• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.1-6
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• 2012

Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

• PNF and Movement
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• v.18 no.3
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• pp.351-363
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• 2020

Purpose: The purpose of this study was to investigate the effects of Pilates exercise on the back pain index, pelvic tilt angle, and physical fitness of pregnant women with low back pain. Methods: All study participants, all of whom had pregnancy-induced back pain, were randomly assigned to either a Pilates exercise group (PG, n = 8) or control group (CG, n = 7). The PG performed a Pilates exercise for 50 minutes three times a week for eight weeks. The back pain scale and pelvic tilt angle were measured using a visual analogue scale and angulometer, respectively. Cardiopulmonary endurance, flexibility, and grip strength were measured to examine the physical fitness. The variables were analyzed using two-way repeated-measures ANOVA with the Holm-Sidak post hoc procedure. Results: Back pain in the PG significantly decreased from 4.69 ± 1.28 to 1.06 ± 0.94, whereas the CG showed significantly increased back pain from 2.63 ± 2.20 to 4.71 ± 2.56. The left pelvic angle in the PG showed a significant decrease from 13.94 ± 3.70° to 12.29 ± 2.95°, while the CG showed a non-significant difference from 13.07 ± 4.42° to 17.37 ± 3.13°. The right pelvic angle in the PG showed a significant decrease from 13.50 ± 4.47° to 10.34 ± 3.66°, while a non-significant difference in the CG from 44 ± 4.98° to 15.30 ± 3.61° was found. These results showed that the regular participation in Pilates exercise was effective in reducing the pelvic tilt angle. In terms of physical fitness, the PG showed a significant increase in cardiopulmonary endurance, flexibility, and grip strength. However, the CG showed any significance increase in those variables. Conclusion: Eight weeks of Pilates exercise was associated with a decrease in lower back pain, a maintained or reduced pelvic tilt angle, and increased cardiopulmonary endurance, grip strength, and flexibility in pregnant woman with lumbar pain.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.78-87
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• 2022

Objective: The purpose of this study was to investigate the effect of high-intensity complex exercise program using whole-body vibration (WBV) and respiratory resistance on pain and dysfunction, psychosocial level, balance ability, and pulmonary function in low back pain (LBP) patients with high obesity. Design: A randomized controlled trial Methods: A total of 44 LBP patients withhigh obesity (body mass index, BMI≥30kg/m²) were randomly assigned to an experimental group (n=22) and a control group (n=22). Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the high-intensity complex exercise program combined with WBV and respiratory resistance. In order to compare the effects depending on the intervention methods, numeric pain rating scale (NRPS), Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire (FABQ), balance ability, and pulmonary function were used for measurement. Results: Both groups showed significant differences in NRPS, RMDQ, FABQ, balance ability before and after intervention (p<0.05). In addition, the experimental groupshowed significant difference in the amount of change in RMDQ, balance ability and pulmonary function values than the control group (p<0.05). Conclusions: High-intensity complex exercise program using WBV and respiratory resistance has been proven to be an effective and clinically useful method to decrease dysfunction, increase balance ablilty, and pulmonary function for LBP patients with high obesity.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.153-160
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• 2022

This retrospective study reports the effectiveness of Daoyin exercise therapy in a patient with lower back pain who suffered from idiopathic scoliosis. A patient was treated with Korean medicine containing Daoyin exercise therapy for 4 weeks. The patient was assessed for the numeral rating scale (NRS), Cobb's angle, correctability, and coronal balance. After treatment, the NRS of low back pain decreased from 9 to 1. The Cobb's angle of the thoracic curve decreased from 27.31° to 17.66°. The Cobb's angle of the lumbar curve decreased from 21.86° to 9.05°. Correctabililty was 35.34% in the thoracic curve and 58.60% in the lumbar curve. And coronal balance decreased from positive 32.80 mm to negative 3.20 mm. This study suggests that Daoyin exercise therapy could be effective therapeutic choice for lower back pain with idiopathic scoliosis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.1
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• pp.51-66
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• 2001

