Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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Correlation Analysis between Lumbar Instability Test Positive Response Number and Breathing Pattern Change Rate and Pain in Young Peoples with Chronic Low Back Pain

젊은 만성허리통증자의 허리부위 불안정성 검사 양성반응 수와 호흡패턴변화율, 통증 간의 상관관계분석

  • Received : 2019.05.29
  • Accepted : 2019.08.12
  • Published : 2019.08.31
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Abstract

PURPOSE: This study examined the correlation between the visual analog scale (VAS) and the rate of change in the respiration patterns according to the result of Lumbar Instability Tests (LITs) in young people with chronic low back pain (CLBP) METHODS: Thirty-six adults, aged 20-40 years with CLBP, participated in this study. The general characteristics and VAS of the participants were recorded by the subjects themselves and seven structure and functional LITs were conducted. According to the positive response number, the positive group was divided into four groups (group 1: n=8, group 2: n=9, group 3: n=10, group 4: n=9). The breathing pattern change tests were performed in three states: during forced breathing exercise and motor control tests. A total of 13 positive lists were set, each of which was scored by 1 or 2 points according to the severity. After the positive lists were scored, the breathing pattern changing rate (BPCR) and VAS were compared according to the positive response number of LITs, and the correlation between them was analyzed. RESULTS: A strong correlation was observed between the number of positive of LITs and BPCR (r= .863, p= .000) and a moderate correlation between the positive number of LITs and VAS (r= .508, p= .002). In addition, there was a poor correlation between the BPCR and VAS (r= .434, p= .008). CONCLUSION: In young CLBP people, when the structural and functional instability are both present, the changes in the respiratory pattern of the whole body can be varied and broader, and the pain scale also increases.

