• Title/Summary/Keyword: Chronic Low Back Pain

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The Changes of Range of Motion of Lumbar Region and Muscle Activities of Lumbar Extensor During Trunk Motions Between Subjects With Low Back Pain and Healthy Subjects (만성요통환자와 정상인의 체간 운동시 요추 신전근의 근활성도와 관절운동범위의 변화)

  • Kim, Tae-Ho
    • Physical Therapy Korea
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    • v.13 no.2
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    • pp.61-69
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    • 2006
  • The purpose of this study was to compare the electromyography (EMG) activities of the lumbar extensor muscles during motion of trunk flexion-extension and compare range of motion (ROM) with a 3-dimensional motion analysis system of the lumbar region between subjects with chronic low back pain (CLBP) and healthy subjects during the trunk flexion-extension, trunk rotation and trunk lateral flexion cycle. Thirty CLBP subjects and thirty healthy subjects were included. We measured the root mean square (RMS) value of the lumbar extensor muscles from resting, standing, lumbar flexion and return position. The RMS ratio was normalized from maximal EMG activity of the lumbar extensor muscles during trunk motion. The results of this study showed that the RMS ratio of the lumbar extensor was significantly higher in CLBP subjects than healthy subjects during all of trunk motion (p<.05). The ratio of the highest RMS value during flexion and extension was higher in CLBP subjects than in healthy subjects (p<.05). The ROM of the lumbar region was significantly lower in CLBP subjects than healthy subjects during trunk flexion-extension, trunk rotation and lateral flexion cycle. The relationship between the RMS ratio for full lumbar flexion and the ROM of lumbar flexion was not correlated significantly. CLBP subjects have both decreased ROM of the lumbar region and higher muscle activities of the lumbar extensor muscle than healthy subjects.

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The Effects of Trunk Stabilization Exercise on the Isometric Muscle Power and Muscle Activation in Chronic Low Back Pain (체간 안정화운동이 만성 요통환자의 근력과 근활성도에 미치는 영향)

  • Kim, Hyoung-Su;Hyong, In-Hyouk;Kim, Eun-Young
    • Korean Journal of Applied Biomechanics
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    • v.18 no.4
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    • pp.115-124
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    • 2008
  • The purpose of this study was to know influenced on the change of Oswestry back pain disability index(OBPDI), isometric muscle power(IMP), muscular activation with chronic low back pain(CLBP) patients after Trunk Stabilization Exercise. Intervention was provided 6 weeks(5 days a week). Muscular activation was measured during IMP(Muscles : transversus abdominis : TA, internal obliqus : IO, external obliqus : EO, rectus abdominis : RA and erector spinae: ES). The results were as follows. 1. OBPDI about the MBE and the SE groups had effective decrease pain and disability. 2. IMP of intervention after the MBE and the SE groups had effective improve muscle power. 3. Muscle activation during IMP of intervention after was : TA, IO, RA had increase in the MBE and the SE groups. EO muscle activation during IMP of intervention after had increase only MBE groups. This shows that the MBE and the SE groups had effective increase because it has effective improve muscle power. Therefore, this study shows £hat trunk stabilization exercise program influenced on the change of OBPDI, IMP, muscular activation with CLBP patients.

Review of the Large-Scale Clinical Researches on Acupuncture in Germany: ASH, ART, ARC, and GERAC (2000년부터 독일에서 수행된 대규모 침 임상연구들에 대한 고찰: ASH, ART, ARC, GERAC)

  • Yoon, Juyeon;Han, Kuk-In;Jeong, Jinsu;Lee, Seungho;Jang, Insoo
    • Korean Journal of Acupuncture
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    • v.30 no.1
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    • pp.21-26
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    • 2013
  • Objectives : The purpose is to introduce the recent large-scale clinical researches for safety, efficacy and effectiveness of acupuncture in Germany. Results : In 2000, the German Federal Committee of Physicians and Health insurer proposed that large research initiatives on acupuncture, Acupuncture Model Projects(Modellvorhaben Akupunktur), could be conducted by health insurance companies for several pain that acupuncture is syndromes to justify the insurance-based reimbursement. Accordingly, 4 clinical researches were carried out; the Acupuncture Safety and Health economics studies(ASH), the Acupuncture Randomised Trial(ART), the Acupuncture in Routine Care studies(ARC), and the German Acupuncture trial(GERAC). Meanwhile, ASH is a prospective observational study for safety and costs. ART and GERAC are composed of RCTs for efficacy. ARC includes 6 pragmatic RCTs with additional non-randomized cohort study for effectiveness. We investigated the papers related to them and discussed about the outcomes. The researches showed that acupuncture is effective in practice for several chronic conditions such as migraine, tension-type headache, chronic low back pain, osteoarthritis of knee, dysmenorrhea, and allergic rhinitis. Based in part on them, the German health authorities decided that acupuncture would be included into routine reimbursement by social health insurance funds for chronic low back pain and chronic osteoarthritis of the knee in 2006. Conclusions : The German clinical researches may suggest the clues for establishing the evidence of acupuncture treatment.

