• Title/Summary/Keyword: Upper back pain

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A Study of Pain, Depression and Self-Efficacy According to the Classifications of Pain among Chronic Pain Patients (만성통증환자의 통증분류에 따른 통증, 우울 및 자기효능감 정도)

  • Yang, Jin-Hyang
    • Korean Journal of Adult Nursing
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    • v.16 no.2
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    • pp.202-210
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    • 2004
  • Purpose: this study was to examine the differences of the level of pain, depression and self-efficacy according to the classifications of pain among chronic pain patients. Method: The data were collected by means of self-reported questionnaire from 164 patients with chronic pain visited in one university hospital and one local pain clinic in Busan, from October 7 to November 16, 2002. Analysis was done by ANOVA, and Scheffe test using SPSS program. Result: The subjects were divided into five classifications of chronic pain : 26.2% low back and extremity pain, 23.2% neck, shoulder and upper extremity pain, 19.5% postherpetic neuralgia, 15.9% complex regional pain syndrome and 15.2% peripheral neuralgia. There were significant differences in pain (p=.000), depression (p=.000) and self-efficacy (p=.003) according to the 5 kinds of chronic pain. With the results of the Scheffe test, the patients with peripheral neuralgia experienced pain and depression higher than those with the other kinds of chronic pain. The patients with neck, shoulder and upper extremity pain experienced self-efficacy higher than those with peripheral neuralgia. Conclusion: Chronic pain patients should be provided effective individualized intervention depending on the classifications of chronic pain. Therefore the development of interventions for pain management according to the classifications of pain in chronic pain patients is needed.

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Effects of Lumbar Stabilization Exercise on Motor Neuron Excitability and Pain in Patients with Lumbar Disc Herniation

  • Kang, Jeongil;Jeong, Daekeun;Choi, Hyunho
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.2
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    • pp.1785-1790
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    • 2019
  • Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

An Atypical Choroid Plexus Papilloma Initially Manifestating as Radicular Symptoms (방사성 증상이 초기 증상으로 나타난 비정형 맥락막 신경총 유두종)

  • Lee, Cheol-Jae;Kim, Jun-Hyung;Kim, Yunhee;Lee, Jang-Bo;Ryu, Byungju
    • Clinical Pain
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    • v.20 no.1
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    • pp.39-42
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    • 2021
  • A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12~L1 and several intradural enhancing nodular lesions at L2~S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

The Relationship between Experience of Workplace Violence and Musculoskeletal Pain among Wage Workers in South Korea (한국 임금 근로자의 직장 내 폭력 경험과 근골격계 증상과의 연관성에 관한 연구)

  • Yoon, Jaehong;Sung, Hyoju;Kim, Yugyun;Kim, Seung-Sup
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.2
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    • pp.211-219
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    • 2015
  • Objectives: We aimed to examine the association between experience of workplace violence and musculoskeletal pain among wage workers in South Korea. Methods: We analyzed a cross-sectional survey of 29,601 wage workers from the third wave Korean Working Conditions Survey in 2011. Experience of workplace violence was assessed through three questions, "Over the past 12 months, have you ever experienced: (1) physical violence, (2) bullying, or (3) sexual harassment at workplace?" Musculoskeletal pain was measured using the three questions, "Over the past 12 months, have you ever experienced: (1) low back pain, or (2) upper limb pain(i.e. shoulder, neck, and arm), or (3) lower limb pain(i.e. hip, leg, knee, and foot)?" Wage workers could answer 'Yes' or 'No' to each of the three questions. Multivariate negative binomial regression was applied to examine the association between workplace violence and musculoskeletal pain after adjusting for confounders including self-reported physical work factors. All analyses were performed using STATA/SE version 13.0. Results: Physical violence was associated with low back pain(PR: 2.16, 95% CI: 1.77, 2.65), upper(PR: 1.65, 95% CI: 1.45, 1.88) and lower limb pain(PR: 1.81, 95% CI: 1.52, 2.15) among male wage workers whereas it was related to upper(PR: 1.86, 95% CI: 1.53, 2.26) and lower limb pain(PR: 2.95, 95% CI: 2.47, 3.53) among female wage workers. Significant association was observed between sexual harassment and upper(PR: 1.25, 95% CI: 1.01, 1.56) and lower limb pain(PR: 2.41, 95% CI: 1.97, 2.93) among female wage workers whereas the association was only significant in the analysis with lower limb pain(PR: 1.87, 95% CI: 1.17, 2.97) among male wage workers. Bullying was associated only with lower limb pains among both male(PR: 1.77, 95% CI: 1.32, 2.37) and female(PR: 2.10, 95% CI: 1.69, 2.61) wage workers. Conclusions: This study found that experience of workplace violence, particularly physical violence and sexual harassment, was associated with musculoskeletal pain among Korean wage workers.

