Exercise Science Vol.28, No.1, February 2019: ISSN(Online) ORIGINAL ARTICLE 스쿠버다이빙전운동강도의차이가

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1 Exercise Science Vol.28, No.1, February 2019: ISSN(Online) ORIGINAL ARTICLE 스쿠버다이빙전운동강도의차이가스쿠버다이빙후정맥기포형성에미치는영향 한길형, 현광석, 박정민 충남대학교체육교육과 The Effect of Pre-Scuba Diving Exercise Intensity on Vein Bubble Formation after Scuba Diving Kil-hyung Han, Kwangseok Hyun, Jeong-Min Park Department of Physical Education, Chungnam National University, Daejeon, Korea PURPOSE: This study was to investigate the effects of pre-scuba diving exercise intensity on vein bubble formation after scuba diving. METHODS: The participants were divided into four groups: Non-Exercise group (NEG/n=20) and Low Intensity-Exercise group (LEG/ n=20) and Moderate Intensity-Exercise group (MEG/n=20) and High Intensity-Exercise group (HEG/n=20). The LEG group and MEG group and HEG group took part in the exercise program on pre-scuba diving. RESULTS: The results of this study were as follows: First, As for the Subclavian vein of Left bubble grade, there were significantly increased in NEG group and MEG group and HEG group. Second, As for the Subclavian vein of Right bubble grade, there were significantly increased in NEG group and MEG group and HEG group. Third. As for the Right atrium of bubble grade. There were significantly increased in NEG group and MEG group and HEG group. CONCLUSIONS: As conclusions, this study confirmed that the pre-scuba diving exercise intensity could improve the vein bubble formation of scuba diver. Key words: Scuba diving, Exercise intensity, Vein bubble formation, Scuba diver 서론 스쿠버다이빙은수면에서활동하는일반적인스킨다이빙에비해장시간깊은수심에서의수중활동을의미하며, 압축된공기를공기조절장치를통해흡입하고배출하는호흡형태를의미한다 [1]. 이러한, 스쿠버다이빙은수중이라는특수한공간에서압축된공기통을메고호흡함으로써수중환경의제한적요인들을극복하는스포츠를의미하며, 수중환경에서의활동은인체의다양한변화와생리학적요인의 제약사항에의한신체항상성의변화를유도하는것으로보고하고있다 [2]. 또한, 스쿠버다이빙과같은수중환경에서의운동은높은수압을견디며다양한혼합기체로호흡해야하는특수한스포츠이기때문에외부온도나환경으로인하여스트레스를받게되어신체의다양한생리적인변인에변화가발생하는것으로보고되고있다 [3,4]. 수중환경에서의인체적제약사항은수온, 수압, 조류및염도등과같은다양한환경적변인과물의밀도차이로인한높은수압은인체에커다란영향을미치는것으로알려져있으며 [5], 수온에의한체온저하와 Corresponding author: Kwangseok Hyun Tel * 이논문은 2017 년충남대학교자체연구과제지원을받아수행된연구임. Keywords 스쿠버다이빙, 운동강도, 정맥기포형성, 스쿠버다이버 Received 1 Jan 2019 Revised 14 Feb 2019 Accepted 14 Feb 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 74 Copyright 2019 Korean Society of Exercise Physiology

