• Title/Summary/Keyword: Chronic Low Back Pain

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Gait Analysis of the Chronic Lumbosacral Radiculopathic Patients (만성 요천추부 신경근병증 환자의 보행분석)

  • Choi, Byung-Ok;You, Jae-Eung;Jung, Seok
    • Physical Therapy Korea
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    • v.11 no.3
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    • pp.19-24
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    • 2004
  • The purposes of this study were to analyze gait patterns of patients with chronic lumboscaral radiculopathy and to investigate gait parameters which can reflect a functional deficit in relation to the level of lumbosacral radiculopathy. The study population consisted of 25 patients of chronic lumbosacral radiculopathy and 25 healthy control subjects. Conventional physical examinations and three-dimensional gait analyses were performed on all participants. The data were analyzed using an independent sample t-test. The results were as follows: (1) In the patients' group, cadence, walking velocity, stride length and double support time were less than in the control group (p<.05). (2) In the patients' group, maximum flexion of hip, maximum flexion of loading response, maximum flexion of swing phase on the knee and maximum plantar flexion of pre-swing were less than the control group (p<.05). Using three-dimensional gait analysis, we could identify specific gait parameters to reflect a functional deficit related to the level of lumbosacral radiculopathy.

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Effect of epidural polydeoxyribonucleotide in a rat model of lumbar foraminal stenosis

  • Lee, Ho-Jin;Ju, Jiyoun;Choi, Eunjoo;Nahm, Francis Sahngun;Choe, Ghee Young;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.394-404
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    • 2021
  • Background: We aimed to investigate the effect of epidural polydeoxyribonucleotide (PDRN) on mechanical allodynia and motor dysfunction in a rat model of lumbar foraminal stenosis (LFS). Methods: This study was conducted in two stages, using male Sprague-Dawley rats. The rats were randomly divided into eight groups. In the first stage, the groups were as follows: vehicle (V), sham (S), and epidural PDRN at 5 (P5), 8 (P8), and 10 (P10) mg/kg; and in the second stage, they were as follows: intraperitoneal PDRN 8 mg/kg, epidural 3,7-dimethyl-1-propargilxanthine (DMPX) (0.1 mg/kg), and DMPX (0.1 mg/kg). The LFS model was established, except for the S group. After an epidural injection of the test solutions, von Frey and treadmill tests were conducted for 3 weeks. Subsequently, histopathologic examinations were conducted in the V, S, P5, and P10 groups. Results: A total of 65 rats were included. The P8 and P10 groups showed significant recovery from mechanical allodynia and motor dysfunction at all time points after drug administration compared to the V group. These effects were abolished by concomitant administration of DMPX. On histopathological examination, no epineurial inflammation or fibrosis was observed in the epidural PDRN groups. Conclusions: Epidural injection of PDRN significantly improves mechanical allodynia and motor dysfunction in a rat model of LFS, which is mediated by the spinal adenosine A2A receptor. The present data support the need for further research to determine the role of epidural PDRN in spinal stenosis treatment.

Objective Evidence for the Effectiveness of Single-session Treatment with a Spinal Thermal Massage Device: A Pilot Study (척추온열마사지기기의 1회 치료의 효과에 대한 객관적 증거: 선행 연구)

  • Na, Yeong-Il;Kim, Si-Yun;Baek, Seung-Min;Lee, Jong-Hoo
    • Journal of Industrial Convergence
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    • v.20 no.10
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    • pp.209-218
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    • 2022
  • Individuals often report significant relief from pain and stress even after a single session of massage therapy; however, no previous studies have provided objective evidence supporting the effectiveness of a solitary massage therapy session. In the present study, we aimed to investigate the effectiveness of one-time treatment with a spinal thermal massage device reported to exert the same therapeutic effects as massage therapy in terms of pain reduction and stress relief. A man with chronic low back pain (LBP) underwent two rounds of experiments involving spinal massage treatment and bed rest, respectively. Pain was assessed using a visual analog scale, and heart rate variability (HRV) was measured in real-time to examine autonomic nervous system (ANS) activity. Blood samples were obtained at five points during each round of the experiment to examine changes in cortisol, epinephrine, and norepinephrine. Spinal massage significantly reduced pain and enhanced parasympathetic activity when compared with the bed rest condition. In addition, both epinephrine and norepinephrine levels were lower following spinal massage than following bed rest. These results are consistent with the reported effects of conventional massage therapy and support the effectiveness of one-time treatment using a spinal thermal massage device.

