본문 바로가기
KERD
논문KCI 등재

비특이성 만성 경부통 환자에게 적용한 동적 균형 운동이 통증과 기능적 수준, 심리사회적 수준에 미치는 효과

Effects of Dynamic Balance Exercise on Pain, Functional level, and Psychosocial Level in Patients with Non-specific Chronic Neck Pain

김선엽|권유희
대한정형도수물리치료학회 (Korean Academy of Orthopedic Manipulative Physical Therapy)|2023.12|대한정형도수물리치료학회지 (Korean Academy of Orthopedic Manipulative Physical Therapy)|제29권 제3호|pp. 43-53|DOI 10.23101/kaompt.2023.29.3.43

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

ExerciseStabilizationEnduranceDynamic balanceNonspecific chronic neck pain

초록

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

Abstract

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

참고문헌 (34)

  1. 최태석, "목뼈 가동 운동과 머리목 굽힘 운동이 만성 목통증 환자의 동적균형과 보행변인에 미치는 영향: 무작위 임상시험", 대한물리의학회지, 15(2), pp.31~38 (2020), 대한물리의학회[DOI]
  2. Joshua A. Cleland, "Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial", Manual Therapy, 10(2), pp.127~135 (2005), Elsevier BV[DOI]
  3. Kevin M. Cross, "Thoracic Spine Thrust Manipulation Improves Pain, Range of Motion, and Self-Reported Function in Patients With Mechanical Neck Pain: A Systematic Review", Journal of Orthopaedic &amp; Sports Physical Therapy, 41(9), pp.633~642 (2011), Journal of Orthopaedic & Sports Physical Therapy (JOSPT)[DOI]
  4. Manuel A. Domenech, "The Deep Neck Flexor Endurance Test: Normative Data Scores in Healthy Adults", PM&amp;R, 3(2), pp.105~110 (2011), Wiley[DOI]
  5. D. Falla, "Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain", Experimental Brain Research, 157(1), pp.43~48 (2004), Springer Science and Business Media LLC[DOI]
  6. Ken Fredin, "Manual therapy, exercise therapy or combined treatment in the management of adult neck pain – A systematic review and meta-analysis", Musculoskeletal Science and Practice, 31, pp.62~71 (2017), Elsevier BV[DOI]
  7. Anita R. Gross, "A Cochrane Review of Manipulation and Mobilization for Mechanical Neck Disorders", Spine, 29(14), pp.1541~1548 (2004), Ovid Technologies (Wolters Kluwer Health)[DOI]
  8. Eric L. Hurwitz, "Treatment of Neck Pain: Noninvasive Interventions", Journal of Manipulative and Physiological Therapeutics, 32(2), pp.S141~S175 (2009), Elsevier BV[DOI]
  9. Kevin D Harris, "Reliability of a Measurement of Neck Flexor Muscle Endurance", Physical Therapy, 85(12), pp.1349~1355 (2005), Oxford University Press (OUP)[DOI]
  10. Hogg-Johnon S, "The burden and determinants of neck pain in the general population: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders", J Manipulative Physiol Ther, 17, pp.39~51 (2008)[DOI]
  11. D.G. Hoy, "The epidemiology of neck pain", Best Practice &amp; Research Clinical Rheumatology, 24(6), pp.783~792 (2010), Elsevier BV[DOI]
  12. Sue Hudswell, "The cranio-cervical flexion test using pressure biofeedback: A useful measure of cervical dysfunction in the clinical setting?", International Journal of Osteopathic Medicine, 8(3), pp.98~105 (2005), Elsevier BV[DOI]
  13. Joo M, "The Effects of Stabilization Exercise on Chronic Neck Pain Patients", Master, pp.2009
  14. Alan Jordan, "Intensive Training, Physiotherapy, or Manipulation for Patients With Chronic Neck Pain", Spine, 23(3), pp.311~318 (1998), Ovid Technologies (Wolters Kluwer Health)[DOI]
  15. Jull G, "Whiplash, Head Ache, and Neck Pain: Research-based Directions for Physical Therapies" (2008), Elsevier Health Sciences
  16. Gwendolen A. Jull, "Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test", Journal of Manipulative and Physiological Therapeutics, 31(7), pp.525~533 (2008), Elsevier BV[DOI]
  17. 정재훈, "PEDALO® 전정감각통합훈련이 중년 여성 요통환자의 요추부 근육에 미치는 영향", 한국체육학회지, 60(1), pp.507~522 (2021), 한국체육학회[DOI]
  18. 김재철, "경부 통증 유무에 따른 심부 경부 굴곡근의 근력과 지구력 비교", 대한인간공학회지, 26(4), pp.25~31 (2007), 대한인간공학회
  19. 김수진, "소도구를 이용한 등뼈 자가 관절 가동성 운동이 만성 목통증 환자의 통증, 관절가동범위, 기능장애에 미치는 영향", 한국전문물리치료학회지, 27(1), pp.1~10 (2020), 한국전문물리치료학회[DOI]
  20. 이주훈, "슬링을 이용한 열린사슬운동과 닫힌 사슬 운동의 턱당기기 동작 시 목굽힘근 두께 비교", PNF and Movement, 18(3), pp.333~341 (2020), 대한고유수용성신경근촉진법학회[DOI]
  21. 이남용, "만성 역학적 목 통증을 가진 환자에게 도수치료만 적용할 때와 도수치료와 안정화운동을 함께 적용할 때 목 통증과 신체기능에 미치는 효과 비교", 대한물리의학회지, 17(1), pp.63~74 (2022), 대한물리의학회
  22. Jordan Miller, "Manual therapy and exercise for neck pain: A systematic review", Manual Therapy, 15(4), pp.334~354 (2010), Elsevier BV[DOI]
  23. Victoria Misailidou, "Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools", Journal of Chiropractic Medicine, 9(2), pp.49~59 (2010), Elsevier BV[DOI]
  24. 남형천, "근막이완술의 적용이 성인의 목통증과 관절가동범위에 미치는 영향", 정형스포츠물리치료학회지, 15(2), pp.117~126 (2019), 대한스포츠물리치료학회[DOI]
  25. 박주희, "바이오피드백을 이용한 심부목굽힘근운동이 목 질환에 미치는 영향: 메타분석", 한국전문물리치료학회지, 28(1), pp.18~26 (2021), 한국전문물리치료학회[DOI]
  26. Bogdan P. Radanov, "Long-Term Outcome after Whiplash Injury: A 2-Year Follow-Up Considering Features of Injury Mechanism and Somatic, Radiologic, and Psychosocial Findings", Medicine, 74(5), pp.281~297 (1995), Ovid Technologies (Wolters Kluwer Health)[DOI]
  27. H Sarig-Bahat, "Evidence for exercise therapy in mechanical neck disorders", Manual Therapy, 8(1), pp.10~20 (2003), Elsevier BV[DOI]
  28. Leon Kaplan, "The Outcomes of Manipulation or Mobilization Therapy Compared with Physical Therapy or Exercise for Neck Pain: A Systematic Review", Evidence-Based Spine-Care Journal, 04(01), pp.030~041 (2013), Georg Thieme Verlag KG[DOI]
  29. Kyung-Jin Song, "Cross-Cultural Adaptation and Validation of the Korean Version of the Neck Disability Index", Spine, 35(20), pp.E1045~E1049 (2010), Ovid Technologies (Wolters Kluwer Health)[DOI]
  30. Munlika Sremakaew, "Effects of local treatment with and without sensorimotor and balance exercise in individuals with neck pain: protocol for a randomized controlled trial", BMC Musculoskeletal Disorders, 19(1), pp.1~12 (2018), Springer Science and Business Media LLC[DOI]
  31. Julia Treleaven, "Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control", Manual Therapy, 13(1), pp.2~11 (2008), Elsevier BV[DOI]
  32. Johan W.S. Vlaeyen, "Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art", Pain, 85(3), pp.317~332 (2000), Ovid Technologies (Wolters Kluwer Health)[DOI]
  33. Watson DH, "Cervical headache: An investigation of natural head posture and upper cervical flexor muscle performance", Cephalalgia, 13(4), pp.272~284 (1993)[DOI]
  34. Thomas Tai Wing Chiu, "Performance of the Craniocervical Flexion Test in Subjects With and Without Chronic Neck Pain", Journal of Orthopaedic &amp; Sports Physical Therapy, 35(9), pp.567~571 (2005), Journal of Orthopaedic & Sports Physical Therapy (JOSPT)[DOI]

