• 대한통합의학회지
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• 제1권3호
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• pp.9-17
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• 2013

Purpose : The purpose of this study was to analyze the effects of transverse abdominal exercise on the change of chronic low back pain and lumbar muscle strength. Method : 18 chronic lumbago patients were transverse abdominal exercise for 3weeks. Result : 1. The strength of the lumbar extensor and flexor of the male subjects was increased significantly after abdominal exercise(p<0.05). 2. The strength of the lumbar extensor and flexor of the female subjects was increased significantly after abdominal exercise(p<0.05). 3. The study can confirm significant relationship between the lumbar muscle strength and lumbar pain before and after the exercise Conclusion : The study of could find the increase of the ability of the lumbar extensor and flexor of both male and female subjects suffering from chronic low back and pain using three-week transverse abdominal exercise. The study confirmed the general decrease of pain after the experiment.

• 대한물리의학회지
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• 제4권1호
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• pp.9-14
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• 2009

Purpose : The purpose of this study is change of lumbar multifidus muslce recorded simultaneously by ultrasound imaging during upper extremity functional movement in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. Multifidus size were measured from L4 vertebral segement. The ultrasound imaging apparatus(Sonoace 6000, Medison, Korea) was epuipped with a 5-MHz convex array transducer. The upper extremity lifting movement used to activate the multifidus was then measured. Results : Results of the analysis showed that at the L4 vertebral leves, healthy asymptomatic subjects had significantly larger multifidus muscle compared with chronic LBP subjects. Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Especially multifidus contraction in L4 vertebral segement. So chronic LBP patients necessary multifidus muscle release treatment.

• 대한물리치료과학회지
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• 제29권4호
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• pp.75-85
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• 2022

Background: The purpose of this study was to investigate the effect of intensively complex physical therapy program on pain, range of motion (ROM) and muscle function in traumatic low back injury by industrial accident. Design: Prospective study Methods: Eight patients with traumatic low back injury by industrial accident participated in this study. They were treated the intensively complex physical therapy program including daily 60 minutes therapist supervised physical therapy at 5 times a week and 30 minutes manual therapy at 5 times a week in 12 weeks. Evaluation was performed before the commencement of the training and again 4, 8 and 12 weeks. There were measured Numerical Rating Scale (NRS) for evaluating pain, ROM of trunk, and isometric muscle strength of trunk, core muscle endurance, neuromuscular control ability for evaluating muscle function. Results: NRS was significantly improved according to time (p<0.05). ROM of extension and rotation, isometric muscle strength of trunk and hip, core muscle endurance and neuromuscular control ability were significantly improved according to time (p<0.05). Conclusion: We could confirm the superiority effect of intensively complex physical therapy program on pain, ROM of trunk and muscle function in traumatic low back pain with industrial accident.

• The Journal of Korean Physical Therapy
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• 제23권4호
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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.

• 한방재활의학과학회지
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• 제19권4호
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• 국제물리치료학회지
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• 제11권4호
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• pp.2253-2260
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• 2020

Background: Patients with low back pain (LBP) experience misalignments in the center of pressure (COP) and muscle imbalances due to frequent onesided posture adjustments to avoid pain. Objectives: To identify the effects of Squat Exercises with Vertical Whole-Body Vibration on the Center of Pressure and Trunk Muscle Activity. Design: Randomized controlled trial. Methods: Thirty LBP patients with an imbalance in the COP were sampled and randomly assigned to an experimental group of 15 patients who under went an intervention involving squat exercises with vertical WBV and a control group of 15 patients who were treated via a walking intervention. As pretests before the interventions, the subjects' COP was identified by measuring their stability index (ST), and erector spinae, rectus abdominis, transverse abdominis, gluteus medius muscle activity was analyzed by determining the % reference voluntary contraction (%RVC) value using surface electromyography while sit to stand. After four weeks, a post test was conducted to remeasure the same variables using the same methods. Results: Statistically significant differences were found in the ST (P<.01) and trunk muscle (P<.05, P<.001) in the experimental group before and after the intervention. In terms of the differences between the left- and right-side (RL) muscle activity, only the transverse abdominis (TrA) and gluteus medius (GM) exhibited statistically significant increase (P<.05). A comparison of the groups showed statistically significant differences in the TrA with respect to muscle activity (P<.05) and in the RLTrA and RLGM in terms ofthe difference between left- and right-side muscle activity (P<.01). Conclusion: Squat exercises with vertical WBV produced effective changes in the COP of patients with LBP by reducing muscle imbalances through the delivery of a uniform force. In particular, strengthening the TrA and reducing an imbalance in the GM were determined to be important factors in improving the COP.

