• 제목/요약/키워드: Chronic Low Back

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Change of Pain, Lumbar Sagittal Alignment and Multifidus after Sling Exercise Therapy for Patients with Chronic Low Back Pain

  • Park, Seung Jin;Moon, Ji Hyun;Shin, Yun A
    • The Journal of Korean Physical Therapy
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    • 제30권5호
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    • pp.173-180
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    • 2018
  • Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 - (The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine -)

  • 윤진원;최성용;이선동
    • 대한예방한의학회지
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    • 제19권1호
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

Effective Low-Level Laser Therapy Including Laser Acupuncture Treatment Conditions for Non-Specific Chronic Low Back Pain: Systematic Review and Meta-Analysis

  • Yeum, Hyewon;Hong, Yejin;Nam, Dongwoo
    • Journal of Acupuncture Research
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    • 제38권2호
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    • pp.85-95
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    • 2021
  • Low-level laser therapy including laser acupuncture has been widely used for non-specific chronic low back pain in primary Korean medical clinics. However, there is no critically appraised data regarding which treatment conditions are most effective. A systematic review and meta-analysis was conducted to determine effective treatment conditions using 12 databases (PubMed, Ovid, CENTRAL, KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS, CNKI, CiNII, and J-STAGE). There were 1,019 studies retrieved and 13 studies included in this review. It was determined that when the power output was ≥ 50 mW, the beam size was increased to ≥ cm2, the energy dose was increased to ≥ 4 J per point, the treatment interval was increased to ≥ 3 times a week, and the number of treatment sessions was increased to ≥ 10 treatments, these conditions appeared to increased treatment effectiveness.

근전도 스펙트럼 분석을 이용한 만성 요통 환자의 요부근육과 복부근육의 피로도 분석 (A Study of Muscle Fatigue in Lumbar and Abdominal Muscles in Patients with Chronic Low Back Pain by Electromyographic Power Spectral Analysis)

  • 남기석;이영희;이충휘;조상현
    • 한국전문물리치료학회지
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    • 제6권2호
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    • pp.16-31
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    • 1999
  • The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.

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만성 요통환자의 치료를 위한 치료용 볼 운동의 효과 (Effect of Therapeutic Gymnastic Ball Exercise in Patients With Chronic Low Back Pain)

  • 이은영;방요순;고자경
    • 한국전문물리치료학회지
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    • 제10권3호
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    • pp.109-126
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    • 2003
  • This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.

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장요근의 신장운동과 근력운동이 만성요통환자의 요부 정적유연성과 통증강도에 미치는 영향 (The effects of the iliopsoas muscle stretching and strengthening exercise on the static flexibility and pain intensity for the chronic low back pain patients)

  • 박관진
    • 대한물리치료과학회지
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    • 제16권1호
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    • pp.11-20
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    • 2009
  • Background: The purpose of this study was to investigate the effect of stretching and strengthening exercise on the static flexibility and pain intensity for the iliopsoas muscle, which is one of the main reasons for the chronic low back pain. Methods: The subjects of this study were 15 male adult patients with showed 6 score or higher in the visual analogue scale(VAS) and complained of low back pain over three months who visited department of the physical therapy, KIA motors Industrial Health Center, from October, 2008 through December, 2008. Fifteen subjects were trained stretching, mat exercises and sling exercises for iliopsoas muscle at 4-5 times a week for 4 weeks. I measured the changes on the extensibility of iliopsoas muscle, static flexibility of low back and VAS between pre- and post exercise treatment. Date were analyzed using the Wilcoxon's signed rank test considering the size of the samples. Results: 1. The angle of the hip joint that showed the extensibility of iliopsoas muscle was relieved, which was significant statistically (p<.05). 2. The static flexibility was statistically significantly improved in the trunk flexion test, trunk extension test and Schober-Test (p<.05). 3. The VAS showed decrease, which is significant statistically (p<.05). Conclusion: It is believed that the exercise treatment of iliopsoas muscle has the significant effects on the improvement of static flexibility and decrease of pain intensity for the chronic low back pain patients.

