DOI QR코드

DOI QR Code

The Effects of Stretching and Strengthening Exercise on the Pain, Pelvic Tilt, Functional Disability Index, and Balance Ability of Patients with Chronic Lower Back Pain

  • Kang, Tae Woo (Department of Physical Therapy, College of Health and Welfare, Woosuk University) ;
  • Kim, Beom Ryong (Department of Physical Therapy, Design Hospital)
  • 투고 : 2019.01.02
  • 심사 : 2019.02.14
  • 발행 : 2019.02.28

초록

Purpose: This study examined the effects of stretching and strengthening exercises on the pain, pelvic tilt (PT), functional disability, and balance of patients with chronic lower back pain (CLBP). Methods: A total of 42 patients with CLBP were randomly divided randomly into either experimental group I (EG I, n=21), who received stretching exercise, or experimental group II (EG II, n=21), who received strengthening exercise. Both interventions were applied three times a week for eight weeks. Assessments were made with a visual analogue scale (VAS), PT, Oswestry disability index (ODI), and Berg's balance scale (BBS) before and after the eight weeks intervention period. A paired t-test was conducted to compare the within-group changes before and after the intervention. An independent t-test was used compare the between-group difference. The statistical significance level was set to ${\alpha}=0.05$ for all variables. Results: The EG I and II showed significant within-group changes in the VAS, PT, ODI, and BBS (p<0.05). The changes in VAS, PT, ODI, and BBS were similar regardless of the exercise form. Conclusion: In this study, the application of stretching and strengthening exercise for subjects who complain of CLBP was effective in changing the level of pain, PT, functional disability, and balance.

키워드

참고문헌

  1. Kumar S. Theories of musculoskeletal injury causation. Ergonomics. 2001;44(1):17-47. https://doi.org/10.1080/00140130120716
  2. Chung MK, Lee I, Yeo YS. Physiological workload evaluation of screw driving tasks in automobile assembly jobs. Int J Ind Ergon. 2001;28(3-4):181-8. https://doi.org/10.1016/S0169-8141(01)00031-2
  3. O'Sullivan PB. Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Man Ther. 2000;5(1):2-12. https://doi.org/10.1054/math.1999.0213
  4. Hides JA, Richardson CA, Jull GA. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine. 1996;21(23):2763-9. https://doi.org/10.1097/00007632-199612010-00011
  5. Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005;85(3):209-25. https://doi.org/10.1093/ptj/85.3.209
  6. Hyoung HK. Effects of a strengthening program for lower back in older women with chronic low back pain. J Korean Acad Nurs. 2008;38(6):902-13. https://doi.org/10.4040/jkan.2008.38.6.902
  7. Jeon JK. The effects of combination patterns exercise of proprioceptive neuromuscular facilitation on balance in chronic low back pain elderly patients. J Digital Convergence. 2013;11(4):361-8. https://doi.org/10.14400/JDPM.2013.11.12.361
  8. Nichols DS, Miller L, Colby LA et al. Sitting balance: its relation to function in individuals with hemiparesis. Arch Phys Med Rehabil. 1996;77(9):865-9. https://doi.org/10.1016/S0003-9993(96)90271-3
  9. Alexander KM, Kinney LaPier TL. Differences in static balance and weight distribution between normal subjects and subjects with chronic unilateral low back pain. J Orthop Sports Phys Ther. 1998;28(6):378-83. https://doi.org/10.2519/jospt.1998.28.6.378
  10. McCollum G, Shupert CL, Nashner LM. Organizing sensory information for postural control in altered sensory environments. J Theor Biol. 1996;180(3):257-70. https://doi.org/10.1006/jtbi.1996.0101
  11. Rantanen P. Physical measurements and questionnaires as diagnostic tools in chronic low back pain. J Rehabil Med. 2001;33(1):31-5. https://doi.org/10.1080/165019701300006515
  12. Frank C, Page P, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach. Champaign, Human Kinetics, 2009.
  13. 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
  14. Van Dillen LR, McDonnell MK, Fleming DA et al. Effect of knee and hip position on hip extension range of motion in individuals with and without low back pain. J Orthop Sports Phys Ther. 2000;30(6):307-16. https://doi.org/10.2519/jospt.2000.30.6.307
  15. An CS. The effects of hamstring stretching exercise on angle of lumbar flexion and pain reduction with chronic low back patients. J Korean Phys Ther. 2005;17(4):559-67.
  16. Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitationbased abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients. J Exerc Rehabil. 2017;13(4):486-90. https://doi.org/10.12965/jer.1735030.515
  17. Lee P, Helewa A, Goldsmith CH et al. Low back pain: prevalence and risk factors in an industrial setting. J Rheumatol. 2001;28(2):346-51.
  18. Lee JJ, Song BB. The effects of the passive and active stretching exercises of iliopsoas muscles on low back pain patients. J Spec Educ Rehabil Sci. 2015;54(2):291-307.
  19. Rone-Adams SA, Shamus E, Hileman M. Physical therapists' evaluation of the trunk flexors in patients with low back pain. IJAHSP. 2004;2(2):3.
  20. Lingjærde O, Foreland AR. Direct assessment of improvement in winter depression with a visual analogue scale: high reliability and validity. Psychiatry Res. 1998;81(3):387-92. https://doi.org/10.1016/S0165-1781(98)00119-X
  21. Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000;25(22):2940-53. https://doi.org/10.1097/00007632-200011150-00017
  22. Berg K, Wood-Dauphinee S, Williams J. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27(1):27-36.
  23. Kwag KI, Lim JH. The effects of stabilization exercise and stretching exercise on muscle strength and pain of patients with lower pack pain. J Korean Acad Clin Electrophys. 2011;9(2):39-46. https://doi.org/10.5627/KACE.2011.9.2.039
  24. Bong SY, Kim YJ, Kang MG et al. Effects of proprioceptive neuromuscular facilitation exercise on forced expiratory volume at one second, pain, and functional disability index of chronic low back pain patients. PNF & Mov. 2016;14(3):185-93. https://doi.org/10.21598/JKPNFA.2016.14.3.185
  25. Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis. Philadelphia, FA Davis, 2011.
  26. Levine D, Whittle MW. The effects of pelvic movement on lumbar lordosis in the standing position. J Orthop Sports Phys Ther. 1996;24(3):130-5. https://doi.org/10.2519/jospt.1996.24.3.130
  27. Kim BG. The influence of exercise for trunk stabilizing on lumbosacral region angle in low back pain patients. Daegu University. Dissertation of Doctorate Degree. 2006.
  28. Park SJ, Shin JY, Hwang R. Sling exercise effects on sagittal alignment of chronic low back pain patients. Korean J Phys Education. 2015;54(1):527-34.
  29. Kim JH, Hur JG, Ko TS et al. The effect of exercise program on work-related back pain in physical therapists. J Korean Acad Med Ther Sci. 2009;1(1):15-23.
  30. Nagrale AV, Patil SP, Gandhi RA, et al. Effect of slump stretching versus lumbar mobilization with exercise in subjects with non-radicular low back pain: a randomized clinical trial. J Man Manip Ther. 2012;20(1):35-42. https://doi.org/10.1179/2042618611Y.0000000015
  31. Gawda P, Dmoszynska-Graniczka M, Pawlak H et al. Evaluation of influence of stretching therapy and ergonomic factors on postural control in patients with chronic non-specific low back pain. Ann Agric Environ Med. 2015;22(1):142-6. https://doi.org/10.5604/12321966.1141384
  32. Kim GY, Ahn CS, Kim SS. The effects of 3-dimensional lumbar stabilization exercise have an effect on the improvement of pain and static or dynamic balance ability in 20's age group with low back pain. J Korean Soc Phys Med. 2011;6(2):235-46.
  33. Park J, Kim K. The analysis of stabilization exercise on lumbar extension strength, balance ability in adult female of chronic back pain patients. Korean J Sports Sci. 2012;21(21):1129-38.

