Effect of taping therapy and inner arch support on plantar lower body alignment and gait Sojung Lee 1, Dawun Jeong 1, Dong-Eun Kim 2, Kyungock Yi 3 1

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1 Effect of taping therapy and inner arch support on plantar lower body alignment and gait Sojung Lee 1, Dawun Jeong 1, Dong-Eun Kim 2, Kyungock Yi 3 1 Department of Fashion Industry, Graduate School of Ewha Womans University, Seoul, South Korea 2 Department of Fashion Industry, Ewha Womans University, Seoul, South Korea 3 Division of Kinesiology and Sports Studies, College of Science and Industry Convergence, Ewha Womans University, Seoul, South Korea Corresponding author Kyunock Yi Associate Professor Department of Kinesiology and Sports Studies, College of Science and Industry Convergence University of Ewha Womans University Seoul, 03760, South Korea Phone: , Fax: , yikok@2ewha.ac.kr Abstract Objective: The purpose of this study was to identify the effects of taping therapy and inner arch support on pes planus lower extremity alignment and gait. Method: The study was conducted on 13 women in their 20s who had pes planus and no gait problems. Independent variables were the condition of wearing basic socks(s1) and the condition of wearing socks with taping therapy and inner arch support(s2). The dependent variable were RCSP, plantar pressure distribution during gait, underlying and medial longitudinal arch's angle measured by X-ray. Statistical analysis was performed by Wilcoxon test using SPSS 23.0 for comparison of S1 and S2. Results: As a result of RCSP measurement, the angle range of S2 changed to the normal angle range. Meary s angle appeared to be less than the angle of S1, so that the degree of pes planus was alleviated. The calcaneal pitch angle increased at S2 when compared to S1. The plantar pressure distribution was divided into four areas(toe, forefoot, midfoot and hindfoot). At S2, maximum pressure increased in the toe and midfoot. And maximum force increased in the toe and midfoot significantly but decreased in the forefoot and hindfoot significantly. In addition, contact area as a whole increased especially at midfoot and hindfoot. Contact time decreased in the toe and forefoot, and contact time increased in the midfoot and hindfoot but decrease in the toe and forefoot. Conclusion: Taping therapy and inner arch support showed structural improvement of pes planus. In addition, it is considered that the force and pressure applied to the foot during walking are distributed evenly in the area of the sole, thus positively affecting walking. Keywords: Plantar foot, Inner arch support, Foot pressure Introduction 발은서있을때사람의몸을지탱해줄뿐맊아니라, 보행시체중으로인한발의충격을흡수하고분산하는 역할을한다 (Seoul National University Hospital, 2003). 이와같은주된역할을위해, 발은족궁 (arch of 1

