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Jung, Kim, and In: Effects of the Support Surface Condition on Muscle Activity of Trunk Muscles during Balance Exercises in Patients with Stroke

Abstract

Purpose:

The purpose of this study was to examine the muscle activity of the trunk muscles during balance exercises on a stable and unstable surface in patients with stroke.

Methods:

Thirteen subjects (8 males, 5 females) with stroke were enrolled in the study. Muscle activity was recorded using surface EMG electrodes from the affected side of the erector spinae, external oblique, and internal oblique muscles.
The exercise was performed under three conditions. For the first condition for balance exercise, subjects were instructed to sit on an exercise mat with legs extended. The second condition was to sit with legs extended, with a balance pad under their buttocks. The third condition was to sit with legs extended, have a balance pad under the buttocks and a balance cushion under the lower legs.

Results:

This study showed significant differences in EMG activities during both arm lifting exercise and weight shifting exercise between conditions. This study showed that the EMG activities of the erector spinae, external oblique, and internal oblique muscles were significantly higher when the trunk exercise was performed using the balance pad with balance ball than when using the stable surface.

Conclusion:

In conclusion, performing balance exercises using an unstable surface is a useful method for facilitating trunk-muscle strength and hence trunk stability.

์„œ๋ก 

์ฒด๊ฐ„ ์กฐ์ ˆ์€ ๊ธฐ์ €๋ฉด ๋‚ด์—์„œ ๋ฌด๊ฒŒ์ค‘์‹ฌ์„ ์œ ์ง€ํ•˜๊ธฐ ์œ„ํ•ด ์ฒด๊ฐ„์˜ ์„ ํƒ์ ์ธ ์›€์ง์ž„์„ ์ˆ˜ํ–‰ํ•˜๋Š” ๋Šฅ๋ ฅ์œผ๋กœ,1 ๋‡Œ์กธ์ค‘ ํ™˜์ž๋Š” ์ฒด๊ฐ„ ๊ทผ๋ ฅ์ด ๋–จ์–ด์ง€๊ฒŒ ๋˜๋ฉฐ, ๋น„๋Œ€์นญ์ ์ธ ๊ณจ๋ฐ˜ ์ •๋ ฌ๋กœ ์ธํ•ด ์ฒด๊ฐ„์˜ ์ž์„ธ ์กฐ์ ˆ๋ฟ ์•„๋‹ˆ๋ผ2 ์ฒด๊ฐ„ ๊ทผ๋ ฅ ๋ฐ ์•‰์€ ์ž์„ธ์˜ ๊ท ํ˜• ๋Šฅ๋ ฅ์ด ๋–จ์–ด์ง€๊ฒŒ ๋œ๋‹ค.3 ์•‰์€ ์ž์„ธ์˜ ๊ท ํ˜• ๋Šฅ๋ ฅ์€ ๊ธฐ๋Šฅ์  ํšŒ๋ณต์˜ ์˜ˆ์ธก์ธ์ž๋กœ, ์„  ์ž์„ธ์— ๋น„ํ•ด ๋ฌด๊ฒŒ์ค‘์‹ฌ์ด ๋‚ฎ์•„์ง์— ๋”ฐ๋ผ ๊ท ํ˜• ์œ ์ง€๋ฅผ ์œ„ํ•œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ์—ญํ• ์ด ์ค‘์š”ํ•ด์ง„๋‹ค.4
๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ธฐ๋Šฅ ํ–ฅ์ƒ์„ ์œ„ํ•ด์„œ๋Š” ์‹ค์ œ ์ƒํ™œ์—์„œ์˜ ๊ณผ์ œ๋ฅผ ๋ฐ˜๋ณต์ ์œผ๋กœ ํ›ˆ๋ จํ•˜๋Š” ๊ฒƒ์ด ํšจ๊ณผ์ ์ด๋ฉฐ, ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ์œ„ํ•œ ์ค‘์žฌ ํ”„๋กœ๊ทธ๋žจ์€ ์ ์ ˆํ•œ ๊ทผ๊ฑฐ์— ๊ธฐ๋ฐ˜์„ ๋‘๊ณ  ์‹œ๊ฐ„์ , ๊ฒฝ์ œ์  ๋น„์šฉ ๋ฌธ์ œ๋ฅผ ๊ณ ๋ คํ•ด์•ผ ํ•œ๋‹ค.5 ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜•์„ ๊ฐœ์„ ํ•˜๊ธฐ ์œ„ํ•œ ํ›ˆ๋ จ ๋ฐฉ๋ฒ•์œผ๋กœ ๊ณจ๋ฐ˜ ๊ฒฝ์‚ฌ ์šด๋™์ด๋‚˜ ํŒ”ยท๋‹ค๋ฆฌ๋ฅผ ์ด์šฉํ•œ ์ฒด๊ฐ„ ์•ˆ์ •ํ™” ์šด๋™, ์ฒด์ค‘ ์ด๋™ ์šด๋™ ๋“ฑ์ด ์žˆ๋‹ค.6 ์•‰์€ ์ž์„ธ์—์„œ ํŒ” ๋“ค๊ธฐ๋Š” ์šด๋™์„ ํ•˜๋Š” ๋™์•ˆ ๋ฐœ์ƒํ•œ ์ž์„ธ๋™์š”์— ๋Œ€ํ•ญํ•˜๊ธฐ ์œ„ํ•ด ์ฒด๊ฐ„ ๊ทผ์œก์ด ์ˆ˜์ถ•ํ•˜๊ฒŒ ๋˜๊ณ ,7 ์ฒด์ค‘ ์ด๋™ ์šด๋™ ์ค‘์—๋Š” ๋ฌด๊ฒŒ์ค‘์‹ฌ์˜ ๋ณ€ํ™”์— ๋Œ€์‘ํ•˜์—ฌ ์ฒด๊ฐ„์˜ ์ •๋ ฌ์„ ์กฐ์ •ํ•˜๋Š” ๋Šฅ๋ ฅ์ด ์š”๊ตฌ๋œ๋‹ค.8
