휠체어 추진 속도에 따른 척주의 운동학적 특성 변화에 관한 연구
The Study of Kinematic Characteristics of Spine Column During Wheelchair Propulsion Under Various Speed Conditions
3
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
장애인 및 노인들의 사회 참여와 삶의 질 확보를 위한 이동 수단으로 사용되는 휠체어는 접근성 향상뿐만 아니라, 신체에 나타날 수 있는 이차적 장애를 예방 및 보완하고, 교정하기 위해 가장 보편적으로 사용되는 재활보조도구이다. 그러나 부적절한 휠체어 사용과 저하된 신체 조절 능력 및 휠체어 추진으로 인해 발생된 근피로는 측만증이나 후만증과 같은 이차적 척주 기형을 초래하여 장애인 및 노인들의 잔존 신체 능력을 저하시켜, 삶의 질을 떨어뜨리고 있다. 본 연구의 목적은 휠체어 추진 시 척주의 운동학적 특성 변화를 파악하여 체간 안정성 향상을 위한 기초 자료를 제공하는 것이다. 이를 위해 본 연구에서는 휠체어 사용 경험이 없으며, 상지와 체간에 근골격계 및 신경계, 그리고 심혈관계통의 이상이 없는 건강한 성인 30명을 대상으로 서로 다른 추진 속도(0.65m/s, 1.0m/s, 1.35m/s)에서 휠체어를 추진하는 동안 각 척주 분절의 전ㆍ후 및 좌ㆍ우 움직임 변화를 분석하였다. 그 결과, 경추, 흉추, 그리고 요추 분절의 시상면 상의 전ㆍ후 움직임은 추진 속도에 따라 유의한 변화를 보였다(p<.05). 반면, 전두면상의 좌ㆍ우 움직임은 요추 분절에서만 유의한 변화를 나타냈다(p<.05). 그러므로 휠체어 추진 속도는 각 척주 분절의 전ㆍ후 및 좌ㆍ우 움직임에 영향을 미쳐 체간 안정성 변화를 야기시키는 것으로 사료된다. 이상의 결과로 미루어 볼 때, 휠체어 추진 시 추진 속도는 척주의 전ㆍ후 및 좌ㆍ우 움직임 변화에 영향을 미쳐 체간 안정성 변화 요인으로 작용하므로 다양한 중재 방안 마련을 통해 체간의 안정성 확보와 이차적인 위험 요인을 감소시켜야 할 것으로 사료된다.
Abstract
The purpose of this study was to describe the kinematic characteristics of spine column from unimpaired individuals during wheelchair propulsion under various speed conditions. Thirty unimpaired subjects was participated in this study after providing informed consent. Subjects propelled test on a motor-driven wheelchair treadmill under three different speed conditions: 0.65m/s, 1.0m/s and 1.35m/s. Spinal column movement was recorded for each speed condition. This study was investigated about the spinal column movements in the wheelchair propulsion were registered by Sonosence. In order to assure the statistical significance of the results, the one-way ANOVA and independent t-test were applied at the .05 level of significance. The results of this study were as follows. 1. There were statistically significant differences in mSBI value variations of cervical column anterior/posterior movement with wheelchair propulsion speed changes (p<.05). But mFBI value variations of cervical column right/left movement were no statistically different(p>.05). 2. There were statistically significant differences in mSBI value variations of thoracic column with wheelchair propulsion speed changes(p<.05). But mFBI value variations of thoracic column were no statistically different(p>.05). 3. There were statistically significant differences in mSBI value variations of lumbar column with wheelchair propulsion speed changes(p<.05). And mFBI value variations of lumbar column were also statistically different(p<.05). These results suggest that spinal columns during wheelchair propulsion under various speed conditions is essential for the trunk stability, with lower back muscle and lumbar column predominating. To prevent risk from trunk instability, wheelchair users should train lower trunk muscle endurance program and artificially stimulating paralyzed trunk muscles. Moreover, education of propulsion posture and a suitable joint position with customizing wheelchair may improved spinal stability and propulsion performance.
