• Title/Summary/Keyword: Chronic Low Back Pain

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Comparison of postural control between subgroups of persons with nonspecific chronic low back and healthy controls during the modified Star Excursion Balance Test

  • Shallan, Amjad;Lohman, Everett;Alshammari, Faris;Dudley, Robert;Gharisia, Omar;Al-Marzouki, Rana;Hsu, Helen;Daher, Noha
    • Physical Therapy Rehabilitation Science
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    • v.8 no.3
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    • pp.125-133
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    • 2019
  • Objective: To compare the postural control between non-specific chronic low back pain (NSCLBP) subgroups and healthy people during dynamic balance performance using a modified Star Excursion Balance Test (mSEBT). Design: Cross-sectional study. Methods: Eighteen NSCLBP subjects (9 active extension pattern [AEP], 9 flexion pattern [FP]), and 10 healthy controls were enrolled in this study. All subjects performed mSEBT on their dominant leg on a force plate. Normalized reach distance and balance parameters, including the center of pressure (COP) displacement and velocity, were recorded. Results: There were significant differences in mean reach distances in both posterolateral and posteromedial (PM) reach directions between AEP and healthy subjects (p<0.001) and between FP and healthy subjects (p<0.001). However, there were no significant differences among the three groups in the anterior reach direction. Also, the results showed no significant differences in mean COP variables (velocity and displacement) between pooled NSCLBP and healthy subjects. However, the subjects were reclassified into AEP, FP and healthy groups and the results showed a significant difference in mean COP velocity in the PM direction between AEP and FP subjects (p=0.048), and between AEP and healthy subjects (p=0.024). Conclusions: The findings in this study highlight the heterogeneity of the individuals with NSCLBP and the importance of identifying the homogenous subgroups. Individuals with AEP and FP experience deficits in dynamic postural control compared to healthy controls. In addition, the findings of this study support the concept of the Multidimensional Classification System.

Efficacy and Safety of Micro Current Tape on Chronic Low Back Pain: One Group Pre-Post Test Design, Multi Center Pilot Study (만성 요통 통증 완화에 대한 미세전류 테이프의 안전성 및 유효성 평가)

  • Park, Hyun-Gun;Kim, Jong-Yeon;Yi, Woon-Sup;Lee, Sin-Ji;Chung, Won-Suk;Kim, Ho-Jun;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.185-194
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    • 2013
  • Objectives The aim of this study was to evaluate the efficacy and safety of micro current taping therapy (MTT) on patients with chronic low back pain (CLBP). Methods We included 50 participants who met the inclusion criteria and 5 participants dropped out during the sessions due to the following reasons: 3 participants were personal reasons, 1 participant was taking medication, 1 participant was fore arm fracture. We attached "I" shaped 40 cm, 2 tapes along the erector muscles of the spine starting from both iliac crest and another "I" shaped 30 cm, 1 tape on the painful site horizontally. This procedure was done 8 times and participants visited a total of 9 times including a final visit for evaluation. We measured visual analog scale (VAS), range of motion (ROM) and schober's test on every visit. Participants completed a questionnaire of oswestry disability index (ODI) and Beck's depression inventory (BDI) on the first and last visits. Results In VAS for pain intensity and bothersomeness, there were significant decreases after 1st, 6th treatments. In range of extension, there was significant increase after 3rd treatment at first. In range of flexion, there was significant increase after 2nd treatment at first. In range of left flexion, there was significant increase after 4th treatment at first. In range of right flexion, there was significant increase after 3rd treatment at first. in schober's test, there was significant increase after 2nd treatment at first. In VAS, ROM, schober's test, BDI, ODI, there were significant improvement after all treatments had done. Conclusions There was a significant effect of MTT on CLBP. And there was no adverse effect.

A Fatigue Analysis on Lumbar Extension Muscle during Repeated Trunk Extention Exercise for Chronic Lumbar Pain (만성요통환자의 반복체간운동 시 요부신전근 피로 분석)

  • So, Jae-Moo;Lee, Chul-Kyu
    • Korean Journal of Applied Biomechanics
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    • v.16 no.1
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    • pp.159-166
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    • 2006
  • The purpose of this study were analysed fatigue character of lumbar extension Muscle during repeated trunk flexion-extension motion we used EMG multi-telemeter (WEB 5000, Nihon Koden, Japan), Medex lumbar extension machine(Ocala, USA). We evaluated 20 persons on chronic low back pain group and 20 persons on control group. We analysed the quantitative variables IMF, MF, decreased ratios of MF to investigate fatigue. As a result, the following conclusion was drawn : 1. Each lumbar IMF of CLBP was L5> L3> L1 in the order of their size. CON group was similar quantitative and same order. But the relationship of two groups were not significantly. 2 The IMF within lumbar position(L1-L3, L1-L5, L3-L5) of two groups was significantly all positions(p<.05). 3. The MF shifting at lumbar position of two groups during repeated trunk flexion-extension motion was decrease shifting pattern with increase repeating motion, especially CLBP group was suddenly dropping than CON at all lumbar positions(L1, L3, L5) on early stage motion(34 set). 4. The lumbar fatigue of CLBP was higher than CON during repeated trunk flexion-extention motion, so CLBP supposed more tired than CON. And it was significantly within two groups at lumbar positions(L1, L3 : p<.05, L5 : P<.01).

