• 국제물리치료학회지
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• 제12권1호
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• pp.2302-2307
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• 2021

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.

• 대한정형도수물리치료학회지
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• 제19권2호
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• pp.39-46
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• 2013

Background: The purpose of this study was to realize the relations between gluteus medius, tensor fascia lata of pelvic muscles and functional leg length in women's university students. This study is examined the change of electromyographic activation on gluteus medius and tensor fascia lata according to the leg length discrepancy. Methods: All of the female of freshman and sophomore in 'D'college were gathered and separated fourteen of healthy women in two groups by functional leg length discrepancy. and The subjects divided into two groups that the difference with less than 2cm or more would have structural defects by tapeline. The electromyographic activation on the gluteus medius and tensor fascia lata muscles were recorded by surface electrodes at maximal voluntary isometric contraction (MVIC) during lunge posture. The collected datas were analyzed using Independent t-test with SPSS win19.0. Results: In intergroup comparison of electromyographic activation levels for gluteus medius and tensor fascia lata in short or long leg, the influence of electromyographic activation on tensor fascia lata is shown to be more statically higher than gluteus medius according to functional leg length discrepancy in coeds. Even though both muscles are shown to be statistically higher in comparison of electoromyographic activation levels for tensor fascia lata and gluteus medius between short leg and long leg in Group I, Differences of electoromyographic activation levels for tensor fascia lata is shown to be statistically higher than gluteus medius. Conclusion: Through this study, we realized that tensor fascia lata than the long leg, and also, tensor fascia lata is significantly effective for functional leg length discrepancy than gluteus medius. It leads to pelvic lateral instability. This means that cause tensor fascia lata to have a leg length discrepancy.

• 대한정형도수물리치료학회지
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• 제12권1호
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• pp.27-36
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• 2006

The purpose of this study was to compare the effects of Mulligan method and PNF method on the pain and limitation of range of motion in patients with frozen shoulder. The subjects of this study were 20 patients, 10(50%) males and 10(50%) females. They visited clinic for physical treatment within 6 months after onset of shoulder pain and limitation of range of motion with frozen shoulder. One group was applied with Mulligan method and other group was with PNF method. The patient were treated 5 times session weekly for 6 weeks from March 4th, 2002. And each treatment session was 15min. with physiotherapy. The pain was measured by visual analogue scale (V AS) and rage of motion (ROM) of flexion, abduction, external rotation, internal rotation were measured by goniometer. The data was analysed by paired T-test and independent T-test. The results of this study were summarized as follow : 1. The ROM of Mulligan method group increase in after treatment in comparison with ROM in before treatment, it is significant increase. Although the V AS of MMG decrease in before than after treatment, it is significant difference. 2. There is significant difference in before and after treatment of ROM of shoulder flexion, abduction, internal rotation, external rotation between PNF method group. The V AS of PMG is decreasing in before than after treatment, it is significant difference. 3. There is significant difference in before movement and after movement ROM of flexion, abduction, internal rotation, external rotation and VAS between Mulligan method session and PNF method session then the scale which measured by Mulligan method was more increased than that of PNF method. The results showed that both Mulligan method and PNF method were effective in pain reduce and ROM increase, but Mulligan method was superior to PNF method in ROM increase and pain reduce.

• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.37-48
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• 2005

Objects: This study is designed to analysis improvement and maintaince of trunk stability targeting patients who need post operative rehabilitation exercise after undergoing opened microscopic laser discectomy(OMLD) due to HNP. Method: Between March 2004 and February 2005 a total sixty patients who underwent OMLD due to $L_4/L_5$, $L_5/S_1$ HNP and who agreed to the experiment were subject for this study. Experimental group consisted of 18 subjects, and they underwent 45 minutes dynamic lumbar stabilization exercise And control group consisted of 18 subjects who conducted conservative physical therapy based on the use of physical modality for 45 minutes except to exercise. Results: Experimental group that was lumbar extensor's isometric peak torque, weight distribution of both leg, trunk muscle balance and Oswestry LBP disability index increased during 12 weeks in a statistically significant manner compared to before exercise (p<.05). When re-test was tried, isometric peak torque (p>.05) and Oswestry LBP disability index(p<.05) maintained 12th week level or improved. Weight distribution rate of both leg and trunk muscle balance maintained the level of 8th week of exercise execution(p<.05). Control group that was lumbar extensor's isometric peak torque, weight distribution rate of both leg and trunk muscle balance aggravated during 12 weeks compared to pre-test(p>.05) But, Oswestry LBP disability index increased in a statistically significant level compared to pre-test(p<.05). When re-test was tried, isometric peak torque increased slightly compared to pre-test, but decreased when at least $60^{\circ}$ flexion angle(p>.05). Weight distribution rate of both leg and trunk muscle balance also aggravated compared to pre-test(p>.05), and Oswestry LBP disability index was similar to the 4th week of physical therapy execution(p>.05). Conclusion: Successive postoperative Especially, Application of dynamic lumbar stabilization exercise program is important than traditional lumbar strengthening exercise program in the maintaince of spinal stability.