A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

  • Lee, Seung Eun;Park, Seung Won;Ha, Sam Yeol;Nam, Taek Kyun
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.370-374
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    • 2014
  • To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

A Survey of the Pain and Quality of Life of the Middle-Aged Women with the Subjective Symptom of Urinary Incontinence (요실금 자각 증상이 있는 중년여성들의 통증 및 삶의 질 정도에 대한 조사)

  • Kim, Eun-Young;Kim, Keun-Jo;Ha, Mi-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4382-4394
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    • 2010
  • The objective of this survey was to understand the effect of the subjective degree and pain of urinary incontinence on the quality of life of the middle-aged women with the subjective symptom of urinary incontinence. A questionnaire was carried out to investigate the quality of life in relation to urinary incontinence for 114 patients of chronic musculoskeletal system from Feb. to May in 2010. Overall, the subjects responded that their quality of life was medium(($61.36{\pm}13.2$score) and the pain related to urinary incontinence was low back pain. The degree of pain was between the moderate and a little severe in the VAS (Visual Analogue Scale) range of 4 to 7. It was also shown that the action of the subjects was affected by urinary incontinence in forms of avoidance limitation and psycosocial effect. Since the survey showed that the urinary incontinence and pain substantially affect the quality of life of the middle-aged women, the result may provide basic information in developing a practical intervention program.

Characteristic of Cross-sectional Area of Lumbar Paraspinal Muscle in Patients of Acute and Chronic LBP (20대와 40대의 급성 및 만성요통환자의 척추주위 근육에 관한 횡단면의 비교)

  • Kim, Dae-Hun;Park, Jin-Kyu;Park, Yun-Jin;Jung, Dae-In;Kim, Seong-Su
    • The Journal of the Korea Contents Association
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    • v.11 no.6
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    • pp.270-278
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    • 2011
  • The purpose of this study was to compare acute and chronic LBP patient in twenties and forties, respectively by size measure paraspinal muscle (cross-sectional area; CSA). CSA of paraspinal muscle (psoas, multifidus, erector muscle) size was measured by free-handling technique of the picture archiving and communication system(PACS) using MRI at the level(lower end-plate of L4) in twenties(9 males, 10 females) and forties(9 males, 8 females) in acute and chronic LBP patient. The results of this study showed no significantly difference between acute and chronic LBP (p>0.05) in twenties patients. However, there was significant difference between acute and chronic LBP (p<0.05) in forties patients. Also, there was significant difference in paraspinal muscle CSA between chronic LBP patients in twenties and chronic LBP patients in forties (p<0.05). This study showed that paraspinal muscle atrophy was observed in forties with various cause, but Not chronic LBP patients in twenties. Accordingly it is required for chronic LBP patients in forties to minimize trunk muscle atrophy through immediate back muscle dynamic exercise and early functional activity.

Extra-spinal sciatica and sciatica mimics: a scoping review

  • Siddiq, Md Abu Bakar;Clegg, Danny;Hasan, Suzon Al;Rasker, Johannes J
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.305-317
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    • 2020
  • Not all sciatica-like manifestations are of lumbar spine origin. Some of them are caused at points along the extra-spinal course of the sciatic nerve, making diagnosis difficult for the treating physician and delaying adequate treatment. While evaluating a patient with sciatica, straightforward diagnostic conclusions are impossible without first excluding sciatica mimics. Examples of benign extra-spinal sciatica are: piriformis syndrome, walletosis, quadratus lumborum myofascial pain syndrome, cluneal nerve disorder, and osteitis condensans ilii. In some cases, extra-spinal sciatica may have a catastrophic course when the sciatic nerve is involved in cyclical sciatica, or the piriformis muscle in piriformis pyomyositis. In addition to cases of sciatica with clear spinal or extra-spinal origin, some cases can be a product of both origins; the same could be true for pseudo-sciatica or sciatica mimics, we simply don't know how prevalent extra-spinal sciatica is among total sciatica cases. As treatment regimens differ for spinal, extra-spinal sciatica, and sciatica-mimics, their precise diagnosis will help physicians to make a targeted treatment plan. As published works regarding extra-spinal sciatica and sciatica mimics include only a few case reports and case series, and systematic reviews addressing them are hardly feasible at this stage, a scoping review in the field can be an eye-opener for the scientific community to do larger-scale prospective research.