2 수압에의한압력불균형은스트레스성과호흡 (hyperventilation) 과폐압착 (lung squeeze) 및잠수반사 (dive reflex) 와공기색전증 (air embolism) 이나감압병 (decompression sickness) 과같은잠수병의위험가능성이높은것으로보고되고있다 [6]. 이러한, 수압의변화는수심이 10 m 깊어질때마다 1기압이증가하는것으로수심이증가할수록인체는외부압력에의한신체적압박도상대적으로증가하는것으로보고되고있다 [7]. 또한, 수압의변화는심장기능의심장박동수의변화와더불어심박출량및동맥압과혈관의저항에영향을주어압축공기중의산소와질소가스에의한신체적기능변화를유도하는것으로보고되고있으며 [8], 수압의증가로인한산소부분압의증가와호흡공기밀도의증가는폐로유입되는기체의분압도증가시켜폐포에서혈액과만나액화되는기체분자수도증가시키는것으로보고되고있다 [9]. 이렇게, 수압의증가로인한주위압력의증가는헨리의법칙에의한압력변화를의미하며, 이는높은데서낮은쪽으로이동하는압력평형과깊은상관관계를보이는것으로기체분자가분압이높은폐를떠나인체조직으로축적되는현상을의미하는것이다. 이러한, 인체조직과폐의용해기체전달은폐와인체조직과혈액내의분압이같아지는현상으로호흡시산소는인체로용해되어각조직에전달되어에너지원으로사용되어소모가진행되지만, 질소는폐보다분압이낮은경우인체에용해되어소모되지않고체내에계속축적되는것이다 [10]. 이렇게, 체내에축적된질소는수압의변화와수중활동시간의변화에따라그축적량이증가하는것으로보고되고있으며, 체내에축적된질소용해량이혈액과폐와같은분압조건이되면주변의압력에맞추어질소의흡수와배출을시작하게된다. 이러한, 질소의흡수와배출은체내질소축적량의포화상태에서는압력의변화가없는한더이상의축적현상은이루어지지않는것으로보고되고있으나, 질소의배출은정상적인감압활동시에만이루어지는것으로보고되고있다. 이는, 급속한압력감소는질소의배출을방해하는원인으로체내질소축척량을급속도로높이는용해질소포화상태의원인이되는것으로보고되고있다 [8,9]. 이렇게, 압력변화로인한체내질소축적요인을이상기압관련장애라고보고하고있으며, 이러한, 이상기압관련장애는흔히잠수병이라불리는감압병을의미한다 [7]. 이러한, 감압병은감압을시행하지않거나표준화된감압방법을따르지않고급속한감압변화를실시하였을경우발생되는것으로보고되고있으며 [11] 체내에잔류한불활성기체인질소의배출시간을고려하지않고수중활동을수행하는경우감압병에이환되는확률이높은것으로보고되고있다 [12]. 또한, 불안정한감압에의해생성된불활성기체인질소는기포형태로체내에축척되어혈관을통해신체전체로이동하여약한조직에서부터강한조직까지점진적으로축척되어감압병을유도하는것으로보고하고있으며, 상승속도, 최대산소섭취량, 나이, 비만도에따라체내에축척량은차이가있는것으로보고하였다 [13]. 이렇듯, 감압병은수중환경이라는특수한환경에서인간이극복해야 할주요요인으로, 이를극복하기위한다양한연구들이진행되고있으 며, 그중신체활동을통한운동방법이감압병의주요요인인체내불활 성기포의축척률을감소시키는것으로보고하고있다 [14]. 하지만, 세 계적인스쿠버다이빙관련단체들은스쿠버다이빙전후운동방법으 로가벼운유산소운동은권장하고있으나그이상의운동강도에대한 방법은우려를나타내고있다. 이에본연구는스쿠버다이빙전간헐 적운동방법 [13] 과중강도에어로빅 [15] 및스쿠버다이빙전운동의효 과 [16,17] 를보고한연구들을기반으로안전한수중환경에서의다이빙 활동과스쿠버다이빙시일어날수있는환경적손상예방및수행메 뉴얼에관한연구를통한검증과평가를시행하고자한다. 따라서, 본연구는특수한환경에서활동를수행하여야하는스쿠 버다이버들의수중활동전운동강도의차이가이상기압관련장애로 불리는잠수병의원인과정맥기포형성의변화를관찰하여스쿠버다 이빙에관한효율성및안전성에필요한자료와기술을정립하고, 안전 한수중활동의지침을제공하고자한다. 연구방법 1. 연구대상 본연구의대상자는필리핀 C 주 L City 에근무하고있는 NAVY Naval Special Operations Group (NASOG) 의 NAVY SEAL Diving Unit 대 원 20 명으로심해잠수경력이 5 년이상, 년평균 50 회이상의스쿠버다 이빙을수행하는자로선정하였다. 연구에앞서본연구의취지를충 분히이해하고실험에대한자발적인참여의사를가진피험자들로선 정하였으며, 연구참여자들은연구참여동의서를작성후실험에참 여하였다. 실험참여자들의그룹선정은그룹간동질성을성립하기위 하여같은대상자들로 4 회에걸쳐실시하였으며, 고강도운동후다이 빙그룹, 중강도운동후다이빙그룹, 저강도운동후다이빙그룹, 비 운동대조그룹으로나누어실시하였다. 대상자들의신체적특성은 Table 1 과같다. 2. 연구설계 본연구의목적에따라설정된실험설계및절차는 Table 2 와같다. Table 1. Physical characteristics of subjects Items Age (yr) Height (cm) Weight (kg) BMI (kg/m 2 ) Divers (n=20) 31.72± ± ± ±3.28 All data represent means±standard deviation. BMI, body mass index. 한길형외 스쿠버다이빙운동강도 75