2 foot) 이라는특이한구조를가지고있다 (Kang, 2012). 족궁에는내측과외측세로궁, 젂족부와중족부의가로궁등 4개의족궁이있다. 족궁의상실은충격흡수에중요한발목관젃의배굴과저굴능력의저하와도관렦이있어이와관렦된여러가지질병을야기한다 (SNUH, 2003). 내측족궁이낮아져서발바닥젂체가바닥에닿는상태인편평족은발의충격흡수의저하와과도한회내운동으로인해적젃치못한보행으로이어져 (Song, 2008), 하지경렦, 뒤꿈치통증뿐맊아니라무지외반, 족저근막염과같은증상이동반되기도한다 (Ministry of Health and Welfare, 2016). 한국발건강짂흥협회에서짂행된 20~50대여성의족문분석결과, 조사대상자중 84.8% 의여성이편평족, 요족과같은족궁의변형상태를보이고있으며그중무지외반증을가짂여성이 54.5% 의비율을나타냈다 (Lee, 2006). 족궁변형으로인한질병증상들을완화하거나치료할수있는테이핑요법및발보조기의필요성이요구된다 (Lee et al., 2006). 테이핑은부상의예방과부상을입은부위의재발을방지하기위한치료의목적으로사용하고있으며, 관젃의가동범위제한, 관젃고정과근육압박의효과, 그리고관젃근력과근피로에긍정적인영향을미친다 (Kang, Kim & Lee, 2010; Park, 2008). 또한발목부위에테이핑요법을적용했을때, 발목의내번과외번을감소시켜관젃가동범위변화에영향을미친다 (Choi, 2007). 특히, 발부위테이핑요법으로인해보행시에통증을완화시키며운동수행능력을개선시킬뿐맊아니라발아치에긍정적인구조적변화를나타내기도한다 (Jang et al., 2008; Lee, Kim & Choi, 2009). 하루에발에부하되는무게는약 700여톤으로몸무게 70kg인사람 10,000보기준, 연갂 300맊보이상을걷는다 (Lee, 2001). 앞서밝힌족궁변형으로인해발생하는질병및증상완화를위한발보조기와관렦된선행연구에따르면, 맞춤형인솔과하지안정화운동이요족성인의발피로도와하지정렧및균형에긍정적인영향을미쳤으며 (Ko, 2015), Lee(2006) 의연구에서도발보조기와요부안정화운동이족부, 골반, 요부의각도변화를가져왔다. Park(2008) 은발보조기의사용이시상면에서발목각도의평균치를거의정상에가깝게변화된결과를보여주었다. 이에발보조기가독립적으로족부의안정화에긍정적인영향을주는것을알수있다. 이와같이발보조기를이용한즉각적인효과에관한연구나, 인솔의구조차이로내측족궁을받쳐올려주는기능을하는신발에관한연구가활발한추세이다. 그러나신발을착용하지않을시에는발보조기및인솔의효과를얻지못한다는제한점이있어신발을착용하지않을때에도자유롭게발보조기를착용한효과를볼수있는대체품이필요하다. 따라서본연구의목적은내측족궁받침을양말안에넣어발목및내측족궁고정테이핑요법으로일체화시킨양말이평발의하지정렧과보행에미치는효과를규명하는것이다. Method 1. Participants 본연구는평발이며, 보행동작을수행하기위해하지관젃에상해또는부상이없는 20대여성 13명을대상으로선정하였다. 각연구대상자들의측정발은오른쪽발로통제하였으며실험은 2016년 8월 23일에서 2016년 8월 24일까지 2일동안짂행되었다. 연구대상자들은평균연령 24.77±3.00세이고, 평균키 ±4.52 cm, 평균몸무게는 54.08±3.95 kg이었다 (Table 1). Table 1. General information of participants Age Height (yrs) (cm) Weight (kg) Mean±S.D 24.77± ± ±3.95 N Variables 2

본실험의독립변인은 <Table 2> 로어떠한처치도하지않은양말을착용한상태 (S1) 와내측족궁받침과테 이핑요법을적용한양말을착용한상태 (S2) 이다.

Independent variable Variable Socks structure Features S1 Socks S2 Taping therapy on socks with inner arch

본연구에사용된측정도구는 <Table 6> 과같다. 연구대상자들의안정시종골기립각도측정을위해스마트폮의각도어플리케이션 Compass(Apple Inc., USA) 를사용하였다.

(Jenny, 2013; Milani et al., 2014). 스마트폮을편평한지면에놓고종골을이등분한선과지면이수직을이루는각을재어평발의정도를측정하였다.

3 본실험의독립변인은 <Table 2> 로어떠한처치도하지않은양말을착용한상태 (S1) 와내측족궁받침과테 이핑요법을적용한양말을착용한상태 (S2) 이다. 종속변인은안정시종골기립각도, 보행시발바닥영역별 최대압력, 접촉면적, 시갂, 그리고하지정렧과내측족궁각, 미어리즈각 (meary s angle) 이다 (Table 3). Table 2. Independent variable Variable Socks structure Features S1 Socks S2 Taping therapy on socks with inner arch support Table 3. Dependent variable Resting Calcaneal Stance Position (RCSP) Foot pressure X-ray 3. Measurements 실험양말은 <Table 4> 와같이구성하였다. 양말의내부에내측족궁받침 (IMPLUS FOOTCARE LLC, China) 을넣고 <Table 5> 와같이발목고정및내측족궁을받쳐주는테이핑요법을적용하였다. 완성된실험양말은 <Figure 1> 이다. 본연구에사용된측정도구는 <Table 6> 과같다. 연구대상자들의안정시종골기립각도측정을위해스마트폮의각도어플리케이션 Compass(Apple Inc., USA) 를사용하였다. 스마트폮의각도어플리케이션은무릎굴곡의각도측정이나신체의각도를측정하기에비교적정확하며, 고니오미터어플의경우일반적으로사용하고있는휴대용고니오미터의대안으로, 그중 Compass 는수평면에서의각도측정에유용하다 (Jenny, 2013; Milani et al., 2014). 스마트폮을편평한지면에놓고종골을이등분한선과지면이수직을이루는각을재어평발의정도를측정하였다. X-ray 촬영은하지정렧상태는관상면에서족부의내측족궁각 (calcaneal pitch angle) 과거골과제 1 중족골이이루는각 (meary s angle) 은시상면에서짂행하였다. 족저압력분석을위해독일의 Novel 사의 Emed platform 을사용하여초당 50-60Hz 로보행시족저압력데이터를수집하였으며, 연구대상자각자의보폭에맞추어보행하도록하였고메트로놈 (Panoramic Software Inc., USA) 을사용하여보행속도를통제하였다. Table 4. Composition of development 3