๋ถˆ์•ˆ์ •ํ•œ ๋ฉด์—์„œ์˜ ์šด๋™์€ ์ž์„ธ ๋™์š”๋ฅผ ์ฆ๊ฐ€์‹œ์ผœ ์ž์„ธ ์œ ์ง€๋ฅผ ์œ„ํ•œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ์„ ๋”์šฑ ์ด‰์ง„์‹œํ‚จ๋‹ค.9 van Nes ๋“ฑ10์€ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์•‰์€ ์ž์„ธ์—์„œ์˜ ๋™์š”๊ฑฐ๋ฆฌ๋ฅผ ์ธก์ •ํ•œ ๊ฒฐ๊ณผ, ๋Œ€์กฐ๊ตฐ์— ๋น„ํ•ด ๋ถˆ์•ˆ์ •ํ•œ ์ง€์ง€๋ฉด์—์„œ ์ž์„ธ ๋™์š”๊ฑฐ๋ฆฌ๊ฐ€ ์œ ์˜ํ•˜๊ฒŒ ํฐ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ์œผ๋ฉฐ, ๋”ฐ๋ผ์„œ ๋ถˆ์•ˆ์ •ํ•œ ์ง€์ง€๋ฉด์„ ์‚ฌ์šฉํ•˜๋Š” ๊ฒƒ์€ ๊ท ํ˜• ํ›ˆ๋ จ์— ์ค‘์š”ํ•œ ์š”์†Œ๊ฐ€ ๋  ์ˆ˜ ์žˆ๋‹ค๊ณ  ํ•˜์˜€๋‹ค.
์ •์ƒ ์„ฑ์ธ์„ ๋Œ€์ƒ์œผ๋กœ ์ง€์ง€๋ฉด์— ๋”ฐ๋ผ ๋„ค๋ฐœ๊ธฐ๊ธฐ์™€ ๊ต๊ฐ์ž์„ธ์—์„œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•œ ์—ฐ๊ตฌ์—์„œ๋Š” ์ง€์ง€๋ฉด์ด ๋ถˆ์•ˆ์ •ํ• ๋•Œ ๋ณต๊ทผ๊ณผ ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ์˜ ํ™œ์„ฑ๋„๊ฐ€ ์ฆ๊ฐ€๋œ๋‹ค๊ณ  ํ•˜์˜€๋‹ค.11,12 Karthikbabu ๋“ฑ9์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด ์œ„์—์„œ ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜• ํ›ˆ๋ จ์„ ์‹ค์‹œํ•œ ๊ฒฐ๊ณผ ์ž์„ธ์กฐ์ ˆ ๋ฐ ๊ท ํ˜•๋Šฅ๋ ฅ์ด ๊ฐœ์„ ๋˜์—ˆ์œผ๋‚˜, ์ด๋Ÿฌํ•œ ๊ฐœ์„  ํšจ๊ณผ๊ฐ€ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„ ์ฆ๊ฐ€์— ๊ธฐ์ธํ•œ ๊ฒƒ์ธ์ง€ ํ™•์ธ๋˜์ง€ ๋ชปํ•˜์˜€๋‹ค. ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๊ต๊ฐ ์šด๋™์‹œ ๋ฌด๋ฆŽ ๊ฐ๋„์— ๋”ฐ๋ฅธ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•œ ์—ฐ๊ตฌ์—์„œ๋Š” ์–‘์ชฝ ๋ฌด๋ฆŽ๊ฐ๋„๋ฅผ ๋‹ฌ๋ฆฌ ํ–ˆ์„ ๋•Œ์™€,13 ๋‹ค๋ฆฌ๊ฐ€ ์ฒด๊ฐ„์œผ๋กœ๋ถ€ํ„ฐ ๋ฉ€์–ด์งˆ์ˆ˜๋ก ํ™˜์ธก ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๊ฐ€ ์ฆ๊ฐ€๋œ๋‹ค๊ณ  ํ•˜์˜€์œผ๋ฉฐ,14 ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์ฐจ์ด๋Š” ๋น„๊ตํ•˜์ง€ ์•Š์•˜๋‹ค.
๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋ฐ˜๋ณต์ ์ธ ์ฒด๊ฐ„ ํ›ˆ๋ จ์ด ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„์— ํšจ๊ณผ๊ฐ€ ์žˆ๋‹ค๋Š” ์—ฐ๊ตฌ๊ฐ€ ์žˆ์—ˆ์ง€๋งŒ,15 ์ง€์ง€๋ฉด์ด ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š”์ง€์— ๋Œ€ํ•œ ์—ฐ๊ตฌ๋Š” ๋งค์šฐ ๋ถ€์กฑํ•œ ์‹ค์ •์ด๋‹ค. ๋˜ํ•œ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•œ ์—ฐ๊ตฌ๋“ค์€ ๋Œ€๋ถ€๋ถ„ ์ •์ƒ์ธ์„ ๋Œ€์ƒ์œผ๋กœ ๊ต๊ฐ์šด๋™์ด๋‚˜ ๋„ค๋ฐœ๊ธฐ๊ธฐ ์ž์„ธ ๋“ฑ ๋Œ€์นญ์ ์ธ ์ž์„ธ์—์„œ๋งŒ ์ธก์ •ํ•˜์˜€๋‹ค.16 ๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์•‰์€ ์ž์„ธ์—์„œ ์ฒด์ค‘ ์ด๋™์„ ํฌํ•จํ•œ ๊ท ํ˜• ์šด๋™์‹œ ์ง€์ง€๋ฉด์ด ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์„ ์•Œ์•„๋ณด๊ณ ์ž ํ•œ๋‹ค.

