of sling exercise and segmental stabilizing exercise on the pain and activation of deep muscles for patients who underwent lumbar discectomy. [METHOD] The subject were 24 patients with lumbar discectomy participated in the experiment for the study and they randomly assigned to two groups: one is a sling exercise group of 12(30.2±4.6) and the other is a segmental stabilizing exercise group of 12(31.0±4.2). The exercise program was applied in the third week of recovery and continued for the next 8 weeks after lumbar discectomy. The outcome were measured three times : before therapeutic exercise, after four weeks and after eight weeks. The degree of pain was determined by or based on a visual analog scale and changes in muscle thickness of the transversus abdominis (TrA) and lumbar multifidus (Mf). These muscles were measured using real-time ultrasound imaging. [RESULT] The results were as follows: First, the TrA activation changed significantly depending on both period and test group, however, no significant difference in interaction between the group and the period was observed. Second, the Mf activation in the group, the period and the interaction between them was not significantly different. Third, VAS in the period was significantly different, however, VAS in the group and interaction between them were no significant differences. [CONCLUSION] In conclusion, these results showed that rehabilitation exercise programs applied to local muscles (TrA and Mf) was effective for pain relief and activation of local muscle for patients after lumbar discectomy.
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