관련 논문AI추천

목뼈 부위 감각운동 조절 훈련이 만성 목 통증 환자의 통증과 기능, 심리사회적 수준에 미치는 영향김선엽, In-gi Min한국전문물리치료학회 · 한국전문물리치료학회지2021 · 제28권 제1호목 통증 환자에 운동치료 시 물리치료사의 구두적 및 수동적 자세교정 방법과 자가 운동에 따른 통증, 기능장애, 심리사회적 수준에 미치는 영향 비교: 사전 연구김선엽, 이인수, 이주영대한정형도수물리치료학회 · 대한정형도수물리치료학회지2025 · 제31권 제2호여성 만성 경통 환자에 대한 등척성 운동과 안정화 운동치료의 효과 비교김선엽, 오덕원한국전문물리치료학회 · 한국전문물리치료학회지2008 · 제15권 제2호뼈 가동성 운동이 기계적 목통증 환자의 목등뼈부 기능 수준과 자세, 통증 수준에 미치는 영향김선엽, 이화정한국전문물리치료학회 · 한국전문물리치료학회지2019 · 제26권 제3호자가 운동이 만성 목 통증 환자의 관절가동범위, 근력, 근 긴장도와 경직도, 목장애지수 및 삶의 질에 미치는 영향박건영, 변용현한국레저사이언스학회 · 한국레저사이언스학회지2025 · 제16권 제4호Comparison of three different exercise trainings in patients with chronic neck pain: a randomized controlled studyBegum Kara Kaya, Besta Hazal Gumuscu, Eylul Pinar Kisa, Rasmi Muammer대한통증학회 · The Korean Journal of Pain2023 · 제36권 제2호

이 간행물의 다른 논문 (8건)

무릎 각도의 차이에 따른 불안정 지지면에서의 스쿼트훈련이 건강한 성인의 균형 능력에 미치는 영향홍현표, 최태석, 유병호pp. 1-11가쪽위관절융기 통증 환자에서 복합 부위와 단일 부위에 기능적 마사지와 스트레칭을 적용할 때 통증, 압통 역치와 악력에 미치는 영향신의주, 전재국, 정민근pp. 13-22관절가동술과 근력강화운동이 앞쪽머리자세 환자의 목기능과 근긴장도에 미치는 영향김진영, 송현승, 최정연pp. 23-30허리 안정화 운동과 병행한 엉덩근육 강화 운동이 제왕절개 분만 후 만성허리통증을 가진 여성의 통증, 기능장애지수, 산후우울증에 미치는 영향손민지, 이명호, 김명권pp. 31-42척주세움근의 스트레칭 후 초음파 적용이 정상 성인의 허리 유연성에 미치는 영향최원제pp. 55-61
원문 보기