허리통증에도움이되는필라테스운동. - Pilates for Low Back Pain 가천대학교운동재활복지학과 노수연교수. CKorea Pilates Federation 2015 all rights reserved
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1 허리통증에도움이되는필라테스운동 - Pilates for Low Back Pain 가천대학교운동재활복지학과 노수연교수
2 Profile Roh, Su Yeon Roh Su Yeon President Korea Pilates Federation Position Professor of Exercise Rehabilitation and Welfare of Gachon University(2014-present) Research Director of the Korea Balance Medical Association(2014-present) Executive Director of Korea Sports Culture Foundation(2013-Present) Executive Director of Korea Council of Sport for All(2013-Present) Executive Director of Women s Association for better life.(2013-present) Executive Director of Korea Exercise Rehabilitation Association (Present) Executive Director of Korea Sport Industry Association, Seoul, Korea (April 2011 Present) Executive Director of Korea Sport Society, Seoul, Korea (July 2012 Present) Education Director of Cha University Chronic Pain Center, IMS (December January 2008) Pilates Professionals of major international license Korea Host site, Faculty member of Balanced Body, USA Korea Host site, Ellie Herman Pilates, USA Pole start pilates, USA ㆍ Pilates for Equestarian 2015 ㆍ Pilates Bible 2015 ㆍ Pilates for rehabilitation by props 2015 ㆍ Improving Brain power by Pilates 2015 ㆍ Pilates for the elderly rehabilitation Bookzen 2011 ㆍ Ellie Herman s Mat Pilates - Deahanmedia 2008 ㆍ Pilates for the elderly Bookzen 2007 ㆍ Morning Pilates Deahanmedia 2007 ㆍ Ellie Herman s Pilates with Props Deahanmedia 2006 ㆍ 30Minutes Pilates for Pregnant women Daehanmedia 2006
3 Profile Research & Study The Influence of Attraction of Pilates Instructors on Exercise Passion and Adherence of Pilates Participants (2015) KJSS The Relationship Among Objectified Body Consciousness, Self-control and Perfectionism of Pilates Participants (2015) KJS An 8-week Aquatic Exercise Program is Effective at Improving Gait Stability of the Elderly. (2013) S.C.I.E. The relationship between pelvic tilt angle and disability associated with low back pain (2013) S.C.I. Pilates and Massage after exercise on the impact of fatigue (2012) Korea Sport Association Props Pilates (2009) KACEP The phenomenological perspective on Pilates (2006) KSSLS Pilates for Rehabilitation (2006) KJHP A phenomenological study of Pilates (2006) KAHPERD A study on leisure ability of Pilates participant (2005) Korea Dance science association Pilates for pregnant (2005) KACEP Media & Press Pilates Column, Shindonga Magazine( ) Ilgam Concert, Pilates professionals, BTN (2013) Exercise for office workers, Director & Producer, Hyundai Motors co. ( ) Wellbeing Exercise, Director& Producer, Samsung Life Insurance co. (July 2005) Sports Magazine Every Sunday Participation, MBC (March 2005 April 2006) Wellbeing Generation Radio, KBS (September 2005) Yamujin TV, KBS (September 2005) Health Program Live Broadcast every Friday, MBC ( )
4 Contents 1. 허리통증 2. 허리통증질환의이해 3. 허리통증에도움이되는필라테스운동 A. 예방 B. 예후 4. 쉽게따라하기
5 1. 허리통증
6 허리통증, 요통 (Low Back Pain) 감기처럼흔한질병, 요통!!! 운동부족및부적절한운동잘못된생활습관운전, 컴퓨터, 스마트폰으로인한잘못된자세
7 L-Spine Pain 전인구의 80% 가일생동안한번은겪게되는근골격계통증 요추통증은급성과만성으로구분 급성요통은대부분척추기립근의과사용이주된원인 허리디스크, 허리관절증, 요추협착증등의원인으로기인 일반적인원인은디스크질환, 정상인의 30% 정도는디스크의퇴행성변화가있으나정상이나타나지않음 허리통증은정확한원인감별이중요하고만성요통의경우는이학적검사와방사선학적검사모두고려
