The Effect of a Stretching Exercise on Myofascial Pain Syndrome Patients in Small and Medium Sized Industries

중소규모 사업장의 근막통증증후군 관리를 위한 스트레칭 운동의 효과

  • Lim, Jung-Wook (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Kwon, Young-Jun (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Jang, Tae-Won (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Lee, Jong-Heon (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Kim, In-Seok (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Ryu, Sang-Cheol (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Roh, Jae-Hoon (Institute of Occupational Health, College of Medicine, Yonsei University) ;
  • Won, Jong-Uk (Institute of Occupational Health, College of Medicine, Yonsei University) ;
  • Cha, Bong-Suk (Department of Preventive Medicine and Institute of Occupational Medicine, Wonju College of Medicine, Yonsei University) ;
  • Lee, Chul-Ho (Changwon Ground Clinic)
  • 임정욱 (한강성심병원 산업의학과) ;
  • 권영준 (한강성심병원 산업의학과) ;
  • 장태원 (한강성심병원 산업의학과) ;
  • 이종헌 (한강성심병원 산업의학과) ;
  • 김인석 (한강성심병원 산업의학과) ;
  • 유상철 (한강성심병원 산업의학과) ;
  • 노재훈 (연세대학교 의과대학 산업보건연구소) ;
  • 원종욱 (연세대학교 의과대학 산업보건연구소) ;
  • 차봉석 (연세대학교 원주의과대학 예방의학교실 및 직업의학연구소) ;
  • 이철호 (창원 터의원)
  • Received : 2010.08.12
  • Accepted : 2010.09.16
  • Published : 2010.12.31

Abstract

Objectives: This study was conducted to identify the effect of a stretching exercise on myofascial pain syndrome patients that work in small and medium-sized industry. Methods: Questionnaires surveys including general characteristics, work-related characteristics, and musculoskeletal symptoms on neck and shoulder area was administered to 393 subjects who worked in small and medium sized industries. Symptomatic workers were examined to identify whether they had myofascial pain syndrome (MPS). Of the 393 subjects, 108 MPS patients performed 6 weeks stretching exercise program. Intensity of pain was estimated with visual analogue scales (VAS). All patients were interviewed to estimate their compliance to stretching exercise program. Results: Of the 393 workers, 119 workers were diagnosed with MPS of the neck and shoulder. Postexercise VAS was significantly reduced compared to pre-exercise VAS (p<0.05). High compliance patients to stretching exercise were more effective to exercise therapy (OR 2.89, 95% CI 1.19~7.04), and overtime workers were less effective to exercise therapy (OR 0.41, 95% CI 0.17~0.95). Conclusion: The Stretching exercise program was identified to be effective in MPS patients in small and medium-sized industries. It is recommended that workers with MPS in small and medium-sized industries practice a well-designed stretching exercise program, and avoid overtime work.

목적: 중소규모 사업장의 근막통증증후군 환자에서 발생할 수 있는 근막통증증후군의 관리를 위한 방법으로 근로자 스스로 실시할 수 있는 운동 프로그램의 효과를 알아보고자 하였다. 방법: 중소규모 사업장에 근무하는 근로자 393명에게 설문조사를 실시하여 증상 유소견자를 선별하고, 선별된 대상자들을 진찰하여 근막통증증후군을 진단하였다. 목과 어깨 부위의 근막통증증후군으로 진단된 환자 119명 중 어깨 부위의 다른 근골격계질환이 동반된 환자 11명을 제외한 108명에게 6주 동안의 스트레칭 운동 프로그램을 처방하였다. 치료 전후의 통증 정도를 VAS를 이용해 파악하였고, 운동 프로그램에 대한 순응도를 치료 3주와 치료 후에 평가하였다. 결과: 전체 대상자 393명 중 목과 어깨 부위의 근막통증증후군은 119명이었으며, 운동 프로그램을 실시한 108명의 환자들은 운동 전에 비해 운동 후 통증 지수가 유의하게 감소하였다. 운동치료의 효과에 영향을 주는 변수로는 운동 프로그램에 대한 순응도와 초과근무 여부로 나타났다. 결론: 이 연구의 결과에 의하면 중소규모 사업장의 근막통증증후군 환자 관리를 위한 운동 프로그램은 효과가 있는 것으로 나타났으며, 운동치료의 효과를 높이기 위해서는 환자가 처방된 운동 프로그램의 내용을 잘 실시하고, 초과근무를 자제하는 것이 좋을 것으로 판단된다.

