만성 요통환자에서 부하에 따른 척추기립근 수축 개시시간와 요부 굴곡 각도에 관한 연구

The Study of Erector Spinae Onset Time and Lumbar Flexion Angle on Loading in Patients with Chronic Low Back Pain

만성 요통환자를 대상으로 부하에 따른 척추기립근 수축 개시시간과 요부 굴곡 각도를 근전도 및 동작분석기를 통해 연구하였다 연구대상자는 . 12명의 요통군과 12명의 정상군으로 구분하여 시행하였는데, 모든 연구대상자는 어깨를 중립위로 유지하고 주관절을 90도 굴곡한 기립자세에서 눈을 뜬 상태와 눈을 감은 상태로 구분하여 상지에 0.1㎏, 1㎏, 3㎏의 낙하부하를 적용하였다. 그 결과, 0.1㎏의 낙하부하를 적용하였을 때, 눈을 뜬 경우와 눈을 감은 경우 모두 요통군에서 요부 굴곡 각도가 증가하였으나, 대조군과 비교하여 통계학적으로 유의한 차이는 관찰되지 않았다. 1㎏의 낙하부하를 적용하였을 때, 눈을 뜬 상태에서 요통군과 대조군의 요부 굴곡 각도에는 통계학적으로 유의한 차이는 관찰되지 않았고, 눈을 감을 상태인 경우, 대조군보다 요통군에서 통계학적으로 유의하게 요부 굴곡 각도가 감소하였다. 3㎏의 낙하부하를 적용하였을 때, 눈을 뜬 경우 대조군보다 요통군에서 요부 굴곡 각도가 통계학적으로 유의하게 증가하였으나, 눈을 감은 경우, 집단간에 통계학적으로 유의한 차이는 발견되지 않았다. 1㎏의 낙하부하를 적용하였을 때, 눈을 뜬 경우, 요부 척추기립근 수축 개시시간은 요통군보다 대조군에서 통계학적으로 유의하게 먼저 수축하였고, 눈을 감은 경우 대조군이 조금 빠르게 수축하였지만, 요통군과 통계학적으로 유의한 차이는 관찰되지 않았다.

Sudden, unexpected loading on the low back pain is associated with a high incidence of low back pain. The purpose of this study was to measure the onset time of lumbar erector spinae and lumbar flexion angle acting on the lumbar spine, when loads are delivered unexpectedly to the hands. Surface EMG and VICON were recorded from the lumbar erector spinae and flexion angle from 12 control subjects without chronic LBP and 12 patients with chronic LBP during expected and unexpected limb loading. 0.1㎏, 1㎏, and 3㎏ loading on limb were dropped in random time intervals from a level of the subjects' eyes. A total of measurements were performed in sequences of 3 trials in each condition(eyes open and eyes closed) following 0.1㎏, 1㎏, and 3㎏ loading. 1. On 0.1㎏ loading, the lumbar flexion angle had increased chronic LBP patients than control group in eyes open and eyes closed condition, but there was no significantly different between groups(p>.05). 2. On 1㎏ loading, the lumbar flexion angle was no significantly different between chronic LBP patients and control group in eyes open condition(p>.05). But, the lumbar flexion angle was significantly different between chronic LBP patients and control group in eyes closed condition(p<.05). 3. On 3㎏ loading, the lumbar flexion angle was increased in the chronic LBP patients in eyes open condition, and there was significantly different between chronic LBP patients and control group(p<.05). But, the lumbar flexion angle was increased in the chronic LBP patients in eyes closed condition, and there was no significantly different between chronic LBP patients and control group(p>.05) 4. The lumbar erector spinae onset time in eyes open condition was early in the control group, and there was significantly different between chronic LBP patients and control group(p<.05). But, the lumbar erector spinae onset time in eyes cloesd condition was early in the control group, and there was no significantly different between chronic LBP patients and control group(p>.05). In conclusion, impaired trunk muscle function has been observed in low back pain patients during upper-limb loading. During the expected load(eye open), lumbar erecter spinae onset time in control subjects has been observed to be faster than chronic back pain subjects. This was more capable of mechanically preparing for a perturbation when subjects were aware of the time at which load would drop. This result indicates altered preparatory reaction (feed-forward) following loading with chronic low back pain patients.