비만 중년여성의 신체조성 및 혈액성상에 대한 습식마사지의 효과 평가를 위한 메타분석 = Meta-Analysis for the Evaluation of the Effects of Wet Massage on the Body Composition and Serum Profile in Obese Middle-Aged Women

국문 초록 (Abstract)

본 연구는 우리나라 비만 중년여성에게 효용성이 높은 습식마사지(wet massage) 요법을 제시할 목적으로 중년여성의 신체조성과 혈액성상에 미친 습식마사지의 효과를 평가하고자 메타분석(meta analysis)을 실시하였다.
비만 중년여성의 신체조성과 혈액성상에 대한 습식마사지의 효과를 평가하기 위해 국내에서 22년간(2000년 1월부터 2022년 9월까지) 발표된 연구물들을 수집한 후 최종적으로 선정된 33편으로 메타분석을 실시하였다.
비만 중년여성의 신체조성과 혈액성상에 미친 습식마사지의 효과를 평가하기 위해 최종적으로 수집된 연구물들의 종속변인은 신체조성과 혈액성상으로 분류하였다.
메타분석을 위해 신체조성의 하위요인은 BMI(체질량지수, body mass index), 체중(body weight), 체지방량(fat mass), 근육량(body muscle) 및 신체계측치(anthropometric measurement)로 분류하였다. 단, 신체계측치는 신체둘레(body circumference)와 피하지방두께(skin-fold thickness)로 다시 분류하였다.
메타분석을 위해 혈액성상의 하위요인은 혈중지질(blood lipid)과 혈당 및 혈중호르몬(blood glucose & hormone)으로 분류하였다. 단, 혈중지질은 중성지방(triglyceride), 총콜레스테롤(total cholesterol), HDL-콜레스테롤(HDL-cholesterol) 및 LDL-콜레스테롤(LDL-cholesterol)로 다시 분류하였다.
그리고 습식마사지(경락, 아로마, 스웨디시) 중 비만 중년여성의 신체조성과 혈액성상에 가장 효과적인 요법도 알아보았다.
또한, 습식마사지의 최적 중재기간을 알아보고자 중재기간(4주 이하, 5∼8주 및 10∼16주)이 비만 중년여성의 신체조성과 혈액성상에 미친 효과도 알아보았다.
본 연구 결과, 비만 중년여성의 신체조성과 혈액성상에 미친 습식마사지의 전체 효과크기(effect size)는 중간 효과크기보다 낮은 수준(0.366)이었다. 신체조성 중 체지방량, BMI, 체중, 근육량 및 신체계측치에 미친 습식마사지의 효과크기는 각각 신체계측치(0.525), 체지방량(0.324), BMI(0.273), 체중(0.222), 근육량(0.222)의 순으로 나타났다. 신체계측치의 하위요인인 신체둘레와 피하지방두께는 각각 0.477과 0.645로 중간 정도의 효과크기로 나타났다. 혈액성상 중 혈중지질(0.307)과 혈당 및 혈중호르몬(0.208)은 중간보다 낮은 효과크기로 나타났다. 그러나 혈중지질의 하위요인은 중성지방(0.414), 총콜레스테롤(0.367), LDL-콜레스테롤(0.295), HDL-콜레스테롤(0.180)의 순으로 나타나 낮은 효과크기부터 중간 효과크기까지 다양하게 나타났다.
비만 중년여성의 신체조성과 혈액성상에 미친 습식마사지 종류에 따른 전체 효과크기는 경락마사지(0.379), 스웨디시마사지(0.375), 아로마마사지(0.311)의 순으로 효과적인 것으로 나타났다. 습식마사지 종류에 따라 신체조성에 미친 효과크기는 스웨디시마사지(0.441), 경락마사지(0.379), 아로마마사지(0.292)의 순으로 나타났다. 또 혈액성상에 미친 효과크기는 경락마사지(0.400), 아로마마사지(0.377), 스웨디시마사지(0.161)의 순으로 나타났다.
비만 중년여성의 신체조성 및 혈액성상에 대한 습식마사지의 중재기간은 10∼16주(0.532), 5∼8주(0.349), 4주 이하(0.299)의 순으로 중재기간이 길수록 효과적인 것으로 나타났다.
특정 마사지 요법에만 한정된 기존의 연구와 달리 본 연구는 우리나라에서 사용 빈도가 높은 습식마시지 요법 중 경락마사지, 아로마마사지 및 스웨디시마사지를 선정하고 신체조성, 혈액성상 및 중지개간이 미친 효과를 종합적으로 평가한 것에 의의가 있다. 차후 본 연구 결과를 토대로 좀 더 심도 있는 프로그램이 개발되어 중년여성의 비만 관리에 효과적으로 사용되길 기대한다.