Keywords

References

  1. KOSHA. Statistics for industrial accidents. Available: http://www.kosha.or.kr [cited 18 January 2010].
  2. Simons DG, Travell JG, Simons LS. Travell and Simon's Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore (MD). Williams and Wilkins. 1998. pp.19-22.
  3. Kim HS. Myofascial pain syndrome. J Korean Acad Fam Med 2001;22(5):S147-54. (Korean)
  4. Simons DG, Travell JG, Simons LS. Travell and Simon's Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore(MD). Williams and Wilkins. 1998. pp.178-228.
  5. Gerwin RD. A review of myofascial pain and fibromyalgia--factors that promote their persistence. Acupunct Med 2005;23(3):121-34. https://doi.org/10.1136/aim.23.3.121
  6. Gerwin RD. Classification, epidemiology, and natural history of myofascial pain syndrome. Curr Pain Headache Rep 2001;5(5):412-20. https://doi.org/10.1007/s11916-001-0052-8
  7. McClaflin RR. Myofascial pain syndrome. Primary care strategies for early intervention. Postgrad Med 1994;96(2):56-70.
  8. Forst R, Ingenhorst A. Myofascial pain syndrome. Internist (Berl) 2005;46(11):1207-17. https://doi.org/10.1007/s00108-005-1525-3
  9. Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Anesthesiol Clin 2007;25(4):841-51. https://doi.org/10.1016/j.anclin.2007.07.003
  10. Simons DG, Travell JG, Simons LS. Travell and Simon's Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore(MD). Williams and Wilkins. 1998. pp.171-73.
  11. Nicolakis P, Erdogmus B, Kopf A, Nicolakis M, Piehslinger E, Fialka-Moser V. Effectiveness of exercise therapy in patients with myofascial pain dysfunction syndrome. J Oral Rehabil 2002;29(4):362-8. https://doi.org/10.1046/j.1365-2842.2002.00859.x
  12. Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med 1989;151(2):157-60.
  13. Kaergaard A, Andersen JH. Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis. Occup Environ Med 2000;57(8):528-34. https://doi.org/10.1136/oem.57.8.528
  14. Jang E, C, Kim HJ, Kwon YJ, Park SB, Lee SJ, Song J, C. The prevalence of cumulative trauma disorders of upper extremities among watch assembly workers in some small-scaled industry. Korean J Occup Environ Med 2000;12(4):457-72. (Korean)
  15. Jang KU, Kang TD, Park JT, Kim DS, Park DH. The prevalence and ergonomic analysis of cumulative trauma disorders in the bank worker and post officer. J Korean Acad Rehabil Med 2000;24(2):301-10.(Korean)
  16. Jang KU, Kang TD, Park JT, Kim DS, Park DH. The prevalence and ergonomic analysis of cumulative trauma disorders in the paper reviewing workers. J Korean Acad Rehabil Med 2001;25(2):321-9. (Korean)
  17. Kim JS, Kim IA, Lee SJ, Kim YK, Park SB, Koh JW, Song JC. Analysis of shoulder range of motion an shoulder myofascial pain syndrome. Korean J Occup Environ Med 2005;17(4):333-42. (Korean)
  18. Simons DG, Travell JG, Simons LS. Travell and Simon's Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore(MD). Williams and Wilkins. 1998. pp.35.
  19. KIM JM. Medical access of myofascial pain syndrome. J Korean Acad Fam Med 2001;22(9):1315-20.(Korean)
  20. Gerwin RD, Shannon S, Hong CZ, Hubbard D, Gevirtz R. Interrater reliability in myofascial triggerpoint examination. Pain 1997;69(1-2):65-73. https://doi.org/10.1016/S0304-3959(96)03248-4
  21. Tough EA, White AR, Richards S, Campbell J. Variability of criteria used to diagnose myofascial trigger point pain syndrome--evidence from a review of the literature. Clin J Pain 2007;23(3):278-86. https://doi.org/10.1097/AJP.0b013e31802fda7c
