• Title/Summary/Keyword: Lumbar range of motion

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The effect of stabilization exercise and movement with mobilization on flexibility and pain of patients with acute low back pain (관절 가동술과 안정화 운동이 급성 요통 환자의 유연성과 통증에 미치는 영향)

  • Kim, Da-Hye;Kim, Jong-Beom;Baek, Hyeon-Kyeong;Oh, Yu-Na;Yoo, Hyeon-Hwa;Yang, Hoe-Young;Lee, Hye-Jin;Yang, Hoe-Song;Yang, Gi-Woong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.68-77
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    • 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.

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Effect of the Lumbar Range of Motion and Back Pain on Kinesiotaping of Erector Spinae Muscle (척주세움근의 키네시오 테이핑이 허리가동범위와 허리통증에 미치는 영향)

  • Park, Jonghang;Kim, Yoonhwan;Lee, Jaejun
    • Journal of The Korean Society of Integrative Medicine
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    • v.3 no.4
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    • pp.53-59
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    • 2015
  • Purpose : To retestify about the changes of the range of motion and pain from kinesiotaping the erector spinae muscle. Method : Targeted the number of 30 people with low back pain and measured lumbar range of motion and pain before kinesiotaping on the erector spinae muscle. After that, the measured value were compared and analyzed. Result : First, before and after kinesiotaping, doing skin distraction test, the changes of the skin distance within each experiment group all statistically showed meaningful differences(p<0.05). Secondly, before and after kinesiotaping and testing pain threshold, it statistically showed meaningful differences(p<0.05). Conclusion : Both two groups showed that the change of the skin distance increased and the pain averagely decreased than before taping. Therefore, kinesiotaping is considered that it affected the low back, the range of motion and pain.

Change of Lumbar Motion after Multi-Level Posterior Dynamic Stabilization with Bioflex System : 1 Year Follow Up

  • Park, Hun-Ho;Zhang, Ho-Yeol;Cho, Bo-Young;Park, Jeong-Yoon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.285-291
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    • 2009
  • Objective : This study examined the change of range of motion (ROM) at the segments within the dynamic posterior stabilization, segments above and below the system, the clinical course and analyzed the factors influencing them. Methods : This study included a consecutive 27 patients who underwent one-level to three-level dynamic stabilization with Bioflex system at our institute. All of these patients with degenerative disc disease underwent decompressive laminectomy with/without discectomy and dynamic stabilization with Bioflex system at the laminectomy level without fusion. Visual analogue scale (VAS) scores for back and leg pain, whole lumbar lordosis (from L1 to S1), ROMs from preoperative, immediate postoperative, 1.5, 3, 6, 12 months at whole lumbar (from L1 to S1), each instrumented levels, and one segment above and below this instrumentation were evaluated. Results : VAS scores for leg and back pain decreased significantly throughout the whole study period. Whole lumbar lordosis remained within preoperative range, ROM of whole lumbar and instrumented levels showed a significant decrease. ROM of one level upper and lower to the instrumentation increased, but statistically invalid. There were also 5 cases of complications related with the fixation system. Conclusion : Bioflex posterior dynamic stabilization system supports operation-induced unstable, destroyed segments and assists in physiological motion and stabilization at the instrumented level, decrease back and leg pain, maintain preoperative lumbar lordotic angle and reduce ROM of whole lumbar and instrumented segments. Prevention of adjacent segment degeneration and complication rates are something to be reconsidered through longer follow up period.

