• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.73-83
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• 2022

Purpose : Low back pain (LBP) is reported as a risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. The lumbar spine in an unstable state causes imbalance and lumbar instability. Therefore, This study examined the effects of lumbar stabilization exercise and self-complex exercise program on pain, function, psychosocial level, static balance ability, and transverse abdominal muscle (TrA) thickness and contraction ratio in patients with lumbar instability. Methods : The design of this is a randomized controlled trial (RCT). Twenty-six LBP patients participated in this study. Screening tests were performed and assigned to the experimental group (n=13) and control group (n=13) using a random allocation program. Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the self-complex exercise program. All interventions were applied three times per week for four weeks. The quadruple visual analog (QVAS), the Korean version of the Oswestry disability index (K-ODI), Korean version of fear-avoidance belief questionnaire (FABQ), static balance ability, TrA thickness, and contraction ratio were compared to evaluate the effect on intervention. Statistical significance was set at 𝛼=.05. Results : Both groups showed significant differences before and after the intervention in QVAS, K-ODI, FABQ, static balance ability, and TrA thickness in contraction (p<.05). In addition, significant differences in K-ODI and FABQ were observed between the experimental group and control group (p<.05). Conclusion : A lumbar stabilization exercise and self-complex exercise program resulted in reduced dysfunctions, psychosocial stability in patients with lumbar instability. Therefore, Lumbar stabilization exercise and self-complex exercise program for patients with lumbar instability are effective method with clinical significance in improving the function and psychosocial stability.

• Proceedings of the KIEE Conference
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• 2015.07a
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• pp.1425-1426
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• 2015

Core spine muscle are related are associated with trunk stability and play a main role for the prevention of low back pain. In this study, it was investigated the effect of spine stabilization exercise device on core spinal muscles using a musculoskeletal model The forward direction of the tilt mainly induced the activation of long and superficial back muscles and the backward affected the front muscles. It was shown that spine stabilization exercise device can induce significant core muscle exercise effect.

• Physical Therapy Korea
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• v.25 no.4
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2155-2163
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• 2020

Background: Various treatments have been proposed for chronic low back pain (CLBP), but recent guidelines and reviews recommend regular physical exercise. However, some other studies have reported opposite results that sling exercise (SE) and other exercises (OE) did not differ in improving CLBP. Objectives: To systematically review and meta-analyze the effects of SE on CLBP in studies published in Korea. Design: A Systemic Review and Meta-analysis. Methods: Randomized controlled trials comparing SE with OE and modality therapy (MT), published up to June 2020, were identified by electronic searches. Primary outcomes were pain and disability. The weighted mean difference (WMD), stand mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model. Results: Based on the results of the meta-analysis, SE was effective for pain in the comparison of SE and MT [short-term: WMD=-1.64, 95% CI (-3.06, -0.22); long-term: WMD=-0.34, 95% CI (-0.42, -0.26)]. It was effective for pain in the comparison of SE and OE [short-term: WMD=-1.18, 95% CI (-2.15, -0.20); long-term: WMD=-0.66, 95% CI (-0.89, -0.43)]. It was also effective for disability in the comparison of SE and MT [short-term: SMD=-15.82, 95% CI (-23.10, -8.54)]. We found no clinically relevant differences in disability between SE and OE. Heterogeneity was high in the comparison of SE and overall variables. Conclusion: If SE is applied to physical therapy to improve the main symptoms of CLBP patients, it may contribute to their recovery. More high-quality randomized studies on the topic are warranted.

• PNF and Movement
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• v.19 no.1
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• pp.43-55
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• 2021

Purpose: The purpose of this study was to determine the effects of contract relaxation and a combination of isotonics in proprioceptive neuromucular facilitation (PNF) on hip and lumbopelvic motions of male patients with chronic low back pain. Methods: As the subjects of this study, a total of 45 male patients with chronic low back pain were divided into groups: 15 who underwent contract relaxation (CR) of the PNF of their hip joints, 15 who underwent a combination of isotonics (CI) of the PNF, and 15 who underwent both techniques. A device for analyzing three-dimensional motion was used to measure hip medial rotation angles, lumbopelvic rotation angles, and hip medial rotation angles at the start of lumbopelvic rotation during hip medial rotation. A two-way repeated measures ANOVA was used to compare the average values. Results: There were interactions in the hip medial rotation angles, lumbopelvic rotation angles and hip medial rotation angles at the start of lumbopelvic rotation based on the methods and periods of exercise (p < 0.05). The CR and the CR+CI groups displayed more increased hip medial angles when compared to the CI group. The CR+CI group had more decreased lumbopelvic rotation angles when compared to the CR and the CI groups. The CR+CI group had more increased hip medial rotation angles at the start of lumbopelvic rotation when compared to the CR and the CI groups. Conclusion: It can be concluded that the combination of stretching and stability exercises was effective in male patients with chronic low back pain who showed limited hip medial rotation.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.439-448
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• 2006

Purpose: The purpose of this study was to show a relationship between health perception and health promoting behaviors in chronic low back pain patients. Method: The subjects for this study were 213 persons who the visited hospital with low back pain-related problems. Results: The higher the level of the health perception in chronic back pain patients was the higher the rate of the practice of health promoting behaviors (r=0.393, p<.001). The health perception T score was $50.00{\pm}10.00$. As for health promoting behaviors, the T score was $49.99{\pm}10.00$. The subscale of the highest mean score was interpersonal support $(2.96{\pm}0.64)$ and the subscale of the lowest mean score was exercise $(2.13{\pm}0.99)$. Conclusion: This study showed that chronic low back pain patients had a lower level of perception of their health, and their practice to improve their health was not enough. Therefore, nurses should educate and encourage chronic low back pain patients in proper exercises and correct posture to strengthen and maintain lumbar extension muscle power.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.53-67
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• 2023