8 2. 허리통증질환의이해
9 하부교차증후군 (Lower Crossed Syndrome) 자세와연관된허리통증은하부교차증후군으로일컫는근육및근막의문제로인해발생 복부근육과둔근이약화, 힙관절과허리근육이단축 약해지거나단축된근육으로인해통증유발점이발생하고허리디스크나관절에과도한부하가생김 간혹, 장요근의긴장으로인한급성요통의원인이되기도함 기본적으로약한근육을강화, 단축된근육을이완
10 척추후관절동통증후군 (Facet Joint Syndrome) 정의 : 구획의운동저하증 ( 후관절잠김증 ) 이유발하는통증과연관통이있는이차적인과운동부위를특징으로하는질환 증상 : 추간판의퇴행에의해서보통발생하며 rotation, side bending 과결합한 extension 시의통증 금기 : 척추의신전동작
11 수핵탈출증 (Herinated Nucleosus Pulposus) 이탈또는돌출괸추간판에의해생기는질환윤상섬유의약화, 수핵의부피감소와협착 증상 : 원위부의통증이나이상감각, 엉덩이나대퇴부종아리발가락의저림증심하면하지의근력과심부건반사의저하도있을수있음 금기 : 급성기나위에열거한증상이있는경우, 척추관절의 flexion 또는수직으로가해지는힘을포함한운동 ( 앉는자세, 서있는자세, 역위자세 ) 다리를곧게편동작이나과도한척추 rotation 피함
12 척추전방위증 (Spondyloisthesis) 정의 : 척추판결손으로인한척추의전방전위가일으키는불안정성 (L5~S1 또는 L4~5 부위에흔함 ) 증상 : 신전동작에의해서특히유발. 부손상이엉덩이쪽으로의산발된급성통증을일으킴, 주손상은척추판의골절을일으키고척추의손상도가져올수있음 금기 : 척추의신전동작을피함
13 척추관협착증 (Spinal stenosis) 정의 : 척주관의협착 ( 중심부협착 ) 또는신경근뿌리관 ( 가측협착 ) 의협착 증상 : 주로신전동작에의해유발되는요통을포함한저림, 일시적인운동기능의저하와일어서거나앉을때발생하는편측또는양측다리의간헐적인통증 금기 : 척추의신전동작
14 연구논문 Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial Natour, J.; de Araujo Cazotti, L.; Ribeiro, L.H.; Baptista, A.S.; Jones, A. SAGE Publications 2015 Pilates exercises improve low back pain and quality of life in patients with HTLV-1 virus: A randomized crossover clinical trial Borges, J.; Baptista, A. o.; Santana, N.; Souza, I.; Kruschewsky, R. A.; Galvão-Castro, B.; Sá, K. N. Elsevier Science B.V., Amsterdam 2014 Indications, Benefits, and Risks of Pilates Exercise for People With Chronic Low Back Pain: A Delphi Survey of Pilates-Trained Physical Therapists Wells, C.; Kolt, G.S.; Marshall, P.; Bialocerkowski, A. APTA AMERICAN PHYSICAL THERAPY ASSOCIATION 2014 The Definition and Application of Pilates Exercise to Treat People With Chronic Low Back Pain: A Delphi Survey of Australian Physical Therapists Wells, C.; Kolt, G.S.; Marshall, P.; Bialocerkowski, A. APTA AMERICAN PHYSICAL THERAPY ASSOCIATION 2014 Effectiveness of Mat Pilates or Equipment-Based Pilates Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial da Luz, M.A.; Costa, L.O.P.; Fuhro, F.F.; Manzoni, A.C.T.; Oliveira, N.T.B.; Cabral, C.M.N. APTA AMERICAN PHYSICAL THERAPY ASSOCIATION 2014 Daily pilates exercise or inactivity for patients with low back pain: a clinical prospective observational study accagnano, G.; Comes, R.; Tafuri, S.; Moretti, B. EDIZIONI MINERVA MEDICA 2014 Notarnicola, A.; Fischetti, F.; Influence of Pilates Mat and Apparatus Exercises on Pain and Balance of Businesswomen with Chronic Low Back Pain Lee, C.-W. SOCIETY OF PHYSICAL THERAPY SCIENCE 2014 Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial. Miyamoto GC, Costa LO, Galvanin T, Cabral CM. Phys Ther Mar;93(3): doi: /ptj Epub 2012 Oct 11 unknownelsevier Science B.V., Amsterdam Donzelli, S, Domenica E., Cova, AM, Galletti, R, & Giunta N.(2006). Two different techniques in the rehabilitation treatment of low back pain: A Randomized Controlled Trial. Eura Medicophys. 42: Gisela C. Miyamoto, Leonardo Oliveira Pena Costa, Thalissa Galvanin and Cristina Maria Nunes Cabral. (2013). Efficacy of the Addition of Modified pilates Exercises to a Minimal Intervention in Patients With Chronic Low Back Pain:A Randomized Controlled Trial. Phys ther.93, Gladwell V, Head S, Haggar M, & Beneke R. (2006). Does a program of Pilates improve chronic non-specific low back pain? J Sport Rejabil. 15:
