• Title/Summary/Keyword: Lumbar disability

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The Effects of Spinal Decompression Combined with Therapeutic Modalities for Patients with Lumbar Radiculopathy (치료적 모달리티를 병용한 척추 감압치료가 요추 신경뿌리병증 환자에게 미치는 효과)

  • Ma, Sang-Yeol;Kwon, Won-An;Lee, Jae-Hong;Min, Dong-Gi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.1
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    • pp.336-343
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    • 2013
  • The purpose of the present study was to determine the effect of 4 weeks course of motorized spinal decompression delivered via SpineMT(mobilization & traction) combined with therapeutic modalities on the treatment of patients with lumbar radiculopathy(LRP). A total of 15 patients with LRP (mean age, 36.63 years; age range 20-50years) participated in this study. 4 weeks course of spinal decompression delivered via SpineMT combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and four times per week for two additional weeks. The entire treatment consisted of 20 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and Oswestry disability index (ODI) at pre-intervention, after 10 treatment sessions, and at discharge (after 20 treatment sessions) were analyzed. There were significant improvements in the outcome measures of MS test, SLR test, and ODI score after 10 and 20 sessions of spinal decompression treatment combined with therapeutic modalities as compared with the pre-intervention(p<0.05). Spinal decompression treatment combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with LRP.

Cut-off Value for Body Mass Index in Predicting Surgical Success in Patients with Lumbar Spinal Canal Stenosis

  • Azimi, Parisa;Yazdanian, Taravat;Shahzadi, Sohrab;Benzel, Edward C.;Azhari, Shirzad;Aghaei, Hossein Nayeb;Montazeri, Ali
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1085-1091
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    • 2018
  • Study Design: Case-control. Purpose: To determine optimal cut-off value for body mass index (BMI) in predicting surgical success in patients with lumbar spinal canal stenosis (LSCS). Overview of Literature: BMI is an essential variable in the assessment of patients with LSCS. Methods: We conducted a prospective study with obese and non-obese LSCS surgical patients and analyzed data on age, sex, duration of symptoms, walking distance, morphologic grade of stenosis, BMI, postoperative complications, and functional disability. Obesity was defined as BMI of ${\geq}30kg/m^2$. Patients completed the Oswestry Disability Index (ODI) questionnaire before surgery and 2 years after surgery. Surgical success was defined as ${\geq}30%$ improvement from the baseline ODI score. Receiver operating characteristic (ROC) analysis was used to estimate the optimal cut-off values of BMI to predict surgical success. In addition, correlation was assessed between BMI and stenosis grade based on morphology as defined by Schizas and colleague in total, 189 patients were eligible to enter the study. Results: Mean age of patients was $61.5{\pm}9.6years$. Mean follow-up was $36{\pm}12months$. Most patients (88.4%) were classified with grades C (severe stenosis) and D (extreme stenosis). Post-surgical success was 85.7% at the 2-year follow-up. A weak correlation was observed between morphologic grade of stenosis and BMI. Rates of postoperative complications were similar between patients who were obese and those who were non-obese. Both cohorts had similar degree of improvement in the ODI at the 2-year followup. However, patients who were non-obese presented significantly higher surgical success than those who were obese. In ROC curve analysis, a cut-off value of ${\leq}29.1kg/m^2$ for BMI in patients with LSCS was suggestive of surgical success, with 81.1% sensitivity and 82.2% specificity (area under the curve, 0.857; 95% confidence interval, 0.788-0.927). Conclusion: This study showed that the BMI can be considered a parameter for predicting surgical success in patients with LSCS and can be useful in clinical practice.

