• Title/Summary/Keyword: Chronic Low Back Pain

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Functional Taping Technique for Chronic Back Pain and Lower Extremity Pain - McConnell's Approach (만성 요통과 하지 통증에 대한 기능적 테이핑 기법 - McConnell 접근법 -)

  • Kim, Suhn-Yeop;Oh, Duck-Won;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.50-59
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    • 2008
  • Taping techniques have been usually used by physical therapists long time ago, which have been considered a useful adjunct to treatment programs for a variety of musculoskeletal disorders. Also, taping techniques may be employed as effective prophylactic methods in clinical setting because of ease application and cost effectiveness. The aims of this study were to describe background information for the management of some chronic low back pain patients with/without leg pain that don't respond to conservative treatment, to demonstrate McConnell taping as successful therapeutic strategies for treating these patients, and to provide detailed application methods of McConnell taping in order that physical therapists can readily use the taping in clinical setting. This study emphasized to illustrate biomechanical benefits of McConnell taping in controlling undesirable muscle activation by decreasing mechanical loads on specific muscles. McConnell taping may be helpful for the inhibition of overactive synergist or antagonists, the facilitation of inactive synergists, the promotion of proprioception, the optimization of joint alignment, pain reduction, and unloading of irritable neural tissue. This study provides taping examples of low back pain, sacroiliac joint dysfunction and lower extremity symptoms associated with these conditions, and discusses the possible mechanisms for their successful application.

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Clinical Research of Warm Needle Acupuncture for Chronic Low Back Pain: A Protocol for Randomized, Controlled Pilot Study (온침이 만성요통에 미치는 효과에 대한 무작위배정 대조군 예비 임상연구 프로토콜)

  • Seo, Yeonho;Kim, Taeoh;Cho, Whisung;Ko, Junhyuk;Ahn, Jonghyun;Kim, Soo Jeon;Lee, Hansol;Chang, Hokyung;Kim, Hyungsuk;Kim, Koh-Woon;Cho, Jae-Heung;Chung, Wonseok;Song, Mi-Yeon
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.155-164
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    • 2020
  • Objectives This study is aimed to evaluate the feasibility of further clinical research of warm needle acupuncture as an effective and safe treatment for chronic low back pain. Methods Thirty participants will be randomly assigned to the Warm needle acupuncture group (n=15) and Dry needle acupuncture group (n=15). All patients will receive acupuncture therapy twice a week for 6 weeks, but only the experimental group will receive thermal stimulation. The primary outcome will be measured using the visual analogue scale for bothersomeness of low back pain, and the secondary outcome will be measured using the VAS for pain intensity, Oswestry disability index, 36-Item Short Form Health Survey, Beck's depression inventory, and amount of analgesics used. Conclusions The results of this study will be used to determine the feasibility of a future large-scale randomized controlled trial that provides clinical evidence for the efficacy and safety of warm needle acupuncture in the treatment of patients with chronic low back pain.

The Effect of Pelvic Stability Exercise Program on Pain and Hip Joint of Patients with Chronic Low Back Pain involving Sacroiliac Joint Pain (골반안정화 운동프로그램이 엉치엉덩관절 통증을 동반한 만성요통환자의 통증과 엉덩관절에 미치는 영향)

  • Kang, Jeong-Il;Choi, Hyun
    • Journal of Digital Convergence
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    • v.11 no.4
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    • pp.331-338
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    • 2013
  • For this research, 27 out of 52 patients with chronic low back pain involving sacroiliac joint pain were classified into the experimental group to conduct pelvic exercise program and traditional physical therapies in parallel, and the remaining 25 ones were classified into the control group to only apply traditional physical therapies for 6 weeks. After that, their clinical samples were randomly extracted. Before the experiment, both of the experimental group and the control group had the Oswestry disability index test to see how big their pain was and their hip joint angles were analyzed during walking. After the post-test, finally, the results of the Oswestry disability index test and hip joint angles while walking before and after the experiment were compared between two groups to know the effect of pelvic stability exercise program. Within-group results and between-group results both displayed significantly reduced low back pain, and when comparing hip joint angles of the experimental group, there were differences between mid stance phase, terminal stance phase, pre swing phase and early swing phase of the right hip joint, and mid stance phase, terminal stance phase, pre swing phase and early swing phase of the left hip joint. In the control group, there were significant differences between mid stance phase, terminal stance phase and early swing phase of the right hip joint, and loading response phase, mid stance phase, terminal stance phase and pre swing phase of the left hip joint. as a result, pelvic stability exercise program is helpful to gait rhythm on stance phase and swing phase although effective to decrease Oswestry disability index including pain.