Comparison of three different exercise trainings in patients with chronic neck pain: a randomized controlled study

  • Besta Hazal Gumuscu;Eylul Pinar Kisa;Begum Kara Kaya;Rasmi Muammer
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.242-252
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    • 2023
  • Background: Neck pain is a common problem in the general population and second only to low back pain in musculoskeletal problems. The aim of this study is to compare three different types of exercise training in patients with chronic neck pain. Methods: This study was conducted on 45 patients with neck pain. Patients were divided into 3 groups: Group 1 (conventional treatment), Group 2 (conventional treatment plus deep cervical flexor training), and Group 3 (conventional treatment plus stabilization of the neck and core region). The exercise programs were applied for four weeks, three days a week. The demographic data, pain intensity (verbal numeric pain scale), posture (Reedco's posture scale), cervical range of motion ([ROM] goniometer), and disability (Neck Disability Index [NDI]) were evaluated. Results: In all groups, a significant improvement was found in terms of pain, posture, ROM, and NDI values in all groups (P < 0.001). Between the groups, analyses showed that the pain and posture improved more in Group 3, while the ROM and NDI improved more in Group 2. Conclusions: In addition to conventional treatment, applying core stabilization exercises or deep cervical flexor muscle training to patients with neck pain may be more effective in reducing pain and disability and increasing ROM than conventional treatment alone.

The Effects of Core Program Exercise on Balance in Patients with Chronic Low Back Pain (코어 프로그램 운동이 만성요통 환자의 균형에 미치는 영향)

  • Choi, Won-Jye;Park, Beom-Seok;Yoo, Byung-Kook;Jeon, Jae-Keun;Son, Kyung-Hyun
    • Journal of Korean Physical Therapy Science
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    • v.25 no.1
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    • pp.1-10
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    • 2018
  • Background: The purpose of this study was to ascertain the effects of core program exercise on balance in patients with chronic low back pain. Thirty-four subjects participated in this study, these subjects were assigned into two groups, a control group(n=17) and an experimental group(n=17). Methods: The subjects in the control group were received a conservative physical therapy and in the experimental group carried out the core program exercise for 30 minutes per day, three times a week during 6 weeks. In order to evaluate the progresses of balance ability, corresponding variables were measured at two times, pre and 6th week. The balance ability was assessed using GOOD BALANCE system. The collected data were analyzed by using the paired t-test and ANCOVA. In all statistical analyses, significance level, ${\alpha}$ was set by 0.05. Results: The results of this study were as follows: 1) In the position of left standing eye closed, there were significant difference of Y in the control group and X, Y, V in the experimental group. 2) In the position of right standing eye closed, there were significant difference of Y in the control group and X, Y, V in the experimental group. 3) In the position of dynamic balance 1, there were significant difference APV in experimental groups. 4) In the position of dynamic balance 2, there were significant difference MLV in experimental groups. 5) There were significances between the two group of X, V in static balance and APV in dynamic balance. Conclusion: The above results indicated that a core program exercise improved balance abilities in patients with chronic low back. The further studies should be focused at development of various modified forms of the core program exercise in keeping up the improvement effect of this exercise.

A Case Report of the Piriformis Syndrome Treated by Caudal Steroid and Local Anesthetic (이상근 증후군 치험 1례)

  • Jeong, Chang-Young;Yeon, Myung-Ha;Im, Woong-Mo;Kim, Byu-Rha
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.149-151
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    • 1995
  • Piriformis syndrome is a syndrome of low back and leg radiating pain thought to be due to a chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. The piriformis muscle is a flat pyramidal muscle, an external rotator and abductor of the hip, originating from the front of the sacrum and inner aspect of the sacroiliac joint, then passes laterally out of the sciatic notch to attach posteriorly to the greater trochanter of the femur, the sciatic nerve passes between the two bellies of the muscle. Mechanical irritation of the sciatic nerve by an inflammatory reaction of the piriformis muscle and its fascia at this pelvic level causes pain to radiate in the dermatomal regions of the nerve roots similar to that disk entrapment. diagnosis of piriformis syndrome is made primary on the basis of history and clinical examination. The incidence is considerably higher in women, with the reported ratio of women to men of 6:1. These patients frequently present with associated symptoms of pelvic pain and/or dyspareunia. Symptoms are usually unilateral but occasionally be bilateral. We had a 42 year-old woman patient with low back and left leg radiating pain and dyspareunia treated by caudal steroid and local anesthetic.

