Effect of Abdominal Drawing-In Maneuver on Peak Expiratory Flow, Forced Expiratory Volume in 1 Second and Pain During Forced Expiratory Pulmonary Function Test in Patients With Chronic Low Back Pain

만성요통환자에서 복부심부근 강화 운동이 노력성 호기 폐기능 검사 동안 최대호기유량 및 1초간노력성호기량과 요통에 미치는 효과

  • Kim, Ki-Song (Dept. of physical Therapy, Kang-nam Severance Hospital, Yonsei University) ;
  • Kwon, Oh-Yun (Dept. of physical Therapy, College of Health Science, Yonsei University, Institute of Health Science Yonsei University) ;
  • Yi, Chung-Hwi (Dept. of physical Therapy, College of Health Science, Yonsei University, Institute of Health Science Yonsei University)
  • 김기송 (연세대학교 강남세브란스병원 물리치료실) ;
  • 권오윤 (연세대학교 보건과학대학 물리치료학과 및 보건과학연구소) ;
  • 이충휘 (연세대학교 보건과학대학 물리치료학과 및 보건과학연구소)
  • Received : 2009.01.14
  • Accepted : 2009.02.06
  • Published : 2009.02.19

Abstract

The aim of this study was to investigate the effect of abdominal drawing-in maneuver (ADIM) on peak exploratory flow (PEF), forced exploratory volume in 1 second ($FEV_1$), and low back pain during forced expiration. Twenty-two subjects (14 subjects in experimental group, 8 subjects in control group) participated in this study. The stabilizer was used for ADIM training for five consecutive days. Vitalograph PEF/$FEV_1$ DIARY and visual analogue scale (VAS) were used to determine forced expiratory pulmonary function and low back pain, respectively. Independent t-test and analysis of covariance were used for statistical analysis with a significance level of .05. The findings of this study were as follows: 1) There were no significant differences of ADIM effect on PEF and $FEV_1$ between experimental group and control group. 2) There was a significant pain reduction in experimental group with ADIM. 3) PEF and $FEV_1$ increased significantly in the fifth day compared with the first day pre-exercise baseline. Therefore, it is concluded that ADIM was effective in improving PEF and $FEV_1$, and reducing VAS during forced expiration in patients with chronic low back pain.

Keywords

References

  1. 김영삼, 안애란, 김세규 등. Mini-Wright Peak Flow Meter로 측정한 한국 성인의 최고호기유량의 정상치. 결핵 및 호흡기질환. 2001;50(3):320-333
  2. 이병기, 지용석, 고일규 등. 걷기와 요부안정화운동이 만성요통환자의 폐기능과 요부심부근에 미치는 영향. 대한임상건강증진학회지. 2008;8(3):168-177
  3. Bach JR, Smith WH, Michaels J, et al. Airway secretion clearance by mechanical exsufflation for post-poliomyelitis ventilator assisted individuals. Arch Phys Med Rehabil. 1993:74(2):170-177
  4. De Troyer A, Estenne M. Functional anatomy of the respiratory muscle. Clin Chest Med 1988;9(2):175-193.
  5. Deyo RA, Rainille J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992;268(6):760-765. https://doi.org/10.1001/jama.268.6.760
  6. Hall L, Tsao H, MacDonald D, et al. Immediate effects of co-contraction training on motor control of the trunk muscles in people with recurrent low back pain. J Electromyogr Kinesiol. 2007;9(27): 1-11.
  7. Hanayama K, Ishikawa Y, Bach JR. Amyotrophic lateral sclerosis. Successful treatment of mucous plugging by mechanical insufflation-exsufflation. Am J Rehabil. 1997;76(4):338-339. https://doi.org/10.1097/00002060-199707000-00017
  8. Hodges PW, Richardson CA. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Arch Phys Med Rehabil. 1999;80(9):1005-1012. https://doi.org/10.1016/S0003-9993(99)90052-7
  9. Jardins TD. Cardiopulmonary Anatomy and Physiology: Essentials for respiratory care. 4th ed. Albany. Delmar Cengage Learning. 2002:49-55.
  10. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137(7):586-597. https://doi.org/10.7326/0003-4819-137-7-200210010-00010
  11. Leung AK, Robson WL. Sneezing. J Otolaryngol 1994;23(2):125-129.
  12. Mannion AF, Kaser L, Weber E, et al. Influence of age and duration of symptoms on fibre type distribution and size of the back muscles in chronic low back pain patients. Eur Spine J. 2009;9(4):273-281. https://doi.org/10.1007/s005860000189
  13. Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol. 2003;13(4):371-379. https://doi.org/10.1016/S1050-6411(03)00044-0
  14. Panjabi MM. A hypothesis of chronic back pain: Ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J. 2006;15(5):668-676. https://doi.org/10.1007/s00586-005-0925-3
  15. Pfaar O, Raap U, Holz M, et al. Pathophysiology of itching and sneezing in allergic rhinitis. Swiss Med Wkly. 2009;139(3-4):35-40.
  16. Rottger C, Trittmacher S, Gerriets T, et al. Sinus thrombosis after a jump from a small rock and a sneezing attack: Minor endothelial trauma as a precipitating factor for cerebral venous thrombosis? Headache. 2004;44(8):812-815. https://doi.org/10.1111/j.1526-4610.2004.04150.x
  17. Ruppel G. The respiratory system. In: Scanlan CL, Wilkins RL, Stoller JK, eds. Egan's Fundamentals of Respiratory Care. 7th ed. St. Louis, Mosby, 1999:40-155.
  18. Schleip R, Vleeming A, Lehmann-Horn F. et al. Letter to the Editor concerning "hypothesis of chronic back pain: Ligament subfailure injuries lead to muscle control dysfunction" (M. Panjabi). Eur Spine J. 2007;16(10):1733-1735. https://doi.org/10.1007/s00586-006-0298-2
  19. Schmidt R, Lee T. Motor Control and Learning: A behavioral emphasis. 4th ed. Idaho, Human Kinetics, 2005:107-109.
  20. Tsao H, Hodges PW. lmmediate changes in feedforward postural adjustments following voluntary motor training. Exp Brain Res. 2007;181(4):537-546. https://doi.org/10.1007/s00221-007-0950-z
  21. Yue JJ, Timm JP, Panjabi MM, et al. Clinical application of the Panjabi neutral zone hypothesis: The Stabilimax NZ posterior lumbar dynamic stabilization system. Neurosurg Focus. 2007;22(1):E12.
  22. Vroomen PC, de Krom MC, Knottnerus JA. Predicting the outcome of sciatica at short-term follow-up. Br J Gen Pract. 2002;52(475):119-123.
  23. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: A review of an emerging area of research. Gait Posture. 2002;160(1):1-14.