마사지 및 정적 스트레칭이 20대 정상 성인의 경부 관절가동범위에 미치는 효과

권원안(Kwon, Won-An),김동대(Kim, Dong-Dae),이재홍(Lee, Jae-Hong) 한국산학기술학회 2010 한국산학기술학회논문지 Vol.11 No.11

본 연구의 목적은 20대의 정상 성인에서 경부의 관절가동범위와 마사지 및 정적 스트레칭이 관절가동범위 에 미치는 영향을 측정하는 것이다. 근골격계와 신경계의 질환이 없는 100명(마사지그룹=50, 스트레칭그룹=50)을 대 상으로 실시하였다. 마사지와 정적 스트레칭은 흉쇄유돌근, 사각근, 승모근, 반극근, 판상근, 후두하근, 다열근과 회선 근에 적용되었다. 두 그룹은 주 3회의 중재를 받았다. 중재 시간은 10분이었다. 마사지그룹은 경찰법, 유날법 및 스 트라이핑 마사지가 사용되었고, 스트레칭그룹은 정적 스트레칭이 사용되었다. 경부의 가동범위 측정도구는 경부의 8 가지 동작(후두하 굽힘과 폄, 경부의 굽힘과 폄, 왼쪽 옆굽힘과 오른쪽 옆굽힘, 왼쪽 돌림과 오른쪽 돌림)을 분석하 기 위하여 사용되었다. 통계학적 분석결과는 다음과 같다. 첫째, 정상적인 경부의 관절가동범위는 남자에서 후두하 굽힘과 폄이 2.39°와 38.36°, 경부의 굽힘과 폄이 54.11°와 69.39°, 왼쪽과 오른쪽의 옆굽힘이 43.50°와 41.28°, 왼쪽 과 오른쪽의 돌림이 66.39°와 65.94°로 나타났고, 여자에서는 후두하 굽힘과 폄이 5.14°와 36.47°, 경부의 굽힘과 폄 이 55.92°와 71.22°, 왼쪽과 오른쪽의 옆굽힘이 43.34°와 41.06°, 왼쪽과 오른쪽의 돌림이 69.38°와 68.63°로 나타났 다. 둘째, 후두하 굽힘, 왼쪽 돌림과 오른쪽 돌림에서 여성이 남성보다 더 높은 관절가동범위를 보였다(p<0.05). 셋째, 마사지군과 스트레칭군은 치료 후에 모든 항목에서 관절가동범위의 증가를 보였지만 두 그룹간의 비교에서는 유의한 차이를 보이지 않았다(p<0.05). 위의 결과는 마사지와 정적 스트레칭이 경부 근육의 신장 및 이완을 통해 가동범위를 증가시키는 적당한 방법이라는 것을 제시한다. 그리고 경부의 가동범위를 조사하는 연구의 기초로 제공될 수 있을 것이다. The purpose of this study was to estimate the cervical range of motion and the effects of massage and static stretching in their 20s of normal adult. One hundred participants(massage=50, stretching=50) with no musculoskeletal and nervous system problems volunteered for this study. Massage and static stretching were applied to sternocleidomstoid, scalenes, trapezius, semispinalis, splenius, suboccipital, multifidi and rotatores. Both groups received intervention for 3 times in a week. The time the intervention was applied was for 10minutes. Effleurage, petrissage and stripping technique was applied to massage group and static stretching technique was applied to stretching group. The cervical range of motion (CROM) instrument was used to measure eight cervical motions (suboccipital flexion, suboccipital extension, neck flexion and extension, and left and right lateral flexion, left and right rotation). As a result of making a statistical analysis of the data, the following findings were given: First, normal cervical range of motion revealed; suboccipital flexion(2.39°) and extension(38.36°), flexion(54.11°) and extension(69.39°), lateral flexion on left(43.50°) and right(41.28°), rotation on left(66.39°) and right(65.94°) in male and suboccipital flexion(5.14°) and extension(36.47°), flexion(55.92°) and extension(71.22°), lateral flexion on left(43.34°) and right(41.06°), rotation on left(69.38°) and right(68.63°) in female. Second, women had greater range of motions than men in suboccipital flexion, left and right rotation(p<0.05). Third, it showed significantly increasing cervical range of motion in all directions within groups following treatments but not between groups(p<0.05). Our results suggest that massage and static stretching are an appropriate intervention to increase cervical range of motion by muscle relaxation and stretching and may be provided a basis for future studies investigating the cervical range of motion.

