DOI QR코드

DOI QR Code

The Immediately Effects of Thoracic Mobilization by Segment on Pain and Range of Motion in Chronic Low Back Pain Patients

분절별 등뼈 관절가동술이 만성허리통증환자의 통증과 관절가동범위에 미치는 즉시적 효과

  • Sim, Jae-Heon (Dept. of Physical Therapy, Ulsan Jaseng Hospital of Korean Medicine, Jaseng Medical Foundation) ;
  • Jeong, Ui-Cheol (Dept. of Physical Therapy, Ulsan Jaseng Hospital of Korean Medicine, Jaseng Medical Foundation) ;
  • Choi, Hee-Yang (Dept. of Physical Therapy, Ulsan Jaseng Hospital of Korean Medicine, Jaseng Medical Foundation) ;
  • Kim, Cheol-Yong (Dept. of Physical Therapy, Ulsan College)
  • 심재헌 (재)자생의료재단 울산자생한방병원) ;
  • 정의철 (재)자생의료재단 울산자생한방병원) ;
  • 최희양 (재)자생의료재단 울산자생한방병원) ;
  • 김철용 (울산과학대학교 물리치료과)
  • Received : 2017.02.03
  • Accepted : 2017.04.19
  • Published : 2017.05.31

Abstract

PURPOSE: This study aims to identify the immediate effects of thoracic mobilization according to segment on disabling low-back pain and the range of motion in patients with chronic low-back pain. METHODS: The participants were divided randomly into two groups: a group (N=12) with pain and disability between the 5th and 9th thoracic vertebrae (T5-T9) and a group (N=12) with pain and disability between the 10th and 12th thoracic vertebrae (T10-T12). The same experiment was conducted in both groups: 10 minutes of thoracic mobilization and 10 minutes of functional massage. The visual analogue scale (VAS) and range of motion measurements were applied to the participants in both groups. All participants were measured again immediately after the program was completed. RESULTS: In both groups, the VAS and range of motion measurements showed statistically significant improvement after the experiment (p<.05). No statistically significant difference was revealed between the two groups (p>.05). CONCLUSION: The results of this study confirmed positive and immediate effects of thoracic mobilization of patients with chronic low-back pain. But, no significant difference in the thoracic mobilization by segment between the two groups. Based on these results, thoracic mobilization could help to improve pain control and functional activity in patients with chronic low-back pain.

