• 대한물리치료과학회지
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• 제9권2호
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• pp.27-36
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• 2002

The purpose of this study was to examine the effects of graded low back exercise program with patient education about low back pain care on abdominal strength, endurance and flexibility of waist of chronic low back pain patents. For this study 13 patients aged 40 to 60 were selected as subjects, who suffered from low back pain and got diagnosed by physician. The exercise program and the education were executed for total 6 weeks, posture education were executed with physical exercises over first 1 to 4 weeks period and over 5 to 6 weeks the exercises were executed. The effect of the exercises and the education were evaluated through weights, WHR, fat(%), flexibility by sit-and-reach and trunk extension test, strength by sit-up test and back sit-up test. Weights were, decreased after physical exercise and education, but there was no statistical significance. Wasit hip ratio(WHR) and fat(%) were decreased after physical exercise and education, but there were no statistical significances. Sit-and-reach was significantly increased from $13.68{\pm}5.59cm$ to $19.45{\pm}3.81cm$ after education and physical exercise(P<0.05). Trunk extension was significantly increased from $30.31{\pm}11.34cm$ to $40.88{\pm}6.16cm$ after education and physical exercise(P<0.05). Sit-up and Back sit-up were increased after physical exercise and education, but there were no statistical significances. These results suggest that graded low back exercise program with patient education about low back pain care increase the abdominal strength, endurance and the flexibility of waist in low back pain patients.

• Journal of Korean Neurosurgical Society
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• 제56권6호
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• pp.482-487
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• 2014

Objective : We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods : A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results : The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion : In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health.

• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.51-57
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• 2017

Background: The purpose of this study is to examine the effects of manual therapy and therapeutic exercise on pain and body function in elder women with chronic low back pain. Methods: The patients with chronic low back pain were randomly divided 2 group. The experiment group (n=11) was taken manual therapy and therapeutic exercise program. The control group (n=10) was taken physical therapy program(hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Both groups intervention performed 3 session during 6 weeks. We measured the quadruple visual analogue scale, flexibility, static balance, leg strength subject of symptom before and after experiment. The significant test pared t-test according to applying the manual therapy and therapeutic exercise group and control group between group used independent t-test. Results: Pain assessment in the experimental group was significantly different between time and group. Flexibility test groups were not significantly different between time and group. The static balance was not significantly different for the time. Strength tests were also not significantly different for the time. Conclusions: According to the results, manual therapy and therapeutic exercise group it was found to be helpful in pain, flexibility, static balance, not strength in elderly patients with chronic low back pain.

• 대한통합의학회지
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• 제7권4호
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• pp.161-170
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• 2019

Purpose : This study aimed to investigate the effects of a thoracic flexibility exercise program on pain, heart rate variability (HRV), and depression in patients with chronic low back pain. Methods : Fifty patients with chronic low back pain participated in this study. Each participant performed a pre-test and post-test. The outcome measures evaluated were a visual analog scale, HRV test results (automatic activity, standard deviation normal to normal [SDNN], low frequency [LF], high frequency [HF], and LF/HF ratio), and the Beck Depression Inventory. Patients underwent conventional physiotherapy for 35 minutes per session. In addition, a thoracic flexibility exercise program (trunk rotation exercise, McKenzie exercise, and supine thoracic extension exercise) were performed 3 times per week for 4 weeks. Results : After the training period, the visual analog scale results showed a significant decrease in the post-test compared to the pre-test. Automatic activity, SDNN, LF, HF, and LF/HF ratio significantly increased in the post-test compared to the pre-test. The Beck depression inventory results significantly decreased in the post-test compared to the pre-test. Conclusion : This study demonstrated that a thoracic flexibility exercise program improves a visual analog scale, HRV (automatic activity, SDNN, LF, HF, and LF/HF ratio), and the Beck Depression Inventory in patients with chronic low back pain.