Clinical Comparison of Posterolateral Fusion with Posterior Lumbar Interbody Fusion

  • Kim, Chang-Hyun;Gill, Seung-Bae;Jung, Myeng-Hun;Jang, Yeun-Kyu;Kim, Seong-Su
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.84-89
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    • 2006
  • Objective : The purpose of this study is to compare the outcomes of two methods for stabilization and fusion : Postero-Lateral Fusion [PLF, pedicle screw fixation with bone graft] and Posterior Lumbar Interbody Fusion [PLIF, cage insertion] for spinal stenosis and recurred disc herniation except degenerative spondylolisthesis. Methods : Seventy one patients who underwent PLF [n=36] or PLIF [n=35] between 1997 and 2001 were evaluated prospectively. These two groups were compared for the change of interbody space, the range of segmental angle, the angle of lumbar motion, and clinical outcomes by Prolo scale. Results : The mean follow-up period was 32.6 months. The PLIF group showed statistically significant increase of the interbody space after surgery. However, the difference in the change of interbody space between two groups was insignificant [P value=0.05]. The range of segmental angle was better in the PLIF group, but the difference in the change of segmental angle was not statistically significant [P value=0.0l7]. Angle of lumbar motion was similar in the two groups. Changes of Prolo economic scale were not statistically significant [P value=0.193]. The PLIF group showed statistically significant improvement in Prolo functional scale [P value=0.003]. In Prolo economic and functional scale, there were statistically significant relationships between follow-up duration [P value<0.001]. change of interbody space [P value<0.001], and range of segmental angle [P value<0.001]. Conclusion : Results of this study indicate that PLIF is superior to PLF in interbody space augmentation and clinical outcomes by Prolo functional scale. Analysis of clinical outcomes showed significant relationships among various factors [fusion type, follow-up duration, change of interbody space, and range of segmental angle]. Therefore, the authors recommend instrumented PLIF to offer better clinical outcomes in patients who needed instrumented lumbar fusion for spinal stenosis and recurred disc herniation.

Comparing the Immediate Effectiveness of Lumbar Flexion and Extension Exercise With Regards to Pain, Range of Motion, Pelvic Tilt, and Functional Gait Ability in Patients With Lumbar Spinal Stenosis

  • Do, Hyun-ho;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.26 no.4
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    • pp.10-19
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    • 2019
  • Background: In patients with lumbar spinal stenosis (LSS), lumbar flexion exercise (LFE) is considered a standard therapeutic exercise that widens the space between the spinal canal and intervertebral foramen. However, some researchers have reported that lumbar extension exercise (LEE) may improve lumbar pain and functional ability in patients with LSS. Although exercise intervention methods for patients with LSS have been widely applied in clinical settings, few studies have conducted comparative analysis of these exercise methods. Objects: This study aimed to compare the effects of LFE, LEE, and lumbar flexion combined with lumbar flexion-extension exercise (LFEE) on pain, range of motion (ROM), pelvic tilt angle, and functional gait ability in patients with LSS. Methods: A total of 30 patients with LSS, LFE (n1=10), LEE (n2=10), and LFEE (n3=10) were assigned to each of the three exercise groups. The numerical pain rating scale (NPRS), modified-modified schober test (MMST)-flexion, MMST-extension, pelvic tilt inclinometer, and 6-minute walking test (6MWT) were measured. Results: After the intervention, statistically significant differences were observed in the NPRS (p=.043), MMST-flexion (p<.001), MMST-extension (p<.001), and 6MWT (p=.005) between groups. According to the post hoc test, the NPRS was statistically significant difference between the LFEE and LEE groups (p=.034). The MMST-flexion was statistically significantly different between the LFE and LEE (p=.000), LFE and LFEE (p=.001), and LEE and LFEE (p=.001) groups. The MMST-extension was statistically significantly different between the LFE and LEE (p<.001), LFE and LFEE (p=.002), and LEE and LFEE (p=.008) groups. The 6MWT was statistically significantly different between the LFE and LFEE (p=.042) and the LEE and LFEE (p=.004) groups. Conclusion: This study suggested that LFEE was the most effective exercise for pain and functional gait ability in patients with LSS, LFE was the most effective exercise for lumbar flexion ROM, and LEE was the most effective exercise for lumbar extension ROM.

The BioFlex System as a Dynamic Stabilization Device : Does It Preserve Lumbar Motion?