Keywords

References

  1. Baek IH. The Effects of Indirect Thoracic Joint Mobilization on Thoracolumbar Proprioception, Active Range of Motion, Pain, and Disability in Patients with Chronic Low Back Pain. Master's Degree. Konyang university. 2015.
  2. Briggs AM, Van Dieen JH, Wrigley TV, et al. Thoracic kyphosis affects spinal loads and trunk muscle force. Phys Ther. 2007;87(5):595-607. https://doi.org/10.2522/ptj.20060119
  3. Cleland JA, Glynn P, Whitman JM, et al. Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther. 2007;87(4):431. https://doi.org/10.2522/ptj.20060217
  4. Debski RE, Sakane M, Woo SL, et al. Contribution of the passive properties of the rotator cuff to glenohumeral stability during anterior-posterior loading. J Shoulder Elbow Surg. 1999;8(4):324-9. https://doi.org/10.1016/S1058-2746(99)90154-4
  5. Edmondston SJ, Singer KP. Thoracic spine: anatomical and biomechanical considerations for manual therapy. Man Ther. 1997;2(3):132-43. https://doi.org/10.1054/math.1997.0293
  6. Godges JJ, Mattson-Bell M, Thorpe D, et al. The immediate effects of soft tissue mobilization with proprioceptive neuromuscular facilitation on glenohumeral external rotation and overhead reach. J Orthop Sports Phys Ther. 2003;33(12):713-8. https://doi.org/10.2519/jospt.2003.33.12.713
  7. Gong WT, Cheun HJ, Lee KM. The effect of cervical stabilized exercise and joint mobilization on maximum muscle strength and static muscle endurance of cervical region. Journal of the Korean Data and Information Science Society. 2010;21(1):33-42.
  8. Haynes S, Williams K. Impact of seating posture on user comfort and typing performance for people with chronic low back pain. Int J Ind Ergon. 2008;38(1):35-46. https://doi.org/10.1016/j.ergon.2007.08.003
  9. Hicks GE, Fritz JM, Delitto A, et al. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005;86(9):1753-62. https://doi.org/10.1016/j.apmr.2005.03.033
  10. Hoeksma HL, Dekker J, Ronday HK, et al. Comparison of manual therapy and exercise therapy in osteoarthritis of hip: a randomized clinical trial. Arthritis & Rheumtism. 2004;51(5):722-9. https://doi.org/10.1002/art.20685
  11. Hur JG. Effect on Thoracic-Exercise Programs in Employees With Chronic Low Back Pain. Phys Ther Kor. 2005;12(2):44-57.
  12. Hwangbo G, Kim GC, Park YK. Effects of Self-stretching Exercise and Upper Thoracic Mobilization on Range of Motion and Pain of the Patients with Chronic Neck Pain. J Korean Soc Phys Med. 2012;7(4):509-14. https://doi.org/10.13066/kspm.2012.7.4.509
  13. Jensen MP, Smith DG, Ehde DM, et al. Pain site and the effects of amputation pain: further clarification of the meaning of mild, moderate, and severe pain. Pain. 2001;91(3):317-22. https://doi.org/10.1016/S0304-3959(00)00459-0
  14. Jeong JD. The immediately Effects of Thoracolumbar Facet Joint Traction on the Spinal Mobility and Functional Ability of Patients With Chronic Low Back Pain. Master's Degree. Konyang university. 2015.
  15. Jeong YT. Effect of Lumbar Stabilization Exercise on Spinal instability in Patients With Low Back Pain : A Literature Review. Phys Ther Kor. 2000;7(4):47-55.
  16. Kader DF, Wardlaw D, Smith, FW. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clinical radiology. 2000;55(2):145-9. https://doi.org/10.1053/crad.1999.0340
  17. Kaltenborn FM, Evjenth O, Kaltenborn TB, et al. The spine: Basic evaluation and mobilization techniques. Olaf Norlis Bokhandel. 1993.
  18. Kang GB, Ahn YJ, Kim YJ, et al. A comparative analysis of thoracic thoracolumbar kyphosis between young men and old men. J Korean Orthop Assoc. 2016;51(1):48-53. https://doi.org/10.4055/jkoa.2016.51.1.48
  19. Kim SY, Baek IH. Effects of transversus abdominal muscle stabilization exercise to spinal segment motion on trunk flexion-extension. Phys Ther Kor. 2003;10(1):63-76.
  20. Ko TS, Jung HB, Kim JA. The effects of thoracic mobilization on pain, disability index and spinal mobility in chronic low back pain patients. J Special Edu Rehabil Sci. 2009;48(2):115-37.
  21. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. British Medical Journal. 2006;332(7555):1430. https://doi.org/10.1136/bmj.332.7555.1430
  22. Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005;85(3):209-25.
  23. Last AR, Hulbert K. Chronic low back pain: evaluation and management. American family physician. 2009;79(12):1067-74.
  24. Lederman E. Fundamentals of manual therapy: physiology, neurology and psychology. Churchill Livingstone. 1997.
  25. Lee BK, Yang HM, Kang KH. Comparison of between Upper Thoracic Manipulation and Cervical Stability Training on Range of Motion and Neck Disability in Patients with Chronic Mechanical Neck Pain. J Korean Soc Phys Med. 2015;10(2):35-45. https://doi.org/10.13066/kspm.2015.10.2.35
  26. Lee SW, Kim SY. Comparison of Range of Motion in The Thoracolumbar Region for Clinical Diagnoses of Patients with Chronic Low Back Pain. J Korean Soc Phys Med. 2010;5(3):363-73.
  27. Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis. FA Davis. 2011.
  28. Lund T, Nydegger T, Schlenzka D, et al. Three-dimensional motion patterns during active bending in patients with chronic low back pain. Spine. 2002;27(17):1865-74. https://doi.org/10.1097/00007632-200209010-00012
  29. McConnell J. Recalcitrant chronic low back and leg pain-a new theory and different approach to management. Man Ther. 2002;7(4):183-92. https://doi.org/10.1054/math.2002.0478
  30. Mousavi SJ, Parnianpour M, Mehdian H, et al. The Oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: translation and validation studies of the Iranian versions. Spine. 2006;31(14):E454-9. https://doi.org/10.1097/01.brs.0000222141.61424.f7
  31. Nachemson A, Waddell G, Norlund, AI. Epidemiology of neck and low back pain. Neck and Back Pain: The scientific evidence of causes diagnosis and treatment. 2000;165-88.
  32. O'Sullivan PB, Burnett A, Floyd AN, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10):1074-9. https://doi.org/10.1097/00007632-200305150-00022
  33. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord Tech. 1992;5(4):383-9. https://doi.org/10.1097/00002517-199212000-00001
  34. Park JH, Kim DD, Kim MH, et al. Diagnosis & Evaluation in Physical Therapy for Musculoskeletal Dideases. HYUNMOON. 2013.
  35. Richardson CA, Hodges P, Hides JA. Therapeutic exercise for lumbopelvic stabilization: a motor control approach for the treatment and prevention of low back pain. Churchill Livingstone. 2004.
  36. Sharpe SR, Holt KG, Saltzman E, et al. Effects of a hip belt on transverse plane trunk coordination and stability during load carriage. Journal of biomechanics. 2008;41(5):968-76. https://doi.org/10.1016/j.jbiomech.2007.12.018
  37. Tawackoli W, Marco R, Liebschner MA. The effect of compressive axial preload on the flexibility of the thoracolumbar spine. Spine. 2004;29(9):988-93. https://doi.org/10.1097/00007632-200405010-00007
  38. Yang JM. The Effect of thoracic Joint Mobilization on Pain, Disability, Spine Curvature, Static Balance, Range of Motion and Proprioception in Back Pain Patients With Thoracic Hypomobility. Doctor's Degree. Daejeon University. 2016.
  39. Yun EH. Comparing the Effects of Lumbar stabilization Exercise and McKenzie Exercise on the Range of Motion and Pain of the Patient with Low Back Pain. Master's Degree. Dankook university. 2003.
  40. Wagner DR, Tatsugawa K, Parker D, et al. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High altitude medicine & biology. 2007;8(1):27-31. https://doi.org/10.1089/ham.2006.0814
  41. Wallden M. The neutral spine principle. J Bodyw Mov Ther. 2009;13(4):350-61. https://doi.org/10.1016/j.jbmt.2009.07.006
  42. Watkins R IV, Watkins R III, Williams L, et al. Stability provided by the sternum and rib cage in the thoracic spine. Spine. 2005;30(11):1283-6. https://doi.org/10.1097/01.brs.0000164257.69354.bb
  43. Weerapong P, Hume PA, Kolt GS. The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Med. 2005;35(3):235-56. https://doi.org/10.2165/00007256-200535030-00004

Cited by

  1. Effects of Joint Mobilization Intervention Combined with Exercise on Range of Motion, Pain Intensity, and Functional Performance in Adolescent Baseball Players with Internal Impingement of the Shoulder vol.13, pp.2, 2018, https://doi.org/10.13066/kspm.2018.13.2.11