DOI QR코드

DOI QR Code

Effects of lumbar stabilization exercise on multifidus muscle cross-sectional area, static posture control and pain in patient's with chronic low back pain

요부 안정화운동이 만성요통환자의 다열근 단면적, 정적자세조절, 통증에 미치는 영향

  • Kim, Deahun (Department of Physical Therapy, Faculty of Health Science, Kyungdong University)
  • 김대훈 (경동대학교 물리치료학과)
  • Received : 2021.08.13
  • Accepted : 2021.10.20
  • Published : 2021.10.28

Abstract

This study analyzed the effects of an exercise program that combined lumbar stabilization exercise and muscle strengthening exercise and an exercise program that applied only lumbar muscle strengthening exercise on multifidus muscle cross-sectional area, static posture control ability, and low back pain in patients with CLBP. For the study method, 28 patients with CLBP were divided into two exercise propram groups and exercised three times a week for 8-weeks. The data analysis of this study used the t-test to compare before and after group exercise program application, and between each group (p<.05). As a result of the study, significant results were found before and after application of the exercise program within each group, such as multifidus muscle cross-sectional area, static posture control ability, and low back pain (p<.05). Between each group, the exercise program that combined lumbar stabilization exercise and muscle strengthening exercise was found to be more effective (p<.05). In conclusion, it was found that the exercise program with additional lumbar stabilization exercise improved the structure and function of various lumbar vertebrae and reduced lumbar pain.

만성요통환자를 대상으로 요추의 구조와 기능적 안정성에 미치는 영향을 알아보기 위하여 요부 안정화운동과 근력강화운동을 병행한 운동 프로그램과 요부 근력강화운동만 적용한 운동 프로그램의 다열근 단면적, 정적자세조절, 요부통증에 미치는 영향을 알아보았다. 연구방법은 만성요통환자 28명을 대상으로 각각의 운동그룹으로 나누워 주 3회씩 8주간 운동프로그램을 실시하였다. 본 연구의 자료분석은 t-test를 활용하여 그룹 운동프로그램 적용전과 적용후, 그리고 각각의 그룹간을 비교하였다. 연구결과 다열근 단면적, 정적자세조절, 요부통증 등 각각의 그룹내 운동프로그램 적용전과 적용후에 유의한 결과가 나타났으나 (p<.05), 각각의 그룹간에는 요부 안정화운동과 근력강화운동을 병행한 운동 프로그램이 더 효과적인 것으로 나타났다 (p<.05). 결론적으로 요부 안정화운동을 추가적으로 실시한 운동 프로그램이 다양한 요추의 구조와 기능을 향상시키고, 요부통증을 감소시키는 것으로 나타났다.