์—ฐ๊ตฌ ๋ฐฉ๋ฒ•

1. ์—ฐ๊ตฌ ๋Œ€์ƒ

๋ณธ ์—ฐ๊ตฌ๋Š” ๊ฒฝ๊ธฐ๋„ ๊ตฌ๋ฆฌ์‹œ์— ์†Œ์žฌํ•œ ์žฌํ™œ ๋ณ‘์›์— ์ž…์›์ค‘์ธ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์‹ค์‹œํ•˜์˜€๋‹ค. ์„ ์ • ๊ธฐ์ค€์— ์ ํ•ฉํ•œ ํ™˜์ž ์ค‘ ์‹คํ—˜์— ๋Œ€ํ•œ ์„ค๋ช…์„ ๋“ฃ๊ณ  ๋™์˜ํ•œ ๋‚จ์ž 8๋ช…, ์—ฌ์ž 5๋ช… ์ด 13๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ์‹ค์‹œํ•˜์˜€๋‹ค. ์„ ์ •๊ธฐ์ค€์€ 30์ดˆ ์ด์ƒ ๋…๋ฆฝ์ ์œผ๋กœ ์•‰์€ ์ž์„ธ๋ฅผ ์œ ์ง€ํ•  ์ˆ˜ ์žˆ๋Š”์ž, ํŽธ์ธก ๋ฌด์‹œ(neglect)๊ฐ€ ์—†๋Š” ์ž, ์–‘์ธก์„ฑ ๋‡Œ์กธ์ค‘, ๋˜๋Š” ์ด์ „์— ๋ฐ˜๋Œ€์ชฝ์˜ ๋Œ€๋‡Œ ๋ฐ˜๊ตฌ์— ๋ฐœ๋ณ‘ ๊ฒฝํ—˜์ด ์—†๋Š” ์ž, ๋ง์ดˆ์„ฑ ์‹ ๊ฒฝ์—ผ์„ ๊ฐ€์ง€๊ณ  ์žˆ์ง€ ์•Š์€ ์ž, ๊ธ‰์„ฑ ๊ทผ๊ณจ๊ฒฉ๊ณ„ ๋ฌธ์ œ๊ฐ€ ์—†๋Š” ์ž, ์˜์‚ฌ์†Œํ†ต์ด ๊ฐ€๋Šฅํ•˜๋ฉฐ ํ”ผ ์‹คํ—˜์ž์˜ ์ง€์‹œ๋ฅผ ์ดํ•ดํ•˜๊ณ  ์ˆ˜ํ–‰ํ•  ์ˆ˜ ์žˆ๋Š” ์ž๋ฅผ ์‹คํ—˜๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค.9 ์—ฐ๊ตฌ ๋Œ€์ƒ์ž์˜ ํ‰๊ท  ๋‚˜์ด๋Š” ํ‰๊ท  56.6ยฑ5.7์„ธ, ์œ ๋ณ‘๊ธฐ๊ฐ„์€ ํ‰๊ท  22.7ยฑ6.8๊ฐœ์›” ์ด์—ˆ์œผ๋ฉฐ ์†์ƒ๋ถ€์œ„๋Š” ์™ผ์ชฝ์ด 8๋ช… ์˜ค๋ฅธ์ชฝ์ด 5๋ช…์ด์—ˆ๋‹ค(Table 1).
Tableย 1
General characteristics of subject (N=11)
Subjects
Gender (male/female) (8/5)
Age (year) 56.6ยฑ5.7
Body weight (kg) 65.9ยฑ7.3
Height (cm) 165.5ยฑ7.3
Duration of stroke (month) 22.7ยฑ6.8
Paretic side (right/left) 5/8
Lesion type (hemorrhage/ischemia) 4/9
Brunnstrom stage (3/4) 10/3

Values are expressed as meanยฑstandard deviation (SD).

