• The Journal of Korean Physical Therapy
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• 제23권4호
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• pp.15-22
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• 2011

Purpose: The purpose of this study was to investigate the relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. Methods: Fifty-two female patients were recruited for this study. The patients' history was recorded and was used to determine the general characteristics of the female complaints. The women were additionally examined to determine whether the level of pain was characteristic of patients with chronic lumbar instability. The following tests were also carried out in the subjects during the examination: 1) the prone instability test. 2) the test for aberrant movement patterns during lumbar flexion test. 3) the straight leg raising test. 4) posterior-to-anterior mobility test, and 5) the test for age and strength of the hip abductor muscle following assessment of the dominant side. In particular, hip abductor muscle strength was evaluated using a dynamometer. Results: The test results showed that the number of positive responses for the five types of lumbar instability tests performed, was significantly related to the strength of the hip abductor muscle. The average hip abductor muscle strength in total subjects was $72.89{\pm}7.66N$, whereas the average hip abductor muscle strength in subjects who showed positive responses to more than four out of the five tests, was $44.70{\pm}5.79N$. Conclusion: The results demonstrated that the hip abductor muscle strength and lumbar instability were negatively correlated. The lower was the strength of the hip abductor muscle, the higher was the possibility of lumbar instability.

• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.181-186
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• 2017

Purpose: The paper presents an intervention for clinical applications in the future by examining the effects of 3D stabilization exercise on patients with lumbar instability, which causes problems in the muscles and balance, and analyzing the effects of balanced lumbar muscles on the static balance. Methods: After collecting samples randomly from thirty patients with lumbar instability, fifteen patients selected for 3D stabilization exercise were placed in the stability group and fifteen patients selected for Swiss ball exercise were placed in the ball exercise group. The intervention program was applied for thirty minutes a session, once a day, three days a week for four weeks. Before the intervention, the lumbar muscle activity and static balance were measured. After four weeks, they were re-measured in the same way and the data were analyzed. Results: In relation to the within-group changes in muscle activity, all groups except for the LEO and REO groups showed significant differences. Regarding the between-group changes in muscle activity depending on the left and right difference, ES, RA, and TrA but not EO showed significant differences. In addition, there were significant differences in the between-group change in static balance. Conclusion: 3D stabilization exercise improves the muscle activity by promoting a balanced posture of lumbar muscles and changing senses, such as a proprioceptor but this had a positive influence on the static balance by controlling the balance of muscles.

• 대한물리치료과학회지
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• 제28권1호
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• pp.23-32
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• 2021

Background: The purpose of this study was to find out how the lumbar instability during clam exercise causes changes in pelvic rotation and hip joint abductor muscle activity. Design: Case-control study. Methods: Twenty male participated in this study. The amount of pelvic rotation was measured using myomotion during the clam exercise in a normal group and a group of patients with low lumbar instability, and the muscle activity of the muscle gluteus medius and the tensor fasciae latae using an EMG device. Results: The amount of pelvic rotation that occurred during the clam exercise was statistically significantly greater in the lumbar instability group than in the normal group (p<.05), and the ratio of muscle activity of the muscle gluteus medius/the tensor fasciae latae was statistically significantly higher in the normal group than in the lumbar instability group (p<.05). Conclusion: In order to stabilize the lumbo-pelvic and strengthen the strength of the hip joints, it is believed that it is necessary to apply exercise while controlling the lumbo-pelvic movement during clam exercises, and various studies will be needed.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.85-93
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• 2011

The purpose of this study was to establish the reliability and validity of the passive lumbar extension (PLE) test and prone instability test (PIT). Thirty-three subjects (14 males, 19 females) with lower back pain enrolled in the study and the subjects were divided into 2 groups (positive and negative instability groups) on the basis of radiographies of flexion and extension. Reliability was determined by the kappa coefficient and validity was examined using calculated sensitivity, specificity, and the likelihood ratio. The results showed that the reliability of the PLE test was higher than the PIT (intra-rater reliability: k=.86 and k=.81, interrater reliability: k=.65 and k=.62) and the validity of the PLE test was also higher than the PIT (sensitivity: 91% and 62%, specificity: 95% and 85% positive likelihood ratio: 20.00 and 4.10, negative likelihood ratio: .10 and .45). In conclusion, we think that the PLE test was a more reliable and valid method for lumbar instability than the PIT.

• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.33-44
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• 2017

Background: Lumbar stabilization exercise and gluteal muscle strengthening exercises are widely used to treat for lower back pain patient. The present study aimed to compare the effects of lumbar stabilization exercise and gluteal muscle strengthening exercises on chronic lower back pain with lumbar spine instability, with regard to pain intensity, disability, and psychosocial factors. Methods: Among 53 patients with chronic lower back pain, those with spine instability were selected using 5 examination tests. The selected 28 patients were randomly assigned to lumbar stabilization exercise group (LSE, n=15) and gluteal strengthening exercise group (GSE, n=13). Each group performed the corresponding exercise for 40 minutes, twice a week for 4 weeks. To analyze and compare the effects, pain intensity, the level of low back disability, and psychosocial factors were assessed before and after intervention. Results: There was significant difference in lower back pain intensity between the two groups before and after intervention. The change in low back disability was significant in the GSE group alone following intervention (p<.05), but no other significant difference was found between the groups. Among psychosocial factors, the changes in the fear-avoidance beliefs questionnaire (FABQ)-physical activity and FABQ-total were significant in the LSE group alone following intervention (p<.05). However, no significant difference were found in these factors between the two groups before and after intervention. Conclusions: LSE and GSE for lower back pain with lumbar spine instability showed no significant difference for pain intensity, physical disability, or psychosocial functioning.

