• 한국전문물리치료학회지
• /
• 제31권1호
• /
• pp.79-88
• /
• 2024

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

• 대한정형도수물리치료학회지
• /
• 제13권2호
• /
• pp.31-44
• /
• 2007

The purposes of this study were to examine the normal lumbar proprioception and identify the effect of vision and proprioception on lumbar movement accuracy through measuring a reposition error in visual and non-visual conditions and to provide the basic data for use of vision when rehabilitation program is applied. The subjects of this study were 39 healthy university students who have average physical activity level. They were measured the ability to reproduce the target position(50% of maximal range of motion) of flexion, extension, dominant and non-dominant side flexion in visual and non-visual conditions. Movement accuracy was assessed by reposition error(differences between intended and actual positions) that is calculated by the average of absolute value of 3 repeated measures at each directions. The data were analysed by paired samples t-test, independent samples t-test, and repeated measures ANOVA. The results were as follows : 1. Movement accuracy of flexion, extension, dominant side flexion, and non-dominant side flexion was increased in visual condition. 2. There were no differences in the lumbar movement accuracy between sexes in visual and non-visual conditions. 3. In non-visual condition, the movement in coronal plane(dominant and non dominant side flexion) is more accurate than that in sagittal plane(flexion and extension). 4. In non-visual condition, there were no differences in the lumbar movement accuracy between dominant and non-dominant side flexion. In conclusion, this study demonstrates that the movement is more accurate when the visual information input is available than proprioception is only available. When proprioception is decreased by injury or disease, it disturbs the control of posture and movement. In this case, human controls the posture and movement by using visual compensation. However it is impossible to prevent an injury or trauma because most of injuries occur in an unexpected situation. For this reason, it is important to improve the proprioception. Therefore, proprioceptive training or exercise which improve the ability to control of posture and movement is performed an appropriate control of permission or interception of the visual information input to prevent an excessive visual compensation.

• The Journal of Korean Physical Therapy
• /
• 제17권3호
• /
• pp.311-327
• /
• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• 한국전문물리치료학회지
• /
• 제15권1호
• /
• pp.61-68
• /
• 2008

The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

• 국제물리치료학회지
• /
• 제4권2호
• /
• pp.618-624
• /
• 2013

The purpose of this study was to test the effect of Gastrocnemius and Low Back-muscle isotonic exercise on static dynamic standing balance during the period of 4 weeks. This study was two groups pretest-posttest design. Nineteen subjects who were over 22 years old were randomly assigned to either the experimental group that received the Gastrocnemius muscle exercise(n=9) or the low back muscle exercise(n=10) : The former group performed isotonic exercise(plantar flexion), the latter group performed isotonic exercise(trunk extension) a total of 18 times for three times per week for four weeks. Two groups also performed static and dynamic balance before the exercise and 4weeks after the exercise. The data were analyzed by using the paired t-test and independent t-test. The results were as follows: As compared with change of dynamic balance performance capacity at two groups, a significant difference was shown in the test(p<.05), but not in static balance(p>.05). Also, a significant difference of balance between groups was not shown in the test. In this study indicated that gastrocnemius and low back muscle isotonic exercise will have positive impact on standing balance.

• 한국전문물리치료학회지
• /
• 제26권3호
• /
• pp.32-41
• /
• 2019

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

• 정형스포츠물리치료학회지
• /
• 제14권2호
• /
• pp.109-115
• /
• 2018

Purpose: McKenzie is a widely-used and conventional clinical therapeutic exercise for patients with mechanical lower back pain. It is a well-designed assessment and classification system for the spine. Main issue: Patients with mechanical lower back pain are classified into one of three mechanical syndromes (posture, dysfunction, or derangement syndrome) by mechanical loading strategies. These methods evaluate symptomatic and mechanical responses during repeated end-range movement and sustained postures. The goal of McKenzie mechanical syndrome diagnosis is to determine directional preferences. Directional preference is a phenomenon of preference for posture or movement in one direction, which reduces or centralizes pain. However, in Korea, there is a lack of awareness of basic McKenzie mechanical syndromes diagnostic concepts. Koreans tend to think of the McKenzie method as a simple lumbar extension exercise. However, an accurate diagnosis of a mechanical syndrome must precede the application of McKenzie exercise. Conclusions: Thus, in this study, I present a classification method of McKenzie mechanical syndrome diagnosis and clinical characteristics of each mechanical syndrome.

• 재활간호학회지
• /
• 제1권1호
• /
• pp.51-60
• /
• 1998

The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

• 대한정형도수물리치료학회지
• /
• 제1권1호
• /
• pp.99-104
• /
• 1995

Markolf and Morris suggests that the deranged disk and torn annulus have an exellent recovery ability from the position of spine extension, where the posterior annulus is not under stress and the gel can move anterioly. McKenzie explains side gliding as a combination of rotation and side bending, his clinical studies indicate that side-gliding can gel laterally. In conclusion, the prone unilateral traction on the opposite side from the patient's pain along with the other treatment appered to have helped reduce those patient's pain. The method of treatment described in this report is suggested for Korean physical therapists who treat patients suspected of posterolateral herniated nucleus pulposus.

• 대한물리치료과학회지
• /
• 제2권2호
• /
• pp.481-486
• /
• 1995

Markolf and Morris suggests that the deranged disk and torn annulus have an exellent recovery ability from the position of spine extension, where the posterior annulus is not under stress and the gel can move anterioly. McKenzie explains side gliding as a combination of rotation and side bending, his clinical studies indicate that side-gliding can gel laterally. In conclusion, the prone unilateral traction on the opposite side from the patient's pain along with the other treatment appered to have helped reduce those patient's pain. The method of treatment described in this report is suggested for Korean physical therapists who treat patients suspected of posterolateral herniated nucleus pulposus.