피인용 문헌

  1. Influence of Slashpipe Exercise on Symmetrical Contraction of Trunk Muscle in Normal Adults vol.31, pp.5, 2019, https://doi.org/10.18857/jkpt.2019.31.5.298
  2. Analysis of Research Trends Using G-power in Physiotherapy Research in Korea: Systematic Review vol.32, pp.2, 2019, https://doi.org/10.18857/jkpt.2020.32.2.114
  3. Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial vol.251, pp.3, 2019, https://doi.org/10.1620/tjem.251.193
  4. Comparison of the Effect of the Fascial Distortion Model, Foam Rolling and Self-Stretching on the Ankle Dorsiflexion Range of Motion vol.32, pp.4, 2019, https://doi.org/10.18857/jkpt.2020.32.4.238
  5. Effect of Local Vibration on Triceps Surae Flexibility Compared to Static Stretching vol.32, pp.4, 2019, https://doi.org/10.18857/jkpt.2020.32.4.245
  6. Effect of Proprioceptive Neuromuscular Facilitation Stretching on Pain, Hip Joint Range of Motion, and Functional Disability in Patients with Chronic Low Back Pain vol.10, pp.2, 2019, https://doi.org/10.14474/ptrs.2021.10.2.225
  7. A Biomechanical Analysis of the Effect of Pilates Exercise on Female College Students with Knee Joint Deformity vol.23, pp.3, 2019, https://doi.org/10.15758/ajk.2021.23.3.20
  8. The Effect of Coordinative Locomotor Training Using Elastic Bands on the Flexibility and Body Alignment of Elementary School Right-Handed Baseball Players vol.33, pp.5, 2019, https://doi.org/10.18857/jkpt.2021.33.5.217