누리다볼운동이중년남성의근기능, 척추정렬및 동적균형능력에미치는영향 최동훈 1 김태경 2 박재명 3 정종환 4 염동철 4 조인호 5 조준용 5 구정훈 5, 1 한국체육대학교운동생화학실, 박사후연구원 2 한국체육대학교체육과학연구소, 교수 3 한국체육대학교스포츠청소년지도학과,

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1 누리다볼운동이중년남성의근기능, 척추정렬및 동적균형능력에미치는영향 최동훈 1 김태경 2 박재명 3 정종환 4 염동철 4 조인호 5 조준용 5 구정훈 5, 1 한국체육대학교운동생화학실, 박사후연구원 2 한국체육대학교체육과학연구소, 교수 3 한국체육대학교스포츠청소년지도학과, 교수 4 한국체육대학교체육학과, 교수 5 한국체육대학교운동건강관리학과, 교수 (2020년 11월 29일접수 : 2020년 12월 14일수정 : 2020년 12월 17일채택 ) Effect of Nurida-Ball exercise on muscle function, spinal alignment, and dynamic balance capacity in Middle-Aged Men Dong-Hun Choi 1 Tae-Kyung Kim 2 Jae-Myoung Park 3 Jong-Hwan Jung 4 Dong-Chul Yeom 4 In-Ho Cho 5 Joon-Yong Cho 5 Jung-Hoon Koo 5 1 Exercise biochemistry Laboratory, Korea National Sport University 2 Institute of Sport Science, Korea National Sport University 3 Department of Youth Guidance and Sport Education, Korea National Sport University 4 Department of Physical Education, Korea National Sport University 5 Department of Health and Exercise Science, Korea National Sport University (Received November 29, 2020; Revised December 14, 2020; Accepted December 17, 2020) 요약 : 본연구는 8 주간의누리다볼운동이중년남성들의등속성근기능, 척추정렬및동적균형능력에미치는영향을규명하는데있다. 본연구의대상자는중년남성 (n=16) 을공운동그룹 (BE, n=8) 과비교그룹 (CON, n=8) 으로구분하였으며 BE 그룹은하루 30 분, 주 3 회, 총 8 주간누리다볼운동을실시하여등속성슬관절및체간의근기능, 척추정렬및동적균형능력을측정하였다. 측정된모든변인들은평균과표준편차를산출하고, Shapiro-Wilk test 를이용하여정규성검증을확인하였다. 이후집단간의차이를확인하기위해서독립 (Independant) t-test 방법과대응 (Paired) t-test 방법을이용하여분석하였다. 본연구의결과, 등속성슬관절및체간근기능은 CON 그룹과비교하여 BE 그룹에서좌측과우측의슬관절신전근의피크파워 (%BW, 60 /sec, p<.001, respectively), 좌측과우측슬관절신전근의평균파워 (%BW, 60 /sec, p<.05, p<.001, respectively), 우측슬관절굴골근의피크파워 (%BW, 180/sec, p<.05) 및우측슬관절신전근의평균파워 (%BW, 180 /sec, p<.05) 가유의하게증가하는것으로나타났다. 등속성체간의근기능변화량은 CON 그룹과비교하여 BE 그룹에서신전근의피크토크 (%BW, 180/sec, p<.05) Corresponding author (

2 2 최동훈 김태경 박재명 정종환 염동철 조인호 조준용 구정훈 Journal of the Korean Applied Science and Technology 가유의하게증가하는것으로나타났다. 또한, 누리다볼운동은몸통앞뒤기울기를감소시켜척추정렬을일부개선한것으로나타났다 (p<0.05). 마지막으로 CON 집단과비교하여 BE 집단에서동적균형능력은 6 단계의전체균형지수 (p<0.01), 전후균형지수 (p<0.05) 및 1 단계의전체균형지수 (p<0.05) 를유의하게감소시켰다. 따라서연구를종합해보면누리다볼운동은중년남성들에게있어등속성근기능, 척추정렬및동적균형능력과같은건강관련체력을향상시킬수있는효과적인운동기구라고사료되며, 향후운동의형태 ( 강도, 빈도등 ) 를다양하게적용한후속연구가필요할것이다. 주제어 : 건강, 척추정렬, 동적균형능력, 등속성근기능, 운동기구 Abstract : The purpose of this study was to investigate the effect of Nurida-Ball exercise on isokinetic muscle function, spinal alignment, and dynamic balance capacity in middle-aged men. All middle-aged men(n=16) were divided into 2 groups: Ball exercise(be, n=8) and control(con, n=8) group. BE group performed the Nurida-Ball exercise(30 min/day, 3 days/week, 8 weeks) and isokinetic knee and trunk