Journal of the Korean Applied Science and Technology (한국응용과학기술학회지)

The Korean Society of Applied Science and Technology (한국응용과학기술학회)
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Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis

노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향

  • Oh, Yoo-Sung (Graduate school of sports science, Seoul University) ;
  • Kim, Ji-sun (Department of Sport Industry Major, Jungwon University) ;
  • Jang, Woo-Seong (Graduate school of sports science, Seoul University)
  • 오유성 (서울시립대학교대학원 스포츠과학과) ;
  • 김지선 (중원대학교 스포츠산업전공) ;
  • 장우성 (서울시립대학교대학원 스포츠과학과)
  • Received : 2019.12.09
  • Accepted : 2019.12.30
  • Published : 2019.12.30
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Abstract

The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

본 연구는 퇴행성 무릎 관절염을 가진 노인여성을 대상으로 12주간의 노르딕 워킹을 통해 신체 기능과 관절염 통증 정도의 개선에 어떠한 효과를 미치는지 규명하는데 목적이 있다. 본 연구의 대상자는 퇴행성관절염으로 진단받은 노인여성 16명(나이: 73.00±3.70year, 신장: 154.30±4.07cm)을 대상으로 무선배정 된 노르딕 워킹 운동그룹(n=9)과 통제그룹(n=7)으로 나누었다. 운동 그룹은 노르딕 스틱을 이용하여 12주간 주 3회, 1회 30분 노르딕 워킹 운동을 실시하였고, 운동 강도는 HRR의 40-60%로 설정하였다. 통제그룹은 동일한 기간 동안 일상생활을 유지하도록 하였다. 종속변인으로 신체조성(체중, 체지방률, 근골격량)과 근력 과 유연성(상·하지 근력, 상·하지 유연성), 균형능력(정적균형, 동적균형) 및 통증정도를 측정하였다. 이러한 지표들의 측정은 운동프로그램을 진행하기 전과 후로 나누어 2번 측정하였다. 자료처리는 SPSS-PC version 25.0을 이용하여 실험집단과 통계집단간의 생리학적 특성 비교를 위해 독립표본 t-test를 사용하였으며, 노르딕 워킹 운동그룹과 통제그룹의 그룹 간, 시기간의 변화를 알아보기 위해 2×2 반복측정 이원배치분산분석을 사용하였다. 연구 결과는 첫째, 12주간의 노르딕 워킹을 통해 신체조성 기능에서 체지방률은 운동 처치 후에 감소하는 결과가 나타났으며(p=.004), 집단 간과 시기 간의 상호작용에서도 감소하는 결과가 나타났다(p=.003). 골격근량은 운동처치 후에 증가하는 결과가 나타났으며(p=.018), 집단 간과 시기 간의 상호작용에서도 증가하는 결과가 나타났다(p=.005). 둘째, 근력과 유연성은 상지근력과 하지유연성에서 집단 간과 시기 간 상호작용에서 증가하는 결과가 나타났으며(p=.009)(p=036), 하지근력에서는 운동집단과 통제집단 간 개선효과가 나타났다(p=.006). 또한, 상지유연성은 운동처치 후에 증가하는 결과가 나타났다(p=.020). 셋째, 균형능력 요인은 정적균형에서 운동처치 후 개선 효과가 나타났으며(p=.016), 동적균형에서는 차이가 나타나지 않았다(p>.05). 넷째, 통증정도는 운동처치 후 개선 효과가 나타났으며(p=.022), 운동집단과 통제집단 간에 개선 효과도 나타났다(p=.013). 결론적으로 12주간의 노르딕 워킹은 퇴행성 무릎 관절염을 가진 노인여성의 신체조성과 근력과 유연성에 긍정적인 영향을 미치는 것으로 나타났다. 따라서 노르딕 워킹은 퇴행성 무릎 관절염을 가진 노인여성에게 신체조성과 안정성, 균형성을 높여 주였으며, 무릎 관절의 통증을 낮춰주어 재활 운동 기능 개선에 효과적인 운동방법이라고 사료된다.

