슬링을 이용한 능동 운동프로그램이 무릎 관절 전치환술 환자의 통증과 균형에 미치는 영향
The Effects of Active Exercise Program using Sling on the Pain and Balance Following Total Knee Replacement
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본 연구는 슬링을 이용한 능동 운동프로그램이 무릎 관절 전치환술 환자의 통증과 균형에 미치는 영향을 알아보고자 실시하였다. 대상자는 무릎 관절 전치환술을 받고 입원 중인 환자 20명이며, 수술 후에 CPM (Continuous passive motion)만을 적용하는 집단 (CPM group; CG)과 CPM과 슬링을 이용한 능동 운동프로그램을 병행하는 집단 (CPM with active exercise program using sling group; CSG)으로 10명씩 무작위로 배치되었다. CG는 CPM을 주 5일, CSG는 CPM을 주 2일, 슬링을 이용한 능동 운동프로그램을 주 3일 실시하였고, 각 중재는 하루 40분씩 총 4주간 실시하였다. 통증은 VAS (Visual analog scale)을 이용하여 평가하였고, 균형은 BT4 (Balance training 4)를 이용하여 C90 area, Trace length, Sway average velocity를 눈을 뜬 상태와 감은 상태로 측정하였다. 그 결과, 두 집단 모두 통증에서 집단 내에서 유의하게 감소하였고, 집단 간의 변화량에서도 유의한 차이가 있었다. 균형에서 CG의 C90을 제외한 모든 변인이 중재 후 유의한 변화가 있었으며, 집단 간 변화량에서는 눈을 감은 상태의 C90과 Vel에서 유의한 차이가 있었다. 따라서 CPM과 슬링을 이용한 능동 운동프로그램을 함께 시행하는 것은 무릎 관절 전치환술 환자의 통증 감소와 균형 향상에 효과적인 중재라고 생각한다.
Abstract
This study was conducted to investigate the effect of the active exercise program using sling on the pain and balance of total knee replacement patients. Subjects were 20 patients who received total knee replacement and are hospitalized, 10 patients in each group were randomly assigned to a group (CPM group) that applied only CPM (Continuous passive motion) and a group (CSG) that combined CPM with a active exercise program using sling. CG was performed CPM 5 days a week, CSG performed CPM 2 days a week and a active exercise program using sling 3 days a week, and each intervention was performed for 40 minutes a day for a total of 4 weeks. Pain was evaluated using VAS (Visual analog scale), and balance was measured using BT4 (Balance training 4) to measure C90 area, trace length, and Sway average velocity with eyes open and closed. As a result, there was a significant decrease in pain in both groups, and there was also a significant difference in the amount of change between groups. In balance, all variables except C90 of CG showed significant changes after intervention, and there was a significant difference between C90 and Vel with eyes closed in the amount of change between groups. Therefore, we believe that CPM and active exercise program using sling are effective interventions to reduce pain and improve balance in total knee replacement patients.
