• 국제물리치료학회지
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• 제10권2호
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• pp.1785-1790
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• 2019

Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.215-224
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• 2022

Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.1-10
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• 2016

Background: Patients with chronic low back pain (CLBP) functionally adapt to decreased postural control due to impaired processing of sensory information. Standing postural control has been the focus of recent research in CLBP. Change in postural control may be a risk factor for CLBP, although available studies are not conclusive. Objects: This study aimed to identify the role of partial weight supported treadmill training (PWSTT) in improving balance, dysfunction, and pain in patients with chronic low back pain. Methods: The study included 22 patients with CLBP. Patients in the control group ($n_1=8$) performed three 20 min stabilization exercise sessions per week, for 4 weeks. Patients in the full weight treadmill training group ($n_2=7$) performed treadmill training for 30 min after stabilization exercise. Patients in the PWSTT group ($n_3=7$) performed PWSTT with 20% of their body weight unloaded after stabilization exercises. By using the Biodex balance system, the dynamic balance abilities of the patients in the three groups were assessed in the quiet standing position under combined conditions of visual feedback (eyes open and closed) and platform stability (level 8). The Korean version of the Oswestry Disability Index and visual analogue scale score were used as the main measure. Results: The results of this study showed that dysfunction and pain were significantly improved in all groups. Although dynamic postural stability with eyes closed was significantly improved only in the PWSTT group (p<.05), no significant difference was found in the other groups. Conclusion: The results of this study indicate that PWSTT improved balance, dysfunction and pain in the patients with CLBP. Thus, this intervention is necessary for patients with CLBP with decreased postural control.

• 대한물리의학회지
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• 제11권4호
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• pp.127-137
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• 2016

PURPOSE: This study aimed to compare the effects of side-lying hip abduction exercise with and without vibration on pain, disability, strength and balance in individuals with low back pain. METHODS: 30 participants enrolled in this study were randomly assigned to an experimental group (EG, n=15) for side-lying hip abduction with vibration and a control group (CG, n=15) for side-lying hip abduction without vibration. Both groups were treated 3 times per week for 4 weeks. Pain (Numeric Rating Scale), disability (Korean Oswestry Disability Index), hip abductor muscle strength, and static balance were measured in both groups before and after the program. Results were analyzed using paired t-test for comparing the difference within the group and independent t-test for comparing the difference between two groups. RESULTS: Compared to the CG, the EG showed significantly greater reductions in pain and disability (p<.05). There was a significant difference in all balance categories of both the painful and non-painful sides within the EG (p<.05). Balance showed a significant decrease except the envelope area (ENV) on the non-painful side within the CG (p<.05). There was a significant increase in all balance categories except ENV of non-painful side between the two groups (p<.05). Balance increased on both the painful and non-painful sides in the EG. Balance improved on the painful side in the CG, but significantly decreased on the non-painful side (p<.05). CONCLUSION: Side-lying hip abduction exercise with vibration is considered an effective treatment for pain, disability and balance in individuals with low back pain.

• 대한물리의학회지
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• 제14권3호
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• pp.29-37
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• 2019

PURPOSE: Prone hip extension (PHE) has been used for assessment of lumbo-pelvic movement and strengthening exercise for weakness of the hip joint muscles in patients with chronic low back pain (CLBP). On the other hand, few studies have examined which are the best PHE exercises to activate the gluteus maximus (GM) selectively in physical therapy practice. To aim of this study compared the muscle activity of the GM, rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) during these four different prone hip extensions, PHE, PHE with quadriceps activation (PHEQA), PHE with ankle dorsiflexion (PHEAD), and PHE with ankle plantarflexion (PHEAP), in subjects with CLBP. METHODS: Nineteen subjects with low back pain participated in this study. Subject performed four PHE exercises and surface electromyography (EMG) was used to evaluate the muscle activity. Data were analyzed by one-way repeated-measures analysis of variance (${\alpha}=.05/3=.017$) and a Bonferroni adjustment was performed if a significant difference was found. RESULTS: The muscle activities recorded by EMG showed significant among the four exercises. The muscle activity of the GM increased significantly during PHEQA than during PHEAP (P=.012). CONCLUSION: PHEQA is the most effective exercise for eliciting greater GM muscle activation among the four PHE exercises in subjects with CLBP.