The Effects of Joint Mobilization with Combined Exercise Therapy of Sling on Post-traumatic Adhesive Capsulitis Patient: A Case Report

권원안,김연정,권혜미,김은지,박우경,신혜원,오정익,우정희,이다혜,이은정,정은주,정재영,정현경,최보영,허은영,이재홍,Kwon, Won-An,Kim, Youn-Joung,Kwon, Hye-Mi,Kim, En-Ji,Park, Woo-Kyung,Shin, Hye-Won,Oh, Joung-Ik,Woo, Joung-Hee,Lee, Da-Hye,Lee, En-young Korea Proprioceptive Neuromuscular Facilitation As 2012 PNF and Movement Vol.10 No.2

본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.

감압치료가 요추간판탈출 6(증)례에 미치는 영향

권원안(Kwon, Won-An),이승호(Lee, Sung-Hou),이재홍(Lee, Jae-Hong) 한국산학기술학회 2012 한국산학기술학회논문지 Vol.13 No.5

본 연구의 목적은 척추감압치료와 한의학적 치료법으로 치료된 요부디스크 탈출 6례에 관한 자기공명영 상의 변화를 보고하는 것이다. 디스크 높이는 T2-강조 자기공명영상의 시상면으로 측정되었다. 탈출된 디스크의 크 기는 MRI와 디스크 탈출지수로 측정되었다. 디스크퇴행에 관한 등급체계와 연산은 MRI 신호강도, 디스크구조, 수 핵과 섬유륜의 구별을 기초로 하였다. 디스크 높이, 디스크 탈출지수와 디스크 변성등급은 MRI로부터 측정하여 치료 전과 후에 수집되었다. 본 증례연구가 보여주는 것은 디스크 탈출에 대한 감압치료가 디스크 높이를 제외한 디스크 탈출지수, 디스크 재생에 긍정적인 영향을 미친다는 것이다. 디스크 탈출에 대한 감압치료의 사용에 관한 임상적 증거는 제한된 연구 때문에 미비하다. 따라서 이 분야에 주의를 기울이기위한 더 많은 시도들은 명확한 결 론을 내리기 위해서 필요할 것으로 사료된다. The Purpose of this study was to report magnetic resonance imaging(MRI) changes of six cases of Lumbar herniated disc which was treated with spinal decompression therapy, oriental medical therapy. 'Disc heights' were measured on sagittal view of T2-weighted MRI. Size of the herniated disc was measured by MRI and 'disc herniations index'. The grading system and algorithm for 'disc degeneration' were based on MRI signal intensity, disc structure, distinction between nucleus and anulus, and disc height. Data for disc height, disc herniations index and disc degeneration grade were collected before and after the treatment together with calculation from the MRI. Case studies were showed that decompression therapy for the herniated disc has an positive effect on disc herniations index, disc regeneration, not disc heights. The clinical evidence for the use of decompression in herniated disc remains inconclusive because of limited researches. Further trials, which give attention to these areas, are needed before any firm conclusions may be made.

대학생의 요통장애지수에 대한 분포

권원안(Kwon, Won-An),김동대(Kim, Dong-Dae),엄기매(Um, Ki-Mae),송영화(Song, Young-Hwa),오현주(Oh, Hyun-Ju),이재홍(Lee, Jae-Hong) 한국산학기술학회 2010 한국산학기술학회논문지 Vol.11 No.10

요통은 청소년과 성인에서 흔히 경험하게 된다. 이 연구의 목적은 20대 대학생의 요통장애지수에 대한 분 포를 조사하는 것이다. 요통장애지수(ODI) 설문지를 이용하여 대학생(남성: 233, 여성: 407)들 대상으로 조사하여 수 집하였다. 통계적 분석은 SPSS 12.0을 이용하여 기술통계, 독립표본 t-test 및 피어슨의 상관분석을 실시하였다. 연구 의 결과는 첫째, 요통장애지수(ODI) 항목 중에서 가장 높은 점수를 나타내는 것은 ‘앉기’이고, 가장 낮은 점수는 ‘개 인위생’로 나타났다. 둘째, 요통장애지수는 남성이 4.62점, 여성이 6.13점으로 나타나 성별간의 차이가 있는 것으로 나타났지만(p<0.01), 요통장애지수 등급은 성별간의 차이가 없는 것으로 나타났다(p<0.01). 셋째, 요통장애지수 등급 과 각각의 요통장애지수 항목은 상관성이 있는 것으로 나타났다(p<0.01). 위의 결과는 앞으로의 임상적, 역학적 연구 자료로 의미를 가질 것이다. Low back pain is commonly experienced by both adolescents and adults. The aim of this study is to research the prevalence of the Oswestry disability index(ODI) in their 20s of college students. The data was collected from the ODI questionnaire on functional disability measures for college students(males: 233, females: 407). Statistical analysis was carried out with SPSS 12.0 program, which was used for descriptive statistics and Pearson correlation analysis. The results were : Firstly, 'sitting' item was showed 'the highest score' and 'the lowest score' was 'personal care' in ODI items. Secondly, there was statistically significant between female(6.13) and male(4.62) on ODI but not ODI grade(p<0.01). Thirdly, there was a statistically significant relationship between ODI grade and each ODI items(p<0.01). These results have specific meaning as future clinical and epidemiological studies.