참고문헌 (46)
- Health Insurance Review, "2020National Health Insurance Statistical Yearbook" (2021), Kyungsung
- 유지형, "슬관절 치환술 환자 대상 동기상담 적용 운동 프로그램의 효과", 근관절건강학회지, 23(3), pp.139~151 (2016), 대한근관절건강학회[DOI]
- 박신준, "Effect of Joint Mobilization and Kinesio Taping on Pain, Range of Motion, and Knee Function in Patients with Knee Osteoarthritis", 대한물리치료학회지, 28(5), pp.279~285 (2016), 대한물리치료학회
- 민혜숙, "근력강화 운동프로그램이 슬관절 전치환술 여성 노인환자의 통증, 피로, 신체적 기능에 미치는 영향", 근관절건강학회지, 18(2), pp.203~214 (2011), 대한근관절건강학회
- "Rehabilitation after total knee arthroplasty" (2019)[URL]
- 이상현, "60세 이상의 노인환자에서 슬관절 전치환술 후 경막외 통증자가조절법과 지속적 경막외 통증조절법의 비교", Korean Journal of Anesthesiology, 50(3), pp.285~291 (2006), 대한마취통증의학회
- R. N. Maniar, "To use or not to use continuous passive motion post-total knee arthroplasty presenting functional assessment results in early recovery", The Journal of Arthroplasty, 27(2), pp.193~200 (2012)[DOI]
- M. Synder, "The use of continuous passive motion (CPM) in the rehabilitation of patients after total knee arthroplasty", Orthopedia, Traumatologia, Rehabilitacja, 6(3), pp.336~341 (2004)
- S. Milne, "Continuous passive motion following total knee arthroplasty", Cochrane Database of Systematic Reviews, (2), pp.CD004260~ (2003)[DOI]
- J. A. Herbold, "Randomized controlled trial of the effectiveness of continuous passive motion after total knee replacement", Archives of Physical Medicine and Rehabilitation, 95(7), pp.1240~1245 (2014)[DOI]
- W. H. Gage, "Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations", Gait & posture, 27(2), pp.286~293 (2008)[DOI]
- J. O. Kim, "Balance in Patients After TKA", Knee Surgery & Related Research, 18(2), pp.167~174 (2006)
- 유진호, "일부 여대생의 세 가지 균형조절 훈련 효과 비교", 한국전자통신학회 논문지, 8(4), pp.619~629 (2013), 한국전자통신학회
- G. C. Gauchard, "On the role of knee joint in balance control and postural strategies: effects of total knee replacement in elderly subjects with knee osteoarthritis", Gait & posture, 32(2), pp.155~160 (2010)[DOI]
- M. V. Radomski, "Occupational therapy for physical dysfunction", pp.2008, Wolters Kluwer
- R. S. Hinman, "Hip muscle weakness in individuals with medial knee osteoarthritis", Arthritis care & research, 62(8), pp.1190~1193 (2010)[DOI]
- S. R. Piva, "Contribution of hip abductor strength to physical function in patients with total knee arthroplasty", Physical therapy, 91(2), pp.225~233 (2011)[DOI]
- J. S. Yoon, "The effect of quadriceps isometric exercise method on pain, muscle strength and balance of early phase of total knee arthroplasty patients", Master, pp.2016
- Y. J. Son, "Immediate effect on muscle strength after quadriceps muscle fatigue regarding applying directions of kinesiology tape on the patella", Master, pp.2019
- J. H. Lee, "Effect of lower extremity patterns of proprioceptive neuromuscular facilitation on pain and balance in total knee replacement", Master, pp.2010
- K. B. Lim, "The effect of balance and pain in the osteoarthritis patients after bio-feedback and strengthening exercises", Master, pp.2009
- T. P. Stitik, "Rehabilitation of orthopedic and rheumatologic disoder. 2. Osteoarthritis assessment, treatment, and rehabilitation", Archives of Physical Medicine and Rehabilitation, 86(Suppl 1), pp.S48~S55 (2005)[DOI]
- J. F. Sarwark, "Essentials of musculoskeletal care" (2010), American Academy of Orthopaedic Surgeons