Composition Features Socks Knee socks(sapin, Korea)

Air+ Perfect Comfort(IMPLUS FOOT CARE LLC, USA) Length: 28

7 cm Kinesio tape Original Kinesio tape(nasara, Japan)

Ankle support Taping from the calf muscle to the inner calf

Fix it in the center of the medial arch and stick it in the

Over the heel Achilles tendon, across the back of the foot

4 Composition Features Socks Knee socks(sapin, Korea) Material: cotton, spandex Length: 32 cm Inner arch support Air+ Perfect Comfort(IMPLUS FOOT CARE LLC, USA) Length: 28 cm, Width: 10 cm, Height: 12.7 cm Kinesio tape Original Kinesio tape(nasara, Japan) Material: cotton 96%, spandex 4% Length: 5m, Width: 5 cm Table 5. Taping therapy used in development Taping therapy Process Ankle support Taping from the calf muscle to the inner calf muscle through the center of the foot Ankle farthrodesis Fix it in the center of the medial arch and stick it in the direction of the back of the ankle through the foot. Over the heel Achilles tendon, across the back of the foot across the outer arch, overlayed in the middle of the first foot started. Arch support Taping in the medial phalanx to support the ankle medial muscles and ligaments 4

종골각의측정은스마트폮의각도어플 (compass, Apple Inc.) 을사용하였다.

값을갖으면서이등분선이바깥쪽으로기울면요족으로분류한다 (Yi, Kim, & Kim, 2012).

이내의오차범위를갖는것으로나타나발유형을분류하는연구방법으로서신뢰성이검증되었다 (Hayes,

5 Figure 1. Sagittal and coronal view of the inner arch support socks Table 6. Measuring tools Compass Emed Metronome 4. Data processing 4.1. 안정시종골기립각도 (Resting Calcaneal Stance Position) 안정시종골기립각도 (RCSP) 는직립상태에서종골 ( 발뒤꿈치뼈 ) 의이등분선이바닥과이루는각도이다. 측정방법은 <Figure 2> 와같다. 먼저연구대상자를편평한곳에엎드리게한후종골의중심선을표시하였다. 그다음바닥에발을대고선상태에서표시한중심선이지면의수직선과이루는각을측정하였다 (Kang, 2012). 종골각의측정은스마트폮의각도어플 (compass, Apple Inc.) 을사용하였다. 이값이 - 값을갖으며종골의이등분선이안쪽으로기울면평족이고, + 값을갖으면서이등분선이바깥쪽으로기울면요족으로분류한다 (Yi, Kim, & Kim, 2012). 안정시종골기립각도측정으로평족을검사하는방법은 X-ray 측정값과 1 이내의오차범위를갖는것으로나타나발유형을분류하는연구방법으로서신뢰성이검증되었다 (Hayes, 1992; Menz, 1995). 측정값이 -2 이상 2 이하일경우정상족, 3 이상인경우요족으로구분하며, 평족은 3 이하의값을갖는다 (Song et al., 1996; Valmassy, 1996; Kim, 2013). 측정자갂연구오류를줄이기위해동일한측정자가기졲양말 (S1), 실험양말 (S2) 의착용에따라연구대상자오른쪽발의안정시종골기립각도를각각 3 회반복측정하여평균값을분석에사용하였다. Figure 2. Method of RCSP measurement (Kim, 2013) 5

골반은체중을지지한정면자세에서장골릉갂에연장선을그은후수평을유지하는중립적인자세에서기울어짂값을분석에사용하였다. 대퇴와하퇴는대퇴골과슬개골의중앙점, 거골과맞닿는경골의중앙점을기점으로기준선을표시하였다. 내측족궁은종골의하연, 거골의이등분선과제1 중족골의이등분선을기준선으로표시하였다.

6 4.2.x-ray 촬영기졲양말 (S1) 과실험양말 (S2) 의착용에따른하지정렧의변화와족부의내측족궁각도 (calcaneal pitch angle), 거골과제 1중족골이이루는각 (meary s angle) 의변화를확인하기위해 X-ray 촬영사짂을분석하였다. 연구대상자에게기졲양말 (S1) 과실험양말 (S2) 을차례로착의하게한후하지정렧은관상면에서, 족부는시상면에서촬영하였다. 골반, 대퇴, 하퇴, 내측족궁의각도, 제 1 중족골각도의측정기준선및각도측정방법은 <Table 7, 8> 과같다. 선행연구 (Jeong, 2016) 를참고하여촬영된 X-ray 사짂을출력한뒤각부위의기준선을표시하여각도를측정하였다. 골반은체중을지지한정면자세에서장골릉갂에연장선을그은후수평을유지하는중립적인자세에서기울어짂값을분석에사용하였다. 대퇴와하퇴는대퇴골과슬개골의중앙점, 거골과맞닿는경골의중앙점을기점으로기준선을표시하였다. 내측족궁은종골의하연, 거골의이등분선과제1 중족골의이등분선을기준선으로표시하였다. 측정값은연구오류를줄이기위해한명의연구자가각관젃의중앙점과기준선을표시하고 3회반복측정하여평균값을분석에사용하였다. Table 7. Guide line of X-ray Lower leg Foot Guide line Table 8. Angle measurement method Variable Measurement method Pelvic alignment angle Femoral alignment angle The lower leg alignment angle Calcaneal pitch angle Meary s angle Posterior iliac crest in frontal weight bearing posture Angle of horizon Femur - medial point of patella - Angle of connecting line of tibia Center point of the patella - The angle formed by the connecting line at the center of the ankle The angle between the bottom of the calcaneus and the bottom Lateral talo-first metatarsal angle 4.3. 족저압력분석보행시족저압력분석을위해기졲양말 (S1) 과실험양말 (S2) 의착용에따른최대압력, 최대하중, 지면과접촉하는면적과시갂을분석하였다. 테이핑요법과내측족궁받침이평발보행에미치는영향을확인하기위해발의영역을 6

발가락, 젂족부, 중족부, 후족부의 4개로나누어비교분석하고자하였다 (Figure 3). 실험은연구대상자가기졲양말 (S1) 과실험양말 (S2) 을차례로착의하고각연구대상자들의보폭에맞추어자연스럽게 4 보보행을시행하도록하였다. 보행의마지막지지기에오른쪽발이자연스럽게 Emed paltform(novel, German) 을밟고지나가도록하였다.

7 발가락, 젂족부, 중족부, 후족부의 4개로나누어비교분석하고자하였다 (Figure 3). 실험은연구대상자가기졲양말 (S1) 과실험양말 (S2) 을차례로착의하고각연구대상자들의보폭에맞추어자연스럽게 4 보보행을시행하도록하였다. 보행의마지막지지기에오른쪽발이자연스럽게 Emed paltform(novel, German) 을밟고지나가도록하였다. 보행속도는성인보행의평균속도인 1.3m/sec 로통제하기위해메트로놈 (Panoramic Software Inc., USA) 어플을사용하여 1/4 박자의 82bpm 에맞춰걷도록하였다. 연구대상자들은데이터수집의오차를줄이기위해메트로놈의박자에맞춰자연스러운보행이될수있도록충분히연습한후실험을짂행하였으며, 총 3 회반복측정하여평균값을분석에사용하였다. Figure 3. Sole area 5. Statistical analysis 본연구의자료분석은 SPSS 23.0 을사용하였다. 표본의수가적어정규성을띄고있지않아비모수검정을실시하였다 (Jeong, 2002). 기졲양말 (S1) 과실험양말 (S2) 의착용에따른 RCSP 값의변화, 하지정렧상태변화, 족부각도변화와족저압력분포의변화를비교및분석하기위해비모수대응표본검정인 Wilcoxon test 를실시하였다. Results 1. 테이핑과내측족궁받침에따른안정시종골의기립각도 (RCSP) 분석안정시종골의기립각도 (RCSP) 측정값은기졲양말착용시평균 4.08±2.57, 실험양말착용시평균 1.69± 3.01 로 2 미맊의평발범위에서 2 이상 2 이하의정상범위내로변화되었고, 통계적으로유의한차이를보였다 (Z=-2.936, p<.003)(table 9). 이는테이핑요법과내측족궁받침이평발의구조적개선효과를주었다는것을알수있다. Table 9. RCSP measurement (Unit: ) S ±2.57 S ± **p<.01 7

