Main cause of low back pain is a poor posture. Most low back pains are due to a poor posture. The poor posture induces muscle tension and finaliy low back pain. The poor posture arehabitually trained from the childhood by the environmetal factors. In general, maintaining good posture during working and sleeping hours are the first line of defence against back pam. (1) Supine posture is the easiest posture that relaxes and fixes muscles. Supine posture is thus a starting position for on exercise. Lying down releases the weight pressures of head and shoulder and thus body can be relaxed and extended which are helpful for treating back pain. However, supine posture can increase the pressure in ribcage posture aspect and disphragram due to visceral oragans. (2) Sitting in one position for a long time results in fatigue and relaxation of spinal muscies. Finally, body strength is weakened and sitting posture will become poor. If this poor posture continues for a longer time, pain will be accompanied due to overelongation of muscle ligaments. The habitual poor posture could induce intervertebral disc distortion. If the intervertebral disc is damaged, sitting in one position or movement causes pain. (3) Abnormal lumbar curve induces the tention of abdominal muscle and paravertebral muscle groups as well as tention of lower limb muscle group connected to pelvis. For a person with weak body strength, muscle relaxation increases curvature in lumbar, chest and cervical regions. This will induce a pelvic anterior tilting of the imaginary line between A. S. I. S. and P. S. I. S. Hip joint extensor muscle acts on releasing the pelvic anterior tilting. Contrections of hamstring muscle and femoral muscle recover the imaginary line between A.S.LS. and P.S.I.S. from pelvic anterior tilting. thus, contraction of rectus abdominis muscle are required to maintain the normal lumbar curve.
The concept of segmental stabilization has been one of the most exciting advancements in the field of physical therapy. Specific deep stabilizing muscle have proven to reverse motor control deficits that occurs after back injury. After an injury, a new motor programming strategy is adopted and there is excessive recruitment of the large , strong , global muscular system works instead of small segmental deep muscle recruitment for stability. Many physical therapists and doctors mistakenly prescribe therapeutic exercise for low back pain to use larger, superficial musculature to strengthen the spine for stability and pain control. But motor control coordination of local segmental muscle is actually the key to stability and pain control, not strengthening of global muscle. A recent focus in physiotherapy management of patients with chronic back pain has been the specific training of muscles surrounding the lumbar spine whose primary role is considered to be the provision of dynamic stability and segmental control to the spine. These are the deep transverse abdominis muscle and lumbar multifudus.
The purpose of this study was to examine the effect of low back pain relieving program on back muscle strength, intensity of pain, low back disability level in elementary school teachers who have low back pain. subjects were elementary school women teachers who worked at eight elementary school located in Seoul. Intended subjects size were seventy consist of thirty-four experimental group(three schools) and thirty-six control group(five schools), but actual subjects size was forty-four. Among the forty-four patients subjects, twenty-three were experimental group receiving health education about right postures, etiologies of low back pain, diagnosis of low back pain and exercise program composed of muscle strengthening exercise, stretching exercises and twenty-one were control group. During the 8 weeks program, the subjects were received two times education and six times group exercise practices in 1st week and three times per week group exercise practices, two times education in other 7 weeks. This study as carried out from April 1, 1999 to June 30, 1999. Back muscle strength was measured by back muscle strength measuring machine and the intensity of pain were measured by the Visual Analogue Scale(VAS), and level of disability was measured by Oswestry low back pain disability scale. Study measurements were taken before and after 8 week exercise program. Data were analyzed using paired t-test, and ANCOVA. The results were summarized as follows. 1. After low back relieving program, back muscle strength was increased significantly(p=0.000) and there was significant difference in back muscle strength change between experimental group and control group(p=0.002). 2. After low back pain relieving program, pain on anterior bending, pain on posterior bending were decreased significantly than measurements before the program(p=0.000 p=0.000) and there was significant difference in pain on anterior bending and posterior bending change between experimental group and control group(p=0.000, p=0.000). 3. After low back pain relieving program, Oswestry disability scale scores were decreased significantly(p=0.000, p=0.000) but there was no significant difference in Oswestry disability score change between experimental group and control group.