3 Vol.28, No.1, February 2019: 연구환경설정본연구는환경적요인의변화에민감한연구로환경적요인의동질성을성립하기위하여현지환경의평균치를조사하였으며, 조사된환경적요인의평균에맞추어연구를진행하였다. 연구환경의특성은 Tables 3, 4와같다. 5. 측정항목및방법본연구의변인측정은안전성과신뢰도를높이기위하여국제스쿠버다이빙강사평가관과필리핀 NAVY SEAL Diving 교관의입회하에스쿠버다이빙강사 3명, 보조강사 2명에연구참여대상자 2인을한그룹으로만들어실시하였다. 4. 운동강도설정본연구의운동강도는크게 3가지로구성하였으며, ACSM [18] 에서권고한운동강도를근거로다음과같은강도설정을하였다. 각집단별운동량을동일하게적용하였으며, 운동방법은트레드밀달리기를통하여운동강도를조절하였다. 또한, 피험자들의운동강도를정량화시키기위하여개개인의안정시심박수를목의경동맥에서측정한후 Karvonen공식을이용하여개인별산출공식을적용하였다. 저강도운동은 HRR 30% 이하의강도로목표심박수약 116회운동을실시하였으며, 중강도운동은 40-70% 의강도로목표심박수약 132회운동을실시하였다. 또한, 고강도운동은 HRR 80% 이상의강도로목표심박수 160회운동을실시하였다. 운동중에는휴식시간을갖지않는방식으로진행하였으며, 심박수측정은가슴밴드형심박계가내장되어있는다이빙컴퓨터운동강도설정의 GALILEO SOL (SCUBA PRO, Wisconsin, USA) 을이용하여측정하였다. 1) 심박수측정본연구의심박수측정은다이빙컴퓨터 GALILEO SOL (Uwatec, US) 을이용하여측정하였으며, 대상자들의가슴에수중심박수신기인 POLAR T3를착용하고다이빙활동전과후, 컴퓨터에 GALILEO SOL을연결하여시간대별심박수를측정하였다. 2) 정맥기포검사본연구의정맥기포검사는혈중기포의소리를감지할수있는헤드셋과초음파 probe가연결되어있는초음파진단기 (Doppler Bubble Monitor, Techno Scientific Ontario, Canada) 를이용하여스쿠버다이빙전과후에정맥기포검사를측정하였다. 정맥기포검사는쇄골하정맥 ( 좌측, 우측 ) 과우심방총 3부위에서측정하였으며, 쇄골하정맥측정은초음파 probe를통한검사준비를마치면측정부위의손을쥐었다풀었다를반복하여총 2분간측정하였다. 또한, 우심방측정은검사준비를마친후앉았다일어났다를반복하여 2분간측정하였으며, 이때측정시간은스쿠버다이빙후 5분을경과하지않도록주의하였다. Table 2. Study design Items Exercise time (min) Warm-up Work-out Cool-down Rest time (min) Total dive time (min) Bubble-checking time Non-Exercise group (NEG/n=20) Immediately after diving Low Intensity-Exercise group (LEG/n=20) Immediately after diving Moderate Intensity-Exercise group (MEG/n=20) Immediately after diving High Intensity-Exercise group (HEG/n=20) Immediately after diving All data represent means±standard deviation. Table 3. Diving Environment characteristics of group Items Date Temp Humidity Water temp Non-Exercise group (NEG/n=20) Low Intensity-Exercise group (LEG/n=20) Moderate Intensity-Exercise group (MEG/n=20) High Intensity-Exercise group (HEG/n=20) All data represent means±standard deviation. Table 4. Diving Plan Max Depth Temp. Bottom Time Total Dive Time Accent Rate Accent Rate After Deco Wave Deco Time 30 m 29 C 25 min 35 min 9 M/min 3 M/min 1 M 5 min at 5 m 76 Kil-hyung Han, et al. Scuba Diving Exercise Intensity

4 Table 5. K-M Code of Bubble Grade Code Frequency Percentage Amplitude No Ab<<Ac Ab<Ac Ab Ac 4 Continuation 100 Ab>Ac 3) 정맥기포분석 본연구의정맥기포분석은캐나다국방청과기상청의연구기관인 Defense and Civil Institute Environment Medicine (DCIEM) 에서 Defence Research and Development Canada (DRDC) 로명칭을변경한국제 유일의다이빙기포연구소소속의 DCIEM Doppler technician David Eastmann & Corry Van den Broek 에의해서분석하였으며, DCIEM Diving Masurel 과 Kisman Masurel Code (K-M Code) 의 Bubble Grade 를 통하여분석하였다. 본연구의정맥기포분석은초음파측정기의 Echo 분석방식으로 Frequency 는구간별빈도의변화를나타내며, Percentage 는구간별빈도에대한 % 를나타낸다. 또한, Amplitude 는구간별진폭의 변화를나타낸다. K-M Code 와 Bubble Grade 는 Tables 5, 6 과같다. 6. 자료처리방법 본연구는 SPSS 20.0 통계프로그램을이용하여고강도운동그룹, 중 강도운동그룹, 저강도운동그룹, 비운동대조그룹각각 20 명씩을대 상으로각네집단에대한평균 (mean) 과표준편차 (standard deviation, SD) 를산출하였다. 