NEUROTHERAPY 이대희대한신경치료학회지, 이상용, 박정서제20, 권한슬기제3호 슬링을이용한교각운동시엉덩관절벌림 - 모음과슬링의높이가배가로근, 배곧은근, 척추세움근의근활성도에미치는영향 이대희 1, 이상용 1, 박정서 2, 한슬기 *1 1 U1 대학교

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1 NEUROTHERAPY 이대희대한신경치료학회지, 이상용, 박정서제20, 권한슬기제3호 슬링을이용한교각운동시엉덩관절벌림 - 모음과슬링의높이가배가로근, 배곧은근, 척추세움근의근활성도에미치는영향 이대희 1, 이상용 1, 박정서 2, 한슬기 *1 1 U1 대학교물리치료학과 2 대전과학기술대학교물리치료과 The Effect of Height of Hip Joint Abduction-Adduction and Sling on Transverse Abdominis, Rectus Abdominis, and Erector Spinae Muscles Activities during Bridging Exercise with Sling Dae-Hee Lee 1, Sang-Yong Lee 1, Jung-Seo Park 2, Seul-Ki Han *1 1 Dept. of Physical Therapy, U1 University, 2 Dept. of Physical Therapy, Daejeon Institute of Science and Technology Purpose This study evaluated the effects of bridge exercise on trunk core muscle activity with respect to sling height and hip joint abduction and adduction. Methods 30 healthy adult males participated. In the bridge exercise, the height of the sling was set low or high during hip joint abduction and adduction. Electromyography was used to compare the differences between the muscle activities of the transverse abdominis, rectus abdominis, and erector spinae muscles. Results The muscle more activities of the transverse abdominis, rectus abdominis, and erector spinae were significantly higher in Hip adductor position. The muscle activities of the transverse abdominis, rectus abdominis were significantly higher in the high sling position. Especially, A high activity in the transverse abdominis muscle was interaction in abduction and adduction of hip, high sling position. Conclusion These findings suggest that the activities of the abdominal and trunk muscles should put adduction of hip and the activities of the abdominal muscle have to make sling position high during bridging exercises with sling. Key words Bridge exercise, Trunk core muscle, Sling, Rectus abdominis, Hip joint 책임저자 Seul-Ki Han (lovewisd@gmail.com) 논문접수일 2016 년 8 월 16 일수정접수일 2016 년 9 월 27 일논문게재일 2016 년 10 월 28 일 I. 서론 몸통의안정성은신체의손상와허리통증을예방하고개선하는데중요하. 1,2) 몸통안정성향상을위해전통적으로교각운동이많이사용되고있다. 3) 교각운동을포함한안정성운동은고유수용성감각을자극하고동원되는근육을더활성화시킬수있는불안정지면을이용하는것이안정지면을이용하는것보다더효과적이다. 4) 특히, Kim과 Kwon (2003) 은슬링이적합한불안정지지면을제공함으로써안정적인매트에서의운동보다더효과적이라고하였고 5) Kang과 Sim (2015) 교각운동을시행하는데있어안정지면이나치료용볼보다슬링을이용한방법이배가로근과뭇갈래근의두께변화에있어더유의하게효과적이라고하였다. 6) 엉덩관절의원활한벌림과모음은동적균형을유지하는데중요하며, 엉덩관절벌림근과모음근은골반의움직임을조절 하는역할을한다. 7) 또한이러한엉덩관절의벌림근과모음근은몸통근육과상호협력작용하여몸통근육을더욱활성화시킬수있다. 8,9) Lee( 2012) 는슬링을이용한교각운동시, 엉덩관절의벌림근과모음근의등척성수축이복부와다리근육의근활성도에영향을미친다고하였다. 10) 또한 Lee 등 (2015) 은슬링을이용한교각운동시, 높은슬링높이에서엉덩관절을모음하며운동하는것이배가로근과척추세움근의근활성에효과적이라고하였다. 11) 그러나이러한연구들은슬링의높이와엉덩관절의벌림- 모음중어떤요인이몸통안정화근육의근활성에영향을주었는지에관한연구는미흡하였다. 이에본연구에서는교각운동시슬링높이변화와엉덩관절벌림- 모음에따른몸통안정화근육의근활성도에어떤요인이영향을미쳤는지알아보고자실시하였다. 슬링을이용한교각운동시엉덩관절벌림 - 모음과슬링의높이가배가로근, 배곧은근, 척추세움근의근활성도에미치는영향 23