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References

  1. Demoulin C, Distree V, Tomasella M, et al. Lumbar functional instability: a critical appraisal of the literature. Ann Readapt Med Phys. 2007;50(8):677-84. https://doi.org/10.1016/j.annrmp.2007.05.007
  2. 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
  3. Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol. 2003;13(4):371-9. https://doi.org/10.1016/S1050-6411(03)00044-0
  4. SjOlie AN, Ljunggren AE. The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents. Spine. 2001;26(23):2629-36. https://doi.org/10.1097/00007632-200112010-00019
  5. Alyazedi FM, Lohman EB, Wesley Swen R, et al. The inter-rater reliability of clinical tests that predict the subclassification of lumbar segmental instability: structure, functional and combined instability. J Man Manip Ther. 2015;23(4):197-204. https://doi.org/10.1179/2042618615Y.0000000002
  6. Beazell JR, Mullins M, Grindstaff TL. Lumbar instability: an evolving and challenging concept. J Man Manip Ther. 2010;18(1):9-14. https://doi.org/10.1179/106698110X12595770849443
  7. Davis AM, Bridge P, Miller J, et al. Interrater and intrarater reliability of the active hip abduction test. J Orthop Sports Phys Ther. 2011;41(12):953-60. https://doi.org/10.2519/jospt.2011.3684
  8. Hicks GE, Fritz JM, Delitto A, et al. Interrater reliability of clinical examination measures for identification of lumbar segmental instability. Arch Phys Med Rehabil. 2003;84(12):1858-64. https://doi.org/10.1016/S0003-9993(03)00365-4
  9. Rabin A, Shashua A, Pizem K, et al. The interrater reliability of physical examination tests that may predict the outcome or suggest the need for lumbar stabilization exercises. J Orthp Sports Phys Ther. 2013;43(2):83-90. https://doi.org/10.2519/jospt.2013.4310
  10. Dankaerts W, O'Sullivan P, Burnett A, et al. Altered pattern of superficial trunk muscle activation during sitting in nonspecific chronic low back pain patients. Spine. 2006;31(17):2017-23. https://doi.org/10.1097/01.brs.0000228728.11076.82
  11. Kolar P, Sulc J, Kyncl M, et al. Postural function of the diaphragm in persons with and without chronic low back pain. J Ortho Sports Phys Ther. 2012;42(4):352-62. https://doi.org/10.2519/jospt.2012.3830
  12. Roussel N, Nijs J, Truijen S, et al. Altered breathing pattern during lumbopelvic motor control tests in chronic low back pain: a case-control study. Eur Spine J. 2009;18(7):1066-73. https://doi.org/10.1007/s00586-009-1020-y
  13. Park DJ. Altered respiratory pattern of individual with LBP and effects of abdominal exhalation maneuver. Doctor's Degree. Pusan Catholic University. 2013.
  14. Hagins M, Lamberg EM. Individuals with low back pain breathe differently than healthy individuals during a lifting task. J Orthop Sports Phys Ther. 2011;41(3):141-8. https://doi.org/10.2519/jospt.2011.3437
  15. Vostatek P, Novak D, Rychnovsky T, et al. Diaphragm postural function analysis using magnetic resonance imaging. PLoS ONE. 2013;8(3):e56724. https://doi.org/10.1371/journal.pone.0056724
  16. Ki C. The effect of breathing pattern correction and strengthening exercise on trunk of lumbar instability patients. Doctor's Degree. Dong shin University. 2018.
  17. Perri MA. Rehabilitation of breathing pattern disorder. In: Liebenson C. Rehabilitation of the spine: a practitioner's manual (2nd ed). Philadelphia. Lippincott Williams & Wilkins. 2007.
  18. Park SH, Lee MM. Effects of a progressive stabilization exercise program using respiratory resistance for patients with lumbar instability: A randomized controlled trial. Med Sci Monit. 2019;25:1740-48. https://doi.org/10.12659/MSM.913036
  19. Kim DH, Kim TH. The effects of sling and resistance exercise on muscle activity and pelvic rotation angle during active straight leg raises and pain in patients with chronic low back pain. J Korean Soc Phys Med. 2018;13(4):113-21.
  20. Biely SA, Silfies SP, Smith SS, et al. Clinical observation of standing trunk movements: what do the aberrant movement pattern tell us? J Orthop Sports Phys Ther. 2014;44(4):262-72. https://doi.org/10.2519/jospt.2014.4988
  21. Seo JK, Kim SY. The relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. J Kor Soc Phys Ther. 2011;23(4):15-21.
  22. Nelson-Wong E, Flynn T, Callaghan JP. Development of active hip abduction as a screening test for identifying occupational low back pain. J Orthop Sports Phys Ther. 2009;39(9):649-57. https://doi.org/10.2519/jospt.2009.3093
  23. Evjenth O, Hamberg J. Muscle stretching in manual therapy: A clinical manual: The extremities, Vol. 1. Sweden. Alfta Rehab Forlag. 1988.
  24. Kaltenborn FM. Manual mobilization of the joint, Vol II. The Spine (5th ed). Oslo. Norl. 2009.
  25. Thue L, Baek IH, Lee KW. Medical training therapy. Seoul. Panmun Publishing Co. 2016.
  26. Hodges PW, Heinjnen I, Gandevia S. Postural activity of the diaphragm is reduced in human when respiratory demand increases. J Physiol. 2001;537(3):999-1008. https://doi.org/10.1113/jphysiol.2001.012648
  27. Ostwal PP, Wani SK. Breathing pattern in patients with low back pain. Int J Physiother Res. 2014;2(1):347-53.
  28. Hicks GE, Fritz JM, Delitto A, et al. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005;86(9):1753-62. https://doi.org/10.1016/j.apmr.2005.03.033
  29. Bogduk N. Clinical anatomy of the lumbar spine and sacrum (3rd ed). New York. Churchill Livingstone. 1997.
  30. Page P, Frank CC, Lardner R. Assessment and treatment of muscle balance: The Janda approach. Seoul. Young Moon. 2012.
  31. Yoshiiwa T, Miyazaki M, Notani N, et al. Analysis of the relationship between ligamentum flavum thickening and lumbar segmental instability, disc degeneration, and facet joint osteoarthritis in lumbar spinal stenosis. Asian spine J. 2016;10(6):1132-40. https://doi.org/10.4184/asj.2016.10.6.1132
  32. Courtney R, van Dixhoorn J, Cohen M. Evaluation of breathing pattern: comparison of a manual assessment of respiratory motion(MARM) and respiratory induction plethysmography. Appl Psychophysiol Biofeedback. 2008;33(2):91-100. https://doi.org/10.1007/s10484-008-9052-3
  33. Hebert JJ, Koppenhaver SL, Magel JS, et al. The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a crosssectional study. Arch Phys Med Rehabil. 2010;91(1):78-85. https://doi.org/10.1016/j.apmr.2009.08.146
  34. Park MC, Goo BO, Bae SS. The review of breathing pattern training for the spinal stabilization. J Kor Soc Phys. 2007;2(2):173-82.
  35. Beekmans N, Vermeersch A, Lysens R, et al. The presence of respiratory disorder in individuals with low back pain: a systematic review. Man Ther. 2016;26:77-86. https://doi.org/10.1016/j.math.2016.07.011
  36. Kim SY. Changes in cross-sectional area of lumbar muscle in patients with chronic back pain. J Kor Soc Phys Ther. 2010;22(5):39-47.

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