• Title/Summary/Keyword: Chronic lower back pain

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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.

Clinical Study for Characteristics of Heart Rate Variability in Low Back Pain Patients (요통 환자의 심박변이도 특성에 대한 임상적 연구)

  • Ryu, Ji-Mi;Kim, Sung-Su;Chung, Seok-Hee
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.2
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    • pp.241-250
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    • 2009
  • Objectives : To study autonomic nervous system dysfunction of Low Back Pain(LBP) patients, using spectral analysis of Heart Rate Variability(HRV). Methods : HRV of 190 patients was measured and seperated into two groups, those with LBP(n=95) and healthy controls(n=95). HRV was measured by SA-6000(Medicore, Korea) for 5 minutes after 5 minutes' resting. Results : 1. Mean heart rate(MHRT) of the experimental group was slightly higher than that of the control group, but did not show significant difference(P=0.428). The square root of the mean squared differences of successive normal-to-normal intervals(RMSSD), logarithmic very low frequency power(Ln VLF) and low frequency power/high frequency power ratio(LH/HF ratio) were not significantly low between experimental group and control group(P=0.16, 0.130, 0.537). 2. The standard deviation of all the normal-to-normal intervals(SDNN), logarithmic total power(Ln TP), logarithmic low frequency power(Ln LF) and logarithmic high frequency power(Ln HF) were significantly low between experimental group and control group(P=0.03, 0.005, 0.001, 0.007). 3. Ln LF of acute group was significantly low compared with those of chronic group(P= 0.039). Conclusions : This study suggests the activity and imbalance of autonomic nervous system in LBP is low. Also sympathetic nervous system of acute LBP is lower than that of chronic LBP. Further study of HRV related to LBP is needed in the clinical medicine.

The Effects of Tai Chi for Arthritis on Chronic Arthritic Pain of Senior Female : A Pilot Study (만성 관절 통증 여성 노인환자에 있어 관절염 태극권의 효과에 대한 pilot study)

  • Hwang, Eui-Hyoung;Kim, Jung-Hwan;Jang, In-Soo;Yang, Chang-Sop;Kang, Jun-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.1
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    • pp.79-90
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    • 2010
  • Objectives : Tai Chi for arthritis was developed in 1997 by Paul Lam, M.D. of family medicine in Australia. It is an exercise treatment program and a good approaching method for arthritis. However its application is limited to arthritis of knee joint only. Even there have been no clinical study in korean traditional medical society. The aim of this study is to investigate effect of the Tai Chi for arthritis on chronic pain of body. Methods : We designed this trial as objectives were (1) senior female over 60 years, (2) suffering for osteoarthritis and chronic body pain, (3) have no physical or mental dysfunctions (4) able to walk and exercise alone. Objectives mactched these criteria had been trained the Tai Chi for arthritis 2 hours a day for 21 weeks. Before and after training, pain of 8 joints (neck, shoulder, elbow, wrist, waist, hip, knee, ankle) were estimated with the VAS(Visual Analog Scale). Results : Training the Tai Chi for arthritis relieved multiple joint pain(especially neck, lower back, shoulder, wrist and knee) and these were statistically significant. Conclusions : This study is a pilot study to investigate effect of the Tai Chi for arthritis on chronic pain of whole body. Absence of control group, and other scale to test joint function except VAS were limitations of this study. It is the first clinical approach about Tai Chi in korean medicine field, also the first study of Tai Chi for pain of the whole body.

A survey on sex life behavior and factors of low back pain (요통환자들의 성생활 행태와 영향 요인 조사)

