Background: The purpose of this study was to investigate the effects of Progressive muscle relaxation training on pain, Korean version of Oswestry disability index (ODI) and psychological level in chronic low back pain patients with somatization. Methods: A total of 30 subjects were treated with the experimental group (n=15) and conservative physical therapy (n=15). The experimental group was trained with progressive muscle relaxation (PMR), and the control group was treated with conservative physical therapy. Physical factor treatment was applied for 60 minutes by hot pack, electrotherapy and ultrasound. Both groups performed three times a week for six weeks. VAS, ODI, psychological level measurements were taken before and after intervention. Results: There was a significant difference in VAS (p<.05) and ODI (p<.01) between experimental and control group. At the psychological level, there were significant differences in somatization (p<0.01) and depression scales (p<.01), but not in anxiety. Conclusion: As a result of this study, the degree of pain was decreased, the level of back pain dysfunction was improved, and the somatization scale and depression scale were decreased by gradual muscle relaxation therapy.
Objective: The purpose of this study is to investigate the effect of stabilization exercise on whole-body vibration on pain, dysfunction, psychosocial factors, balance ability, and abdominal contraction with patients with low back pain. Design: A randomized controlled trial Methods: A total of 34 patients with low back pain were assigned randomly to experimental group (n=17) and control group (n=17). Both groups underwent a neuromuscular stabilization exercise program. In addition, the experimental group implemented the neuromuscular stabilization exercise program using whole-body vibration. All interventions were applied 60 min per session, 3 times per week for total 4 weeks. Numeric Rating Scale (NRS), Korean version of Oswestry Disability Index (K-ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), balance ability, muscle thickness and contraction ratio were compared to evaluate the effect on intervention. Results: Both groups showed significant differences in NRS, balance ability, and muscle thickness in contraction, contraction ratio before and after intervention (p<0.05). In addition, the experimental group showed significant difference in the amount of change in NRS, balance ability and muscle thickness in contraction, contraction ratio values than the control group (p<0.05). Conclusions: Neuromuscular stabilization exercise program combined with whole-body vibration stimulation has been proven to be an effective and clinically useful method to decrease pain, dysfunction, increase balance ablilty, and transverse abdominis muscle thickness in contraction and contraction ratio for patients with low back pain.
Kim, Jae-Eun;Cho, Ji-Eun;Do, Kwang-Sun;Lim, Seung-Yeop;Kim, Hee-Joong;Yim, Jong-Eun
대한물리의학회지
/
제12권3호
/
pp.23-32
/
2017
PURPOSE: Flexibility and range of motion are very important factors in sports performance, rehabilitation, and musculoskeletal pain. The purpose of this study was to measure the effects of cupping therapy on flexibility, muscle activity, and pain threshold of hamstring muscle compared to passive stretching in healthy subjects. METHODS: Thirty healthy subjects were randomly assigned in a crossover design to cupping therapy and passive stretching. Subjects were tested to compare their effects according to the intervention such as Passive range of motion (PROM) (straight leg raising) and active range of motion (AROM). And algometer (pain) testing and MVC assessment using EMG were performed as dependent variables. RESULTS: The cupping therapy group and passive stretching group showed significant differences in all variables including PROM (p=.00, p=.00), AROM (p=.00, p=.03), Pain Threshold (p=.03, p=.08), Semitendinosus MVC (p=.01, p=.00), and Biceps femoris MVC (p=.01, p=.16). There were no significant differences between the two groups in all variables. CONCLUSION: These findings of this study suggested that cupping therapy has as much positive effect on flexibility, pain threshold, and muscle contraction as passive stretching. Also, it is more convenient and easier to work on patients than passive stretching. Therefore, cupping therapy should be considered as another option to treat range of motion, pain, and muscle activity in the clinical field.
