상부흉추 자가관절운동이 전방머리자세 성인의 목 통증 및 정렬에 미치는 영향
Effects of Upper Thoracic Self-Mobilization exercise on Neck Pain and Postural Alignment in Adults with Forward Head Posture
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초록
본연구는전방머리자세(Forward Head Posture, FHP)를가진성인을대상으로상부흉추에대한 관절가동술과자가관절운동을병행적용하였을때, 경부통증감소, 정렬지표(CVA, CRA) 개선, 및 기능장애(NDI) 변화에미치는효과를분석하고자하였다. 대한민국대구소재정형외과에내원한 만성목통증환자30명을대상으로무작위대조군실험(Randomized Controlled Trial, RCT)을 실시하였다. 실험군(n=15)은 상부흉추 관절 가동술(Upper Thoracic Mobilization, UTM)과 자가관절운동(Upper Thoracic Self-Mobilization Exercise, UTSE)을병행하였고, 대조군(n=15)은 관절가동술만적용하였다. 중재는주3회, 4주간시행되었으며, 통증(VAS), 정렬지표(CVA, CRA), 기능장애(NDI)를사전·사후로평가하였다. 실험군과대조군모두중재후통증, CRA, NDI가 유의하게감소하였고, CVA는유의하게증가하였다(p < .05). 군간비교에서는실험군이대조군에 비해CVA와NDI에서유의한개선을보였으며(p < .05), CRA는두군모두개선되었으나그룹간 유의한차이는나타나지않았다. 상부흉추에대한관절가동술과자가관절운동의병합은FHP의 정렬개선, 경부통증감소, 기능향상에효과적인중재로나타났다. 비교적짧은중재기간에도 유의한변화가확인되었으며, 이는수동적·능동적접근의통합이임상적으로유용한치료전략이 될수있음을시사한다.
Abstract
This study investigated the effects of combined upper thoracic mobilization (UTM) and self-mobilization exercise (UTSE) on neck pain, posture (CVA, CRA), and functional disability (NDI) in adults with forward head posture (FHP). A randomized controlled trial was conducted with 30 adults suffering from chronic neck pain who visited an orthopedic clinic in Daegu, South Korea. Participants were randomly assigned to either the experimental group (n = 15), which received both UTM and UTSE, or the control group (n = 15), which received UTM alone. The intervention was conducted three times per week over four weeks. Outcome measures, including Visual Analogue Scale (VAS), Cranial Vertebral Angle (CVA), Cranial Rotation Angle (CRA), and Neck Disability Index (NDI), were assessed pre- and post-intervention. Both groups showed significant improvements in VAS, CRA, and NDI, as well as significant improvements in CVA after the intervention (p < .05). Between-group comparison revealed significantly greater improvements in CVA and NDI in the experimental group than in the control group. However, no significant between-group difference was observed in CRA, despite within-group improvements. The combined application of UTM and UTSE was effective in improving postural alignment, reducing neck pain, and enhancing functional status in individuals with FHP. The results suggest that an integrated approach involving both passive and active mobilization strategies can be a clinically useful intervention even within a short intervention period.