  • Nam, Chul-Hyun;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.31-49
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    • 2002
  • The purpose of this study was to investigate discomforts and sexual life and to identify the relation between the discomforts and sexual life with low back pain. The data were collected from March 2 through July 31, 2001. Four hundred forty-two questionnaires were returned (response rate=88.0%). Analysis of the data was done with SPSS PC+ and use descriptive statistics, $x^2$-test, t-test, ANOVA. regression. The statistics shows that over than 80% of the adults experienced lumbago at least one time in their life, and Back pain is known as one of the most common complaints made by the patients of all ages in the general hospital or local medical clinics throughout. However, in certain case it leads to a chronic condition which can cause a great deal of problems in management and in financial burden to individuals and society. The result of this study was summarized as follows: 1) It appeared that regarding the distribution of gender, male was the higher(63.6%) then that of female, the portion of forties was 28.5%. Sitting for long time was 23.1% in men and 21.7% in women. Unknown reason including sexual behaviour was 12.9% in men and 15.5% in women. Patients treated medicine and physical therapy were 36.4%. In level of educational background, the rate of high school was 31.0%, technical college was 28.5%. The highest proportion by occupation was 18.3% of office workers, occupation posture was 41.9% of sitting. 2) Men(26.0%) and most of women(34.8%) were not satisfied in the explanation satisfaction rate of sex life concerned disease. 23.8% in men and 23.6% in women considered flexibility of waist good. Man(33.3%) and most of woman(35.0%) considered that Health education is necessary. 32.7% in men and 27.3% in women did't mind educator is whoever. Preventing of lower back pain(LBP) and proper Health education of sex life are demanded in daily life. 3) 58.0% of man and 64.0% of woman mostly had a posture which is man over woman. 28.5% in men and 27.8% in women considered that proper information finding of LBP and sex life was very few and few. 37.7% in men and 42.7% in women have acquired information about sex life flung their friends. 4) The number of sex life was decreased from 2.96 0.98 to 2.61 1.63 and also the time of sex life was decreased from 3.65 1.89 to 226 1.64. The satisfaction rate of sex life changed from 3.60 0.86 to 2.77 1.10. In the number of sex life, The non correct group was 2.62 1.91 and the correct group was higher in 2.68 1.65. In the time of sex life, The non correct group was 2.02 1.47 and the correct group was higher in 229 1.65. The satisfaction rate of sex life was 2.76 0.86 in non correct group and 2.88 1.10 in correct group. So there was a difference. 5) In the satisfaction rate of sex life, Men who have a lower back pain were higher than women and no attack group was higher than attack group. As they had many sex life, the satisfaction rate was higher significantly in statistics. As the time of sex life was short, the satisfaction rate was lower significantly in statistics. As the age was low, the demand rate of Health education was high and as means of patient who had a lower back pain was high, the demand rate of Health education was high. As the patient who had a lower back pain had a long married life, the demand rate of Health education was high and as education level was high, the demand rate of Health education was high. It is necessary to provide patients with conservative treatment, educational teaching, and training to prevent further injuries in the future. In general, it is important to educate the public how to prevent back injuries and how to treat themselves in an onset period to prevent further injuries sliding into a chronic state. Sexuality is an integral part of normal and healthy relationships, but patients are unable to enjoy sex because they are riot able to get into a comfortable position due to back pain. Many conditions of the spine can make certain positions uncomfortable. Health educator should make the education program of the discomforts and the sexual pattern for low back pain in workplace and/or hospital. Further study Is needed on how to integrate the educational program on sexuality into the total rehabilitation program.

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The Analysis of 278 Cases Who were Medicated with Cheonga-won (청아원을 사용한 환자 278례에 대한 증례 분석)

  • Kang, Jae-Hui;Lee, Hyun;Choi, Joo-Young;Yoon, Kwang-Sik
    • Journal of Acupuncture Research
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    • v.28 no.1
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    • pp.93-100
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    • 2011
  • Objectives : The purpose of this study is to observe the general distribution that was medicated with Cheonga-won. Methods : The 278 patients who were medicated with Cheonga-won more than two weeks in Cheonan oriental hospital, Daejeon university from December 2007 to December 2010 were observed. The other general oriental therapys were also carried out according to individual condition. The 278 patients were analyzed according to the distribution of sex, age, the period of medication, symptoms, the change of VAS score and T-score, side effects and abnormal reactions. Results : 1. Cheonga-won was mostly used for Shin-huh, which induces lower back pain, knee pain, vertigo, dysuria, tinnitus. 2. More patients in their fifties, sixties and seventies were prescribed with the medication than those in their thirties and forties. 3. After medication with Cheonga-won, there are tendency in reduce chronic pain. 4. After medication with Cheonga-won, there are tendency in increase BMD(bone mineral density). 5. There are no side effects and abnormal reaction cases that related with Cheonga-won. Conclusions : Cheonga-won was used in Shin-huh symptoms, and may be effective in reduce chronic pain, improve Shin-huh symptoms and increase BMD.

Effects of Local and Sa-am Acupuncture on Hypoadrenia and Chronic Low Back Pain (신정격(腎正格) 침치료와 요추부 국소 침치료가 신허요통(腎虛腰痛)에 미치는 유효성 비교평가)

