• 대한정형도수물리치료학회지
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• 제7권1호
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• pp.5-28
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• 2001

본 연구는 2000년 7월 20일부터 2001년 1월 12일까지 대구광역시에 소재한 가톨릭병원 건강검진센타에서 골다공증 검사를 시행한 여성 50명을 대상으로 실시하였다. 연령은 50~59세가 66.0%로 가장 많았고, 평균연령은 56세이고, 49세 이하는 정상군이 18.7%, 50~59세는 골감소군 83.4%, 60세 이상은 골다공증군이 36.4%로 각각 가장 많았으며, 요추부의 평균골밀도는 연령의 증가에 따라 감소되었지만 유의하지 않았다. 요통유무는 요통이 있다가 76.0%로 많았고, 요통이 있다는 골다공증군 90.9%, 요통이 없다는 정상군이 43.7%로 각각 유의하게 많았으며 (p<0.05), 골밀도는 요통이 있다가 1.00g/$cm^2$로 유의하게 낮았다(p<0.05). 좋아하는 식품은 채소류가 62.0%로 많았고, 생선류는 요통군과 비요통군에서 정상군이 각각 33.3%, 57.1%, 채소류는 요통군과 비요통군에서 골다공증군이 각각 85.0%, 100.0%로 각각 가장 많았고, 골밀도는 요통군에서 채소류가 0.71g/$cm^2$로 각각 유의하게 낮았으며 (p<0.05), 비요통군에서도 채소류가 0.82g/$cm^2$로 낮았지만 유의하지 않았다. 혈액형은 B형은 요통군과 비요통군에서 골다공증군이 각각 50.0%, O형은 요통군과 비요통군에서 정상군이 각각 44.4%, 42.9%로 요통군이 많았고, 골밀도는 요통군과 비요통군에서 O형이 각각 가장 유의하게 높았다(p<0.05). 골밀도(BMD)는 평균골밀도(BMD)는 0.79g/$cm^2$, 요통군에서 0.90~0.99g/$cm^2$는 정상군이 77.8%, 0.60~0.69g/$cm^2$는 골다공증군이 50.0%로 각각 가장 많았고, 골밀도는 요통군과 비요통군에서 골밀도 수치가 증가할수록 유의하게 높았다(p<0.05) 다중회귀분석을 이용한 요추골밀도의 관련성 있는 요인은 연령, 결혼상태, 운동시간, 좋아하는 식품, 칼슘(Calcium), 골밀도의 표준편차인 T값이다(P<0.05). 요통과 골밀도의 관련변수별 상관관계에서 연령과 요통유무, 알카리포스파타제(Alkaline phosphatase), 몸무게와 체질량지수는 유의한 상관관계를 나타냈고 (p<0.01), 몸무게와 신장, 알카리포스파타제(Alkaline phosphatase)와 칼슘(Calcium), 골밀도와 폐경유무는 유의한 상관관계를 나타냈으며(p<0.05), 연령과 폐경유무, 골밀도, 골밀도의 표준편차인 T값, 골밀도와 좋아하는 식품, 알카리포스파타제(Alkaline phosphatase)는 유의한 역상관관계를 나타냈다(p<0.01). 이상의 결과를 요약하면, 요추골밀도의 관련성있는 요인은 연령, 운동시간, 좋아하는 식품, 칼슘(Calcium), 골밀도의 표준편차인 T값이고, 본 연구의 연구대상자의 50대가 66.0%로 가장 많아 폐경유무에서 폐경이다는 골감소군이 83.3%로 가장 많았으므로 폐경 후 기간이 길수록 요추골밀도가 낮아지는 현상을 본 연구에서는 의미 있는 설명 변량이 되지 못했다. 요통과 골밀도의 관련변수별 상관관계에서 연령, 요통유무, 폐경유무, 칼슘(Calcium), 인(Phosphorus), 알카리포스파타제(Alkaline phosphatase)가 중요한 요인으로 생각된다.

• The Korean Journal of Pain
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• 제33권2호
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• pp.153-165
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• 2020

Background: Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods: A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service-National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results: During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell's C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions: LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

• Journal of the Korean Data and Information Science Society
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• 제20권2호
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• pp.339-348
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• 2009

자동 굴곡-신연기법이 만성요통 환자의 요천추 각, 요추만곡, 요추 5번 추간판 각, 그리고 통증에 미치는 영향에 대하여 연구하였다. 만성요통 환자 30명을 대상으로 실험군과 대조군의 두 그룹으로 나누어 실험 전과 후의 요천추 각, 요추만곡, 요추 5번 추간판 각, 그리고 통증을 측정 하였다. 실험군은 온습포, 간섭파, 초음파, 그리고 자동 굴곡-신연기법을 적용하였으며, 대조군은 온습포, 간섭파, 초음파, 그리고 스트레칭운동을 적용하였다. 실험전과 후를 비교해 보면 대조군과 실험군 둘 다 처리효과가 있음을 알 수 있다. 또한 실험군의 굴곡-신연기법적용이 대조군에서의 스트레칭운동보다 효과가 월등히 좋다는 것을 알 수 있다.

• 한방재활의학과학회지
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• 제19권4호
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• The Korean Journal of Pain
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• 제34권4호
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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.

