편평등 증후군 환자의 교정운동 프로그램이 척추구조 변화와 자세균형 능력에 미치는 영향

Abstract

국문요지

편평등 증후군 환자의 교정운동 프로그램이 척추구조 변화와 자세균형능력에 미치는 영향.

서영삼 한양대학교 대학원 스포츠과학과

이 연구는 척추 편평등 증후군 환자에게 12주간 교정운동 프로그램을 적용하여 신체조성, 척추구조(경추 전만곡, 흉추 후만곡, 요추 전만곡, 경추 위치각, 어깨 위치각, 골반 위치각) 형태적 변위 변화와 자세균형 및 목 장애지수(NDI)에 미치는 영향을 규명하여 교정운동 프로그램의 효과를 검증하고 나아가 본 운동프로그램이 편평등 증후군 환자의 개선방안 기초자료로 제공하는데 이 연구의 목적이 있다. 통계처리는 PASW Statistics 18.0을 이용하여 모든 자료의 기술 통계치를 산출한 뒤, 집단과 시기에 따른 종속변인의 차이를 알아보기 위해 Two-way ANOVA를 실시하여 상호작용이나 주 효과가 유의한 경우, 사후에 대한 집단 간 차이는 One-way ANOVA를 실시할 것이고 통계적 유의차가 발생할 경우 Tukey의 사후검증을 실시할 것이며, 집단 내 시기별 차이는 Paired samples t-test를 실시할 것이다. 모든 통계적 유의 수준은 p<.05로 할 것이다. 본 연구의 측정된 결과를 종합하여 다음과 같은 결론을 도출하였다.

1. 신체조성 신체조성의 변화는 체중(kg)과 체질량 지수(BMI), 체지방율(%)은 집단과 시기에서의 교호작용과 주 효과, 집단 내 시기 모두 통계적 유의한 차이가 나타나지 않았다.

2. 목 장애지수(NDI) 집단과 시기 모두 유의한 차이가 있는 것으로 나타났으며(p<.001), 시기에서는 12주간 처치 후 물리치료군(p<.5), 저항운동군(p<.01), 교정운동군(p<.001) 통계적으로 유의하게 감소한 것으로 나타났고 집단 간에도 유의한 차이가 나타났다(p<.001). 사후 검증 결과 교정운동군과 물리치료군 간에 유의한 차이가 나타났다(p<.05).

3. 경추 전만각 집단과 시기 모두 유의한 차이가 있는 것으로 나타났다(p<.001). 시기에서는 교정운동군에서 유의하게 감소하는 것으로 나타났다(p<.01). 집단 간에서 유의한 차이가 발생했으며(p<.05), 사후검증결과 저항운동군과 물리치료군에서 유의한 차이가 나타났고((p<.01), 교정운동군과 물리치료군에서도 유의한 차이가 나타났다(p<.001).

4. 흉추 후만각 집단과 시기 모두 유의한 차이가 있는 것으로 나타났다(p<.01). 시기에서는 교정운동군에서 유의하게 감소한 것으로 나타났다(p<.01). 집단 간에는 유의한 차이가 발생했으며(p<.05, ) 사후검증결과 교정운동군과 물리치료군 비교하여 유의한 차이를 나타냈다(p<.01).

5. 요추 전만각 집단과 시기 모두 유의한 차이가 나타났다(p<.001). 시기에서는 물리치료군(p<.001)과 교정운동군(p<.01)에서 유의하게 감소한 것으로 나타났다. 집단 간에는 유의한 차이가 발생했으며(p<.001), 사후검증결과 저항운동군과 물리치료군 비교하여 유의한 차이가 나타났고(p<.001) 교정운동군과 물리치료군 비교하여 유의한 차이가 나타났다(p<.001).

6. 경추 위치각 집단과 시기 모두 유의한 차이가 있는 것으로 나타났다(p<.001). 시기에서는 교정운동군에서 유의하게 감소한 것으로 나타났다(p<.001). 집단 간에는 유의한 차이가 발생했으며(p<.01), 사후검증결과 교정운동군과 물리치료군 비교하여 유의한 차이가 나타났고(p<.01), 교정운동군과 저항운동군 비교하여 유의한 차이가 나타났다(p<.01).

7. 어깨 위치각 집단과 시기의 교호작용(p<.001)과 시기의 주 효과(p<.001) 집단의 주 효과(p<.05) 모두 유의한 것으로 나타났다. 시기에서는 저항운동군(p<.05)과 교정운동군(p<.01)에서 유의하게 감소하였으며, 집단 간에서는 유의차가 발생하였으며(p<.01), 사후검증결과 교정운동군과 물리치료군과 비교하여 유의한 차이가 나타났고(p<.01), 교정운동군과 저항운동군 비교하여 유의한 차이가 나타났다(p<.05).

8. 골반 위치각 집단과 시기 모두 유의한 것으로 나타났다(p<.001). 시기에서는 저항운동군과 교정운동에서 유의하게 감소하였으며(p<.01), 집단 간에서도 유의차가 발생했으며(p<.01), 사후검증결과 교정운동군과 물리치료군과 비교하여 유의차가 나타났으며(p<.001), 교정운동군과 저항운동군 비교하여 유의한 차이가 나타났다(p<.001).

9. 자세균형능력 집단과 시기의 교호작용(p<.001), 시기의 주 효과(p<.001)와 집단 주 효과(p<.05)에서 유의한 것으로 나타났다. 시기에서는 교정운동군에서 유의하게 감소한 것으로 나타났다(p<.01). 집단 간에서는 유의차가 발생했으며(p<.001), 교정운동군과 물리치료군과 비교하여 유의한 차이가 나타났으며 교정운동군과 저항운동군 비교하여 유의한 차이를 타나냈다(p<.01).

