• Clinical Pain
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• v.19 no.2
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• pp.70-79
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• 2020

Objective: We evaluated the efficacy of a newly-developed spinal orthoses (V-LSO) by comparing the stabilizing effect, abdominal pressure, and comfort of 3 different semirigid LSOs (classic LSO, V-LSO, and Cybertech^®) during various body movements. Method: Thirty healthy volunteers (23~47 years, 24 males, 6 females) were selected. A dual inclinometer measured the range of motion (ROM) while the participants performed flexion/extension and lateral flexion of the lumbar spine with 3 LSOs. The LSO's pressure on the abdominal surface was measured using 9 pressure sensors while lying, sitting, standing, flexion/extension, lateral flexion, axial rotation, and lifting a box. Comfort and subjective immobilization were analyzed by a questionnaire. Results: V-LSO had a statistically significant effect on flexion over Cybertech^®. No significant differences were noted during extension and lateral flexion between the 3 LSOs. The abdominal pressure showed no significant differences while supine. While sitting, standing, and lifting a box, the mean abdominal pressure for V-LSO were significantly higher than those for Cybertech^®. During lumbar flexion, the mean abdominal pressures for classic LSO and V-LSO were significantly higher than that of Cybertech^®. For extension, lateral flexion and axial rotation, the abdominal pressure for V-LSO was significantly higher than those of classic LSO and Cybertech^®. In the subjective analysis, V-LSO and Cybertech^® scored best for comfort. Conclusion: The V-LSO and Cybertech^® were more comfortable than the classic LSO, and hence, may have improved compliance with decreased discomfort. V-LSO may be superior to the other LSOs in restricting lumbar movement and increasing intraabdominal pressure.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.1-9
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• 2018

PURPOSE: The purpose of this study was to determine the effect of exercise therapy on low back pain (LBP), the function of paraspinal and abdominis muscles, and the sacrohorizontal angle as seen on the radiographs of the lumbar spine in a young female golf player with LBP. METHODS: This case report describes an 11-year-old female golfer who presented with LBP. The exercise therapy program comprised lumbar joint mobilization, lumbar spine flexion distraction, abdominal bridge, plank, side plank, and single-leg extensions from a 4-point kneeling position for 40 min/day; this was done twice a week for 8-weeks. LBP [visual analog scale (VAS) and Oswestry disability index (ODI)] and function of paraspinal and abdominis muscles [Ito test, curl-up test, $90^{\circ}$ stop test, squat test, opened eye one leg stance test (OEOL), and closed eye one leg stance test (CEOL)] were measured before and after 4 and 8 weeks of exercise therapy. The radiographs were analyzed for the lumbar Cobb's angle and sacrohorizontal angle before and after 8 weeks of exercise therapy. RESULTS: After 4 and/or 8 weeks of exercise therapy, VAS and ODI scores decreased; results for the Ito test, curl-up test, $90^{\circ}$ stop test, squat test, and OEOL and CEOL of muscle function improved; and the lumbar Cobb's angle and sacrohorizontal angle improved. CONCLUSION: These results suggest that exercise therapy improves LBP, muscle function, and radiographic parameters associated with LBP in young golf players. These findings have clinical implications for exercise therapy in young female golf players who have LBP.

• Journal of muscle and joint health
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• v.18 no.2
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• pp.238-248
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• 2011

Purpose: The purpose of this study was to examine the effects of exercise on pain, exercise self-efficacy, activities of daily living for postoperative lumbar spinal surgery. Method: The study used a nonequivalent control group pre- and post-test design in quasi-experimental research. The data were collected from April, 2010 to July, 2011. The subjects were 40 lumbar spine surgery patients who had been hospitalized in neurosurgery of G university hospital, 20 assigned for the experimental and 20 for the control group. Exercise of this study reformed to be adapted to lumbar spine surgery patients on the basis of William's flexion exercise and exercise for HIVD surgery patients developed by Kim(1995) and was practiced three times a day for 3 weeks. The data were analysed with ${\chi}^2$-test, t- test, Repeated measures ANOVA using the SPSS program. Result: There was a significant decrease in pain in the experimental group, but there was no significant increase in exercise self-efficacy and activities of daily living between the groups. Conclusion: Muscle strengthening exercise after surgery was effective in improvement of pain. Postoperative muscle strengthening exercise in lumbar spinal patients may be a useful intervention to reduce pain.

