• The Korean Journal of Pain
• /
• 제31권2호
• /
• pp.109-115
• /
• 2018

Background: Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome. Methods: A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy. Results: All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group. Conclusions: Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.

• 척추신경추나의학회지
• /
• 제5권2호
• /
• pp.95-102
• /
• 2010

Objectives: This study aims to investigate the sense of improvement and satisfaction from 7 cases of herniated lumbar disc patients which was treated with spine decompression&chuna. Methods: Each patient has been treated with spine decompression and chuna treatment. The degree of improvement has been evaluated by VAS(Visual Analogue Scale) and ODI(Oswestry Disability Index) score starting from the day of admission, after 1week, and 2weeks. Results and Conclusions: Through the result, spine decompression and chuna treatment proved to have valid effect for Herniated Lumbar Disc. and there needs more clinical studies into synergy between spine decompression and Chuna treatment.

• 대한물리의학회지
• /
• 제11권4호
• /
• pp.115-125
• /
• 2016

PURPOSE: This study aimed to compare the effects of lumbar stabilization exercise with those of the neurodynamic technique on low back pain in patients with lumbar instability. METHODS: The subjects included those with more than three tests with positive results for lumbar instability and those with a positive sign during the neurodynamic test, all of whom had low back pain. For the lumbar stabilization exercise group (n=15), lumbar stabilization exercise was performed using a sling system, while the neurodynamic technique group (n=15) performed the neurodynamic technique. The intervention was performed 5 days a week for 4 weeks. All measurement of each subject were measure at pre-intervention and post-intervention (after 4 weeks). SPSS/PC ver. 18.0 program was used to compile results. RESULTS: There was no significant difference in general characteristics of subjects between both groups (p>.05). Assessed items included the visual analog scale score (VAS), Korean version of the Oswestry Disability Index (KODI), lumbar instability test positive response counter (LIC) and Fear-Avoidance Beliefs Questionnaire score (FABQ), and a significant reduction was observed post-intervention compared to pre-intervention values in both groups (p<.01). Other assessed items such as trunk flexibility and lumbar extensor endurance and lumbar flexor endurance were significantly increased post-intervention in both groups compared to pre-intervention values (p<.01). There was no significant difference in all parameters between both groups (p>.05). CONCLUSION: Our results indicate that the neurodynamic technique may be useful for improving low back pain in patients with lumbar instability.

• 대한물리의학회지
• /
• 제19권2호
• /
• pp.29-45
• /
• 2024

PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.

• Journal of Acupuncture Research
• /
• 제32권3호
• /
• pp.185-195
• /
• 2015

Objectives : This is a case series reporting of the improvement in patients with a lumbar herniated intervertebral disc by means of acupotomy combined with oriental medicine. Methods : We treated seven patients with a lumbar herniated intervertebral disc with acupotomy combined with oriental medical treatment. We checked the numeric rating scale(NRS), oswestry low back pain disability index(ODI) and range of motion(ROM). Results : NRS and ODI decreased, and ROM improved in all cases. Conclusions : This study shows acupotomy has a meaningful effect when applied on a lumbar herniated intervertebral disc.

• Physical Therapy Rehabilitation Science
• /
• 제11권2호
• /
• pp.198-206
• /
• 2022

Objective: This study was to investigate the effect of a lumbar stabilization exercise program accompanied by proprioceptive stimulation in women in their 20s with low back pain. Design: A randomized controlled trial Methods: A total of 30 women in their 20s with low back pain were selected and randomly assigned to an experimental group and a control group. Both groups performed a lumbar stabilization exercise program, and only the experimental group applied for a stabilization exercise program with proprioceptive stimulation. The exercise program lasted 60 minutes at a time, 3 times a week, for 4 weeks. The measurement tools used were the Numeric Rating Scale (NRS), the Korean version of the Oswestry Disability Index (K-ODI), the lumbar alignment, and the transverse abdominis(TrA) muscle thickness and contraction ratio. Results: Both groups showed statistically significant differences in NRS, K-ODI, and muscle thickness before and after the experiment (p<0.05). The lumbar alignment and contraction ratio at the time of contraction of TrA in the experimental group was statistically significantly increased, and there was also a significant difference in the difference between the two groups (p<0.05). Conclusions: The lumbar stabilization exercise program with proprioceptive stimulation reduced pain, improved low back pain induced dysfunction, and increased TrA muscle thickness and contraction ratio. Therefore, it can be an effective therapeutic exercise program for women in their 20s with LBP.