2. ์‹คํ—˜๋ฐฉ๋ฒ•

1) ์‹คํ—˜์ ˆ์ฐจ

์„ ์ •๊ธฐ์ค€์— ์ ํ•ฉํ•œ ๋‡Œ์กธ์ค‘ ํ™˜์ž 13๋ช…์„ ๋Œ€์ƒ์œผ๋กœ ์–‘ํŒ” ๋“ค๊ธฐ์™€ ์ฒด์ค‘ ์ด๋™ ์šด๋™์‹œ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ํ™˜์ธก ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ์ธก์ •ํ•˜์˜€๋‹ค.
์–‘ํŒ” ๋“ค๊ธฐ์™€ ์ฒด์ค‘ ์ด๋™ ์šด๋™์€ ๋ฌด๋ฆŽ์„ ํŽด๊ณ  ์•‰์€ ์ž์„ธ์—์„œ ์‹ค์‹œํ•˜์˜€์œผ๋ฉฐ, ๋ถˆ์•ˆ์ •ํ•œ ์ •๋„์— ๋”ฐ๋ผ ์„ธ ๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ๋ฌด์ž‘์œ„ ์ˆœ์„œ๋กœ ์ธก์ •ํ•˜์˜€๋‹ค.
์ฒซ ๋ฒˆ์งธ๋Š”, ์•ˆ์ •ํ•œ ๋ฉด ์œ„์— ๋ฌด๋ฆŽ์„ ํŽด๊ณ  ์•‰์€ ์ƒํƒœ์—์„œ ์šด๋™์„ ์‹ค์‹œํ•˜์˜€๋‹ค.
๋‘ ๋ฒˆ์งธ๋Š”, ๋‘”๋ถ€ ์•„๋ž˜์— ๋ฐœ๋ž€์Šค ํŒจ๋“œ(Balance pad, Airexยฎ, Germany)๋ฅผ ๋Œ€๊ณ  ๋ฌด๋ฆŽ์„ ํŽด๊ณ  ์•‰์€ ์ƒํƒœ์—์„œ ์šด๋™์„ ์‹ค์‹œํ•˜์˜€๋‹ค.
๋งˆ์ง€๋ง‰์œผ๋กœ ์„ธ ๋ฒˆ์งธ๋Š”, ๋‘”๋ถ€ ์•„๋ž˜์— ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋ฅผ ๋Œ€๊ณ  ํ•˜ํ‡ด์™€ ๋ฐœ์•„๋ž˜์—๋Š” ๋ฐœ๋ž€์Šค ๋ณผ(balance ball, Toguยฎ, Germany)์„ ๋Œ€๊ณ  ๋ฌด๋ฆŽ์„ ํŽด๊ณ  ์•‰์€ ์ƒํƒœ์—์„œ ์šด๋™์„ ์‹ค์‹œํ•˜์˜€๋‹ค(Figure 1, 2).
Figureย 1
Arm lifting exercise.
JKPT_27_196_fig_1.tif
Figureย 2
Weight shifting exercise.
JKPT_27_196_fig_2.tif
๋ณด๋‹ค ์ •ํ™•ํ•˜๊ฒŒ ์ˆ˜ํ–‰ํ•˜๊ธฐ ์œ„ํ•ด ๋Œ€์ƒ์ž๋“ค์€ ํ‰๊ฐ€๋ฅผ ํ•˜๊ธฐ ์ „, ์•ˆ์ •๋œ ๋ฉด์— ์•‰์€ ์ƒํƒœ์—์„œ ์ฒด์ค‘ ์ด๋™ ๋ฐ ์–‘ํŒ” ๋“ค๊ธฐ ๋™์ž‘์— ๋Œ€ํ•œ ์—ฐ์Šต์„ ์ถฉ๋ถ„ํžˆ ํ•˜์˜€๋‹ค. ์–‘ํŒ” ๋“ค๊ธฐ์˜ ๊ฒฝ์šฐ, ์•ˆ์ •๋œ ๋ฉด์—์„œ ์ตœ๋Œ€ํ•œ ํŒ”์„ ์˜ฌ๋ฆด ์ˆ˜ ์žˆ๋Š” ๋†’์ด๋ฅผ ์ธก์ •ํ•˜์—ฌ ๋ˆˆ๊ธˆ์ด ๊ทธ๋ ค์ง„ ๊ฑฐ์šธ์— ๋งˆ์ปค๋ฅผ ๋ถ€์ฐฉํ•˜์˜€๋‹ค. ์ธก์ •์€ ์–‘์†์œผ๋กœ ์ง€ํŒก์ด๋ฅผ ์žก๊ณ , ์–ด๊นจ๊ด€์ ˆ์ด 90๋„๊ฐ€ ๋˜๋„๋ก ํŒ”์„ ์˜ฌ๋ฆฐ ์ƒํƒœ์—์„œ ์‹œ์ž‘ํ•˜์—ฌ ์ตœ๋Œ€ํ•œ ํŒ”์„ ๋“ค์–ด์˜ฌ๋ฆฌ๊ฒŒ ํ•˜์˜€์œผ๋ฉฐ, ์–‘ํŒ”์„ ๋“ค์–ด ์ง€ํŒก์ด๊ฐ€ ๊ธฐ์ค€์ ์— ๋„๋‹ฌํ•˜๊ณ  5์ดˆ๊ฐ„ ์ž์„ธ๋ฅผ ์œ ์ง€ํ•˜๊ฒŒ ํ•˜์˜€๋‹ค.
์ฒด์ค‘ ์ด๋™์˜ ๊ฒฝ์šฐ ์•ˆ์ •๋œ ๋ฉด ์œ„์— ๋ฌด๋ฆŽ์„ ํŽด๊ณ  ์•‰์€ ์ž์„ธ์—์„œ ํ™˜์ธก์œผ๋กœ ์ตœ๋Œ€ ์ด๋™ ๊ฐ€๋Šฅํ•œ ๊ฑฐ๋ฆฌ๋ฅผ ์ธก์ •ํ•˜์—ฌ ๋ฐ”(bar)๋ฅผ ์„ค์น˜ํ•˜์˜€๋‹ค. ์ฒด์ค‘ ์ง€์ง€์ธก ์ฒด๊ฐ„์˜ ๊ธธ์ด๊ฐ€ ๋Š˜์–ด๋‚˜๊ณ  ๋ฐ˜๋Œ€์ธก ์ฒด๊ฐ„์˜ ๊ธธ์ด๊ฐ€ ์งง์•„์ง€๋„๋ก ์ฒด์ค‘์ด๋™์„ ํ•˜์—ฌ ํ™˜์ธก ๊ฒฌ๋ด‰(arcromion)์ด ๊ธฐ์ค€์ ๊นŒ์ง€ ๋„๋‹ฌํ•˜๊ณ  5์ดˆ๊ฐ„ ์ž์„ธ๋ฅผ ์œ ์ง€ํ•˜๋„๋ก ํ•˜์˜€๋‹ค. ์ž๋ฃŒ ๋ถ„์„์€ ์ฒ˜์Œ 1์ดˆ์™€ ๋งˆ์ง€๋ง‰ 1์ดˆ๋ฅผ ์ œ์™ธํ•œ 3์ดˆ ๋™์•ˆ ์ธก์ •๋œ ๊ทผ ํ™œ์„ฑ๋„๋ฅผ ์‚ฌ์šฉํ•˜์˜€๋‹ค. ์šด๋™ ์‹œ ํ”ผ๋กœ๋ฅผ ๊ณ ๋ คํ•˜์—ฌ ๊ฐ ์šด๋™ ํ›„ 1๋ถ„๊ฐ„์˜ ํœด์‹์„ ์ทจํ•˜๊ฒŒ ํ•˜์˜€์œผ๋ฉฐ, ๊ฐ ์šด๋™์€ 3๋ฒˆ ์ธก์ •ํ•˜์—ฌ ํ‰๊ท ๊ฐ’์„ ๊ตฌํ•˜์˜€๋‹ค.