• Physical Therapy Korea
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• v.27 no.3
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• pp.171-177
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• 2020

Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20° or less (Group 1), 10 subjects who had a popliteal angle of 21°-39° (Group 2), and 10 subjects who had a popliteal angle of 40° or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.

• Journal of Korean Physical Therapy Science
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• v.19 no.1
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• pp.1-7
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• 2012

Purpose : This study aims to examine effects of trunk strengthening exercise in three rigid cerebral palsy adolescents aged between 11 and 13 on their spinal segments and gait. Methods : 2A trunk strengthening program for proprioceptive neuromuscular facilitation was made focusing on improvement in their school life and mental and social activities during their school years, and then trunk strengthening exercise was applied to the three subjects for 30 minutes five times per week for four weeks. With the subjects in a static state, each group's gait analysis was made and maximum anterior flexion, maximum extension, maximum left and right lateral flexion, and cross rotation of the trunk were measured using Sonosens (Germany) prior to and after the intervention. Results : Assessment of spinal segment mobility with the subjects in a static state showed that the trunk muscle strengthening exercise increased their maximum joint movement angles from the right side to the center and rotational abilities of the cervical and lumbar spines. Gait analysis indicated increased movements in the thoracic and lumbar spines and relatively decreased anterior-posterior movement of the cervical spine. Conclusion : Trunk strengthening program is effective in enhancing spinal segment mobility and balance ability of cerebral palsy adolescents and considered able to be used together with diverse treatment interventions.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.167-179
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• 2018

The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.114-123
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• 2021

Background: Evaluation of the effectiveness of caudal epidural injection on pain, spine mobility, disease activity, and activity of daily living in axial spondyloarthritis (SpA) patients. Methods: A total sample of 47 patients were registered in this study. They were randomly assigned into 2 groups; Group I received caudal epidural injections, ultrasound-guided, with 1% lidocaine hydrochloride mixed with triamcinolone, whereas Group II did not receive any injections. All participants fulfilled the ASAS criteria for axial SpA. Outcome measures were as follows: visual analogue scale, Oswestry disability index (ODI), modified Schober test, lateral lumbar flexion, and Ankylosing Spondylitis Disease Activity Score (ASDAS) with assessment at baseline, 2 weeks, and 8 weeks post-treatment. This clinical trial was registered on clinicaltrials.gov under the number NCT04143165. Results: There was a significant difference between both groups regarding pain, ODI, spine mobility and ASDAS scores in favor of group I. This effect was at its maximum after 2 weeks. Despite the decline of this effect after 2 months, the difference between the groups remained significant. Higher disease activity, younger age, and shorter disease duration were associated with better outcomes. Conclusions: Epidural injection of lidocaine and triamcinolone is a cost effective and a practical technique for controlling pain, as well as improving the function of the spine and disease activity scores in axial SpA patients with acceptable complications and relatively sustained effect.

• Journal of Biomedical Engineering Research
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• v.26 no.3
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• pp.151-155
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• 2005

Interspinous spacers have been developed as an alternative surgical treatment for laminectomy or fusion with pedicle screws and rods for the treatment of lumbar spinal stenosis. However, its biomedical efficacies are well not known. In this study, we evaluated kinematic behaviors of the surgical and the adjacent levels before and after inserting interspinous spacers. Three porcine lumbar spines were prepared. On each specimen, an interspinous spacer was inserted at the L4-L5. Flexion-extension moments (0, 2.5, 5.0, 7.5, 10Nm) were applied. A stereophotogrammetric set-up with DLT algorithm was used to assess the three-dimensional motions of the specimen where three markers $({\square}0.8mm)$ were attached to each vertebra. Results showed that extension motion decreased by $15-24\%$ at the surgical level (L4-L5) after insertion of interspinous spacer. At the adjacent levels, the range of motion remained unchanged. In flexion, no significant changes in motion were observed regardless of levels. Therefore, our experimental results demonstrated the interspinous spacer is very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramen while maintaining kinematic behaviors at the adjacent levels. Further, these results suggested that the use of interspinous spacer may be able to prevent lower back pain at the surgical level and to lower the incidence of degenerative changes at the adjacent levels.