Comparison of Ranges of Motion in The Thoracolumbar Region for Clinical Diagnoses of Patients with Chronic Low Back Pain (만성요통 환자의 질환명에 따른 흉요추부의 관절가동범위 비교)

  • Lee, Sang-Wook;Kim, Suhn-Yeop
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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    • pp.363-373
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    • 2010
  • Purpose : The purpose of this study was to compare differences in thoracolumbar ranges of motions by comparing ratios among 4 type diagnosis for patient with chronic low back pain. Methods : The subjects were 58 chronic low back pain patients. A motion analysis program (Global Postural System) was used after photography for posture measurement. To analyze differences in mobility percentages and ratios of thoracolumbar ranges of motion, one-way ANOVA was used. Results : Regional difference spinal posture and movement were found to diagnosis patients with chronic low back pain. Comparison of thoracolumbar ranges of motion revealed significant differences in the thoracic region during forward-bending of the trunk (p<.05). In the upper thoracic region, the herniated intervertebral lumbar disc (HILD) group was significantly larger than the spinal stenosis/herniated intervertebral lumbar disc (SS/HILD) group (p<.05). In the lower thoracic region, chronic sprains (CS) were significantly greater than in the spinal stenosis (SS) group and in the (SS/HJLD) group (p<.05). Comparative analysis of thoracic/lumbar mobility ratio showed the CS group's ratio during forward bending was largest: 1.66, while the HILD group's ratio was smallest: 84 a significant difference between the two groups (p<.01). Diagnosis was not associated with difference in thoracolumbar backward-bending range of motion (p>.05). Conclusion : Theses results indicate the clinical efficacy of diagnosing for chronic low back pain by evaluating spinal mobility.

Comparison of Multifidus Thickness Change During Contralateral Arm Lift(CAL) in Patients with Chronic Low Back Pain and Normal Adults (반대쪽 팔 들기 동작 시 만성요통환자와 정상인의 다열근 두께 변화 비교)

  • Song, Won-bin;Kim, Chi-hyok;Jung, Woong-keun;Ha, Ye-ji;Han, Seong-gu;Hwangbo, In
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.24 no.2
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    • pp.51-58
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    • 2018
  • Backdround: Using RUSI (Rehabilitation Ultra Sound Imiging) method, which showed high reliability in soft tissue measurements, we compared the muscle relax and contraction, sex, and physical characteristics of the activity of the multifidus muscle in patients with chronic low back pain and normal subjects. Methods: In this study, 16 patients (male: 8, female: 8) with chronic low back pain and 16 healthy adult (male: 8, female: 8) were participated. Subjects lied prone posture on the table with elbow flexed $90^{\circ}$ and shoulder abducted $120^{\circ}$ (starting position). Test was applied two types that muscle relax position and muscle contraction position. Muscle relax position is equal to starting position and muscle contraction position is that upper extremity lift up about 5cm from the table. We measured the thickness of the multifidus muscle in each position by ultrasound. Results: There was a statistically significant difference between the two groups in deviation of Both Side Difference of Activated resting-Arm Lifting Ratio according to posture change between the chronic low back pain patient group and the normal group. Conclusion: The result of this study support previous study showing that there is an imbalance in the activity of multifidus in patients with chronic low back pain.

The Use of Rasch Model in Developing a Short Form Based on Self-Reported Activity Measure for Low Back Pain

  • Choi, Bong-Sam
    • Physical Therapy Korea
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    • v.21 no.4
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    • pp.56-66
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    • 2014
  • For maintaining adequate psychometric properties when reducing the number of items from an instrument, item level psychometrics is crucial. Strategies such as low item correlation or factor loadings, using classical test theory, have traditionally been advocated. The purpose of this study is to describe the development of a new short form assessing the impact of low back pain on physical activity. Rasch measurement model has been applied to the International Classification of Functioning, Disability and Health Activity Measure (ICF-AM). One hundred and one individuals with low back pain aged 19-89 years (mean age: $48.1{\pm}17.3$) who live in the community were participated in the study. Twenty-seven items of lifting/carrying construct of the ICF-AM were analyzed. Ten items were selected from the construct to create a short form. Item elimination criteria include: 1) high or low mean square (out of the range: .6-1.4 for the fit statistics), 2) similar item calibrations to adjacent items, 3) person separation value, and item-person map for potential gap in person ability continuum. All 10 items of the short form fit to the Rasch model except one item (i.e., carrying toddler on back). Despite its high infit and outfit statistics (1.90/2.17), the item had to be reinstated due to potential gaps at the upper extreme of person ability level. The short form had a slightly better spread of person ability continuum compared to the entire set of item. The created short form separated individuals with low back pain into nearly 4 groups, while the entire set of items separated the individuals into 6 groups. The findings prompted multidimensional models for better explanation of the lifting/carrying domain. The item level psychometrics based on the Rasch model can be useful in developing short forms with rationally retained items.

