재활운동프로그램이 요통산재근로자의 통증과 염증지표에 미치는 영향
Effects of Rehabilitation Exercise Program on Back Pain and Inflammatory Markers in Workers with Occupational Low Back Pain
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연구배경: 염증반응은 요통을 유발하는 원인 중 하나로 밝혀지고 있다. 규칙적인 운동은 염증감소에 효과적인 것으로 알려져 있으나 운동이 요통 환자들의 혈중 염증지표들과 통증에 미치는 영향에 관한 연구는 매우 부족한 실정이다. 따라서 이 연구의 목적은 요통산재근로자들을 대상으로 8주간 재활운동 프로그램 실시 전후의 요통수준과 혈중 염증지표들인 C-reactive protein (CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6) 수준 등에 변화가 있는지를 조사하는 데 있다. 방법: 요통산재요양을 마친 남자 근로자들 15명으로 구성된 운동군의 피험자들을 대상으로 8주간의 복합 운동프로그램을 실시하였다. 대조군은 요통이 없는 건강한 남성들 11명으로 구성되었다. 모든 피험자를 대상으로 프로그램 실시 전후에 허리유연성, hs-CRP, IL-1β, IL-6과 시각적 통증평가표에 의한 요통수준을 측정하였다. 결과: 운동군의 경우 운동프로그램 실시 후 혈중 염증지표들 중 CRP 수준만 유의하게 감소한 것으로 나타났으며(P<0.05), IL-1β와 IL-6 수준에서 유의한 차이는 나타나지 않았다. 또한 운동군에서 통계적으로 유의한 통증의 감소(P<0.05)와 유연성의 증가(P<0.001)를 보였다. 대조군에서는 모든 측정치에서 통계적으로 유의한 변화가 나타나지 않았다. 결론: 요통근로자에게서 운동은 혈중 CRP 양과 요통의 감소 및 유연성 향상을 가져왔다. 이는 요통 환자에게서 운동의 염증감소 효과가 통증감소와 체력향상과 관련되어 있음을 나타내는 것으로 사료된다.
Abstract
Background: Inflammation may be one mechanism that causes low back pain (LBP). Although regular exercise has an anti-inflammatory effect, little is known about the effects of exercise on serum inflammatory markers and back pain in patients with LBP. The aim of this study was to investigate the effects of an 8-week exercise intervention on back pain and serum C-reactive protein (CRP), interleukin-1β (IL-1β), and interleukin-6 (IL-6) levels in automotive workers with LBP. Methods: Male workers (n=15) with LBP completed an 8-week multi-component exercise program. Age-matched healthy men (n=11) without back pain served as the control group (CG). Levels of serum inflammatory markers, back flexibility, and back pain using a visual analogue scale were measured at baseline and after the 8-week intervention. Results: After 8 weeks, serum CRP levels were lower compared with baseline (P<0.05) in the exercise group (EG), whereas IL-1β and IL-6 levels were not significantly changed. Back flexibility improved (P<0.001) and back pain decreased (P<0.05) in the EG. No significant changes occurred in back pain, back flexibility, and serum inflammatory marker levels in the CG over the same period. Conclusions: CRP and back pain were both reduced and back flexibility improved with exercise in subjects with LBP suggesting that exercise may play a role in reducing inflammation in subjects with LBP. This would lead to improvement in pain and physical function.
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