• 대한정형도수물리치료학회지
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• 제29권1호
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• pp.41-52
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• 2023

Background: Bulgarian split squat (BSS) is beneficial to improve dynamic balance ability and muscle activity of lower extremities, however its effects have not been fully investigated. Therefore, this study aimed to compare changes in dynamic balance ability and muscle properties according to various modifications of BSS exercises. Methods: Thirty healthy male volunteers participated in this study, and they were randomly divided into three different groups. The subjects performed the BSS exercise either on a stable surface with the eyes opened (n=10) or eyes closed (n=10), and on an unstable support plane with eyes opened (n=10) conditions, respectively. Dynamic balance ability was measured via Biodex balance system under the eyes-opened and closed conditions. Additionally, muscle properties of the rectus femoris (RF), vastus medialis (VM) and vastus lateralis (VL) were evaluated. Results: Dynamic balance ability did not show the significant differences among the groups that performed the BSS exercises. However, in the Unstable group, there were significant differences in the overall stability index and anterior posterior stability index under the eyes-closed condition between pre-exercise and post-exercise. In comparison of muscle properties according to the groups, RF muscle showed a significant difference in amount of change of elasticity (p=.038). Additionally, there were significant changes in post measurements of VM muscle tone (p=.016), stiffness (p=.012) and elasticity (p=.002). VL muscle, however had no significant differences in muscle properties. Conclusion: These results indicate that BSS exercises could induce the alteration of RF and VM muscle properties, in particular VM muscle which is susceptible to weakness. Thus, BSS could be applied in various ways as an effective rehabilitation exercise.

• 대한정형도수물리치료학회지
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• 제14권2호
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• pp.1-15
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• 2008

Purpose : This survey was to investigate on the effect of each region changed in trunk through sagittal plane after Trunk Flexion-Extension Exercise. Methods : 18 students of Gimcheon College participated in this study for the period of July 9-30, 2007. Analyzed factor were 1) degree of pain 2) presence of Gillet test and 3) difference of right-left for 7 landmark region in trunk applying I.B.S.-2000 after Trunk Flexion - Extension Exercise. We used the SPSS $PC^+$ program for classifying into analysis of frequency, $x^2$-test, t-test and Simple Linear Regression analysis test. Results: Followings are concluded For degree of pain, 13(72.2%) of students answered "No pain" after Trunk Flexion-Extension Exercise and in the result 4 more students decreased the pain. In the Gillet test, 14(77.8%) of students answered "positive" after Trunk Flexion-Extension Exercise and in the result 4 more students increased mobility of Sacroiliac joint. In the differences of right-left for 7 landmark region in trunk by B.M.I. scale, Slim type was decreased both Acromion(0.45mm), both Iliac crest(0.44mm), and both ASIS(0.31mm) to anterior plane, Normal type was decreased both inferior angle of Scapular(0.02mm), both L4-5(0.07mm), and both PSIS(0.09mm) to posterior plane Fatness type was decrease both Acromion(0.05mm), both ASIS(0.05mm) to anterior plane. In the differences of right-left for 7 landmark region in trunk for degree of pain No pain group was decreased both Acromion(0.17mm), both Nipple(0.25mm) to anterior plane and both PSIS(0.13mm) to posterior plane Pain group was decreased both Acromion(0.04mm), both Iliac creast(0.03mm) to anterior plane and both inferior angle of Scapular(0.18mm) both PSIS(0.13mm) to posterior plane. In the difference of right-left for 7 landmark region in trunk for each of the exercises, Both iliac crest(0.1mm), both ASIS(0.12mm) to anterior plane were decreased after Flexion Trunk Exercise. Both acromion(0.27mm) to anterior plane, both inferior angle of scapular(0.14mm) and both PSIS(0.12mm) to posterior plane were decreased after Extension Trunk Exercise. Each of the exercises, The both inferior angle of Scapular showed high scores($0.65{\pm}0.23$) at Trunk Extension Exercise group and there was statistical significance between Trunk Flexion Exercise group and Extension exercise group(t :-2.502, p < 0.05). 7. At Pre-exercise group, Both inferior angle of Scapular showed low scores($0.23{\pm}8.27$) at Trunk Extension Exercise group and there was statistical significance between Pre- Exercise group and Trunk Extension Exercise group(t :-2.5430, p<0.05). Conclusion : The simple linear regression analysis was presented at Acromion(-0.243), L4-5(-0.753), PSIS(0.576) and there was statistical significance in BMI scale(p<0.01).

