DOI QR코드

DOI QR Code

머리-목 굽힘 운동이 편측 뇌성마비 환자의 깊은 목 굽힘근의 두께와 보행에 미치는 영향

The Effects of Craniocervical Flexion Exercise on Deep Cervical Flexor Muscle Thickness and Gait for Children with Hemiplegic Cerebral Palsy

  • 윤창교 (대구대학교 일반대학원 물리치료전공) ;
  • 김현성 (대구대학교 일반대학원 물리치료전공)
  • Yun, Changkyo (Dept. of Physical Therapy, College of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kim, HyunSung (Dept. of Physical Therapy, College of Rehabilitation Science, Graduate School, Daegu University)
  • 투고 : 2018.02.28
  • 심사 : 2018.03.15
  • 발행 : 2018.03.30

초록

Purpose : The purpose of this study was to evaluate the effect of craniocervical flexion exercise on deep cervical flexor thickness and gait in children with hemiplegic cerebral palsy. Methods : Twelve children with hemiplegic cerebral palsy were recruited for this study. All subjects performed active craniocervical flexion exercise 3times a week over the course of 6weeks. using a pressure bio feedback unit. Ultrasonography was used to assess deep cervical flexor thickness, and a 10m walking test was used to assess gait function. For the statistical analysis, a paired t-test was used to compare the differences pre- and post-value. SPSS Statistics version 20.0 was used for statistical analysis, and statistical significance was defined as a p-value less than 0.05. Result : The results of this study indicate that children with hemiplegic cerebral palsy experienced statistically significant positive changes in both deep cervical flexor thickness (p<.05). and gait(p<.05) following the intervention. Conclusion : In conclusion, craniocervical flexion exercise can positively affect deep cervical flexor thickness in children with hemiplegic cerebral palsy, which in turn positively affects gait.