구체적으로통계처리는이원반복측정변량분석 (two-way repeated measures, ANOVA) 을실시하여 2 시기 ( 사전및사후 ) 에따른 4 집단간의차이 (2 4) 를분석하였다. ANOVA 검사후유의한 차이가나타날경우, 각집단의시기간차이검증은 Paired t-test, 각집 단간차이검증은일원변량분석 (One-way, ANOVA) 을이용하여분석 하였으며, 사후검증으로 Turkey 방법을실시하였다. 이때모든통계적 유의수준은 α =.05 로설정하였다. 연구결과 1. 쇄골하정맥기포의변화 1) 쇄골하정맥좌측 운동강도에따른좌측쇄골하정맥의변화는 Table 7 에제시한바와 같다. 운동강도에따른좌측쇄골하정맥의변화중 Frequency 의변화 는 NEG (p =.001), MEG (p =.032), HEG (p =.000) 에서스쿠버다이빙후 에통계적으로유의하게증가하였으며, Percentage 의변화는 NEG (p =.016), MEG (p =.028), HEG (p =.000) 에서스쿠버다이빙후에통계 적으로유의하게증가하였다. 또한, Amplitude 의변화는 NEG (p =.001), Table 6. K-M Code of Bubble Grade Analysis fpa g fpa g fpa g fpa g 111 I- 211 I- 311 I 411 II- 112 I 212 I 312 II- 412 II 113 I 213 I+ 313 II 413 II+ 114 I+ 214 II- 314 II 414 III- 121 I+ 221 II- 321 II 421 III- 122 II 222 II 322 II+ 422 III 123 II 223 II+ 323 III- 423 III 124 II 224 II+ 324 III 424 III+ 131 II 231 II 331 III- 431 III 132 II 232 III- 332 III 432 III+ 133 III- 233 III 333 III 433 IV- 134 III- 234 III 334 III+ 434 IV 141 I 241 III- 341 III 441 III+ 142 III- 242 III 342 III+ 442 IV 143 III 243 III 343 III+ 443 IV 144 III 244 III+ 344 IV- 444 IV MEG (p =.019), HEG (p =.000) 에서스쿠버다이빙후에통계적으로유 의하게증가하였다. 하지만, LEG 그룹은 Frequency (p =.234), Percentage (p =.412), Amplitude (p =.094) 에서스쿠버다이빙후에통계적으로유 의한차이는나타나지않았으나기포의변화는스쿠버다이빙후에증 가한것으로나타났다. 또한, 운동강도에따른좌측쇄골하정맥의그 룹간의변화는 Frequency (LEG < MEG <NEG <HEG), Percentage (LEG< MEG<NEG<HEG), Amplitude (LEG< MEG< NEG<HEG) 순 으로나타났다. 2) 쇄골하정맥우측 운동강도에따른우측쇄골하정맥의변화는 Table 8 에제시한바와 같다. 운동강도에따른우측쇄골하정맥의변화중 Frequency 의변화 는 NEG (p =.014), MEG (p =.001), HEG (p =.000) 에서스쿠버다이빙 후에통계적으로유의하게증가하였으며, Percentage 의변화는 NEG (p =.042), MEG (p =.037), HEG (p =.000) 에서스쿠버다이빙후에통계 적으로유의하게증가하였다. 또한, Amplitude 의변화는 NEG (p =.001), MEG (p =.018), HEG (p =.000) 에서스쿠버다이빙후에통계적으로유 의하게증가하였다. 하지만, LEG 그룹은 Frequency (p =.096), Percentage (p =.233), Amplitude (p =.068) 에서스쿠버다이빙후에통계적으로 유의한차이는나타나지않았으나기포의변화는스쿠버다이빙후에 증가한것으로나타났다. 또한, 운동강도에따른우측쇄골하정맥의 그룹간의변화는 Frequency (LEG < NEG < MEG < HEG), Percentage (LEG < NEG < MEG < HEG), Amplitude (LEG < MEG < NEG < HEG) 순으로나타났다. 한길형외 스쿠버다이빙운동강도 77

5 Vol.28, No.1, February 2019: Table 7. Subclavian vein of Left bubble grade Items Group pre K-M Code poet Source F (p) Post-hoc Frequency NEG (n = 20) 0.03 ± ± 0.25 ##,+++ T (.001) B<C<A<D LEG (n=20) 0.02± ±0.11 G (.234) MEG (n = 20) 0.02 ± ± 0.65 #,+ G T (.032) HEG (n = 20) 0.03 ± ± 1.02 ###, (.000) Percentage NEG (n = 20) 0.03 ± ± 0.28 #,++ T (.016) B<C<A<D LEG (n = 20) 0.02 ± ± G (.412) MEG (n = 20) 0.02 ± ± 0.84 #,++ G T (.028) HEG (n = 20) 0.03 ± ± 1.21 ###, (.000) Amplitude NEG (n = 20) 0.03 ± ± 0.68 #,+++ T (.001) B<C<A<D LEG (n = 20) 0.02 ± ± 0.61 #,+ G (.094) MEG (n = 20) 0.02 ± ± 0.72 #,++ G T (.019) HEG (n = 20) 0.03 ± ± 1.64 ###, (.000) A: Non-Exercise group. B: Low Intensity-Exercise group. C: Moderate Intensity-Exercise group. D: High Intensity-Exercise group. T: time. G: group. G T: group time. Significantly different from pre-and post-values: # p<.05, ## p<.01, ### p<.001. Significantly different among the groups: + p<.05, ++ p<.01, +++ p<.001. Significantly interaction among groups and time: *p<.05, **p<.01, ***p<.001. Table 8. Subclavian vein of Right bubble grade Items Group pre K-M Code poet Source F (p) Post-hoc Frequency NEG (n = 20) 0.02 ± ± 0.62 #,++ T (.014) B<A<C<D LEG (n = 20) 0.02 ± ± G (.096) MEG (n = 20) 0.01 ± ± 0.74 ##,++ G T (.001) HEG (n = 20) 0.01 ± ± 1.14 ###, (.000) Percentage NEG (n = 20) 0.02 ± ± 0.62 #,++ T (.042) B<A<C<D LEG (n = 20) 0.02 ± ± G (.233) MEG (n = 20) 0.01 ± ± 0.38 #,+ G T (.037) HEG (n = 20) 0.01 ± ± 1.06 ###, (.000) Amplitude NEG (n = 20) 0.02 ± ± 1.02 #,+++ T (.001) B<C<A<D LEG (n = 20) 0.02 ± ± 0.84 #,+ G (.068) MEG (n = 20) 0.01 ± ± 1.02 #,++ G T (.018) HEG (n = 20) 0.01 ± ± 1.04 ###, (.000) A: Non-Exercise group. B: Low Intensity-Exercise group. C: Moderate Intensity-Exercise group. D: High Intensity-Exercise group. T: time. G: group. G T: group time. Significantly different from pre-and post-values: # p<.05, ## p<.01, ### p<.001. Significantly different among the groups: + p<.05, ++ p<.01, +++ p<.001. Significantly interaction among groups and time: *p<.05, **p<.01, ***p< 우심방기포의변화운동강도에따른우심방기포의변화는 Table 9에제시한바와같다. 운동강도에따른우심방기포의변화중 Frequency의변화는 NEG (p =.001), LEG (p =.039), MEG (p =.014), HEG (p =.000) 에서스쿠버다이빙후에통계적으로유의하게증가하였으며, Percentage의변화는 NEG (p =.008), MEG (p =.006), HEG (p =.000) 에서스쿠버다이빙후에통계적으로유의하게증가하였다. 또한, Amplitude의변화는 NEG (p =.000), NEG (p =.017), MEG (p =.019), HEG (p =.000) 에서스쿠버다이빙후에 통계적으로유의하게증가하였다. 하지만, LEG 그룹은 Percentage (p =.222) 에서스쿠버다이빙후에통계적으로유의한차이는나타나지않았으나기포의변화는스쿠버다이빙후에증가한것으로나타났다. 또한, 운동강도에따른우심방기포의그룹간의변화는 Frequency (LEG < MEG < NEG < HEG), Percentage (LEG < NEG < MEG < HEG), Amplitude (MEG<LEG<NEG<HEG) 순으로나타났다. 78 Kil-hyung Han, et al. Scuba Diving Exercise Intensity