• 대한정형도수물리치료학회지
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• 제11권2호
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• pp.83-95
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• 2005

The purpose of this study is to analyze, durability of motor effort after finishing rehabilitation program and the influence from the isotonic lumbar region extension exercise after an operation according to the different operation way in invasive degrees. We selected randomly 80 patients who have no complication and musculoskeletal system diseases with finishing the 12 weeks' rehabilitation program after getting laser discectomy, but fail to conservative treatment, about Lumbar HNP, and divided into minimal invasive groups 38 and invasive groups 42 for study. As the results, in minimal invasive group, after finishing cure and 6 months later, the degree of hold muscle of women is much better than that of men. but in Invasive group, that of men is better than that of women, in case of women, the $0^{\circ}$ and $72^{\circ}$ in lumbar flexion angle have weaken or no improvement than before beginning exercise. and muscle force in $72^{\circ}$ in lumbar flexion angle increased to all men and women than before beginning exercise in Minimal invasive group. but in invasive group. it decreased. When analyze the lapsed time in Minimal invasive group, the groups who start the exercise within 3 months are better than the groups who start the exercise above 3 months after an operation the hold muscle degree all angles after finishing cure and 6 months later. Meanwhile, in invasive group, the groups who start the exercise within 3 months are better than the groups who start the exercise above 3 months after an operation about the hold muscle degree in 36-72 of lumbar flexion angle but 0-36 are not good after finishing cure and 6 months later. When analyze BMI in Minimal invasive group, the normal groups are better than the overweight groups about hold muscle degree in all angles after finishing cure and 6 months later.

• 대한정형도수물리치료학회지
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• 제7권1호
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• pp.29-50
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• 2001

This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

• 대한물리치료과학회지
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• 제11권3호
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• pp.28-37
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• 2004

Background: Lumbar joint dysfunction is reported to be the main cause of lower back pain (LBP). The purpose of this study was to evaluate the effect of joint dysfunction on the postural balance of the lower hack and pelvis in different normal activities such as walking or stair management. Also it was studied whether the status of LBP (intensity and duration of LBP, length of treatment) contributes to die pelvic height difference (PHD) in various postures. Subjects: 28 patients with LBP and 32 normal adult volunteers, 60 years of age or younger, who came to the Community Health Center and orthopedic clinics in Incheon, South Korea. Methods: In order to determine the accuracy of the manual angulometer method in measuring the PHD, it was compared to the pelvic x-ray method in selected subjects. In the manual angulometer method, the arm of the angulometer was placed on the top of both iliac crests. The PHD was measured in static upright stance, then one-legged stance, on the affected leg or unaffected leg each time. Information regarding the disease status was obtained through interviews. Visual assessment scale was used to grade the intensity of LBP. Data analysis was performed using SPSS 10.0/PC program. Homogeneity between the two groups was tested by 2-test and t-test. To compare the PHD of the subgroups, we used t-test, F-test and two-way ANOVA. Relationships among dependent variables were analyzed by Pearson correlation analysis. Conclusion: In patients with LBP, lumbar joint dysfunction causes lumbar and pelvic postural asymmetry during normal activities.

• 대한정형도수물리치료학회지
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• 제4권1호
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• pp.71-82
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• 1998

The purpose of this study is to analyze the phases of back pain occurring on pregnant women, and to raise the necessity of the pain management on the basis of the former analysis. The objective group is 284 pregnant women who visited department of OBGY of hospital located both in Seoul and Andong. The results are as follows; 1. 204(71.8%) pregnant women were suffering from back pain. The ratio of pain occurrance in terms of the duration of pregnancy shows that 78.3% within 3 pregnant months, 68.4% between four and six months and 72.1% over seven month. Most common ares of pain was low back area rating 60.5%. 2. The most painful postural for the suffering women was lying on the back rating 35.9% and the next painful posture was standing rating 34.4%. And the most painful movement was to maintaining continues movement(57.8%). Twisting back rates the second(17.2%). These two variables were relevant each other(p<0.05). 3. 46.7% of pregnant women were experiencing nocturnal pain. Among women experienced the pain before pregnancy, 39.9% were suffering during the pregnancy. The occurrence of nocturnal pain was related to the pain before and after the pregnancy(p<0.05). 4. 58.8% of pregnant women who experience back pain take the pain for granted as a normal proceeding of pregnancy while 3.9% recognize the symptom as an abnormal. Pain recognition in accordance with the phases does not show much difference(p<0.05). 5. It is shown that the more one delivers the number of babies, the faster back pain occurs(p<0.01). 6. 32.3% of the pain-suffering women have family member(s) having back pain. Family member(s) of the women who does not experience the pain don't have the pain either. This case reports 46.1%. Statistically, these two variables are relevant(p<0.01). 7. 43.0% of back pain experiencing women does not have any particular management plan against the pain. 20.7% is exercising as for prevention. Women who recognize the necessity of some means of therapy for their pain marked 42.9%. The majority(65.8%) of women responded exercise gymnastic work-out are most appropriate pain management. The above results show that a great number of pregnant women is experiencing back pain, however, they properly managed. This span suggests that appropriate advocacy and education for pregnant women is necessary. It is recommended that positive contribution can be made to better health of pregnant women when pain management by physical therapist is given.