muscle function, spinal alignment, and dynamic balance capacity were measured. All of the measured variables calculated the mean and standard deviation and verified normality using the Shapiro-Wilk test. The independent t-test method and the Paired t-test method were then analyzed to identify differences between groups. This study found that isokinetic knee and trunk muscle function was significantly strengthened in the BE compared with CON group by increasing peak torque(pt) of right and left knee extension(60 /sec, p<0.01, respectively), average power(ap) of right and left knee extension(60 /sec, p<0.05, p<0.01, respectively), and PT of right knee flexion(180 /sec, p<0.05) and AP of right knee extension(180 /sec, p<0.05). In the change of isokinetic trunk muscle function, only PT of trunk extension(180 /sec) was increased in the BE compared with the CON group(p<0.05). In addition, Nurida-ball exercise can improve the spinal alignment by reducing the trunk inclination(p<0.05) in the BE compared with the CON group. Finally, dynamic balance capacity was also enhanced in the BE compared with the CON group by decreasing the score of overall balance index(obi, p<0.01) and Antero-posterior balance index(p<0.05) in the Stage-6, and OBI(p<0.05) in the Stage-1. This result demonstrated that Nurida-ball exercise may improve spinal alignment, dynamic balance capacity, and isokinetic muscle function, which might be an effective way for the improvement of health-related fitness in middle-aged men. Keywords : Fitness, Spinal Alignment, Dynamic Balance Capacity, Isokinetic Muscle Function, Exercise Equipment 1. 서론 의료기술발달은인간의기대수명을증가시킨반면자동화기술의발달로인해신체활동을감소시켜많은대사성질환의발병률이증가되고있다. 특히노년기로접어들기전중 장년기의근감소, 체지방증가및균형능력소실등과같은신체기능저하는다양한질병을유발할수있는가능성이매우높은것으로보고되었다 [1, 2]. 그중에서도노화에따라나타나는심부근육들의위축은척추의정렬을무너뜨리고근육퇴행을 유발하여요통이유발할수있다 [3, 4]. 또한, 하지에우선적으로나타나는 type-ii 근섬유의소실은근력을감소시킬뿐만아니라균형능력을떨어뜨려결과적으로낙상과같은위험한사고에노출될수있다 [5, 6]. 따라서질병을치료하는것이아닌질병을예방하는관점에서고려해보면노년기에접어들기전중 장년기부터다양한방법을통해신체능력을유지하거나개선시키는것이중요하다. 그중신체활동 (Physical activity) 은뇌기능, 근육, 심장과같은다양한조직에긍정적인영향

3 누리다볼운동이중년남성의근기능, 척추정렬및동적균형능력에미치는영향 3 을미쳐건강한삶을영위하는데필수적이라고보고되었다 [7, 8]. 특히유산소성운동은심폐지구력향상과함께체지방을감소시켜일부요통을완화시킬수있는효과적인방법이라고보고되었다 [9, 10]. 대표적인유산소성운동인걷기는대다수의중 장년층이즐기는운동의형태로신체능력뿐만아니라정신적인측면에서도효과적인것으로보고되었다 [11, 12]. 하지만걷기운동의효율성과환경적인요인으로일부제한점이언급되고있다. 먼저중년기에접어들면서나타나는근력의감소는근위축과관련이있기때문에 [13], 이시기에근육을단련시키기위해서는유산소성운동뿐만아니라근육을자극시킬수있는저항성운동이병행되어야한다. 또한, 최근미세먼지와전염성이강한코로나바이러스등과같은환경적인문제는걷기와같은실외운동을제한하고있어이를극복하기위한다양한운동방법들과기구들이필요한실정이다. 최근개발되어좁은실내에서도운동수행이가능한 누리다볼 은 <Fig 1> 과같이스펀지를이용한특수제작된공으로공에끈에매달아목에착용하고신장에맞게조절하여양발로번갈아가며공을맞추는형태의운동기구이다. Koo 등 [14] 의연구에의하면, 중년남성들을대상으로일회성누리다볼운동기구를 30 분실시한결과, 운동강도는심폐지구력을향상시킬수있는중강도 (HRpeak: 55~85%, VO2peak: 23~61%) 수준에이르는것으로나타났으며, 8 주간의규칙적인공운동은근손상이나타나지않는범위에서체지방과혈중지질을감소시키고, 심폐지구력을향상시키는것으로보고되었다. 