• Physical Therapy Korea
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• v.18 no.3
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• pp.94-102
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• 2011

The purpose of this study was to review existing assessment tools for patients with low back pain and improve them through combination. A total of 314 patients with low back pain participated. Their condition was assessed using the Oswestry Disability Questionnaire (ODQ), the Quebec Back Pain Disability Scale (QBPD), and the Back Pain Functional Scale (BPFS). Rasch analysis was applied to identify inappropriate items, item difficulties, and the separation index. In this study, the 'sex life' item of the ODQ (10 items) and the 'sleeping' item of the BPFS (12 items) showed misfit statistics, whereas all items of the QBPD (20 items) were appropriate. After combining the ODQ, QBPD and BPFS, Rasch analysis was applied. The 'pain intensity', and the 'sex life' item of the ODQ and the 'throw a ball' item of QBPD showed misfit statistics. These 3 items were retained for further analysis. The remaining 42 combined ODQ-QBPD-BPFS items were arranged according to difficulty. For all subjects, the most difficult item was 'pain intensity', whereas the easiest was 'take food out of the refrigerator'. As the separation index of 42 combined ODQ-QBPD-BPFS was higher than that of the three questionnaires separately, difficulty of items varied with some need for rearrangement. The results of this study confirmed the possibility and need for a new back pain disability assessment tool, and produced one. Further study is needed to refine the questionnaire in consideration of psychosocial and occupational factors.

• PNF and Movement
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• v.15 no.3
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• pp.353-360
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• 2017

Purpose: This study aimed to measure static balance of low back pain patients while one-leg standing in abdominal compression belts. Methods: The study included 40 adult males and females at J university, divided into a low back pain patient group and a normal group through the Oswestry disability questionnaire (ODQ). The subjects were instructed to hold a one-leg standing posture for 15 seconds on a balance measurement plate while wearing an abdominal compression belt. Shifting distance (0.1 cm), mean velocity (cm/s), pressure, and contact area were analyzed using BioRescue (BioRescue, RMINGEIEIRIE, Rodez, France). The average value was used to measure the result 3 times for each condition. Results: Both normal and low back pain groups significantly decreased in the speed of sway while wearing the abdominal compression belt. Furthermore, the pressure of the center of motion significantly decreased in the low back pain groups while wearing abdominal compression belt. However, there were no significant differences in the speed of sway or the pressure of center of motion between groups after wearing the abdominal pressure belt. Conclusion: These results suggest that abdominal compression belts are one option for improving balance temporarily. However, balance after wearing abdominal compression vests depends on onset of back pain, age, and symptoms of pain in the groups with low back pain. Further research is needed to investigate muscle activity, dynamic balance, and the effect of the period of wearing abdominal compression belts in the variety of low back pain patients.

• Physical Therapy Korea
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• v.14 no.2
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• pp.76-84
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• 2007

This study was designed to determine the efficacy of ultrasound and laser therapy for sub-acute lower back pain. Twenty-seven patients with sub-acute low back pain were recruited, who were randomly assigned to three groups: Ultrasound group (actual ultrasound, 1.1 MHz, $1.0W/cm^2$, duty cycle 100%, 10 min/session, n=9), laser group (actual laser, 904 nm, 155 ns, 13.5 W, 12 mW, 90 sec/point, n=9), and control group (placebo ultrasound or placebo laser, n=9). All of treatments including placebo procedures were applied to patients over a period of 2 weeks, five times a week. Visual Analogue Scale (VAS), Modified Schober's Test (MST), and Modified Oswestry Disability Questionnaire (MODQ) were used by the clinical and functional evaluations before and after intervention. At post-hoc, significant differences were observed in all groups with respect to VAS, MST (p<.05), except MODQ. VAS and MST score were more significantly improved in the ultrasound group than the laser and control group (p<.0167). However, no significant difference was present between the laser group and the control group. Therefore, this study revealed that ultrasound therapy was effective in pain relief and improvement of lumbar mobility in patients with sub-acute lower back pain. However, laser therapy did not show the effects for sub-acute lower back pain.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.217-228
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• 2021

Background: The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain. Methods: Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients' visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3. Results: A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05). Conclusions: bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

• PNF and Movement
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• v.10 no.4
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• pp.33-40
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• 2012

Purpose : The purpose of this study was to investigate the effects of PNF on active lumbar flexion ROM and difficulty of activity of daily living for adult scoliosis with low back pain. Methods : A 23-aged adult scoliosis with diagnosed herniated lumbar disc. The patient was treated by PNF for 30 minutes a day, 2 times a week during six weeks. Active lumbar flexion ROM and difficulty of activity of daily living were evaluated by the Modified-Modified Schober test and Oswestry Disability Questionnaire every week after treatment including the pretest of the first day of treatment. Results : There were a significant improvement in active lumbar flexion ROM between pretest and the last test. There were significant decreased in difficulty of activity of daily living positive between pretest and the last test. Conclusion : PNF will be useful for increasing active lumbar flexion ROM and decreasing the difficulty of activity of daily living positive for adult scoliosis with low back pain.