Radiologic Features and Surgical Outcome of Juxtafacet Cyst Associated with Degenerative Lumbar Disease (퇴행성 요추 질환에서 발생한 후관절 근접 낭종의 방사선적 특징 및 수술의 결과)

  • Kim, Whoan Jeang;Chang, Shann Haw;Yang, Hwa Yeol;Kwon, Won Jo;Sung, Hwan Il;Park, Kyung Hoon;Choy, Won Sik
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.65-72
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    • 2017
  • Purpose: The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome. Materials and Methods: We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale. Results: The L4-5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods. Conclusion: Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment-not just simple cyst excision-should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

Effects of Interferential Current Treatment on Pain, Functional Ability, and Health-Related Quality of Life in Chronic Stroke Patients with Lumbago; A Randomized Controlled Study

  • Jung, Kyoung-Sim;In, Tae-Sung
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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    • pp.25-32
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    • 2020
  • PURPOSE: This study examined the efficacy of an interferential current (IFC) treatment on the improvement of pain, disability, and quality of life in stroke patients with lumbago. METHODS: A double-blind, randomized clinical trial was conducted on 40 stroke patients with lumbago. The patients were allocated randomly into two groups: the IFC treatment group (n= 20) and the placebo treatment group (n= 20). The IFC group received 30 minutes of IFC treatment on the lumbar region, while the placebo group received IFC treatment but without real electrical stimulation. The intervention was administered five days a week for four weeks. The primary outcomes of pain intensity were measured using a visual analogue scale. The secondary measurements included the Barthel Index, Oswestry Disability Index (ODI), and health-related quality of life (HRQoL). RESULTS: The measurements were conducted before and after the two-week intervention period. Compared to the placebo treatment group, the IFC treatment group showed significantly greater improvement in the pain intensity (p<.05), ODI (p<.05), and SF-36 (p<.05) at the end of the intervention. No significant differences in the Barthel Index were found between the two groups. CONCLUSION: These findings show that an IFC treatment can improve pain, functional ability, and quality of life, highlighting the benefits of somatosensory stimulation from IFC in stroke patients with lumbago.

Effects of a Muscle Energy Technique on Pain and Functionality in Patients with Chronic Low Back Pain (근 에너지 기법이 만성요통환자의 통증과 기능에 미치는 영향)

  • Oh, Yeong-Taek
    • PNF and Movement
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    • v.14 no.2
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    • pp.139-147
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    • 2016
  • Purpose: This study examined whether a single application of a lumbar flexion muscle energy technique (MET) could significantly influence pain, functional status, and range of motion in chronic back pain patients with restricted active trunk flexion. Methods: Twenty volunteers were randomly assigned to either a control group or an experimental group. Ten subjects in the control group received no treatment. Ten subjects in the experimental group received five sessions with the muscle energy technique, five times per week for two weeks. Outcomes were measured before and after two weeks of treatment in both groups. Pain intensity was assessed using a visual analogue scale (VAS). Range of motion was measured using the sit-and-reach test (SRT). Functional disability levels were assessed using the Korean version of the Oswestry Disability Index (KODI). Results: The experimental group showed a significant difference in VAS, KODI, and SRT between pre- and post-treatment (p < .05), while the control group showed no significant changes. The changes in VAS, ODI, and SRT were statistically significant between the groups pre- and post-treatment (p < .05). Conclusion: This muscle energy technique is clinically effective for chronic low back pain patients.

DENTAL TREATMENT OF THE PATIENT WITH ACHONDROPLASIA UNDER GENERAL ANESTHESIA (연골무형성증 환아의 전신마취하 치과치료)

  • Jeon, Eun-Kyung;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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    • pp.119-122
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    • 2011
  • Achondroplasia is one of the most common types of dwarfism and is inherited as an autosomal dominant trait. Clinical features of achondroplasia include disproportionate short stature with normal trunk length, shortening of the extremities, bowing of the lower extremities, short stubby trident hands, spinal stenosis and lumbar lordosis. Characteristic craniofacial features include macrocephaly, prominent forehead, depressed nasal bridge, maxillary hypoplasia, otolaryngeal system dysfunction, and foramen magnum stenosis. These characteristics may lead to number of complications including hydrocephalus, apnea, upper-airway obstruction, otitis media, sinusitis and dental malocclusion. Apart from these features, the affected children have good general health and normal intelligence. Dentists should be aware of the clinical characteristics of achondroplasia and the complications that may arise as a result of this disorder. This case report is to present dental treatment of a patient with achondroplasia under general anesthesia and discuss special considerations.