15 3. 허리통증에도움이 되는필라테스운동
16 척추를위한움직임원리 1. 호흡 (Breathing) 2. 코어활성화 (Core Activation) 3. 골반의중립 (Neutral Pelvis) 4. 복부강화 (Abdominal Strengthening) 5. 요추골반안정화 (Lumbopelvic Stability) 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) 7. 정렬 (Alignment) 8. 이완동작및스트레칭 (Release work & Stretching)
17 A. 예방
18 Abodominal Curls
19 Bridge
20 Hundred
21 Single Leg Circle
22 Rolling Like a Ball
23 Single Leg Stretch
24 Double Leg Stretch
25 Single Straight Leg Stretch
26 Criss Cross
27 Roll Up
28 Push Ups
29 Leg Pull Down
30 Leg Pull Up
31 Teaser
32 Roll Over
33 Jackknife
34 B. 예후
35 1. 호흡 (Breathing) Diaphragmatic (Belly)Breathing : Relaxing Lateral(Rib)Breathing : Stimulating
36 1. 호흡 (Breathing) One Lung Breathing : Scoliosis Acute & chronic lung problems(pneumonia, Asthma) Sniffing Breathing : Rapid Movement
37 2. 코어활성화 (Core Activation) 코어의주요근육 횡경막 (Diaphragm) 골반저근 (Pelvic Floor) 요방형근 (Quadratus Lumborum) 다열근 (Multifidi) 복횡근 (Transversus Abdominis) 대요근 (Psoas Major)
38 2. 코어활성화 (Core Activation) Fingertip Abdominals All Four Abdominals
39 2. 코어활성화 (Core Activation) Standing Multifidi
40 3. 골반의중립 (Neutral Pelvis) Finding Neutral
41 3. 골반의중립 (Neutral Pelvis) Pelvic Clock Imprinted Spine Supported Neutral
42 4. 복부강화 (Abdominal Strengthening)
43 4. 복부강화 (Abdominal Strengthening) Abdominal Curls Oblique Abdominal
44 전방사근시스템 (anterior oblique sling system) -Serratus anterior( 전거근 ) -Internal oblique abdominals( 내복사근 ) -External oblique abdominals( 외복사근 ) -Adductors( 내전근 ) 5. 요추골반안정화 (Lumbopelvic Stability) 후방사근시스템 (posterior oblique sling system) -Latissimus dorsi( 광배근 ) -Contralateral gluteus maximus( 대측성대둔근 ) 심부경선시스템 (deep longitudinal system) -Erector spinae( 척추기립근 ) -Quadratus Lumborum( 요방형근 ) -Thoracolumbar fascia( 흉요근막 ) -Sacrotuberous ligament( 천골결절인대 ) -Biceps femoris( 대퇴이두근 ) 측면시스템 (lateral system) -Gluteus medius( 중둔근 ) -Gluteus minimus( 소둔근 ) -Contralateral adductors( 대측성내전근 )
45 5. 요추골반안정화 (Lumbopelvic Stability) Marching Toe Taps
46 5. 요추골반안정화 (Lumbopelvic Stability) Opposite Arm & Leg Reach
47 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Cat / Cow
48 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Hip and Shoulder Circle
49 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Poodle Tail
50 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Tail Wag
51 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Round Back Bridging Flat Back Bridging
52 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Typewriter/Hip Dips/Figure 8
53 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Prone Arm reach
54 6. 척추의강화및가동성 (Strengthening and Mobilizing Spine) Mini Swan
55 7. 정렬 (Alignment) Side view
56 7. 정렬 (Alignment) Front view : Vertical
57 7. 정렬 (Alignment) Front view : Horizontal
58 7. 정렬 (Alignment) Back view : Vertical
59 7. 정렬 (Alignment) Back view : Horizontal
60 8. 이완동작및스트레칭 (Release work and Stretching) Knee Folds
61 8. 이완동작및스트레칭 (Release work and Stretching) Child s pose
62 8. 이완동작및스트레칭 (Release work and Stretching) Knees to Chest Torso Twist
63 8. 이완동작및스트레칭 (Release work and Stretching) Figure 4
64 4. 쉽게따라하기
65 쉽게따라하기 앉아서다리들기
66 쉽게따라하기 상체비틀기와스트레칭
67 쉽게따라하기 척추비틀기
68 쉽게따라하기 다리들기
69 쉽게따라하기 골반과허리운동
70 Thank you!
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