6 Table 9. Right atrium of bubble grade Items Group pre K-M Code poet Source F (p) Post-hoc Frequency NEG (n = 20) 0.00 ± ± 1.26 ##,+++ T (.001) B<C<A<D LEG (n = 20) 0.02 ± ± 0.84 #,++ G (.039) MEG (n = 20) 0.02 ± ± 0.92 ##,++ G T (.014) HEG (n = 20) 0.02 ± ± 1.38 ###, (.000) Percentage NEG (n = 20) 0.00 ± ± 1.24 ###,++ T (.008) B<A<C<D LEG (n = 20) 0.02 ± ± G (.222) MEG (n = 20) 0.02 ± ± 0.88 ###,++ G T (.006) HEG (n = 20) 0.02 ± ± 1.38 ###, (.000) Amplitude NEG (n = 20) 0.00 ± ± 0.68 ###,+++ T (.000) C<B<A<D LEG (n = 20) 0.02 ± ± 1.02 ##,++ G (.017) MEG (n = 20) 0.02 ± ± 0.94 ##,++ G T (.019) HEG (n = 20) 0.02 ± ± 1.52 ###, (.000) A: Non-Exercise group. B: Low Intensity-Exercise group. C: Moderate Intensity-Exercise group. D: High Intensity-Exercise group. T: time. G: group. G T: group time. Significantly different from pre-and post-values: # p<.05, ## p<.01, ### p<.001. Significantly different among the groups: + p<.05, ++ p<.01, +++ p<.001. Significantly interaction among groups and time: *p<.05, **p<.01, ***p<.001. 논의 본연구는스쿠버다이빙전운동강도의차이가스쿠버다이빙후체내정맥기포형성에미치는영향을조사하여이상기압관련장애로불리는잠수병의원인인불활성기체의체내축적과운동의효과에대해연구함으로써특수한환경에서활동를수행하여야하는스쿠버다이버들의효율적이고안전한다이빙을위한수중활동의지침을제공하고자수행된연구이다. 이러한, 연구목적을토대로스쿠버다이빙전, 후의체내정맥기포형성을관찰한결과다음과같이논의하고자한다. 스쿠버다이빙 (SCUBA Diving) 은대자연에대한인간의투지와한계극복의의미를담고있는모험스포츠로서 [19], 스쿠버란 Self-Contained Underwater Breathing Apparatus (SCUBA) 의약자로우리말로는 수중자가호흡기 란뜻을가지고있다 [7]. 이러한, 스쿠버다이빙은수중에서압축된공기통을메고잠수하여공기조절장치를통해호흡하는잠수활동으로장시간깊은수심에서의수중활동을의미하는것으로 [20] 특수한환경인수중환경에서의운동은환경적제한요인들의극복과인체의적응에있지만, 높은수압과다양한혼합기체로의호흡은외부온도나환경적요인으로인하여스트레스를받게되어신체의다양한생리적인변인에변화가발생하게된다 [3,4]. 이렇듯, 스쿠버다이빙은수온과수압, 조류및염도등과같은다양한수중환경적요인에의하여불안전한호흡과압력변화로인한감압병 (decompression sickness) 과같은잠수병의위험가능성이높은것으로보고되고있으며 [21], 그중압력과공기의변화에의한잠수병의위험요인은돌이킬수없는사고를유발할수있는매우중요한요인인것이다. 이러 한, 잠수병의주원인수중환경에서의압력과공기의관계는다양한물리적법칙에의해서설명하고있으며, 그중압력의변화와밀도의차이및수중환경에서의감압속도는잠수병의요인현상으로매우중요하게인식되고있다 [22]. 하지만, 잠수병의원인인체내불활성기체의축적은감압속도의변화와인체적개별성에의하여차이가있는것으로보고되고있으며, 불활성기체와잠수병의관계는연령과체지방및건강상태와신체적요인에의에서변하는것으로보고하고있다 [23]. 이렇게다양한요인에의한수중활동의제약사항들은보다전문적이고과학적접근방법에의한해결방안들을제시하기시작하였으며, 그중스쿠버다이빙과신체활동량및운동과의관계에관한연구들이속속보고되고있다. 스쿠버다이빙시불안전한감압의변화는잠수병의주요인인체내불활성기포의형성을높이는것으로그위험성또한, 더욱높아지는것으로보고 [24] 하고있으며, 감압시에는신체적활동량이줄어들어불안전한감압은체내정맥기포형성을증가시키는것으로보고하고있다 [25]. 또한, 쥐를대상으로한불안전한압력변화전운동이감압병의신경학적발병률을감소시키는것으로보고 [14] 하고있으며, 인간을대상으로한다이빙전고강도에어로빅운동이체내불활성기포형성을감소시키는것으로보고 [16] 하였다. 이는본연구결과와동일한결과로서스쿠버다이빙전운동그룹이비운동대조그룹에비해전반적으로체내불활성기포형성이적은것으로나타났다. 하지만, 본연구에서는저강도운동그룹은비운동대조그룹에비해체내불활성기포형성이쇄골하정맥양쪽과우심방에서현저히감소한것으로나타났으며, 중강도운동그룹또한, 불활성기포형성이비운동대조그룹에비해감소한것으로나타난반면, 고강도운동그룹 한길형외 스쿠버다이빙운동강도 79

7 Vol.28, No.1, February 2019: 은비운동대조그룹에비해체내불활성기포형성이높은것으로나타나전반적인운동의효과와는상반된결과이다. 이는본연구시작전제시한운동강도의차이를확인하기위한연구방법으로긍정적인연구결과를도출한것으로생각되며, 이를규명하기위한후속연구의필요성을제시하는바이다. 위와같이, 스쿠버다이빙은수중환경에서의제한적요인을극복하는특수한스포츠로다양한생리학적변인들의변화를확인할필요가있으며, 환경적불안전요인으로인한인체의생리학적기전에변화를극복하기위한방법중의하나로운동의효과를확인할수있었다. 또한, 수중환경과같은환경적요인에서의인체적변화요인과이를효과적으로극복하기위한신체활동과운동의효과에관한연구는더욱다양하게일어나야할것이며, 본연구결과와같이수중환경에서의신체적변화와운동의효과에관한연구는운동강도와운동량과같은운동생리학적접근에의한다양하고구체적인연구결과들을적립한다면스쿠버다이빙의안정성과효율성을확인할수있는것으로보다안전한수중활동을위한교육적자료를제공할것이다. 