누리다볼운동은걷기와비교하여무릎을직각으로들면서공을발등으로정확히연속적으로차야하기때문에동작의범위가크며이로인해하지근육의수축과이완으로일부근력을향상시킬수있다 고보고하였다 <Fig 1>. 또한, 공을차는과정에서상체를정확히세워야하기때문에척추를지탱하는주변근육들을자극하고이로인해척추의부정렬을일부완화시킬수있을것이라고기대된다. 만약누리다볼운동에의한근기능과척추의정렬및균형감각개선이확인된다면유산소성능력뿐만아니라저항성운동능력향상에도효율적인운동기구라고제시할수있을것이다. 하지만아직까지이운동기구에대한효과검증연구는매우부족하며새롭게개발된운동기구혹은프로그램의효율성을제시하기위해서는많은연구가진행되어야한다. 따라서본연구는누리다볼운동기구를이용한 8 주간의신체활동이중년남성들의등속성근기능과척추정렬및동적균형능력에미치는영향을분석하여누리다볼운동기구의효과를과학적으로검증하는데있다 연구대상 2. 연구방법 본연구의대상자는척추관련근골격계질환이없는 50 대중년남성 16 명을대상으로누리다공운동집단 (Ball exercise: BE, n=8) 과비교집단 (Control: CON, n=8) 으로구분하였다. 먼저대상자들에게본연구에대한내용과과정을충분히설명한후자발적으로참여하기를희망하는대상자들에게실험동의서 (informed consent form) 를받고연구를진행하였다. 연구대상자의신체적인특성은 <Table 1> 과같다 누리다볼운동프로그램 본운동기구는바닥과공의높이에따라운동의난이도가조절되는기구로처음운동을접하 Table 1. Characteristics of subjects Variables Group BE(n=8) CON(n=8) t-value p-value Age (yr) 53.25± ± Hight (cm) ± ± Weight (kg) 75.90± ± BMI (kg/m2) 25.07± ± Value are mean and SD BE: Ball exercise group, CON: control group

4 4 최동훈 김태경 박재명 정종환 염동철 조인호 조준용 구정훈 Journal of the Korean Applied Science and Technology 는대상자를고려하여공의높이를무릎에고정하고실험을실시하였으며선행연구에서진행했던프로그램을참고하여계획하였다 [14]. 먼저대상자는태권도의앞차기동작중 1 단계인무릎을직각으로올리는동작을취하는동시에발등으로공을찰수있도록수행하여기구에대한적응을할수있도록유도하였다 (5 회 / 주, 10 분, 1 주 ). 이후본운동은총 8 주간, 1 일 30 분, 주 3 회에걸쳐실시하였다 <Fig. 1>. Fig. 1. Nurida-ball exercise equipment 측정항목및방법 신체구성 운동시작전대상자들의신체적특성을확인하기위해대상자는공복상태에서가벼운옷차림으로신장 (cm) 과체중 (kg) 을측정하고 ( 동산제닉스, Korea), Dual Energy X-ray Absorptiometry (DEXA, GX system, Madison, WI, USA) 기기위에누워연속적으로횡축촬영을 10 분간시행하였다 척추정렬분석 척추의구조와형태및변형을객관적으로분석하기위해 3 차원영상처리기 (Formetric Ⅲ, Germany) 를이용하여측정하였다. 먼저대상자는 <Fig. 2> 와같이엉덩이꼬리뼈가보일정도로상의탈의한후측정을실시하였다. 이후대상자는 2~3 회의심호흡으로안정을취하게하고정확한자료를얻기위해대상자와기구간의거리를 2m 정도두고짧은시간 ( 초 ) 동안촬영을실시하였다. 측정방법은 4 가지의해부학적정점인경추 7 번 (vertebra prominrns, VP), 오른쪽및왼쪽후상장골극 (PSIS Dimple Left and Right, DL and DR) 그리고양쪽후상장골극중앙 (dimple middle, DM) 을기반으로척추형태를측정하였다. 측정항목은몸통앞뒤기울기 (Trunk inclination, TIC), 몸통좌우기울기 (Trunk imbalance, TIM), 골반기울기 (Pelvic tilt, PT), 골반비틀림각 (Pelvic torsion, PTS), 척추측만곡 (Lateral deviation, LD), 흉추후만각 (Kyphotic angle, KA), 요추전만각 (Iordotic angle. LA) 에대한변인을분석하였다 동적균형능력 대상자들의동적균형능력은 Biodex Balance System(Biodex, U.S.A) 장비를이용하였고, 소프트웨어 (Biodex , Biodex Inc.,U.S.A) 로연결된발판을사용하여객관적으로측정치를분석하였다. 측정된변인은전체균형지수 (Overall Balance Index: OBI), 전 후균형지수 (Anteroposterior Balance Index: ABI) 및좌 우균형지수 (Medio-lateral Balance Index: MBI) 로나타난다. 측정방법은대상자의기본정보를입력하고 Fig. 2. Spine Alignment analyzer