• 대한통합의학회지
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• 제8권3호
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• pp.71-81
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• 2020

Purpose : The purpose of this study is to investigate the instant effect of Kinesio taping on pain decrease and improvement of functional disorder of the subjects who have lumbar instability. Methods : A total of 20 patients (13 men and 7 women) who have lumbar instability were chosen as the subjects. The experiment was conducted by assigning the subjects into Kinesio taping group and placebo taping group. A visual analog scale (VAS) was used to measure back pain and Biering-Sorensen test was applied to measure the muscle endurance of back extensor muscles. A digital dynamometer was used to test the isomeric contraction strength of lumbar extensor muscle. The subject performed single-leg stance and double-leg stance task and their static balancing ability was measured by a testing device that captures the static balancing ability. Results : In a within-group comparison, Kinesio taping group showed a significant decrease of VAS (p<.05) and a significant increase of endurance and strength of lumbar extensor muscle (p<.05). In Kinesio taping group, the shift distance in anterior-posterior sway and medial-lateral sway during the double-leg stance significantly decrease (p<.05). The shift distance in anterior-posterior sway and medial-lateral sway also significantly decreased during the single-leg stance (p<.05). Placebo taping group showed a significant decrease of visual analog scale (p<.05). In a between-group comparison, Kinesio taping group showed a significantly larger decrease of VAS (p<.05), significant larger increase of muscle endurance and muscle strength (p<.05), and significant larger decrease of anterior-posterior sway in the double-leg stance (p<.05), compared to placebo taping group. Conclusion : Application of Kinesio taping to the subjects with lumbar instability produced positive effect of reducing pain, increasing muscle strength and endurance, and improving static balancing ability.

• The Journal of Korean Physical Therapy
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• 제29권5호
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• pp.234-240
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• 2017

Purpose: The aim of this study was to determine the effectiveness of breathing exercises and lumbar segmental exercises on the segmental stability of patients with chronic back pain. Methods: Fifty-nine patients, who suffered from chronic low back pain, were enrolled in this examination. They were divided randomly into three groups: experiment group 1 underwent breathing and segmental stabilization exercises (n=20), experiment group 2 experienced segmental stabilization exercises (n=20), and the control group was given the modality treatment (n=19). The measurements were assessed through an Oswestry disability questionnaire (ODQ), as well as a lumbar segmental instability test (LSIT). Results: The ODQ results for experimental groups 1 and 2 were similar (p<0.05), both before and after six weeks of exercise, but different among the three groups (p>0.05). The differences in segmental instability of each of the three groups were similar (p<0.05), and also similar among the three groups (p<0.05). Conclusion: These findings suggest that lumbar segmental stabilization exercises are efficient in increasing the segmental stability and alleviating pain in patients with chronic back pain. Additional studies on this subject will be needed to improve the clinical applications in the future.

• 디지털융복합연구
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• 제15권5호
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• pp.479-486
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• 2017

본 연구의 목적은 요부안정화운동이 요부 불안정성을 가진 산업체 만성요통환자의 통증관련 기능에 미치는 효과를 알아보고자 하였다. 산업체 만성요통환자 20명을 대상으로 대조군과 실험군으로 10명씩 할당하여 신체기능은 배근력, 유연성, 균형능력을 측정하였고, 통증은 visual analog scale(VAS)를 이용하였다. 연구결과 두군 모두 운동 후 배근력과 균형능력은 유의하게 향상되었고, 통증은 유의하게 감소되었다. 군간 비교에서는 실험군이 대조군에 비해 균형능력이 유의하게 향상되었고, 통증은 유의하게 감소되었다. 결론적으로 요부안정화운동은 요부 불안정성을 가진 산업체 만성요통환자의 균형능력을 향상시키고 통증 감소에 긍정적인 영향을 미친다.

• 대한기계학회논문집A
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• 제35권10호
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• pp.1205-1210
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• 2011

척추 불안정성은 요통과 관련되어 있다고 알려져 있다. 하지만 척추 불안정성과 관련된 임상적 연구가 충분하지 않아서 불안정성의 정의가 정량적으로 확립되어 있지 않다. 또한 추간판 퇴행 및 손상, 인대 결손, 협부 결손 등이 불안정성을 발생시키는 요인으로 알려져 있으나, 척추 불안정성에 미치는 영향이 명확하게 분석되어 있지 않다. 본 연구에서는 요추 단분절의 3 차원 유한요소 모델을 이용하여 인대 결손과 협부 결손이 단독 또는 복합적으로 척추 불안정성에 미치는 영향을 정량적으로 분석하였다. 여기서 굽힘 및 신전 시 척추의 시상각과 전위거리가 척추 불안정성을 나타내는 지표라고 가정하였다. 본 연구의 결과는 척추 불안정성의 원인과 기전을 이해하는데 도움이 될 수 있을 것이다.

• 한국전문물리치료학회지
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• 제25권4호
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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.