The Effects of Spinal Stabilization Exercise using Gravity on patients with Degenerative Disc Disease (중력을 이용한 요부안정화 운동이 만성요통을 가진 노인환자에게 미치는 영향)

  • Kim, Hee-Ra;Kim, Yoon-Shin
    • The Journal of Korean Physical Therapy
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    • v.20 no.1
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    • pp.23-31
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    • 2008
  • Purpose: The purpose of this study was finding out the effects of spinal stabilization exercise using Centaur which is a 3D spinal stabilization sports implement on Chronic low back pain patients over 8 weeks. Methods: 30 patients with DDD were observed during the study. Their average age was 66.88years, height was 152.12cm and average weight was 58.91kg, 4 males and 26 females were involved. 8 various investigations were performed and varied values were compared with reinvestigation done after having exercised 8 weeks using 3-D CENTAUR We used VAS(visual analog scale) in order to see the variation of pain intensity, MOI(modified oswestry index) in order to see limitation of daily life. Results: VAS was lessened from 7.57 to 2.63, limitation of routine life(MOS) from 23.48 to 11.30, there were remarkable differences statistically(p<0.05). As a result of muscular investigation for static spinal stabilization by 8 variations of body deflection, muscular strength were all increased and there were signigicant differences statistically(p<0.05). Conclusion: It has turned out that pain and limitation of routine life was lessened, as a result of 8 weeks exercise using CENTAUR, and deep muscular power was increased. Thus it has turned out that 3-D spinal stabilization exercise has an effect on the strengthening spinal muscles and alleviation of their pain for old patients with DDD.

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Naturopathic Effects of Arthritis, Frozen Shoulder and Lumbago Using the Qi-Therapy (관절염, 오십견 및 요통에 대한 기(氣)치유 효과)

  • Kim, Munki;Lee, Hyung Hoan
    • Journal of Naturopathy
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    • v.8 no.2
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    • pp.53-62
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    • 2019
  • Purpose: To investigate the healing effect of 21 patients with chronic back pain, shoulder pain, and knee arthritis by a Qigong. Methods: The study performed by hand injection of a Soojung Qi-therapy. Results: Ten patients (47.6%) had low back pain, eight (38%) had frozen shoulders, and three (14.3%) had knee arthritis. Satisfaction after five times of the Qi-healing was 72% in those who returned to normal and 14% in those who improved. When the maximum pain level set at 5.0, the difference between before and after healing was 3.33 in arthritis subjects, 3.75 in fifty shoulder subjects, and 3.80 in low back pain. In general, the degree of pain decreased as the number of healings increased. In particular, even after the first healing, the pain reduction of the subjects was high in arthritis, frozen shoulders, and low back pain. That is, there was a possibility of controlling pain with only one Qi-healing. Conclusions: Soojung Qi-therapy is one of the natural healing treatments because it reduces fast pains and accessible to handling anytime and anywhere. Conclusions: With Qi-therapy, arthritis, frozen shoulder, and lumbago patients almost recovered to their original shape. Therefore, Qi-therapy regarded as one of the useful natural healing therapies.

Short Term Outcomes and Prognostic Factors Based on Radiofrequency Thermocoagulation on Lumbar Medial Branches (요추 후지내측지에 대한 고주파열응고술의 단기 성적과 예후 인자)

  • Choi, Byung In;Kweon, Tae Dong;Park, Kyung Bae;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.116-122
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    • 2007
  • Background: Lumbar zygapophysial joints are a common source of chronic lower back pain and radiofrequency thermocoagulation (RF) of the medial branches (MB) has been shown to be effective at providing substantial pain relief for chronic low back pain. Therefore, we carried out this study to determine the short term outcomes and prognostic factors of RF on the MB of patients with lumbar facet syndrome. Methods: We performed RF in fourteen patients who showed greater than 80% pain relief up to three times after a diagnostic MB block was conducted using 0.3 ml of 0.5% bupivacaine. Using 10 cm curved electrodes with 10-mm active tip, a 60 second, $80^{\circ}C$ lesion was made after electrical stimulation at 50 Hz for sensory and 2 Hz for motor nerve testing. The degree of pain relief was then assessed after 2 weeks, and again after 3 months using a visual analog scale (VAS) and a four point Likert scale. The outcome was regarded as 'success' if at least a 50% reduction in the VAS was observed. Possible prognostic factors between the two groups were also evaluated Results: The success rate was 71.4% (10/14) after three months of follow-up. However, there were transient complications, such as neuritis like syndrome, in 4 patients. In addition, short symptom duration and low minimal voltage (< 0.4 V) for sensory stimulation were shown to be the relevant prognostic factors for a successful outcome. Conclusions: RF may be an alternative to repeated MB block or intraarticular injection for palliation of lumbar facet syndrome. For better outcomes, early diagnosis and strict patient selection should be coupled with efforts to avoid anatomically incorrect RF.