2) ์ธก์ •๋„๊ตฌ์™€ ์ž๋ฃŒ์ˆ˜์ง‘๊ณผ์ •

์„ธ ๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ๊ท ํ˜• ์šด๋™์„ ํ•˜๋Š” ๋™์•ˆ ๊ทผ ํ™œ์„ฑ๋„๋ฅผ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด ํ‘œ๋ฉด ๊ทผ์ „๋„(Telemyo 2400 G2 Telemetry EMG system, Noraxon, U.S.A. 2007)๋ฅผ ์‚ฌ์šฉํ•˜์˜€๋‹ค. ํ‘œ๋ณธ ์ถ”์ถœ๋ฅ (sampling rate)์€ 1,000 Hz์œผ๋กœ ์„ค์ •ํ•˜์˜€๊ณ , ์ฃผํŒŒ์ˆ˜ ๋Œ€์—ญํญ์€ 10-500 Hz๋กœ ํ•˜์˜€๋‹ค. ์–‘์ชฝ ์ฒด๊ฐ„์˜ ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ(Erector Spinae)๊ณผ ์™ธ๋ณต์‚ฌ๊ทผ(External Oblique), ๋‚ด๋ณต์‚ฌ๊ทผ(Internal Oblique)์— ์ „๊ทน์„ ๋ถ€์ฐฉํ•˜์˜€์œผ๋ฉฐ, ์ „๊ทน์„ ๋ถ€์ฐฉํ•˜๊ธฐ ์ „ ํ”ผ๋ถ€ ์ €ํ•ญ์„ ์ตœ์†Œํ™”ํ•˜๊ธฐ ์œ„ํ•ด ํ„ธ์„ ์ œ๊ฑฐํ•˜๊ณ  ์•Œ์ฝ”์˜ฌ๋กœ ๋ถ€์ฐฉ๋ถ€์œ„๋ฅผ ๊นจ๋—์ด ๋‹ฆ์€ ํ›„ ์ „๊ทน์„ ๋ถ€์ฐฉํ•˜์˜€๋‹ค. ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ์€ ์š”์ถ” 3๋ฒˆ์—์„œ ์™ธ์ธก์œผ๋กœ 2 cm ๋–จ์–ด์ง„ ์ง€์ ์— ๋ถ€์ฐฉํ•˜์˜€์œผ๋ฉฐ, ์™ธ๋ณต์‚ฌ๊ทผ์€ ๋ฐฐ๊ผฝ์—์„œ ์™ธ์ธก์œผ๋กœ 15 cm ๋–จ์–ด์ง„ ์ง€์ ์— ๋ถ€์ฐฉํ•˜์˜€๋‹ค. ๋‚ด๋ณต์‚ฌ๊ทผ์€ ์ „์ƒ์žฅ๊ณจ๊ทน์—์„œ ํ•˜ยท๋‚ด๋ฐฉ์œผ๋กœ 2 cm ์ง€์ ์— ๋ถ€์ฐฉํ•˜์˜€๋‹ค.17
์ด ์—ฐ๊ตฌ์—์„œ ์ธก์ •ํ•œ ๊ทผ์œก์˜ ๊ทผ์ „๋„ ์‹ ํ˜ธ๋Š” ์ „ํŒŒ์ •๋ฅ˜(full wave rectification)๋กœ ์ฒ˜๋ฆฌ ํ›„ root mean square (RMS) ๊ฐ’์„ ์ทจํ•˜์˜€๋‹ค. ๊ฐ ๊ทผ์œก์˜ ํ™œ๋™์ „์œ„๋ฅผ ํ‘œ์ค€ํ™”ํ•˜๊ธฐ ์œ„ํ•ด ์ˆ˜์˜์  ์ตœ๋Œ€ ๋“ฑ์ฒ™์„ฑ ๊ทผ์ˆ˜์ถ• ๊ฐ’์œผ๋กœ ๋‚˜๋ˆ„์–ด ๋ฐฑ๋ถ„์œจ๋กœ ํ™˜์‚ฐํ•œ ๊ฐ’์ธ %MVIC ๊ฐ’์„ ์‚ฌ์šฉํ•˜์—ฌ ์ฒด์ค‘ ์ด๋™์‹œ ๊ทผ์ „๋„ ์‹ ํ˜ธ๋ฅผ ์ •๊ทœํ™”(normalization)ํ•˜์˜€๋‹ค. ๊ฐ ๊ทผ์œก์˜ ์ตœ๋Œ€ ๋“ฑ์ฒ™์„ฑ ์ˆ˜์ถ•๊ฐ’์€ 3๋ฒˆ ์ธก์ •ํ•˜์—ฌ ํ‰๊ท ๊ฐ’์„ ๊ตฌํ•˜์˜€๋‹ค.

3) ๋ถ„์„๋ฐฉ๋ฒ•

๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” SPSS ver.18.0์„ ์ด์šฉํ•˜์—ฌ ์ž๋ฃŒ๋ฅผ ๋ถ„์„ํ•˜์˜€๋‹ค. ์„ธ ๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„ ์ฐจ์ด๋Š” ์ผ์› ๋ฐ˜๋ณต์ธก์ • ๋ถ„์‚ฐ๋ถ„์„(one-way repeated ANOVA)์„ ์‚ฌ์šฉํ•˜์˜€๊ณ , ์‚ฌํ›„ ๊ฒ€์ฆ์€ ์ตœ์†Œ์œ ์˜์ฐจ๊ฒ€์ฆ(least significant difference, LSD)์„ ์ด์šฉํ•˜์—ฌ ๋ถ„์„ํ•˜์˜€๋‹ค. ํ†ต๊ณ„ํ•™์  ์œ ์˜์ˆ˜์ค€์€ 0.05 ์ดํ•˜๋กœ ํ•˜์˜€๋‹ค.

๊ฒฐ๊ณผ

1. ์–‘ํŒ” ๋“ค๊ธฐ ์šด๋™์‹œ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์ฒด๊ฐ„ ๊ทผํ™œ์„ฑ๋„์˜ ๋ณ€ํ™”

์•‰์€ ์ž์„ธ์—์„œ ์–‘ํŒ” ๋“ค๊ธฐ ์šด๋™์‹œ ์ง€์ง€๋ฉด์— ๋”ฐ๋ผ 3๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ํ™˜์ธก ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•œ ๊ฒฐ๊ณผ, ์ง€์ง€๋ฉด์— ๋”ฐ๋ผ ๊ทผ ํ™œ์„ฑ๋„์— ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ํ™˜์ธก ์ฒ™์ถ”๊ธฐ๋ฆฝ๊ทผ, ์™ธ๋ณต์‚ฌ๊ทผ๊ณผ ๋‚ด๋ณต์‚ฌ๊ทผ ๋ชจ๋‘ ๋ฐœ๋ž€์Šค ํŒจ๋“œ์™€ ๋ฐœ๋ž€์Šค ๋ณผ์„ ์ ์šฉํ•˜์˜€์„ ๋•Œ ๊ฐ€์žฅ ๋†’์€ ๊ทผ ํ™œ์„ฑ๋„๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ์œผ๋ฉฐ(๊ฐ๊ฐ 32.94ยฑ18.56 %MVIC, 52.94ยฑ24.49 %MVIC, 58.77ยฑ17.17 %MVIC) (p<0.05), ์•ˆ์ •๋œ ๋ฉด๊ณผ ๋‘”๋ถ€ ์•„๋ž˜ ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋งŒ ์ ์šฉํ•˜์˜€์„ ๋•Œ๋Š” ๋‘ ๋ฐฉ๋ฒ•๊ฐ„ ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜๋‹ค(Table 2).
Tableย 2
Comparison of activation of the trunk muscles according to the support surface conditions during arm lifting exercises (%MVIC)
Parameter Stable Balance pad Balancepad+ balance ball p
ES 24.28ยฑ18.66โ€ก 26.97ยฑ18.89โ€ก 32.94ยฑ18.56*โ€  0.01
EO 40.97ยฑ17.37โ€ก 42.89ยฑ18.83โ€ก 52.94ยฑ24.49*โ€  0.03
IO 50.63ยฑ17.60โ€ก 52.76ยฑ18.20โ€ก 58.77ยฑ17.17*โ€  0.01

Values are expressed as meanยฑstandard deviation (SD).