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만성요통 환자들에서 스트레스지각과 대응전략 간의 관계 (The Relationship between Perceived Stress and Coping Strategies in Patients with Chronic Low Back Pain)

  • 신윤식;고경봉
    • 정신신체의학
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    • 제10권1호
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    • pp.18-26
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    • 2002
  • 연구목적: 본 연구의 목적은 만성요통 환자에서 스트레스지각 및 통증지각과 대응전략 간의 관계를 알아보고자 하는데 있다. 본 연구에는 만성요통 환자 80명과 정상대조군 100명이 참여하였다. 방법: 스트레스인자 및 스트레스반응에 대한 지각은 각각 스트레스인자 지각척도 (Global Assessment of Recent Stress Scale) 및 스트레스반응 척도(Stress Response Inventory)를, 대응전략 및 통증지각은 각각 대응척도(The Way of Coping-revised) 및 통증지각척도(Pain Discomfort Scale)를 이용하여 평가하였다. 결과: 만성요통환자들이 정상대조군보다 일 및 직장, 대인관계, 대인관계의 변화, 질병 및 상해에 관련된 스트레스인자 지각점수, 전체 스트레스인자지각 정수가 각각 유의하게 더 높았다. 스트레스반응점수에서는 피로점수가 정상대조군보다 환자군에서 유의하게 더 높았으나, 통증지각에서는 양군 간에 유의한 차이를 보이지 않았다. 대응전략에서는 환자군이 정상대조군에 비해 계획적 문제해결 및 긍정적 재평가를 더 많이 사용하였다. 환자군에서 통증지각은 전체 스트레스반응 점수, 질병 및 상해에 관련한 스트레스인자지각 점수와 각각 유의한 양상관성을 보였다. 도피 회피 점수는 연령과 유의한 음상관성을, 거리감두기 및 도피-회피 점수는 유의한 양상관성을 보였다. 한편 책임수용은 여자가 남자보다 더 유의하게 많이 사용하였다. 그러나 대응전략과 스트레스인자지각 및 스트레스반응 통증지각 간에는 각각 유의한 상관성을 보이지 않았다. 결론: 이상의 결과들은 만성요통환자들이 정상인에 비해 스트레스인자에 대한 지각이 더 높으나, 더 적극적인 대응을 하고 있음을 시사한다. 또한 환자군에서 사용하는 대응전략은 스트레스인자지각, 스트레스반응, 통증지각과 연관성을 보이지 않는 반면 사회인구학적 특정들과 연광성이 높음을 시사한다.

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골반교정이 중년 여성의 만성요통과 척추골반지표에 미치는 영향 (Effect of pelvic adjustment on chronic low back pain and spino-pelvic parameters in middle-aged women)

  • 서윤교;김재희
    • 한국산학기술학회논문지
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    • 제18권9호
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    • pp.347-355
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    • 2017
  • 본 연구의 목적은 골반 교정이 중년 여성의 만성 요통과 척추 골반 지표들에 미치는 영향을 규명하는데 있다. 이를 위하여 만성 요통이 있는 중년 여성 38명을 실험군(20명)과 무처치 대조군(18명)에 무선 할당하여 실험군에게는 골반 교정을 주 4회, 8주 간 시술하였다. 시술 전과 8주 후에 요통은 시각적 상사 척도와 Oswestry 요통 장애 지수로 측정하였고, 그 외 요부 유연성, 염증인자인 혈중 C-reactive protein (CRP) 및 척추 골반 지표들을 평가하였다. 처치 8주 후 대조군에 비하여 골반 교정군에서 요통 강도, 요통 장애 지수 및 요부 유연성 모두가 유의하게 향상되었으며, 혈중 CRP의 유의한 변화는 없었다. 척추 골반 지표들을 분석한 결과 골반 교정군에서 대조군에 비해 요추전만각, 천골경사 및 골반균형지표는 유의하게 변화된 반면, 골반입사각의 변화가 뚜렷하지 않았다. 따라서 골반 교정은 요통 환자의 통증 경감과 기능 향상에 효과적일 것이며, 척추 골반 정렬의 변화의 결과일 것이다.