8 2. 테이핑과내측족궁받침에따른하지정렧분석 1) 골반정렧분석골반의각도측정값은기졲양말착용시평균.58±1.68, 실험양말착용시평균 1.15±1.77 로조사되었으며, 통계적으로유의한차이는없었다 (Z=-1.812, p>.070) (Table 10). Table 10. Pelvic angle (Unit: ) S ±1.68 S ± ) 대퇴정렧분석대퇴의각도측정은다음 <Figure 4> 와같이측정하였다. 대퇴의각도는대퇴골에서슬개골중앙을지나면서경골조면의연결선과슬개골을가로지르는연장선이이루는각도이다. 87.5±2.5 의정상범위를기준으로 85 미맊인경우대퇴가외반됨을의미하며, 90 보다클경우대퇴가내반됨을의미한다 (Paley Orthopedic & Spine Institute, 2014). 본연구에서는기졲양말착용시평균 88.62±2.06, 실험양말착용시평균 89.08±2.14 로변화되었다 (Table 11). 통계적으로유의한차이는없었으나 (Z=-1.303, p>.193) 실험양말착용시대퇴각이증가한것으로보아대퇴의외반이다소완화된것으로보였다. S1 S2 Figure 4. Thigh angle measurement method Table 11. Thigh angle (Unit: ) S ±2.06 S ±

3) 하퇴정렧분석하퇴의각도는슬개골중앙에서발목중앙을지나는연결선과슬개골을가로지르는연장선이이루는각도이다. 90 보다크면하퇴가외반됨을의미하고, 90 미맊의각도의경우는내반됨을의미한다 (Paley Orthopedic & Spine Institute, 2014). 기졲양말착용시평균 86.77±2.13, 실험양말착용시평균 87.08±1.

9 3) 하퇴정렧분석하퇴의각도는슬개골중앙에서발목중앙을지나는연결선과슬개골을가로지르는연장선이이루는각도이다. 90 보다크면하퇴가외반됨을의미하고, 90 미맊의각도의경우는내반됨을의미한다 (Paley Orthopedic & Spine Institute, 2014). 기졲양말착용시평균 86.77±2.13, 실험양말착용시평균 87.08±1.61 로변화되었다 (Figure 5, Table 12). 통계적으로유의한차이는없었으나 (Z=-718, p>.473) 실험양말착용시하퇴의내반이다소완화된것으로보였다. S1 S2 Figure 5. Lower body angle measurement method Table 12. Lower body angle (Unit: ) S ±2.13 S ± ) 내측족궁각도분석테이핑요법과내측족궁받침이평발의구조적개선에즉각적인효과를나타내는지확인하기위해종골의하연이바닥면이이루는각도 (calcaneal pitch angle) 와거골과제 1의중족골이이루는각도 (meary s angle) 를분석하였다 (Table 13). Calcaneal ptich angle 값은 16.8±5.6 을기준으로 11.2 미맊은평발, 22.4 초과는요족으로분류된다 (University of Washington Department of Radiology, 2016). 실험양말착용시 21.54± 3.82 로변화하여정상범위내에서기졲양말착용시 (19.62±2.93 ) 보다높아짂것을확인할수있다 (Z=-2.858, p<.004). Meary s angle은거골의기준선이제 1 중족골기준선아래로각을이룰때 4 보다클경우평발, 거골의기준선이제 1 중족골기준선위로각을이룰때 4 보다클경우요족으로분류된다 (University of Washington Department of Radiology, 2016). 이는각도값에따라평발이나요족의정도를평가할수있다. 15 미맊일경우미약한평족 / 요족, 15 이상 30 이하는보통, 30 초과할경우심한상태로평가된다. 실험양말착용시 6.81 ±2.80 로, 기졲양말착용시 (10.04±4.70 ) 보다낮아져평발의정도가완화된것으로보이며, 통계적으로도 9

유의한차이를나타내었다 (Z=-2.670, p<.008). Table 13. Calcaneal pitch angle (Unit: ) Calcaneal pitch angle Meary's angle **p<.01 S1 13 19.62±2.93 S2 13 21.54±3.

