• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.11-22
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• 2004

The concept of segmental stabilization has been one of the most exciting advancements in the field of physical therapy. Specific deep stabilizing muscle have proven to reverse motor control deficits that occurs after back injury. After an injury, a new motor programming strategy is adopted and there is excessive recruitment of the large , strong , global muscular system works instead of small segmental deep muscle recruitment for stability. Many physical therapists and doctors mistakenly prescribe therapeutic exercise for low back pain to use larger, superficial musculature to strengthen the spine for stability and pain control. But motor control coordination of local segmental muscle is actually the key to stability and pain control, not strengthening of global muscle. A recent focus in physiotherapy management of patients with chronic back pain has been the specific training of muscles surrounding the lumbar spine whose primary role is considered to be the provision of dynamic stability and segmental control to the spine. These are the deep transverse abdominis muscle and lumbar multifudus.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.71-82
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• 2023

PURPOSE: This study examined the effect of training using video content on abdominal muscle thickness, Oswestry disability index (ODI), and pain in college students with chronic back pain. METHODS: Twenty-nine college students with chronic back pain participated in this study. The subjects were assigned randomly to 15 experimental groups who trained using video content and 14 control groups who exercised voluntarily using back exercise leaflets. The video used for the intervention was obtained from YouTube, and the difficulty level of the video was classified into six levels. Both groups participated in the intervention for 40 minutes/day, three times a week for six weeks, and the variables of abdominal muscle thickness, ODI, and pain were compared before and after the intervention. RESULTS: In the experimental group, there were statistically significant changes in the thickness of the internal oblique and transverse abdominis muscles, ODI, and pain after the intervention, except for the external oblique muscle (p < .05). In the control group, there was no statistically significant difference in all variables after the intervention (p > .05). A statistically significant difference in all variables was observed between the experimental group and the control group after the intervention except for the external oblique muscle (p < .05). CONCLUSION: Treatment of chronic low back pain using video content is a possible alternative treatment if quality images are selected and the difficulty levels are adjusted.

• Journal of Korean Physical Therapy Science
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• v.16 no.1
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• pp.11-20
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• 2009

Background: The purpose of this study was to investigate the effect of stretching and strengthening exercise on the static flexibility and pain intensity for the iliopsoas muscle, which is one of the main reasons for the chronic low back pain. Methods: The subjects of this study were 15 male adult patients with showed 6 score or higher in the visual analogue scale(VAS) and complained of low back pain over three months who visited department of the physical therapy, KIA motors Industrial Health Center, from October, 2008 through December, 2008. Fifteen subjects were trained stretching, mat exercises and sling exercises for iliopsoas muscle at 4-5 times a week for 4 weeks. I measured the changes on the extensibility of iliopsoas muscle, static flexibility of low back and VAS between pre- and post exercise treatment. Date were analyzed using the Wilcoxon's signed rank test considering the size of the samples. Results: 1. The angle of the hip joint that showed the extensibility of iliopsoas muscle was relieved, which was significant statistically (p<.05). 2. The static flexibility was statistically significantly improved in the trunk flexion test, trunk extension test and Schober-Test (p<.05). 3. The VAS showed decrease, which is significant statistically (p<.05). Conclusion: It is believed that the exercise treatment of iliopsoas muscle has the significant effects on the improvement of static flexibility and decrease of pain intensity for the chronic low back pain patients.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.1
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• pp.523-531
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• 2013

Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.

• Physical Therapy Rehabilitation Science
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• v.2 no.1
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• pp.27-30
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• 2013

Objective: Low back pain is a primary of source of dysfunction and economic costs. Gluteus medius muscle co-activation and activity pattern change caused the low back pain. Active release technique (ART) is a patented, non-invasive, soft tissue treatment process that both locates and breaks down the scar tissue and adhesions. The purpose of this study was to assess the effects on chronic low back pain using ART on gluteus medius so that suggest usable treatment method for treating chronic low back pain. Design: One group pretest-posttest design. Methods: Twelve patients with chronic low back pain were participated in this study. Subjects in ART group were received 2 times a week for 3 weeks treatments with either ART on gluteus medius muscle trigger points. Outcome measures were conducted by pain intensity with a pain visual analogue scale and pressure pain threshold on gluteus medius. Results: Completion of the intervention, the visual analogue scale was decreased in ART group (p<0.05). Also pressure pain threshold was decreased in ART group (p<0.05). Conclusions: Our results suggest that the response to ART may be usable to treat low back pain. ART was presented to reduce pain level of low back in people with chronic low back pain. Further study is required to management for low back pain due to gluteus medius and more ART study.

• Journal of Korean Physical Therapy Science
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• v.2 no.4
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• pp.817-822
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• 1995

Even though back pain therapy has greatly improved as spinal bio-mechanics is introduced, many patients still have difficulties due to low back pain. At the initial therapeutic stage, the aim of rehabilitation therapy for low back pain is pain control, but, at the later therapeutic stage, the prime aims are to reduce the late complication and to prevent the recurrence of low back pain. Accurate diagnosis should be a first step before any therapy is planned. Thus, accurate physical, neurologic, E.M.G. and radiologic tests are required to give prescription for therapeutic exercise to the patients. In addition to this, the roles of theraphists and therapeutic exercise should be re-evaluated after the therapeutic exercise is performed. Fist of all, the most important things are to educate the patients to understand the low back pain and to let the patients join the therapeutical planning. 1. Bed rest and muscle relaxing exercise for releasing the muscle tention are required for the treatment of acute low back pain. An active exercise is recommended rather than a passive exercise. If the therapeutic exercise depravate the low back pain, the exercise should be immediately terminated and the therapeutical exercise should be replanned. 2. For the treatment of the chronic back pain, stretching exercise and para-spinal muscle strengthening exercise should be performed steadily and actively to prevent the recurrence of low back pain and the low back injury due to minor damage. The patients should be educated to do proper exercise and to maintain good posture in everyday life. 3. As the low back pain is released and the body function is recovered, control of whole body function is necessary. Swiming, bicycling and walking for $30\sim40$ minutes a day and $3\sim4$ days a week are recommended. Other exercise could be recommended depending on the patients condition.