Current Concepts of Degenerative Disc Disease -A Significance of Endplate- (퇴행성 추간판 질환의 최신 지견 -종판의 중요성-)

  • Soh, Jaewan;Jang, Hae-Dong;Shin, Byung-Joon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.283-293
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    • 2021
  • Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

A Review of Questionnaire for the Clinical Trials on Chronic Low Back Pain (만성 요통 임상연구에 사용된 설문지 현황 고찰)

  • Kim, Doo-Hee;Shin, Woo-Suk;Lee, Jin-Won;Park, Won-Hyung;Cha, Yun-Yeop;Ko, Youn-Seok;Lee, Jung-Han;Chung, Won-Suk;Shin, Byung-Cheul;Song, Yun-Kyung;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.95-115
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    • 2013
  • Objectives The aim of this review is to provide fundamental data for low back pain scales which can be used in clinical trial. Methods We investigated the latest studies on chronic low back pain via PubMed. And we also investigated domestic studies through "http://oasis.kiom.re.kr". 95 research papers were analyzed. Scales were classified into pain scale, function scale, generic health status scale and psychological scale. Results 1) According to foreign clinical studies, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) were used 18 times as pain scale. Oswestry Disability Index (ODI) was used 20 times as function scale, Roland-Morris Disability Questionnaire (RMDQ) was 17, and Hannover Functional Ability Questionnaire (HFAQ) was used 3 times. 36-item Short Form Health Survey (SF-36) was used 13 times as generic health status scale, Euroqol-5 Dimentions Questionnaire (EQ-5D) was 11, and 12-item Short Form Health Survey (SF-12) was used 3 times. Fear-Avoidance Beliefs Questionnaire (FABQ) was used 9 times as psychological scale, Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK-R) both were used 3 times. 2) According to domestic clinical studies, VAS was used 37 times as pain scale, NRS was 11, and Short Form McGill Pain Questionnaire (SF-MPQ) was used 6 times. ODI was used 30 times as function scale, RMDQ was 2 times only. SF-36 was used once as generic health status scale and Beck's Depression Inventory (BDI) was used 3 times as psychological scale. Conclusions We recommend VAS or NRS as a measure to evaluate pain, and ODI as a measure to evaluate functional disability. And we also recommend SF-36 or SF-12 and EQ-5D as a measure to evaluate generic health status. Finally, we recommend FABQ for use in measuring psychological scale.

Work related diseases in Korean fire fighters (소방공무원의 직무관련질환과 건강실태 조사)

  • Roh, Sang-Gyun;Kim, Jee-Hee
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.571-576
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    • 2013
  • The purpose of this study is to investigate work related diseases in Korean firefighters and to prepare the preventive measure for health management for the firefighters. Structured self-reported questionnaire was distributed to the firefighters. The result revealed that 37.7% of fire fighters had chronic diseases and 12.3% had chronic low back pains. The affected parts included lumbar region(41.5%), shoulder(33.0%), and neck(23.6%). The affected parts caused physical pain and work discomfort for more than a month. A total of 54.1% firefighters visited to the hospital within a year. This results suggest that it is necessary to develop the health promotion program for the prevention of musculoskeletal disease and regular health checkup for the acute disorders caused by workload.

Effect on Thoracic Exercise Programs in Employees With Chronic Low Back Pain (만성 요통근로자의 흉추운동프로그램 효과)

  • Hur, Jin-Gang
    • Physical Therapy Korea
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    • v.12 no.2
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    • pp.44-57
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    • 2005
  • The objectives of this study were to examine the relative efficacy of three active exercise programs for work-related, chronic low back pain, and to observe to what extent the programs affected the mechanical stability of the lumbar region. The subjects were 64 employees who were randomly divided into three groups to match the three active exercise programs which were performed 3 times a week for 6 months. All subjects were assessed with the same measurements at a pre-study examination, and then were reassessed at 2 weeks, 3months and 6 months after the study. The pain intensity didn't show any significant difference among the three groups. However, the Oswestry Disability Index showed significant differences among the three groups at 6 months and the lumbar and thoracic exercise groups showed significant decreases compared to the general physiotherapy group (p<.05). Maximal stretching with both hands in the overhead direction showed a significant difference among the three groups at 3 months and 6 months, and the thoracic exercise group at 6 months showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The group that performed maximal stretching with both hands in the overhead direction showed the most significant among the 3 months and 6 months. At 6 months, the thoracic exercise group showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The lumbar region angle of inclination showed significant differences among the three groups at 2 weeks 3 months, and 6 months, with the thoracic exercise group being decreased more significantly at 6 months than the lumbar exercise and general physiotherapy groups (p<.05). Exercise aimed at increasing thoracic mobility has an effect on lumbar stability. Furthermore, it is far more effective for lumbar stabilization than general physiotherapy and deep muscle strengthening lumbar exercise.

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