Background: This study comparatively evaluated the effects of equipment-based pilates exercises (EPE) and lumbar stability exercises (LSE) in patients with chronic low back pain in terms of their Visual Analogue Scale(VAS), Oswestry Disability Index(ODI), and abdominal muscle thickness. Methods: A total of 30 participants were recruited and randomly assigned to either the EPE or the LSE. The VAS, ODI, and abdominal muscle thicknesses of the participants were measured before and after the intervention. Results: The EPE were more effective in terms of the duration of a sustained reduction in VAS scores. post hoc test revealed that EPE were more efficacious in terms of a sustained improvement in ODI scores. With respect to changes in abdominal muscle thickness, there was a significant difference in the thickness of internal oblique muscles(IO) and the external oblique muscles(EO) between the two groups. Conclusion: In this study, both types of exercise interventions resulted in improvements in the VAS, ODI scores, and abdominal muscle thickness in patients with chronic low back pain. However, EPE were found to be more effective than LPE in terms of longer sustained improvements in VAS and ODI scores. Also, with respect to abdominal muscle thickness, the thickness of EO and IO improved only in the EPE group.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.4
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• pp.238-245
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• 2017

This retrospective observational study was aimed to evaluate that Daoyin Exercise therapy improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 7 patients, who satisfied with inclusion and exclusion criteria. The subjects of the study were the patients who were prescribed Daoyin Exercise Therapy and Korean medical treatments for lumbar intervertebral disc herniation at Dunsan Korean Medicine Hospital of Daejeon University from July 25th, 2016 to March 31th, 2017. The effects of Daoyin Exercise Therapy was evaluated by comparing before and after taking Daoyin Exercise Therapy through 0-10 Numeric Rating Scale(NRS), Roland & Morris Disability Questionnaire(RMDQ), Trunk Extension Flexion(TEF) Program, EuroQol five Demension Questionnaire(EQ-5D, EQVAS) of the symptoms including lower back pain. The Daoyin Exercise Therapy combined with Korean medicine treatment reduced NRS($3.357{\pm}3.038$) and RMDQ($9.50{\pm}6.364$), and improved Muscle endurance($44.429{\pm}45.136$), EQ-5D($0.09{\pm}0.12$) and EQVAS($6.571{\pm}19.260$) of the 7 patients without side effects. These results implied that Daoyin Exercise Therapy might helps to improve symptoms of patients with lumbar disc herniation by reducing the symptoms of lower back pain and improving muscle endurance, quality of life, strength enhancement and core muscles.

• PNF and Movement
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• v.18 no.2
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• pp.223-231
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• 2020

Purpose: The purpose of the study was to compare the effects of different methods of pelvic control on abdominal muscle activity and lumbopelvic rotation angle during active straight leg raising (ASLR) in patients with chronic back pain. Methods: The study participants were patients with low back pain (n = 30). They were instructed to perform ASLR with pelvic control, ASLR with pelvic belt, and ASLR only. Surface electromyography data were collected from the ipsilateral rectus femoris (IRF), ipsilateral internal oblique (IIO), contralateral external oblique (CEO), and ipsilateral rectus abdominal (IRA) muscles, and lumbopelvic rotation angle was measured using a motion analysis device. Results: Activation of all abdominal muscles was greater in the ASLR with pelvic control group than in the ASLR with pelvic belt and ASLR groups. The lumbopelvic rotation angle was lower in the ASLR with pelvic control group than in the other two groups (p < 0.05). Conclusion: These results suggest that ALSR with pelvic control is an effective means of increasing abdominal muscle activity and reducing unwanted lumbopelvic rotation in patients with chronic low back pain. Controlling the pelvis using the opposite leg is an effective form of ASLR exercise for patients with chronic low back pain.

• Journal of Digital Convergence
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• v.11 no.4
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• pp.331-338
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• 2013

For this research, 27 out of 52 patients with chronic low back pain involving sacroiliac joint pain were classified into the experimental group to conduct pelvic exercise program and traditional physical therapies in parallel, and the remaining 25 ones were classified into the control group to only apply traditional physical therapies for 6 weeks. After that, their clinical samples were randomly extracted. Before the experiment, both of the experimental group and the control group had the Oswestry disability index test to see how big their pain was and their hip joint angles were analyzed during walking. After the post-test, finally, the results of the Oswestry disability index test and hip joint angles while walking before and after the experiment were compared between two groups to know the effect of pelvic stability exercise program. Within-group results and between-group results both displayed significantly reduced low back pain, and when comparing hip joint angles of the experimental group, there were differences between mid stance phase, terminal stance phase, pre swing phase and early swing phase of the right hip joint, and mid stance phase, terminal stance phase, pre swing phase and early swing phase of the left hip joint. In the control group, there were significant differences between mid stance phase, terminal stance phase and early swing phase of the right hip joint, and loading response phase, mid stance phase, terminal stance phase and pre swing phase of the left hip joint. as a result, pelvic stability exercise program is helpful to gait rhythm on stance phase and swing phase although effective to decrease Oswestry disability index including pain.