Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Effectiveness of Individualized Upper Extremity Exercise Program for Patients after Mastectomy

유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램 효과

  • Lim, Kyung Hee (College of Nursing & Research Institute of Nursing Science, Keimyung University)
  • 임경희 (계명대학교 간호대학 & 간호과학연구소)
  • Received : 2018.07.19
  • Accepted : 2018.10.05
  • Published : 2018.10.31
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Abstract

This study was conducted to develop an individualized upper extremity exercise program for patients after mastectomy and evaluate its effectiveness. A nonequivalent control-group pretest-posttest design was used for this investigation. Research participants were patients with breast cancer who underwent mastectomy at two university hospitals (experimental group, n=17; control group, n=16). The experimental group received an individualized upper extremity exercise program three times a week for 7 weeks. Data were analyzed by the ${\chi}^2-test$, Fisher's exact test, Mann-Whitney U-test and Wilcoxon Signed Rank test using SPSS WIN 21.0. Inter-group comparison revealed significant differences between pre-test and post-test in hands behind the back, flexion, abduction, external rotation, internal rotation, and grip strength. Moreover, the experimental group showed significant improvements in hands behind the back, flexion, abduction, external rotation, internal rotation, and grip strength relative to the control. In conclusion, the individualized upper extremity exercise program was shown to be an effective intervention to improve physical functions in upper limbs and shoulders. Therefore, this program should be applied to patients after mastectomy in clinics since many patients have suffered from decreased physical functions in upper extremities.

본 연구의 목적은 유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램을 개발하여 적용하고 그 효과를 검증하기 위한 것이다. 연구설계는 유사실험설계이며, 연구대상은 D지역의 2개 대학병원에서 유방절제술을 받은 3년 이내의 환자로 실험군 17명, 대조군 16명이 연구에 참여하였다. 본 연구에 참여하는 실험군에게는 2015년 6월부터 7월동안 총 주 3회의 운동프로그램을 7주간 실시하였고, 대조군에게는 운동프로그램을 제공하지 않았다. 본 연구 프로그램의 사전, 사후 어깨관절 유연성은 줄자를 이용한 등 뒤 손잡기와 관절 각도계를 이용한 어깨가동범위를 측정하였으며, 악력은 악력계를 이용하여 측정하였다. 자료 분석은 SPSS/Win 21.0 program을 이용하였고, 사전 동질성 검증은 카이제곱 검정과 Fisher's exact test, Mann-Whitney U-test를 이용하였으며, 가설 검증은 Mann-Whitney U-test, Wilcoxon Signed Rank test를 이용하였다. 연구결과, 맞춤형 상지 운동프로그램에 참여한 실험군은 대조군에 비해 등 뒤로 두 손 마주잡기(p=.001), 굽힘(p<.001), 벌림(p=.032), 바깥돌림(p=.024), 안쪽돌림(p=.041) 등에서 모두 유의한 변화를 나타내 유연성과 관절가동범위가 증가한 것으로 나타났다. 또한 실험군은 대조군에 비해 악력(p<.001)도 유의하게 증가한 것으로 나타났다. 본 연구에서 개발된 개별 유방암 환자의 특성과 신체적 상태를 고려하여 과부하의 원리와 점증적 원리로 구성된 유방절제술 후 환자를 위한 맞춤형 상지 운동프로그램은 수술 후 환자들의 어깨관절 유연성과 악력 향상에 효과적이었으며 수술 후 많은 환자들이 호소하는 어깨관절 기능 및 악력 저하를 예방하고 신체기능을 향상시켜 일상생활로의 복귀를 도와줄 수 있을 것으로 기대된다.

Keywords

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