• The Journal of Korean Physical Therapy
• /
• v.16 no.4
• /
• pp.11-22
• /
• 2004

The concept of segmental stabilization has been one of the most exciting advancements in the field of physical therapy. Specific deep stabilizing muscle have proven to reverse motor control deficits that occurs after back injury. After an injury, a new motor programming strategy is adopted and there is excessive recruitment of the large , strong , global muscular system works instead of small segmental deep muscle recruitment for stability. Many physical therapists and doctors mistakenly prescribe therapeutic exercise for low back pain to use larger, superficial musculature to strengthen the spine for stability and pain control. But motor control coordination of local segmental muscle is actually the key to stability and pain control, not strengthening of global muscle. A recent focus in physiotherapy management of patients with chronic back pain has been the specific training of muscles surrounding the lumbar spine whose primary role is considered to be the provision of dynamic stability and segmental control to the spine. These are the deep transverse abdominis muscle and lumbar multifudus.

• The Journal of Korean Physical Therapy
• /
• v.29 no.5
• /
• pp.234-240
• /
• 2017

Purpose: The aim of this study was to determine the effectiveness of breathing exercises and lumbar segmental exercises on the segmental stability of patients with chronic back pain. Methods: Fifty-nine patients, who suffered from chronic low back pain, were enrolled in this examination. They were divided randomly into three groups: experiment group 1 underwent breathing and segmental stabilization exercises (n=20), experiment group 2 experienced segmental stabilization exercises (n=20), and the control group was given the modality treatment (n=19). The measurements were assessed through an Oswestry disability questionnaire (ODQ), as well as a lumbar segmental instability test (LSIT). Results: The ODQ results for experimental groups 1 and 2 were similar (p<0.05), both before and after six weeks of exercise, but different among the three groups (p>0.05). The differences in segmental instability of each of the three groups were similar (p<0.05), and also similar among the three groups (p<0.05). Conclusion: These findings suggest that lumbar segmental stabilization exercises are efficient in increasing the segmental stability and alleviating pain in patients with chronic back pain. Additional studies on this subject will be needed to improve the clinical applications in the future.

• Physical Therapy Korea
• /
• v.20 no.3
• /
• pp.81-88
• /
• 2013

Active straight-leg raise (ASLR) is a physical evaluation procedure to test lumbar spine stability. Several previous studies have reported various methods to control the activation of abdominal muscles during ASLR. We investigated the effects of three different hip positions in frontal plane on abdominal muscles to increase or decrease the difficulty level of lumbar spine stability exercise during ASLR in pain free subjects. Eleven young and healthy subjects voluntarily participated in this study (6 men, 5 women; mean age=$24.0{\pm}1.2$ years, height=$160.0{\pm}7.3cm$, weight=$55.0{\pm}10.6kg$, body mass index=$21.5{\pm}2.3kg/m^2$). The subjects had three trials on each ASLR with hip $10^{\circ}$ adduction, neutral hip, and hip $30^{\circ}$ abduction. Separate repeated-measures analysis of variance (ANOVA) and the post hoc Bonferroni tests (with ${\alpha}$=.05/3=.017) were performed for each muscle among the three different hip positions in frontal plane (ASLR with hip $10^{\circ}$ adduction, neutral hip, and hip $30^{\circ}$ abduction). The ipsilateral external oblique (EO), contralateral EO, ipsilateral internal oblique/transverse abdominis (IO/TrA), and contralateral IO/TrA were significantly greater in ASLR with hip $30^{\circ}$ abduction compared with ASLR with hip $10^{\circ}$ adduction. Also, the ipsilateral EO, contralateral EO, and ipsilateral IO/TrA were significantly greater in ASLR with hip $30^{\circ}$ abduction compared with ASLR with neutral hip. These results suggest that ASLR with hip $30^{\circ}$ abduction and neutral would be useful method to strengthen the EO and IO/TrA. And, ASLR with hip $10^{\circ}$ adduction would be effective in early stages of lumbar stabilization program due to low activation of EO and IO/TrA during maintaining of ASLR position with low load.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.4 no.1
• /
• pp.7-20
• /
• 1998

Activity of the trunk muscles is essential for maintaining stability of the lumbar spine because of the unstable structure of that portion of the spine. The central nervous system deals with stabilization of the spine by contraction of the abdominal and multifidus muscles in anticipations of reactive forces produced by limb movement. Recent evidence indicates that the lumbar multifidus muscle and transversus abdominis muscle may be involved in controlling spinal stability. Stabilization training in neutral spine is an integrated approach of education in proper posture and body mechanics along with exercise to improve strength, flexibility, muscular and cardiovascular endurance, and coordination of movement.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.23 no.2
• /
• pp.9-16
• /
• 2017

Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

• PNF and Movement
• /
• v.10 no.2
• /
• pp.47-54
• /
• 2012

Purpose : The purpose of this study was investigated to find the approach in the various method for patients with chronic low back pain. Methods : For research purposes that meet the search was focused papers. Treatments include PNF, chiropractic, joint mobilization, microcurrent, electroacupuncture, stabilizing exercise, resistance exercise, aquatic rehabilitation exercise, lumbar flexion and extension exercise were included as Gymball exercise. Results : Treatment with the three major manual therapy, electrical therapy and therapeutic exercise were divided. The result of applying manual therapy increased balance, increased strength, stability increased and decreased pain. The result of applying the electrical therapy increased flexibility, and decreased pain. The result of applying therapeutic exercise increases muscle strength, reduced pain, and decreased body fat. Conclusion : Previous studies by examining the effects of chronic low back pain treatment was intended to help in the selection and application Aquatic therapy, manual therapy, electrical therapy for patients with chronic low back pain with pain reduction was found to be effective.

• Journal of Korean Physical Therapy Science
• /
• v.28 no.1
• /
• pp.11-22
• /
• 2021

Background: This study was to investigate the effects of active stretching and stability exercise on piriformis muscle thickness and low back pain of male patients with chronic low back pain. Design: Randomized Controlled Trial. Methods: 45 male patients participated in this study. All subjects were randomly assigned. Subjects divided into 15 who underwent contract relaxation (CR) of the proprioceptive neuromuscular facilitation (PNF) to their hip joints, 15 who underwent a combination of isotonic (CI) of the PNF, and the rest 15 who underwent the two techniques (CR+CI). Real-time diagnostic ultrasound was used to measure thickness of the piriformis muscles. The visual analogue scale (VAS) was used to measure degrees of low back pain. A two-way repeated measures ANOVA was used to compare the average values. The SPSS 24.0 was used as the statistical program, and the significance level was set at .05. Results: The CR and the CR+CI groups had more decreased thickness of piriformis muscle when compared to the CI group. The CR+CI group had more decreased pain when compared to the CR and the CI groups. Conclusion: These results suggest that combination of stretching and stability exercise was effective on male patients with chronic low back pain showing limited hip medial rotation.

• Physical Therapy Korea
• /
• v.7 no.4
• /
• pp.47-55
• /
• 2000

요통은 산업화된 현대사회에서 흔히 발생하는 질환이다. 요통의 다양한 원인 중에서도 척추의 정상 가동범위를 넘은 불안정성이 요통의 한 원인으로 보고되고 있다. 이 문헌고찰의 목적은 요추 부위의 안정성을 부여하는 운동 프로그램 후 근육 기능의 강화, 통증의 감소를 보고한 논문들을 비교, 분석하는 것이다. 그리하여 요통의 한 원인인 척추의 안정성을 증가시켜 요추 부위의 통증을 감소시키고 기능을 향상시키는 운동 프로그램의 효과를 입증하는 것이다.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
• /
• v.12 no.2
• /
• pp.52-65
• /
• 2006

Sling exercises therapy can speak as appliable comprehensive exercises therapy technique efficiently in general exercise field for injured worker's rehabilitation process and health improvement patient or athlete, injury or disease that have pain or dysfunction to neuromuscular system using that shake. At 1990 an early stage, because physical therapist and doctors of medical treatment developed country norway of north europe cooperate sling exercises therapy's concept trend spreading worldwide establishing theory newly based on scientific basic be. Musculoskeletal system, old man and young child's nervous system injurer's treatment and exercise and industry worker's rehabilitation process, athlete's rehabilitation etc. several fields introduced in early 2000s to Korea apply. Sling exercises therapy neuromuscular system disease continuous abatement as general concept of active exercise and treatment that use sling exercises equipment by purpose know can. This review article wishes to introduce about neuromuscular activation, "Neurac" technique that can speak as step developed more concept based on application principle etc, of basic sling exercises effort's change by suspension point's change that is concept, stability exercises principle, open kinetic chain exercises and closed kinetic chain exercises. Arranged about Plateau potential's characteristic and working mechanism and Neurac technique's application method that can say as Neurac technique's neuro-physiologic base, and presented treatment method of lumbar part disease and cervical part, shoulder joint part disease to application example. Because plateau potential forward player that induce using Neurac technique in part muscles that act role that keep spine surrounding stability in this article keeps muscle's contraction continuously, between global and local muscles, presented several study findings that can cause affirmative change in insufficient muscle adjustment state such as imbalance of muscles' action order. Expect that case studies that use this Neurac technique here after consist continuously.

• The Journal of Korean Physical Therapy
• /
• v.17 no.3
• /
• pp.311-327
• /
• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.