Keywords

References

  1. Ministry of Health & Welfare. Korea Centers for Disease Control and Prevention. adult disease information. (2018).
  2. National Health Insurance. 2017 Ranking of Multiple Diseases for Senior Citizens aged 65 and Over.Statistical Yearbook of Health Insurance. (2018).
  3. S. L. Hame, R. A. Alexander, "Knee osteoarthritis in women", Current reviews in musculoskeletal medicine, Vol.6, No.2 pp. 182-187, (2013). https://doi.org/10.1007/s12178-013-9164-0
  4. Korea Institute for Health and Social Affairs. www.kihasa.re.kr. (2014).
  5. Ministry of Health & Welfare. A Survey on the Population of the Elderly, (2015).
  6. M. S. Lee, H. J. Lim, "Factors related to the health promotion activities of the elderly and the elderly in rural areas", Regional Health in Rural Medicine, Vol.35, No.4 pp. 370-382, (2010).
  7. H. S. Kim, "The effect of therapeutic tapping on the joint renal motion of patients with osteoarthritis and pain when walking the stairs", a master's degree thesis to be unregistered, Dankook University Graduate School, (2002).
  8. A. J. Baliunas, D. E. Hurwitz, A. B. Ryals, A. Karrar, J. P. Case, J. A. Block, T. P. Andriacchi, "Osteoarthritis and cartilag", Vol.10, No.7 pp. 573-579, (2002). https://doi.org/10.1053/joca.2002.0797
  9. E. Roddy, W. Zhang. M. Doherty, Aerobic walking or strengthening exercise for osteoarthritis of the knee?. Vol.64, No.4 p. 544-548, A systematic review. Annals of the rheumatic diseases, (2005). https://doi.org/10.1136/ard.2004.028746
  10. S. I. Kim, J. D. Choi, "Effects of Trampolin Versus Balance pad Exercise on the Balance, Gait and Knee Joint Function in Elderly Women with Knee Osteoarthritis", Korean Society of Sports Physical Therapy, Vol.12, No.2 pp. 9-18, (2016).
  11. I. Haq, E. Murphy, J. Darce, Osteoarthritis. Postgrad Med J, Vol79, No.933 p. 377-833, (2003). https://doi.org/10.1136/pmj.79.933.377
  12. R. S. Hinman. S. E. Heywood, A. R. Day, "Aquatic physical therapy for hip and knee osteoarthritis: Results of single-blind randomized controlled trial", Physical Therapy, Vol.87, No.1 pp. 32-43, (2007). https://doi.org/10.2522/ptj.20060006
  13. K. D. Gross, "Daily walking and the risk of incident functional limitation in knee OA: An observational study", Arthritis Care & Research. DOI 10.1002acr.22362, (2014).
  14. S. K. Hong, H. Y. Kang, "The Effect on the Pain, Discomfort in Daily living and Life Satisfaction of Flexibility Exercise and Local Heat in Rular Elderly with Osteoarthritis", The Journal of Muscle and Joint Health, Vol.6, No.2 pp. 197-210, (1999).
  15. S. S. Han, W. O. Kim, Y. J. Kim, Y. H. Baek, M. H. Lee, "Effects of Moxibustion and Theraband Exercise on Physical and Psychological Variables of the Aged with Degenerative Osteoarthritis", Dong-seo nursing research journal, Vol.14, No.2 pp. 16-23, (2008).
  16. J. H. Choi, "Effect of Taping on a Home Program of Hip Abductor Exercise on Pain and Quadriceps Muscle Strength in Elderly Women with knee Osteoarthritis", Department of Physical Therapy, Daegu Haany University, Vol.13, No.3 p. 61-66, (2018).
  17. S. M. Nam, Walking Exercise 30minutes. Seoul : Nexus Books, (2005).
  18. H. K. Choi, N. S. Kim, H. S. Kim, "Effects of Water Exercise Program on Physical Fitness, Pain and Quality of Life in Patients with Osteoarthritis", J Muscle Joint Health, Vol.16, No.1 pp. 55-65, (2009).
  19. S. W. Han, K. T. Kim, "The effect of aquarobic and swimming exercise for female elderly suffering from degenerative arthritis on body composition, gait function and pain", The Korea Journal of Sports Science, Vol.21, No.3 pp. 1077-1089, (2012).
  20. S. I. Batterham, S. Heywood, J. L. Keating, "Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes", BMC musculoskeletal disorders, Vol.12, No.1 pp. 123, (2011). https://doi.org/10.1186/1471-2474-12-123
