• 대한물리치료과학회지
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• 제28권3호
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• pp.42-52
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• 2021

Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.93-102
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• 2015

Prolonged sitting can contribute to low back pain. The lumbar taping can be applied to correct the sitting posture. This study aimed to investigate the effect of lumbar taping on lumbar kinematics and the muscle activities of multifidus (MF) and internal oblique in the individuals with nonspecific chronic low back pain (NSCLBP) as they type for 30 minutes. Nineteen subjects with NSCLBP (9 people in non taping group and 10 people in taping group) were recruited. Lumbar taping was applied to the taping group before typing. Both groups started typing in a neutral sitting position with their feet on the floor. The change of posture and S2 posterior tilting (S2P) were measured to investigate kinematic data. Three sensors were attached on T12, L3, and S2 to identify the change of posture. Surface electromyography was used to measure the muscle activities. Palpation meter was used to standardize the angle of pelvic tilt in sagittal plane before typing. All instruments were used to measure each data before and after typing. Independent t-test was used to compare the changing values of lumbar kinematics and muscle activities before and after typing between both groups. The changing values of S2P and change of posture of L3 and S2 were significantly smaller in the taping group compared to the non taping group (p<.05). The changing value of muscle activities of MF between before and after typing was significantly smaller in the taping group compared to the non taping group (p<.05). In conclusion, the lumbar taping during the 30-minute typing task can be applied to maintain correct sitting posture in the lumbar and pelvis and to maintain activation of MF.

• 대한물리치료과학회지
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• 제7권2호
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• pp.415-425
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• 2000

It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

• 융합정보논문지
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• 제11권10호
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• pp.223-229
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• 2021

만성요통환자를 대상으로 요추의 구조와 기능적 안정성에 미치는 영향을 알아보기 위하여 요부 안정화운동과 근력강화운동을 병행한 운동 프로그램과 요부 근력강화운동만 적용한 운동 프로그램의 다열근 단면적, 정적자세조절, 요부통증에 미치는 영향을 알아보았다. 연구방법은 만성요통환자 28명을 대상으로 각각의 운동그룹으로 나누워 주 3회씩 8주간 운동프로그램을 실시하였다. 본 연구의 자료분석은 t-test를 활용하여 그룹 운동프로그램 적용전과 적용후, 그리고 각각의 그룹간을 비교하였다. 연구결과 다열근 단면적, 정적자세조절, 요부통증 등 각각의 그룹내 운동프로그램 적용전과 적용후에 유의한 결과가 나타났으나 (p<.05), 각각의 그룹간에는 요부 안정화운동과 근력강화운동을 병행한 운동 프로그램이 더 효과적인 것으로 나타났다 (p<.05). 결론적으로 요부 안정화운동을 추가적으로 실시한 운동 프로그램이 다양한 요추의 구조와 기능을 향상시키고, 요부통증을 감소시키는 것으로 나타났다.

• 대한통합의학회지
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• 제1권2호
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• pp.67-80
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• 2013

Purpose : This study was to investigate effects of closed kinetic chain and open kinetic chain exercise on the lumbar stabilizarion. Methods : A total of 30 healthy over 20 years old college students(men = 14, women = 16) who were participated in this. We selected randomly people of CKC, OKC, and control group. For the past four weeks, CKC and OKC group worked out 3 times per week and then we compared within group and between groups on muscle width. Results : 1. The width of internal oblique, transverse abdominis, and multifidus were all significantly increased after four weeks exercise in the CKC group(P<.05). 2. The width of internal oblique, transverse abdominis, and multifidus were all increased after four weeks exercise in the OKC group but transverse abdominis musule only showed significant difference. 3. Difference values between pre-exercise and post-exercise of transverse abdominis and multifidus in the CKC group was significantly high and difference among the groups were significant. Conclusion : Accordingly, lumbar stabilizing exercise was more effective to increase a width of abdominal deep muscles through CKC exercise.

• 대한정형도수물리치료학회지
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• 제4권1호
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• pp.7-20
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• 1998

Activity of the trunk muscles is essential for maintaining stability of the lumbar spine because of the unstable structure of that portion of the spine. The central nervous system deals with stabilization of the spine by contraction of the abdominal and multifidus muscles in anticipations of reactive forces produced by limb movement. Recent evidence indicates that the lumbar multifidus muscle and transversus abdominis muscle may be involved in controlling spinal stability. Stabilization training in neutral spine is an integrated approach of education in proper posture and body mechanics along with exercise to improve strength, flexibility, muscular and cardiovascular endurance, and coordination of movement.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.9-15
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• 2010

