거북목증후군의 경추만곡 호전에 대한 봉추나요법과 침술의 효과와 방사선학적 평가방법 연구

Clinical Effect of Bong Chuna Manual Therapy and Acupunture Treatment for Improving Cervical Curvature of Turtle Neck Syndrome and Measurement Method of Radiography

  • 오원교 (시흥중앙한방병원 한방재활의학과) ;
  • 이유진 (원광대학교 한의과대학 한방재활의학과교실) ;
  • 신병철 (부산대학교 한의학전문대학원)
  • Oh, Won-Kyo (Dept. of Oriental Rehabilitation Medicine, Siheung Jungang Oriental Medicine Hospital) ;
  • Lee, Eugune (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Won-Kwang University) ;
  • Shin, Byung-Cheul (Dept. of Oriental Rehabilitation Medicine, School of Oriental Medicine, Pusan National University)
  • 투고 : 2008.12.17
  • 심사 : 2009.01.18
  • 발행 : 2009.01.13

초록

Objectives : The aim of this study was to observe the effect of Bong Chuna manual therapy(BCMT) and acupuncture on the Turtle Neck Syndrome(TNS) by the changes of radiological findings and symptoms. Methods : Total twenty-eight patients diagnosed as TNS were evaluated. Twenty patients in experimental group were treated by the combination of BCMT and acupuncture, eight patients in control group were treated by acupuncture only. We measured VAS(Visual analogue scale) as pain intensity and Neck Pain and Disability Scale(NDI) at pre- and post-treatment. Also the four line Cobb's method and Jochumsen method were assessed for evaluating the radiographical changes, additionally we used 'two line method'. Results : VAS score showed statistically significant reduction in pain intensity in both experimental group and control group after 8 weeks treatment, $-44.05{\pm}14.91$ vs $-23.75{\pm}14.08$ respectively. Also NDI score presented $-11.40{\pm}8.63$ reduction in experimental group, and it was significant statistically, however not in control group, $-8.63{\pm}9.84$ reduction after 8weeks treatment. In radiological findings, the four line Cobb's method, Jochumsen method and two line method were reduced after 8weeks treatment, $-9.30{\pm}10.33$, $-0.65{\pm}1.72$ and $-14.35{\pm}5.68$ in experimental group respectively, $-0.75{\pm}1.91$, $-0.25{\pm}0.71$ and $0.38{\pm}2.20$ in control group respectively. However they were statistical significance only in the four line Cobb's method and two line method in both group. Conclusions : Combination treatment of CMT and acupuncture showed better effect on pain reduction, VAS score and the correction of neck anteversion than acupuncture only in TNS. Two line method seems valuable for evaluating the improvement of radiographical changes in TNS.