2 NEUROTHERAPY NEUROTHERAPY 2016;20(3):23-26 II. 연구방법 1. 연구대상본연구는건강한 20대남성 30명을대상으로실시하였다. 연구대상자의선정기준은다음과같았다. 1) 근육뼈대계, 신경계손상이없는자 2) 자세조절에영향을미칠수있는안뜰계손상이없는자 3) 최근, 3주이내에정기적인운동을새로시작하지아니한자 4) 본연구의목적및방법을이해하고자발적으로동의한자연구대상자의연령은 ±2.389이었고신장은 177± 6.057이었으며체중은 64.6±8.974이었다. 2. 운동방법대상자들에게교각운동시바로누운자세에서팔은가슴위로모은상태를시작자세로하도록하였다. 머리와눈의방향은실험자세에영향을미치지않도록천장을바라보도록고정하였으며양발목에슬링밴드를감싸고발을지면에서들려있는상태에서, 골반을들어올리도록하였다. 슬링의높이변화는바로선자세에서지면과종아리뼈머리의중간을 LOW로설정하였고, HIGH도바로선자세에서넙다리뼈의큰돌기와종아리뼈머리의중간으로설정하였다. 엉덩관절벌림은대상자의최대벌림위치로, 모음은양발을닿게모은위치로설정하였다. 총 4가지동작으로첫째, LOW위치에서엉덩관절을벌림하여실시. 둘째, LOW위치에서엉덩관절을모음하여실시. 셋째, HIGH위치에서엉덩관절을벌림하여실시. 넷째, HIGH위치에서엉덩관절을모음하여실시하였다. 각동작은 3회반복하여측정하였으며, 실험순서는무작위로실시하였다. 각각의조건에서 5초간유지하여중간 3초간의근활성도자료를 3회측정하여평균값을분석하여사용하였다. 운동시, 근피로를방지하기위하여 10초간의운동후 1분의휴식기간을가졌다. 3. 측정방법근육의근활성도변화를측정하기위하여 MP150(BIOPAC System Inc. SantaBarbara, CA, U.S.A) 을사용하였으며 Acqknowledge 4.02 소프트웨어 (BIOPAC System Inc. Santa Barbara, U.S.A) 를이용하여자료를처리하였다. 각각의대상자들은 EMG 신호의평균값을최대등척성수축 (%MVIC) 의백분율로표현하였다. 표면전극의부착은피부저항과측정오류를감소시키기위해부착부위의피부를제모를한후알콜솜으로닦아냈으며다음과같이부착하였다. 배가로근은위앞엉덩뼈가시에서가슴우리의아래모서리까지이은선의몸쪽끝부분 2cm안쪽에부착하였다. 배곧은근은배꼽 2cm옆에근섬유와평행하게부착하였다. 척주세움근은인체중심선 2cm옆에 L2 가시돌기높이로근섬유와평행하게부착하였다. 4. 분석방법 본연구의통계분석을위해 SPSS 18.0 을사용하였고유의수준 은 0.05 로하였다. 슬링의높이변화와엉덩관절의벌림 - 모음 이몸통근육에근활성에미치는영향을알아보기위해이원배 치분산분석 (two way ANOVA) 를실시하였다. III. 결과 배가로근은슬링의높이가높은것이낮은것보다더유의하게 활성화되었고 (p<0.05) 엉덩관절벌림보다모음시더유의하 게활성화되었으며 (p<0.05), 슬링의높이와엉덩관절벌림 - 모 음이교호효과를나타냈다 (p<0.05). 배곧은근은슬링의높이가높은것이낮은것보다더유의 하게활성화되었고 (p<0.05) 엉덩관절벌림보다모음시더유 의하게활성화되었으며 (p<0.05), 슬링의높이와엉덩관절벌 림 - 모음이교호효과는확인할수없었다 (p>0.05). 척추세움근은슬링의높이가높은것이낮은것보다더활 성화되었으나통계학적으로유의한차이가없었고 (p>0.05) 엉 덩관절벌림보다모음시더유의하게활성화되었으며 (p<0.05) 슬링의높이와엉덩관절벌림 - 모음이교호효과는확 인할수없었다 (p>0.05)(table 1). IV. 고찰 최근연구들은목표하는근육을선택적으로훈련시키는방법에관심이있다. 12) 슬링을이용한교각운동이몸통안정화근육의 근활성에미치는영향에대한연구는지속적으로이루어지고 있지만 6,10,11) 좀더세분화하여근육을선택적으로훈련시키는 방법에대한연구는미흡하였다. 이에본연구는교각운동시 슬링높이변화와엉덩관절벌림 - 모음에따른몸통안정화근육 의근활성도에어떤요인이영향을미쳤는지알아보고자실시 하였다. 본연구결과배가로근, 배곧은근, 척추세움근은모두, 엉덩 관절벌림보다모음자세에서유의하게더활성화되었다 (p<0.05). 그것은엉덩관절모음근이골반을동적으로안정화 시키는데중요한역할을담당하고있어엉덩관절모음에따라 엉덩관절모음근이좀더활성화되었고그로인해골반아래근 육과몸통근육의상호협력작용이촉진되었기때문이라고생 각한다. 8-10) 이에대해 Na 등 (2015) 은 대건강한성인 남녀 38 명을대상으로교각운동시엉덩관절모음근의동시수 축이몸통근육들의활성도에영향을미칠수있으며, 특히소근육의활성도를높이는데기여한다고하였다. 13) 24 The Effect of Height of Hip Joint Abduction-Adduction and Sling on Transverse Abdominis, Rectus Abdominis, and Erector Spinae Muscles Activities during Bridging Exercise with Sling

