단축된 슬괵근에 적용한 멀리건 기법의 효과 비교

The Comparison of Effects Mulligan's Technique Applied to Shortened Hamstring

  • 최율정 (로이병원 물리치료실) ;
  • 심현보 (강남세브란스병원 물리치료실) ;
  • 이준용 (서울특별시 북부병원 물리치료실)
  • Choi, Yul-jung (Dept. of Physical Therapy, Roi Hospital) ;
  • Sim, Hyun-po (Dept. of Physical Therapy, Gangnam Severence Hospital) ;
  • Lee, Jun-yong (Dept. of Physical Therapy, Seoul North Municipal Hospital)
  • 투고 : 2017.12.28
  • 심사 : 2018.02.23
  • 발행 : 2018.06.30

초록

Background: The purpose of this study is to investigate the effects of Mulligan's bent leg raise (BLR), two leg rotation (TLR) and straight leg raise with traction (traction SLR) technique on the change of shortened hamstring length. Methods: Sixty subjects participated in this study. The subjects were randomly assigned to either the BLR group (n=20) or TLR group (n=20) or traction SLR group (n=20). 90-90 SLR test was performed for evaluation of hamstring shortening at initial time of study. After intervention, immediate effect(immediately after intervention) and effect of maintenance (after 60 minutes from intervention) were assessed. Results: All three groups showed significant differences in the immediate evaluation and the post evaluation after 60 minutes on the change of shortened hamstring length compared to the initial evaluation. When three groups were compared, in the immediate effect, BLR and traction SLR groups were higher than TLR group (p<.05). And the effect after 60 minutes, BLR group was higher than the other two groups (p<.05). Conclusion: In the results of this study, three groups showed immediately and lasting effectiveness in flexibility of shortened hamstring. In addition, BLR and traction SLR groups were more flexible than TLR group in the immediate evaluation and BLR group had better maintenance of flexibility than the other two groups in the post evaluation after 60 minutes.