5 누리다볼운동이중년남성의근기능, 척추정렬및동적균형능력에미치는영향 5 발판위에서게한후발을움직여화면중심점에발을맞추면장비는그중심점을기록하고발의좌표는수동으로입력하였다. 이후발의위치를변화시키지않는범위내에서몸의중심을이동하여 30 초간중심점의이동을측정하였다. 측정빈도는 2 회반복하여측정하고측정간휴식은 1 분으로하였다. 결과값은 0-9 까지기록되며 0 은안전화상태인반면 9 는매우불안정한상태를나타낸다. 측정은발판의안정도를변화시켜 stage-6( 어렵다 ) 와 stage-1( 매우어렵다 ) 의총 2 단계로각각측정하였다 등속성근기능 등속성근기능검사는 HUMAC NORM(USA) 을이용하여 CSMI (Humac Norm Testing & Rehabilitation System User's Guide)[15] 의매뉴얼에따라슬관절과체간의신전근및굴곡근근력을측정하였다. 먼저슬관절측정은대상자의몸통, 허리및대퇴는스트랩을이용하여단단히고정하고슬관절의관절가동범위는신전 0 에서부터굴곡 90 까지수행하도록하였다. 측정준비가완료되면예비운동을 3 회실시하고각속도 60 /sec 에서 5 회, 180 /sec 에서 15 회측정하여관절의신전근및굴곡근능력을각각측정하였다. 또한, 체간근력은대상자의장골능연장선이척추와만나는지점을기준으로발판의높이조절과함께대퇴부와견갑골을매뉴얼에따라단단히고정하고허리관절에의하여굴곡과신전을반복하는동작을실시하여측정하였다. 측정준비가완료되면예비운동을 3 회실시하고각속도 30 /sec 에서 5 회, 180 /sec 에서 15 회측정하였다. 본측정에서확인한피크토크 (Peak torque: PT) 와평균파워 (Average power: AP) 는체중당상대근력 으로나타냈다 자료처리방법 SPSS 24.0 통계프로그램을이용하여측정된모든변인들은평균 (mean) 과표준편차 (standard deviation, SD) 로산출하였다. 먼저운동전후척추형태, 동적균형감각및등속성근기능관련변인들을 Shapiro-Wilk test 를이용하여정규성검증을확인한결과모든항목에서정규분포를만족하였다. 이후집단간의차이를확인하기위해서각집단에서변인들의점수차이분석방법 (Change-score analysis) 에서얻어진평균차이 ( 사후 - 사전 ) 값을독립 (Independant) t-test 이용 하여분석하였다. 또한, 집단내운동전후시기간차이는대응 (Paired) t-test 이용하여분석하였다. 통계학적검증을위한유의도수준은 α <0.05 로설정하였다. 3. 결과및고찰 3.1. 슬관절및체간근기능의변화 노화에의한척추의변형은좌식생활증가및신체활동감소등과같은다양한요인으로나타나며이는인체중심의불균형과척추의틀어짐및근골격계질환을유발한다 [3, 4]. 따라서코어근육을강화시켜척추의불안정을완화시키고균형능력을증가시키기위해다양한운동방법들과도구들이개발되고있다. 누리다볼 운동기구는가느다란줄에걸려있는공을정확히발등으로맞춰야하므로무릎을걷기보다더큰범위로움직일수있도록만들어져, 본연구는규칙적인누리다볼운동이하체근육에미치는영향을확인하기위해슬관절의근기능능력을분석하였다 <Table 2>. 먼저슬관절신전근에서는 PT(%BW, 60 /sec) 의집단간변화량차이가우측과좌측모두 CON 집단과비교하여 BE 집단이통계적으로유의하게증가한것으로나타났다 ( 우측 : t=3.881, p=0.002; 좌측 : t=3.020, p=0.009). 또한, 집단내시기간의변화에서도 BE 집단에서만운동후우측과좌측모두유의하게증가한것으로나타났다 ( 우측 : t=-5.624, p=0.001; 좌측 : t=-4.339, p=0.003). 슬관절신전근 AP(%BW, 60 /sec) 의집단간변화량차이도우측과좌측모두 CON 집단과비교하여 BE 집단이통계적으로유의하게증가한것으로나타났고 ( 우측 : t=2.474, p=0.027; 좌측 : t=3.070, p=0.008), BE 그룹에서만운동후우측과좌측모두유의하게증가한것으로나타났다 ( 우측 : t=-4.109, p=0.005; 좌측 : t=-4.223, p=0.004). 한편슬관절 180 /sec 의 PT 에서는굴곡근의우측에서만 CON 집단과비교하여 BE 집단이유의하게증가한것으로나타났다 (t=2.558, p=0.023). 집단내시기간의차이는 BE 집단에서운동후신전근의좌측 (t=-4.932, p=0.002) 과굴곡근의우측 (t=-7.494, p=0.001) 및좌측 (t=-4.293, p=0.004) 에서유의하게증가한것으로나타났다. 마지막으로슬관절 180 /sec 의 AP 에서

6 6 최동훈 김태경 박재명 정종환 염동철 조인호 조준용 구정훈 Journal of the Korean Applied Science and Technology Table 2. Changes in Knee isokinetic muscle function Knee 60 PT Knee 60 AP Knee 180 PT Knee 180 AP BE group(n=8) CON group(n=8) Pre Post Δ Pre Post Δ Extension Right## ± ±34.88** ± ± Left ## ± ±31.99** ± ± Flexion Right ± ± ± ± Left ± ± ± ± Extension Right# ± ±22.07** ± ± Left ## ± ±19.29** ± ± Flexion Extension Flexion Right ± ± ± ± Left ± ± ± ± Right ± ± ± ± Left ± ±28.20** ± ± Right # 92.88± ±17.72*** ± ± Left 88.75± ±17.76** ± ± Extension Right# ± ±62.61** ± ± Left ± ±67.16** ± ± Flexion Right ± ±57.69* ± ± Left ± ± ± ± Value are mean and SD BE: Ball exercise group, CON: control group PT: Peak torque, AP: Average power *p<0.05, **p<0.01, and, ***p<0.001 from Pre and Post within group. #p<0.05 and ##p<0.01 between groups. 