• Title/Summary/Keyword: Chronic Low Back

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The Effect of Proprioceptive Neuromuscular Facilitation Respiratory Muscle Strengthening Exercise on Pulmonary Function and Disability Level in Chronic Low Back Pain Patients (고유수용성신경근촉진법 호흡근 강화 운동이 만성 허리통증 환자의 폐 기능과 장애 수준에 미치는 영향)

  • Kim, Hye-Mi;Kang, Tae-Woo;Kim, Beom-Ryong
    • PNF and Movement
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    • v.19 no.1
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    • pp.57-65
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    • 2021
  • Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) respiratory muscle strengthening exercise on the pulmonary function, back pain, and disability level of patients with chronic low back pain (CLBP). Methods: There were 24 CLBP patients randomly divided into the experimental group (n = 12) who took part in PNF respiratory muscle strengthening exercise and the control group (n = 12) who performed a mock treatment. Both groups performed their respective interventions for 15 min five times per week for four weeks. The pulmonary function was measured using a portable spirometer. The back pain of the participants was assessed using a visual analogue scale. The Oswestry disability index was conducted to measure disability level. A paired t-test was performed to compare within-group changes before and after the PNF respiratory muscle strengthening exercise. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: The within-group change in pulmonary function was significantly different in the experimental group (p < 0.05), and the levels of back pain and disability were significantly different between the groups (p < 0.05). There was also a significant between-group difference in pulmonary function, back pain, and disability level after intervention (p < 0.05). Conclusion: These results suggest that PNF respiratory muscle strengthening exercise enhances pulmonary function and reduces levels of back pain and disability in patients with CLBP.

Epidural Steroid Therapy as a Treatment of Post-laminectomy Low Back Pain (추궁 절제술 후의 요하지통에 대한 경막외 Steroid 주입요법)

  • Choe, Huhn;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.162-167
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    • 1991
  • Epidural steroid therapy has been well-established for the treatment of sciatica and low back pain. Disappointing results following surgical decompression or discectomy pain owing for to nerve root compression have led to trials of corticosteroids injected either systemically or into the intrathecal or epidural space to treat intervertebral disc. Epidural steroid is less effective in the patients with low back pain who have a history of surgical operation, so that the use of epidural morphine and methylprednisolone has been advocated for the amelioration of chronic low back pain in the post-laminectomy pain("failed back") syndrome over the past several years. We treated 47 patients with low back pain who had a history of one or two surgical procedures. We concluded that epidural steroid therapy is less effective in the patients with "failed back" syndrome than in the virgin back furthermore, there is a greater risk of complication such as inadvertent dural puncture and corresponding motor paralysis and headache.

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Study on Pelvic Parameters and Biomechanical Characteristics of Foot in Patients with Chronic Low Back Pain (만성 요통 환자의 골반지표와 발의 생체역학적 특징 연구)

  • Kong, Jae-Cheol;Moon, Soo-Jeong;Jo, Dong-Chan;Ko, Youn-Suk;Song, Yung-Sun;Lee, Jung-Han
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.1
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    • pp.81-87
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    • 2012
  • The structural and biomechanical characteristics of pelvic and foot are important factors of back pain, but it is still complicated to clearly explain the relationship among them. The purpose of this study was to find out the characteristic of pelvic parameters and biomechanics of foot in patients with low back pain. Thirty-three female subjects with chronic low back pain were enrolled and ODI and VAS score were measured for back pain index. All subjects were taken the X-ray examination for major pelvic parameters and foot scan analysis for foot pressure, gait angle, fore-foot/rear-foot peak pressure ratio and asymmetric index. Statistical analysis were performed to examine the inter-relation between the measurement. As a result, it was shown the positive interrelation between back pain and F/R ratio, but others were not shown the relationship related to low back pain. And there were correlations between the lumbo-pelvic structure and biomechanics of foot in some aspects, but the causal relationship between them are still indefinable. In order to get more information about structures and biomechanics related to low back pain, subsequent researches are needed.