Objective: The purpose of study was to compare physical therapy duration in relation tohealth care organization system in patients with low back pain. Subjects: Subjects of this study were 759 patients who are receiving physical therapy at 56 health care organization. Methods: Data were collected by questionnaire that had been completed by patients and physical therapist for two months. Physical therapy procedures consisted of modality application, manual therapy, active therapeutic exercise, and patient education. Physical therapy session duration was investigated for each physical therapy procedure. Data were analyzed in relation to the university hospital, hospital, and clinic. Results: The mean age of subjects was $42.84{\pm}15.46$. There were no significant differences in age among three groups. The number of patients diagnosed with herniated disc were 244(32.15%) and with mechanical low back pain was 187(24.64%). The mean treatment duration per day was 53.22 minutes, and the longest treatment duration was 61.28 minutes at the university hospitals (p<0.001). The mean modality application duration was 42.17 minutes, and the longest application duration was 46.26 minutes at the university hospitals (p<0.001). The mean duration for manual therapy was 5.11 minutes, and the longest treatment duration was 5.97 minutes at clinics. The mean duration for active therapeutic exercise was 4.16 minutes. It was 7.60 minutes at the university hospitals, and 2.48 minutes at clinics. There was a significant difference in active therapeutic exercise duration between university hospitals and clinics(p<0.001). For modalities, hot packs(89.33%) and interferential current therapy(60.87%) were mostly applied. For manual therapy, Soft tissue mobilization(32.93%) and manipulation(14.10%) were mostly applied. In general, treatment application duration was longer at University hospital (p<0.05). For therapeutic exercise, exercise without equipment(18.84%) and muscle strengthening (16.73%) were mostly performed. The longest treatment duration for therapeutic exercise was 7.60 minutes at the university hospital(p<0.05). Conclusion: physical therapy session duration for low back pain was 53.22 minutes. Modality application constitutes 79%, manual therapy 10%, active therapeutic exercise 8% of total treatment duration. It is concluded that patients do not participate actively in treatment procedures.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.2
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• pp.233-242
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• 2014

PURPOSE: The purpose of this study was to determine the correlation between the hip adductor muscles and abdominal muscles during bridge exercise. METHOD: Participants who met the criteria for this study(n=36) were divided into the three groups. The first experimental group performed normal bridge exercises and the second group performed bridge exercises with the contraction of the hip adductor muscles and the control group didn't perform any exercise. Transversus abdominis muscle thickness was measured by ultrasound imaging with a special transducer head device, at pre exercise, after 2 weeks, 4 weeks, and 6 weeks. RESULT: Data were analyzed using repeated ANOVA with the level of significance set at ${\alpha}=.05$. Transversus abdominis muscle thickness was influenced by contraction of the hip adductor muscles during bridge exercise in people without lower back pain. Compared with normal bridge exercise, transversus abdominis muscle thickness significantly increased in thickness during bridge exercise with contraction of the hip adductor muscles(p<.05). CONCLUSION: The results from this study showed that contraction of the hip adductor muscles during bridge exercise increased change in the transversus abdominis muscle thickness. These results can be a good source to prevent low back pain due to hip adductor weakness. Therefore, inducing activation of hip adductor with abdominal stabilizing exercise is more effective in patients with low back pain.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.9-16
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• 2017

Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

• Journal of the Korea Convergence Society
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• v.11 no.3
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• pp.245-252
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• 2020

The present study aimed to identify the effects of the trunk stability exercise on functional movement, dynamic balance, and trunk stability in patients with chronic low back pain, and to compare the difference among yoga exercise, pilates exercise and core exercise. Forty-three patients with chronic low back pain were divided into three groups; 15 yoga groups, 15 pilates groups, and 13 core exercise groups. All subjects were tested the Functional movement, dynamic balance, and trunk stability using Functional Movement Screen (FMS), Lower Quater Y-Balance Test (YBT-LQ) and Trunk Stability Test (TST), respectively, and after each 8-week exercise program was applied, all variables were retested. After exercising during 8 weeks, FMS, YBT-LQ and TST scores of all three groups were significantly improved, compared to before, but there were no interaction effect among three groups depending on application of exercise program. These results showed that yoga, pilates and core exercise help to improve functional movement, dynamic balance and trunk stability in adults with chronic low back pain.

• The Journal of Korean Physical Therapy
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• v.18 no.1
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• pp.41-51
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• 2006

Purpose: The purpose of this study was to investigate effects of mobilization combined active movement(SNAGS) on the pain and recovery of function of acute low back pain patients. Methods: The subjects were consisted of 135 patients with acute low back pain. All subjects randomly assigned to mobilization group, stretching exercise group and modality treatment group. The mobilization group received mobilization combined active movement(SNAGS) with modality treatment, exercise group received stretching exercise with modality treatment and modality treatment group received modality treatment. Visual Analogue Scale(VAS) was used to measure patient's pain level and Patient Specific Functional Scale(PSFS) was used to measure patient's functional disability level. Results: The results of this study were summarized as follows : 1. Visual Analogue Scale(VAS) was mobilization group showed significantly decreased more than comparison group(p<.01) and active treatment group showed significantly decreased more than passive treatment group(p<.01). 2. Patient Specific Functional Scale(PSFS) was mobilization group showed significantly increased more than comparison group(p<.01) and active treatment group showed significantly increased more than passive treatment group(p<.01). Conclusion: It maybe suggested that mobilization combined active movement(SNAGS) is beneficial treatment for acute low back pain patient.