  • Zhang, Ho-Yeol;Park, Jeong-Yoon;Cho, Bo-Young
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.431-436
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    • 2009
  • Objective : This study examines whether functional motion is present at one or more years after Bioflex System placement. BioFlex System is a flexible rod system which has been used to preserve motion at the area of implantation. There has not been a scientific study showing how much motion is preserved after implantation. Methods : A total of 12 consecutive patients underwent posterior dynamic stabilization using the BioFlex System. Six patients were treated using a L3-4-5 construct and other six patients using a L4-5-S1 construct. Follow-up ranged from 12 to 33 months and standing neutral lateral, extension, flexion and posteroanterior (PA) radiographs were obtained at 3, 6, 9, and 12 months and at more than 12 months postoperatively. Range of motion (ROM), whole lumbar lordosis, and ROMs of motion segments from L2 to S1 were determined. Results : Patients with a L3-4-5 construct demonstrated a decrease in mean ROM for whole lumbar decreased from 40.08 to 30.77. Mean ROM for L3-4 (6.12 to 2.20) and L4-5 (6.55 to 1.67) also decreased after one year. Patients with a L4-5-S1 construct demonstrated L4-5 (8.75 to 2.70) and L5-S1 (9.97 to 3.25) decrease of mean ROM at one year postoperatively. Lumbar lordosis was preservep at both L3-4-5 and L4-5-S1 constructs. Clinical results showed significant improvements in both study groups. Conclusion : The present study provides preliminary information regarding the BioFlex motion preservation system. We conclude that the BioFlex System preserves functional motion to some degree at instrumented levels. However, although total lumbar lordosis was preserved, ROMs at implantation segments were lower than preoperative values.

Changes in the Cervical and Lumber Flexion-Relaxation Ratio, Range of Motion, Pressure Pain Threshold, and Perceived Comfort Following the Wearing of a Trunk Brace during Smartphone Watching (스마트폰 시청 시 몸통 교정기 착용에 따른 목, 허리 굽힘-이완 비율, 관절가동범위, 압통, 착용감 변화)

  • Park, Jin-Seong;Park, Du-Jin
    • PNF and Movement
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    • v.19 no.3
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    • pp.413-422
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    • 2021
  • Purpose: This study was conducted to investigate changes in the cervical and lumbar flexion-relaxation ratio, range of motion, pressure pain threshold, and perceived comfort following the wearing of a trunk brace during smartphone watching. Methods: To calculate the number of subjects for this study, an analysis with G*Power was performed at a statistical power of 0.8, an effect size of 0.5, and a significance level of 0.05, based on the results of a preliminary experiment on five subjects. In total, 27 adult men and women were recruited who had been informed of the study's purpose and process and had agreed to participate. All subjects watched content on a smartphone for 20 minutes in the same posture and conditions while wearing and not wearing a trunk brace, and then their cervical and lumbar flexion-relaxation ratio, range of motion, pressure pain threshold, and perceived comfort were measured. Results: Compared to the non-wearing of a trunk brace, the wearing of a trunk brace resulted in a statistically significant smaller decline in cervical extension and right-side cervical rotation (p<0.05). When the subjects wore a trunk brace, their right- and left-side cervical and right-side lumbar pressure pain statistically significantly improved when compared to not wearing a trunk brace (p<0.05). They also perceived a significantly lowered level of comfort 20 minutes after wearing a trunk brace compared to immediately after wearing it (p<0.05). Conclusion: The trunk brace was effective in reducing declines in right-side cervical rotation and the occurrence of left- and right-side cervical and right-side lumbar pressure pain. The findings indicate the need to improve the perceived comfort of trunk braces.

