Journal of Korea Entertainment Industry Association (한국엔터테인먼트산업학회논문지)

The Korea Entertainment Industry Association (한국엔터테인먼트산업학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect on Trunk Forward Flexion Motion of Thoraco-Abdominal Breathing Pattern Correction for Life Care Promotion in Lumbar Instability People

라이프케어증진을 위한 흉·복부 호흡패턴교정이 요추부 불안정성자들의 몸통 전방 굴곡 동작에 미치는 영향

  • Ki, Chul (Seoul Sei-yeon Pain Clinic, Department of Manual Therapy Reha-Center) ;
  • Heo, Myoung (Department of Occupational Therapy Gwangju University)
  • 기철 (서울 세연통증클리닉 도수치료 센터) ;
  • 허명 (광주대학교 작업치료학과)
  • Received : 2020.11.17
  • Accepted : 2020.12.29
  • Published : 2020.12.31
⟨ Previous Next ⟩

Abstract

This study has conducted to investigate the changes in the mobility of the three thoraco-abdominal lines(TAMs) during breathing and in the thoracic and lumbar spine mobility(TSM, LSM) during trunk forward flexion, after breathing pattern correction. The 30 subjects with lumbar instability(LI) have divided into the breathing pattern correction exercise(BPC) group of 15 subjects and the lumbar stabilization exercise(LSE) group of 15 subjects and performed each exercise for 40 minutes at one session, and a total of 18 sessions were applied for 6 weeks. As a result, The BPC group during breathing showed a significant increase in all TAMs(p<.001) and in the TSM(p<.001) than the LSE group. Besides, had a more decrease in the LSM than the LSE group(p<.001). The BPC showed high positive correlations with TAMs(rest: r=.868, forced: r=.870) and the TSM(r=.672) and had a negative correlation with the LSM(r=-.420). Based on this result of the study, the authors believe that the BPC in LI people could decrease the lumbar flexion mobility when they have motion of trunk forward flexion with promotions in the thoracic spine and rib joint mobility by improvements in relative mobility of thoraco-abdominal lines.

본 연구는 호흡 패턴 교정 후, 호흡 동안 흉·복부 둘레 선 세 곳의 운동성(TAMs) 변화와 몸통 전방 굴곡 동안 흉추(TSM) 및 요추부 운동성(LSM)의 변화를 조사하기 위해 수행되었다. 요추부 불안정성이 있는 30명의 대상자들을 15명의 호흡패턴 교정운동 그룹과 15명의 요추부 안정화운동그룹으로 나누어, 한 세션 당 40분 운동, 총 18 세션을 6주 동안 적용하였다. 연구 결과, 호흡패턴교정 그룹은 안정화 운동 그룹에 비해 모든 TAMs과 TSM 이 유의하게 더 증가한 것으로 나타났고 LSM은 더 유의한 감소를 보였다(p<.001). 호흡패턴교정은 전체 TAM(안정호흡: r= .868, 노력성호흡: r= .870) 및 TSM(r= .672)과는 높은 양의 상관관계를, LSM(r= -.420)과는 음의 상관관계를 나타내었다. 본 연구 결과를 기초로, 요추부 불안정성자의 호흡패턴교정이 흉·복부 둘레 선의 상대적 운동성 개선을 통해 흉추와 늑골 관절의 운동성을 촉진하여 몸통 전방 굴곡 시 요추부 굴곡 운동성을 감소시킬 수 있다고 제안한다.

Keywords

Acknowledgement

이 논문은 2020년도 광주대학교 학술연구비 지원을 받아 수행되었음.