이상의 연구 결과를 종합하면 편평등 증후군 환자의 교정운동 프로그램 적용이 척추구조 변위 변화와 목 장애지수, 자세균형능력에 긍정적인 영향을 미치는 것으로 나타났다. 물리적 치료나 저항운동방법도 비교적 통증감소에는 긍정적이었으나 증상개선을 위한 척추구조를 비롯한 자세균형능력 변화에 맞춤형 교정운동 프로그램 적용이 효과적임을 알 수 있었다.; Abstract

The effects of thoracolumbar junction corrective exercise program on spinal curvature structural change and posture balance for chronic back pain patients with flat back syndrome .

Seo Young Sam Graduate Schol in Hanyang University Department of Sports Science

On this study, a correction exercise program was applied to patients with flat back syndrome for 12 weeks. Verifying the effects of the program by finding the changes of body composition, morphological displacement of vertebration(cervical lordosis, thoracic kyphosis, lumbar lordosis, cervical position angle, shoulder position angle, pelvic position angle), static posture balance, and neck discomfort index (NDI), the goal of this study is to suggest basic data for improving the patients with flat back syndrome.

Statistics were treated by using the PASW Statistics 18.0 to produce descriptive statistics through data. Two-way AVOVA was performed to find the dependent variables according to groups and times, when interaction and main effects were significant. One-way ANOVA was done to find the change of the groups after applying this exercise program. Posteriori tests of Turkey was taken when statistical differences were significant. Paired sample t-tests were taken to show the differences between times in a group. All significance level of statistics are p<.05. The following conclusions are drawn by putting the measured results of this study together.

1. Body Composition

The changes of body composition were measured with the differences of body weight (kg), body mass index (BMI), percentage of body fat (%). Statistically, they were not meaningful when interaction between groups and times, main effects, and the times in a group were measured.

2. Neck Discomfort Index (NDI)

Significant differences were shown between groups and times (p<.001). Statistically, NDI meaningfully decreased according to times. The indexes in the group of physical therapy (p<.5), the group of resistance exercise (p<.01), and the group of correction exercise (p<.001) decreased after having been treated for 12 weeks.

3. Cervical Lordosis

Meaningful differences were shown between groups and times (p<.001). According to the times, the group of correction exercise showed significant decrease. Important changes were also evident for all groups (p<.05). The results of posteriori tests showed that the differences were meaningful in the group of resistance exercise and physical therapy (p<.01). Meaningful differences also appeared in the group of correction exercise and physical therapy. (p<.001)

4. Thoracic Kyphosis

Important differences were shown between groups and times (p<.01). According to the times, meaningful decreases appeared in the group of correction exercise (p<.01). Significant differences were noticed between all groups. (p<.05). The results of posteriori tests showed that the differences were meaningful by comparing with the group of correction exercise and physical therapy (p<.01).

5. Lumbar Lordosis

The differences were significant in groups and times (p<.001). According to the times, meaningful decreases appeared in the group of physical therapy (p<.001) and correction exercise (p<.01). Important changes happened between groups (p<.001). The results of posteriori tests suggested that the differences were meaningful by comparing the group of resistance exercise with the group of physical therapy (p<001), and significant differences were also apparent by comparing the group of correction exercise with the group of physical therapy (p<.001).

6. Cervical Position Angle

The differences were meaningful in groups and times (p<.001). According to the times, they decreased significantly in the group of correction exercise (p<.001). Explicit changes happened between groups p(<.01). The results of posteriori tests showed that the differences were clear by comparing the group of correction exercise with the group of physical therapy (p<.01), and meaningful changes were also apparent by comparing the group of correction exercise with the group of resistance exercise.

7. Shoulder Position Angle

The differences were meaningful in the interaction between groups and times (p<.001), the main effects of the times (p<.001), and the main effects of the groups (p<.05). According to the times, significant decreases were appeared in the group of resistance exercise (p<.05) and the group of correction exercise (p<.01). Explicit changes were evident between the groups (p<.01). The results of posteriori tests said that differences were meaningful by comparing the group of correction exercise with the group of physical therapy (p<.01), and significant differences were also appeared by comparing the group of correction exercise and the group of resistance exercise (p<.05).

8. Pelvic Position Angle

Meaningful differences were shown in groups and times (p<.001). According to the times, the decreases were significant in the groups of resistance exercise and correction exercise (p<.01). Explicit changes were seen between groups (p<.01) The results of posteriori tests showed that the differences were meaningful by comparing the group of the correction exercise with the group of physical therapy (p<.001), and they were also significant by comparing the group of the correction exercise with the group of the resistance exercise (p<.001).

9. Posture Balance Ability

The differences were significant in the interaction between groups and times (p<.001), the main effects of times (p<.001), and the main effects of groups (p<.05). According to times, decreases were meaningful in the groups of correction exercise (p<.01). Explicit changes were seen between the groups (p<.001). The results of posteriori tests showed that meaningful differences were appeared by comparing the groups of correction exercise with the groups of physical therapy, and the changes were also significant by comparing the groups of correction exercise with the group of resistance exercise (p<.01).

Putting the results of this study together, the correction exercise program carried out by chronic back pain patients with flat back syndrome positively affected the changes of spinal curvature structure, neck discomfort index and posture balance. Physical therapy and resistance exercise were also positive in decreasing pains. But, the personalized correction exercise program was the most effective on improving the symptom of the spinal curvature structure and changing the posture balance.