Effects of Straight Leg Lifts and Double Leg Lowering Exercise on Abdominal Muscle Activity, Back Pain, and Flexibility in Patients with Chronic Low Back Pain in their 50s (50대 만성허리통증 환자들을 대상으로 다리들기와 다리내리기 운동이 배 근육의 활성도, 허리통증, 그리고 유연성에 미치는 영향)

  • Bae, Wonsik;Lee, Keoncheol;Park, Hankyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.3
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    • pp.61-69
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    • 2019
  • Purpose : The purpose of this study was to investigate the effects of Straight leg lifts (SLL) and double leg lowering (DLL) exercise on abdominal muscle activity, visual analog scale (VAS), and flexibility in patients with chronic low back pain (LBP). Methods : A total of 30 LBP patients were divided into two groups: those with SLL exercise group 15 (male=8, female=7) and those with DLL exercise group 15 (male=7, female=8). Before the intervention, the abdominal muscle activity, VAS, and flexibility were measured. After 4 weeks of intervention, the above variables were measured in the same way. The SLL exercise bends the leg $45^{\circ}$ in the supine position, and the DLL exercise was performed as opposed to SLL. At this time, the pressure biofeedback unit (PBU) was placed behind the lumbar to reduce the instability of the pelvis and muscles. The subjects were instructed to use the PBU to maintain the target pressure determined (40 mmHg) during the exercise. Results : The external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were significantly different in the SLL and DLL group, and EO, IO, and TrA activity improved more significantly increased in the DLL than SLL group (p<.05). The results on the VAS and flexibility were significantly different both group (p<.05). However, there was no significant difference between the groups (p>.05). Conclusion : SLL and DLL exercises in patients with LBP were able to confirm the increased activity of the abdominal muscles, decreased pain, and increased flexibility of the waist. In addition, DLL exercise is more effective in patients with LBP in terms of muscle activity.

Comparison of Difference of the Gluteus Medius Muscle Fiber Thickness during maximum muscle contraction between Chronic Low Back Pain with Gluteus Medius Weakness and Healthy Subject (중둔근 약화를 가진 만성요통환자와 건강한 대상자간 중둔근 최대 근수축 시 근섬유별 두께 비교)

  • Lee, Sang-Wk;Kim, Suhn-Yeop;Yang, Jin-Mo;Park, Seong-Doo
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.1
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    • pp.71-82
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    • 2015
  • PURPOSE: The aim of this study is to compare changes in the thickness of the gluteus medius muscle fiber between chronic low back pain(clbp) with gluteus medius weakness and healthy subject. METHODS: Ultrasound imaging was used to measure in the thickness of each fiber of the gluteus medius muscle based on maximal muscle contraction during abduction motion of the hip joint in a healthy group (11 subjects) and a chronic CLBP group (21 subjects). An independent t-test was performed to analyze the difference of thickness in each fiber of the gluteus medius muscle and the rate of changes in the fibers in the two groups. RESULTS: The fiber thickness changes in the gluteus medius muscle were significantly lower for the posterior fiber in the CLBP group compared to the healthy group (p<0.01). The changes in rate of difference of thickness the posterior part of the gluteus medius muscle was significantly lower in the CLBP group than in the healthy group (p<0.05). CONCLUSION: The findings of this study CLBP patients with weakness of the gluteus medius muscle that lower for the posterior fiber's difference of thickness and rate of change in the CLBP group compared to the healthy group. Indicate that rehabilitation of CLBP patients with weakness of the gluteus medius muscle should consider the functions of posterior fiber of the gluteus medius muscle.