Pain, Depression, Body Mass Index in Conscripts with Chronic Low Back Pain in South Korea

  • Lee, Ju Hwan;Um, Ki Mai;Wang, Jung San;Lee, Sa Gyeom;Park, Joo Hyun;Koo, Ja Pung;Kim, Jung Hee;Lee, Suk Hee;Moon, Ok Kon
    • 국제물리치료학회지
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    • 제5권1호
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    • pp.661-667
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    • 2014
  • This study is a cross-sectional study for conscripts with chronic low back pain, where it is designed to investigate general characteristics that conscripts with chronic low back pain carry, and it is also aimed to analyze the correlation as well as discrepancy within pain, depression and body mass index depending on their ranks. In this study, 90 Korean conscripts with chronic low back pain participated. And in order to analyze general characteristics as well as pain, depression and body mass index of the subjects, this study adopted a survey questionnaire upon general characteristics, and it also employed Visual Analogue Scacle(VAS) and Center for Epidemiological Studies Depression(CES-D) Scale which have proven their credibility, where BMI values for the subjects were calculated based on 'Asian Pacific standard' Body Mass Index(BMI). From the general characteristics exhibited by the subjects through this study, average age and average height of the subjects were $20.78{\pm}1.41$ and $175.97{\pm}5.34$ respectively; and corporals displayed the highest ratio of 42% with the chronic low back pain while 40% of the total subjects experienced the duration of the illness less than 6 to 9 months. Moreover, 57.8% of all subjects were reportedly suffering moderate pain, and 48% exhibited depression while 49% carried BMI value between 18.5 and $22.9kg/m^2$(normal range). Based on the analysis of correlation among pain, depression, discrepancy of BMI depending on the ranks and each independent variable, it appears that there is no significant difference amongst the ranks, and there is no correlation between independent variables; however, it was obvious that all groups divided by the ranks had a moderate pain(45-74mm), depression(${\geq}16$) and BMI value in normal range(18.5-22.9).

Effect of Hamstring Eccentric Exercise on Pain and Functional Activity in Patients with Chronic Low Back Pain

  • Seong-Won Kim;Dong-Min Kum;Won-Seob Shin
    • Physical Therapy Rehabilitation Science
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    • 제13권1호
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    • pp.36-42
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    • 2024
  • Objective: The aim of this study is to investigate the effect of hamstring eccentric exercise on pain and functional activity in patients with chronic low back pain. Design: Randomized controlled trial Methods: Participants comprised 27 subjects with back pain persisting for 3 months. They were randomly assigned to the experimental group (Eccentric exercise: n=13) and the control group (Stretching: n=14). The experimental group performed gastrocnemius, iliopsoas, and quadratus lumborum stretching along with hamstring eccentric exercise, while the control group engaged in the same stretches along with hamstring stretching. The eccentric exercise for the hamstrings was Nordic curl exercise. Each group practiced for 1 hour a day, 3 times a week, for 4 weeks. Pain, disability index, balance, and hamstring length were measured. Results: Significant differences were observed in the comparison of changes in back pain, back disability index, and hamstring length before and after exercise within each group (p<0.05). The balance ability of the experimental group showed a difference before and after exercise (p<0.05), whereas no significant difference in the control group. There were no significant differences in back pain and hamstring length between the groups. Changes in back disability index and balance ability significantly increased in the experimental group compared to the control group (p<0.05). Conclusion: Hamstring eccentric exercise using Nordic curls has a positive effect on back pain, back disability index, balance ability, and hamstring length changes.