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The effects of deep neck flexor exercise on pain and neck disability index of the patients with chronic neck pain

심부목굽힘근 운동이 만성 목통증 환자의 통증과 기능에 미치는 영향

  • Lee, Gyu-Chang (Dept. of Physical Therapy, Graduate school of Sahmyook University) ;
  • Lee, Dong-Yeop (Dept. of Physical Therapy, Sunmoon University)
  • 이규창 (삼육대학교 대학원 물리치료학과) ;
  • 이동엽 (선문대학교 물리치료학과)
  • Received : 2010.08.11
  • Accepted : 2010.11.19
  • Published : 2010.11.30

Abstract

This study was to investigate the effectiveness of deep neck flexor exercise with using modalities in pain reduction and functional improvement to those who have chronic neck pain. The subjects were instructed the patients with chronic neck pain (37 people). Randomized study design of two groups was used: Only using modalities group and deep neck flexor exercise group with using modalities, and each group was taken by three times per week for 12 weeks. To evaluate the effects of therapies was to research the questionnaire about VAS(visual analog scale), NDI(neck disability index), and endurance of deep neck flexor before experiment, after 6 weeks and after 12 weeks. In visual analog scale(VAS) and neck disability index(NDI), there were significant decreased in using modalities group and deep neck flexor exercise group after 6 weeks more than before experiments but were only significant decrease in deep neck flexor exercise group after 12 weeks. The endurance of deep neck flexor was significantly increased in deep neck flexor exercise group after 6 weeks and 12 weeks more than before experiments. Thorough these results deep neck flexor exercise has the effectiveness to the therapies of chronic neck pain. Using the deep neck flexor exercise would be high effects on pain reduction and functional improvement and also considered in improving the living qualities of those who have chronic neck pain.

본 연구는 만성 목통증 환자를 대상으로 심부목굽힘근 운동을 적용하여 통증, 목장애지수, 그리고 심부목굽힘근의 지구력에 미치는 영향을 알아보고자 하였다. 본 연구에서는 만성 목통증 환자 37명을 무작위로 도구를 이용한 중재와 심부목굽힘근 운동을 시행하는 실험군과 도구를 이용한 중재만을 실시하는 대조군으로 나누었다. 모든 중재는 12주 동안 주 3회 실시하였다. 실험 전, 6주 후, 그리고 12주 후에 통증을 평가하기 위한 VAS, 기능을 평가하는 목 장애지수, 그리고 심부목굽힘근의 지구력을 측정하여 효과를 비교하였다. 통계처리 방법으로 실험 전 후 차이를 검증하기 위하여 반복측정 분산분석을 실시하였고, 두 군 간의 차이를 검증을 위하여 독립표본 t검증을 실시하였다. 모든 통계적 유의수준은 0.05로 하였다. 본 연구의 결과 심부목굽힘근 운동이 적용된 실험군에서 통증과 목장애지수가 유의하게 향상되었고(p<.05), 심부목굽힘근의 지구력이 유의하게 증가하였다(p<.05). 본 연구의 결과를 통해 심부목굽힘근 운동이 만성 목통증 환자에게 효과적임을 알 수 있다. 심부목굽힘근 운동은 통증과 기능을 향상시키고 더 나아가 만성 목통증 환자의 삶의 질도 향상시킬 수 있을 것으로 기대된다. 따라서 재활에 있어 효과적인 방법을 제시할 수 있을 것으로 사료되어진다.