Changes of Physicopsychological Function difference on Trunk Control Exercise in Patients with Chronic Low Back Pain (체간 조절운동 양식에 따른 만성요통환자의 신체·심리적 기능변화)

  • Ko, Dae-Sik;Kim, Chan-Kyu;Jung, Dae-In
    • The Journal of the Korea Contents Association
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    • v.13 no.4
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    • pp.331-338
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    • 2013
  • This study conducted the following experiment to examine change of physicopsychological function on Dynamic Trunk Control Exercise(3D-DTCE) and Static Trunk Control Exercise (STCE) to chronic low back pain patients subject for lumbago therapy and management. Physical function was measured by equlibrium and lumbar muscle activities and psychological function was measured by self-efficacy on comparative analysis of pre, post exercise and each groups in 30 lumbago patient subject. Equlibrium was measured by total, front back and left right sway index, lumbar muscle activities were measured by abdominal rectus and oblique abdominalis, erector spinae and self efficacy with lumbago patients was measured index of self efficacy. These result lead us to the conclusion that each group were statistically improved at all physicopsychological test. but equlibrium and lumbar muscle activities were more statistically improved at DTCE group and self efficacy with lumbago patients were not differanced on each group. Consequently, DTCE would be lead to positive increment of physical function more than STCE.

The Relationship between Hip Abductor Muscle Strength and Lumbar Instability in Patients with Chronic Low Back Pain (만성 요통환자의 요추부 불안정성과 고관절 외전근 근력수준간의 상관관계)

  • Seo, Jun-Kyoung;Kim, Suhn-Yeop
    • The Journal of Korean Physical Therapy
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    • v.23 no.4
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    • pp.15-22
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    • 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.

The Comparison of the Gluteus Maximus Activity during Various Prone Hip Extension in Subject with Chronic Low Back Pain

  • Kwon, Yoo-Hun;Cynn, Heon-Seock;Park, Dong-Hwan;Shin, A-Reum;Baik, Seung-Min;Lee, Ji-Hyun
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.3
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    • pp.29-37
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    • 2019
  • PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.

Comprasion of Effectiveness of CT vs C-arm Guided Percutaneous Radiofrequency Lumbar Facet Rhizotomy

  • Park, Chan-Hong
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.137-141
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    • 2010
  • Background: Facet joint have been implicated as a source of chronic low back pain. Radiofrequency denervation has demonstrated the most solid evidence. To increase safety and efficacy of treatment, computed tomography (CT) guidance injection has been used in several disease. The purpose of this study was to evaluate the efficacy of CT-guided radiofrequency rhizotomy in the treatment of facet joint pain. Methods: A total of 40 patients were randomized to undergo radiofrequency facet joint denervation under CT guidance or C-arm guidance. All patients were examined visual analogue scale (VAS) score before treatment, 1 month, and 3 months after treatment. Results: The VAS in both groups showed significant improvement over the 1-month interval. No significant difference in the VAS score among the group was observed. Conclusions: In this study there was no significant difference between CT guidance lumbar rhizotomy and C-arm guidance lumbar rhizotomy. Therefore CT-guided radiofrequency denervation of the lumbar facet joint was a minimally invasive technique that appears effective.

Effects of Sling and Resistance Rotation Exercises on Pelvic Rotation and Pain in Patients with Chronic Low Back Pain

  • Kim, Dae Hyun;Kim, Tea Ho
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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    • pp.166-172
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    • 2018
  • Purpose: This study compared the different sling and resistance exercises on pelvic rotation during active straight leg raises (ASLR) and on pain in patients with chronic low back pain (CLBP). Methods: Twenty subjects were divided randomly into a sling group (SG) and a resistance exercise group (REG). Internal oblique (IO), external oblique (EO), rectus abdominis (RA), and rectus femoris (RF) muscle activity; pelvic rotation angle during ASLR; and visual analogue scale, pressure pain threshold were measured. Sling and resistance exercises were then performed for 30 minutes and the measurements taken again. Results: Both groups showed significantly lower RF muscle activity and significantly higher EO and IO muscle activity (p<0.05). The RA muscle activity decreased significantly in the SG, but increased significantly in the REG (p<0.05). The pelvic rotation angle was significantly lower in the SG (p<0.05). The pain press threshold increased significantly in both groups (p<0.05). The visual analogue scale decreased significantly in the SG (p<0.05). Conclusion: Both exercises appear to be beneficial for modifying the muscle activity and pain control in the intervention of CLBP. On the other hand, the sling was more effective in increasing the pressure threshold than resistance exercise, and the pelvic rotation angle was reduced. Therefore, both exercises can help patients with CLBP change their muscle activity and control pain. CLBP patients should use a sling for short periods of time to learn to reduce the pain and control pelvic rotation.