다국어 초록 (Multilingual Abstract)

This study aims to propose wet massage therapies which are effective for obese middle-aged women in Korea. To this end, a meta-analysis was conducted to evaluate the effects of wet massage on the body composition and serum profile in middle-aged women.
For the purpose of evaluating the effects of wet massage on the body composition and serum profile in obese middle-aged women, a meta-analysis was conducted with 33 finally selected for the data collected from research papers domestically published over 22 years (from Jan. 2000 to Sep. 2022) were collected
For the evaluation of the effects of wet massage on the body composition and serum profile in obese middle-aged women, dependent variables for meta-analysis were categorized into body composition and serum profile.
For the meta-analysis, sub-factors of body composition were classified into BMI (body-mass index), body weight, fat mass, body muscle, and anthropometric measurement. Among them, anthropometric measurement was again classified into body circumference and skin-fold thickness.
For the serum profile, sub-factors were classified into blood lipid and blood glucose & hormone. And serum profile was again classified into triglyceride, total cholesterol, HDL-cholesterol, and LDL-cholesterol.
In addition, the most effective therapy for body composition and blood properties in obese middle-aged women among wet massage (meridian, aroma, and swedish) was also investigated.
In the meta-analysis process for body composition and serum profile, the intervention period of wet massage was categorized into 4 or fewer weeks, 5∼8 weeks, and 10∼16 weeks.
The results of the meta-analysis are as follows. The total effect size of wet massage on the body composition and serum profile in obese middle-aged women was lower (0.366) than the median level. As for the sub-factors of body composition of wet massage, that is, fat mass, BMI, body weight, body muscle, and anthropometric measurement, the effect size was largest for anthropometric measurement (0.525), followed by fat mass (0.324), BMI (0.273), body weight (0.222), and body muscle (0.222), respectively, in the presented order. Regarding body circumference and skin-fold thickness, which are the sub-factors of anthropometric measurement, the effect size was 0.477 and 0.645, respectively, which was at around the median level. And among the sub-factors of the serum profile, the effect size for blood lipid (0.307) and blood glucose and hormone (0.208) was lower than the median level. However, the effect size of the sub-factors of blood lipid was widely distributed along the spectrum from the lower end to the median level: triglyceride (0.414), total cholesterol (0.367), LDL-cholesterol (0.295), and HDL-cholesterol (0.180), in the presented order.
The total effect size of wet massage on the body composition and serum profile of obese middle-aged women was largest for meridian massage (0.379), followed by swedish massage (0.375) and aroma massage (0.311). In the evaluation of effect size on body composition depending on the type of wet massage, swedish massage (0.441) showed the largest effect size, followed by meridian massage (0.379) and aroma massage (0.292). In addition, the effect size on serum profile was largest in the case of meridian massage (0.400), while aroma massage (0.377) was ranked second and swedish massage (0.161) showed the smallest effect size.
The results of this study also showed that as the intervention period gets longer, the effect size of wet massage on the body composition and serum profile in obese middle-aged women becomes larger, in the order of 10∼16 weeks (0.532), 5∼8 weeks (0.349) and 4 or fewer weeks (0.299).
While previous studies selected and analyzed a specific type of massage therapy, this study has its significance in that it comprehensively analyzed body composition, serum profile, and the effects of the intervention period by selecting meridian massage, aroma massage, and swedish massage, which are the wet massage therapies most frequently used in Korea. The findings of this study are expected to be utilized in the future in developing more intensive wet massage programs that could be effective in managing the obesity in middle-aged women.