• 국제물리치료학회지
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• 제12권2호
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• pp.2314-2322
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• 2021

Background: Back pain is associated with a high risk of recurrence. Various physical therapy techniques for back pain have been studied, including reprogramming the central nervous system by integrating sensation and motion with sensory exercise training. Objectives: To aimed verify the effectiveness of sensorimotor training in improving postural stability and pain levels. Design: A randomized controlled trial. Methods: The study population was randomized into a sensory exercise training group and trunk stabilization training group and treated three times a week for 4 weeks. Each group took part in sensorimotor training for 15 minutes or lumbar stabilization exercise for 15 minutes. Results: After the intervention both groups showed Improvements in the variables. There was a significant difference in the dynamic postural stability, limit of stability, and modified visual analog scale scores in the sensorimotor training group compared to the lumbar stabilization exercise group (P<.05). Conclusion: Sensorimotor training appears to be an effective physical therapy exercise program that can be applied in patients with low back pain to improve muscle control ability.

• 대한물리의학회지
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• 제7권1호
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• pp.1-9
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• 2012

Purpose : This study aimed to compare the effect of two modes (proprioceptive neuromuscular facilitation combination patterns and ball exercise) of low back stability for chronic low back patients. Methods : The subjects were recruited fourty patients who had low back pain. All subjects were randomly assigned to PNF combination patterns group, ball exercise group. Measurements were performed fourtimes: pre test, 2weeks, 4weeks, and 6weeks. Main outcome measures comprised the visual analogue scale(VAS), balance performance monitor(BPM). Results : The results were as follows. In the comparison of VAS score, sway area, sway path, and sway velocity according treatment period, score was significantly reduced in both PNF combination pattern group and ball exercise group. In the comparison of the both VAS and sway area between groups, there were significant. PNF combination pattern group significantly more decrease than ball exercise group at 6 weeks. However, both sway path and sway max velocity between group, there were not significantly. Conclusion : These results of this study indicated that PNF combination pattern which performed for six weeks had a significant influence than ball exercise group on low back pain.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.1-2
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• 2010

Chronic non-specific low back pain (CLBP) is one of the major health problems casting substantial amount of economic expenses and negative impact on quality of life onto an individual as well as society. On contrary to public familiarity, the ways of management of CLBP are diverse and there is yet no general consensus about which approach is better than others or to whom the specific management should be applied. Some hold the negative point of view on the efficacy of the invasive maneuver such as epidural injection because there is no controlled clinical trial (RCT) yielding better long term outcome of those invasive managements over conservative ones. But the experts of interventional or surgical treatment stress the methodological difficulty in performing RCT and assert that those invasive treatments can bring the prompt and complete resolution of low back pain and restoration of function in appropriately selected cases. These seemingly opposite views on the invasive management on CLBP are rather complimentary each other than to be contradictory.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.3-6
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• 2010

The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

• The Korean Journal of Pain
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• 제31권1호
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• pp.27-38
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• 2018

Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

• 한국전문물리치료학회지
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• 제22권3호
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• pp.1-11
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• 2015

The purpose of this study was to investigate the effect of lumbar stabilization training and additional thoracic mobilization on pain, proprioception and static balance in patients with chronic low back pain. The subjects of this study were 48 chronic low back pain patients who were randomly allocated to an experimental group 1 ($n_1=16$, lumbar stabilization and thoracic mobilization, thoracic hypomobility), experimental group 2 ($n_2=16$, lumbar stabilization and thoracic mobilization, thoracic normal mobility), and a control group ($n_3=16$, lumbar stabilization, thoracic hypomobility) after a thoracic mobility test. Both experimental groups underwent lumbar stabilization training and additional thoracic mobilization. The control group underwent only lumbar stabilization training. The intervention was performed 3 times per week, 30 minutes each time, for a total of 6 weeks. Thoraco-lumbar joint reposition error was measured using an electrogoniometer and static balance ability was measured using the Tetrax posture analysis system. Subjects' pain level was measured using a 100 mm visual analogue scale. Statistical analyses were performed using a one-way analysis of variance and a paired t-test. Post-hoc testing was carried out with a Bonferroni test. The pain level was significantly lower in both experimental groups compared to the control group. Both experimental groups showed significant reductions in joint reposition error angle (flexion, extension, and side bending) compared to the control group. The static balance level was significantly lower in both experimental groups than in the control group. In summary, lumbar stabilization exercises and additional thoracic mobilization significantly improved the pain level, proprioception, and static balance in patients with chronic low back pain.