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Provocative Discography Following Focal Selective Coagulation in a Patient with Chronic Lumbar Discogenic Pain (만성 요추간판성 통증 환자에서 선택적 조직 응고술 후 유발성 추간판조영술의 진단적 소견 변화)

  • Kim, Dahn;Kim, Nackhwan;Lee, Sang-Heon
    • Clinical Pain
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    • v.18 no.2
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    • pp.142-146
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    • 2019
  • This is a case report of the provocative discographic findings before and after focal selective coagulation of the major annular fissure using intradiscal navigable catheter. A 46-year-old woman had a 30-month history of axial low back pain and magnetic resonance imaging findings suspicious for painful L4/5 disc. The provocative discography confirmed painful disc before coagulation. The final electrode tip position in the coagulation procedure was at the largest fissure within the outer annular margin identified through the discography. Six months after the successful coagulation therapy, inadvertently performed discography resulted in decreased pressure rise over time. Neither evoked pain nor change in the integrity of outer annulus as compared with the previous results was reported. Such an interventional method has not been reported previously, and the analytic results suggest that it may be possible to relocate the pressure of the entire nucleus pulposus only by focal selective coagulation of the fissure.

Acupuncture Experience in Patients with Chronic Low Back Pain(2): A Qualitative Study - Focused on Participants in Randomized Controlled Trial (만성 요통 환자의 침 치료 경험(2): 질적 연구 - 무작위 대조군 연구 피험자를 대상으로)

  • Kim, Song-Yi;Lee, Kee-Byoung;Lee, Hyangsook;Son, Haeng-Mi;Song, Mi-Yeon;Lee, Hyejung;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.29 no.4
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    • pp.581-597
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    • 2012
  • Objectives : To explore the experiences of patients with chronic low back pain(CLBP) in a randomized controlled trial(RCT) of acupuncture. Methods : Five qualitative focus group interviews were conducted at three Korean Medicine Hospitals. Two to 4 participants from the same group(real or sham acupuncture) in the RCT of acupuncture for CLBP discussed their experiences and perceptions of the clinical trial and the acupuncture treatment. Transcribed data were read independently by researchers and analyzed to categorize information and identify themes. Results : A total of 14 participants were included. Most of them discovered positive aspects of being a study subject and a patient. They recognized the differences between experimental and real-world clinical settings such as formal procedures of treatment, and different acupuncture device. Participants also expressed the weaker sensation of acupuncture compared to the previous experience. Especially, they were well aware of the 'subjects' role themselves, thus they observed their changes of symptom closely. As subjects were generally satisfied with their treatment and they had a good feeling to acupuncture after the trial, they expressed their willingness to participate in the future clinical trial of acupuncture. Conclusions : Our finding suggests that the Korean patients' experience of participating in an RCT was generally positive. Their tendency to perform the 'subject' role might affect the trial's process or overall results.

A Clinical Study on Correlation between Cervical, Lumbar Lordosis and Low Back Pain (요통과 경추, 요추전만의 관계에 대한 임상적 연구)

  • Jeong, Da-Un;Yeo, Kyeong-Chan;Yoon, In-Ae;Kang, Hyun-Sun;Moon, Sung-Il
    • Journal of Acupuncture Research
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    • v.26 no.2
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    • pp.15-29
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    • 2009
  • Objectives: This study was designed to investigate the correlation between cervical, lumbar lordosis and low back pain(LBP), sex, age and duration of LBP. Methods : Cervical, lumbar lordosis(by Cobb's Method) and Ferguson's angle were measured and evaluated in LBP group and control. Radiograph was taken in lateral direction, erect position. Cobb's angle between C1-C7, C2-C7, L1-L5, L1-S1 and Ferguson's angle were measured and investigated with statistical program. Results: 1. Cervical lordosis have no relation to LBP, sex and age. 2. Lumbar lordosis and Ferguson's angle have no relation to LBP and sex. 3. Cobb's angle L1-L5 have no relation to age. Lumbar lordosis from L1 to S1(Cobb's angle L1-S1) increased in old group(Age>40) compared to young group(Age${\leq}$40). 4. In LBP group, Cobb's angle L1-S1 have no relation to duration of LBP. Lumbar lordosis from L1 to L5(Cobb's angle L1-L5) decreased in acute LBP group compared to Chronic group. Conclusions : Cervical, lumbar lordosis and Ferguson's angle have no relation to LBP and sex. As far as age is concerned, old group have larger lumbosacral lordosis than young group. Acute LBP group have smaller lumbar lordosis(Cobb's angle L1-L5) than chronic group.

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