  22. Wolfe F, Simons DG, Fricton J, Bennett RM, Goldenberg DL, Gerwin R, Hathaway D, McCain GA, Russell IJ, Sanders HO. The fibromyalgia and myofascial pain syndromes: a preliminary study of tender points and trigger points in persons with fibromyalgia, myofascial pain syndrome and no disease. J Rheumatol 1992;19(6):944-51.
  23. Nice DA, Riddle DL, Lamb RL, Mayhew TP, Rucker K. Intertester reliability of judgments of the presence of trigger points in patients with low back pain. Arch Phys Med Rehabil 1992;73(10):893-8.
  24. Njoo KH, Van der Does E. The occurrence and interrater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice. Pain 1994;58(3):317-23. https://doi.org/10.1016/0304-3959(94)90125-2
  25. Simons DG, Travell JG, Simons LS. Travell and Simon's Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore (MD). Williams and Wilkins. 1998. pp.117.
  26. Han SC, Harrison P. Myofascial pain syndrome and trigger-point management. Reg Anesth 1997;22(1):89-101. https://doi.org/10.1016/S1098-7339(06)80062-3
  27. Ga H, Choi JH, Park CH, Yoon HJ. Acupuncture needling versus lidocaine injection of trigger points in myofascial pain syndrome in elderly patients--a randomised trial. Acupunct Med 2007;25(4):130-6. https://doi.org/10.1136/aim.25.4.130
  28. Kamanli A, Kaya A, Ardicoglu O, Ozgocmen S, Zengin FO, Bayik Y. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int 2005;25(8):604-11. https://doi.org/10.1007/s00296-004-0485-6
  29. Ojala T, Arokoski JP, Partanen J. The effect of small doses of botulinum toxin a on neck-shoulder myofascial pain syndrome: a double-blind, randomized, and controlled crossover trial. Clin J Pain 2006;22(1):90-6. https://doi.org/10.1097/01.ajp.0000151871.51406.c3
  30. Graboski CL, Gray DS, Burnham RS. Botulinum toxin A versus bupivacaine trigger point injections for the treatment of myofascial pain syndrome: a randomised double blind crossover study. Pain 2005;118(1-2):170-5. https://doi.org/10.1016/j.pain.2005.08.012
  31. Tschopp KP, Gysin C. Local injection therapy in 107 patients with myofascial pain syndrome of the head and neck. ORL J Otorhinolaryngol Relat Spec 1996;58(6):306-10. https://doi.org/10.1159/000276860
  32. Ebell MH. Exercises for mechanical neck disorders. Am Fam Physician 2006;74(7):1126.
  33. Son MH, Choi JS, Sohn SJ, Kim YO, Park J. The effectiveness of the intervention in the workplace on patients suffering from cervicobrachial disorder. Korean J Occup Environ Med 1999;11(4):460-75. (Korean)
  34. Yang YA, Kim YH, Kim YK, Hur JG, Song J, C, Kim YS. Effects of thoracic spinal exercise program in VDT workers: pain relief and increased flexibility. Korean J Occup Environ Med 2004;16(3):250-61. (Korean)
  35. Hur JG, Song J, C, Roh YM, Park DS, Yang YA, Kim YS. Effect on active exercise programs in employees with chronic low back pain. Korean J Occup Environ Med 2005;17(1):44-57. (Korean)
  36. Chae HJ, Lee SK, Lee KJ, Moon JD. Characteristics of work-related musculoskeletal disorders and effect of intervention program in shipyard workers. Korean J Occup Environ Med 2002;14(4):468-77. (Korean)
  37. Kim BK, Park CY, Yim HW, Koo JW, Lee KS. Selection of high risk group and the effectiveness of an exercise program on musculoskeletal symptoms in small and medium sized enterprises. Korean J Occup Environ Med 2005;17(1):10-25. (Korean)
  38. Auleciems LM. Myofascial pain syndrome: a multidisciplinary approach. Nurse Pract 1995;20(4):4-22.