A Study of the Relationship between Spine Distortion and Pain of Elementary and Middle School Students - through moire measurement and questionnaire investigation - (초.중학생의 척추비틀림과 통증과의 관계고찰 - 경근무늬(모아레) 측정법과 설문지 조사를 통해 -)

  • Yoo, Han-Keel;Shin, Byung-Cheul;Min, Byung-Il
    • The Journal of Korea CHUNA Manual Medicine
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    • v.2 no.1
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    • pp.133-142
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    • 2001
  • Objectives : The aim of this study is to investigate the relationship between spinal distortion and pain in elementary and middle school students. Methods : Using the phase-shifting moire developed by KAIST(Korea Advanced Institute of Science and Technology) we measured the back surface distortion, and using questionnaire investigation, we investigated the partial pain in 1008 elementary and middle school students(532 boy students(52.8%), 476 girl students(47.2%)) in Seoul in 1999. And, we statistically analyzed the relationship between spinal distortion and partial body pain Results : This study show that the more age increase, the more the pain in head, neck, shoulder, back and low back Increase considerably among the students aged 9 to 15. The ratio of each partial body pain was 28.4%, 19.7%, 18.2%, 18.7%. 16.0% at the age of 9 and 59.7%, 67.4%, 51.8%, 51.8%, 64.4% at the age of 15 respectively. And, it was shown there was a significant correlation between spine distortion and partial body pain area. When the spinal distortion was found at the upper thoracic and cervical area, the students complained the more pain on head, neck and shoulder(p<0.05) and when the spinal distortion was found at the sacral base, the more headache(p<0.05) Conclusions : It is suggested that the significant correlation exist between the spinal distortion and pain and the pain related to spine disorder get more increase as students grow. We have to study further more about Juvenile postural distortion and it's prevention.

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Clinical Availability of Unstable Support Surface During Bridge Exercise for Training Core muscles

  • LEE, Jae-Hyuk
    • Journal of Wellbeing Management and Applied Psychology
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    • v.5 no.1
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    • pp.31-35
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    • 2022
  • Purpose: This study was conducted to investigate the effects of change in the unstable support surface location during bridge exercise on the muscle activity of erector spinae and gluteus maximus. Research design, data and methodology: 12 healthy participants aged 23.32 ±1.02 were measured muscle activities of erector spinae and gluteus maximus during bridge exercise and compared between the exercise conditions; unstable support surface located on upper back and feet during bridge exercise. Paired t-test was performed to identify whether there was a significant difference in the muscle activities between the exercise conditions. Results: As a result, even though higher levels of the averaged muscle activities of both erector spinae and gluteus maximus during exercise in unstable support surface located on feet than upper back were observed, no significant differences were found. Conclusions: The change of unstable support surface location during bridge exercise for low back pain rehabilitation would be more appropriate to be used to increase levels of tension of muscle activities and train fine motor control rather than to strengthening muscle strength.

Analysis of Lumbar Spine Load during Golf Swing in Pro. Golfer

  • Park, Sung-Kyu;Cho, Woong;An, Ho-Jung
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.2
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    • pp.162-168
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    • 2010
  • Low back pain is a common phenomenon among the golfers. In an attempt to understand low back pain, the kinematic changes and golf swing motion analysis has been performed to focus on lumbar spine in pro. golfers. According to the swing pattern, significant variations of the lumbar joint forces and loads has related with muscles activities so the motion analysis of lumbar spine were discussed. The purpose of this study was to analyze motion of lumbar spine and it was to compare joint force during golf swing in pro. golfers. The swing motion of the subjects was tracked using a 3D motion analysis system by Motion Analysis Ltd. and SIMM software. The angle changes of lumbar spine rapidly in vx direction during the top back swing and the finish and in vy direction during the follow through and in vz direction during the down swing and the impact(Subject A). The angle changes of lumbar spine rapidly in vx direction during the top back swing and in vy direction during the down swing, the impact and the follow through and in vz direction during the down swing(Subject B). In conclusion, subject A and B both show sudden angle changes between 1st-3rd lumbar spine and 4th-5th lumbar spine during the stage from address to top back swing which caused by over upper body twisting.

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