Purpose: This study aimed to investigate the effects of the crocodile breathing exercise on the muscle activity of the erector spinae muscle in patients with low back pain. Methods: The study subjects included 36 patients with low back pain. The patients were divided equally into the experimental group (EG) and the control group (CG). The EG performed the crocodile breathing exercise, and the CG performed a chest expansion breathing exercise. The intervention was conducted for 10 minutes each day for a total of eight weeks. Measurements of muscle activity were conducted using an MP150 system. An electrode was attached 2 cm to the side of the spinous process at the L4-L5 level. The muscle activity value used was %MVIC, and the statistical significance was 0.05. The paired t-test was the statistical method used to determine the pre- and post-average value of each breathing exercise, while the independent t-test was used to assess the delta value of muscle activity in the pre-post test. Results: Inspiration muscle activity showed a significant increase in both the EG and the CG, while expiration muscle activity decreased significantly in both groups. The delta value of muscle activity showed a significant difference in inspiration (p<0.05), but for expiration, there was no significant difference in muscle activity (p>0.05). Conclusion: This study suggests that crocodile breathing is a good method for improving muscle activity in patients with low back pain.
Purpose: The purpose of the present study was to examine joint position senses and muscle activity in subjects with and without chronic low back pain and to determine the effects of different types of bridge exercises on their trunk muscle activity. Methods: Thrity-eight subjects with chronic low back pain and thrity healthy controls participated in the experiment. Joint position senses and trunk muscle activity levels were measured during the different bridge exercise methods. Results: The joint position senses of the healthy group and chronic low back pain group showed significant differences during lumbar flexion, lumbar extension, lumbar lateral flexion, and lumbar rotation. The muscle activity levels of the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) were highest in the prone bridge exercise (PBE) group, followed by the supine bridge swiss ball exercise (SBSE) group and supine bridge exercise (SBE) group in order of precedence. The muscle activity level of the erector spinae (ES) was highest in the SBSE group, followed by the SBE and PBE groups in order of precedence. Conclusion: Overall, the results suggest that chronic low back pain is associated with declines in joint position senses and that PBEs increase trunk muscle activity more than conventional bridge exercises.
Purpose : This study was to investigate effects of pilates and taping on flexibility and muscular strength of low back. Methods : A total of 29 healthy over 20 years old college students(men = 6, women = 23) who were participated in this. We selected randomly for lo people of pilates, taping, and 9 people of control group. For the past six weeks, pilates worked out twice aweek for 40 minuates and taping stuck once a week for 24 hours and then we compared before and after muscle strength and flexibility of low back. Results : 1. The sesult compared of flexibility of low back have found no significant diffrences between pilates and taping groups.(P>.05) 2. The result compared of experimental groups have found significant diffrences between before and after flexibility of low back.(P<.05) 3. The result compared of muscle strength of low back have found no significant diffrences between pilates and taping groups.(P>.05) 4. The result compared of experimental groups have found significant diffrences between before and after muscle strength of low back.(P<.05) Conclusion : In conclusion there were not differences between pilates and taping on muscle strength and flexibility of low back. Those were increased in comparison with control group.
PURPOSE: Postural and structural asymmetry due to muscle imbalances around the lower back and pelvis are the causes of back pain. Muscle imbalances in patients with chronic low back pain affect the pelvic tilt and movement, and it is necessary to assess the pelvic movement ability using the appropriate tools to determine the mediating effects of lower back pain. This paper reports the reliability and validity of the Sensbalance Therapy Cushion (STC) for pelvic movement and proprioception. METHODS: In this study, the Wii balance board (WBB) was used as a golden standard for pelvic movement measurements. FABQ, KODI, Myovision, and Pelvic movement were measured in 50 patients with chronic low back pain. The correlation between the lower-back muscle activity and pelvic movement was checked. The pelvic movement parameter was measured twice to determine the intra-rater reliability. RESULTS: The STC showed high test-retest reliability in the pelvic tilt measurements (ICC = .672 - .809). The test-retest reliability of proprioception measurements (ICC = .588 - .859) and reaction time measurements (ICC = .542 - .836) were also high. The relationship between the WBB and STC showed a significant positive correlation with the pelvic tilt test (p < .01). The posterior pelvic tilt and lower-back muscle activity showed a significant negative correlation (p < .01). The pelvic left tilt and lower-back muscle activity showed a significant negative correlation (p < .05). CONCLUSION: The results revealed the high reliability and validity of the STC. Therefore, the STC can be used as an objective measuring device for evaluating pelvic tilt, proprioception, and reaction time in low back pain patients.
