학술논문
전신진동 운동이 만성 발목 불안정성 환자들의 정적,동적 자세 제어능력에 미치는 영향 / The Effects of Whole-body Vibration Exercise on Static and Dynamic postural Control in Patients with Chronic Ankle Instability
Document Type
Dissertation/ Thesis
Author
Source
Subject
Language
Korean
Abstract
발목 염좌는 스포츠 상황뿐만이 아니라 일상생활에서도 빈번히 일어나는 부상 중 하나이다. 발목 염좌가 발생하게 되면 이때 발생하는 구조적인 손상은 근-건 조직뿐만 아니라 발목 주변에 있는 신경조직에 까지 영향을 미치게 되는데 이로 인하여 인대의 느슨함을 느끼는 기계적인 불안정성뿐만 아니라 서있거나 움직일 때 ‘휘청거림’을 느끼는 기능적인 불안정성으로 이어지게 된다. 기계적인 불안정성은 수술요법으로 인하여 비교적 간단한 방법으로 치료할 수 있는데 반해 기능적인 불안정성은 수술적인 처치가 힘들 뿐만 아니라 나아가 만성 발목 불안정성으로 이어질 수 있기 때문에 치료가 필수적이다. 본 연구에서는 전신 진동 운동이 만성 발목 불안정성 환자들에 자제제어 능력에 어떠한 영향을 미치는지 알아보고자 하였다. 전신 진동 운동은 자제 제어 조절 능력을 향상 시킨다고 보고 하는 선행 연구들이 많이 있는데 이들은 전신 진동 운동 직후의 단기 효과를 보았거나 근력 운동과 복합한 연구들이 대부분이다. 본 연구에서는 근육에 직접적인 진동이 근-신경 흥분성을 증가시킨다는 점과 직접적인 진동자극뿐 아니라 전신진동과 같은 간접적인 진동을 통해서도 같은 반응을 유발될 수 있다는 점에 착안하여 전신 진동운동을 신경학적 결손이 있는 만성발목불안정성 환자들에게 적용함으로써 그들의 운동 신경원 활성화와 자세 제어 능력에 어떠한 변화를 가져 오는지 알아보고자 하였다. 전신 진동은 8명의 CAI그룹(나이: 22.8±3.23; 키: 171.7±8.94; 몸무게: 70.7±13.12)과 9명의 Healthy그룹(나이: 25.3±2.45; 키: 171.0±11.32; 몸무게:66.4±14.11)이 4주에 걸쳐 실시하였다. 전신 진동운동기 위에서 한발로 서기 동작을 실시하였으며 운동 전 2주후, 4주후 총 3번 측정을 하였다. 정적 자세 제어 능력을 평가하기 위해서 Single leg balance test를 실시하였고 동적 자세 제어 능력을 평가하기 위하여 Star excursion balacne test를 실시하였다. 운동신경원 활성화를 평가하기 위하여 Hoffmann reflex(H-reflex) 방법을 사용하였다. 두 그룹과 시간에 따른 운동효과를 보기 위해 반복측정 분산분석을 실시하였다.실험 결과 정적 자세 제어능력에서 Control 그룹과 비교하였을 때, CAI 그룹의 정적 내외 방향 SD값 감소, 속도 증가, TTB 값 증가를 보였으며, 전후 방향의 mean TTB 값의 증가를 보였다(P
The ankle sprain is the most common injury over all sports. When ankle sprain occurs, structural damage occurs not only to the ligamentous tissue, but also to the nervous and musculotendinous tissue around the ankle complex. It can lead to mechanical ankle instability (MAI) having a feeling of instability or functional ankle instability (FAI), feeling of ‘giving away’ or unstable during functional activities. MAI can be easily treated by an operation. However, FAI is too complicated to be treated by and operation. Moreover, it can lead to the chronic ankle instability (CAI). So, the treatment for FAI is necessary.There have been many studies showing whole-body vibration exercise (WBVE) improves postural control. However, these studies usually reported only short-term effect after WBVE or results after combining with strength training.Therefore, the purpose of this study is to determine the effect of WBVE in patients with CAI. Based on the fact that motor neuron pool excitability comes after whole body vibration, four weeks of WBVE without strength training had performed.Eight young adults with CAI (age: 22.8±3.23; height: 171.7±8.94; mass: 70.7±13.12) and nine healthy volunteers (age: 25.3±2.45; height:171.0±11.32; mass:66.4±14.11) participated in 4 sessions of WBVE per week and each session took 15minutes. Participants did a single-leg standing an a WBV machine and total 3 measurements were taken (pre, two weeks after and 4weeks after). In order to measure statics postural control ability, single-leg balance test had done and to measure dynamic postural control ability, star excursion balance test had thken. For measuring motor neuron pool excitability, Hoffmann reflex (H-reflex) were used.The study used 2 ways repeated measure ANOVA test at the .05 significance level to define the effect of WBVE within both group according to the time of exercise.In results of this study, CAI group showed decrease in SD x and Velocity x and increase in TTB x and mean TTB y during static balance (x: anterior-posterior direction; y: medial-lateral direction). There were no significant difference in dynamic balance and MNPE.According to this study, 4 weeks of WBVE brings improvements in static postural control to CAI patients without changing resting MNPE.Applying these findings to patients, having limited range of motion of athletes in isometric training phase, may possibly provide improvement in static postural control ability.For the future research, there is a need to look for the relation between postural control and MNPE by measuring the H-reflex during the task where requires postural control.
The ankle sprain is the most common injury over all sports. When ankle sprain occurs, structural damage occurs not only to the ligamentous tissue, but also to the nervous and musculotendinous tissue around the ankle complex. It can lead to mechanical ankle instability (MAI) having a feeling of instability or functional ankle instability (FAI), feeling of ‘giving away’ or unstable during functional activities. MAI can be easily treated by an operation. However, FAI is too complicated to be treated by and operation. Moreover, it can lead to the chronic ankle instability (CAI). So, the treatment for FAI is necessary.There have been many studies showing whole-body vibration exercise (WBVE) improves postural control. However, these studies usually reported only short-term effect after WBVE or results after combining with strength training.Therefore, the purpose of this study is to determine the effect of WBVE in patients with CAI. Based on the fact that motor neuron pool excitability comes after whole body vibration, four weeks of WBVE without strength training had performed.Eight young adults with CAI (age: 22.8±3.23; height: 171.7±8.94; mass: 70.7±13.12) and nine healthy volunteers (age: 25.3±2.45; height:171.0±11.32; mass:66.4±14.11) participated in 4 sessions of WBVE per week and each session took 15minutes. Participants did a single-leg standing an a WBV machine and total 3 measurements were taken (pre, two weeks after and 4weeks after). In order to measure statics postural control ability, single-leg balance test had done and to measure dynamic postural control ability, star excursion balance test had thken. For measuring motor neuron pool excitability, Hoffmann reflex (H-reflex) were used.The study used 2 ways repeated measure ANOVA test at the .05 significance level to define the effect of WBVE within both group according to the time of exercise.In results of this study, CAI group showed decrease in SD x and Velocity x and increase in TTB x and mean TTB y during static balance (x: anterior-posterior direction; y: medial-lateral direction). There were no significant difference in dynamic balance and MNPE.According to this study, 4 weeks of WBVE brings improvements in static postural control to CAI patients without changing resting MNPE.Applying these findings to patients, having limited range of motion of athletes in isometric training phase, may possibly provide improvement in static postural control ability.For the future research, there is a need to look for the relation between postural control and MNPE by measuring the H-reflex during the task where requires postural control.