  21. M. H. Cameron, Physical Agents in Rehabilitation-E Book: An Evidence-Based Approach to Practice. Elsevier Health Sciences, (2017).
  22. R. B. Kim, J. H. Cho, "Comparative Analysis of Nordic Walking and Normal Gait Based on Efficiency", Korean Journal of Sport Biomechanics, Vol.20, No.4 pp. 365-372, (2010). https://doi.org/10.5103/KJSB.2010.20.4.365
  23. S. C. Timothy, P. E. Conrad, M. M. Gina, "Field testing of physiological responses associated with nordic walking", Research Quarterly for Exercise and Sport, Vol.73, No.3 pp. 296-300, (2002). https://doi.org/10.1080/02701367.2002.10609023
  24. S. H. Yoon, "The Effect of Pedestrian Pawl on the Moment of Upper extremity in the Pedestrian Movement of the Elderly", Korea Sports Research, Vol.20, No.5 pp. 69-78, (2009).
  25. J. R. Willson, M. R. Torry, M. J. Decker, T. Kemozer, J. R. Steadman, "Effects of walking poles on lower extermity gait mechanics", Medicine and Science in Sports and Exercise, Vol.33, No.1 pp. 142-147, (2001). https://doi.org/10.1097/00005768-200105001-00807
  26. F. Kreuizer, E. Gollner, H, Fichtner, "Das ist Nordic Walking. Ausrustung, Technic, Training. Munchen-Jena", I. : Urban & Fischer verlag, auflage, Vol.98, (2002).
  27. K. E. Barbour, J. M. Hootman, C. G. Helmick, L. B. Murphy, K. A. Theis. T. A. Schwartz, J. M. Jordan, "Meeting physical activity guidelines and the risk of incident knee osteoarthritis: a populationbased prospective cohort study", Arthritis care & research, Vol.66, No.1 pp. 139-146, (2014). https://doi.org/10.1002/acr.22120
  28. R. Campbell, M. Evans, M. Tucker, B. Quilty, P. Dieppe, J. L. Donovan, "Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee", Journal of Epidemiology & Community Health, Vol.55, No.2 pp. 132-138, (2001). https://doi.org/10.1136/jech.55.2.132
  29. H. S. Byun, K. H. Kim, "General characteristics of degenerative arthritis old people and pain and motor disability perception according to the stage of exercise", Journal of the Korean Gerontological Society, Vol.26, No.1 pp. 17-30, (2016).
  30. American College of Sports Medicine. FITT recommendations for arthritis sufferers of Arthritis. Book, (2018).
  31. G. Borg, physical performance and perceived exertion. Lund Gleerup, (1962).
  32. R. E. Rikli, C. J. Jones, "Senior fitness test manual", Human Kinetics, (2013).
  33. R. W. Bohannon, P. A. Larkin, A. C. Cook, J. Gear. J. Singer, "Decrease in timed balance test scores with aging", j Physical therapy, Vol.64, No.7 pp. 1067-1070, (1984). https://doi.org/10.1093/ptj/64.7.1067
  34. T. Haupstein, P. Goldie, "Visual judgements of steadiness in one-legged stance: reliability and validity", Physiotherapy Research International, Vol.5, No.3 pp. 141-156, (2000). https://doi.org/10.1002/pri.195
  35. D. Podsiadlo, S. Richardson, "The timed "Up & Go": a test of basic functional mobility for frail elderly persons", Journal of the American geriatrics Society, Vol.39, No.2 pp. 142-148, (1991). https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  36. P. A. Brill, J. C. Probst, D. L. Greenhouse, B. Shell, C. A. Macera, "Clinical feasibility of a free-weight strength-training program for older adults", J Am Board Fam Pract, Vol.11, No.6 pp. 445-451, (1998). https://doi.org/10.3122/jabfm.11.6.445
  37. J. K. Kim, S. M. Yang, "Analysis on Body-composition Change and Walking Type after Aquatic Exercise and Nordic Walking Exercise in Patients with Degenerative Knee Arthritis", The Korea Journal of Sports Science, Vol.18, No.2 pp. 1379-1392, (2009).
  38. J. H. Lim, Y. S. Ji, Adult Disease and Exercise. Vol.8, No.4 p. 195-207, Korea Coaching Development Center, (2006).
