• The Journal of Korean Physical Therapy
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• 제19권5호
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• pp.1-10
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• 2007

Purpose: Leg-crossing sitting is very common for men and woman. No solid evidence exists for either a beneficial or a detrimental effect of this posture. This study investigated the change of activities of trunk muscles between the normal group and the low back pain group during various leg-crossing positions. Methods: The subjects were consisted of 10 subjects who don't have low back pain and 10 subjects who have low back pain. In this study, we used electromyography(EMG) to evaluate the activities of both the trunk muscles (rectus abdominis, external oblique, internal oblique, and multifidus) during various leg-crossing positions (up-right, leg-crossing, tailor-crossing, and ankle-crossing). We analyzed the data by using repeated one way ANOVA. Results: In normal group, there were increased in EMG activities of trunk muscles, but no significant differences during leg-crossing positions. In back pain group, there were increased in EMG activities of right external oblique, left. internal oblique, and both multifidus muscles in leg-crossing and tailor-crossing position, but no significant differences during leg-crossing positions. There was no significant difference of muscle activity of trunk muscles between the back pain group and the normal group. Conclusion: We suggest that low back pain people who have weak muscles of rectus abdominis, external and internal oblique are often experienced in leg-crossing posture than normal. To compensate this unstability of trunk, leg-crossing posture is substituted passive structure for activities of active muscle.

• 재활간호학회지
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• 제1권1호
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• pp.51-60
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• 1998

The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.69-79
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• 2002

Many pregnant women have experienced low back pain (LBP) during pregnancy and after delivery, and it has been an important component in women health. This study was designed to investigate the characteristics and management of the LBP in postpartum women. Eighty-five postpartum women were participated in this survey. Mean age of 85 women was 28.1 years. Of 85 postpartum women, 55.3% (n=47) had LBP after pregnancy. Thirty of 47 women had pain on lumbar region, 17 postpartum women had pain on sacroilium region. Of 85 postpartum women, 74% (n=54) had LBP before pregnancy and 71.8% (n=61) had LBP during pregnancy. Of 47 postpartum women who had LBP, 83% (n=39) had not received medical management for LBP, 12.8% (n=6) took medication, and 4.3% (n=2) performed self-exercise. None of postpartum women had received physical therapy during pregnancy and after delivery for treatment low back pain. The pain in SI region was more severe than in lumbar region after pregnancy according to VAS (visual analog scale) (p<.05). However, there was no significant difference in VAS scores between SI pain and lumbar pain before and during pregnancy (p>.05). Pain region after delivery was related to pain region of pre-pregnancy and during pregnancy (p<.01). Pain level after delivery was related to the pain and night pain level during pregnancy (p<.01).

• 동서간호학연구지
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• 제26권1호
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• pp.1-16
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• 2020

Purpose: The purpose of this study was to evaluate the effectiveness of non-pharmacologic interventions for chronic nonspecific low back pain (CLBP) in adults aged 18-64 years. Methods: We searched for potentially relevant randomized controlled trials and non-randomized controlled trials through five Korean electronic databases (i.e., Korean Studies Information Service System, Research Information Sharing Service, Korean Medical Database, KoreaMed, and National Assembly Library) published from January 2010 to May 2019. Two investigators independently selected the studies based on the criteria and assessed risk of bias in the included studies. We estimated the effect size of interventions using Comprehensive Meta Analysis 3.3. Results: Of 10,151 studies, 26 studies met the inclusion criteria and 15 studies were included in the meta-analysis. Exercise reduced low back pain (Hedges's g=-1.53, 95% CI: -2.22 to -0.85) and pain-related disabilities (Hedges's g=-0.92, 95% CI: -1.40 to -0.45). We found that taping was effective in decreasing low back pain (Hedges's g=-1.12, 95% CI: -1.51 to -0.73) and pain-related disabilities (Hedges's g=-0.50, 95% CI: -0.93 to -0.07). Manual therapy yielded a marginally significant reduction in low back pain (Hedges's g=-2.32, 95% CI: -4.64 to 0.00), the therapy was not effective in decreasing pain-related disabilities. Conclusion: Although there was little evidence for the effectiveness of manual therapy in adults with CLBP, exercise and taping were effective to relieve pain and pain-related disabilities. Based on these findings, we suggest the development of non-pharmacologic interventions or a nursing intervention protocol for the CLBP management. Also, nurses should consider implementation of effective non-pharmacologic interventions for CLBP.