• 대한정형도수물리치료학회지
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• 제24권2호
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• pp.43-49
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• 2018

Background: In this study, the importance of constipation and back pain was assessed by regression analysis of the effects of stress, dietary habits, and water intake on constipation in women in their twenties and the influence of constipation and body mass index (BMI) To provide basic data. Methods: This study selected 109 having constipation of 120 students attending G University in Gwangju and eating habits, water intake level, stress and BMI. Trigger point at the tip of erector spina was palated with tenderness set in order to examine whether muscle tenderness and actual low back muscle tenderness level were same and left and right parts were measured three times and average of Max values was used. We examined the effect of constipation on low back pain and examined constipation and BMI to determine whether they affected low back pain. Results: There was no significant difference in eating habit although there was a significant difference in the effect of stress and water intake on constipation. Constipation had significant difference in back pain. However, there was no significant difference in BMI, normal weight, overweight, and obesity except for low body weight. Conclusions: This study found that constipation was associated with stress levels, water intake, and back pain. In conclusion, this study suggests basic data to prevent and treat constipation-related back pain, and recommends plenty of water intake, proper exercise and stress management to prevent constipation.

• 정형스포츠물리치료학회지
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• 제14권2호
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• pp.109-115
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• 2018

Purpose: McKenzie is a widely-used and conventional clinical therapeutic exercise for patients with mechanical lower back pain. It is a well-designed assessment and classification system for the spine. Main issue: Patients with mechanical lower back pain are classified into one of three mechanical syndromes (posture, dysfunction, or derangement syndrome) by mechanical loading strategies. These methods evaluate symptomatic and mechanical responses during repeated end-range movement and sustained postures. The goal of McKenzie mechanical syndrome diagnosis is to determine directional preferences. Directional preference is a phenomenon of preference for posture or movement in one direction, which reduces or centralizes pain. However, in Korea, there is a lack of awareness of basic McKenzie mechanical syndromes diagnostic concepts. Koreans tend to think of the McKenzie method as a simple lumbar extension exercise. However, an accurate diagnosis of a mechanical syndrome must precede the application of McKenzie exercise. Conclusions: Thus, in this study, I present a classification method of McKenzie mechanical syndrome diagnosis and clinical characteristics of each mechanical syndrome.

• PNF and Movement
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• 제17권1호
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• pp.157-166
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• 2019

Purpose: This study compares and examines the effects of proprioceptive neuromuscular facilitation (PNF) on patients with chronic low back pain through systematic literature review and meta-analysis. Methods: Domestic literature was searched with combinations of keywords including "proprioceptive neuromuscular facilitation," "PNF," "back pain," and "low back pain" using the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Korean Medical Database (KMbase). Six studies (n=148) were finally included in the analysis through a selection and exclusion process. The quality of the studies was evaluated using the PEDro scale. Results: According to the meta-analysis results, the low back pains of the PNF group and the contrast group showed a standardized mean difference (SMD) of 2.21 (95% CI: -3.35, -1.07, p=0.01, $I^2=83%$) after intervention. Thus, the PNF group showed a statistically significant decrease in low back pain compared with the control group. In addition, the SMDs of the Oswestry Disability Index (ODI), lung function, and the Roland and Morris Disability Questionnaire (RMDQ) were -1.34 (95% CI: -1.88, -0.79, p<0.01, $I^2=35%$), 1.14 (95% CI: 0.49, 1.79, p=0.01, $I^2=0%$), and -1.59 (95% CI: -2.56, -0.62, p=0.01, $I^2=46%$), respectively. Thus, the PNF group showed statistically significant differences from the control group. Conclusion: At present, there is some limit to obtaining definite results about effect sizes because there are relatively few randomized controlled experiments that analyze the effects of PNF exercise in patients with chronic low back pain. Therefore, continuous efforts should be made to conduct randomized clinical trials and long-term efficacy studies in the future.

• 대한물리의학회지
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• 제18권2호
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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.

• 대한통합의학회지
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• 제1권4호
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• pp.67-74
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• 2013

Purpose : The purpose of this study was to investigate the effect of horseback riding exercise for BMI(body mass index) and waist circumference in the obese women. Method : 20 subjects in Y-equestrian were randomly divided two group, horseback machine exercise(HME) group and horseback-riding exercise(HRE) group. Each group carried out 30 minutes exercise two times a week for 8 weeks. BMI were measured for body composition, and evaluation of waist circumference. Result : The results were as follows, the BMI(body mass index) between horseback machine exercise and horseback-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The waist circumference between horseback machine exercise and horseback-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horseback-riding exercise was effective on BMI and waist circumrerence of obese women so that these exercise can be new altematives exercise for obesity management in the obese women.