A Comparison of Lumbar Lordotic Curves between Herniated Nucleus Pulposus Patients and Normal Subject Using a Flexible Curve Ruler

  • Jung, Yong-Mi (Department of Physical Therapy, Daejeon Jaseng Hospital of Oriental Medicine, Graduate School, Daejeon University) ;
  • Choi, Jong-Duk (Department of Physical Therapy, College of Natural Science, Daejeon University)
  • 투고 : 2012.05.16
  • 심사 : 2012.06.07
  • 발행 : 2012.06.26

초록

Purpose: We attempt to assess the differences in the degree of lumbar lordosis in patients with lower back pain caused by the herniation of the nucleus pulposus and in normal people (divided into male and female groups). Methods: This study was conducted with 14 patients (7 males, 7 females) diagnosed with, and being treated for, lumbar herniated nucleus pulposus and 14 normal people (7 males, 7 females). In order to examine the degree of lumbar lordosis in these subjects, hip flexor lengthening tests were conducted and the lumbar curves were measured in three postures (supine, sitting, and prone) and the results were compared. Results: The measured values of the curves for the standing and prone postures showed statistically significant differences between the normal group and the patient group, between the normal male group and the male patient group, and between the normal female group and the female patient group (p<0.05). Conclusion: The measurement method that uses flexible curve rulers in the standing or prone postures can be usefully utilized in assessing the lumbar lordosis of patients with lumbar herniation of the nucleus pulposus.