집단간의변화량차이는신전근우측에서만 CON 집단과비교하여 BE 집단에서유의하게증가한것으로나타났고 (t=2.163, p=0.048), 집단내시기간의차이는 BE 집단에서운동후신전근의우측 (t=-4.055, p=0.005) 과좌측 (t=-4.972, p=0.002) 및굴곡근의우측 (t=-2.467, p=0.043) 에서유의하게증가한것으로나타났다. 이는누리다볼운동을통해슬관절의근기능이일부개선된것으로해석되며본운동과유사한걷기운동을통해대퇴사두근의근기능증가를보고한선행연구와일치하는결과를나타냈다 [16, 17]. 이러한결과는아마도공을차는동작중무릎을직각으로움직여고관절의굴곡을증가시켜결과적으로대퇴사두근의자극을유도했기때문이라고생각된다. 누리다볼운동에따른척추주변근육에미치는효과를규명하기위하여체간근의등속성운 동능력을측정한결과는 <Table 3> 과같다. 집단간변화량 ( 사후 - 사전 ) 의차이에서는체간신전근의 PT(%BW, 180 /sec) 에서만 CON 집단과비교하여 BE 집단에서유의하게증가한것으로나타났다 (t=2.500, p=0.025). 한편집단내시기간의차이에서는 30 /sec 의신전근 AP(t=-2.676, p=0.032) 와 180 /sec 의신전근 PT(t=-6.117, p=0.000) 및 AP(t=-4.673, p=0.002) 에서유의하게증가한것으로나타났다. 이러한결과는누리다볼기구를이용한볼차기동작을통한기립자세유지가척주주변근육을자극하여나타난것으로사료되며본운동과유사한걷기운동을통해척주주변근육의향상을보고한선행연구와유사한결과를나타냈다 [18, 19]. 본연구의볼운동기구동작은걷기와비교하여더큰움직임을유도하기때문에슬관절및체간근기능개선에더효율적수있다고사료되지만이를증

7 누리다볼운동이중년남성의근기능, 척추정렬및동적균형능력에미치는영향 7 Table 3. Changes in trunk isokinetic muscle function) Trunk 30 PT Trunk 30 AP Trunk 180 PT Trunk 180 AP BE group(n=8) CON group(n=8) Pre Post Δ Pre Post Δ Extension ± ± ± ± Flexion ± ± ± ± Extension ± ±22.47* ± ± Flexion ± ± ± ± Extension # ± ±107.43*** ± ± Flexion ± ± ± ± Extension ± ±67.70** ± ± Flexion ± ± ± ± Value are mean and SD BE: Ball exercise group, CON: control group PT: Peak torque, AP: Average power *p<0.05, **p<0.01, and, ***p<0.001 from Pre and Post within group. #p<0.05 between groups. 명하기위한근육의활성도혹은걷기와의비교연구를수행하지못하였기때문에추후연구를통해서보다구체적인근육활성도를확인할필요가있다. 따라서본연구결과를종합해보면 8 주간누리다볼운동수행은슬관절과체간의등속성근기능을개선시킬수있는효과적인운동기구라고생각된다 척추정렬의변화 척추주변근기능의감소는척추부정렬과관련이있기때문에 [20, 21] 누리다볼운동에의한등속성그녁의변화와척추정렬의효과를규명하기위한척추정렬검사의결과는다음 <Table 4> 과같다. 본연구의두집단간에몸통앞뒤기울기의변화량차이 ( 사후 - 사전 ) 는 CON 집단과비교하여 BE 집단이유의하게감소한것으로나타났고 (t=-2.553, p=0.023), 나머지모든항목에서는통계적으로유의한차이가나타나지않았다. 또한, BE 집단의몸통앞뒤및좌우기울기는운동전과비교하여운동후유의하게감소한것으로나타났다 ( 몸통앞뒤기울기 : t=3.742, p=0.007; 몸통좌우기울기 : t=3.813, p=0.007). 몸통앞뒤기울기는인체를옆면에서바라보았을때몸통의앞과뒤의기울기로 0 가가장이상적인수치로알려져있다. 주목할점은일부 연구에서노화에따라척주주변근육감소는상체의전방경사 ( 굽은등 ) 가일어나는데 [22, 23], 본연구에서도중년남성들의사전몸통앞뒤기울기는 BE 및 CON 그룹이각각 2.38 와 2.75 으로일부전방경사가진행된것을확인할수있었다. 특히, 이러한전방경사의증가는자세의불균형뿐만아니라이를보상하기위해주변다른근육들의경직을유발하여요통을일으킬수있다 [22, 24]. 그런면에서본연구에서운동후전방경사가감소되었다는의미는일부척주주변근육들의경직을완화시키고요통과관련된통증을감소시킬수있는가능성을시사한다. 또한몸통좌우기울기는뒤쪽에서보았을때척추가좌측혹은우측으로얼마나기울어졌는지나타내는기울기로 0 가가장이상적인수치이다. 본연구에서집단간변화량의차이는나타나지않았지만 BE 그룹에서운동후몸통좌우기울기가유의하게감소하는것으로나타났다. 이런결과는좌우로치우친척추의형태가일부정상범위로개선되었다는것을의미하며이는골반의구조적변화와관련이있을것으로생각된다. 하지만 BE 그룹에서의운동후골반기울기 (0.5mm) 는증가하고골반튀틀림 (-0.63 ) 은감소하는경향이나타났지만통계적