References

  1. Liebenson, C.(2007). Rehabilitation of the Spine: A Practitioner's Manual. Williams & Wilkins.
  2. Ferreira, P.H., Ferreira, M.L., Maher, C.G., Refshauge, K., Herbert, R.D., & Hodges, P.W.(2010). Changes in recruitment of transversus abdominis correlate with disability in people with CLBP. Br J Sports Med, 44(16): 1166-1172. https://doi.org/10.1136/bjsm.2009.061515
  3. Kolar, P., Sulc, J., Kyncl, M., Sanda, J., Cakrt, O., Andel, R., Kumagai, K., & Kobesova, A.(2012). Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther, 42(4): 352-362. https://doi.org/10.2519/jospt.2012.3830
  4. Ostwal, P.P., & Wani, S.K.(2014). Breathing pattern in patients with low back pain. Int J Physiother Res, 2(1): 347-353.
  5. Hagins, M., & Lamberg, E.M.(2011). Individuals with low back pain breathe differently than healthy individuals during a lifting task. J Orthop Sports Phys Ther, 41(3): 141-148. https://doi.org/10.2519/jospt.2011.3437
  6. Hodges, P.W., Gurfinkel, V.S., Brumagne, S., Smith, T.C., & Cordo, P.C.(2002). Coexistence of stability and mobility in postural control: evidence from postural compensation for respiration. Exp Brain Res, 144(3): 293-302. https://doi.org/10.1007/s00221-002-1040-x
  7. O'Sullivan, P.B.(2000). Lumbar segment instability : clinical presentation and specific stabilizing exercise management. Man Ther, 5(1): 2-12. https://doi.org/10.1054/math.1999.0213
  8. O'Sullivan, P.B.(2005). Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther, 10(4): 242-255. https://doi.org/10.1016/j.math.2005.07.001
  9. Lee, K.W.(2012). Effect of Thoracic Manipulation and Deep Cervical Flexor Exercise in Chronic Neck pain patients. Samyook University Graduate School. Doctoral Dissertation.
  10. 전영욱, 소현정, 정연도, 엄성흠(2015). Kaltenborn-Evjenth concept을 이용한 상부흉추 관절가동술이 만성 경부통증 환자의 경흉추 관절 가동범위의 변화와 통증에 미치는 영향. 한국방사선학회논문지, 9(7): 479-486. https://doi.org/10.7742/JKSR.2015.9.7.479
  11. 강권영, 김은경, 홍기훈(2011). 만성 허리통증 환자의 운동프로그램에 대한 효과. 대한물리치료과학회논문지, 18(2): 1-8.
  12. Thue, L., Baek, I.H., & Lee, K.W.(2015). Medical Training Therapy. Panmun Publishing Co.
  13. 기철, 허명(2014). 피드백 강화호흡운동이 만성요통환자의 물건들기와 흉추부 안정화에 미치는 영향. 한국엔터테인먼트산업학회논문지 8(3): 441-449.
  14. Fritz, J.M., Piva, S.R., & Childs, J.D.(2005). Accuracy of the clinical examination to predict radiographic instability of the lumbar spine. Eur Spine J, 14: 743-750. https://doi.org/10.1007/s00586-004-0803-4
  15. O'Sullivan, P.B., & Beales, D.J.(2007). Changes in pelvic floor and diaphragm kinematics and respiratory patterns in subjects with sacroiliac joint pain following a motor learning intervention: a case series. Man Ther, 12(3): 209-218. https://doi.org/10.1016/j.math.2006.06.006
  16. Ki, C., Heo, M., Kim, H.Y., & Kim, E.J.(2016). The effects of forced breathing exercise on the lumbar stabilization in chronic low back pain patients. J Phys Ther Sci, 28(12): 3380-3383. https://doi.org/10.1589/jpts.28.3380
  17. Courtney, R., van Dixhoorn, J., & Cohen, M.(2008). Evaluation of breathing pattern: comparison of a Manual Assessment of Respiratory Motion(MARM) and respiratory induction plethysmography. Appl Psychophysiol Biofeedback, 33(2): 91-100. https://doi.org/10.1007/s10484-008-9052-3
  18. Chapman, E.B., Hansen-Honeycutt, J., Nasypany, A., Baker, R.T., & May, J.(2016). A clinical guide to the assessment and treatment of breathing pattern disorders in the physically active: part 1. Int J Sports Phys Ther, 11(5): 803-809.