참고문헌 (30)
- 공진용, "휠체어 추진에 따른 근피로 발생이 손목관절과 주관절의 운동학적 특성에 미치는 영향", 박사, pp.2004
- 권혁철, "우리나라 의료재활 전문인력 수요ᆞ공급 및 추세에 관한 연구", 대한물리치료학회지, 9(1), pp.19~35 (1997)
- Baum, K., "Continous monitoring of spine geometry: A new approach to study back pain in space", International journal of sports medicine, 18(S4), pp.331~333 (1997)
- Cailliet, R., "Low back pain syndrome", pp.116~146 (1992), F. A Davis Company
- Curtis, K. A., "Shoulder pain in wheelchair users with tetraplegia and paraplegia", Archives of Physical Medicine and Rehabilitation, 80(4), pp.453~457 (1999)
- Gerard, A., "Occupational Medicine", State of the Art Review: Low Back Pain, 13(1) (1998), Hanley and Belfus, Inc
- Glaser, R. M., "An exercise test to evaluate fitness for wheelchair activity", Paraplegia, 16(4), pp.341~349 (1979)
- Hobson, D. A., "Seated lumbar", pelvic alignment. A comparison between spinal cord-injured and noninjured groups, 1992, pp.17(3), 293~298
- Hughes, C. J., "Biomechanics of wheelchair propulsion as a function of seat position and user-to-chair interface", Archives of Physical Medicine and Rehabilitation, 73(3), pp.263~269 (1992)
- Kim, J., "Seating", wheelchair technology in the developing world: Need for a closer look, 1999, pp.11(2), 21~27
- Latin, R. W, "The accuracy of the ACSM and a new cycle ergometry equation for young women", Medicine & Science in Sports & Exercise, 26(5), pp.642~646 (1994)
- Lindh, M., "Biomechanics of lumbar spine. in: Basic biomechanics of musculoskeletal system, 2nd ed", pp.183~207 (1989), Lea and Febiger
- Norris, C. M., "Function load abdominal training; part 1", Journal of bodywork and movement therapies, 3(3), pp.150~158 (1999)
- Panjabi, M. M., "The stabilizing system of the spine. Part Ⅰ function, dysfunction adaption and enhancement", Journal of Spinal Disorders & Techniques, 5(4), pp.383~389 (1992)
- Parent, F., "Evaluation of the new flexible contour backrest for wheelchairs", Journal of Rehabilitation Research & Development, 37(3), pp.325~333 (2000)
- Rintala, D. H., "Chronic pain in a community-based sample of men with spinal cord injury: prevalence, severity, and relationship with impairment, disability, handicap, and subjective well-being", Archives of Physical Medicine and Rehabilitation, 79(6), pp.604~614 (1998)
- Roders, M. M., "Upper-limb fatigue-related joint power shifts in experienced wheelchair users and nonwheelchair users", Journal of Rehabilitation Research & Development, 40(1), pp.27~38 (2003)
- Rosalind, H., "Wheelchair users and postural seating: A clinical approach", pp.7~9 (1998), Churchill Livingstone
- Rozendal, L. A., "The push force pattern in manual wheelchair propulsion as a balance between cost and effect", Journal of biomechanics, 36(2), pp.239~247 (2003)
- Salvi, F. J., "Physiologic comparison of forward and reverse wheelchair propulsion", Archives of Physical Medicine and Rehabilitation, 79(1), pp.36~40 (1998)
- Samuelsson, K. A., "The effect of rear-wheel position on seating ergonomics and mobility efficiency in wheelchair users with spinal cord injuries: A pilot study", Journal of Rehabilitation Research & Development, 41(1), pp.65~74 (2004)
- Sanderson, D. J., "Kinematic features of wheelchair propulsion", Journal of biomechanics, 18(6), pp.423~429 (1985)
- Shimada, S. D., "Kinematic characterization of wheelchair propulsion", Journal of Rehabilitation Research & Development, 35(2), pp.210~218 (1998)
- Sinnott, K. A., "Factors associated with thoracic spinal cord injury, lesion level and rotator cuff disorders", Spinal Cord, 38(12), pp.748~753 (2000)
- Triolo, R. J, "The effect of functional electrical stimulation during wheelchair propulsion", XXth Congress of the nternational Society of Biomechanics & 29th Annual Meeting of the American Society of Biomechanics (2005), Cleveland
- Vanlandewijck, Y. C., "Wheelchair propulsion efficiency: movement pattern adaptations to speed changes", Medical Science in Sports Exercise, 26(11), pp.1373~1381 (1994)
- Vanlandewijck, Y. C, "Wheelchair propulsion biomechanics", Sports Meicine, 31(5), pp.339~367 (2001)
- Veeger, H. E. J., "Wrist motion in handrim wheelchair propulsion", Journal of Rehabilitation Research & Development, 35(3), pp.305~313 (1998)
- Wei, S. H, "Wrist kinematic characterization of wheelchair propulsion in various seating position: implication to wrist pain", Clinical biomechanics, 18(6), pp.S46~S52 (2003)
- Yang, Y. S., "Effect of functional electrical stimulation on trunk musculature during wheelchair propulsion", 박사, pp.2005