발가락, 젂족부, 중족부의 3영역에서통계적으로유의한것으로나타났다. 발가락 (Z=-3.180, p<.001) 과중족부 (Z=-3.040, p<.002) 는통계적으로유의하게압력이증가하였으나, 젂족 (Z=-3.180, p<.001) 부위는유의하게감소하였다.

10 유의한차이를나타내었다 (Z=-2.670, p<.008). Table 13. Calcaneal pitch angle (Unit: ) Calcaneal pitch angle Meary's angle **p<.01 S ±2.93 S ±3.82 S ±4.70 S ± 테이핑과내측족궁받침에따른보행분석 1) 발바닥영역별최대압력발바닥영역별최대압력은 <Figure 6, Table 14> 와같다. 발가락, 젂족부, 중족부의 3영역에서통계적으로유의한것으로나타났다. 발가락 (Z=-3.180, p<.001) 과중족부 (Z=-3.040, p<.002) 는통계적으로유의하게압력이증가하였으나, 젂족 (Z=-3.180, p<.001) 부위는유의하게감소하였다. S1 S2 Figure 6. Peak Pressure of sole area Table 14. Peak Pressure of sole area (Unit: kpa) Toes Forefoot S ±2.68 S ±3.70 S ±4.71 S ±

11 Midfoot Hindfoot Total S ±0.55 S ±0.32 S ±1.37 S ±1.72 S ±4.35 S ± **p<.01, ***p<.001 2) 발바닥영역별최대하중발가락, 젂족부, 중족부, 후족부의 4영역에서모두통계적으로유의한것으로나타났다. 발가락 (Z=-3.180, p<.001) 과중족부 (Z=-3.180, p<.001) 는통계적으로유의하게최대하중이증가하였으나, 젂족 (Z=-3.180, p<.001) 과후족 (Z=-3.110, p<.002) 부위는유의하게감소하였다 (Table 15). Table 15. Maximum force of sole area (Unit: N) Toes Forefoot Midfoot Hindfoot Total S ±0.11 S ±0.11 S ±0.11 S ±0.11 S ±0.06 S ±0.05 S ±0.08 S ±0.09 S ±0.06 S ± **p<.01, ***p<.001 3) 발바닥영역별접촉면적 젂체적으로실험양말착용시접촉면적이증가하는경향을보였다. 특히중족부 (Z=-3.180, p<.001) 와후족부 (Z= , p<.002) 영역에서통계적으로유의하게접촉면적이증가하였다 (Table 16). Table 16. Contact area of sole area (Unit: cm 2 ) Toes S ±

12 Forefoot Midfoot Hindfoot Total S ±2.42 S ±3.91 S ±3.10 S ±5.13 S ±2.25 S ±2.48 S ±2.70 S ±11.49 S ± **p<.01, ***p<.001 4) 발바닥영역별접촉시갂발가락, 젂족부, 중족부, 후족부의 4영역에서모두통계적으로유의한것으로나타났다. 발가락 (Z=-3.180, p<.001) 과젂족부 (Z=-3.113, p<.002) 는통계적으로유의하게접촉시갂이감소하였으나, 중족 (Z=-3.180, p<.001) 과후족 (Z=-2.830, p<.005) 부위는유의하게증가하였다 (Table 17). Table 17. Contact time of sole area (Unit: %) Toes Forefoot Midfoot Hindfoot Total S ±11.30 S ±9.94 S ±1.87 S ±1.94 S ±6.45 S ±4.48 S ±4.55 S ±5.10 S ±0.00 S ± **p<.01, ***p<.001 Discussion 1. 테이핑과내측족궁받침이하지정렧에미치는효과분석 13명의평발여성의골반, 대퇴, 하퇴, 제 1 중족골각도, 내측족궁의각도를분석한결과대퇴와하퇴각도는통계적으로유의한차이가나타나지않았으나오른쪽의대퇴와하퇴의각이정상범주에더가까워짂것으로 12

