PURPOSE: The purpose of this study was to determine if the program focusing on gluteal muscle exercise combined lumbar stabilization had an effects on pain, functional disability and lumbar instability in chronic low back pain patients who had lumbar instability. METHODS: Thirty four patients were recruited in this study. The participants were randomly allocated stabilization exercise group (SEG) (n=17) and gluteal muscle exercise group (GEG) (n=17). The gluteal muscle exercise group conducted gluteal muscle exercises combined lumbar stabilization and stabilization exercise group did only lumbar stabilization exercise for 30 minutes three times a week for six weeks. Pre-exercise assessment tools, visual analogue scale (VAS) and Korean version Oswestry Disability Index level (KODI) were used for pain and functional disability each. Also, these were scored by the tool of lumbar instability. The pain, functional disability levels, and lumbar instability after six weeks with this exercise were re-evaluated. RESULTS: First, SEG showed a significant decrease in the lumbar pain, functional disability levels and lumbar instability. Second, GEG showed a significant decrease in the lumbar pain, functional disability levels and lumbar instability. The third, GEG showed even more significant decrease in the lumbar pain levels, functional disability levels and lumbar instability than SEG. CONCLUSION: Gluteal muscle exercises combined lumbar stabilization are more effective than only lumbar stabilization exercise in the pain levels, functional disability levels and lumbar instability for the chronic low back pain patients with lumbar instability.
The purpose of this study was to find the effects of the dynamic lumbar stabilization exercise on functional recovery of low back pain patients. The subjects were consisted of sixty patients who had nonspecific subacute low back pain. All subjects randomly assigned to dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group. The dynamic lumbar stabilization exercise group received modalities treatment with dynamic lumbar stabilization exercise. Williams exercise group received modalities treatment with Williams flexion exercise and modalities treatment group received modalities treatment without exercise. The Oswestry low back pain disability questionnaire was used to measure disability of low back pain. Assessment was carried out before treatment fur obtain baseline measurement of low back pain and reassessment were carried out at after 20 and 40 treatment sessions. The results of this study were as following: 1. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in dynamic lumber stabilization exercise group(p<.05). 2. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in Williams exercise group(p<.05). 3. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in modalities treatment group(<.05). 4. There were no statistical difference between the 3 groups at pre-treatment with Oswestry low back pain disability questionnaire scores(p>.05). 5. There were no statistical difference between the 3 groups after 20th treatment with Oswestry low back pain disability questionnaire scores(p>.05). 6. There were statistical difference between the 3 groups after 40th treatment with Oswestry low back pain disability questionnaire scores(p<.05). 7. The Oswestry low back pain disability questionnaire scores were significantly decreased after 40th treatment in all 3 groups and the decrement were greater in order of dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group.
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.
Background: This study investigated the effects of sustained natural apophyseal glides (SNAGS) technique on lower back pain and pain disability among university students with lower back pain. Methods: A total thirty 20~30 year old university students with lower back pain were divided into two groups. A lumbar flexibility exercise was applied to the control group (n=15). The SNAGS technique group (n=15) received L1~L4 segment mobilization using SNAGS technique. Intervention was implemented for 20 minutes, 3 times a week for 3 weeks. The SNAGS were performed using belt with flexion and extension, whereas lumbar flexibility exercise included lumbar flexion and extension. Lower back disability was measured using the Korean Oswestry disability index (KODI), and pain sensitivity was measured by pain pressure threshold (PPT). The groups were assessed for lower back pain disability and pain, before and after the intervention. Results: There were significant improvements in both the KODI and PPT of the SNAGS technique group (p<.05), while the lumbar flexibility exercise group showed no significant change (p>.05). In addition, the SNAGS technique group had a statistically significant difference in KODI and PPT compared to the lumbar flexibility exercise group (p<.05). Conclusion: SNAGS technique is more effective than lumbar spine joint flexibility exercise in the improvement of lower back pain disability and pain among university students with lower back pain.