  19. Roussel, N., Nijs, J., Truijen, S., Vervecken, L., Mottram, S., & Stassijns, G.(2009). Altered breathing patterns during lumbopelvic motor control tests in chronic low back pain: a case-control study. Eur Spine J, 18(7): 1066-1073. https://doi.org/10.1007/s00586-009-1020-y
  20. Beeckmans, N., Vermeersch, A., Lysens, R., Van Wambeke, P., Goossens, N., Thys, T., Brumagne, S., & Janssens, L.(2016). The presence of respiratory disorders in individuals with low back pain: A systematic review. Man Ther, 26: 77-86. https://doi.org/10.1016/j.math.2016.07.011
  21. Anderson, B.E., & Bliven, K.C.(2017). The use of breathing exercises in the treatment of chronic, nonspecific LBP. J Sport Rehabil, 26(5): 452-458. https://doi.org/10.1123/jsr.2015-0199
  22. Stephens, R.J., Haas, M., Moore, W.L. 3rd, Emmil, J.R., Sipress, J.A., & Williams, A.(2017). Effects of diaphragmatic breathing patterns on balance: A preliminary clinical trial. J Manipulative Physiol Ther, 40(3): 169-175. https://doi.org/10.1016/j.jmpt.2017.01.005
  23. 기철, 남기원(2019). 젊은 만성허리통증자의 허리부위 불안정성 검사 양성반응 수와 호흡 패턴변화율, 통증 간의 상관관계분석. 대한물리의학회논문지, 14(3): 73-80.
  24. 기철, 이관우(2020). 만성허리통증자의 호흡 패턴과 배부 운동성 변화에 대한 주관적 허리부위 불안정성 요소의 유용성에 관한 연구. 한국산학기술학회논문지, 21(3): 206-214. https://doi.org/10.5762/KAIS.2020.21.3.206
  25. Ki, C., & Heo, M.(2020). Changes in thoracoabdominal usage rate after reapiratory pattern correction in patients with lumbar instability. 한국엔터테인먼트산업학회논문지, 14(7): 581-587.
  26. Biely, S.A., Silfies, S.P., Smith, S.S., & Hicks, G.E.(2014). Clinical observation of standing trunk movements: what do the aberrant movement patten tell us? J Orthop Sports Phys Ther, 44(4): 262-72. https://doi.org/10.2519/jospt.2014.4988
  27. Kaltenborn, F.M.(2009). Manual Mobilization of the Joint, Vol. II, The Spine. Norli.
  28. Hicks, G.E., Fritz, J.M., Delitto, A., & Mishock, J.(2003). Interrater reliability of clinical examination measures for identify-cation of lumbar segmental instability. Arch Phys Med Rehabil, 84(12): 1858-1864. https://doi.org/10.1016/S0003-9993(03)00365-4
  29. Mohan, V., Dzulkifli, N.H., Justine, M., Haron, R., Leonard, J.H., & Rathinam, C.(2012). Intrarater reliability of chest expansion using cloth tape measure technique. Bangladesh journal of medical science, 11(4): 307-311. https://doi.org/10.3329/bjms.v11i4.12602
  30. Obayashi, H., Urabe, Y., Yamanaka, Y., & Okuma, R.(2012). Effects of respiratory-muscle exercise on spinal curvature. J Sport Rehabil, 21(1): 63-68. https://doi.org/10.1123/jsr.21.1.63
  31. Ishida, H., Hirose, R., & Watanabe, S.(2012). Comparison of change in the contraction of the lateral abdominal muscles between the abdominal drawing-in maneuver and breath held at the maximal expiratory level. Man The, 17(5): 427-431.
  32. Neumann, D.A.(2002). Kinesiology of the musculoskeletal system: foundations for rehabilitation. St Louis, Mosby.
  33. Writh, B., Ferreira, T.D., Mitteholzer, M., Humphrey, B.K., & Boutellier, U.(2016). Respiratory muscle endurance training reduces chronic neck pain: A pilot study. Journal of Back and Musculoskeletal Rehabilitation, 29(4): 825-834. https://doi.org/10.3233/bmr-160695
  34. Chaitow, L.(2004). Breathing pattern disorders, motor control, and low back pain. J Osteop Med, 7(1): 33-40. https://doi.org/10.1016/S1443-8461(04)80007-8