결론 본연구는스쿠버다이빙전운동강도의차이가스쿠버다이빙후체내정맥기포형성에미치는영향을조사하여이상기압관련장애로불리는잠수병의원인인불활성기체의체내축적과운동의효과에대한연구이다. 이러한, 연구목적을토대로스쿠버다이빙전후의체내정맥기포형성을관찰한결과다음과같이결론을얻었다. 1. 스쿠버다이빙전운동강도의차이가스쿠버다이빙후체내정맥기포형성의변화중좌측쇄골하정맥의변화는 Frequency, Percentage, Amplitude 모두운동하지않은그룹과저강도운동그룹, 중강도운동그룹, 고강도운동그룹에서스쿠버다이빙후에통계적으로유의하게증가하였으나, 저강도운동그룹은체내정맥기포형성은발생하였으나 Frequency 는나머지그룹에비해통계적으로유의한차이가나타나지않았다. 또한, 그룹간의변화는 Frequency, Percentage, Amplitude 모두저강도운동그룹 < 중강도운동그룹 < 운동하지않은그룹 < 고강도운동그룹순으로나타났다. 2. 스쿠버다이빙전운동강도의차이가스쿠버다이빙후체내정맥기포형성의변화중우측쇄골하정맥의변화는 Frequency, Percentage, Amplitude 모두운동하지않은그룹과저강도운동그룹, 중강도운동그룹, 고강도운동그룹에서스쿠버다이빙후에통계적으로유의하게증가하였다. 또한, 그룹간의변화는 Frequency 와 Percentage는저강도운동그룹 < 운동하지않은그룹 < 중강도운동그룹 < 고강도운동그룹순으로나타났으며, Amplitude는저강도운동그룹 < 중강도운동그룹 < 운동하지않은그룹 < 고강도운동그룹순으로나타났다. 3. 스쿠버다이빙전운동강도의차이가스쿠버다이빙후체내정맥기포형성의변화중우심방기포의변화는 Frequency, Percentage, Amplitude 모두운동하지않은그룹과저강도운동그룹, 중강도운동그룹, 고강도운동그룹에서스쿠버다이빙후에통계적으로유의하게증가하였다. 또한, 그룹간의변화는 Frequency 는저강도운동그룹 < 중강도운동그룹 < 운동하지않은그룹 < 고강도운동그룹순으로나타났으며, Percentage는저강도운동그룹 < 운동하지않은그룹 < 중강도운동그룹 < 고강도운동그룹순으로나타났다. Amplitude는중강도운동그룹 < 저강도운동그룹 < 운동하지않은그룹 < 고강도운동그룹순으로나타났다. 본연구를종합해볼때, 스쿠버다이빙전운동강도의차이가스쿠버다이빙후체내정맥기포형성에변화를주는것으로확인할수있었으며, 이를토대로스쿠버다이빙전운동조절이안전하고효율적인수중활동에긍정적인도움을줄것으로생각된다. 또한, 개개인에맞는운동강도와신체활동을적용한다면수중환경적요인에서올수있는신체적불안정요인에의한손상및상해위험률의예방및관리를위해효과적일것으로생각된다. CONFLICT OF INTEREST 이논문작성에있어서어떠한조직으로부터재정을포함한일체의지원을받지않았으며, 논문에영향을미칠수있는어떠한관계도없음을밝힌다. REFERENCES 1. Hyun GS, Jee YS, Park JM, Cho NH, Cha JY. Injury survey in scuba divers of British Sub-Aqua Club: A retrospective study. J Exerc Rehabil. 2015;11(6): Park JM, Hyun KS, Han GH, Jee YS, Cha JY. Effects of pressure equalizing insecurity symptoms on the heart rate and respiration the during scuba diving on beginner college student dive. Journal of Learner- Centered Curriculum and Instruction. 2017;17(11): Doubt TJ. Cardiovascular and thermal responses to SCUBA diving. Med Sci Sports Exerc. 1996;28(5): Kim KJ. Comparison by the submergence duration of physiological responses in SCUBA diving. The Korean Society of Living Environmental System. 2001;8(3): Song SH, Lee WK, Chung YA, Hong SK. Mechanism of apneic bradycardia in man. J Appl Physiol. 1969;27(3): Kim YB, Choi JI. The change of the blood lactate, glucose, free fat acid, 80 Kil-hyung Han, et al. Scuba Diving Exercise Intensity

