비특이적 목 통증을 가진 환자의 상부 흉추에 관절가동술과 자가관절운동을 적용 했을 때 통증과 기능에 미치는 영향
The effect of Upper Thoracic Spine Mobilization and Self-mobilization Exercise on Pain and Function of Non-Specific Neck Pain patients
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초록
본연구는비특이적목통증(Non-specific Neck Pain, NNP)을가진성인을대상으로상부흉추관절가동술과자가관절운동의병행적용이통증감소, 경추관절가동범위(ROM) 개선및기능향상에미치는영향을확인하고자하였다. 대한민국대구소재D정형외과를내원한만성목통증환자중선정기준을충족한30명을대상으로무작위대조군실험(Randomized Controlled Trial)을수행하였다. 실험군(n=15)은상부흉추관절가동술과자가관절운동을병행적용하였고, 대조군(n=15)은관절가동술만적용받았다. 운동중재는칼텐본웨지를이용해바로누운자세또는엎드린자세에서상부흉추움직임을증진시키기위한관절가동술과자가관절운동으로구성되었고, 3회/1주, 4주간연구자가직접운동지도를하며정확한자세를피드백하였다. 운동중재에대한평가지표로는시각적상사척도(Visual Analogue Scale, VAS), 경추관절가동범위(Baseline Bubble Inclinometer), 목장애지수(Neck Disability Index, NDI)를사용하였다. 연구결과는두군모두중재후VAS, ROM, NDI에서유의한향상을보였다(p<.05). 그룹간비교결과는실험군이통제군에비해통증, 굽힘/폄/측면굽힘및회전등의관절가동범위, 그리고NDI의변화량에서유의한결과를보여주었다(p<.05). 이것은상부흉추에대한관절가동술과자가관절운동의병행적용은NNP를가진성인의통증감소와관절가동범위및기능향상에효과적인중재임이확인되었다. 따라서본중재는비특이적목통증환자를위한통합적물리치료접근법으로서임상적활용가능성이높으며, 향후장기효과와다양한연령층을포함한후속연구가필요하다.
Abstract
This study aimed to investigate the effects of combining upper thoracic joint mobilization and self-mobilization exercises on pain reduction, cervical range of motion (ROM), and functional improvement in adults with non-specific neck pain (NNP). A randomized controlled trial was conducted with 30 adults diagnosed with chronic NNP who met the inclusion criteria at an orthopedic clinic in Daegu, South Korea. Participants were randomly assigned to either the experimental group (n = 15), which received both upper thoracic mobilization and self-mobilization exercises, or the control group (n = 15), which received only joint mobilization. Interventions were administered three times per week over a four-week period. Outcome measures included the Visual Analogue Scale (VAS) for pain, cervical ROM assessed with a Baseline Bubble Inclinometer, and the Neck Disability Index (NDI) for functional disability. Both groups showed significant improvements in VAS, ROM, and NDI scores after the intervention (p < .05). However, the experimental group demonstrated significantly greater improvements in pain reduction, flexion/extension, lateral bending, rotation ROM, and NDI compared to the control group (p < .05). The combined application of upper thoracic joint mobilization and self-mobilization exercises proved to be an effective intervention for reducing pain and improving cervical ROM and functional outcomes in adults with NNP. Therefore, this integrated intervention shows high clinical utility as a physical therapy approach for patients with non-specific neck pain. Further research, including long-term follow-up and a broader age range, is warranted.