• 대한추나의학회지
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• 제4권1호
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• pp.119-127
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• 2003

본 증례는 약 8 주간의 운동치료와 스트레칭 프로그램의 운용으로 요통의 감소와 함께 요부근력의 상승을 가져왔다. 환자 관리에 유용한 입원 치료를 통하여 타 연구에 비해 뛰어난 요부근력의 향상을 보였는데 이는 일정 기간 내에서 환자 관리에 따라서 요부 근력의 상승정도를 높일 수 있음을 보여준다고 생각된다. 추나치료, 침구치료 등이 미치는 영향에 대해서 일일이 제한을 두지 않았고 이러한 한방치료의 병행 자체가 미치는 영향에 대하여서는 보다 많은 case 연구가 필요하다고 생각된다.

• 대한물리의학회지
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• 제18권2호
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• pp.49-59
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• 2023

PURPOSE: This study examined the relationship between lumbar instability and shortening of the iliopsoas muscles in patients with chronic low back pain. METHODS: Forty-nine patients with chronic low back pain participated in this study. The modified Thomas test was used to examine the shortening state of the iliopsoas muscle. The length of the iliopsoas muscle was measured using the hip flexion angle, and those with a flexion angle of 10° or more were classified as positive. Five subtests were used for the lumbar instability test: testing for prone lumbar instability, passive lumbar extension, anterior-posterior mobility, passive straight leg raise, and age. Those who tested positive for at least three of these tests were classified as positive for the lumbar segment instability test. RESULTS: There was a significant association between the results of the lumbar instability test and the shortening of the iliopsoas test (p < .05). After analyzing the association between the iliopsoas length test and the five lumbar instability subtests, the results of the prone lumbar instability test (p < .001) and the anterior-posterior mobility test (p < .05) showed a significant association with the iliopsoas length test. CONCLUSION: The association between lumbar instability and shortening of the iliopsoas muscles was examined in 49 patients with chronic low back pain. Patients with shortened iliopsoas muscles tested positive in the lumbar instability tests more often. Hence, the length test of the iliopsoas muscle can be used to determine lumbar instability in patients with chronic low back pain.

• Safety and Health at Work
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• 제7권1호
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• pp.49-54
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• 2016

Background: Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods: Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results: Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values ($t_{(9)}=-11.97$ to -2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion: Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.67-75
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• 2011

The purpose of this study was to assess the agreement of manual muscle testing (MMT) and test-retest reliability of a hand held dynamometer for the posterior gluteus medius muscle, with and without lumbar stabilization, using a pressure biofeedback unit for patients with low back pain. The pressure biofeedback unit was used to minimize the substitute motion of the lumbopelvic region during hip abduction in patients lying on their side. Fifteen patients with low back pain participated in this study. A tester determined the MMT grades of the posterior gluteus medius with and without the pressure biofeedback unit. Active hip abduction range of motion with an inclinometer and the strength of their posterior gluteus medius using a hand held dynamometer were measured with and without the pressure biofeedback unit in the MMT position. The agreement of the grade of muscle strength in the MMT, and intra-rater reliability of both the active hip abduction range of motion and the strength of posterior gluteus medius were analyzed using the weighted kappa and intraclass correlation coefficient (ICC), respectively. The agreement of MMT with the pressure biofeedback unit (weighted kappa=.92) was higher than the MMT (weighted kappa=.34)(p<.05). The inclinometer with pressure biofeedback unit measurement of the active hip abduction range of motion had an excellent intra-rater reliability (ICC=.90). Also, the hand held dynamometer with pressure biofeedback unit measure of strength of the posterior gluteus medius had a good intra-rater reliability (ICC=.85). Therefore, the test for muscle strength with pressure biofeedback unit will be a reliable method for the determination of the MMT grades or amount of posterior gluteus medius muscle strength and the measurement of the range of motion for hip abduction in patients with low back pain.