노인의 우울증과 여가활동의 상관성에 관한 연구 - 대구시 북구를 중심으로 -

권원안,김한수,Kwon, Won-An,Kim, Han-Soo 대한물리치료학회 2008 대한물리치료학회지 Vol.20 No.4

Purpose: The aim of this study was to evaluate the correlation between the types of leisure activity and Korean form of geriatric depression score in the elderly. Methods: We surveyed elderly (>60 years old) people who participated in leisure activities using interviews in Bukgu district, Daegu city. Data collection was performed from 1 - 31 May, 2008. The data was analyzed with SPSS 12.0 program, which was used for descriptive statistics and Pearson correlation analysis. Results: Common leisure activities scored 'often' and 'very often' were family conversations, offspring visiting, eating out, plant cultivation, entertainment, conversation, walking or jogging, and TV or radio. It was investigated at the rate of 19.2% in the moderate depression and 8.3% in the severely depression. Depression positively associated with newspaper or magazine, family conversation, offspring visiting, social service, movie & theater, exercise and tour. Conclusion: Most elderly people surveyed indicated they were depressed, which should recommend significant leisure activities for elderly to reduce depression in Bukgu district, Daegu city.

칵스 신연교정이 L4-5 추간판 탈출증 환자의 기능적 평가측정과 추간판탈출지수에 미치는 효과

권원안,류영상,마상렬,Kwon, Won-An,Ryu, Young-Sang,Ma, Sang-Yeol 한국데이터정보과학회 2012 한국데이터정보과학회지 Vol.23 No.4

본 연구의 목적은 요추 추간판 탈출증 환자에게 치료적 모달리티와 칵스 신연교정치료 효과에 대하여 알아보고자 한다. 요추 추간판 탈출증 환자 15명 (나이 36.62, 범위 20-50, 남자 7명과 여자 8명)을 대상으로 4주간 적용하였다. 치료적 모달리티와 칵스 신연교정치료를 첫 2주 동안 주 6일, 12회 적용하였으며, 마지막 2주간은 주 3일 6회 적용하였다. 모든 실험대상자에게 4주 동안 18회를 적용하였다. 측정은 오스웨스트리 요통장애지수, 근력, 하지 직거상 검사는 실험 전, 치료 2주 후, 치료 4주 후 변화의 차이를 일요인 반복측정을 이용하였으며, 추간판 탈출지수는 실험 전, 치료 4주 후 변화 차이를 대응표본 t-검정을 이용하여 측정하였다. 치료적 중재 기간에 따라 치료 전, 2주 후, 4주 후 측정결과 오스웨스트리 요통장애 지수, 하지 직거상 검사, 그리고 근력은 치료 2주 후, 치료 4주 후가 치료 전에 비하여 통계학적 유의한 변화가 있었다. 그러나 추간판 탈출지수는 치료 전에 비하여 감소함을 나타냈으나 통계학적으로 유의한 변화는 없었다. 결론적으로 요추 추간판 탈출증 환자에게 치료적 모달리티와 칵스 신연교정치료가 요통장애지수, 하지 직거상 검사, 근력개선에 효과적이란 결론을 얻었다. 이것은 칵스 신연교정치료의 안전성과 효과의 확인, 그리고 요추 추간판 탈출증 환자에게 비수술적 치료법으로서의 근거를 제시하였다. The purpose of the present study was to determine the effect of a 4 week course of Cox distraction manipulation (CDM) combined with therapeutic modalities on the treatment of patients with L4-5 herniated nucleus pulposus (HNP). A total of 15 patients with L4-5 HNP (mean age, 37.76 years; age range 20-50years) participated in the study. A 4 week course of CDM combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and three times per week for two additional weeks. The entire treatment consisted of 18 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and oswestry disability index (ODI) at pre-intervention, after two weeks treatment sessions, and at discharge (after 18 treatment sessions) were analyzed. Comparisons of changes in the disc herniation index (DHI) at pre-intervention and at discharge were analyzed using the paired t-test. There were significant improvements in the outcome measures of MS Ibs, SLR test, and ODI score after 2 weeks and 4 weeks sessions of CDM combined with therapeutic modalities as compared with the pre-intervention. However, no significant different pre-test and post-test DHI. CDM combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with L4-5 HNP.

