• Journal of the Korean Society of Physical Medicine
• /
• v.15 no.2
• /
• pp.109-120
• /
• 2020

PURPOSE: This study was conducted to verify the effects of a functional correction of the pain of patients with chronic low back pain(CLBP), and to examine the effect of dysfunctional factors on health-related quality of life. METHODS: A preliminary survey was first conducted on 90 patients with CLBP after functional orthodontic treatment. Some revised questionnaires were also prepared. The survey was distributed for approximately eight weeks, and 215 copies were used as the final analysis data, except for questionnaires that were inadequate, error or non-response. RESULTS: Path analysis using the structural equation model of CLBP patients showed a positive correlation between all the path coefficients and the potential factors. The multidimensional relationship between pain and dysfunction after orthognathic treatment was confirmed using three subdivisions of the pain variables as independent variables and the dysfunctional variables as the dependent variables. Multiple regression analysis was performed to examine the effects of pain on the dysfunction. To identify the multidimensional relationship between dysfunction and the health-related quality of life, eight sub-factors of dysfunctional variables were set as the independent variables, and multiple regression was analyses were performed with the dependent variables of the health-related quality of life. CONCLUSION: This study examined the structural and influence relationships of the functional correction with pain, dysfunction, and health-related quality of life. The results, suggest that a functional orthodontic treatment can be used as a positive program for the health-related quality of life. In addition, this study is meaningful in that it provieds useful information for intervention such as psychosocial change of patients.

• The Journal of Korean Physical Therapy
• /
• v.26 no.2
• /
• pp.110-116
• /
• 2014

Purpose: The purpose of study was to investigate the effects of combination patterns exercise of Proprioceptive Neuromuscular Facilitation (PNF) on unstable surfaces on pain, functional disability, and fear avoidance belief in patients with chronic low back pain. Methods: Twenty four patients were assigned to either the experimental group (n=12) or the control group (n=12). Patients in the experimental group performed combination patterns exercise of PNF on unstable surfaces. Patients in the control group performed combination patterns exercise of PNF on stable surfaces. Both exercises were performed for five days per week, for a period of six weeks. Pain was measured by the Visual Analogue Scale (VAS) and University of Alabama at Birmingham (UAB). Functional disability was measured using the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ). Fear avoidance belief was measured using the Fear Avoidance Beliefs Questionnaire (FABQ). A paired t-test was used for determination of differences before and after treatment, and an independent t-test was used for determination of differences between treatment groups. Results: In within group comparison, the experimental group showed statistically significant difference for all variables (p<0.05). In comparison between two groups, the experimental group showed relatively greater significant difference for all variables (p<0.05). Conclusion: Based on such results, it can be said that combination patterns exercise of PNF on unstable surfaces has an effect on pain, functional disability, and fear avoidance belief in patients with chronic low back pain.

• Physical Therapy Korea
• /
• v.25 no.4
• /
• pp.37-45
• /
• 2018

Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.

• The Journal of Korean Physical Therapy
• /
• v.23 no.4
• /
• pp.15-22
• /
• 2011

Purpose: The purpose of this study was to investigate the relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. Methods: Fifty-two female patients were recruited for this study. The patients' history was recorded and was used to determine the general characteristics of the female complaints. The women were additionally examined to determine whether the level of pain was characteristic of patients with chronic lumbar instability. The following tests were also carried out in the subjects during the examination: 1) the prone instability test. 2) the test for aberrant movement patterns during lumbar flexion test. 3) the straight leg raising test. 4) posterior-to-anterior mobility test, and 5) the test for age and strength of the hip abductor muscle following assessment of the dominant side. In particular, hip abductor muscle strength was evaluated using a dynamometer. Results: The test results showed that the number of positive responses for the five types of lumbar instability tests performed, was significantly related to the strength of the hip abductor muscle. The average hip abductor muscle strength in total subjects was $72.89{\pm}7.66N$, whereas the average hip abductor muscle strength in subjects who showed positive responses to more than four out of the five tests, was $44.70{\pm}5.79N$. Conclusion: The results demonstrated that the hip abductor muscle strength and lumbar instability were negatively correlated. The lower was the strength of the hip abductor muscle, the higher was the possibility of lumbar instability.

• Physical Therapy Korea
• /
• v.18 no.1
• /
• pp.74-82
• /
• 2011

The purpose of this study was to compare the anaerobic threshold (AT) between subjects with and without non-specific chronic low back pain (NCLBP). The patient group included 15 women with NCLBP. The normal group included 15 women without NCLBP who were age-, height-, weight-, and activity level-matched. The subjects performed a Balke treadmill protocol which was symptom-limited progressive loading test. Their heart rate (HR), ventilatory gas and metabolic equivalents (METs) were measured using the automatic breath gas analyzing system. After the test, each subjects' ratings of perceived exertion (RPE) were evaluated. The visual analog scale (VAS) was assessed pre- and post-test. The independent t-test and Wilcoxon's signed-rank test were used for analysis of the data. Time, HR, the volume of oxygen consumption ($VO_2$), relative $VO_2$, and METs at the AT level of the patient group were significantly lower than those of the healthy group (p<.05). However, there were no significant differences in RPE, VAS, and breathing frequency at the AT level (p>.05). The findings of this study indicate that patients with NCLBP had a lower aerobic fitness than healthy subjects. Thus, implementation of rehabilitation program to increase aerobic fitness may be considered in patietns with NCLBP, and further studies are required to determine the etiological factors of decreased aerobic fitness.