키워드

참고문헌

  1. Andersson GB. Epidemiologic aspects on low-back pain in industry. Spine (Phila Pa 1976). 1981;6(1):53-60. https://doi.org/10.1097/00007632-198101000-00013
  2. Biering-Sorensen F, Thomsen C. Medical, social and occupational history as risk indicators for low-back trouble in a general population. Spine (Phila Pa 1976). 1986;11(7):720-5. https://doi.org/10.1097/00007632-198609000-00011
  3. Oh YT, Gwon HC. The Effects of Auriculotherapy for Pain Control in HIVLD with Sciatica. J Korean Soc Phys Ther. 1999;11(3):45-55.
  4. Moon DC, Kown YS, Song YJ et al. Changes of lumbar lordosis according to different heel heights in normal adults and patients with HNP. J Korean Soc Phys Ther. 2001;467-75.
  5. Bjerkeset T, Johnsen LG, Kibsgaard L et al. Surgical treatment of degenerative lumbar diseases. Tidsskr Nor Laegeforen. 2005;125(13):1817-9.
  6. Brown JR. Factors contributing to the development of low back pain in industrial workers. Am Ind Hyg Assoc J. 1975;36(1):26-31. https://doi.org/10.1080/0002889758507203
  7. Fennell AJ, Jones AP, Hukins DW. Migration of the nucleus pulposus within the intervertebral disc during flexion and extension of the spine. Spine (Phila Pa 1976). 1996;21(23):2753-7. https://doi.org/10.1097/00007632-199612010-00009
  8. Magee DJ. Orthopaedic physical assessment. 3rd ed. Philadelphia, WB Saunders, 1997.
  9. Adams MA, Hutton WC, Stott JR. The resistance to flexion of the lumbar intervertebral joint. Spine (Phila Pa 1976). 1980;5(3):245-53. https://doi.org/10.1097/00007632-198005000-00007
  10. Nachemson A. Lumbar intradiscal pressure. Experimental studies on post-mortem material. Acta Orthop Scand Suppl. 1960;43:1-104.
  11. Lundin A, Magnuson A, Nilsson O. A stiff and straight back pre operatively is associated with a good outcome 2 years after lumbar disc surgery. Acta Orthop. 2009;80(5):573-8. https://doi.org/10.3109/17453670903316785
  12. Kendall FP, McCreary EK, Provance PG. Muscles: testing and function: with posture and pain. 4th ed. Baltimore, Md: Williams& Wilkins, 1993.
  13. Cailliet R. Low back pain syndrome. 5th ed. Philadelphia, Pa: FA Davis Co, 1995.
  14. Kisner C, Colby LA. Therapeutic Exercise: foundations and techniques. 3rd ed. Philadelphia, FA Davis, 1996.
  15. Jull GA, Janda V. Muscle and motor control in low back pain: assessment and management. In: Twomey LT, Taylor JR eds. Physical therapy for the low back. Clinics in physical therapy. New York, Churchill Livingstone, 1987:253-78.
  16. Kim KT, Seo HK, Lee HK et al. Effect of lumbar extensor strength according to lumbosacral angle change on chronic lumbar back pain patients. J Korean Soc Phys Ther. 2004;16(1):1-12. https://doi.org/10.1589/jpts.16.1
  17. Bergenudd H, Nilsson B, Udén A et al. Bone mineral content, gender, body posture, and build in relation to back pain in middle age. Spine (Phila Pa 1976). 1989;14(6):577-9. https://doi.org/10.1097/00007632-198906000-00005
  18. Hultman G, Saraste H, Ohlsen H. Anthropometry, spinal canal width, and flexibility of the spine and hamstring muscles in 45-55-year-old men with and without low back pain. J Spinal Disord. 1992;5(3):245-53. https://doi.org/10.1097/00002517-199209000-00001
  19. Youdas JW, Garrett TR, Harmsen S et al. Lumbar lordosis and pelvic inclination of asymptomatic adults. Phys Ther. 1996;76(10):1066-81. https://doi.org/10.1093/ptj/76.10.1066
  20. Norton BJ, Sahrmann SA, Van Dillen FL. Differences in measurements of lumbar curvature related to gender and low back pain. J Orthop Sports Phys Ther. 2004;34(9):524-34. https://doi.org/10.2519/jospt.2004.34.9.524
  21. Youdas JW, Garrett TR, Egan KS et al. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Phys Ther. 2000;80(3):261-75.
  22. Christie HJ, Kumar S, Warren SA. Postural aberrations in low back pain. Arch Phys Med Rehabil. 1995;76(3):218-24. https://doi.org/10.1016/S0003-9993(95)80604-0
  23. Park BG. Differences in the radiologic parameters between patients with low back pain and normal population. Ann Rehabil Med. 1992;16(3):276-82.
  24. Luedtke K, Rushton A, Wright C et al. Effectiveness of anodal transcranial direct current stimulation in patients with chronic low back pain: design, method and protocol for a randomised controlled trial. BMC Musculoskelet Disord. 2011;12:290. https://doi.org/10.1186/1471-2474-12-290
  25. Millar WJ, Stephens T. The prevalence of overweight and obesity in Britain, Canada, and United States. Am J Public Health. 1987;77(1):38-41. https://doi.org/10.2105/AJPH.77.1.38
  26. Murtezani A, Hundozi H, Orovcanec N et al. A comparison of high intensity aerobic exercise and passive modalities for the treatment of workers with chronic low back pain: a randomized, controlled trial. Eur J Phys Rehabil Med. 2011;47(3):359-66.
  27. Youdas JW, Suman VJ, Garrett TR. Reliability of measurements of lumbar spine sagittal mobility obtained with the flexible curve. J Orthop Sports Phys Ther. 1995;21(1):13-20. https://doi.org/10.2519/jospt.1995.21.1.13
  28. Ohlen G, Spangfort E, Tingvall C. Measurement of spinal sagittal con figuration and mobility with Debrunner's kyphometer. Spine (Phila Pa 1976). 1989;14(6):580-3. https://doi.org/10.1097/00007632-198906000-00006
  29. Hart DL, Rose SJ. Reliability of a noninvasive method for measuring the lumbar curve. J Orthop Sports Phys Ther. 1986;8(4):180-4. https://doi.org/10.2519/jospt.1986.8.4.180
  30. Link CS, Nicholson GG, Shaddeau SA et al. Lumbar curvature in standing and sitting in two types of chairs: relationship of hamstring and hip flexor muscle length. Phys Ther. 1990;70(10):611-8. https://doi.org/10.1093/ptj/70.10.611
  31. Nourbakhsh MR, Arab AM. Relationship between mechanical factors and incidence of low back pain. J Orthop Sports Phys Ther. 2002;32(9):447-60. https://doi.org/10.2519/jospt.2002.32.9.447