Regression Analysis of the Relationship Among the Level of Pain and Dysfunction and Psychosocial Factors in Patients With Chronic Back Pain (회귀분석을 이용한 만성요통환자의 통증 및 기능장애수준과 심리사회학적 요인의 상관성 연구)

  • Choi, Im-soon;Jang, Hyun-jeong;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.23 no.1
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    • pp.38-45
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    • 2016
  • Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

Effect of the Electro-acupuncture Stimulation into the Multifidus on Subjective Pain and Lumbar Flexibility in Patients with Chronic Low Back Pain (만성요통 환자의 다열근에 적용한 전침이 통증 및 유연성에 미치는 효과)

  • Jang, Won-Seok;Park, Hung-Ki;Kim, Keun-Joo
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.3
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    • pp.185-192
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    • 2008
  • Purpose : The purpose of this study is to examine the effect of the electro-acupuncture stimulation into the multifidus for the lumbar flexibility improvement and pain reduction. The subjects were consisted of 20 women patients with chronic low back pain. Methods : 20 women patients with chronic low back pain voluntary participated for the research. 15 minute electro-acupuncture stimulation(frequency: 4Hz, Intensity: below threshold of pain) with Infra-red therapy, 3 times a week during 6 weeks period. Acupuncture application given to the patients' trigger point of the multifidus. The Application of multifidus was L3, L4, L5 spinal vertebra levels Short form McGill pain questionnaire (SFMPQ) was used to measure patient's pain level. Lumbar flexibility measurement was trunk flexion and trunk extension. Global Perceived Effect Scale(GPES) was used to measure recovery or worse of patient's condition. Results : SFMPQ was after treatment showed significantly decreased more than before stimulation treatment (P<.05). Lumbar flexibility was after treatment showed significantly increase more than before treatment(P<.05). GPES was after treatment showed significantly increased more than before treatment(p<.05). Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. So chronic LBP patients necessary multifidus muscle release treatment.

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Comparison of the effects of joint mobilization, gym ball exercises, and breathing exercises on breathing pattern disorders and joint position sense in persons with chronic low back pain

  • Lim, Chae-Gil
    • Physical Therapy Rehabilitation Science
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    • v.9 no.1
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    • pp.25-35
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    • 2020
  • Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on breathing pattern disorders and joint position sense in persons with chronic lower back pain. Design: Three-group pretest-posttest design. Methods: Thirty-six individuals with chronic low back pain who were undergoing a postural correction and vertebral movement at a rehabilitation center participated in this study. The subjects were randomly divided into the joint mobilization group (n=12), gym ball exercises group (n=12), and the breathing exercises group (n=12). The exercises were applied for 40 minutes a day, twice a week for a total of 12 weeks. Measurement tools included the end-tidal CO2 (ETCO2), respiration rate (RR), breath hold time, Nijmegen Questionnaire (NQ), excursion, and joint position error (JPE). Results: The groups showed significant differences in the ETCO2, RR, NQ, Excursion and JPE test before and after the intervention (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in ETCO2 and RR (p<0.05). The differences between the groups were most significant in the group that received breathing exercises in NQ and excursion (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in JPE Lt. and Rt. (p<0.05). Conclusions: All three interventions had a significant impact on the biomechanical changes, respiratory variables, and joint position sense in participants with chronic lower back pain. Breathing exercises were found to be particularly effective in improving respiratory parameters.

Effects of the Gluteus Muscle Exercise combined with the Lumbar Stabilization Exercise on Pain, ODI, and Postpartum Depression in Women with Chronic Back Pain After C-section Delivery (허리 안정화 운동과 병행한 엉덩근육 강화 운동이 제왕절개 분만 후 만성허리통증을 가진 여성의 통증, 기능장애지수, 산후우울증에 미치는 영향)