ES, Erector spinae; EO, External oblique; IO, Internal oblique.

* indicates a significant differences compared with stable surface condition (p<0.05);

โ€  indicates a significant differences compared with balance pad condition (p<0.05);

โ€ก indicates a significant differences compared with balance pad + balance ball condition(p<0.05).

2. ์ฒด์ค‘ ์ด๋™ ์šด๋™์‹œ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์ฒด๊ฐ„ ๊ทผํ™œ์„ฑ๋„์˜ ๋ณ€ํ™”

์ฒด์ค‘ ์ด๋™ ์šด๋™์‹œ ํ™˜์ธก ์™ธ๋ณต์‚ฌ๊ทผ๊ณผ ๋‚ด๋ณต์‚ฌ๊ทผ์€ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์„ธ ๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ๊ทผ ํ™œ์„ฑ๋„์— ๋ชจ๋‘ ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ์žˆ์—ˆ๋‹ค. ํ™˜์ธก ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ์˜ ๊ฒฝ์šฐ์—๋Š” ๋ฐœ๋ž€์Šค ํŒจ๋“œ์™€ ๋ฐœ๋ž€์Šค ๋ณผ์„ ๋ชจ๋‘ ์ ์šฉํ•˜์˜€์„ ๋•Œ๊ฐ€ 40.97ยฑ16.99 %MVIC๋กœ ์•ˆ์ •๋œ ๋ฉด๊ณผ ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋งŒ ์ ์šฉํ•˜์˜€์„ ๋•Œ(๊ฐ๊ฐ 37.64ยฑ15.70 %MVIC, 38.81ยฑ16.06 %MVIC)๋ณด๋‹ค ์œ ์˜ํ•˜๊ฒŒ ๋†’์€ ๊ทผ ํ™œ์„ฑ๋„๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ์œผ๋ฉฐ(p<0.05), ์•ˆ์ •๋œ ๋ฉด๊ณผ ๋‘”๋ถ€ ์•„๋ž˜ ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋งŒ ์ ์šฉํ•˜์˜€์„ ๋•Œ๋Š” ๋‘ ๋ฐฉ๋ฒ•๊ฐ„ ๊ทผ ํ™œ์„ฑ๋„์— ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜๋‹ค(Table 3).
Tableย 3
Comparison of activation of the trunk muscles according to the support surface conditions during weight shifting exercises (%MVIC)
Parameter Stable Balance pad Balancepad+ balance ball p
ES 37.64ยฑ15.70โ€ก 38.81ยฑ16.06โ€ก 40.97ยฑ16.99*โ€  0.02
EO 36.69ยฑ17.00โ€ โ€ก 39.36ยฑ15.70*โ€ก 41.93ยฑ14.86*โ€  0.01
IO 49.79ยฑ21.38โ€ โ€ก 53.53ยฑ20.57*โ€ก 57.97ยฑ19.20*โ€  0.01

Values are expressed as meanยฑstandard deviation (SD).

ES, Erector spinae; EO, External oblique; IO, Internal oblique.

* indicates a significant differences compared with stable surface condition (p<0.05);

โ€  indicates a significant differences compared with balance pad condition (p<0.05);

โ€ก indicates a significant differences compared with balance pad + balance ball condition(p<0.05).

