• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.198-206
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• 2022

Objective: This study was to investigate the effect of a lumbar stabilization exercise program accompanied by proprioceptive stimulation in women in their 20s with low back pain. Design: A randomized controlled trial Methods: A total of 30 women in their 20s with low back pain were selected and randomly assigned to an experimental group and a control group. Both groups performed a lumbar stabilization exercise program, and only the experimental group applied for a stabilization exercise program with proprioceptive stimulation. The exercise program lasted 60 minutes at a time, 3 times a week, for 4 weeks. The measurement tools used were the Numeric Rating Scale (NRS), the Korean version of the Oswestry Disability Index (K-ODI), the lumbar alignment, and the transverse abdominis(TrA) muscle thickness and contraction ratio. Results: Both groups showed statistically significant differences in NRS, K-ODI, and muscle thickness before and after the experiment (p<0.05). The lumbar alignment and contraction ratio at the time of contraction of TrA in the experimental group was statistically significantly increased, and there was also a significant difference in the difference between the two groups (p<0.05). Conclusions: The lumbar stabilization exercise program with proprioceptive stimulation reduced pain, improved low back pain induced dysfunction, and increased TrA muscle thickness and contraction ratio. Therefore, it can be an effective therapeutic exercise program for women in their 20s with LBP.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.63-71
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• 2015

PURPOSE: The purpose of this study to investigate the effects of exercise on lumbar stabilization in muscle activity and isokinetic muscle strength of female with chronic low back pain. METHODS: The candidates was chose to twenty women in their 30s and 40s complaining back pain for over 12 weeks and consist of 10 people for lumbar stabilization and general physical therapy group(PL group), another 10 people for general physical therapy group(GP group). Lumbar stabilization exercise was conducted for 8 weeks and was comprised of 60 minutes for two times a week. In order to examine the effects of lumbar stabilization, results in the present study were analyzed maximal voluntary isometric contraction (MVIC) using electromyogram to measure muscle activity and isokinetic performance including peak torque and average power at the pre to post. RESULTS: The following are results in this study. The MVIC and isokinetic muscle strength were gradually increased in all group. As the result of the test of the MVIC and isokinetic muscle strength, the difference of lumbar stabilization and general physical therapy group is statistically more significant than that of general physical therapy group. CONCLUSION: In the present study, results indicate that lumbar stabilization helps to improve the muscle activity and isokinetic muscle strength.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.35 no.2
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• pp.30-36
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• 2012

This study is aimed to show that an asymmetric load in the frontal plane leads to an increase in low back loading and fatigue in comparison with a symmetric load when workers lift an external weight by investigating previous studies and verifying the phenomenon with an experiment. Ten male subjects are required to lift and hold an given external load at 70cm height during 50sec, then the EMG amplitude and median frequency on bilateral low back muscle groups (Longissimus, Iliocostalis, and Multifidus) are recorded and analyzed. Independent variables are two-level load weight (13kg, 20kg) and three-level LCG (Center, 6.5cm to the right, and 13cm to the right), and dependent variables are EMG amplitude average, difference, and Fatigue Index (FI). Results show that load weight increases significantly amplitude average and FI, but LCG does significantly amplitude difference and FI significantly (P-value < 0.05). Also the correlation coefficient between amplitude difference and FI is over 0.99. These implies that trunk loading should be explained by not EMG amplitude but muscle fatigue aspect since the association between an external load and amplitude is linear, but the relationship between an external load and median frequency as muscle fatigue index is almost exponential.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.173-180
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• 2018

Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.4
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• pp.159-169
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• 2010

Objectives : This study was designed to evaluate the correlation of the cross-sectional areas(CSA) of paraspinalis(iliocostalis lumborum, multifidus, longissimus thoracis parts lumborum) and psoas muscle and sex, age, change of the VAS(visual analogue scale) and past history of chronic low back pain in patients suffering from HIVD(herniation of intervertebral disc). Methods : Medical records of 140 subjects with HIVD were retrospectively reviewed. The MRI(magnetic resonance imaging) findings on the patients were scanned and analyzed by PiView program to find the paraspinal and psoas muscle CSA and were evaluated by the correlation of sex, age, change of the VAS, and past history of chronic low back pain. Results : There was significant difference between groups in male and female, young-adults age and middle age, middle age and old age, young-adults age and old age. But the correlation of the paraspinal and psoas muscle CSA and past history of chronic low back pain were partially significant. On the other hand, the correlation of the paraspinal and psoas muscle CSA and change of the VAS were not significant. Conclusions : These results suggest that the cross-sectional areas(CSA) of paraspinalis and psoas muscle have relevance to sex and age.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.147-157
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• 2020