Purpose: To evaluate, in patients with degenerative disc disease (DDD), the efficacy of using spinal stabilizing exercises for the reversal? of atrophy of the multifidus and psoas major, reductions in pain and disability, and for increases in paraspinal muscle strength. Methods: Nineteen patients diagnosed with DDD participated for 10 weeks in a spinal stabilization exercise program. Pain and disability were measured before and after exercise using, respectively, a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Paraspinal muscular strength in four directions was evaluated using CENTAUR. Both before and after exercise we used computed tomography (CT) too measure cross-sectional areas (CSAs) of both the left and right multifidus and the psoas major at the upper & lower endplate of L4. Results: After 10 weeks of a spinal stabilization exercise program, pain was significantly decreased from $5.7{\pm}0.9$ to $2.5{\pm}0.9$ (p<0.01); the ODI score decreased from $16.7{\pm}4.9$ to $7.3{\pm}3.1$. Paraspinal muscle strength was significantly increased (p<0.01) and the CSAs of the left and right multifidus and psoas major muscles were significantly increased (p<0.01). Conclusion: Spinal stabilization exercise is effective in reversing atrophy in DDD patients, in reducing pain and disability, and in increasing paraspinal muscle strength. It is an effective treatment foro aiding rehabilitation in these cases.

• 국제물리치료학회지
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• 제11권4호
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• pp.2178-2183
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• 2020

Background: Trunk flexor-extensor muscles' co-activation and upright posture are important for spinal stability. Abdominal bracing and maximal expiration are being used as exercises to excel torso co-contraction. However, no study has on comparison of the effect of this exercise on multifidus in the upright sitting posture. Objectives: This study aims to verify the effectiveness of abdominal bracing and expiration maneuvers in lumbo-pelvic upright sitting. Design: Cross-sectional study. Methods: Eighteen healthy women were recruited for this study. The multifidus muscle thickness of all subjects was measured in three sitting conditions (lumbo-pelvic upright sitting, lumbo-pelvic upright sitting with abdominal bracing, and lumbo-pelvic upright sitting with maximum expiration) using ultrasound. One-way repeated measure analysis of variance was used for the evaluation. Results: Compared to lumbo-pelvic upright sitting, lumbo-pelvic upright sitting with abdominal bracing and lumbo-pelvic upright sitting with maximum expiration were associated with significantly increment of muscle thickness. There was no significant difference in muscle thickness between lumbo-pelvic upright sitting with abdominal bracing and lumbo-pelvic upright sitting with maximum expiration. Conclusion: Abdominal bracing and maximum expiration could be beneficial to increasing lumbar multifidus thickness in lumbo-pelvic upright sitting.

• 국제물리치료학회지
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• 제2권1호
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• pp.260-266
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• 2011

The purpose of this study was to investigate the effects of meditation music with lumbar stabilization exercise on balance, concentration and muscle activation. Participants are divided into Group A and Group B. Group A listened to meditation music while doing 4 sets of lumbar stabilization exercise. Group B did not listen to meditation music while doing 4 sets of lumbar stabilization exercise. Surface EMG data was obtained rectus abdominis, external oblique, erector spinae, multifidus muscle during lumbar stabilization exercise. To examine the effect of before-after experiment for concentration and balance, paired t-test was adopted. Changes in EMG data of each muscles were analyzed by independence t-test. There were statistically significant increasing at concentration level and balance level in Group A. But significant difference was not shown in muscle activation. The clinical effect of the meditation music with lumbar stabilization exercise was investigated in this study with more excellent results in concentration and balance. In conclusion, these results suggest that meditation music and lumbar stabilization exercise may be useful in elderly people.

• Physical Therapy Rehabilitation Science
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• 제1권1호
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• pp.28-32
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• 2012

Objective: The purpose of this study is to compare chronic low back pain patients' pain provocation position so as to identify the relevance with lumbar stabilizing muscles atrophy and pain provocation position. Design: Cross-sectional study. Methods: Fifty five chronic low back pain patients were participated in this study. Subjects were eligible for study participation if they were 35-55 years old and had experienced low back pain for more than 3 months. Subjects were questioned about pain and pain provocation test were done. And then they were inspected their cross sectional area (CSA) of lumbar muscles (erector spinae, iliopsoas, and multifidus) by using computed tomography. Analyze the relevance through the result data with painful area, aspect of pain and pain provocation position. Results: CSA of erector spinae showed significant decrease on ipsilateral extension position (p<0.05). Iliopsoas muscle showed significant decrease on contralateral position (p<0.05). Multifidus showed significant decrease on the position of contralateral extension and contralateral flexion (p<0.05). Conclusions: Based on the results of our study, it may be possible to evaluate muscle atrophy by assessing causing position.