๊ณ ์ฐฐ

๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜• ์šด๋™์‹œ ์ง€์ง€๋ฉด์ด ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์— ๋Œ€ํ•ด ์•Œ์•„๋ณด๊ธฐ ์œ„ํ•ด, ๋ถˆ์•ˆ์ •ํ•œ ์ •๋„์— ๋”ฐ๋ผ ์„ธ ๊ฐ€์ง€ ์กฐ๊ฑดํ•˜์—์„œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ์•‰์€ ์ž์„ธ์—์„œ ์–‘ํŒ” ๋“ค๊ธฐ ์šด๋™์‹œ ๋ฐœ๋ž€์Šค ํŒจ๋“œ์™€ ๋ฐœ๋ž€์Šค ๋ณผ์„ ๋ชจ๋‘ ์ ์šฉํ•˜์˜€์„ ๋•Œ ๋‹ค๋ฅธ ๋‘ ๊ฐ€์ง€ ์กฐ๊ฑด์— ๋น„ํ•ด ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ๊ณผ, ์™ธ๋ณต์‚ฌ๊ทผ ๋ฐ ๋‚ด๋ณต์‚ฌ๊ทผ์˜ ๊ทผ ํ™œ์„ฑ๋„๊ฐ€ ์œ ์˜ํ•˜๊ฒŒ ๋†’์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค.
์•‰์€ ์ž์„ธ์—์„œ ํŒ”์„ ๋“ค๋•Œ ๋ฌด๊ฒŒ ์ค‘์‹ฌ์ด ์ „๋ฐฉ์œผ๋กœ ์ด๋™๋จ์— ๋”ฐ๋ผ ์ž์„ธ ์•ˆ์ •์„ฑ์„ ์œ ์ง€ํ•˜๊ธฐ ์œ„ํ•ด ์ฒด๊ฐ„์˜ ๋ชจ๋ฉ˜ํŠธ๊ฐ€ ํ›„๋ฐฉ์œผ๋กœ ์ž‘์šฉํ•˜๊ฒŒ ๋˜๊ณ ,18 ์ด๋Ÿฌํ•œ ๋ฌด๊ฒŒ์ค‘์‹ฌ์˜ ์ด๋™๊ณผ ๋ฐ˜๋ฐœ๋ ฅ(reaction force)์— ๊ธฐ์ธํ•˜์—ฌ ์ž์„ธ๋™์š”๊ฐ€ ๋ฐœ์ƒํ•˜๊ฒŒ ๋œ๋‹ค.19 ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด์—์„œ ์ฒด๊ฐ„์˜ ์•ˆ์ •์„ฑ์„ ์œ ์ง€ํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ์ง€๋ฉด์˜ ํ”๋“ค๋ฆผ์— ๋”ฐ๋ฅธ ์ž์„ธ ๋ณ€ํ™”๋ฅผ ์ธ์‹ํ•˜๊ณ  ๋ฌด๊ฒŒ์ค‘์‹ฌ์„ ๊ธฐ์ €๋ฉด ์•ˆ์—์„œ ์œ ์ง€ํ•˜๊ธฐ ์œ„ํ•ด ์‹ ๊ฒฝ๊ณ„์˜ ์กฐ์ ˆ์„ ํ†ตํ•œ ๊ทผ์œก๋“ค์˜ ์ ์ ˆํ•œ ํ˜‘์‘ ์ž‘์šฉ์ด ํ•„์š”ํ•˜๋‹ค.20,21 ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋ฐœ๋ž€์Šค ํŒจ๋“œ์™€ ๋ฐœ๋ž€์Šค ๋ณผ์„ ๋ชจ๋‘ ์ ์šฉํ•˜์˜€์„ ๋•Œ ์ง€๋ฉด์˜ ํ”๋“ค๋ฆผ์— ๋”ฐ๋ผ ์ด์— ๋Œ€ํ•œ ๋ฐ˜๋ฐœ๋ ฅ์ด ์ฆ๊ฐ€ํ•จ์œผ๋กœ์จ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ๋™์„ ๋”์šฑ ์ด‰์ง„์‹œํ‚จ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค. ์ง€์ง€๋ฉด์ด ๋ถˆ์•ˆ์ •ํ•œ ๊ฒฝ์šฐ์—๋Š” ์‹ ์ฒด๊ฐ€ ๊ท ํ˜•์„ ์œ ์ง€ํ•˜๊ธฐ ์œ„ํ•ด ์‹ ์ฒด ๋ถ„์ ˆ์„ ์ง€๋‚˜๋Š” ๊ทผ์œก๋“ค์˜ ๊ณต๋™ ์ˆ˜์ถ•์ด ์ฆ๊ฐ€ํ•˜๊ณ , ๊ทผ๋ฐฉ์ถ”๋ฅผ ๋ฏผ๊ฐํ•˜๊ฒŒ ๋งŒ๋“ค์–ด ์คŒ์œผ๋กœ์จ ๊ด€์ ˆ์˜ ์•ˆ์ •์„ฑ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๊ฒŒ ๋œ๋‹ค.22 ๊ทธ๋Ÿฌ๋‚˜ ๋ณธ ์—ฐ๊ตฌ์—์„œ ์–‘ํŒ” ๋“ค๊ธฐ ์šด๋™์‹œ ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋งŒ ์ ์šฉํ•˜์˜€์„ ๋•Œ๋Š” ์•ˆ์ •๋œ ๋ฉด๊ณผ ๊ทผ ํ™œ์„ฑ๋„์—์„œ ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ๋‚˜ํƒ€๋‚˜์ง€ ์•Š์•˜๋‹ค. ์ด๋Ÿฌํ•œ ์ด์œ ๋Š” ๋ณธ ์—ฐ๊ตฌ์—์„œ 30์ดˆ ์ด์ƒ ๋…๋ฆฝ์ ์œผ๋กœ ์•‰์•„ ์žˆ์„ ์ˆ˜ ์žˆ๋Š” ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๊ธฐ ๋•Œ๋ฌธ์— ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋งŒ ์ ์šฉํ•˜์˜€์„ ๋•Œ๋Š” ๋ถˆ์•ˆ์ •ํ•œ ๊ฐ•๋„๊ฐ€ ๋‹ค์†Œ ์•ฝํ–ˆ์„ ๊ฒƒ์ด๋ผ๊ณ  ํŒ๋‹จ๋œ๋‹ค.
๋˜ํ•œ ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์ฒด์ค‘ ์ด๋™ ์šด๋™์‹œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ๊ทผ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ํ™˜์ธก ์™ธ๋ณต์‚ฌ๊ทผ๊ณผ ๋‚ด๋ณต์‚ฌ๊ทผ์ด ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์„ธ ๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ๊ทผ ํ™œ์„ฑ๋„์— ๋ชจ๋‘ ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. Marshall๊ณผ Murphy10๋Š” ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด ์œ„์—์„œ ๋ฌด๊ฒŒ์ค‘์‹ฌ์ด ์ค‘์‹ฌ์„ ์—์„œ ๋ฉ€์–ด์งˆ์ˆ˜๋ก ์ฒด๊ฐ„์— ๋Œ€ํ•œ ์ž์„ธ๋™์š” ๋ฐ ๊ณผ์ œ์ˆ˜ํ–‰๊ณผ ๊ด€๋ จ๋œ ๊ทผ์œก์˜ ํ™œ๋™์ด ์ฆ๊ฐ€๋œ๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๊ทผ ํ™œ์„ฑ๋„๋ฅผ ์ธก์ •ํ•˜๊ธฐ ์ „ ์ตœ๋Œ€ ์ฒด์ค‘์ด๋™ ๊ฑฐ๋ฆฌ๋ฅผ ๋ฏธ๋ฆฌ ํ™•์ธํ•˜์˜€์œผ๋ฉฐ, ๋ชฉํ‘œ์ง€์ ์— ๋„๋‹ฌํ–ˆ์„ ๋•Œ 5์ดˆ๊ฐ„ ์œ ์ง€ํ•˜๊ฒŒ ํ•˜์—ฌ ์ž์„ธ๋™์š”๊ฐ€ ์ฆ๊ฐ€๋œ ์ƒํƒœ์—์„œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ๋™์„ ๊ธฐ๋กํ•˜์˜€๋‹ค. ์™ธ๋ณต์‚ฌ๊ทผ๊ณผ ๋‚ด๋ณต์‚ฌ๊ทผ์˜ ๊ทผ ํ™œ์„ฑ๋„๊ฐ€ ์„ธ๊ฐ€์ง€ ์กฐ๊ฑด์—์„œ ๋ชจ๋‘ ์œ ์˜ํ•œ ์ฐจ์ด๋ฅผ ๋ณด์ธ ๊ฒƒ์€ ๋ถˆ์•ˆ์ •ํ•œ ๊ฐ•๋„๊ฐ€ ๋†’์„์ˆ˜๋ก ์ฒด์ค‘ ์ด๋™์‹œ ์ž์„ธ๋™์š”๊ฐ€ ์ฆ๊ฐ€ํ•˜๊ธฐ ๋•Œ๋ฌธ์— ๊ท ํ˜•์„ ์žก๊ธฐ ์œ„ํ•ด ๋”์šฑ ๋งŽ์€ ๊ทผ์ˆ˜์ถ•์„ ์œ ๋ฐœํ•œ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค.
๊ทธ๋Ÿฌ๋‚˜ ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ์˜ ๊ฒฝ์šฐ ์•ˆ์ •๋œ ๋ฉด๊ณผ ๋ฐœ๋ž€์Šค ํŒจ๋“œ๋งŒ ์ ์šฉํ•˜์˜€์„ ๋•Œ๋Š” ์œ ์˜ํ•œ ์ฐจ์ด๊ฐ€ ์—†๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ์ด๊ฒƒ์€ ์ฒ™์ถ”๊ธฐ๋ฆฝ๊ทผ์ด ์ค‘์ถ•์„ฑ(axial)์˜ ์ฒด๊ฐ„ ๊ทผ์œก์œผ๋กœ ํŽธ์ธก ์šฐ์„ธ์  ๊ฒฝํ–ฅ์„ ๋ณด์ด๋Š” ์™ธ๋ณต์‚ฌ๊ทผ, ๋‚ด๋ณต์‚ฌ๊ทผ๊ณผ ๊ฐ™์€ ์™ธ์ธก ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ์— ๋น„ํ•ด ์ฒด์ค‘ ์ด๋™์‹œ ์ง€์ง€๋ฉด์˜ ์˜ํ–ฅ์„ ๋น„๊ต์  ์ ๊ฒŒ ๋ฐ›์€ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋˜๋ฉฐ,23,24 ๋ฐœ๋ž€์Šค ํŒจ๋“œ์™€ ๋ฐœ๋ž€์Šค ๋ณผ์„ ๋ชจ๋‘ ์ ์šฉํ•˜์˜€์„ ๋•Œ ์œ ์˜ํ•˜๊ฒŒ ๊ทผ ํ™œ์„ฑ๋„๊ฐ€ ์ฆ๊ฐ€ํ•œ ๊ฒƒ์€ ๋‘”๋ถ€์ชฝ์œผ๋กœ ๋ฌด๊ฒŒ์ค‘์‹ฌ์ด ์ด๋™๋˜๋ฉด์„œ ์ฒ™์ถ” ๊ธฐ๋ฆฝ๊ทผ์˜ ์—ญํ• ์ด ์ค‘์š”ํ•ด์ง„ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค.
์ž์„ธ ์กฐ์ ˆ์€ ๋ณดํ–‰์ด๋‚˜ ์›€์ง์ž„ ์ˆ˜ํ–‰ ์‹œ ์ž์„ธ ์œ ์ง€๋ฅผ ์œ„ํ•œ ๊ธฐ๋ณธ์ ์ธ ์š”์†Œ๋กœ, ๋…๋ฆฝ์ ์ธ ์ผ์ƒ์ƒํ™œ์„ ์œ„ํ•ด ๋ฐ˜๋“œ์‹œ ํ•„์š”ํ•˜๋‹ค.25 ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์•‰์€ ์ž์„ธ์—์„œ์˜ ๊ท ํ˜• ์šด๋™์‹œ ์ง€์ง€๋ฉด์— ๋”ฐ๋ฅธ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„๋ฅผ ๋น„๊ตํ•œ ๊ฒฐ๊ณผ, ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด์—์„œ ์šด๋™์‹œ ์•ˆ์ •๋œ ๋ฉด๋ณด๋‹ค ๊ทผ ํ™œ์„ฑ๋„๊ฐ€ ์ฆ๊ฐ€ํ•˜๋Š” ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ์œผ๋ฉฐ, ์ž์„ธ๋™์š”๊ฐ€ ์ฆ๊ฐ€ํ•˜๋Š” ํ™˜๊ฒฝ์ผ์ˆ˜๋ก ๊ท ํ˜•์„ ์œ ์ง€ํ•˜๊ธฐ ์œ„ํ•œ ๊ทผ์œก์˜ ํ™œ๋™์ด ์ฆ๊ฐ€ํ•˜๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ์—ฐ๊ตฌ์˜ ๋Œ€์ƒ์ž์ˆ˜๊ฐ€ ์ ์–ด ์ผ๋ฐ˜ํ™”ํ•˜๊ธฐ ์–ด๋ ค์šฐ๋ฉฐ, ์ง€๋ฉด์˜ ๋ถˆ์•ˆ์ •ํ•œ ์ •๋„์— ๋”ฐ๋ฅธ ์ž์„ธ๋™์š”์˜ ์ฐจ์ด๋ฅผ ๋น„๊ตํ•˜์ง€ ์•Š์•˜๋‹ค. ๋˜ํ•œ ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด์—์„œ์˜ ๋ฐ˜๋ณต์ ์ธ ๊ท ํ˜• ํ›ˆ๋ จ์ด ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์†์ƒ๋œ ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„์— ์–ด๋– ํ•œ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š”์ง€ ํ™•์ธํ•˜์ง€ ๋ชปํ–ˆ๋‹ค. ๋”ฐ๋ผ์„œ ์•ž์œผ๋กœ์˜ ์—ฐ๊ตฌ์—์„œ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด์—์„œ์˜ ๋ฐ˜๋ณต์ ์ธ ๊ท ํ˜• ํ›ˆ๋ จ์ด ์ฒด๊ฐ„ ๊ทผ์œก์˜ ํ™œ์„ฑ๋„ ๋ฐ ์ž์„ธ์กฐ์ ˆ์— ๋ฏธ์น˜๋Š” ํšจ๊ณผ๋ฅผ ์•Œ์•„๋ณด๋Š” ์—ฐ๊ตฌ๊ฐ€ ํ•„์š”ํ•˜๊ฒ ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋Š” ์ž์„ธ์กฐ์ ˆ์ด ์†์ƒ๋œ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋“ค์˜ ๋ถˆ์•ˆ์ •ํ•œ ๋ฉด์—์„œ์˜ ๊ท ํ˜• ํ›ˆ๋ จ์˜ ํšจ๊ณผ์— ๋Œ€ํ•œ ๊ทผ๊ฑฐ๋ฅผ ์ œ์‹œํ•ด ์ค„ ์ˆ˜ ์žˆ์„ ๊ฒƒ์œผ๋กœ ๊ธฐ๋Œ€๋œ๋‹ค.

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