Purpose: The purpose of this study was to determine the effects of a modified abdominal draw-in maneuver on trunk stability and functional capacity as well as pain in patients with chronic low back pain. Methods: The study included 3 patients with chronic low back pain who volunteered to participate. The modified abdominal draw-in maneuver included a posterior pelvic tilt, a traditional abdominal draw-in maneuver, and a vibration sensory feedback device. Voluntary abdominal contraction using the vibration sensory feedback device was performed by the subjects for more than 1 hour per day, 5 times per week, for 6 weeks along with common low back pain treatment. Electromyographic signals in the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were measured to compare muscle activation. The degree of pain was measured using the visual analogue scale (VAS), and functional capacity was measured using the Korea Oswestry Disability Index (K-ODI). All results were compared to the means before and after intervention. Results: After the intervention, the RA, EO, and IO showed increased muscle activation and the ES showed decreased muscle activation. The visual analogue scale decreased after intervention and the K-ODI decreased after intervention. Conclusion: Modified abdominal draw-in maneuvers in daily life combined with therapeutic exercises may be effective in relieving pain and dysfunctions in chronic low back pain patients.
PURPOSE: This study examined the effect of training using video content on abdominal muscle thickness, Oswestry disability index (ODI), and pain in college students with chronic back pain. METHODS: Twenty-nine college students with chronic back pain participated in this study. The subjects were assigned randomly to 15 experimental groups who trained using video content and 14 control groups who exercised voluntarily using back exercise leaflets. The video used for the intervention was obtained from YouTube, and the difficulty level of the video was classified into six levels. Both groups participated in the intervention for 40 minutes/day, three times a week for six weeks, and the variables of abdominal muscle thickness, ODI, and pain were compared before and after the intervention. RESULTS: In the experimental group, there were statistically significant changes in the thickness of the internal oblique and transverse abdominis muscles, ODI, and pain after the intervention, except for the external oblique muscle (p < .05). In the control group, there was no statistically significant difference in all variables after the intervention (p > .05). A statistically significant difference in all variables was observed between the experimental group and the control group after the intervention except for the external oblique muscle (p < .05). CONCLUSION: Treatment of chronic low back pain using video content is a possible alternative treatment if quality images are selected and the difficulty levels are adjusted.
Purpose : This study determines the effect and sustainability of the trunk stability exercise program, specifically using the bridge exercise, by measuring Visual Analogue Scale(VAS), Menstrual Distress Questionaire(MDQ) and muscle strength in women university students complaining of low back pain. Methods : The trunk stability exercise program was progressed by 22 women university students, for 4 weeks, (3 times a week, 1 hour per session). At this time, low back pain happened at the period of menstruation and was measured using VAS, Dysmenorrhea using the MDQ tool and abdominal and back muscle strength using HUR. This study was evaluated 4 times (before and after the exercise program, after 4 weeks and 8 weeks) to investigate the effect of time variation after the exercise program. Results : The trends showed a decrease in VAS and MDQ and an increase in abdominal and back muscle strength. Therefore, these results were evaluated positively from a statistical perspective(p<.05). Conclusions : The trunk stability exercise results in a decreased VAS and MDQ, and increases the muscle strength in women university students who complained of low back pain form dysmenorrhea. Therefore, the low back pain from dysmenorrhea could have been avoided and quality of everyday life improved.
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