• Physical Therapy Rehabilitation Science
• /
• 제10권2호
• /
• pp.235-243
• /
• 2021

Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

• Clinical Pain
• /
• 제19권2호
• /
• pp.90-96
• /
• 2020

Objective: To investigate the diagnostic accuracy of two physical examinations (straight leg raise [SLR] and Bragard test) and electromyography (EMG) in patients with lumbosacral monoradiculopathy in acute and chronic state on confirmation of different diagnostic criteria (MRI vs MRI and diagnostic selective nerve root block [DSNRB]). Method: We identified 297 participants retrospectively from the departmental database. MRI evidence of L5 or S1 nerve root compression and a positive result in diagnostic SNRB served as reference standards. They were divided into two groups by the symptom duration: lasting more than 12 weeks in the chronic group and less than 12 weeks in the acute group. The diagnostic value of clinical tests and EMG were compared. Results: The clinical tests (SLR and Bragard test) done in acute stage on detection by MRI and DSNRB had the highest sensitivity (68%) compared to the chronic stage (63%), but sensitivity was low (57%) on confirmation of MRI alone. However, there was no significant difference on sensitivity and specificity of EMG regardless of reference standards and symptom duration. Electromyography was a significant predictor of neuropathic abnormalities on both acute (OR, 6.3; 95% CI, 2.4 to 16.7; p<0.01) and chronic (OR, 6.8; 95% CI, 2.9 to 16.3; p<0.01). Conclusion: In general, individual physical tests are easy to do and a combination of those tests could be a sensitive indicator of L5 or S1 radiculopathy. Furthermore, the use of provocation tests could provide useful information, especially in proceeding therapeutic selective nerve root block.

• Biomedical Engineering Letters
• /
• 제8권4호
• /
• pp.345-353
• /
• 2018

This study suggested a new EMG-signal-based evaluation method for knee rehabilitation that provides not only fragmentary information like muscle power but also in-depth information like muscle fatigue in the field of rehabilitation which it has not been applied to. In our experiment, nine healthy subjects performed straight leg raise exercises which are widely performed for knee rehabilitation. During the exercises, we recorded the joint angle of the leg and EMG signals from four prime movers of the leg: rectus femoris (RFM), vastus lateralis, vastus medialis, and biceps femoris (BFLH). We extracted two parameters to estimate muscle fatigue from the EMG signals, the zero-crossing rate (ZCR) and amplitude of muscle tension (AMT) that can quantitatively assess muscle fatigue from EMG signals. We found a decrease in the ZCR for the RFM and the BFLH in the muscle fatigue condition for most of the subjects. Also, we found increases in the AMT for the RFM and the BFLH. Based on the results, we quantitatively confirmed that in the state of muscle fatigue, the ZCR shows a decreasing trend whereas the AMT shows an increasing trend. Our results show that both the ZCR and AMT are useful parameters for characterizing the EMG signals in the muscle fatigue condition. In addition, our proposed methods are expected to be useful for developing a navigation system for knee rehabilitation exercises by evaluating the two parameters in two-dimensional parameter space.

• Physical Therapy Rehabilitation Science
• /
• 제12권2호
• /
• pp.92-104
• /
• 2023

Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.

• 대한물리의학회지
• /
• 제13권4호
• /
• pp.113-121
• /
• 2018

PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.

• 척추신경추나의학회지
• /
• 제15권2호
• /
• pp.63-73
• /
• 2020

Objectives The purpose of this study was to investigate the possibility of spinal mobilization with leg movement (SMWLM) using Korean Medicine treatment on acute lower limb muscle weakness through four case studies. Methods SMWLM, with other Korean Medicine treatments, was performed on four patients who underwent treatment at OOOO Korean Medicine Hospital from August 2017 to July 2018. Additionally, results of the Numerical Rate Scale(NRS), EuroQol-FiveDimensions(EQ-5D),Oswestry lowback pain disability questionnaire(ODI), Straight Leg Raise(SLR) test, and Manual Muscle Test(MMT) were evaluated. Results There was a significant increase in NRS, ODI, and EQ-5D scales with im-rovements of SLR angle and MMT figures to a normal range. Conclusions This study suggested that Korean Medicine treatment combined with SMWLM may affect treating acute lower limb muscle weakness. Further clinical studies are needed to establish a definite conclusion.