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구 필요성 및 목적 1
• Ⅱ. 이론적 배경 4
• 1. 마사지의 정의 및 효과 4
• 1) 정의 4
• 2) 효과 5
• 2. 마사지의 역사 9
• 1) 서양 11
• 2) 동양 26
• 3) 한국 36
• 3. 습식마사지의 종류 44
• 1) 경락마사지 45
• 2) 아로마마사지 47
• 3) 스웨디시마사지 49
• 4. 여성의 중년기와 비만 관련 건강 문제 52
• 1) 여성의 중년기 52
• 2) 비만 관련 건강 문제 53
• Ⅲ. 연구 방법 56
• 1. 연구설계 56
• 2. 연구대상 수집 및 선정 57
• 1) 문헌검색 및 자료 수집 57
• 2) 연구물 선정 58
• 3. 연구자료의 특성 분석 및 코딩 61
• 1) 연구자료의 특성 분석 61
• 2) 코딩표 개발 71
• 3) 자료의 코딩 73
• 4) 연구의 질 평가 74
• 4. 메타분석 75
• 1) 효과크기 산출 77
• 2) 효과크기의 신뢰구간 검증 80
• 3) 이질성 검정 81
• 4) 이질성 검정에 따른 분석모형 선택 82
• 5) 출판편향 83
• 6) 분석 84
• Ⅳ. 연구 결과 85
• 1. 습식마사지가 비만 중년여성의 신체조성과 혈액성상에 미친전체 효과크기 85
• 1) 전체 효과크기 85
• 2) 출판편향 88
• 2. 습식마사지가 비만 중년여성의 신체조성에 미친 효과크기 91
• 1) 전체 효과크기 91
• 2) 신체조성 관련 하위요인에 미친 효과크기 93
• 3. 습식마사지가 비만 중년여성의 혈액성상에 미친 효과크기 98
• 1) 전체 효과크기 98
• 2) 혈액성상 관련 하위요인에 미친 효과크기 100
• 4. 습식마사지의 종류에 따른 비만 중년여성의 신체조성과 혈액성상에 미친 효과크기 104
• 1) 전체 효과크기 104
• 2) 습식마사지의 종류가 비만 중년여성의 신체조성에 미친 효과크기 106
• 3) 습식마사지의 종류가 비만 중년여성의 혈액성상에 미친 효과크기 분석 108
• 5. 습식마사지의 중재 기간이 비만 중년여성의 신체조성과 혈액성상에 미친 효과크기 110
• Ⅴ. 논의 및 제언 113
• 참고문헌 117
• Abstract 141

참고문헌 (Reference)

1. Aromatherapy, Ha BJ, pp. 7-36, , 2006

2. Meta analysis, Hwang SD, pp. 241-254, , 2014

3. Swedish massage, Nam TY, pp. 11-25, , 2007

4. Basic skin management, Lee JN, pp. 9-23, , 2014

5. Face manual treatment, Im JS, Choi KI, p. 99, , 2009

6. National beauty major, ADIGA, from https://www. adiga. kr/PageLinkAll. do?link=/kcue/ast/eip/eis/inf/sjinf/eipSjinfGnrl. do&p_me nu_id=PG-EIP-05101 Accessed2023, , 2023

7. Essential aromatherapy, Choi SW, pp. 312, , 2014

8. Essential aromatherapy, Choi SY, Hong H., pp. 205-217, , 2009

9. Massage therapy manual, Seong GS, pp. 9-45, , 2005

10. Meta-analysis using R., Hwang SD, pp. 11-136, , 2015

11. The history of massage, Calvert RN, pp. 1-147, , 2002

12. Rules on massage parlors, ANMAUP, http://www. anmaup. or. kr/#top-sub-menu02/ Accessed, , 2023

13. Whole body management study, Lee JN, Lee HY, pp. 1-254, , 2013

14. Yeom Song-ok's inner beauty, Yeom SO, p. 278, , 2002

15. Natural basic swedish massage, Nam TY, pp. 10-25, , 2004

16. Wilson Meagher sports therapy, Meagher J., https://www. sports massageinc. com/About-Jack-Meagher. htm Accessed, , 2023