How to Effects of Manual Therapy : Chronic Low Back Pain Patients (도수치료가 만성요통환자의 기능회복에 미치는 영향)

  • Jung, Yeon-Woo;Lee, Woo-Hyung
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.1
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    • pp.50-56
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    • 2010
  • Purpose : To evaluate effects of joint mobilization on the range of motion of chronic low back pain patients. Methods : The subjects were consisted of sixty patients who had non specific chronic low back pain(10 females. 10 males; mean aged 36.5). All subjects received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. Results : The MR-MDQ, VAS, RCT and F-T-FT were significantly different within-subjects(p<.05), Conclusion : The manual therapy included therapeutic massage and joint mobilization found that improved chronic low back pain patients. Further studies are needed to including more subjects on long-term outcomes.

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Effect of Walking Exercise with Functional Shoes on Chronic Low Back Pain (기능성 신발을 활용한 보행운동이 만성 요통에 미치는 효과)

  • Ku, Ji-Young;Lee, Seung-Hwon;Kwon, Gi-Sun;Cho, Sung-Woo;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho;Kim, Cheol-Hong;Hong, Sang-Hoon
    • Journal of Acupuncture Research
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    • v.28 no.3
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    • pp.73-84
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    • 2011
  • Objectives : The purpose of this study is to evaluate the effect of 12 weeks-walking exercise with functional shoes on chronic low back pain. Methods : The subjects of this study were 18 females from thirty to sixty years old who had suffered from low back pain over 12 weeks. They wore S shoes with curved out-sole and soft material in arch of foot We asked them to walk wearing shoes for 1 hour a day over 4 days a week for 12 weeks. Improvement of the symptoms was evaluated by pain rating scale, Oswestry low-back pain disability index. We measured lumbar lordotic angle, Ferguson's angle, bone mineral density, body composition. The measurements were checked before and after exercise. Results : This study showed significant improvement in pain rating scale, oswestry low-back pain disability index, and body composition. And lumbar lordotic angle, Ferguson's angle and bone mineral density decreased. Conclusions : These results showed that walking exercise with functional shoes could decrease the symptoms of chronic low back pain. But, it's too difficult to conclude whether the efficacy was due to functional shoes or walking exercise because we didn't set the control group wearing general shoes.

Traumatic Disc Injuries and the Iatrogenic Spinal Disability (외상성 추간판 손상과 의원성 척추장애인 만들기)

  • Lee, Kyeong-Seok;Doh, Jae-Won;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.935-939
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    • 2000
  • Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

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Effects of spinal stabilization training on Chronic Low Back Pain in Private Guard and Security (척추안정화 운동이 민간 경호.경비원들의 허리통증에 미치는 영향)

  • Kim, Seong-Ho;Lee, Wan-Hee
    • Korean Security Journal
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    • no.20
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    • pp.71-93
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    • 2009
  • The purpose of this study was to evaluate the effects of using spinal stabilization exercise for the improvement of atrophy of the multifidus and psoas major, of pain and disability with chronic low back pain in private guard and security. For 42 patients diagnosed with CLBP, and divided into spinal stabilization exercise group(SSEG) and general spinal strengthening exercise group(GSSEG). Each exercise was conducted for 10 weeks. Pain and disability were measured before and after exercise using the Visual analogue scale(VAS) and the Oswestry disability index(ODI). Cross section area(CSA) of both the left and right multifidus and the psoas major at the upper end plate of L4 were measured before and after exercise using computed tomography(CT). After 10 weeks of exercise, the both group's pain and lumbar disability were significantly decreased(p<0.01). Also there was significant difference in both group(p<0.05). In addition, the CSA of the left and right multifidus and posas major were significantly increased as compared to the pre-exercise in both group(p<0.01). But SSEG's cross sectional areas of multifidus was more significantly increase than GSSEG(p<0.05). In summary, Spinal stabilization exercise is more effective in improving atrophy in private guard and security patients, in reducing patients' pain and disability. It is an effective treatment to aid rehabilitation in these cases.

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