시각장애인의 치료안마 수기가 요통환자의 통증, 유연성 및 신경근기능에 미치는 영향
Effects of Therapeutic An-Ma Manipulative Therapy on Pain, Flexibility, and Neuromuscular Function in Patients with Low Back Pain
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본 연구의 목적은 시각장애인의 치료안마수기가 요통환자의 요부 통증과 신경근기능에 미치는 영향을 규명하는데 있다. 이를 위하여 요통환자를 안마치료군(N=15)과 경피신경전기자극치료군(N=16)에 무작위 배정하여, 주 2회 5주간 치료하였다. 치료 전과 후에 요통장애지수와 유연성을 측정하였고, 5개의 각도에서 등척성 신전근력, 근활성도와 근피로도를 평가하였다. 자료는 반복측정 이원분산분석으로 분석하여 측정시기 또는 상호작용이 유의할 경우, 각 집단 내 차이를 종속 t-검정으로 검증하였다. 종속 t-검정 결과 요통장애지수는 안마치료군에서만 유의하게 감소하였으며(p<.01), 유연성과 근력은 두 집단 모두에서 유의하게 향상되었다(모두 p<.05). 135°에서 요추 1번 우측과 120°와 135°에서 요추 5번 좌측 근육의 근활성도는 안마치료군에서만 유의하게 향상되어(모두 p<.05), 안마치료군에서는 근활성도가 허리 상하부 모두에서 유의하게 증가하였다(p<.05). 근피로도는 요추 5번 좌측에서 전기치료군에서 대부분 유의하게 감소하였다(p<.05). 결론적으로 본 연구 결과 안마치료가 더 효과적이라고 여겨진다.
Abstract
The aim of this research was to investigate the effect of An-Ma manipulative therapy on back pain and neuromuscular functions in patients with low back pain. Thirty-one patients with low back pain were randomly assigned to the An-Ma group (N=15) or transcutaneous electrical nerve stimulation (TENS) group (N=16) and received the An-MA or TENS therapy two times a week for 5 weeks. Before and after intervention Oswestry disability index (ODI), lumbar flexibility, isometric extension strength, muscle electromyographic activity, and muscle fatigue were measured. Data was analyzed using two-way repeated-measure ANOVA. When main effect for time or interaction effect was statistically significant, the within-group differences were analyzed using paired t-tests. According to paired t-tests, ODI was significantly decreased only in the An-Ma group (p<.01). Lumbar flexibility and strength were significantly improved in both groups (all p<.05). At 135° on the right side of the first lumbar spine and at 120° and 135° on the left side of the fifth lumbar spine, muscle activities were significantly increased only in the An-Ma group (all p<.05). In the An-Ma group muscle activities were significantly increased both in the upper and lower parts of the lumbar regions (all p<.05). In addition, according to paired t-tests the magnitudes of muscle fatigue were significantly reduced only on the left side of the fifth lumbar spine mostly in the TENS group (all p<.05). In conclusion, our results suggest that the An-Ma and TENS therapies both may be effective for alleviating low back pain, but the An-Ma manipulative therapy might be more effective.
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