Purpose: The purpose of this study was to examine the effect of neuropathic pain by peripheral nerve injury on mass and Type I and II fiber cross-sectional areas on hindlimb muscles of the neuropathic pain model rat. Method: Adult male Sprague-Dawley rats (body weight 200-220 g) were assigned to one of two groups: a neuropathic pain group (n=7) that had a ligation of the left L5 spinal nerve, a control group (n=5), a naive rat without any procedures. Withdrawal threshold, activity, body weight and food intake were measured daily. At 8 days after neuropathic pain, all rats were anesthetized and the soleus and plantaris muscles were dissected from the both hindlimbs. Body weight, food intake, muscle weight and Type I and II fiber cross-sectional area of the dissected muscles were determined. Result: The neuropathic pain group showed a significant decreases (p<.05) as compared with the control rats, in diet intake, body weight, muscle weight and Type II fiber cross-sectional area of the left (affected side) soleus and plantaris muscles, and the right (unaffected side) muscle weight of plantaris and Type II fiber cross-sectional area of the soleus muscle. Conclusion: The hindlimb muscle atrophy occurs in both affected and unaffected side due to neuropathic pain by the peripheral nerve injury. The hindlimb muscle atrophy of the affected side is more pronounced than that of the unaffected side.
Background: Patients with lumbar spinal stenosis show abnormal changes in muscle activity due to pain and limited range of motion of the lumbar spine. Excessive increased muscle tone and decreased muscle activity patterns threaten the patients' quality of life. However, there have been a few studies showing how to improve muscle performance in patients with lumbar spinal stenosis. Among these, joint mobilization is one way of improving muscle performance through pain relief and increasing the range of motion. Objectives: To investigate the effect of lumbar mobilization by orthopedic manual physical therapy on paravertebral muscle activity and tone in patients with lumbar spinal stenosis. Design: A randomized controlled trial. Methods: In this study, 24 patients with lumbar spinal stenosis were randomized (1:1 ratio) into two groups. The experimental group underwent lumbar posteroanterior mobilization, and the control group underwent conventional physical therapy (conventional transcutaneous electrical nerve stimulation) for 15 minutes each. For outcome measures, Myoton®PRO was used to evaluate muscle tone when resting of the paravertebral muscle in the pain area. For muscle activity evaluation, the reference voluntary contraction of the paravertebral muscle was evaluated using surface electromyography. Results: Muscle tone and activity were significantly improved after intervention in both the experimental and control groups. In addition, the experimental group showed more significant decrease in muscle tone and activity than the control group. Conclusion: These results suggest that lumbar mobilization improving muscle performance in patients with lumbar spinal stenosis.
Piriformis muscle syndrome is a condition that causes direct muscle pain around piriformis muscle or sciatica from irritated sciatic nerve and the diagnosis remains debatable. The main treatment is symptomatic relief from conservative therapy such as medication and piriformis stretching exercise, and various therapeutic injections including local anesthetic, corticosteroid, botulinum toxin can be considered for diagnostic and therapeutic purposes. In this case, a 54-year-old male who had sciatica and gait disturbance showed piriformis muscle hypertrophy in the pelvis MRI. From imaging studies, electrodiagnostic study and physical examination, he was diagnosed with piriformis muscle syndrome. He underwent trigger point injection and botulinum toxin injection into the piriformis muscle, and pain and gait disturbance significantly improved. This case reports a case of piriformis muscle syndrome with clinical symptom of gait disturbance, which was improved by botulinum toxin injection.
The purpose of this study was to examine the effect of low back pain relieving program on back muscle strength, intensity of pain, low back disability level in elementary school teachers who have low back pain. subjects were elementary school women teachers who worked at eight elementary school located in Seoul. Intended subjects size were seventy consist of thirty-four experimental group(three schools) and thirty-six control group(five schools), but actual subjects size was forty-four. Among the forty-four patients subjects, twenty-three were experimental group receiving health education about right postures, etiologies of low back pain, diagnosis of low back pain and exercise program composed of muscle strengthening exercise, stretching exercises and twenty-one were control group. During the 8 weeks program, the subjects were received two times education and six times group exercise practices in 1st week and three times per week group exercise practices, two times education in other 7 weeks. This study as carried out from April 1, 1999 to June 30, 1999. Back muscle strength was measured by back muscle strength measuring machine and the intensity of pain were measured by the Visual Analogue Scale(VAS), and level of disability was measured by Oswestry low back pain disability scale. Study measurements were taken before and after 8 week exercise program. Data were analyzed using paired t-test, and ANCOVA. The results were summarized as follows. 1. After low back relieving program, back muscle strength was increased significantly(p=0.000) and there was significant difference in back muscle strength change between experimental group and control group(p=0.002). 2. After low back pain relieving program, pain on anterior bending, pain on posterior bending were decreased significantly than measurements before the program(p=0.000 p=0.000) and there was significant difference in pain on anterior bending and posterior bending change between experimental group and control group(p=0.000, p=0.000). 3. After low back pain relieving program, Oswestry disability scale scores were decreased significantly(p=0.000, p=0.000) but there was no significant difference in Oswestry disability score change between experimental group and control group.
