• The Journal of Korean Medicine
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• v.37 no.1
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• pp.125-134
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• 2016

Objectives: The aim of this study is to develop diagnostic questionnaires for the lumbar movement system impairment syndrome. Methods: We had reviewed the previous study and literature and organized various checkable items for differential diagnosis of five different lumbar movement system impairment syndromes. Next, we selected items which can be developed as questionnaire items. Finally, we conducted face validity study with eight Korean medicine doctors and survey research for the importance score of the items with three experts. Results: We developed a diagnostic questionnaire as followings: 6 items for lumbar extension syndrome; 5 items for lumbar flexion syndrome; 6 items for lumbar rotation syndrome. With the 2 rounds of survey research, we could bridge the differences of the importance score of each items. Conclusions: Questionnaire for the diagnosis of movement system impairment syndrome was developed. With this questionnaire, objective diagnosis of lumbar movement system impairment syndrome can be expected. This tool may also be used for detecting sub-health status of musculoskeletal systems.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.2
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• pp.31-44
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• 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.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.240-250
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• 2023

Objective: The purpose of this study was to characterize the movement of adjacent segments that occurred when posteroanterior joint mobilization was applied to the 3rd lumbar and thereby to provide basic clinical data. Design: Randomized controlled trial design. Methods: While the subjects were receiving posteroanterior joint mobilization of the 3rd lumbar vertebra, LD (lumbar displacement), LID (lumbar intervertebral distance), LIA (lumbar intervertebral angle), and LLA (lumbar lordosis angle) were measured using X-ray, and the data were then analyzed. Changes before and after posteroanterior joint mobilization were analyzed using a paired-sample t-test, and a one-way ANOVA of variance was performed to determine the difference between segmental movements. In addition, Pearson's correlation analysis was performed to determine the correlation between segmental movements. Results: The results revealed that there was a significant change in LD before and after the application of joint mobilization of the 3rd lumbar in all lumbar vertebrae (p<0.000), among which the 2nd lumbar vertebra, an adjacent segment, showed the most significant change. A significant change in LIA angle was observed in all segments (p<0.000), with the most significant change observed between the 2nd and 3rd lumbar vertebrae. There was a significant change in LLA before and after the application of posteroanterior joint mobilization (p<0.000). The correlation analysis showed a high correlation between displacement of the 3rd lumbar vertebra and displacement of all the other lumbar vertebrae. Conclusions: The presence of kinematic movements of the lumbar vertebrae when segmental movements were generated through the application of posteroanterior joint mobilization of the 3rd lumbar vertebra.

• Physical Therapy Korea
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• v.19 no.4
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• pp.61-69
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• 2012

The purpose of this study was to identify the effects of tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching exercise on the lumbopelvic movement patterns during active prone hip lateral rotation (HLR) in subjects with lumbar extension rotation syndrome accompanying TFL-ITB shortness. Eleven subjects (9 male and 2 female) were recruited for the two-week study. A three dimensional ultrasonic motion analysis system was used to measure the lumbopelvic movement patterns. The TFL-ITB length was measured using the modified Ober's test and was expressed as the hip horizontal adduction angle. The subjects were instructed how to perform TFL-ITB self-stretching exercise program at home. A paired t-test was performed to determine the significant difference in the angle of lumbopelvic rotation, movement onset time of lumbopelvic rotation, TFL-ITB length, and LBP intensity before and after the two-week period of performing the TFL-ITB self-stretching exercise. The results showed that after the intervention, the lumbopelvic rotation angle decreased significantly (p<.05), the movement onset time reduced significantly (p<.05), and LBP intensity decreased slightly but not significantly (p=.07). The hip horizontal adduction angle increased significantly (p<.05) after the intervention. These findings indicate that TFL-ITB stretching exercise increased TFL-ITB length, decreased lumbopelvic rotation angle, and delayed the movement onset time of lumbopelvic rotation after two-weeks. In conclusion, the TFL-ITB self-stretching exercise performed over a period of two weeks may be an effective approach for patients with lumbar extension rotation syndrome accompanying TFL-ITB shortness.

• Physical Therapy Korea
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• v.21 no.4
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• pp.49-55
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• 2014

Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.1
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• pp.19-28
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• 2008

Objectives : The object of this study is to report a clinical effect of oriental medical treatments with chuna for foot drop caused by herniated intervertbral lumbar disc. Methods : The patient was diagnosed as lumbar bulging disc, and was treated by lumbar traction technique with other conservative treatments including acupunture herbal mixture. And we measured Visual Analog Score(VAS), Modified Bathel Index(MBI), Nurick's Classification, Range of movement of ankle joint. Results : After treatments, Visual Analog Score, Modified Bathel Index, Nurick's Classification, Range of movement of ankle joint were improved in case. Conclusion : Oriental medical treatments with Chuna manual therapy were associated with improvement of foot drop by herniated intervertbral lumbar disc.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.23-32
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• 2021

Background: The purpose of this study was to find out how the lumbar instability during clam exercise causes changes in pelvic rotation and hip joint abductor muscle activity. Design: Case-control study. Methods: Twenty male participated in this study. The amount of pelvic rotation was measured using myomotion during the clam exercise in a normal group and a group of patients with low lumbar instability, and the muscle activity of the muscle gluteus medius and the tensor fasciae latae using an EMG device. Results: The amount of pelvic rotation that occurred during the clam exercise was statistically significantly greater in the lumbar instability group than in the normal group (p<.05), and the ratio of muscle activity of the muscle gluteus medius/the tensor fasciae latae was statistically significantly higher in the normal group than in the lumbar instability group (p<.05). Conclusion: In order to stabilize the lumbo-pelvic and strengthen the strength of the hip joints, it is believed that it is necessary to apply exercise while controlling the lumbo-pelvic movement during clam exercises, and various studies will be needed.

• Physical Therapy Korea
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• v.25 no.4
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• Physical Therapy Korea
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• v.31 no.1
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• pp.79-88
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• 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.

• PNF and Movement
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• v.20 no.1
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• pp.51-58
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• 2022

Purpose: The purpose of this study was to investigate the effect of thoracic-lumbar dissociation motion and slump motion on thoracic-lumbar erector spinae and rectus abdominis muscle activity. Methods: Seventeen healthy adult volunteers participated in this study. All participants performed two motions (thoracic-lumbar dissociation motion, slump motion). Muscle activation during the two motions was measured using a surface electromyography device. The data from this were collected from the iliocostalis thoracis, iliocostalis lumborum, and rectus abdominis. The activities of these muscles before and after each motion were then compared. Results: The iliocostalis thoracis activation was significantly greater during the thoracic-lumbar dissociation motion than during the slump motion (p <0.05). The iliocostalis lumborum activation was greater during the slump motion than during the thoracic-lumbar dissociation motion (p <0.05). The rectus abdominis activation was lesser during the slump motion than during the thoracic-lumbar dissociation motion (p <0.05). Conclusion: This study confirmed that individual contraction of the erector spinae muscles is possible during thoracic-lumbar dissociation motion, which increases the stability of the thoracic spine. In addition, this motion could improve control of the rectus abdominis. Therefore, thoracic-lumbar dissociation motion should be considered for rehabilitation programs for patients with kyphosis and back pain.