Purpose : The purpose of this study was to investigate the effects of active release technique and lumbar stabilization exercise on pelvic asymmetry, muscle activation and pain in chronic low back pain patients. Methods : The subjects were 37 outpatients diagnosed with chronic low back pain. The patients were randomly divided into an active release technique therapy group (ART; n=18), and lumbar stabilization exercise group (LSE; n=19). These groups performed their respective therapy for a 30-minute session occurring two times a week over six-weeks period. To assess the patients' pelvic asymmetry, their pelvic tilt, and pelvic rotation was measured using X-ray imaging. EMG was used to evaluate the muscle activity of the lumbar muscle. The visual analogue scale (VAS) were used to measure the subjects' pain. Results : Both ART group, and LSE group exhibited statistically significant differences in their subjects' VAS and muscle activation of lumbar muscle after the therapy (p<.05). In ART group exhibited statistically significant decreases in their subjects' pelvic tilt and pelvic rotation after therapy (p<.05). There was a significant difference between the ART group, and LSE group (p<.05). Conclusion : The results of this study suggest that active release technique and lumbar stabilization exercise are effective in decrease pain and increase muscle activation in chronic low back pain patient. In addition active release technique is considered to be more effective in improving pelvic tilt and pelvic rotation than lumbar stabilization exercise.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.39-47
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• 2010

Purpose: The purpose of this study was to characterize changes in back muscles in patients with chronic back pain. Accordingly, we studied 154 patients with chronic low back pain with regard to area, aspect and triggering position of the pain. We also determined muscle atrophy in painful areas. Methods: Subjects were questioned about pain and a pain provoking test was done. On Magnetic Resonance Imaging (MRI), we measured cross sections of the multifidus, erector spinae, iliopsoas and quadratus lumborum muscles at each spinal level. Results: Muscles in painful regions (multifidus and erector spinae muscles) decreased in area significantly more than nonpainful regions, and showed a significant difference (p<0.05) at levels L3, L4, and L5. Painful regions of the iliopsoas and quadratus lumborum did not change significantly more than non-painful regionsexcept at L5 (p<0.05). The group that had unilateral low back pain showed a significant decrease in cross section compared to the group that had central or bilateral pain (p<0.05). Conclusion: Chronic low back pain causes variable decreases in cross-sectional areas of some but not all back muscles, and at some but not all spinal levels.

• Physical Therapy Korea
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• v.11 no.4
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• pp.19-29
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• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• Physical Therapy Rehabilitation Science
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• v.8 no.4
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• pp.175-186
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• 2019

Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.1-10
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• 2022

PURPOSE: This study examined the effects of the resistance levels on the muscle activities around the hip and spine during bridge exercise with hip abduction resistance in patients with chronic back pain. METHODS: A cross-over study design was used. Twenty subjects with low back pain were enrolled in this study. The subjects performed bridge exercises with hip abduction resistances (20 mmHg, 40 mmHg, and 60 mmHg). A Narrow Sling was used to provide resistance. Surface electromyography was used to measure the activity of the erector spinae, biceps femoris, gluteus maximus, and gluteus medius. RESULTS: The muscle activity of the gluteus maximus and gluteus medius increased significantly with increasing resistance levels. There was a significant difference in the muscle activity of the biceps femoris with a resistance level between 20 mmHg and 40 mmHg, but there was no significant difference in the other resistance levels. There was no significant difference according to resistance level in the erector spinae. The muscle activity ratios of the gluteus medius/erector spinae and gluteus maximus/erector spinae increased significantly with increasing resistance strength. CONCLUSION: The different levels of abduction resistance for hip abduction during bridge exercise will help activate the gluteus maximus selectively in patients with chronic back pain.