• Journal of muscle and joint health
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• v.15 no.2
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• pp.175-182
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• 2008

Purpose: The purpose of the study was to identify low pain prevalence rate and factors affecting low back pain in emergency medical technicians. Method: A descriptive relationship research design was utilized. The participants were 74 emergency medical technicians who worked at fire stations in W and J city and agreed to participate in this study. Data were collected between April and August 2008 using a questionnaire, which included demographic factors, severity of low back pain using a visual analog scale, factors related to low back pain and health behavior, and BMI. Descriptive statistics and multiple regression were performed for data analysis. Results: 85.1% of emergency medical technicians experienced low back pain. The mean score of low back pain was relatively low (M=4.0, SD=2.33). Significant factors affecting low back pain were found to be age, marital status, exercise, hours of standing work, and BMI. These variables explained 35.1% of variance in low back pain (F=8.45, p<.001). Conclusion: These results suggest that further research is needed to develop interventions for prevention and management of low back pain among emergency medical technicians.

• Korean Journal of Applied Biomechanics
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• v.15 no.4
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• pp.67-74
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• 2005

The purpose of this study is to compare and analyze the muscle activations between the professional golfers without low back pain symptom and the professional golfers with low back pain symptom, and so identify the stress related to golf swings, and provide the basic data to minimize the low back pain and the injury risk. Using surface electrode electromyography, we evaluated muscle activity in 6 male professional golfers during the golf drive swing. Surface electrodes were used to record the level of muscle activity in the Abdominal Oblique, Elector Spinae, Rectus Abdominis, Gluteus Maximus muscles during the golfer's swing. These signals were compared with %RVC(Reference voluntary contraction) which was normalized by IEMG(Integrated EMG). The golf swing was divided into five phases: take away, forward swing, acceleration, early follow through, late follow through. we observed patterns of trunk muscle activity throughout five phases of the golf swing. The results can be summarized as follows: RES(Right Elector Spinae) had statistically significant difference in take away phase, LGM(Left Gluteus Maximus), LRA(Left Rectus Abdominis), LOA(Left Oblique Abdominal) had statistically significant difference in forward swing phase, RES(Right Elector Spinae), RGM(Right Gluteus Maximus), ROA(Right Oblique Abdominal) had statistically significant difference in acceleration phase, RES(Right Elector Spinae), RGM(Right Gluteus Maximus) had statistically significant difference in early follow-through phase, LES(Left Elector Spinae), RGM(Right Gluteus Maximus) had statistically significant difference in late follow through phase.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.69-75
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• 2021

Objective: This study was aimed at investigating the effects of lumbar stabilization exercise according to correct verbal instructions in pain and muscle strengthening of the low back pain patients. Design: A randomized controlled trial. Methods: Twenty subjects with low back pain were selected. They were randomly assigned to one of two groups (10 in each group): namely the lumbar stabilization exercise and lumbar stabilization exercise according to the correct verbal instructions group. The lumbar stabilization exercise group performed lumbar stabilization exercises for 6 weeks (5 times a week). The lumbar stabilization exercise according to correct verbal instructions group performed lumbar stabilization exercise according to correct verbal instructions for 6 weeks (5 times a week). We measured pain, muscle power, proprioception, and body balance before and after exercise by using visual analog scale (VAS), digital handheld dynanometer, Joint repositioning error, time up and go test respectively. Results: We found statistically significant differences in pain, muscle power, proprioception, and body balance in lumbar stabilization exercise and lumbar stabilization exercise according to correct verbal instructions group, before and after (p<0.05). Conclusions: We confirmed the effect of lumbar stabilization exercise according to correct verbal instructions. Thus we thought these results could be used as basic data and reference for low back pain. But we need more study effect of correct verbal instructions on other exercises.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.329-334
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• 2022

Objective: Low back pain (LBP) is a symptom that accounts for a large proportion of musculoskeletal pain. Among them, non-specific LBP (NSLBP) means that the pathological cause is unknown, and belongs to the most common LBP. Studies on the mechanism of muscle control in LBP are insufficient, and quantitative studies are needed. Design: Observational cross-sectional study design Methods: A Thirty participants with NSLBP symptoms were enrolled, and their pressure pain thresholds (PPT) and muscle and fat thickness were measured. Participants measured the paraspinal muscles (PM) of the thoracic and lumbar spine and medial hamstring (semitendinosus) on the dominant and non-dominant sides in the prone position. Results: Among the variables that were significant in the correlation analysis, PM of the thoracic and lumbar spine showed a significant relationship in the PPT ([thoracic spine PM]=1.141+0.912 [lumbar spine PM]). Also, there was a significant relationship between the lumbar spine PM in the PPT and the thoracic spine PM in the muscle thickness ([lumbar spine PM of PPT]=4.057+0.117 [thoracic spine PM of muscle thickness]) Conclusions: Although there was no muscle imbalance according to the dominant and non-dominant side, there is a correlation between the pressure pain threshold and the muscle thickness between the paraspinal muscles of the thoracic spine and the lumbar spine.