8 and hemoglobin following diving stage in control water and open water Scubadiving. The Korea Journal of Sport. 2012;10(2): Kang SY. A study on the scuba certification and status of leisure diving in Southeast Asia countries, Journal of Korean Navigation and Port Research. 2008;32(1): Han GH. A comparison of effectiveness of side-mount and backmount system in scuba diving. Korea Maritime and Ocean University NAUI. Leadership Instruction and Instructor Guide. NAUI: FL BSAC. Scuba Diving. Circle Books Richardson D, Kinsella J, Shreeves K. The encyclopedia of recreational diving. 3rd ed. Rancho Santa Margarita (CA): PADI Walker R, Edmonds C. Long-term effects of diving. In: Edmonds C, Lowry C, Pennefather J, Walker R, editors. Diving and subaquatic medicine. 4th ed. London: Arnold Publishers, 2002; Carturan D, Boussuges A, Vanuxem P, Bar-Hen A, Burnet H, et al. Ascent rate, age, maximal oxygen uptake, adiposity, and circulating venous bubbles after diving. J Appl Physiol. 2002;93(4): Jankowski LW, Nishi RY, Eaton DJ, Griffin AP. Exercise during decompression reduces the amount of venous gas emboli. Undersea Hyperb Med. 1997;24(2): Dujic Z, Duplancic D, Marinovic-Terzic I, Bakovic D, Ivancev V, et al. Aerobic exercise before diving reduces venous gas bubble formation in humans. J Physiol. 2016;555(3): Madden D, Thom SR, Milovanova TN, Yang M, Bhopale VM, et al. Exercise before scuba diving ameliorates decompression-induced neutrophil activation. Med Sci Sports Exerc. 2014;46(10): Madden D, Thom SR, Dujic Z. Exercise before and after SCUBA diving and the role of cellular microparticles in decompression stress. Med Hypotheses. 2016;86: ACSM s Guidelines for Exercise Testing and Prescription (8th Edition). American College of Sports Medicine Lindholm P, Lundgren CE. Alveolar gas compositionbefore and after maximal breath-holds incompetitive divers. Undersea Hyperb Med. 2006;33(6): Andersson JP, Linér MH, Rünow E, Schagatay EK. Diving response and arterial oxygensaturation during apnea and exercise in breathholddivers. J Appl Physiol. 2002;93(3): NAUI. NAUI Advanced diving Technology and Techniques. 1991; Kang SY. NAUI. Scuba Diver. Asia-Pacific Rim: Malaysia Carturan D, Boussuges A, Burnet H, Fondarai J, Vanuxem P, et al. Circulating venous bubbles in recreational diving: relationships with age, weight, maximal oxygen uptake and body fat percentage. Int J Sports Med. 1999;20(6): Spencer MP. Decompression limits for compressed air determined by ultrasonically detected blood bubbles. J Appl Physiol. 1976;40(2): Carturan D, Boussuges A, Vanuxem P, Bar-Hen A, Burnet H, et al. Ascent rate, age, maximal oxygen uptake, adiposity, and circulating venous bubbles after diving. J Appl Physiol (1985). 2002;93(4): 한길형외 스쿠버다이빙운동강도 81

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