8 8 최동훈 김태경 박재명 정종환 염동철 조인호 조준용 구정훈 Journal of the Korean Applied Science and Technology Table 4. Changes in spinal alignment BE group(n=8) CON group(n=8) Pre Post Δ Pre Post Δ Trunk inclination( ) # 2.38± ±0.9** ± ± Trunk imbalance(mm) 9.75± ±3.49** ± ± Pelvic tilt(mm) 3.13± ± ± ± Pelvic Torsion( ) 2.50± ± ± ± Surface rotation(rms) 2.63± ± ± ± Lateral beviation(rms) 8.38± ± ± ± Kyphotic angle( ) 44.38± ± ± ± Lordotic angle( ) 42.00± ± ± ± Value are mean and SD BE: Ball exercise group, CON: control group **p<0.01 from Pre and Post within group. #p<0.05 between groups. Table 5. Changes in dynamic balance capacity BE group(n=8) CON group(n=8) Pre Post Δ Pre Post Δ Stage-6 OBI ## 1.56± ±0.60** ± ± Stage-6 API # 1.15± ±0.38** ± ± Stage-6 MLI 0.90± ±0.32** ± ± Stage-1 OBI # 4.65± ±2.01** ± ± Stage-1 API 3.66± ±1.55** ± ± Stage-1 MLI 2.83± ±1.05** ± ± Value are mean and SD BE: Ball exercise group, CON: control group OBI: Overall balance index, API: Anteroposterior balance index, MLI: Mediolateral balance index **p<0.01 from Pre and Post within group. # p<0.05 and ## p<0.01 between groups. 으로유의한차이는나타나지않았다. 따라서척추의정렬에관여하는근골격계의메커니즘은매우복잡하고이를증명하기에는한계가있기때문에관련기전들을확인하기위해서는추후운동역학적인연구가필요하다고생각된다. 이상의연구를통하여누리다볼운동은중년남성들에게있어증가된하지와체간의근기능개선으로척추의정렬에일부개선시킬수있는긍정적인영향을미칠수있는운동기구라고사료된다 동적균형능력의변화 균형능력은노화가진행됨에따라감소하며이는근위축과척추의부정렬과매우관련이깊다 [25, 26]. 따라서누리다볼운동에의한등속성근기능과척추정렬의척추정렬에도영향에따라균형능력에도영향을미칠수있을것이다. 이에본연구에서동적균형능력을두단계로 (Stage-6, Stage-1) 확인한결과 <Table 5>, 6 단계에서 OBI 와 API 의집단간변화량차이는 CON 집단과비교하여 BE 집단이유의하게감

9 누리다볼운동이중년남성의근기능, 척추정렬및동적균형능력에미치는영향 9 소한것으로나타났다 (OBI: t=-3.475, p=0.004; API: t=-2.582, p=0.022). 또한, 집단내시기간의변화에서는 BE 집단에서운동후 OBI, API 및 MLI 가유의하게감소한것으로나타났다 (OBI: t=4.473, p=0.003; API: t=4.406, p=0.003; MLI: t=3.813, p=0.007). 다음으로 1 단계에서 OBI 의집단간변화량차이는 CON 집단과비교하여 BE 집단이유의하게감소한것으로나타났고 (t=-2.831, p=0.013), 집단내시기간의변화에서도 BE 집단에서운동후 OBI, API 및 MLI 가유의하게감소한것으로나타났다 (OBI: t=4.455, p=0.003; API: t=3.676, p=0.008; MLI: t=4.243, p=0.004). 이는동적균형능력이운동을통해개선되었다는것을의미한다. API 는전후균형지수로앞서언급한체간의신전근의증가와몸통앞뒤기울기감소와일부연관이있는것으로생각할수있다. 즉누리다볼운동을통해척주주변근육이강화되어몸통의전방경사가감소되고이로인해전후동적균형능력이개선된것으로사료된다. 또한, 이러한균형능력의증가는노화에따라나타나는낙상사고뿐만아니라일상생활에나타나는다양한부상과도매우관련이높기때문에 [27] 운동을통한균형능력증가는매우의미있는결과라고할수있다. 하지만본운동기구에대한선행연구와연구에참여한대상자의수가매우부족하여관련기전을확인하기위한과학적인측면을제시하기에는한계가있기때문에추후다양한연령층과많은대상자들을모집하여누리다볼운동의효과를검증할필요가있다. 4. 결론 본연구는누리다볼운동기구를이용한 8 주간의신체활동이중년남성들의등속성근기능과척추정렬및동적균형능력에미치는영향을분석하여누리다공운동기구의효과를규명하는데있으며그결과들은다음과같다. 8 주간누리다볼운동기구를통한신체활동은슬관절과체간의등속성근기능을증가시켰다. 또한, 척추정렬이운동을통해몸통앞뒤및전후및좌우기울기가감소되어결과적으로척추정렬에긍정적인영향을미치는것으로나타났다. 마지막으로누리다볼운동을통해동적균형능력이향상된것으로나타났다. 이러한결과를종합해보면 8 주간의규칙적인누리다볼운동은중년남성들의하지및척추주변근육을자극하고척추의정렬을개선시킬뿐만아니라동적균형감각기능에효과적이기때문에근위축에의한척추불균형과그에따른균형감각소실이나타나는중년남성들의건강체력향상에도움을줄수있는운동방법으로사료된다. References 1. L. Larsson, H. Degens, M. Li, L. Salviati, Y. I. Lee, W. Thompson. M. Sandri, Sarcopenia: aging-related loss of muscle mass and function, Physiological reviews, Vol. 99, No. 1, pp , (2019). 