Purpose : This study is to offer clinical primary data that examines the change of imaging structure and the quantitative evaluation of muscle activity on myofascial trigger points. This study examines neuromuscular physiological characteristic by comparing the differences in physical findings, pressure pain threshold, imaging, and electrophysiological characteristics in latent and active myofascial trigger points muscle and normal muscle through the following experimental procedures. Methods : The participants for the study were thirty-three adults in their twenties. We divided three groups into normal, latent and active myofascial trigger points groups by physical findings. We analyzed the results of measured pressure pain, threshold for pain, ultrasound imaging perform for structure characteristic of muscle, surface EMG according to type of muscle contraction for function of muscle contraction. Results : Significant differences were indicated in pressure pain threshold (p<0.05). Significant differences were discovered in the ultrasound imaging analysis. There were increases in muscle Echogenicity white area index (p<0.001). There were significant differences that decrease in %MVIC (p<0.05), increase in MDF (p<0.05). Conclusion : From these results, active rnyotascial trigger points muscle showed quality deterioration on ultrasound imaging and decreased function of muscle contraction, increased motor unit action potential of II type fiber, and electrophysiologically. Imaging structure and neuromuscular physiological characteristic can be diagnostic and quantitative analytical techniques for myofascial pain syndrome and a primary factor that reflected in physical therapy intervention.
The purpose of this study is to identify the level of masseter muscle tension according to the levels of restricted movement and pain in the temporomandibular joint(TMJ), thereby verifying the fact that excessive masseter muscle tension can be a cause for restricted movement and pain in the TMJ. The subjects of this study were 81 men and women in their 20s and 30s, who feel uncomfortable with their masticatory function on the preferred chewing side. The subjects were measured in terms of the range of motion (ROM) and deviation of the TMJ and the degree of pain in the affected region. The ROM and deviation of the TMJ were measured using the Global Posture System(GPS) after instructing each subject to open his/her mouth to the fullest and taking photos of the subject with a digital camera. The tension of the masseter muscle was measured with a Pressure Threshold Meter(PTM). After the measurements, in order to compare the ROM of the TMJ, the subjects were divided into two groups based on the ROM of above 35mm and below 35mm. For the deviation and pain, based on the average of total subjects, the subjects were divided into two groups of above and below average. Thereafter, the levels of masseter muscle tension were compared between each pair of groups. According to the results, when each variable was compared between the respective two groups, in terms of the deviation, the pressure pain threshold(PPT) of the masseter muscle revealed a statistically significant difference(p<.05). However, the ROM and pain showed no statistically significant difference. Consequently, masseter muscle tension may cause restricted movement in the TMJ. In particular, the deviation and tension in the masseter muscle is considered to be a factor that causes deviation in the TMJ.
Objective: The shoulders are a particularly an important body part for elite boxers. The purpose of this study was to investigate the characteristics of the upper trapezius (UT), infraspinatus (IS) muscle tone, pain, and isokinetic muscle function of shoulder movements such as external rotation, internal rotation, protraction, and retraction according to the scapular position of elite boxers of the Korean national team. Design: Cross-sectional study. Methods: Using the double square method, the scapular position was measured and divided into the forward scapular position group (n=8) with a measurement distance of 135 mm or more, and the normal scapular position group (n=10) with a measurement distance of less than 135 mm. Through the numeric rating scale of the subject, the pain value displayed during movement was measured. The muscle tone of the subjects' UT and IS were measured. The isokinetic muscle function of ER, IR, protraction, and retraction were measured using isokinetic exercise equipment. Results: The results of this study showed statistically significant differences when comparing muscle tone of the UT and IS, shoulder pain, isokinetic function of ER and IR, protraction, and retraction according to scapular position (p<0.05). Conclusions: The findings of this study were that shoulder muscle tone, pain, and isokinetic muscle function were affected according to the scapular position of elite boxers. In the future, this information may be a useful indicator when studying the effects of medium and long-term intervention in elite boxers who possess these characteristics.
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