• The Journal of Korean Physical Therapy
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• v.16 no.1
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• pp.157-182
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• 2004

The purpose of this study was to evaluate effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients. The subjects were consisted of sixty patients who had non specific chronic low back pain(32 females. 28 males; mean aged 37.3) from 19 to 65 years of age(mean age : 37.3). All subjects randomly assigned to the lumbar stabilizing exercise group, the modalities treatment group, the manual treatment group. Lumbar stabilizing exercise group received manual treatment with lumbar stabilizing exercise for 30minutes, modalities treatment group received hot pack used thermal therapy for 20minutes and ICT used electrical therapy for 20minutes and US or MWD used deep thermal therapy for 15minutes, manual treatment group received modalities treatment with therapeutic massage for 10minutes and joint mobilization or manipulation for 10minutes per day and three times a week during 4 weeks period. The Multilevel Roland-Morris Disability Questionnaire(MR-MDQ) was used to measure functional disability level. Visual Analogue Scale(VAS) was used to measure subjective pain level. Remodified Schober test(RST) was used to measure forward flexion range of motion of lumbar segment. Finger-to-Floor test(F-T-FT) was used to measure forward flexion range of motion of full spine of low back pain patients. All measurements of each patients were measured at pre-treatment and 4 week post-treatment. The results of this study were summarized as follows : 1. The MR-MDQ of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 2. The VAS of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 3. The RST of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 4. The F-T-FT of lumbar stabilizing exercise group, modalities treatment group, and manual treatment group was significantly reduced between pre-treatment and post-treatment(p<.05). 5. The results of analyzed effects of MR-MDQ, RST, F-T-FT were significantly reduced (p<.05), but VAS wasn't significantly reduced(p>.05) between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment. 6. The results of LSD post-hoc to find difference between treatment type of lumbar stabilizing exercise group and modalities treatment group and manual treatment group according to pre-treatment and post-treatment that MR-MDQ was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and VAS wasn't significantly reduced all treatment group(p>.05), and RST was significantly reduced stabilizing exercise group than modalities treatment group(p<.05), and F-T-FT was significantly reduced stabilizing exercise group than modalities treatment group and manual treatment group (p<.05).

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.40-48
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• 2005

In this study, the muscle strength and endurance of the lumbar at flexion and extension were determined using an isokinetic muscle strength meter (Biodex) in patients with chronic lumbar go (10 male and 10 females), and the changes in muscle strength and endurance of the lumbar at flexion and extension after application of Y-shaped sacrospinalis muscle taping, typically used for patient with lumbar go, were studied. In addition, the sacrospinalis muscle taping of a different shape (I-shaped taping) was applied bilaterally centering on the spine, and the muscle strength and endurance of the lumbar at flexion and extension were determined and compared with those before taping. In addition, the results after application of Y-shaped taping and I-shaped taping were also compared. 1. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio taping and after application of Y-shaped taping did not show the level of significance. 2. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and application of Y-shaped taping did not show the level of significance. The extensor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of Y-shaped taping did not show the level of significance. 3. The extensor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). The flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 4. The flexor muscle endurance of the lumbar at loading of $90^{\circ}$/sec before application of kinesio taping and after application of I-shaped taping showed the level of significance. The extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec before application of kinesio Taping and after application of I-shaped taping showed the level of significance (p<.05). 5. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $60^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $60^{\circ}$/ sec showed the level of significance (p<.05). 6. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the flexor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not show the level of significance. In comparison between after application of Y-shaped taping and after application of I-shaped taping, the extensor muscle strength of the lumbar at loading of $90^{\circ}$/sec did not showed the level of significance (p<.05).