머리-목굽힘검사 시 통증 유무에 따른 표층 및 심부 목 굽힘근의 두께 비교연구
Comparison of muscles thickness of deep and superficial neck flexors between University students with and without neck pain during cranio-cervical flexion test
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초록
목통증은 신경근동원의 체계를 변화시켜 정상적인 목 주변 근육의 활성과 근동원 패턴을 어렵게 한다고 보고된다. 따라서 본 연구의 목적은 목통증을 가진 사람들을 대상으로 머리-목굽힘검사(CCFT, cranio-cervical flextion test)시 머리-목굽힘검사시에 나타나는 통증군과 대조군의 목 굽힘근 두께를 비교하여 목굽힘근(neck flexor)들의 근육 동원 패턴을 이해하는 것이다. 목통증이 없는 17명의 대학생과 목통증을 경험하고 있는 17명의 대학생을 대상자로 선정하였다. 대상자들의 목 굽힘근 동원 패턴을 알아보기 위해서 머리-목굽힘검사 동안 초음파 측정을 통해 목굽힘근 근육의 두께변화를 측정하였다. 두 집단 모두에서 머리-목굽힘검사 시 압력의 증가에 따라 근 두께 변화량의 증가를 보였으며 목빗근(sternoclavicle muscle)의 근두께 변화량은 통증군이 비통증군에 비해 더 큰 증가량을 보였고, 심부 목굽힘근(deep neck flexors)의 근두께 변화량은 비통증군이 통증군에 비해 더 큰 증가량을 보였다. 결과분석을 바탕으로 목통증을 가진 사람들은 그렇지 않은 사람들에 비해 심부목굽힘근의 활성능력이 떨어지고 그 보상으로 인한 표층목굽힘근의 과활성을 확인 할 수 있엇다. 이에 목 통증을 가지는 사람을 위한 운동처방에서 심부목굽힘근의 활성을 유도할 수 있는 운동법이 제시되어야 할 것이다.
Abstract
The purpose of this study is to analyse the recruitment pattern of the neck flexor muscle during bothe the CCFT and the arm movement with CCFT. Using a cross-sectional design, the study was performed in an experimental group of 17 subjects (8 male, 12 female) with cervical pain and in an control group of 17 subjects (11 male, 9 female) with no cervical pain. Participants were instructed to perform the CCFE, and during the five incremental stages of the test, changes in thickness, as compared to resting baseline values, were measured using ultrasonography for sternocleidomastoid muscle (SCM) and deep cervical muscles (DCF). In analysis by ultrasonographic measurment, there was an increase in DCF and SCM recruitment with each progressive phase of the CCFT. Statistically significant difference were found between control group and experimental group in both DCF and SCM. In change of muscle thickness, experimental group had higher measures of change of SCM thickness compared to the control group, on the other hand control group had higher measures of change of DCF thickness compared to the experimental group. According to the results of this study, there was a strong trend for greater muscle activity in the SCM as compensation of poor activity of DCF in the neck pain group during the CCFT.
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