키워드

참고문헌

  1. 권해경, 정향미. 요부강화 프로그램이 간호사의 요통, 유연성 및 근력에 미치는 효과. 한국자료분석학회. 2009;11(1):213-227.
  2. 김기철, 황보각. 정상 성인의 슬괵근 유연성 정도에 따른 체간 굴곡 시 요추의 운동학적 분석. 대한물리의학회지. 2012;7(4):501-507. https://doi.org/10.13066/kspm.2012.7.4.501
  3. 김도현, 김태호, 정도영, 등. 글라스톤 기법을 이용한 연부조직가동술과 자가근막이완술이 넙다리뒤근 유연성에 미치는 영향. 대한물리의학회. 2014;9(4): 455-463. https://doi.org/10.13066/kspm.2014.9.4.455
  4. 임상훈, 손정민, 박동수, 등. 슬괵근 유연성 증가에 대한 근에너지기법(MET)과 스트레칭 운동의 효과 비교 연구. 한방재활의학과학회. 2009;19(1):201-211.
  5. 오세준, 최종덕. 슬괵근 단축 유무에 따른 요통환자에 대한 능동적 움직임 조절 검사의 타당도 연구. 대한물리의학회지. 2012;7(4):443-450. https://doi.org/10.13066/kspm.2012.7.4.443
  6. 심현보, 윤홍일, 이준용. 족관절의 능동 관절가동범위 운동이 수동 하지 직거상에 미치는 즉각적 영향. 대한정형도수치료학회지. 2010;16(2):40-47.
  7. 최율정, 윤홍일, 이준용. 멀리건의 견인을 동반한 하지직거상 기법이 요통 환자의 제한된 하지직거상에 미치는 즉각적인 영향에 관한 연구. 대한정형도수물리치료학회. 2013;19(1):55-61.
  8. 최율정, 심현보, 이준용. 유지-이완 기법과 멀리건의 견인을 동반한 뻗은다리올림 기법이 단축된 넙다리 뒤근의 유연성에 미치는 영향. 대한정형도수물리치료학회. 2015;21(1):5-11.
  9. Adler SS, Beckers D, Buck M. PNF in Practice: An Illustrated Guide. Springer. 3rd ed. 2007.
  10. Ahmed H, Iqbal A, Anwer S, et al. Effect of modified hold-relax stretching and static stretching on hamstring muscle flexibility. J Phys Ther Sci. 2015;27(2):535-538. https://doi.org/10.1589/jpts.27.535
  11. Barash HL, Galante JO, Lambert CN, et al. Spondylolisthesis and tight hamstrings. J Bone Joint Surg Am. 1970;52(7):1319-1328. https://doi.org/10.2106/00004623-197052070-00004
  12. Chan SP, Hong Y, Robinson PD. Flexibility and passive resistance of the hamstrings of young adults using two different static stretching protocols. Scand J Med Sci Sports. 2001;11(2):81-86. https://doi.org/10.1034/j.1600-0838.2001.011002081.x
  13. Donatelli RA, Wooden MJ. Orthopaedic Physical Therapy. Churchill Livingstone. 4th ed. 2010.
  14. Hall T, Cacho A, McNee C, et al. Effect of the mulligan traction straight leg raise technique on range of movement. J Man Manip Ther. 2001;9(3):128-133. https://doi.org/10.1179/jmt.2001.9.3.128
  15. Hall T, Hardt S, Schafer A, et al. Mulligan bent leg raise technique- a preliminary randomized trial of immediate effects after a single intervention. Man Ther. 2006;11(2):130-135. https://doi.org/10.1016/j.math.2005.04.009
  16. Hall T, Beyerlein C, Hansson U, et al. Mulligan traction straight leg raise: A pilot study to investigate effects on range of motion in patients with low back pain. J Man Manip Ther. 2006;14(2):95-100. https://doi.org/10.1179/106698106790820782
  17. Hing W, Hall T, Rivett D, et al. The Mulligan Concept of Manual Therapy: Textbook of Technique. Chruchill Livingstone. 1st ed. 2015.
  18. Johnson EN, Thomas JS. Effect of hamstring flexibility on hip and lumbar spine joint excursions during forward-reaching tasks in participants with and without low back pain. Arch Phys Med Rehabil. 2010;91(7):1140-1142. https://doi.org/10.1016/j.apmr.2010.04.003
  19. Kage V, Ratnam R. Immediate effect of active release technique versus mulligan bent leg raise in subjects with hamstring tightness: A randomized clinical trial. Int J Physiother Res. 2014;2(1):301-304.
  20. Kisner C, Colby LA. Therapeutic Exercise: Foundations and Techniques. FA. Davis Company. 6th ed. 2012.
  21. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-1434. https://doi.org/10.1136/bmj.332.7555.1430
  22. Kumar GP. Comparison of cyclic loading and hold relax technique in increasing resting length of hamstring muscles. Hong Kong Physiother J. 2011;29(1):31-33. https://doi.org/10.1016/j.hkpj.2011.03.002
  23. Magee DJ. Orthopedic Physical Assessment. Saunders. 5th ed. 2007.
  24. Magnusson SP. Passive properties of human skeletal muscle during stretch maneuvers. Scand J Med Sci Sport. 1998;8(2):65-77. https://doi.org/10.1111/j.1600-0838.1998.tb00171.x
  25. Mulligan BR. Manual Therapy: Nags, Snags, Mwms, Etc. Orthopedic Physical Therapy Products. 6th ed. 2010.
  26. Phansopkar PA, Kage V. Efficacy of mulligan's two leg rotation and bent leg raise techniques hamstring flexibility in subjects with acutenon-specific low back pain: Randomized clinicaltrial. Int J Physiother Res. 2014;2(5):733-741.
  27. Puentedura EJ, Huijbregts PA, Celeste S, et al. Immediate effects of quantified hamstring stretching: Hold-relax proprioceptive neuromus cular facilitation versus static stretching. Phys Ther Sport. 2011;12(3):122-126. https://doi.org/10.1016/j.ptsp.2011.02.006
  28. Rebain R, Baxter GD, McDonough S. A systemic review of the passive straight leg raising test as a diagnostic aid low back pain. Spine. 2002;27(17):388-395. https://doi.org/10.1097/00007632-200209010-00025
  29. Spernoga SG, Uhl TL, Arnold BL, et al. Duration of maintained hamstring flexibility after a one-time, modified hold-relax stretching protocol. J Athl Train. 2001;36(1):44-48.
  30. Waxman R, Tennant A, Helliwell P. A prospective follow up study of low back pain in the community. Spine. 2000;25(16):2085-2090. https://doi.org/10.1097/00007632-200008150-00013