• 한국전문물리치료학회지
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• 제16권1호
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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.

• The Korean Journal of Pain
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• 제27권3호
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• pp.285-289
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• 2014

Transcranial magnetic stimulation (TMS) is a noninvasive and safe technique for motor cortex stimulation. TMS is used to treat neurological and psychiatric disorders, including mood and movement disorders. TMS can also treat several types of chronic neuropathic pain. The pain relief mechanism of cortical stimulation is caused by modifications in neuronal excitability. Depression is a common co-morbidity with chronic pain. Pain and depression should be treated concurrently to achieve a positive outcome. Insomnia also frequently occurs with chronic lower back pain. Several studies have proposed hypotheses for TMS pain management. Herein, we report two cases with positive results for the treatment of depression and insomnia with chronic low back pain by TMS.

• PNF and Movement
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• 제17권1호
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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.

• 동의생리병리학회지
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• 제31권1호
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• pp.25-35
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• 2017

About 60% to 90% of a total population experience low back pain at least once of life, and about 35% to 79% among them experience a recurrent and chronic low back pain. thread-embedding therapy is mainly used to improve appearance or treat obesity in early stage, but recently it is also used to treat musculoskeletal pain. This study aimed to search Chinese study using thread-embedding therapy on low back pain and to analyse their methodology. Three Chinese database(CNKI(www.cnki.net), WANFANG(www.wanfangdata.com), WEIPU(www.cqvip.com)) were searched for clinical study of thread-embedding therapy up to March 2016. The characteristics of included studies and regimen of thread-embedding in those studies were analyzed. The total 21 studies (4 case studies, 16 non-randomized controlled trials, 1 randomized controlled trial) were included. All studies on thread embedding treatment of low back pain reported that its effectiveness was very good. The most frequently used acupoints was Ashi acupoints and acupoints on bladder meridian(BL) or governor vessel(GV). Thread-embedding therapy is considered very useful for low back pain in Traditional Chinese medicine. Further studies are needed to investigate the effect of thread-embedding therapy and to expand its application. This study is limited in that the literature search in the Chinese database were restricted.

• PNF and Movement
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• 제18권2호
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• pp.223-231
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• 2020

Purpose: The purpose of the study was to compare the effects of different methods of pelvic control on abdominal muscle activity and lumbopelvic rotation angle during active straight leg raising (ASLR) in patients with chronic back pain. Methods: The study participants were patients with low back pain (n = 30). They were instructed to perform ASLR with pelvic control, ASLR with pelvic belt, and ASLR only. Surface electromyography data were collected from the ipsilateral rectus femoris (IRF), ipsilateral internal oblique (IIO), contralateral external oblique (CEO), and ipsilateral rectus abdominal (IRA) muscles, and lumbopelvic rotation angle was measured using a motion analysis device. Results: Activation of all abdominal muscles was greater in the ASLR with pelvic control group than in the ASLR with pelvic belt and ASLR groups. The lumbopelvic rotation angle was lower in the ASLR with pelvic control group than in the other two groups (p < 0.05). Conclusion: These results suggest that ALSR with pelvic control is an effective means of increasing abdominal muscle activity and reducing unwanted lumbopelvic rotation in patients with chronic low back pain. Controlling the pelvis using the opposite leg is an effective form of ASLR exercise for patients with chronic low back pain.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.40-48
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• 2014

Differential item functioning (DIF) based on Rasch model can be used to examine whether the items function similarly across different groups and identify items that appear to be too easy or difficult after controlling for the ability levels of the compared groups. The Oswestry low back pain disability (Oswestry) has traditionally been proved as an effective instrument measuring disability resulting from low back pain (LBP). In this study, DIF method was used to explore whether items on the Oswestry perform similarly across two different groups (participants with LBP and no LBP). A series of Rasch analyses on the 10 items of the Oswestry were performed using Winsteps$^{(R)}$ software. Forty-two participants with back pain were recruited from 3 rehabilitation hospitals in Gainesville, Florida. Another 42 participants with no LBP were recruited from several public places in the rehabilitation hospitals. Based on the DIF analysis across the two groups, several items were found to have an uniform DIF. Participants with no LBP had more difficulty on lifting and personal care items and participants with LBP had more difficulty on sleeping and social life items. For non-LBP group, a high ceiling effects (83% of participants with non-LBP) was detected, which was not be able to be effectively measured with the Oswestry items. Although 4 items of the Oswestry function differently across the two groups, all items of the Oswestry were well targeted the LBP group.