키워드

참고문헌

  1. Abaspour O, Javanshir K, Amiri M, et al(2015). Relationship between cross sectional area of longus colli muscle and pain laterality in patients with cervicogenic headache. J Back Musculoskelet Rehabil, 28(2), 393-399. https://doi.org/10.3233/BMR-140532
  2. Bae SS, kim BJ, Lee KH(2001). A study of muscle imbalance of head, cervical and shoulder region. J Korean Soc Phys Ther, 13(3), 769-776.
  3. Bobath B(1990). Adult hemiplegia: evaluation and treatment. 2ed, London, William Heinemann Medical Books.
  4. Boyd-Clark LC, Briggsn CA, Galea MP(2002). Muscle spindle distribution, morphology, and density in longus colli and multifidus muscle of the cervical spine. Spine, 27(7), 694-701. https://doi.org/10.1097/00007632-200204010-00005
  5. Cagnie B, Danneels L, Van Tiggelen D, et al(2007). Individual and work related risk factors for neck pain among office workers: a cross sectional study. Eur Spine J, 16(5), 679-686. https://doi.org/10.1007/s00586-006-0269-7
  6. Cagnie B, Dickx N, Peeters I, et al(2008). The use of functional MRI to evaluate cervical flexor activity during different cervical flexion exercises. J Appl Physiol, 104(1), 230-235. https://doi.org/10.1152/japplphysiol.00918.2007
  7. Choi SJ, Bang DH, So HJ, et al(2014). Characteristics of the abdominal and neck flexor muscles of children with cerebral palsy. J Kor Phys Ther, 26(6), 453-458.
  8. Eunson P(2012). Aetiology and epidemiology of cerebral palsy. Paediatr Child Health, 22(9), 361-366. https://doi.org/10.1016/j.paed.2012.05.008
  9. Fabianna MR, Paulo H, Manuela L, et al(2011). Ultrasonographic measurement of neck muscle recruitment: a preliminary investigation. J Manual Manipulative Ther, 16(2), 89-92. https://doi.org/10.1179/106698108790818486
  10. Falla D, Jull G, Dall'Alba P, et al(2003). An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Phys Ther, 83(10), 899-906.
  11. Hadders-Algra M, Brogren E, Forssberg H(1996). Ontogeny of postural adjustments during sitting in infancy: variation, selection and modulation. J Physiol, 493(1), 273-288. https://doi.org/10.1113/jphysiol.1996.sp021382
  12. Hunt CC(1990). Mammalian muscle spindle: peripheral mechanism. Physiol Rev, 70(3), 643-663. https://doi.org/10.1152/physrev.1990.70.3.643
  13. Jesus FM, Ferreira PH, Ferreira ML(2008). Ultrasonographic measurement of neck muscle recruitment: a preliminary investigation. J Man Manip Ther, 16(2), 89-92. https://doi.org/10.1179/106698108790818486
  14. Jull GA, Falla D, Vicenzino B, et al(2009). The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther, 14(6), 696-701. https://doi.org/10.1016/j.math.2009.05.004
  15. Kim SE(2013). Effect of deep neck flexor strength training and bridge exercise on sitting balance of children with spastic cerebral palsy. Daegu University, Dissertation of Master's Degree.
  16. Kim YJ(2016). The effects of variation of kinematics and kinetics on trunk and lower extremities based on flexion and extension of head postures during weight-bearing tasks. Daegu Catholic University, Dissertation of Doctorate Degree.
  17. Lacey JL, Henderson-Smart DJ, Edwards DA, et al(1985). The early development of head control in preterm infants. Early Hum Dev, 11(3-4), 199-212. https://doi.org/10.1016/0378-3782(85)90074-X
  18. Lazar HM(2014). The immediate effects of a cervical spine adjustment on gait in individuals with asymptomatic cervical facet joint dysfunction. University of Johannesburg, Dissertation of Master's Degree
  19. Ledebt A, Becher J, Kapper J, et al(2005). Balance training with visual feedback in children with hemiplegic cerebral palsy: Effect on stance and gait. Motor Control, 9(4), 459-468. https://doi.org/10.1123/mcj.9.4.459
  20. Lieber RL, Friden J(2000). Functional and clinical significance of skeletal muscle architecture. Muscle Nerve, 23(11), 1647-1666. https://doi.org/10.1002/1097-4598(200011)23:11<1647::AID-MUS1>3.0.CO;2-M
  21. Murphy N, Such-Neibar T(2003). Cerebral palsy diagnosis and management: the state of the art. Curr Probl Pediatr Adolesc Health Care, 33(5), 146-169. https://doi.org/10.1016/S1538-5442(03)00002-6
  22. Pavao SL, dos Santos AN, Woollacott MH, et al(2013). Assessment of postural control in children with cerebral palsy: a review. Res Dev Disabil, 34(5), 1367-1375. https://doi.org/10.1016/j.ridd.2013.01.034
  23. Ryerson S, Levit K(1997). Functional movement reeducation: a contemporary model for stroke rehabilitation. New York, Churchill Livingstone.
  24. Ryu HJ(2015). Effects of core exercise and neck stabilizing exercise on proprioception and balance in children with cerebral palsy due to premature birth. Daegu University, Dissertation of Doctorate Degree.
  25. Sankar C, Mundkur N(2005). Cerebral palsy–definition, classification, etiology and early diagnosis. Indian J pediatr, 72(10), 865-868. https://doi.org/10.1007/BF02731117
  26. Sakzewski L, Ziviani J, Boyd RN(2014). Efficacy of upper limb therapies for unilateral cerebral palsy: a meta-analysis. Pediatrics, 133(1), 175-204. https://doi.org/10.1542/peds.2013-3502
  27. Seo HJ, kim JH, Son KK(2014). The effect of different head positions with whole body vibration on muscle activation related to postural stability in standing. J Kor Phys Ther, 26(3), 156-162.
  28. Wilson VJ, Jones GM(1979). Mammalian vestibular physiology. New york, Plenum Press.
  29. Wingert JR, Burton H, Sinclair RJ, et al(2009). Joint-position sense and kinesthesia in cerebral palsy. Arch Phys Med Rehabil, 90(3), 447-453. https://doi.org/10.1016/j.apmr.2008.08.217
  30. Wolf SL, Catlin PA, Gage K, et al(1999). Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile. Phys Ther, 79(12), 1122-1133.
  31. Woo HS(2013). The effects of cranio-cervical flexion on activation of swallowing-related muscles in stroke patients and age-matched healthy adults. Yonsei University, Dissertation of Doctorate Degree.
  32. Yun KH, Kim K(2013). Effect of craniocervical flexiom exercise using sling on thickness of sternocleidomastoid muscle and deep cervical flexor muscle. J Korean Soc Phys Med, 8(2), 253-261. https://doi.org/10.13066/kspm.2013.8.2.253
  33. Zito G, Jull G, Story I(2006). Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther, 11(2), 118-129. https://doi.org/10.1016/j.math.2005.04.007