• Physical Therapy Korea
• /
• v.14 no.2
• /
• pp.21-28
• /
• 2007

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in erector spinae, multifidus, rectus abdominis and biceps brachii during perturbation between subjects with and without work-related chronic low back pain (LBP). Twenty-nine subjects, 14 with and 15 without LBP, participated in this study. The muscle responses were measured by surface EMG (electromyography) during perturbation in eye opened and eye closed conditions. The EMG onset times of the erector spinae, multifidus, rectus abdominis and biceps brachii were similar between groups in eye closed condition. But the onset times of the erector spinae, multifidus, rectus abdominis were significantly delayed in subjects with LBP in eye opened condition. The results provide an evidence for impaired feed-forward control of the trunk muscles in subjects with LBP. Further studies are needed to identify whether the impaired feed-forward control of the trunk muscles is the contributing factor to LBP.

• Journal of International Academy of Physical Therapy Research
• /
• v.11 no.3
• /
• pp.2155-2163
• /
• 2020

Background: Various treatments have been proposed for chronic low back pain (CLBP), but recent guidelines and reviews recommend regular physical exercise. However, some other studies have reported opposite results that sling exercise (SE) and other exercises (OE) did not differ in improving CLBP. Objectives: To systematically review and meta-analyze the effects of SE on CLBP in studies published in Korea. Design: A Systemic Review and Meta-analysis. Methods: Randomized controlled trials comparing SE with OE and modality therapy (MT), published up to June 2020, were identified by electronic searches. Primary outcomes were pain and disability. The weighted mean difference (WMD), stand mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model. Results: Based on the results of the meta-analysis, SE was effective for pain in the comparison of SE and MT [short-term: WMD=-1.64, 95% CI (-3.06, -0.22); long-term: WMD=-0.34, 95% CI (-0.42, -0.26)]. It was effective for pain in the comparison of SE and OE [short-term: WMD=-1.18, 95% CI (-2.15, -0.20); long-term: WMD=-0.66, 95% CI (-0.89, -0.43)]. It was also effective for disability in the comparison of SE and MT [short-term: SMD=-15.82, 95% CI (-23.10, -8.54)]. We found no clinically relevant differences in disability between SE and OE. Heterogeneity was high in the comparison of SE and overall variables. Conclusion: If SE is applied to physical therapy to improve the main symptoms of CLBP patients, it may contribute to their recovery. More high-quality randomized studies on the topic are warranted.

• Korean Journal of Acupuncture
• /
• v.27 no.2
• /
• pp.183-201
• /
• 2010

Objective : To explore and describe chronic low back pain (cLBP) patients' experience of acupuncture treatment Methods : Eleven patients with cLBP who agreed and completed the informed consent to take part in this qualitative study were interviewed thoroughly and tape-recorded. Transcribed data were read independently by 4 researchers and analysed thematically with ground theory. Results : All participants chose acupuncture treatment for their cLBP because either they preferred, other people recommended, or felt conventional treatment being more comfortable. Most of the participants experienced improvement during acupuncture treatment and continued treatment motivated by mere expectations. Participants also expressed the specific physical responses/sensations to the effect of acupuncture; various adverse effects during the course of acupuncture treatment. Economic burden was another concern when combined with other therapies in Korean Medicine hospitals. It is considered as a specifically important to those who give acupuncture treatment to obtain a full treatment effect. Conclusions : The emotional facts that Korean patients with cLBP receiving acupuncture treatment benefited by the treatment and considering specific sensations from doctor-patient relationship were turned out to be important to have the maximum treatment effect. Findings from this study should be considered in both acupuncture research and practice.

• The Korean Journal of Pain
• /
• v.34 no.4
• /
• pp.454-462
• /
• 2021

Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.3
• /
• pp.73-80
• /
• 2019

PURPOSE: This study examined the correlation between the visual analog scale (VAS) and the rate of change in the respiration patterns according to the result of Lumbar Instability Tests (LITs) in young people with chronic low back pain (CLBP) METHODS: Thirty-six adults, aged 20-40 years with CLBP, participated in this study. The general characteristics and VAS of the participants were recorded by the subjects themselves and seven structure and functional LITs were conducted. According to the positive response number, the positive group was divided into four groups (group 1: n=8, group 2: n=9, group 3: n=10, group 4: n=9). The breathing pattern change tests were performed in three states: during forced breathing exercise and motor control tests. A total of 13 positive lists were set, each of which was scored by 1 or 2 points according to the severity. After the positive lists were scored, the breathing pattern changing rate (BPCR) and VAS were compared according to the positive response number of LITs, and the correlation between them was analyzed. RESULTS: A strong correlation was observed between the number of positive of LITs and BPCR (r= .863, p= .000) and a moderate correlation between the positive number of LITs and VAS (r= .508, p= .002). In addition, there was a poor correlation between the BPCR and VAS (r= .434, p= .008). CONCLUSION: In young CLBP people, when the structural and functional instability are both present, the changes in the respiratory pattern of the whole body can be varied and broader, and the pain scale also increases.