Spinal Subdural Hematoma Associated with Intracranial Subdural Hematoma

  • Kim, Myoung Soo;Sim, Sook Young
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.397-400
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    • 2015
  • The simultaneous occurrence of an intracranial and a spinal subdural hematoma (SDH) is rare. We describe a case of cranial SDH with a simultaneous spinal SDH. An 82-year-old woman visited the emergency room because of drowsiness and not being able to walk 6 weeks after falling down. A neurological examination showed a drowsy mentality. Brain computed tomography showed bilateral chronic SDH with an acute component. The patient underwent an emergency burr-hole trephination and hematoma removal. She exhibited good recovery after the operation. On the fourth postoperative day, she complained of low-back pain radiating to both lower limbs, and subjective weakness of the lower limbs. Spine magnetic resonance imaging revealed a thoracolumbosacral SDH. A follow-up spinal magnetic resonance imaging study that was performed 16 days later showed a significant decrease in the size of the spinal SDH. We discuss the pathogenesis of this simultaneous occurrence of spinal and cranial SDH.

The Effect of Horse-Riding Exercise on Pain and Body Flexibility for the Patient with Chronic Low Back Pain (승마 운동이 직장여성의 비만도에 미치는 영향)

  • Lee, Chaewoo;Lee, Insil;Kim, Hyeonsu
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.4
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    • pp.67-74
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    • 2013
  • Purpose : The purpose of this study was to investigate the effect of horseback riding exercise for BMI(body mass index) and waist circumference in the obese women. Method : 20 subjects in Y-equestrian were randomly divided two group, horseback machine exercise(HME) group and horseback-riding exercise(HRE) group. Each group carried out 30 minutes exercise two times a week for 8 weeks. BMI were measured for body composition, and evaluation of waist circumference. Result : The results were as follows, the BMI(body mass index) between horseback machine exercise and horseback-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The waist circumference between horseback machine exercise and horseback-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horseback-riding exercise was effective on BMI and waist circumrerence of obese women so that these exercise can be new altematives exercise for obesity management in the obese women.

Physical Recovery through Health Management Education for the Disabled or the Elderly

  • SON, Byung-Kook;CHOI, Eun-Mee;KWON, Lee-Seung
    • Journal of Wellbeing Management and Applied Psychology
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    • v.4 no.1
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    • pp.27-34
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    • 2021
  • Purpose: The number of people with disabilities and the elderly over 65 years of age is gradually increasing due to physical disabilities and social aging. Their typical physical disorders or chronic diseases include low back pain, sciatic pain, arthritis, and musculoskeletal systems such as discs. The average prevalence of disease is 78%. These are various physical obstacles and hindrances in daily life. Research design, data and methodology: From August 6, 2019 to September 24, 2019, the Senior Welfare Center in Gyeyang-gu, Incheon, operated a healthy body exercise and health education program for living health management. Results: The vascular health index using U-Bio pulse wave was relatively good at the first average of +7.4, but the second average of -6.3. This can be seen as a result of the combination of diet and lifestyle education along with the effect of corrective exercise. As a result of body shape measurement analysis, the number of persons requiring management with 3 or more body imbalances was found to be from 75% before to 62.5% afterwards. Conclusions: Exercise effect appears when exercise lasts for at least 10 weeks. Some performances were good, but there were limitations due to the operation of a short training period.