간헐적 견인과 도수 견인이 요추 추간판 탈출에 미치는 효과

권원안,마상렬,황윤태,Kwon, Won-An,Ma, Sang-Yeol,Hwang, Yoon-Tae 대한물리치료학회 2009 대한물리치료학회지 Vol.21 No.3

Purpose: The purpose of this study was to investigate the effects of intermittent lumbar traction and manual traction on a $L_{4-5}$ herniated disc. Method: The subjects were randomly divided into the intermittent lumbar traction group (n=10) and the manual traction group (n=10). The intermittent traction group had traction-treatment applied for 12 times in the first two weeks, and then 6 times in the next two weeks. The time the traction was applied was for 30 minutes. The manual traction group had flexion-distraction therapy applied for 12 times in first two weeks, and for 6 times in next two weeks. The time the traction was applied was 3 to 6 minutes per treatment. Results: The change of the muscle test (MT), the disc herniation index (DHI) and the sagittal $T_2$ weighted MRI was measured at pretreatment and 4weeks and 12weeks after treatment. Conclusion: We found that intermittent lumbar traction and manual traction could improved the MT and DHI and this could improve the rehabilitation of patients with lumbar herniated disc.

물리치료사의 직무관련 근골격계 통증의 유병률과 발생요인에 관한 연구

권원안,이재홍,김소연,이영화,Kwon, Won-An,Lee, Jae-Hong,Kim, So-Yeon,Lee, Young-Hwa 대한고유수용성신경근촉진법학회 2012 PNF and Movement Vol.10 No.3

Purpose : The purpose of the present study was to describe the prevalence and causes of occurrence on work-related musculoskeletal disorders(WMSDs) in physical therapist. Methods : Self-administered questionnaires were distributed by mail to 100 physical therapists in Daegu city. 85 of the questionnaires were returned and 80 of them except 5 unclearly answered ones were analyzed. Results : They felt the pain at shoulders(80%), lower back(74%), wrists(71%), neck(70%), elbow(48%), finger(40%). The major causes of the pain were "repeating the same job constantly(93%)," and "bending wrists too much and doing things that require excessive strength(90%)." It was significant different more Exercise therapist than modality therapist. Conclusion : We suggest that physical therapist for exercise therapy need the development and applies of various program for prevention of work-related musculoskeletal disorders.

한국과 미국의 스포츠 물리치료 교육 프로그램 비교분석

권원안,민동기,이재홍,Kwon, Won-An,Min, Dong-Gi,Lee, Jae-Hong 대한고유수용성신경근촉진법학회 2012 PNF and Movement Vol.10 No.1

Purpose : This thesis aims to explore sports physical therapist program of university of education of korea and usa for the whole process of becoming sports physical therapist and provide better education programs for cultivating sports physical therapist in the future. Methods : This thesis education programs of physical therapy department in Korea and 3 universities in east california region were selected with recommendation of a professional on sports physical therapist in USA. for the purpose of this study, curriculum of physical education department at school of education was analyzed using internet survey, phone survey, visitor survey and examination of hand book in korea. in usa, homepage, internet survey, e-mail and examination of handbook were used to analyze the data. Results : First, the results of this study can be summarized as follows: second, In comparison of required subjects and selective subject of physical therapy education in Korea and USA, Korea presents the least required subjects for major while USA offer more required subjects for majors. Korea puts focus on education practice while USA offers initial field experience and education practice well connected and organized systematically. Third, comparison of system of professional sports physical therapist, Korea did not establish system of a professional sports physical therapist, USA systematically established system of a professional sports physical therapist. Conclusion : On the basis Professional physical therapist, PNF association has to need to study hardly about special therapist.

요추간판 탈출의 자연적 축소(3례 증례보고)

권원안,김한수,Kwon, Won-An,Kim, Han-Soo 대한물리치료학회 2008 대한물리치료학회지 Vol.20 No.3

Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.