• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.10-15
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• 2013

Purpose: Low back pain occurs and frequently recurs in many people. An imbalance of paraspinal muscle activity can cause low back pain. Mulligan's concept of mobilizations with sustained natural apophyseal glides (SNAG) is a common method for treating low back pain. The purpose of this study was to investigate the effects of this method on paraspinal muscle activity in patients with chronic low back pain. Methods: Twenty-one patients with low back pain participated in this study. Patients were classified using the Oswestry disability index. The subjects' paraspinal muscles were measured by surface electromyography both before and after the SNAG mobilization. We measured the root mean square value of the paraspinal muscles during lumbar flexion and extension. Results: Paraspinal muscle activity in patients with chronic low back pain was different between the right and left sides. Importantly, paraspinal muscle activity significantly decreased after using the SNAG mobilization method. Conclusion: This study shows a difference between paraspinal muscle activity in chronic low back pain patients and finds that the Mulligan's concept of SNAG mobilization is effective at reducing imbalances in paraspinal muscle activity in low back pain patients.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.51-84
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• 2001

Objective : The therapeutic exercise on low back found In the literatures mostly have adopted methods that are applied to only certain muscles. The purpose of this paper to classify various low pains and to Investigate an active physical treatment can be applied to certain low back pain. Methods : By exploring the journals and medical publications. Results and Conclusions 1. A goal of low back exercise is reinforcement and extension of muscles in order to control pains. 2 Low back exercise which causes the movement of the spinal joint and disk can control pains. 3. Flexion exercise of lumbar spine can be generally applied to any low back pains except kyposis. 4. Extension exercise of lumbar spine can be applied to any low back pains except facet joint syndrome or hyperlordosis. 5. Rotation exercise of lumbar spine can be applied to any low back pains except facet joint syndrome. 6. Lateral bending exercise of lumbar spine can be applied to HNP. facet Joint syndrome, scoliosis.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.1
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• pp.30-36
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• 2003

Purpose: The strength of hand grip, low back muscles and knee joint muscles were measured and then compared to the bone mineral density (BMD) of each forearm bones (including ulna and radius), lumbar spine, and femur in young women in order to identify the relationship between muscle strength and bone mineral density. Method: The BMD was measured with a Dual Energy X-ray Absorptiometry and muscle strength was measured with a handgrip dynamometer and a Cybex Norm. Data were analyzed with frequencies, percentages, means, and Pearson correlation coefficients. Result: 1) Higher grip strength correlated positively with higher BMD in the forearm (r=.246, p=.007), higher low back extensor strength with higher BMD in the femur (neck, trochanter and Ward's triangle)($r=.323{\sim}.226$, $p=.003{\sim}.043$) and higher strength in the knee joint extensor with higher BMD in the lumbar spine (r=.227, p=.041), femur neck, and femur trochanter significantly ($r=.295{\sim}.226$, $p=.007{\sim}.043$). There was no significant correlation between the strength of low back extensors and BMD in the lumbar spine, now with strength of knee joint flexor and the BMD in the femur. 2) The muscle strength of each part of the body had significant positive correlations to each other part ($r=.255{\sim}.728$ $p=.021{\sim}.000$) Conclusion: The results of this study showed that with the development of a muscle there was an increased BMD of the corresponding part, and the BMD of each part was influenced by adjacent muscles. To promote the health of bones, it is important to strengthen the muscles of related bones, based on balanced development of all muscles.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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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.

• 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.

• Physical Therapy Korea
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• v.5 no.3
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• pp.63-71
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• 1998

Trunk holding test (Sorensen test) appear to have more value than strength test in prediction the occurrence of low back pain. Electromyographic activity of trunk extensor muscles during these test may provide clues to the etiology of neuromuscular-based low back pain. This study investigated the difference in back muscle endurance between healthy adult men and women using surface electromyographic (EMG) power spectral analysis. Thirty hea1thy subjects (15 men and 15 women) performed an unsupported trunk holding test for 60 seconds. Recording surface electrodes were placed over the erector spinae medially and laterally at vertebral levels of $L_1$ and $L_5$. Slope of total frequency was evaluated using the MP100WSW Fast Fourier Transform spectrum analysis program. The slopes of all indices of back muscle fatigue, except right $L_5$, were significantly steeper in men than in women (p<0.05). Our results indicated that the trunk holding test using EMG power spectral analysis of erector spinae muscles is useful for the evaluation of fatigue rate of these muscles. Our results also showed a higher muscle endurance in healthy adult women than in men.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.191-202
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• 2020

