• Journal of Korean Medicine Rehabilitation
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• v.19 no.4
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2253-2260
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• 2020

Background: Patients with low back pain (LBP) experience misalignments in the center of pressure (COP) and muscle imbalances due to frequent onesided posture adjustments to avoid pain. Objectives: To identify the effects of Squat Exercises with Vertical Whole-Body Vibration on the Center of Pressure and Trunk Muscle Activity. Design: Randomized controlled trial. Methods: Thirty LBP patients with an imbalance in the COP were sampled and randomly assigned to an experimental group of 15 patients who under went an intervention involving squat exercises with vertical WBV and a control group of 15 patients who were treated via a walking intervention. As pretests before the interventions, the subjects' COP was identified by measuring their stability index (ST), and erector spinae, rectus abdominis, transverse abdominis, gluteus medius muscle activity was analyzed by determining the % reference voluntary contraction (%RVC) value using surface electromyography while sit to stand. After four weeks, a post test was conducted to remeasure the same variables using the same methods. Results: Statistically significant differences were found in the ST (P<.01) and trunk muscle (P<.05, P<.001) in the experimental group before and after the intervention. In terms of the differences between the left- and right-side (RL) muscle activity, only the transverse abdominis (TrA) and gluteus medius (GM) exhibited statistically significant increase (P<.05). A comparison of the groups showed statistically significant differences in the TrA with respect to muscle activity (P<.05) and in the RLTrA and RLGM in terms ofthe difference between left- and right-side muscle activity (P<.01). Conclusion: Squat exercises with vertical WBV produced effective changes in the COP of patients with LBP by reducing muscle imbalances through the delivery of a uniform force. In particular, strengthening the TrA and reducing an imbalance in the GM were determined to be important factors in improving the COP.

• Physical Therapy Korea
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• v.22 no.1
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• pp.37-48
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• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.9-16
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• 2010

Objectives : This study is planned to classify different biomechanics of men and women, from the comparison of normal range and hip internal rotation angle in chronic low back pain patients. Methods : We measured the hip internal rotation angle of the 30 men and 30 women patients with low back pain that has been over 3 months in BuCheon Jaseng Hospital of Oriental medicine. We set 35-45 degrees as normal range, and found the patients with exceeding normal range, the patients with normal range, and the patients with under normal range. Results : Men appeared to have less hip internal rotation angle than women. Especially, the men's left hip internal rotation angle was less than normal range. On the other hand, women's right hip internal rotation angle was often larger than normal range which was stastically significant. Conclusions : Contraction of hip external rotation muscle including gluteus maxius muscle and piriformis muscle in men, or relaxation of posterior gluteus medius, gluteus maxius and piriformis muscle with contraction of tensor fasciae latae, a part of hip internal rotation muscle, in women seems to be the basis for biomechanics of chronic low back pain.

• Safety and Health at Work
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• v.7 no.1
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• pp.49-54
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• 2016

Background: Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods: Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results: Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values ($t_{(9)}=-11.97$ to -2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion: Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.4
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• pp.203-215
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• 2008

Objectives : The purpose of this study was to investigate abdominal muscles in chronic low back pain patients by meridian-electromyograph. Methods : Sample group of 11 with from low back pain during three months and control group of 10 subjects without low back pain have been recruited. Outcomes were assessed using meridian-electromyograph, visual analogue scale, and oswestry disability index. Results : Contraction power of external oblique abdominalis in control group was significantly higher than sample group, but there was no significant difference in muscle fatigue. Conclusions : According to above results, there are correlations between abdominal muscles and low back pain.

• Journal of Korean Academy of Nursing
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• v.38 no.6
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• pp.902-913
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• 2008

Purpose: The purpose of this study was to identify effects of a strengthening program for the lower back in older women with chronic low back pain. Methods: The research design was a nonequivalent control group pretest-posttest experiment. The experimental group consisted of 16 older women and the control group, 14, all of whom had experienced low back pain for at least 3 months. The strengthening program for the lower back included lumbar stabilization exercises and education on pain management in daily living. For an 8 week period, exercises were done 3 days a week and on one day education was also given. Results: Pain and disability scores decreased significantly in the experimental group compared to the control group. Flexibility, life satisfaction and lumbar muscle strength scores increased significantly in the experimental group compared to the control group. Conclusion: Low back pain and disability can be relieved, and flexibility, muscle strength, and life satisfaction increased through a program to strengthen the lower back. It is suggested that a program to strengthen the lower back would be an effective nursing intervention for older women with low back pain.

• Physical Therapy Rehabilitation Science
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• v.2 no.1
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• pp.27-30
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• 2013

Objective: Low back pain is a primary of source of dysfunction and economic costs. Gluteus medius muscle co-activation and activity pattern change caused the low back pain. Active release technique (ART) is a patented, non-invasive, soft tissue treatment process that both locates and breaks down the scar tissue and adhesions. The purpose of this study was to assess the effects on chronic low back pain using ART on gluteus medius so that suggest usable treatment method for treating chronic low back pain. Design: One group pretest-posttest design. Methods: Twelve patients with chronic low back pain were participated in this study. Subjects in ART group were received 2 times a week for 3 weeks treatments with either ART on gluteus medius muscle trigger points. Outcome measures were conducted by pain intensity with a pain visual analogue scale and pressure pain threshold on gluteus medius. Results: Completion of the intervention, the visual analogue scale was decreased in ART group (p<0.05). Also pressure pain threshold was decreased in ART group (p<0.05). Conclusions: Our results suggest that the response to ART may be usable to treat low back pain. ART was presented to reduce pain level of low back in people with chronic low back pain. Further study is required to management for low back pain due to gluteus medius and more ART study.

• Korean Journal of Applied Biomechanics
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• v.15 no.2
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• pp.139-146
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• 2005

We selected six kinds of stretching exercises that can be easily acquired and put to practical use by back pain patients and arranged the practicing order of the exercising method after measuring the % MlVC of the muscle power when a normal person was exercising with a surface EMG. Among the patients complaining of back pain, 20 case groups were given the selected exercise and physical therapy, and 20 control groups were only given a physical therapy. Before and 2 weeks, 4weeks, 6 weeks and 8 weeks after the exercise therapy, a muscle power was measured with a fitness machine and the effectiveness of the exercise was compared. After six weeks difference of the muscle power between the case group and control group was shown, and after 8weeks the case group manifested the stronger muscle power than that of the control group in both male and female. Exercising therapy clearly seems to be helpful in strengthening the muscle power of the back pain patients.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.2
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• pp.127-133
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• 2008

Purpose : The purpose of this study was carried out to review the correlation between foot shape(supination foot, pronation foot) and low back pain, hip abduction muscle and ankle lateral sprain. Methods : By using internet, we research the PubMed, Science Direct, KISS, DBpia We selected the article between 1990 and 2007. Key words were supination foot, pronation foot, balance. Results : Normal control balance of human body needs a optimal anatomical alignment and function of musculoskeletal and central nerve system that control continuously to integrate. Especially ankle and foot complex play an important role in postural control because it is located distal part in human body. Supination foot brings to chronic ankle sprain or chronic ankle instability and range of motion limitation due to the weakness of lateral ankle muscle. Pronation foot brings to knee injury because of lower leg internal rotation force. Conclusion : Excessive supination and pronation foot happen to muscle imbalance. Especially weakness of hip abduction or injury of ankle lateral muscle or low back pain are due to abnormal balance and anatomical alignment.