  • Kim, Seoung-Min;Kim, Ho-Jun;Lee, Myeong-Jong;Shin, Young-Jin
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.104-116
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    • 2009
  • Objectives: This experimental study was designed to show the relationship between kidney qi deficiency and hypoadrenia. A comparative study between Sa-am and local area acupuncture stimulation was conducted. The test results help to show the relationship between kidney qi deficiency and hypoadrenia as well as the recuperation of the patient with the use of VAS, ROM, Sch ber test, ODI and salivary cortisol testing. Methods: 1. Twenty-four adults with chronic low back pain were recruited. Once selected the test population was divided into two different groups. One group was treated only with the use of local area acupuncture and the other with Sa-am acupuncture. 2. At the completion of each acupuncture treatment both groups underwent a VAS, ROM, ODI, $Sch{\ddot{o}}ber$ Test and salivary cortisol test. Results: 1. Both the Sa-am acupuncture group and the local area acupuncture group had statistical significance in VAS decrease and flection ROM increase. 2. Only the Sa-am acupuncture group had statistical significance in extension ROM increase. Only the local area acupuncture group had statistical significance in both lateral flection ROM increase and ODI test. 3. There was statistical significance of correlation between morning salivary cortisol test and adrenal fatigue questionnaire. Conclusions: Both local area acupuncture as well as Sa-am acupuncture treatments were effective for treating lower back pain caused by kidney qi deficiency. In addition, each patients recuperation level can be verified with the results seen from the salivary cortisol test results. The cortisol results suggest a similarity between kidney qi deficiency and hypoadrenia.

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Paraplegia Caused by Vertebral Metastasis during Pain Control in Cervical Cancer Patient -A case report- (자궁경부암 환자의 통증치료중 척추전이에 의한 하반신 마비 -증례 보고-)

  • Kim, In-Jung;Chun, Bum-Soo;Kyeon, Il-Soo;Lee, Jung-Koo
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.304-307
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    • 1997
  • Continuous epidural infusion, a combination of local anesthetic and opioid, have been widely administered for treatment of chronic cancer pain. A serious complications of epidural block is paraplegia which can also be caused by : direct spinal cord injury, epidural hematoma, epidural abscess, ischemic change, neurotoxicity, preexisting disease. Continuous epidural block for pain control of patient with cervical cancer was performed at $T_{12}/L_1$ interspace. A 4 cm catheter was inserted cephalad into the epidural space. After four months, back pain and motor weariless of lower extremities progressively developed. Spine CT showed bony destruction and soft mass-like lesion at $T_9$ & $T_{12}$ spine. We propose paraplegia was caused by spinal cord compression which resulted from vertebral metastasis of cervical cancer.

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Difference of Pain Description According to Gender in the Elderly (노인의 성별 만성동통 호소의 차이에 대한 조사연구)

  • 김명애;박경민;김효정
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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    • pp.369-379
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    • 1998
  • Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence (69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001), the greatest impact was on movement (83.5%) , followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture.byssocausis(55%). The conclusion : Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, especially by gender and by age.

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Effects of Plank Exercise on Abdominal Muscle Thickness and Disability in Subjects With Mild Chronic Low Back Pain (플랭크 운동이 경한 만성 요통 대상자의 복부 근육 두께와 장애에 미치는 영향)

  • Jeong, Hye-jin;Ha, Su-jin;Jeong, Ye-ji;Cho, Woo-hyun;Kim, Jun-ki;Won, Jong-im
    • Physical Therapy Korea
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    • v.26 no.1
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    • pp.51-59
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    • 2019
  • Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

The Effects of Maintained Muscle Contraction of Abdominal and Pelvic Floor Muscles on 3D Pelvic Stability in Individuals with Chronic Low Back Pain During Gait

  • Yu, Min;Choi, Yu-Ri;Choi, Jeong-Eun;Jeon, Seong-Yeon;Kim, Yong-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.3
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    • pp.23-30
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    • 2022
  • PURPOSE: This study was designed to investigate the effects of keeping contraction of abdominal and pelvic floor muscles on 3D pelvic stability in individuals with nonspecific chronic low back pain (CLBP) during normal speed walking. METHODS: The subjects were 20 adults with CLBP deformity and had moderate pain intensity of the visual analog scale. A three-dimensional camera capture system was used to collect kinematic pelvic motion data with and without contraction of the abdominal and pelvic floor muscles during gait. The subjects were asked to walk on a walkway in the lab room and they were attached 40 reflective markers to their pelvic segment and lower extremities. A Visual3D Professional V6 program and Vicon Nexus software were used to analyze 3D pelvic kinematic data. RESULTS: There were significant differences between with and without contraction of the abdominal and pelvic floor muscles of the pelvic depression and the total pelvic motion in coronal plane during gait (p < .05). However, there were no significant differences in any of the maximal motion of the pelvic segment in sagittal and transverse motion plane according to the different muscle contraction conditions (p > .05). CONCLUSION: The results of this study suggest that maintaining co-contraction of the abdominal and pelvic floor muscles in individuals with CLBP increased pelvic stability and contributed to preventing excessive pelvic movements during gait.