• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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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.

• Journal of Acupuncture Research
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• v.26 no.4
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• pp.19-27
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• 2009

Objectives : To investigate the improvement rate of muscle weakness caused by lumbar disc herniation, 17 patients was treated with oriental medicine. Methods : To evaluate weakness of big toe extensor muscles caused by lumbar disc herniation, we measured the active range of motion(ROM) of big toe extension and muscle grading of big toe extensor muscles. We also measured numerical rating scale(NRS), oswestry disability index(ODI) and compared them with the active ROM of big toe extension. Results : 1. Progressive weakness of big toe extensor muscles was observed in 2 patients. Weakness of big toe extensor muscles were improved in 13 patients(76%). 2. Changes in manual muscle testing(MMT) scores corresponded with improvement rate of big toe extension. 3. Numerical rating scale(NRS) and oswestry disability index(ODI) improvement rate did not correspond with improvement rate of big toe extension. Conclusions : Muscle weakness caused by lumbar disc herniation can be treated with oriental medicine and progressive muscle weakness must be observed constantly.

• Korean Journal of Adult Nursing
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• v.20 no.2
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• pp.269-279
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• 2008

Purpose: The study was to examine the effect of lumbar stabilization exercise on back pain, physical fitness, sleep, and depression in middle-aged women who have chronic back pain. Methods: With one group pre-post test design, 18 subjects who have had more than 6 months of back pain were recruited by convenience sampling in D metropolitan area. Lumbar stabilization exercise was based on Tai Chi for back pain program developed by Lam(2003). This program was mainly focusing on strengthening lumbar stabilizing muscle for one hour per session, twice a week for 20 weeks. Degree of back pain, back pain disability, sleep, and depression were measured at three time points(pretest, 12 weeks, and 20 weeks) by a structured study questionnaire. Physical fitness variables including waist flexibility, mobility, and back muscle strength were measured three times at health promotion center located in the university hospital. Data were analyzed by frequency, descriptive statistics, and repeated measures of ANOVA. Results: Mean age of subjects was 52 years(SD = 6.4). Most of them(90%) had suffered from back pain more than one year and 67% was taking medicine to relieve their back pain. Results showed that back pain score and disability score were not significantly decreased after the exercise. On physical fitness variables, however, waist flexibility(F = 3.50, p = .04) and mobility(F = 3.31, p = .04) were improved after the exercise. Quality of sleep(F = 4.48, p = .03) was improved gradually and depression scores were also decreased(F = 3.12, p = .05) after the exercise. Conclusion: This lumbar stabilization exercise was not able to reduce chronic back pain, but could improve physical fitness and psycho-social variables for community dwelling women who have chronic back pain. Further study is needed to replicate this exercise with control group to confirm the positive effect.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.4
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• pp.238-245
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• 2017

This retrospective observational study was aimed to evaluate that Daoyin Exercise therapy improves the symptoms related to lumbar disc herniation. We analyzed the medical records of 7 patients, who satisfied with inclusion and exclusion criteria. The subjects of the study were the patients who were prescribed Daoyin Exercise Therapy and Korean medical treatments for lumbar intervertebral disc herniation at Dunsan Korean Medicine Hospital of Daejeon University from July 25th, 2016 to March 31th, 2017. The effects of Daoyin Exercise Therapy was evaluated by comparing before and after taking Daoyin Exercise Therapy through 0-10 Numeric Rating Scale(NRS), Roland & Morris Disability Questionnaire(RMDQ), Trunk Extension Flexion(TEF) Program, EuroQol five Demension Questionnaire(EQ-5D, EQVAS) of the symptoms including lower back pain. The Daoyin Exercise Therapy combined with Korean medicine treatment reduced NRS($3.357{\pm}3.038$) and RMDQ($9.50{\pm}6.364$), and improved Muscle endurance($44.429{\pm}45.136$), EQ-5D($0.09{\pm}0.12$) and EQVAS($6.571{\pm}19.260$) of the 7 patients without side effects. These results implied that Daoyin Exercise Therapy might helps to improve symptoms of patients with lumbar disc herniation by reducing the symptoms of lower back pain and improving muscle endurance, quality of life, strength enhancement and core muscles.