- 이재구, "슬링운동이 여성노인의 등속성 각근력, 보행관련 변인 및낙상위험도와의 상관에 미치는 영향", 한국사회체육학회지, (32), pp.1119~1126 (2008), 한국사회체육학회
- W. T. Gong., "Effects of bridge exercises with a sling and vibrations on abdominal muscle thickness in healthy adults", Journal of back and musculoskeletal rehabilitation, 28(4), pp.645~649 (2015)[DOI]
- A. H. Saeterbakken, "Effect of core stability training on throwing velocity in female handball players", Journal of strength and conditioning research, 25(3), pp.712~718 (2011)[DOI]
- A. Mau-Moeller, "The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study", Health and quality of life outcomes, 12, pp.68~ (2014)[DOI]
- M. D. Kim, "Comparison of Trunk Stabilization Muscle Activity According to Change of the Sling Height and Hip Abduction, Adduction during Bridging Exercise", Korea Academy Industrial Cooperation Society, pp.588~590 (2015)
- 박경은, "대학생들의 일회성 슬링운동이 경부의 관절가동범위, 근력 및 통증척도에 미치는 영향", 한국스포츠학회, 16(1), pp.415~422 (2018), 한국스포츠학회
- 배창환, "The Effect of Sling Exercise on Muscular Strength and Range of Motion in Female Patients who Received Total Knee Replacement", 한국산학기술학회논문지, 15(7), pp.4395~4404 (2014), 한국산학기술학회[DOI]
- 성동훈, "슬링운동과 고유수용성신경근촉진법 복합 적용이 무릎관절 전치환술 후 족저압과 관절가동범위에 미치는 영향: 사례연구", 한국체육과학회지, 26(5), pp.1335~1343 (2017), 한국체육과학회[DOI]
- E. C. Huskisson, "Measurement of Pain", The lancet, 304(7889), pp.1127~1131 (1974)[DOI]
- B. Cole, "Physical rehabilitation outcome measure" (1994), Canadian physiotherapy association
- H. S. Hwang, "Comparison of the effects of visual feedback training and unstable surface training on static and dynamic balance in patients with stroke", Journal of physical therapy science, 29(10), pp.1720~1702 (2017)
- G. Borg, "Borg’s perceived exertion and pain scales" (1998), Human Kinetics
- 안혜림, "슬링 운동이 요통 환자의 통증 감소 및 근력 강화에 미치는 영향", 한방재활의학과학회지, 17(4), pp.167~174 (2007), 한방재활의학과학회
- 박세주, "무릎관절 전치환술 환자에게 적용한 운동 프로그램이 통증 및 균형에 미치는 효과: 메타분석", 한국컴퓨터정보학회논문지, 26(5), pp.119~126 (2021), 한국컴퓨터정보학회[DOI]
- 정명실, "슬관절 전치환술 후 하지 근육강화 운동 프로그램 효과", 한국간호교육학회지, 14(1), pp.20~29 (2008), 한국간호교육학회
- 지상구, "과제 지향 훈련이 슬관절 전치환술을 시행한 퇴행성 관절염 환자의 균형 능력에 미치는 효과", 한국콘텐츠학회 논문지, 12(3), pp.222~232 (2012), 한국콘텐츠학회
- C. C. Jørgensen, "Fall-related admissions after fast-track total hip and knee arthroplast - cause of concern or consequence of success", Journal of Clinical Interventions in Aging, 8, pp.1569~1577 (2013)[DOI]
- I. Schwartz, "Balance is an important predictive factor for quality of life and function after primary total knee replacement", The Journal of bone and joint surgery. British volume, 94(6), pp.782~786 (2012)[DOI]
- W. H. Gage, "Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations", Gait & posture, 27(2), pp.286~293 (2008)[DOI]
- 배지영, "무릎 관절 각도에 따른 교각운동이정적 균형과 동적 균형에 미치는 영향", 한국엔터테인먼트산업학회논문지, 8(3), pp.381~390 (2014), 한국엔터테인먼트산업학회
- S. J. Hwang, "Effects of Core Program Exercise on Static Balance of Females in Their Twenties", Journal of the Korean Academy of Clinical Electrophysiology, 8(1), pp.31~36 (2010)[DOI]
- Y. H. Pua, "Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis", Arthritis Care Res(Hoboken), 63(12), pp.1706~1714 (2011)[DOI]
- S. J. Lim, "The effects of standing balance in anteroposterior and mediolateral directions on knee strengthening in post-total knee replacement", Journal of physical therapy science, 28(1), pp.261~263 (2016)[DOI]