17. The) seasons of a woman's life, Levinson DJ, Kim AS, pp. 500-887, , 2004

18. Beauty meridian: Theory and practice, Ahn NH, pp. 1-374, , 2000

19. Theory and practice of meta-analysis, Cho JH, 27: 83-89, , 2020

20. A general history of Chinese medicine, Boo YG, pp. 1-545, , 2000

21. Statistical Methods for Meta-analysis, Hedges, L. V. & Olkin, I, pp. 149-167, , 1985

22. Obesity as a cardiovascular risk factor, Sowers JR., 8: 37S-41S, , 2003

23. NECA systematic literature review manual, Heo DS, pp. 118-223, , 2011

24. Theory and practice of therapeutic massage, Beck MF, pp. 1-490, , 2008

25. Statistical Considerations in Meta-Analysis, Kang H., 35: 23-32, , 2015

26. The origin and development of sports massage, Kwon HS, Beck JH, 10: 219-229, , 2002

27. Oriental medicine beauty and meridian massage, Kim HN, pp. 1-156, , 2004

28. Statistical power analysis for the behavioral science, Cohen J, 2nd ed pp. 6-27, , 1988

29. A study on literature on effectiveness of sports massages, Im YY, Yong YL, 5: 899-937, , 2002

30. An introduction of the systematic review and meta-analysis, Shin WJ, 35: 9-17, , 2015

31. Developmental psychology: human development throughout life, Jeong OB, pp. 525-585, , 2014

32. The effects of meridian massage on female abdominal obesity, Im JS, 3: 5-18, , 2008

33. Alternatives to P value: Confidence interval and effect size, Lee, D. K., 69: 555-562, , 2016

34. Effect of capsaicin on middle aged women s abdominal obesity, Eun E, Im MH, 30: 121-143, , 2019

35. The effect of massage to the bad postnatal uterine restoration, Yuk JY, 9: 563-569, , 2011

36. The origin and developmental history of ancient Saireumin Korea, Jeong CM, Ji CM, 5: 1-20, , 2000

37. A meta-analysis of obesity management effects of aromatherapy use, Jeon YA, Woo N, 12: 275-281, , 2014

38. A study on the effects of obesity management for reducing body fat, Yoon YS, 6: 165-187, , 2000

39. Anatomical physiology (for beauty) = Aesthetic anatomy & physiology, Han JM, pp. 51-61, , 2020

40. The effect of bone-muscle massage on belly obesity of middle-aged women, We GS, We SY, Im EJ, 19: 581-587, , 2013

41. Effect of massage with warming stone on abdominal obesity in middle aged woman, Heo HI, Kim H., 7: 207-214, , 2011

42. A study on the relatedness & practicability of alternative medicine & skin care, Cho SE, 9: 389-402, , 2002

43. The influence of lymph drainage using body slimming on abdomen obesity in women, Park SH, Yoon CS, 15: 1159-1168, , 2009

44. Spring Conference of the Korean obesity society-symposium: 3. obesity and weight loss, Cho JG, 9: 48-54, , 2000

45. Influences of self-esteem and loneliness on subjective well-being of middle-aged women, Cha EJ, Lee SH, 25: 163-170, , 2020

46. Effect of aromatherapy massage on abdominal fat and body image in post-menopausal women, Kim HJ, Park OJ, 37: 603-612, , 2007

47. A study of meridian massage effect on decrease in abdominal obesity in middle-aged women, Byeon HJ, Shin GR, 12: 174-191, , 2011

48. The effect of chuna and swedish massages on abdominal obesity in Korean middle-aged women, Han CJ, Jung EA, 22: 171-180, , 2010

49. Guidelines for prevention of cardiovascular disease in women: a summary of recommendations, Mosca L., 10: 19-25, , 2007

50. The effect of the meridian massage on the hand edema and function of the hemiplegic patient, Lee SE, Lee HR, 15: 520-530, , 2003

51. The effects of essential oil and massage on abdominal obesity improvement of middle-aged wome, Shin DH, Jin JW, 9: 1-12, , 2011

52. A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis, Duval S, Tweedie R., 56: 455-463, , 2000

53. The effect of chest meridian massage on post- anesthetic recovery of general anesthesia patients, Lee BY, Son GH, 17: 612-621, , 2005

54. Effect of aromatherapy massage on body composition and serum lipid in obese women after menopause, Kim HJ, 9: 29-39, , 2007

55. The effects of crystal thermal therapy on body composition and blood lipids in obesity university student, Jung JY, Kim KR, 22: 570-579, , 2016

56. Effects of aquatic exercise on fitness and obesity-related blood lipids in postmenopausal middle-aged women, An SH, 29: 725-733, , 2020

57. The impact of methodological factors on child psychotherapy outcome research: a meta-analysis for researchers, Weiss B, Weisz JR, 18: 639-670, , 1990

58. Symposium: lifestyle disease; which is more important in treating obesity, lifestyle improvement or medication?, Kim DJ, 69: 682-684, , 2005

59. Effects of a exercise program on body composition, physical fitness and lipid metabolism for middle-aged obese women, Lee KJ, 35: 1248-1257, , 2005

60. The problem of depression of the middle - aged people and the method to cope with it-centered around the theory of Jung CG, Park CA, 49: 533-554, , 2016

61. The effests of the aroma massage on abdominally obess on middle-age women's physiological indices, depression and concern with look, Kim HJ, Ahn SA, 15: 1261-1270, , 2009

62. The comparison of the influence by manipulation with that by high frequency management in adjustment of blood lipid for middle- aged women, Park SM, 9: 1-10, , 2011

63. Regular articles: The comparison of the influence by manual technique with that by high frequency management in effect of obesity for middle-aged women, Park SM, 7: 131-136, , 2011

64. Effect of abdominal massage and catechin intake on body composition, serum lipid level, DNA damage, and total antioxidant status of women with abdominal obesity, Yoon JH, Ahn HS, 18: 10-16, , 2012