• 대한정형도수물리치료학회지
• /
• 제14권2호
• /
• pp.68-77
• /
• 2008

Purpose : The purpose of this study was to investigate effects of movement with mobilization(MWM) and stabilization exercise on pain and range of motion of patients with acute low back pain. Methods : The subjects were consisted of 24 patients who had non specific acute low back pain. All subjects randomly assigned to the MWM group and the stabilization exercise group. The MWM group received sustained natural apophyseal glides(SNAGs) with modality treatment and stabilization exercise group received stabilization exercise with modality treatment. The remodified schober test(RST) was used to measure forward flexion and lateral flexion range of motion of lumbar segment. Visual Analogue Scale(VAS) was used to measure subjective pain level of the patients. The Oswestry Low Back Pain Disability Scale was used to measure functional disability level of the patients. Results : The lumbar flexion range of motion of MWM group was significantly increased compared with stabilization exercise group(p<.01). The range of motion of lumbar segment of MWM group was significantly decreased compared with stabilization exercise group(p<.01). The left lateral flexion range of motion of lumbar of MWM group was significantly decreased compared with stabilization exercise group(p<.05). The right lateral flexion range of motion of lumbar of MWM group was significantly decreased compared with stabilization exercise group(p<.05). The VAS of both MWM group and stabilization exercise group was significantly decreased(p<.001). The Oswestry Low Back Pain Disability Scale of stabilization exercise group was significantly increased compared with mobilization group(p<.001). Conclusion : In the result of this study, mobilization with movement and stabilization exercise had significant difference on pain and flexibility of patients with acute low back pain.

• 한국전문물리치료학회지
• /
• 제12권2호
• /
• pp.44-57
• /
• 2005

The objectives of this study were to examine the relative efficacy of three active exercise programs for work-related, chronic low back pain, and to observe to what extent the programs affected the mechanical stability of the lumbar region. The subjects were 64 employees who were randomly divided into three groups to match the three active exercise programs which were performed 3 times a week for 6 months. All subjects were assessed with the same measurements at a pre-study examination, and then were reassessed at 2 weeks, 3months and 6 months after the study. The pain intensity didn't show any significant difference among the three groups. However, the Oswestry Disability Index showed significant differences among the three groups at 6 months and the lumbar and thoracic exercise groups showed significant decreases compared to the general physiotherapy group (p<.05). Maximal stretching with both hands in the overhead direction showed a significant difference among the three groups at 3 months and 6 months, and the thoracic exercise group at 6 months showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The group that performed maximal stretching with both hands in the overhead direction showed the most significant among the 3 months and 6 months. At 6 months, the thoracic exercise group showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The lumbar region angle of inclination showed significant differences among the three groups at 2 weeks 3 months, and 6 months, with the thoracic exercise group being decreased more significantly at 6 months than the lumbar exercise and general physiotherapy groups (p<.05). Exercise aimed at increasing thoracic mobility has an effect on lumbar stability. Furthermore, it is far more effective for lumbar stabilization than general physiotherapy and deep muscle strengthening lumbar exercise.

• 한국전문물리치료학회지
• /
• 제22권1호
• /
• pp.37-48
• /
• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• 한방재활의학과학회지
• /
• 제21권4호
• /
• pp.227-239
• /
• 2011

Objectives: This study was performed to report the case of oriental medical treatment for the left lower limb monoplegia after herniated intervertebral disc(HIVD) operation at lumbar(L)-spine. Methods: A 38-year-old man who underwent lumbar HIVD operation at a hospital admitted with motor weakness of left lower limb, a little decreased left leg radiation pain and low back pain. We treated him by acupuncture, herbal medicine, bee venom injection moxibustion, cupping treatment physical therapy and measured with visual analogue scale(VAS), Oswestry disability index(ODI), Roland-Morris disability questionnaire(RMDO) and manual muscle test(MMT) from 8th February to 4th May 2011. Results: After treatment most symptoms decreased, VAS score changed from 10 to 3, ODI changed 71% to 37% RMDQ changed 13 to 8 and MMT changed from 3 to 5. Conclusions: Our study suggested that oriental medical treatments are significantly applicable to the monoplegia and pain after lumbar HIVD operation. And further studies ire required to identify underlying mechanism of the treatment.