Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Muscle Stiffness and Elasticity Related to Physical Therapeutic Modalities

물리치료에 따른 근육의 경도와 탄성도 비교

  • Kim, Sung-Hwan (Department of Oral Medicine, School of Dentistry, Dankook University) ;
  • Kim, Mee-Eun (Department of Oral Medicine, School of Dentistry, Dankook University)
  • 김성환 (단국대학교 치과대학 구강내과학교실) ;
  • 김미은 (단국대학교 치과대학 구강내과학교실)
  • Published : 2007.09.30
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Abstract

The purpose of this study was to quantitatively assess treatment effect of physical therapy on experimentally-induced masseter muscle fatigue by two parameters of muscle stiffness and elasticity. Three physical therapeutic modalities inducing electroacupunture stimulation therapy(EAST), Microwave diathermy and low-level laser therapy(LLLT) were compared. 10 healthy volunteers with normal occlusion (mean age of $26.3{\pm}1.16$ years, M:F=1:1) were participated in this study. All subjects were asked to chew gum on the right side until they felt pain(more and VAS 5 (0 to 10)) and their masseter muscles were examined with a tactile sensor in order to evaluate changes of stiffness and elasticity according to gum chewing and three physical therapeutic modalities. Subjective discomfort or pain was self-estimated by VAS as well. Unilateral gum chewing increased stiffness and decreased elasticity only on the chewing side but VAS increased on the both sides(p<0.05). EAST or Microwave diathermy greatly decreased stiffness and VAS and increased elasticity(p<0.05) but LLLT did not exhibit significant difference. From the results of this study, it is concluded that both EAST and Microwave diathermy have favorable effect on stiffness and elasticity of muscles and pain relief while effect of LLLT is not reliable. In addition, experimental unilateral gum chewing compromises stiffness and elasticity of masseter muscles only the chewing side while subjective discomfort or pain can be felt on the both sides.

본 연구는 근육의 경도와 탄성도를 측정하여 교근 피로에 대한 물리치료의 효과를 정량적으로 평가하고자 하였으며, 측두하악장애 치료에 가장 흔히 사용되는 물리치료이면서 작용기전은 서로 다른 세 가지 치료법인 전기침자극치료(EAST), 극초단파(Microwave diathermy), 저수준레이저치료(LLLT)의 효과를 비교하였다. 실험을 위하여 건강한 20대 지원자 10명을 선정하여, 교근의 전부와 하부의 근육 경도와 탄성도를 촉각센서로 측정하였다. 실험적으로 교근 피로를 유발하기 위해 피검자가 VAS (0 to 10) 5 이상의 통증을 느낄 때까지 껌을 씹게 하여 근육 변화를 조사하였으며 치료 없이 15분간의 휴식을 준 다음 다시 검사하여 물리치료 후의 효과 비교를 위한 대조군으로 사용하였다. 하루 간격으로 사흘에 걸쳐 동일한 시간 동안 껌을 씹게 한 다음, 물리치료 한 가지씩을 매일 시행하였으며 3가지 물리치료법의 적용 순서는 무작위로 하였다. 껌 저작 전, 직후, 15분 후, 각각의 물리치료 시행 후에 근육 경도와 탄성도 측정과 함께 피검자들이 느끼는 근육의 피로도를 VAS로 평가 하도록 조사하였다. 실험 결과, 저작측에서만 껌 저작 직후와 15분 후에 근육경도의 증가와 탄성도의 감소가 관찰되었으며 (p<0.05) 비저작측에서는 유의한 차이가 없었으나 VAS는 저작측과 비저작측 모두에서 증가하였다(p<0.05). 껌 저작으로 인해 변화되었던 근육경도와 탄성도는 전기침자극치료나 극초단파 치료 후에 효과적으로 회복되고 VAS가 감소했으나(p<0.05) 저수준레이저 치료 후에는 유의한 변화를 보여주지 않았다. 이상의 결과로 보아, 편측 저작은 저작측 근육의 경도를 증가시키고 탄성도는 감소시키는 반면, 비저작측에서는 변화가 없는 것을 알 수 있다. 또한 전기침자극치료와 극초단파치료는 모두 근육의 경도를 감소시키고 탄성도를 증가시켜 근육의 피로를 감소시키는데 효과적인 치료법인데 반해 저수준레이저치료의 효과는 미약한 것으로 판단된다.

Keywords

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