• Physical Therapy Korea
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• v.16 no.1
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• pp.52-60
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• 2009

The objectives of this study were to investigate the relationship between fear-avoidance beliefs and functional status in individuals suffering from low back pain, and to identify factors that influence on fear-avoidance beliefs, functional status and pain. A cross-sectional study included 214 individuals with low back pain. Each of subjects completed a fear-avoidance beliefs questionnaire (FABQ) which divided into two subscales, FABQ for physical activity (FABQ-PA) and FABQ for work(FABQ-W), Oswestry disability index (ODI) and numeric pain rating scale (NPRS). Individuals with radiating pain were significantly higher in FABQ-PA, FABQ-total, and ODI scores than with no radiation pain (p<.05). Individuals who had received surgery were significantly higher in FABQ-PA, FABQ-total, ODI and NPRS scores when compared with individuals who had not received it (p<.05). And individuals with taking medication were significantly higher in all variables (FABQ-PA, FABQ-W, FABQ-total ODI and NPRS) than individuals not taking medication (p<.05). In correlation analysis. age appeared to be significantly correlated with FABQ-PA, FABQ-total and ODI scores (p<.05), and all variables was significantly correlated with each other (p<.01). These findings indicate that individuals suffering from low back pain have psychosocial problems such as fear-avoidance beliefs as well as functional status and pain. Fear-avoidance beliefs may contribute to aggravate physical symptoms, and therefore it should be carefully considered for the management of individuals with low back pain.

• PNF and Movement
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• v.17 no.1
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• pp.157-166
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• 2019

Purpose: This study compares and examines the effects of proprioceptive neuromuscular facilitation (PNF) on patients with chronic low back pain through systematic literature review and meta-analysis. Methods: Domestic literature was searched with combinations of keywords including "proprioceptive neuromuscular facilitation," "PNF," "back pain," and "low back pain" using the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Korean Medical Database (KMbase). Six studies (n=148) were finally included in the analysis through a selection and exclusion process. The quality of the studies was evaluated using the PEDro scale. Results: According to the meta-analysis results, the low back pains of the PNF group and the contrast group showed a standardized mean difference (SMD) of 2.21 (95% CI: -3.35, -1.07, p=0.01, $I^2=83%$) after intervention. Thus, the PNF group showed a statistically significant decrease in low back pain compared with the control group. In addition, the SMDs of the Oswestry Disability Index (ODI), lung function, and the Roland and Morris Disability Questionnaire (RMDQ) were -1.34 (95% CI: -1.88, -0.79, p<0.01, $I^2=35%$), 1.14 (95% CI: 0.49, 1.79, p=0.01, $I^2=0%$), and -1.59 (95% CI: -2.56, -0.62, p=0.01, $I^2=46%$), respectively. Thus, the PNF group showed statistically significant differences from the control group. Conclusion: At present, there is some limit to obtaining definite results about effect sizes because there are relatively few randomized controlled experiments that analyze the effects of PNF exercise in patients with chronic low back pain. Therefore, continuous efforts should be made to conduct randomized clinical trials and long-term efficacy studies in the future.

• Physical Therapy Korea
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• v.21 no.2
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• pp.74-81
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• 2014

The versions of the Oswestry disability questionnaire (ODQ) is regarded as one of the most extensively used condition-specific instruments measuring disability resulting from low back pain. It has been shown to have adequate psychometrics, reliability, validity, and responsiveness as a whole, yet the summated total score of the instrument often provide little information to rehabilitation clinicians. A keyform analysis based on Rasch measurement model is an innovative way of illustrating the specific test items that an individual may or may not perform. By applying the keyform of the Rasch measurement model to the ODQ, rehabilitation clinicians may able to select more challenging ODQ items matching an individual's ability and document them as attainable treatment goals. The results demonstrated how a keyform analysis assist to setting possible goals for the treatment of individuals with low back pain. Forty-two individuals with low back pain were recruited from rehabilitation clinics in Gainesville, Florida. A series of Rasch analyses on the 10 items of the ODQ were performed using Winsteps software. The performance of two individuals on those 10 items was illustrated on the keyform. The keyform analysis of the Rasch measurement model may be translated into a useful tool for making clinical judgements.

• Physical Therapy Korea
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• v.23 no.1
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• pp.38-45
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• 2016

Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

• Journal of Acupuncture Research
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• v.35 no.2
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• pp.81-87
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• 2018

Background: The purpose of the present study was to evaluate efficacy and patient satisfaction of acupuncture or Chuna therapy for back pain. Methods: Amongst all the patients with back pain who had been treated at Sun-cheon korean medicine hospital, Dong-shin university, only patients that had received either acupuncture or Chuna manual therapy between September 1 and October 31, 2017 were selected and their medical charts retrospectively analyzed. A questionnaire was used in the investigation that consisted of a numeric rating scale (NRS), the Oswestry low-back pain disability index (ODI), general, emotional, conversational, and technical satisfaction. The questionnaire was completed before treatment and at weekly intervals (approximately). Treatment efficacy was analyzed using the first and last questionnaires. The last questionnaire was also used to establish patient satisfaction. The data were analyzed using SPSS for Windows version 21.0. Results: The NRS, Current degree of pain (ODI-1), and total ODI were significantly decreased in both the acupuncture and Chuna groups. The differences in NRS, ODI-1, and total ODI changes between treatment groups were not significant. There were no statistically significant differences between the acupuncture and Chuna groups in terms of general, emotional, conversational, and technical satisfaction. Conclusion: Acupuncture treatment significantly reduces NRS and ODI in patients who have back pain without structural transformation, and Chuna therapy significantly reduces NRS and ODI-1 in patients who have back pain with structural transformation. These results indicate that further studies should be conducted in more patients and over a longer period.