3 이대희, 이상용, 박정서, 한슬기 Table 1. Activities of the trunk core muscles with respect to sling height and hip joint abduction and adduction Mean±SD Transverse abdominis Rectus abdominis Erector spinae Low High abduction 11.09± ± ±27.80 adduction 22.22± ± ±29.77 abduction 32.01± ± ±26.86 adduction 76.00± ± ±27.27 LH 1) 36.69(<0.01)** 34.69(<0.01)** 0.44(0.51) F(p) BD 19.98(<0.01)** 11.70(<0.01)** 12.76(<0.01)** LH*BD 7.10(<0.01)** 2.96(0.09) <0.01(0.95) *p<0.05, **p<0.01 1) LH, sling height low-high; BD, hip joint abduction-adduction; LH*BD, interaction of sling height low-high and hip joint abduction-adduction 또한본연구에서배가로근과배곧은근은슬링의높이가낮은것보다높은것이더활성화되었다. 이것은슬링의높이가높을수록인체의등과골반이바닥에지지되는면적이감소하여더불안정한지면으로작용하고인체가좀더익숙하지않은환경에서운동함으로써더많은신경근활성이된결과라고생각한다. 6) 반면, 척추세움근에서는슬링의높이에따른근활성도의차리를확인할수없었다 (p>0.05). 그것은슬링의높이를높였을때인체의등과골반이바닥에지지되지않아골반이좀더불안정해진것에대해몸통과골반을안정화시키는척추세움근보다는다른근육이동원되기때문이라고생각한다. 12) 특히, 큰볼기근이이와같은역할을수행할것으로사료되며향후, 교각운동시슬링의높이변화에따른큰볼기근의근활성화를연구할필요가있을것이다. 본연구결과슬링을이용한교각운동시, 배가로근은슬링의높이와엉덩관절벌림- 모음간에교호작용을확인할수있었다 (p<0.05). 그러므로배가로근을활성화시키기위해서는엉덩관절만모음할뿐만아니라슬링의높이도높이는것이효과적일것이다. 반면, 척추세움근은슬링의높이변화에따른차이가없고엉덩관절을모음하는것이효과적이므로엉덩관절모음을더잘유지할수있고보상작용에대한우려가적으며, 좀더지속적인수축을유도할수있는자세를선택하여실시하는것이더효율적일것이다. 향후다양한질환과연령의대상자를대상으로하거나큰볼기근, 뭇갈래근, 안쪽- 가쪽배빗근과같은좀더다양한근육의근활성을확인하는후속연구가진행되어야할것이다. V. 결론본연구는교각운동시슬링높이변화와엉덩관절벌림- 모음에따른몸통안정화근육의근활성도에어떤요인이영향을미 쳤는지알아보기위해성인남성 30명을대상으로실시하였다. 본연구결과배가로근, 배곧은근, 척추세움근은모두, 엉덩관절을모음한상태에서운동하는것이더효과적이었고배가로근과배곧은근은슬링의높이가높은것이더효과적이었다. 또한배가로근은엉덩관절을모음할뿐만아니라슬링의높이를높이는것이더욱효과적이었다. 본연구가슬링을이용한교각운동시, 좀더세분화된중재방법이개발되는데기여할것으로생각된다. 참고문헌 1. Durall CJ, Udermann BE, Johansen DR, et al. The effects of preseason trunk muscle training on low-back pain occurrence in women collegiate gymnasts. J Strength Cond Res. 2009;23(1): Stuge B, Laerum E, Kirkesola G, et al. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine (Phila Pa 1976). 2004;29(4): Lehman GJ, Hoda W, Oliver S. Trunk muscle activity during bridging exercises on and off a Swiss ball. Chiropr Osteopat. 2005;13(1): O'Sullivan PB, Phyty GD, Twomey LT, et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine (Phila Pa 1976). 1997;22 (24): Oh JS, Park JS, Kim SY, et al. Comparison of muscle activity during a push-up on a suspension sling and a fixed support. PTK. 2003;10(3): 슬링을이용한교각운동시엉덩관절벌림 - 모음과슬링의높이가배가로근, 배곧은근, 척추세움근의근활성도에미치는영향 25

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80%, O'Sullivan (2003), (reposition sense)..(, 2001) Arokoski (2001) 1937 williams,,,,,,. (bridging exercise).,.(stevens, 2007). (lumbar stabilization

80%, O'Sullivan (2003), (reposition sense)..(, 2001) Arokoski (2001) 1937 williams,,,,,,. (bridging exercise).,.(stevens, 2007). (lumbar stabilization 1) 스위스볼을적용한교각자세변화에따른체간의근활성도비교 The Comparison of Trunk Muscles Activity During Bridging Stabilization Exercises on Swiss Ball According to Change of Position Sun-tae Son, Min-hye Kim, Hee-jin Kim, Ji-hye