Keywords

References

  1. A. M. Kaigle, S. H. Holm & T. H. Hansson. (1995). Experimental instability in the lumbar spine. Spine, 20, 421-430. DOI : 10.1097/00007632-199502001-00004
  2. I. D. Cho, C. G. Jeon, S. Y. Lee, D. W. Lee & G. J. Hwang. (2015). Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. Journal of physical therapy science, 27(6), 1983-1985. DOI : 10.1589/jpts.27.1983
  3. C. Kisner & L. A. Colby. (2007). Therapeutic Exercise Foundations and Techniques(5th ed). Philadelphia: The F.A. Davis.
  4. H. J. Christie, S. Kumar & S. A. Warren. (1995). Postural aberration in low back pain. Archives of Physical Medicine and Rehabilitation, 76, 218-224. DOI : 10.1016/s0003-9993(95)80604-0
  5. N.B. Alexander et al. (1996). Gait disorders in older adult. Journal of American Geriatric Society, 44(4), 434-451. DOI : 10.1111/j.1532-5415.1996.tb064 17.x
  6. B. T. Saragiotto, C. G. Maher, T. P. Yamato, L. O. Costa, L. C. Menezes Costa, R. W. Ostelo & L. G Macedo. (2016). Motor control exercise for chronic non-specific low-back pain. Cochrane Database of Systematic Review, 20(1), CD012004. DOI : 10.1002/14651858.CD012004
  7. C. Richardson, G. Jull, P. Hodges & J. Hides. (1999). Therapeutic exercise for spinal segmental stabilization in low back pain. London : Churchill Livingstone. DOI : 10.1179/108331900786166597
  8. H. J. Wilke, A. Rohlmann, S. Neller, F. Graichen, L. Claes & G. Bergmann. (2003). ISSLS prize winner: A novel approach to determine trunk muscle forces during flexion and extension: a comparison of data from an in vitro experiment and in vivo measurements. Spine, 28, 2585-2593. DOI : 10.1097/01.BRS.0000096673.16363.C7.
  9. J. A. Hides, C. A. Richardson & G. A. Jull. (1996). Multifidus muscle recovery is not automatic after resolution acute, first-episode low back pain. Spine, 21(23), 2763-2769. DOI : 10.1002/14651858.CD012004.
  10. D.H. Kim, J.K. Park, Y.J. Park & D.I. Jung. (2010). Characteristic of Cross-sectional Area of Lumbar Paraspinal Muscle in Patients of Acute and Chronic LBP. International journal of contents, 4(4), 11-19. DOI : 10.5392/JKCA.2011.11.6.270
  11. M. Kamaz, D. Kiresi, H. Oguz, D. Emlik & F. Levendoglu. (2007). CT measurement of trunk muscle areas in patients with chronic low back pain. Diagn Interv Radiol, 13, 144-148.
  12. C. M. Norris et al. (2001). Functional load abdominal training: Part 2. Physical Therapy in Sport, 12(2), 149-156. DOI : 10.1054/ptsp.2001.0033
  13. S. S. Kim. (2008). Effects of lumbar rehabilitation exercise on lumbar herniated nucleus pulposus (HNP)-suffering patient's lumbar extension muscle, and deep muscle and scar tissue in their operatedareas. Master's depree. Korea University, Seoul. DOI : 10.1589/jpts.28.1418
  14. L. A. Danneels, G. G. Vanderstraeten & D. C. Cambier. (2000). CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J, 9(4), 266-272. DOI : 10.1007/s005860000190
  15. L. A. Danneels, G. G. Vanderstraetens & D. C. Cambier. (2001). Effects ofthree different training modalities on the cross sectional area of the lumbar. multifidus muscle in patients with chronic low back pain. Br J Sports Med. 35, 886-911. DOI : 10.1136/bjsm.35.3.186
  16. C. Maher. (2017). Underwood M, Buchbinder R. Non-specific low back pain. Lancet, 389, 736-747. DOI : 10.1016/S0140-6736(16)30970-9
  17. B. G. Kim, H. K. Seo & Y. W. Jung. (2004). The effect of sling exercise on Lumbar stabilization and muscle strength. Journal of Korean Physical Therapy Science. 16(4), 603-612.
  18. L, Berger, C. Klein & M. Commandeur. (2008). Evaluation of the immediate and midterm effects of mobilization in hot spa water on static and dynamic balance in elderly subjects. Annales de readaptation et de me-decine physique. 51(2), 84-85. DOI : 10.1016/j.annrmp.2007.10.007.
  19. K. J. Lee. (2006). Comparison between Middle-Aged Women with Chronic Lower Back Pain and Normal Middle-Aged Women in Dynamic Balance. Master's depree. Dankook University, Gyeonggi-do. DOI : 10.5762/KAIS.2016.17.6.389
  20. V. Akuthota & S. F. Nadler. (2004). Core strengthening. Archives of Physical Medicine and Rehabilitation, 85(3), 86-92. DOI : 10.1053/j.apmr.2003.12.005
  21. W. J. Choil, B. S. Park, B. K. Yoo, J. K. Jeon & K. H. Son. (2018). The Effects of Core Program Exercise on Balance in Patients with Chronic Low Back Pain. Journal of Korean Physical Therapy Science, 25(1), 1-10. DOI : 10.26862/jkpts.2018.06.25.1.1
  22. J. G. Oh et al. (2019). Effect of Sling Using Stabilization Exercise on Pain, Trunk Stability and Deep Muscle Thickness in Non-specific Low Back Pain Patients. Master's depree. Chosun University, Gwangju. DOI : 10.1589/jpts.26.1301