2. P. JafariNasabian, J. E. Inglis, W. Reilly, O. J. Kelly, J. Z. Ilich, Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake, Journal of Endocrinology, Vol. 234, No. 1, pp , (2017). 3. M. Masaki, Studies on sagittal spinal alignment in middle-aged and elderly women and on strength training of lumbar back muscles, (2016). 4. E. S. Choi, S. H. Cho, J. H. Kim, Relationship between rectus abdominis muscle thickness and metabolic syndrome in middle-aged men, PloS one, Vol. 12, No. 9, (2017). 5. R. Nilwik, T. Snijders, M. Leenders, B. B. Groen, J. van Kranenburg, L. B. Verdijk, L. J. van Loon, The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size, Experimental gerontology, Vol. 48, No. 5, pp , (2013). 6. I. F. Kramer, T. Snijders, J. S. Smeets, M. Leenders, J. van Kranenburg, M. den Hoed, L. J. van Loon, Extensive type II muscle fiber atrophy in elderly female hip fracture patients. Journals of Gerontology Series A Biomedical Sciences and Medical Sciences, Vol. 72, No. 10, pp ,

10 10 최동훈 김태경 박재명 정종환 염동철 조인호 조준용 구정훈 Journal of the Korean Applied Science and Technology (2017). 7. B. K. Pedersen, Physical activity and muscle brain crosstalk, Nature Reviews Endocrinology, Vol. 15, No. 7, pp. 383, (2019). 8. L. Long, I. R. Mordi, C. Bridges, V. A. Sagar, E. J. Davies, A. J. Coats, R. S. Taylor, Exercise based cardiac rehabilitation for adults with heart failure, Cochrane Database of Systematic Reviews, Vol. 1, No. 1, CD (2019). 9. J. G. Kin. The Role of Exercise for the Heath of Vertebral Column, Journal of the Korea Entertainment Industry Association, Vol. 9, No. 1, pp , (2015). 10. J. G. Wasser, T. Vasilopoulos, L. A. Zdziarski, H. K. Vincent, Exercise benefits for chronic low back pain in overweight and obese individuals, PM&R, Vol. 9, No. 2, pp (2017). 11. T. C. Chen, C. C. Hsieh, K. W. Tseng, C. C. Ho, K. Nosaka, Effects of Descending Stair Walking on Health and Fitness of Elderly Obese Women, Medicine and science in sports and exercise, Vol. 49, No. 8, pp , (2017). 12. Y. Iwata, Á. N. Dhubháin, J. Brophy, D. Roddy, C. Burke, B. Murphy, Benefits of group walking in forests for people with significant mental ill-health, Ecopsychology, Vol. 8, No. 1, pp , (2016). 13. Y. Yamada, Muscle mass, quality, and composition changes during atrophy and sarcopenia Muscle Atrophy, Adv Exp Med Biol, No. 1088, pp , (2018). 14. J. H. Koo, W. H. Cho, J. Y. Cho. A study on verification of exercise intensity and efficiency in Nurida-ball exercise equipment, Journal of the Korean Applied Science and Technology, Vol. 36, No. 2, pp (2019). 