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자세 안정화 운동 프로그램이 척수장애인의 흉추 가동범위, 호흡 기능, 통증 및 우울감에 미치는 효과

The effect of a stabilization exercise program on thoracic mobility, respiratory function, pain and depression of an individual with spinal cord injury

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한국특수체육학회 (Korean Society Of Adapted Physical Activity)|2024.12|한국특수체육학회지 (Korean Journal of Adapted Physical Activity)|제32권 제4호|pp. 183-198|DOI 10.17006/kjapa.2024.32.4.183

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키워드

우울DepressionPain통증폐기능Respiratory functionStructural deformation구조적 변형흉추 가동범위Thoracic spine range of mobility

초록

척수손상으로 인해 유발되는 자세의 구조적 변형은 일차적으로 흉추의 가동범위 감소에 영향을 미치고 과후만(hyperkyphosis)의 원인이 된다. 과후만은 간접적으로 호흡 기능을 비롯한 폐 기능의 감소, 만성적인 경부/흉부의 통증, 우울감의 증가를 유발한다고 보고된다. 따라서, 본 연구의 목적은 척수장애인의 자세에 관련된 구조적 변형에서 기인한 문제를 개선하기 위해 자세 안정화 운동 프로그램이 그들의 흉추 가동범위와 호흡 기능, 만성적인 경부/흉부의 통증 및 우울감에 미치는 효과를 알아보는 것이다. 자료수집을 위해 21명의 성인 척수장애인을 편의추출법을 통해 모집하였고, 각각 12명을 실험집단, 9명을 통제집단에 무선배치하였다. 자세 안정화 운동 프로그램은 주 2회, 회당 75분, 총 8주간 진행하였다. 혼합선형모형(linear mixed modeling)을 이용한 분석 결과, 흉추 가동범위에서 시간에 따른 주효과Δ사후-사전=20.96°, p=.003와 시간과 집단의 상호작용효과가 있는 것으로 나타났다. 하지만, 호흡 기능, 통증, 우울감은 통계적으로 유의미한 변화가 나타나지 않았다. 이러한 결과는 중재가 여러 해부학적인 면을 고려하지 못하고 시상면에서의 움직임에만 집중되었기 때문으로 판단된다. 또한, 직접적인 유산소성 중재의 부재가 연구 결과에 영향을 미친 잠재적인 한계점으로 판단된다. 결론적으로, 8주간의 자세 안정화 운동은 척수장애인의 흉추 가동범위를 증진할 수 있을 것으로 기대되나, 호흡 기능, 통증 및 우울감의 세 변인에 유의미한 변화를 끌어내기 위해서는 여러 해부학적인 면을 고려하며, 유산소성 중재가 포함된 복합운동이 필요할 것으로 사료된다.

Abstract

Structural deformation of posture induced by spinal cord injury primarily reduces the range of motion of the thoracic spine and causes hyperkyphosis. Hyperkyphosis may indirectly cause a decrease in lung function including respiratory function, chronic neck/thoracic pain, and an increase in depression. Therefore, the purpose of this study was to investigate the effects of a postural stabilization exercise program on thoracic spine range of motion, respiratory function, chronic neck/thoracic pain, and depression in order to improve problems resulted from structural deformities related to the posture of people with spinal cord injury. To collect data, 21 adults with spinal cord injury were recruited through convenience sampling. They were randomly assigned to an experimental group of 12 people and a control group of 9 people, respectively. The postural stabilization exercise program was conducted twice a week, 75 minutes per session, for a total of 8 weeks. Linear mixed modeling showed that there was a main effect of time (Δpost-pre: 20.96°, p=.003) and an interaction effect of time and group (p=.03) in thoracic spine range of motion. However, there were no statistically significant changes in respiratory function, pain, and depression. The potential reason would be that the intervention failed to consider various anatomical aspects and focused only on movements in the sagittal plane. Additionally, the absence of aerobic intervention is considered a study limitation. In conclusion, 8 weeks of postural stabilization exercise is expected to improve the range of motion of the thoracic spine in people with spinal cord disability. However, in order to have a significant effect on the respiratory function, pain, and depression, several anatomical aspects must be considered and a multicomponent exercise program, including aerobic intervention, should be planned and implemented.

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