Effects of Lumbar Stabilization Exercise on the Strength, Range of Motion and Pain

  • Kim, Chihwan;Cho, Sunghak
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.4
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    • pp.2229-2236
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    • 2020
  • Background: Few comparative studies have been conducted on strengthening the anterior and posterior muscles of the trunk via lumbar stabilization exercises. Objectives: To compare the effects of forward leaning exercise and supine bridging exercise in stability exercise. Design: Randomized controlled clinical trial (single blind). Methods: Thirty subjects with spondylolisthesis were participated in this study. Fifteen subjects performed the bridging exercises and fifteen subjects performed the forward leaning exercises. Each exercise was held for ten seconds per repetition, and four repetitions were considered one sub-session. A total of four sub-sessions were performed in one full exercise session. The full exercise session required thirty minutes, including rest time. Trunk strength and range of motion and Oswestry disability index were measured. Results: Two weeks later, trunk flexion strength and trunk extension range of motion were significantly increased in the forward leaning exercise group than in the supine bridging group, trunk extension strength were significantly increased in the supine bridging exercise group than in the forward leaning group. After two weeks, the pain score was significantly lower in the forward leaning exercise group than in the supine bridging group. Conclusion: This study has shown that stabilization exercises are effective in increasing range of motion and strength in spondylolisthesis subjects. It was especially confirmed that the method of strengthening the anterior muscles of the trunk is more effective than the standard stabilization exercise method.

Development of Posture Evaluation System through Digital Recognition Method (디지털 영상인식 방법을 통한 자세평가 및 운동가동범위 측정시스템 개발)

  • Moon, Young-Jin;Lee, Soon-Ho;Back, Jin-Ho;Lee, Jong-Gak;Lee, Gun-Bum
    • Korean Journal of Applied Biomechanics
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    • v.14 no.3
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    • pp.49-65
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    • 2004
  • The purpose of this study is development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. The results of this study are as follows. First, Scoliosis evaluation through this research measurement system represent 3mm error in 7 cervical point and deepest lumbar point, 0.7mm error in other point. This mean this research measurement system have a reliability for scoliosis evaluation. Second, for spine line evaluation on high fat subject, we need reconstrection spine line after measurement for fat thickness in 7 cervical point and deepest lumbar point. Third, In pedioscope error test, it present 0.01848cm in X axis and 0.01757cm in Y axis. This results mean pedioscope have a reliability foot evaluation. Forth, Posture evaluation and Range of Motion measurement system by using digital vision analysis method can fast measure in range of motion and foot evaluation and posture. therefore we can expect this system application in young people posture clinic center and hospital and so on.

The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charite$^{TM}$ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload: A Comparative Study between Load Control Protocol and Hybrid Protocol

  • Kim, Se-Hoon;Chang, Ung-Kyu;Chang, Jae-Chil;Chun, Kwon-Soo;Lim, T. Jesse;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.144-151
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    • 2009
  • Objective: To compare two testing protocols for evaluating range of motion (ROM) changes in the preloaded cadaveric spines implanted with a mobile core type Charite$^{TM}$ lumbar artificial disc. Methods: Using five human cadaveric lumbosacral spines (L2-S2), baseline ROMs were measured with a bending moment of 8 Nm for all motion modes (flexion/extension, lateral bending, and axial rotation) in intact spine. The ROM was tracked using a video-based motion-capturing system. After the Charite$^{TM}$ disc was implanted at the L4-L5 level, the measurement was repeated using two different methods: 1) loading up to 8 Nm with the compressive follower preload as in testing the intact spine (Load control protocol), 2) loading in displacement control until the total ROM of L2-S2 matches that when the intact spine was loaded under load control (Hybrid protocol). The comparison between the data of each protocol was performed. Results: The ROMs of the L4-L5 arthroplasty level were increased in all test modalities (p < 0.05 in bending and rotation) under both load and hybrid protocols. At the adjacent segments, the ROMs were increased in all modes except flexion under load control protocol. Under hybrid protocol, the adjacent segments demonstrated decreased ROMs in all modalities except extension at the inferior segment. Statistical significance between load and hybrid protocols was observed during bending and rotation at the operative and adjacent levels (p< 0.05). Conclusion: In hybrid protocol, the Charite$^{TM}$ disc provided a relatively better restoration of ROM, than in the load control protocol, reproducing clinical observations in terms of motion following surgery.