  • Min-Ji Son;Myoung-Ho Lee;Myoung-Kwon Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.29 no.3
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    • pp.31-42
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    • 2023
  • Background: This study aimed to investigate the effects of combining the lumbar stabilization exercise with the gluteal muscle strength exercise on pain, the dysfunction index, and postnatal depression in women experiencing chronic low back pain after a cesarean section. Methods: The study used a randomized design with two groups: one group (n=15) performed the lumbar stabilization exercise along with the gluteal muscle strength exercise, while the other group (n=15) only did the lumbar stabilization exercise. The intervention consisted of 30 minute exercise sessions, twice a week, for 6 weeks. The pain was assessed using the visual analog scale (VAS), the dysfunction index with the Oswestry disability index (ODI), and postnatal depression using the edinburgh postnatal depression scale-Korean version (EPDS-K). Results: Both groups showed significant improvements in their VAS, ODI, and EPDS-K scores within their respective groups (p<.05). Additionally, the between-group analysis revealed significant differences in post-test results (p<.05). Conclusion: The combination of the lumbar stabilization exercise and the gluteal muscle strength exercise proved to be more effective in reducing pain, improving the dysfunction index, and alleviating postnatal depression in women with chronic low back pain after a cesarean section. Therefore, incorporating these exercises could be beneficial as an intervention program for women experiencing chronic low back pain after a cesarean section.

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Comparison of the Effects of Abdominal Draw-In and Expansion Maneuvers on Trunk Stabilization in Patients With Low Back Pain and Lumbar Spine Instability (요추부 불안정성을 가진 요통환자의 복부 드로우-인 기법과 복부 확장 기법을 이용한 체간안정화운동의 효과 비교)

  • Lee, Ho-Jun;Kim, Suhn-Yeop
    • 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.

A Retrospective Study: Influence of Beck Depression Inventory Score to a Patient under the Early Stages of Oriental Medical Treatment for Low Back Pain (Beck 우울 척도 점수가 요통 환자의 한방 치료 초기에 미치는 영향에 대한 후향적 연구)

  • Hong, Nam-Jung;Lee, Je-Kyun;Lee, Tae-Gyu;Park, Jong-Hoon
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.4
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    • pp.41-50
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    • 2011
  • Objectives : The purpose of this study is to know that Beck Depression Inventory(BDI) score to effect on improvement degree of low back pain after oriental medical treatment. Methods : We analyzed charts of 33 inpatients who were treated in Ja-Seng Hospital of Oriental Medicine and Bu-Cheon Ja-seng Hospital of Oriental Medicine. Subject is divided into Group A(BDI<10) and Group B(BDI${\geqq}$10). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were checked on admission, after 1 week, NRS and ODI were rechecked to estimate the efficacy of treatments. Results : 1. In both groups, NRS was significantly decreased(p<0.05). Analyzed result of the interaction between the two groups didn't show significant difference(p=0.197). 2. In Group A, ODI was significantly decresed(p<0.05). In Group B, ODI wasn't significantly decreased(p=0.058). The interaction analysis between the two groups didn't show significant difference(p=0.173). 3. Analyzing patients with chronic back pain longer than 6 months by the presence of depression tendency and NRS, ODI decrease after 1 week of ambulation, while the NRS reduction showed relevancy by the depression tendency (p<0.05), the ODI reduction didn't(p=0.272). Conclusions : 1. Although improvement of pain before and after the treatment and degree of functional recovery in high-level BDI group was less than low-level BDI group, but it was stastically insignificant. 2. High BDI score of patients with chronic low back pain is the factor of disturbing pain improvement.

Use of the Complementary and Alternative Therapies, Pain and Quality of Life in Patients with Chronic Back Pain (만성 요통환자가 이용하는 대체요법과 통증, 삶의 질에 대한 연구)

  • Ha, Sung-Wha;Suh, Yeon-Ok
    • The Korean Journal of Rehabilitation Nursing
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    • v.11 no.1
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    • pp.5-12
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    • 2008
  • Purpose: The purpose of this study was to identify the uses of complementary and alternative therapies(CAT), pain, and quality of life(QOL) in patients with chronic back pain. Method: A descriptive survey was conducted using convenient sample. One hundred sixty two patients with chronic back pain participated in this study. Types and satisfaction of CAT, pattern of back pain, and QOL were investigated. Result: 83.3% of all participants reported in the use of CAT. The most common types of CAT used were acupuncture and half-bath. Yoga were the most high satisfaction among the types. The mean score of back pain was 4.12, QOL was 3.10, that was mostly low score. There was no significant difference back pain and QOL between CAT user and nonuser. Correlation with satisfaction of CAT according the most using types were a negative correlation with back pain and a positive correlation with QOL. Conclusion: These result indicate that the mostly patients with back pain feels the satisfaction of CAT use. It is important that provide the obvious information about CAT which can be helpful to patient.

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