Purpose : The purpose of this study is to examine the effect of the segmental mobilization technique of the lower back on the characteristics of the muscles and limited of stability of chronic backache patients. Methods : The subjects of the study were 30 chronic back pain patients who were divided into groups of 15, a manual therapy group (Group I) and a spinal decompression therapy group (Group II), via random assignation. The subjects had 15 minutes of superficial heat therapy, 15 minutes of interference wave therapy, and 5 minutes of ultrasound therapy for conservative physical therapy. Additionally, manual therapy and spinal decompression therapy were administered to each group for 30 minutes, 5 times a week for 8 weeks. Before intervention, the characteristics of the muscles and limited of stability of the muscles were analyzed. After 8 weeks of intervention, the above items were re-measured in the same manner and analyzed between groups. Results : The results of comparative analysis of the characteristics of the muscles and limited of stability between groups showed that there were statistically significant differences. The manual therapy group (Group I) showed significant differences in characteristics of the muscles compared to the spinal decompression therapy group (Group II). The manual therapy group (Group I) showed significant differences in limited of stability compared to the spinal decompression therapy group (Group II). Conclusion : The result confirmed that manual therapy was more effective in the characteristics of the muscles and limited of stability. Based on this study, additional studies are necessary on the effect of various techniques of manual therapy on muscle activity and muscle thickness in chronic back pain patients. In order to develop an effective manual therapy program, studies using a variety of evaluations are needed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.27-36
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• 2021

Background : Prone hip extension (PHE) is commonly used for exercises and tests in patients with low back pain. Previous studies have shown that pelvic compression belts (PCB) and non-elastic taping (NET) contribute greatly to improvements in lumbopelvic stability. This study aimed to compare the effect of two lumbopelvic stability methods such as PCB and NET on the trunk and hip extensor muscle activities during PHE tests. Methods: Subjects who experienced low back pain (low back pain group, LBPG; n=20) and those who did not experience low back pain (non-LBPG; n=20) participated in this study. The subjects were instructed to perform PHE with and without a PCB and NET. PHE tests were performed in the condition wherein the two stabilization methods were applied, and the actions of the muscles at that time were measured using surface electromyography (EMG). EMG data were collected from the hamstring, gluteus maximus, erector spine (ES), and multifidus (MF) muscles. The data were collected three times for 5 s with a 1-min rest between each of the three sets. Results: In the LBPG, EMG of the ES muscle was significantly reduced when NET or a PCB was applied (p<.05). There was no difference in the change in the ES muscle activity when NET and a PCB were applied. The ratio of MF/ES muscleactivity showed a significant increase in the LBPG with NET (p<.05). Conclusion: Both NET and PCB applied to subjects who experienced low back pain significantly reduced the ES muscle activity during PHE exercises and helped control the balance of the superficial and deep trunk extensor muscles.

• Physical Therapy Korea
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• v.16 no.2
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• pp.31-39
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• 2009

This study is performed to investigate the difference of the spinal stability system with and without low back pain. There were 9 participants with low back pain and 9 asymptomatic subjects to be recruited, they were measured thoracic and lumbar curvature, trunk muscle activation in upright sitting postures and slump sitting, back muscle endurance, and lumbar proprioception. Spinal curvature and surface electromyography of 4 trunk muscles were measured in an upright sitting postures and slump sitting in 18 subjects. The result of the study was that there were significant differences between the groups in spinal curvature (p<.05), significantly higher external oblique activity and less internal oblique in the low back pain group than the healthy subjects (p<.05), and significantly less proprioception in the low back pain group (p<.05). But there was not a significant difference between the trunk muscle endurance groups. According to the result, the low back pain group had greater thoracic extension and higher global muscle activity in the upright sitting posture and less proprioception. This study was useful to suggest postural training for normal muscle activation, selective muscle strengthening to prevent chronic deterioration, and helpful in making a treatment plan to indicate a synthetic care method that includes increasing proprioception.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.454-462
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• 2021

Background: This study was performed to reveal the relationships between the cross-sectional areas (CSAs) of the paraspinal muscles and the severity of low back pain (LBP), including the level of disability. Methods: This single-center cross-sectional study was conducted on 164 patients with chronic LBP. The effects of demographic characteristics, posture, level of physical activity, disc herniation type, and sarcopenia risk on the CSAs of paraspinal muscles were evaluated along with the relationship between the CSAs and severity of pain and disability in all patients. The CSAs of paraspinal muscles were evaluated using the software program Image J 1.53. Results: A negative significant correlation was found between age and the paraspinal muscle's CSA (P < 0.05), whereas a positive correlation was present between the level of physical activity and the CSA of the paraspinal muscle at the L2-3 and L3-4 levels. The CSAs of paraspinal muscles in patients with sarcopenia risk was significantly lower than those in patients without sarcopenia risk (P < 0.05). The CSAs of paraspinal muscles at the L2-3 and L3-4 levels in obese patients were significantly higher than those in overweight patients (P = 0.028, P = 0.026, respectively). There was no relationship between the CSAs of paraspinal muscles and pain intensity or disability. Conclusions: Although this study did not find a relationship between paraspinal CSAs and pain or disability, treatment regimens for preventing paraspinal muscles from atrophy may aid pain physicians in relieving pain, restoring function, and preventing recurrence in patients with chronic LBP.