키워드

참고문헌

  1. Jeoung CH. Occupation and health. Seoul: Shinkwang Pub. 2008:175.
  2. Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles testing and function with posture and pain fifth edition. Seoul:Hanmi medical Pub. 2006:60-5, 152-3.
  3. Kapandji IA. Physiologie articulaire III, fifth edition. Seoul:Yeong mun Pub. 2001:14-5, 128-9, 178-94.
  4. Lee SM, Choi YS, Park YH, Keum DH. Chuna treatment cases report on neck pain patients with abnormal cervical curvature. J Oriental Rehab Med. 2002;12(4):1-10.
  5. Tsukimoto Tadashi. A study of standing posture: The body's line of gravity and center of gravity in patients with chronic back pain. Journal-medical society of Toho university. 1999;46(1):29-37.
  6. Lafage V, Schwab F, Skalli W, Hawkinson N, Gagey PM, Ondra S, Farcy JP. Standing balance and sagittal plane spinal deformity: Analysis of spinopelvic and gravity line parameter. Spine. 2008;33(14):1572-8. https://doi.org/10.1097/BRS.0b013e31817886a2
  7. Terry RY, Lindsay JR. Essentials of skeletal radiology. Baltimore. Williams & Wilkins. 1987;1:152-3.
  8. Harrison DE, Harrison DO, Betz JJ, Janik TJ, Holland B, Colloca CJ, Haas JW. Increasing the cervical lordosis with chiropractic biophysics seated combined extension-compression and transverse load cervical traction with cervical manipulation: Nonrandomized clinical control trial. J Manipulative Physiol Ther. 2003 Mar-Apr;26(3):139-51. https://doi.org/10.1016/S0161-4754(02)54106-3
  9. Pal GP, Sherk HH. The vertical stability of the cervical spine. Spine. 1988;13:447. https://doi.org/10.1097/00007632-198805000-00001
  10. Cote P, Cassidy JD, Yong-Hing K, Sibley J, Loewy J. Apophysial joint degeneration, disc degeneration, and saggital curve of the cervical spine. Spine. 1997;22:859-64. https://doi.org/10.1097/00007632-199704150-00007
  11. Harrison DD, Troyanovich SJ, Harrison DE, Janik TJ, Murphy DJ. A normal sagittal spinal configuration: a desirable clinical coutcome. J Manipulative Physiol Ther. 1996;19:398-405.
  12. Harrison DE, Harrison DD, Betz JJ, Janik TJ, Holland B, Colloca CJ, Haas JW. Increasing the cervical lordosis with chiropractic biophysics seated combined extension-compression and transverse load cervical traction with cervical manipulation: nonrandomized clinical control trial. J Manipulative Physiol Ther. 2003;26(3):139-51. https://doi.org/10.1016/S0161-4754(02)54106-3
  13. Lee SM, Choi YS, Park YH, Keum DH. Chuna treatment cases report on neck pain patients with abnormal cervical curvature. J Oriental Rehab Med. 2002;12(4):1-10.
  14. Oh WK, Shin BC. Effect of Bong Chuna manual treatment combined with oriental medical treatment on posterior inferior ilium deviation; 3 cases report. J Oriental Rehab Med. 2008;18(1):173-85.
  15. Her-Jun. Dongeubogam. Namsandang Pub:Seoul. 2000:332.
  16. Cline NE, Herman J, Shaw ER, Morton RD. Standardization of Visual Analogue Scale. NURS Res. 1992;41:378-80.
  17. Vernon H, Mior S. The Neck Disability Index: A study of reliability and validity. J Manipulative Physio Ther. 1991;14(7):409-15.
  18. McHorney CA, Ware JE. Construction and validation of an alternate form general mental health scale for the Medical Outcomes Study Short-Form 36-Item Health Survey. Med Care. 1995;33(1):15-28. https://doi.org/10.1097/00005650-199501000-00002
  19. Hains F, Waalen J, Mior S. Psychometric properties of the neck disability index. J Manipulative Physiol Ther. 1998;21(2):75-80.
  20. Cobb JR. In: Edwards JW, ed. Outlines for the Study of Scoliosis: Instructional Course Lecture. Vol 5. Ann Arbor, MI: American Academy of Orthopedic Surgeons. 1948:261-75.
  21. Jochumsen OH. The curve of the cervical spine. ACA J Chiro. 1970:49.
  22. H. Ferner, J. Staubesand. Sobotta atlas of human anatomy;Vol. 1:Head, Neck, Upper Extremities. Kastner & Callwey Munchen: Urban & Schwarzenberg. 1992:288.
  23. Haas M, Talyor JAM, Gillete GG. The routine use of radiographic spinal displacement analysis: a dissent. J Manipulative Physiol Ther. 1999;22:254-9. https://doi.org/10.1016/S0161-4754(99)70053-9
  24. Helliwell PS, Evans PF, Wright V. The staight cervical spine: Does it indicate muscle spasm- J Bone Joint Surg. 1994;76:103-6.
  25. Ruiz-Saez M, Fernandez-de-las-Penas C, Blanco CR, Martinez-Segura R, Garcia-Leon R. Changes in Pressure Pain Sensitivity in Latent Myofascial Trigger Points in the Upper Trapezius Muscle After a Cervical Spine Manipulation in Pain-Free Subjects. J Manipulative Physio Ther. 2007;30(8):578-83. https://doi.org/10.1016/j.jmpt.2007.07.014
  26. Lucas KR, Polus BI, Rich PA. Latent myofacial trigger points: their effects on muscle activation and movement efficiency. J of Bodywork and Movement Ther. 2004;8(3):160-6. https://doi.org/10.1016/j.jbmt.2003.12.002
  27. Harrison DE, Harrison DD, Troyanovich SJ, Harmon S. A normal spinal position: It's time to accept the evidence. J Manipulative Physiol Ther. 2000;23(9):623-44. https://doi.org/10.1067/mmt.2000.110941
  28. Boline P, Nelson C. Chiropractic and pharmaceutical therapy: a randomized clinical trial for the treatment of chronic muscle contraction headache. Proceedings of the FCER International Conference on Spinal manipulation, Washinton D.C. 1991:177-89.
  29. Gary Fryer B. Somatic Dysfunction: updating the concept. Australian. J of Osteopathy. 1999;10(2):14-9.
  30. Clay JH, Pounds DM. Basic clinical massage therapy. Seoul:Yeong mun Pub. 2007:5-10.
  31. Oh WK, Shin BC. Introduction of Bong Chuna Manual Therapy. The J of Korea CHUNA Manual Med for Spine & Nerves. 2007;2(1):99-114.
  32. Shin BC, Shin JS, Lim HH, Lee JS. Chuna coordinative & orthopedic manual medicine. The J of Korea CHUNA Manual Med for Spine & Nerves. 2006:143.
  33. Reading I, Walker-Bone K, Palmer KT, Cooper C, Coggon D. Anatomic distribution of sensory symptoms in the hand and their relation to neck pain, psychosocial variables, and occupational activities. Am J Epidemiol. 2003;157(6):524-30. https://doi.org/10.1093/aje/kwf225
  34. Smith TM, Sawyer SF, Sizer PS, Brismee JM. The Double Crush Syndrome: A Common Occurrence in Cyclists With Ulnar Nerve Neuropathy-A Case-Control Study. Clin J Sport Med. 2008 Jan;l8(1):55-61.
  35. Cuevas-Trisan RL, Cruz-Jimenez M. Provocative F Waves May Help in the Diagnosis of Thoracic Outlet Syndrome: A Report of Three Cases. Am J Phys Med Rehabil. 2003 Sep;82(9):712-5. https://doi.org/10.1097/01.PHM.0000083670.41890.2C
  36. 전국한의과대학 침구.경락학교실 편저. 침구학(상). 서울:집문당. 1991:201,477.
  37. Kwon YD, Lee SG, Lee CW, Jung SK, Kim DE, Choi SM. The short-term efficacy of acupuncture for chronic low back pain : randomized sham controlled trial. J Oriental Rehab Med. 2007;17(2):123-32.