• 대한물리의학회지
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• 제14권3호
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• pp.73-80
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• 2019

PURPOSE: This study examined the correlation between the visual analog scale (VAS) and the rate of change in the respiration patterns according to the result of Lumbar Instability Tests (LITs) in young people with chronic low back pain (CLBP) METHODS: Thirty-six adults, aged 20-40 years with CLBP, participated in this study. The general characteristics and VAS of the participants were recorded by the subjects themselves and seven structure and functional LITs were conducted. According to the positive response number, the positive group was divided into four groups (group 1: n=8, group 2: n=9, group 3: n=10, group 4: n=9). The breathing pattern change tests were performed in three states: during forced breathing exercise and motor control tests. A total of 13 positive lists were set, each of which was scored by 1 or 2 points according to the severity. After the positive lists were scored, the breathing pattern changing rate (BPCR) and VAS were compared according to the positive response number of LITs, and the correlation between them was analyzed. RESULTS: A strong correlation was observed between the number of positive of LITs and BPCR (r= .863, p= .000) and a moderate correlation between the positive number of LITs and VAS (r= .508, p= .002). In addition, there was a poor correlation between the BPCR and VAS (r= .434, p= .008). CONCLUSION: In young CLBP people, when the structural and functional instability are both present, the changes in the respiratory pattern of the whole body can be varied and broader, and the pain scale also increases.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.156-164
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• 2022

Background: Low back pain (LBP) is a representative disease, and LBP is characterized by muscle dysfunction that provides stability to the lumbar spine. This causes physical functional problems such as decreased posture control ability by reducing the muscular endurance and balance of the lumbar spine. Pelvic compression using instruments, which has been used during recent stabilization exercises, focuses on the anterior superior iliac spine of the pelvis and puts pressure on the sacroiliac joint during exercise, making the pelvis more symmetrical and stable. Currently, research has been actively conducted on the use of pelvic compression belts and non-elastic pelvic belts; however, few studies have conducted research on the application effect of pelvic compression using instruments. Objects: This study aimed to investigate whether there is a difference in trunk muscular endurance and dynamic and static balance ability levels by applying pelvic stabilization through a pelvic compression device between the LBP group and the non-LBP group. Methods: Thirty-nine subjects currently enrolled in Daejeon University were divided into 20 subjects with LBP group and 19 subjects without LBP (NLBP group), and the groups were compared with and without pelvic compression. The trunk muscular endurance test was performed with 4 movements, the dynamic balance test was performed using a Y-balance test, and the static balance test was performed using a Wii balance board. Results: There was a significant difference the LBP group and the NLBP group after pelvic compression was applied to all tests (p < 0.05). In the static and dynamic balance ability test after pelvic compression was applied, there was a significant difference in the LBP group than in the NLBP group (p < 0.05). Conclusion: These results show that pelvic compression using instruments has a positive effect on both those with and without LBP and that it has a greater impact on balance ability when applied to those with LBP.

• 대한물리치료과학회지
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• 제16권3호
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• pp.11-17
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• 2009

Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test Mattress Test by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.9-14
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• 2011

Purpose: The pelvic tilting exercise is a well recognized rehabilitation maneuver. However, little information is available on the changes of lumbar segmental motion during pelvic tilting. This study was conducted to measure the kinematics of the pelvic tilting exercise on the supine and prone positions via fluoroscopy. Methods: A total of 10 female subjects were enrolled. During anterior, neutral, and posterior pelvic tilting, radiographs were taken in each exercise via fluoroscopy (ARCADIS Orbic, Siemens, USA). Images were sent to the picture archiving communication system (PACS), and the digitized images were analyzed using LabVIEW software (National Instruments, USA). Lumbosacral lordosis and the intervertebral body angle, intervertebral disc angle, and intervertebral displacement were analyzed. Results: The results of lumbar kinematic analysis during three tilting postures in the supine and prone positions demonstrated that lumbosacral lordosis and the intervertebral body angle and intervertebral disc angle were significantly higher when the pelvis was tilted anteriorly (p>0.05). However, there was no significant difference between anterior and neutral tilting in the intervertebral disc angle at the L3/4 level in the prone position (p>0.05), and there was no significant difference among tilting positions in intervertebral body displacement in the prone position (p>0.05). Conclusion: This study provides scientific evidence about the pelvic tilting exercise in lumbosacral segmental motion. Depending on the pelvic tilting exercise, kinematic changes were demonstrated in both positions, especially in the supine position. It is suggested that the supine position is effective for mobility, but it should be used carefully for the LBP (Low back pain) patient with hypermobility.

• 대한통합의학회지
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• 제1권4호
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• pp.57-66
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• 2013

PURPOSE: The purpose of this study was to investigate the effects using pressure biofeedback and teaching abdominal hollowing exercise on pelvic stabilization during the active straight leg raising test. METHOD: The subjects were divided into 3 groups who were fourty eight healthy participants, aged 20~25 years recruited for this study. First group wad control group. This group didn't any education. Second group was teaching them for a week. And last group was teaching abdominal hollowing exercise. The rotation angles of pelvic were measured by the motion anayalyser on flat surface and on form roll for the active leg raising. RESULT: Using pressure biofeedback and teaching abdominal hollowing exercise groups were significantly effective than control group in rotation angles of pelvis. And using pressure biofeedback group was more effective than teaching core stability muscles contraction group. CONCLUSION: This study suggested that patients with low back pain and pelvic instability can improve pelvic stabilization through pressure biofeedback and teaching abdominal hollowing exercise.