Purpose: This study was to develop a post-operative exercise program, apply it to patients undergone lumbar spinal fusion surgery, and evaluate the effectiveness of the program on pain and disability activities of daily living. Methods: Fifty six patients who had lumbar spinal fusion were enrolled in this study. The patients were divided into two groups; 28 patients in the intervention group completed post-operative lumbar exercise program including walking for four weeks and 28 patients in the control group only did walking exercises. The degrees of pain on low back and leg were evaluated using visual analog scale (VAS) and the functional outcome was evaluated using the Korean version of Oswestry Disability Index (KODI) before surgery and 5 weeks after surgery. The data were analyzed using descriptive statistics, Chi-square test, t-test with SPSS 18.0 program. Results: Low back and leg pain of the participants in both experimental and control groups were improved after surgery compared to pre-surgery pain. However, there was no statistically significant difference between the groups. KODI score in the intervention group was significantly lower than that of the control group (p=.014). Conclusion: The developed post-operative exercise program in patients with lumbar spinal fusion surgery seems to be a useful intervention to reduce disability in activities of daily living.
This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.
Background: The purpose of this study was to investigate the effects of lumbar stabilization exercise with neurodynamic techniques on lumbar muscular strength and Oswestry index in lumbar disc herniation patient. Method: The Lumbar stabilization exercise with neurodynamic techniques was performed by 30 pt's in G hospital. The subjects were randomly organized into a study group 15 and control group 15. The exercises and neurodynamic technique were conducted for 40 minutes and, 3 times a week (total 24 times for 8 weeks). General characteristics of the Lumbar muscular strength and Oswestry disability index (ODI) were measured before the training and at 4 weeks and 8 weeks after the intervention. Comparison of the time dependent variable for each group was Calculated by a one way repeated analysis of variance (ANOVA). Comparison between the two groups was Calculated by an analysis of covariance (ANCOVA). Result: There was a significant difference in the Lumbar muscular strength and ODI (p<.05). Similarly in the inter-group analysis, significant differences (p<.05) occurred. Conclusion: In this study, we demonstrated that lumbar stabilization exercises with neurodynamic techniques are an effective therapy for Lumbar muscular strength and ODI in lumbar disc herniation patient's.
Background: The purpose of this study was to investigate the effects on static balance and disability in chronic low back pain with lumbar rotation extension subgroup of trascranial direct current stimulation (tDCS) and lumbar motor control exercise (MCE). Methods: In 40 male low back pain with lumbar rotation extension subgroup subjects were recruited for the study. Subjects were randomly allocated into two groups. Experimental groups received tDCS and MCE, Control groups received sham-tDCS and MEC. Before and after intervention, measured in surface area, whole path length and Roland-Morris low back pain questionnaire (RMQ). Results: Showed a significant static balance and disability from the experimental groups compared to the control group. Showed a no significant RMQ score from experimental groups compared to the control group. Conclusions: tDCS and lumbar MCE showed the increased static balance in chronic low back pain with lumbar rotation extension subgroup.
Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.
Objective: The purpose of this study was to investigate the effects of Pilates breathing exercises on functional disability and lumbar flexibility in patients with non-specific chronic low back pain. Design: A randomized controlled trial. Methods: 30 patients with non-specific low back pain were selected and classified into an experimental group (n=15) and a control group (n=15). Both groups were assessed for functional disability using the Oswestry Disability Index and flexibility of the lumbar spine using the modified-modified Schober test before and after the intervention. The intervention was applied twice a week for four weeks. The experimental group performed Pilates breathing exercises followed by spinal stabilization exercises, while the control group only performed spinal stabilization exercises. Results: Both groups showed significant improvements in functional disability and lumbar flexibility after the intervention. However, when comparing between the two groups, the experimental group showed a more significant effect than the control group. Conclusions: The combination of Pilates breathing exercises and spinal stabilization exercises can be considered an effective approach to improve low back pain and prevent chronic pain in patients with non-specific chronic low back pain.
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