• Journal of Korean Physical Therapy Science
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• v.11 no.3
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• pp.38-48
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• 2004

The purpose of present study is to examine the relative efficacy of active exercise programs for work-related chronic low back pain and to figure out how much they affect mechanical stability of lumbar. Subjects are 43 employees with work-related chronic low hack pain, and they were randomly divided into two groups with general physiotherapy groups and thoracic exercise groups for increasing thoracic mobility. Active exercise programs were done 3 times a week, for 6 months, and the subjects were tested for Pain intensity(VAS), the Oswestry Disability Index, Maximal stretching with both hands in the overhead direction and the lumbar region angle of inclination. All subjects were reassessed with same measurement with Pre-study and 6 months after study After applying active exercise programs, pain intensity didn't show any significant difference between two groups. The Oswestry Disability Index showed significant difference between two groups and thoracic exercise groups decreased significantly compare to general physiotherapy group(p<0.05). Maximal stretching with both hands in the overhead direction showed significant difference between two groups and thoracic exercise group increased significantly more than general physiotherapy groups(p<0.05). The lumbar region angle of inclination showed significant difference between two groups and thoracic exercise group decreased significantly more than general physiotherapy groups (p<0.05). According to the results above, exercise for increasing thoracic mobility has an effect on lumbar stability. For the work-related chronic lower hack pain workers, it is far more effective for lumbar stabilization than general physiotherapy.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.92-104
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• 2023

Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.

• Physical Therapy Korea
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• v.26 no.1
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• pp.51-59
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• 2019

Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.379-383
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• 2013

Objective : There are differences in the clinical characteristics and surgical results between upper (L1-2 and L2-3) and lower (L3-4, L4-5, and L5-S1) lumbar disc herniations. We conducted this study to compare the clinical features and surgical outcomes between the two types of lumbar disc herniations. Methods : We retrospectively reviewed the clinical features of patients who underwent microdiscectomies from 2008 to 2012. We evaluated the clinical characteristics such as age, preoperative autonomic dysfunction, the presence or absence of previous lumbar surgery and fusion required during surgery. Visual Analogue Scale (VAS) scores about back pain and leg pain were evaluated preoperatively and at the final follow-up. Results : Upper lumbar group (n=15) was significantly older than lower lumbar group (n=148). The incidence of autonomic dysfunction was significantly higher in upper lumbar group. The number of patients with a previous lumbar surgery was significantly greater in upper lumbar group. There was no statistical significance for fusion required during surgery between two groups. Both groups showed a significant decrease in the VAS scores of leg pain. VAS scores of back pain were significantly decreased in lower lumbar group. But this was not seen in upper lumbar group. Both groups showed significant improvement of Oswestry Disability Index score. Conclusion : Upper lumbar group had different clinical characteristics from those of lower lumbar group and these include older age, a higher incidence of autonomic dysfunctions and a higher incidence of patients with previous lumbar surgery. There were no significant differences in surgical outcomes, except for back pain, between two groups.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.6 no.2
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• pp.109-119
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• 2011

Objective : The aim of this study is to investigate the effectiveness of ShinBaro Pharmacopuncture in the treatment of patients with Lumbar spine Herniated Nucleus Pulposus. Methods : We investigated 20 cases of patients with lumbar disc herniation and devided into two groups. Experimental group were treated with ShinBaro Pharmacopuncture with integrated package treatment and control group were treated the same therapies without ShinBaro Pharmacopuncture. To evaluate the treatment effects of two groups, we used numeric rating scale(NRS), oswestry disability index(ODI). Results : In NRS of lumbar and sciatica pain and ODI, that of experimental group was much more improved than control group, and decrement of NRS of lumbar pain showed statistical significance along with the duration of treatment. Conclusions : ShinBaro Pharmacopuncture was thought to be effective for relieving symptoms of lumbar spine herniated nucleus pulposus, although further study is needed.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.80-87
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• 2020

Purpose: Some patients who have undergone surgery due to lumbar disc herniation still complain of leg pain and other abnormal sensations. Therefore, the study examined the effects of the neurodynamics on pain and other abnormal nerve sensations in post-operated patients with lumbar disc herniation. Methods: The participants of this study comprised 20 adults (10 males and 10 females) who were diagnosed with lumbar disc herniation. The subjects were classified into two groups of 10 patients each in the lower extremity neurodynamics (LEN) and lumbar stabilization exercise (LSE) groups. Each intervention was applied twice a day for one week and was composed of two different exercise patterns; one was applied by a therapist, and the other was performed by the patients themselves. The data were analyzed using assessment methods of Digital Infrared Thermal Imaging (DITI), Toronto clinical neuropathy scoring system (TCNSS), Sympathetic Skin Response (SSR) test, and Oswestry Disability Index (ODI) scale. Results: Significant differences in TCNSS, DITI, ODI scale were observed between the LEN and LSE group (p<0.01). On the other hand, there was no significant difference in the SSR test between pre and post-treatment (p>0.05). Conclusion: The results indicated that neurodynamics treatment is effective in pain reduction and abnormal sensations, such as leg muscle cramps, in post-operated patients with lumbar disc herniation.