Keywords

References

  1. Cote, P., Cassidy, J. D., & Carroll, L., The Saskatchewan health and back pain survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine., Vol.23, No.15, pp,1689-1698, 1989.
  2. Hoving, J. L., de Vet, H. C., Twisk, J. W., Deville, W. L., van der Windt, D., Koes, B. W., & Bouter, L. M., Prognostic factors for neck pain in general practice. Pain., Vol.10, No.3, pp,639-645, 2004.
  3. Picavet, H. S., & Schouten, J. S., Musculoskeletal pain in the Netherlands: Prevalences, consequences and risk groups, the DMC(3)-study. Pain., Vol.102, No.1-2, pp,167-178, 2003. https://doi.org/10.1016/s0304-3959(02)00372-x
  4. Dvorak, J., Valach, L., & Schmid, S., Injuries of the cervical spine in Switzerland. Orthopade., Vol.16, No.1, pp,2-12, 1987.
  5. Viljanen, M., Malmivaara, A., Uitti, J., Rinne, M., Palmroos, P., & Laippala, P., Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: Randomised controlled trial. BMJ., Vol.327, No.7413, pp,475, 2003. https://doi.org/10.1136/bmj.327.7413.475
  6. Barton, P. M., & Hayes, K. C., Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache. Arch Phys Med Rehabil., Vol.77, No.7, pp,680-687, 1996. https://doi.org/10.1016/S0003-9993(96)90008-8
  7. Falla, D., Unravelling the complexity of muscle impairment in chronic neck pain. Man Ther., Vol.9, No.3, pp,125-133, 2004. https://doi.org/10.1016/j.math.2004.05.003
  8. Falla, D. L., Jull, G. A., & Hodges, P. W., Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine., Vol.29, No.19, pp,2108-2114, 1987.
  9. Falla, D. L., Campbell, C. D., Fagan, A. E., Thompson, D. C., & Jull, G. A., Relationship between cranio-cervical flexion range of the motion and pressure change during the cranio-cervical flexion test. Man Ther., Vol.8, No.2, pp,92-96, 2003. https://doi.org/10.1016/S1356-689X(03)00008-0
  10. Boyd-Clark, L. C., Briggs, C. A., & Galea, M. P., Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine., Vol.27, No.7, pp,694-701, 2002. https://doi.org/10.1097/00007632-200204010-00005
  11. Jull, G. A., O'Leary, S. P., & Falla, D. L., Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther., Vol.31, No.7, pp,525-533, 2008. https://doi.org/10.1016/j.jmpt.2008.08.003
  12. McDonnell, M. K., Sahrmann, S. A., & Van Dillen, L., A specific exercise program and modification of postural alignment for treatment of cervicogenic headache: a case report. J Orthop Sports Phys Ther., Vol.35, No.1, pp,3-15, 2005. https://doi.org/10.2519/jospt.2005.35.1.3
  13. Cassidy, J. D., Lopes, A. A., & Yong-Hing, K., The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial. J Manipulative physiol Ther., Vol.15, No.9, pp,570-575, 2005.
  14. Young, J. L., Press, J. M., & Herring, S. A., Bed rest and exercise. The nonsurgical management of acute low back pain. New York: Desmos Vermande., 1997.
  15. Elnaggar, I. M., Nordin, M., Sheikhzadeh, A., Parnianpour, M., & Kahanovitz, N., Effects of spinal flexion and extension exercises on low-back pain and spinal mobility in chronic mechanical low-back pain patients. Spine., Vol.16, No.8, pp,967-972, 1991. https://doi.org/10.1097/00007632-199108000-00018
  16. Dusunceli, Y., Ozturk, C., Atamaz, F., Hepguler, S., & Durmaz, B., Efficacy of neck stabilization exercises for neck pain: a randomized controlled study. J Rehabil Med., Vol.41, No.8, pp,626-631, 2009. https://doi.org/10.2340/16501977-0392
  17. Chiu, T. T., Lam, T. H., & Hedley, A. J., A randomized controlled trial on the efficacy of exercise for pateints with chronic neck pain. Spine., Vol.30, No.1, pp,E1-E7, 2005. https://doi.org/10.1097/00007632-200511010-00031
  18. Griffiths, C., Dziedzic, K., Waterfield, J., & Sim, J., Effectiveness of specific neck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. J Rheumatol., Vol.36, No.2, pp,390-397, .2009. https://doi.org/10.3899/jrheum.080376
  19. Masuda, A., Koga, Y., Hattanmaru, M., Minagoe, S., & Tei, C., The effects of repeated thermal therapy for patients with chronic pain. Psychother Psychosom., Vol.74, No.5, pp,288-294, 2005. https://doi.org/10.1159/000086319
  20. Nnoaham, K. E., & Kumbang, J., Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database Syst Rev., Vol.16, No.3, CD003222, 2008.
  21. Grubisic, F., Grazio, S., Jajić, Z., & Nemcic, T., Therapeutic ultrasound in chronic low back pain treatment. Reumatizam., Vol.53, No.1, pp,18-21, 2006.
  22. Jull, G. A., Falla, D., Vicenzino, B., & Hodges, P. W., The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther., Vol.14, No.6, pp,696-701, 2009. https://doi.org/10.1016/j.math.2009.05.004
  23. Keele, K. D,. The pain chart. Lancet., Vol.2, No.6514, pp,6-8, 1948.
  24. Vernon, H., & Mior, S., The neck disability index: A study of reliability and validity. J Manip Physiol Ther., Vol.14, No.7, pp,409-415, 1994.
  25. Chiu, T. T., Law, ,E. Y., & Chiu, T. H., Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther., Vol.35, No.9, pp,567-571, 2005. https://doi.org/10.2519/jospt.2005.35.9.567

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