  39. T. W. Jeong, Y. C. Choi, J. W. Lee, "Effects of Land-Based and Water-based Walking Exercise on WOMAC and Activity Fitness in Female Elderly with Knee Osteoarthritis", Vol.25, No.3 pp. 1409-1421, (2016).
  40. S. Nottingham, A. Jurasin, "Nordic walking for total fitness", Human Kinetics, (2009).
  41. S. H. Kim, S. I. Ma, "Effects of Nordic walking exercise program on the fall-related fitness and muscle mass in elderly women, The Korea Journal of Sports Science, Vol.18, No.2 pp. 993-1002, (2009).
  42. S. W. Cha, "The Effects of Nordic Walking for 12 Weeks on Body Composition, Health-Related Fittness, Leukocyte and Immunoglobulin on the Middle Age Obese Women", The Korean Journal of Growth and Development, Vol.18, No.4 pp. 241-250, (2010).
  43. S. J. Kim, Y. S. Kang, "The Effects of Nordic Walking on Body Composition and Physical Fitness in Obese Women with Intellectual Disability", Journal of Digital Convergence, Vol.16, No.9 pp. 427-435, (2018). https://doi.org/10.14400/JDC.2018.16.9.427
  44. J. Y. Kim, "he Influence of Nordic Walking Movement of Female Elderly Patients with Degenerative Knee Arthritis upon a Change in Pain and Muscle Activity", Graduate School of Kwang-Won, (2009).
  45. S. W. Park, "Sarcopenia of the Old Age", Departments of Internal Medicine, College of Medicine, Pochon CHA University, (2007).
  46. T. N. Kim, "What is the Most Reliable Obesity Index in Korean Elderly Population?", Department of Endocrinology and Metabolism, Haeundae Paik Hospital, Inje University College of Medicine, Vol.21, No.3 pp. 118-119, (2013).
  47. D. I. Seo, S. K. Kim, H. K. Chang, "The Effects of 12 Weeks of Walking Exercise on Body Composition and Physical Fitness in Middle Aged Women", Vol.23, No.1 pp. 61-68, (2009).
  48. S. T. Jueng, Power Exercise Physiology. 8rd edition, Life Science, (2014).
  49. S. I. Kang, Health Walking/Nordic Walking, Korea Nordic Walking Federation. Book, (2005).
  50. C. S. Lee, D. J. J, "Effects of Nordic Walking for Older Women with Chronic Low Back Pain on the Reduction of Pain and Changing body strength", Korea Journal of Adapted of Physical Activity, Vol.25, No.1 pp. 161-171, (2017).
  51. M. Farnsworth, P. Burtscher, "Nordic walking: Global trend set to make an impact on Australia's health and fitness", Journal of Science and Medicine in Sport, Vol.12, No.3, (2010).
  52. Public Officials Benefit Association, Prevention method of degenerative arthritis that makes the spring thinner than winter. p. 64-65, Urban problem, Book, (2018).
  53. R. Y. Song, K. J. Jeon, Y. J. No, C. K. Kim, "Effects of Motivation-Enhancing Program on Health Behaviors, Cardiovascular Risk Factorsm, and Functional status Institutionalized Elderly Women", Journal of Korean Academy of Nursing, Vol.31, No.5 pp. 858-870, (2001). https://doi.org/10.4040/jkan.2001.31.5.858
  54. P. B. Choi, D. T. Lee, J. K. Jin. "Effects of aqua-exercises and knee joint-exercises on body composition and bone mineral density levels in elderly with osteoarthritis", The Korean Journal of Physical Education, Vol.46, No.2 pp. 379-387, (2007).
  55. International Nordic walking Federation. What is the nordic walking. Retrieved December. 2018, http://www.inwanordicwalking.com, (2000).
  56. P. Lanyon, S. O'Reilly, A. Jones, M. Doherty, "Radiographic assessment of symptomatic knee osteoarthritis in the community: definitions and normal joint space", Annals of the rheumatic diseases, Vol.57, No.10 pp. 595-601, (1998). https://doi.org/10.1136/ard.57.10.595
  57. J. H. Lee, D. S. Hong, "Changes of EMG Activities on the upper and lower Limb muscles with Different Pole during Nordic Walking Exercise", The Korea Journal of Sports Science, Vol.27, No.1 pp. 803-809, (2018). https://doi.org/10.35159/kjss.2018.02.27.1.803