• 한국산학기술학회논문지
• /
• 제16권11호
• /
• pp.7439-7446
• /
• 2015

이 연구는 FMS를 통하여 선수들의 상해에 대한 위험요인 등을 찾아내고 이를 복합트레이닝프로그램에 적용하여 선수들의 신체 불균형 및 기초체력, 근 기능을 개선함으로써 FMS 점수에 어떠한 영향을 미치는지를 규명하고 국가대표 여자 럭비선수들의 경기력을 향상시키고자 실시되었다. 제17회 인천아시안게임에 참가를 준비하는 국가대표 여자럭비선수 14명을 대상으로 하여 FMS 검사를 실시하였으며, 2014년 5월~8월까지 12주간 복합트레이닝프로그램을 실시하여(주4회/120분${\geq}$) 복합트레이닝 전 후의 FMS 점수를 paired t-test를 통해 검증하였다. 이 연구의 결과에서 Deep Squat와 Hurdle Step, Active Straight Leg Raise, Trunk Stability Push up의 항목에서는 12주간의 복합트레이닝 전보다 트레이닝 후에 FMS의 점수가 유의하게 증가되었으며(p<.05), Inline Lunge(p<.01)와 Rotary Stability(p<.001)에서도 트레이닝 후, 유의하게 증가된 것으로 나타났다. 또한 전체 항목의 점수 합산도 복합트레이닝 후에 유의하게 증가되었다(p<.001). 그러나 Shoulder Mobility 항목에서 유일하게 트레이닝 후에 약간 증가하는 경향을 보였지만 통계적 유의수준에는 도달하지 못하였다. 이상의 결과에서 복합트레이닝프로그램이 FMS 점수를 유의하게 증가시키는 효과가 있는 것으로 나타났으며 이는 국가대표 여자럭비선수들의 상해 위험성이 줄이는데 효과가 있음을 의미한다. 또한 주기적인 FMS의 평가는 선수들의 상해예방과 경기력 향상에 도움일 될 것으로 사료된다.

• 한국산학기술학회논문지
• /
• 제14권1호
• /
• pp.336-343
• /
• 2013

본 연구의 목적은 요추 추간판 탈출증 환자에게 치료적 모달리티와 SpineMT(mobilization & traction)를 이용한 척추 감압치료 효과를 확인하는 것이다. 요추 추간판 탈출증 환자 15명(나이 36.62, 범위 20-50, 남자 7명과 여자 8명)을 대상으로 4주간 적용하였다. 치료적 모달리티와 척추 감압치료를 첫 2주 동안 주 6일, 12회 적용하였으며, 마지막 2주간은 주 4일 8회 적용하였다. 모든 실험대상자에게 4주 동안 20회를 적용하였다. 측정은 오스웨스트리 요통장애지수, 근력, 하지 직거상 검사는 실험 전, 치료 10회 후, 치료 20회 후 변화의 차이를 일요인 반복측정을 이용하였으며, 추간판 탈출지수는 실험 전, 치료 20회 후 변화 차이를 대응표본 t-검정을 이용하여 측정하였다. 치료적 중재 기간에 따라 치료 전, 2주 후, 4주 후 측정결과 오스웨스트리 요통장애 지수, 하지 직거상 검사, 그리고 근력은 치료 10회 후, 치료 20회 후가 치료 전에 비하여 통계학적 유의한 변화가 있었다(p<0.05). 그러나 추간판 탈출 지수는 치료 전에 비하여 감소함을 나타냈으나 통계학적으로 유의한 변화는 없었다(p>0.05). 결론적으로 요추 추간판 탈출증 환자에게 치료적 모달리티와 척추 감압치료가 요통장애지수, 하지 직거상 검사, 근력 개선에 효과적이란 결론을 얻었다. 이것은 척추 감압치료의 안전성과 효과의 확인, 그리고 요추 추간판 탈출증 환자에게 비수술적 치료법으로서의 근거를 제시하였다.

• Journal of Korean Neurosurgical Society
• /
• 제52권2호
• /
• pp.156-158
• /
• 2012

Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

• 대한물리의학회지
• /
• 제16권3호
• /
• pp.45-53
• /
• 2021

PURPOSE: The current case study focuses on identifying the effects of the independent application of TECAR therapy and physiotherapeutic intervention using TECAR therapy on pain self-awareness and hip joint function in patients with hip impingement syndrome caused by nonstructural changes. Subjects: The research subject was a 34-year-old woman struggling with acute pain in her left hip, difficulty in actively moving the hip, and a problem in its overall function. METHODS: The subject's pain awareness and hip joint function were measured using a Visual Analog Scale (VAS) and passive range of motion (PROM), respectively. The experimental intervention was carried out in 24 sessions of 16 minutes each, three times a week, for eight weeks. RESULTS: The VAS score decreased to 0 cm on the post-test from 4.3 cm, 6.5 cm, and 7.2 cm in the pre-test at the rest, standing, and gait positions, respectively. The index of PROM measured hip joint flexion, extension, abduction, adduction, internal rotation, external rotation, and passive straight leg raise. The values increased to 122.5°, 24.5°, 78°, 33°, 65°, 42°, and 96.5° in the post-test compared to 88.5°, 15°, 39°, 21.5°, 23°, 22°, and 46.5° in the pre-test, respectively. CONCLUSION: TECAR therapy and physiotherapeutic intervention using TECAR can help reduce pain and enhance the hip joint function in patients with hip impingement syndrome.