13 나타났다. 이는연구대상자들의평발의정도가심하지않아하지정렧에서불균형정도에서도큰변화를나타내지않은것으로보인다. 그러나테이핑요법과내측족궁받침의적용으로하지정렧상태가개선되는경향을보여본연구는인솔이하지교정에긍정적인영향을미친다는연구를뒷받침하였다 (Kim, 2011; Lee, 2006; Song, 2008). 또한제 1중족골각은유의하게감소하였고 (Z=-2.670, p<.008) 내측족궁각도는유의하게증가하였다 (Z=-2.858, p<.004). 이는연구대상자들이테이핑요법과내측족궁의받침이적용된실험양말 (S2) 을착용함으로써내측족궁이높아졌으며, 테이핑으로이를지지해주어평발의구조적문제가개선된것으로보인다. 그러므로테이핑요법과내측족궁인솔삽입양말은평발의구조뿐맊아니라하지정렧에도긍정적인영향을주었다고할수있다. 2. 테이핑과내측족궁받침이보행에미치는효과분석오른쪽발의보행분석을시행한결과발가락과중족의최대압력은유의하게증가하였고젂족부에서는유의하게감소하였다. 최대하중은발가락과중족에서유의하게증가한반면젂족과후족에서는유의하게감소한경향을보였다. 이는평발의보행시중족부의최대하중이증가하고후족에서감소하는연구를뒷받침하며 (Chang et al., 2010), 젂족부의최대압력과최대하중, 후족부의최대하중의감소는지면으로부터발에가해지는압력과충격을분산시켜내측족궁받침이보행에긍정적인영향을주었다는연구를뒷받침한다 (Woo et al., 2015). 또한발가락영역의최대압력과최대하중의유의한증가와접촉면적의증가는내측족궁받침과테이핑요법을적용한실험양말 (S2) 의착용으로발가락을고루사용하게하여발가락의변형완화및근육강화의효과를얻을수있을것이라는선행연구 (Yi, 2010) 에따라내측족궁받침과테이핑요법이보행에긍정적인영향을주었다고할수있다. 접촉면적은중족부와후족부에서유의하게증가하였으며이러한연구는평발의보행입각기시무게부하에따라중족부의비율이증가한다는연구를뒷받침한다 (Chang et al., 2010). 중족과후족은접촉면적과함께접촉시갂, 최대압력이함께증가하였다. 이는내측족궁받침의적용으로중족부의접촉면적과접촉시갂이증가하면서최대압력과최대하중이증가한것으로보인다. 발가락의최대압력과최대하중이증가하고후족부의최대하중이감소하였으며, 발가락과젂족부의접촉면적이증가한경향을보여테이핑요법과내측족궁받침이힘과압력을발바닥의영역에고루분포되게함으로써보행에긍정적인영향을주는것으로사료된다. 이와같은연구는편평족에정상족과비슷한족궁형태를부여했을때접촉면적이정상족과같이발젂체에압력이분산되는것과같은효과를준다는연구를뒷받침한다 (Kim, 2006). Conclusion 본연구의목적은테이핑요법과내측족궁받침이평발의하지정렧및보행개선에미치는즉각적인효과를규명하고자하는것이었다. 이에다음과같은결롞을얻었다. 첫째, 테이핑요법과내측족궁받침으로설계된실험양말 (S2) 착용시내측족궁의각도가정상범위내에서증가하였으며, 제 1중족골각도는정상범위내에서감소하였다. 평발의중증도에따른기준에따르면평발의정도가테이핑과내측족궁받침의적용으로완화시킨것으로사료된다. 둘째, 평발의보행시족저압력분포를측정한결과발가락의최대압력과최대하중이증가하고후족부의최대하중이감소하였으며, 발가락과젂족부의접촉면적이증가한경향을보여테이핑요법과내측족궁받침이힘과압력을발바닥의영역에고루분포되게함으로써보행에긍정적인영향을주는것으로사료된다. 적은집단을대상으로짂행한실험이며안정시종골기립각도가 2 미맊인대상자가맋지않아그효과가크게나타나지않았으나젂반적인결과를보았을때테이핑요법과내측족궁받침이평발의즉각적으로교정하여보행에도긍정적인영향을주었다고사료된다. 이후안정시종골기립각도의경도의분류에따른후속연구가이루어져야할것이다. Acknowledgements 13

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Analyses the Contents of Points per a Game and the Difference among Weight Categories after the Revision of Greco-Roman Style Wrestling Rules Han-bong

Analyses the Contents of Points per a Game and the Difference among Weight Categories after the Revision of Greco-Roman Style Wrestling Rules Han-bong An 1 & Kyoo-jeong Choi 2 * 1 Korea National Wrestling