15. C. Humac, Norm Testing & Rehabilitation System User s Guide: Stoughton, (2006). 16. A. H. Alghadir, S. Anwer, B. Sarkar, A. K. Paul, D. Anwar, Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial), BMC musculoskeletal disorders, Vol. 20, No. 1, pp. 159, (2019). 17. M. Vakula, Quadriceps Function and Walking Biomechanics in Obese Young Adults, California State University, Fullerton, (2017). 18. S. Choi, M. Kim, E. Kim, G. Shin, Low back muscle activity when using a smartphone while walking, Proceedings of the Human Factors and Ergonomics Society Annual Meeting, Vol. 63, No. 1, pp , (2019). 19. L. Zoffoli, F. Lucertini, A. Federici, M. Ditroilo, Trunk muscles activation during pole walking vs. walking performed at different speeds and grades, Gait & posture, Vol. 46, pp , (2016). 20. R. Menezes-Reis, G. P. Bonugli, C. E. G. Salmon, D. Mazoroski, C. F. P. da Silva Herrero, M. H. Nogueira-Barbosa, Relationship of spinal alignment with muscular volume and fat infiltration of lumbar trunk muscles, PloS one, Vol. 13, No. 7, (2018). 21. W. Xia, H. Z. Fu, C. Liu, K. Wang, S. Xu, H. Liu, Association between back muscle degeneration and spinal-pelvic parameters in patients with degenerative spinal kyphosis., BMC musculoskeletal disorders, Vol. 20, No. 1, pp. 454, (2019). 22. L. Balzini, L. Vannucchi, F. Benvenuti, M. Benucci, M. Monni, A. Cappozz, S.J. Stanhope, Clinical characteristics of flexed posture in elderly women, Journal of the American Geriatrics Society, Vol. 51, No. 10, pp , (2003). 23. D. M. Kado, M. H. Huang, A. S. Karlamangla, E. Barrett Connor, G. A. Greendale, Hyperkyphotic posture predicts

11 누리다볼운동이중년남성의근기능, 척추정렬및동적균형능력에미치는영향 11 mortality in older community dwelling men and women: a prospective study, Journal of the American Geriatrics Society, Vol. 52, No. 10, pp , (2004). 24. P. B. O Sullivan, T. Mitchell, P. Bulich, R. Waller, J. Holte, The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain, Manual therapy, Vol. 11, No. 4, pp , (2006). 25. D. Fattal, M. Hansen, B. Fritzsch, Aging Related Balance Impairment and Hearing Loss, The Wiley handbook on the aging mind and brain, pp (2018). 26. T. G. Jeong, J. S. Park, J. D. Choi, J. Y. Lee, J. S. Kim, The effects of sensorimotor training on balance and muscle activation during gait in older adults, The Journal of Korean Physical Therapy, Vol. 23, No. 4, pp , (2011). 27. D. L. Sturnieks, R. St George, S. R. Lord, Balance disorders in the elderly, Neurophysiologie Clinique/Clinical Neurophysiology, Vol. 38, No. 6, pp (2008)

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