Even though back pain therapy has greatly improved as spinal bio-mechanics is introduced, many patients still have difficulties due to low back pain. At the initial therapeutic stage, the aim of rehabilitation therapy for low back pain is pain control, but, at the later therapeutic stage, the prime aims are to reduce the late complication and to prevent the recurrence of low back pain. Accurate diagnosis should be a first step before any therapy is planned. Thus, accurate physical, neurologic, E.M.G. and radiologic tests are required to give prescription for therapeutic exercise to the patients. In addition to this, the roles of theraphists and therapeutic exercise should be re-evaluated after the therapeutic exercise is performed. Fist of all, the most important things are to educate the patients to understand the low back pain and to let the patients join the therapeutical planning. 1. Bed rest and muscle relaxing exercise for releasing the muscle tention are required for the treatment of acute low back pain. An active exercise is recommended rather than a passive exercise. If the therapeutic exercise depravate the low back pain, the exercise should be immediately terminated and the therapeutical exercise should be replanned. 2. For the treatment of the chronic back pain, stretching exercise and para-spinal muscle strengthening exercise should be performed steadily and actively to prevent the recurrence of low back pain and the low back injury due to minor damage. The patients should be educated to do proper exercise and to maintain good posture in everyday life. 3. As the low back pain is released and the body function is recovered, control of whole body function is necessary. Swiming, bicycling and walking for $30\sim40$ minutes a day and $3\sim4$ days a week are recommended. Other exercise could be recommended depending on the patients condition.
Yeonghun Han;Chung-hwi Yi;Woochol Joseph Choi;Oh-yun Kwon
한국전문물리치료학회지
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제30권1호
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pp.59-67
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2023
Background: Posterior capsule tightness (PCT), commonly seen in overhead athletes, is a soft tissue adaptation that is also noted in non-throwers. PCT is associated with scapular and humeral kinematic alterations, significant restriction of shoulder internal rotation (IR) range of motion (ROM), and significant scapular anterior tilting. Sleeper and cross-body stretches (CBS) are suggested for PCT and IR deficits, and have been modified since introduction. A novel modified sleeper stretch (NMSS) was designed in this study to prevent the risk of anterior translation of the humeral head. Though the effects of posterior shoulder stretching exercise have been widely studies, to the best of our knowledge, no previous studies have investigated the effectiveness of posterior shoulder exercises in decreasing scapular anterior tilting. Objects: To compare the immediate effects of two posterior shoulder stretching exercises (NMSS and CBS) on scapular anterior tilting and shoulder IR ROM. Methods: Thirty-two subjects with anteriorly tilted scapula and IR deficits [mean age: 24.3 ± 2.5 years; 15 males and 17 females] participated in this study. Subjects were randomly assigned to either the NMSS or CBS groups. Scapular anterior tilting (at rest and at shoulder 60° active IR) and shoulder IR ROM were measured before and immediately after intervention. Results: Scapular anterior tilting significantly decreased, while the shoulder IR ROM significantly increased in both groups. However, there was no significant group-by-time interaction effect or significant difference between the groups. Conclusion: Both stretching exercises were effective in restoring shoulder IR ROM and decreasing scapular anterior tilting.
For elderly people, an advanced training machine that uses actuator and can adjust load according to muscle activity is proposed. The proposed machine allows users to have a safe and effective training through exercise close to ordinal motion appears in daily life such as stretching or stooping motion. A muscle activity sensor real-timely monitors the activation level of user's muscle during the exercise and the training load is adjusted based on the measured data. The training load is exerted and continuously controlled by electric/pneumatic actuator.
The objective of this study was to discover the effects of the short-term home visiting physical therapy program involving patients with some chronic brain disorders at Gimhae City, Kyongnam. Recovery of activities of daily living (ADL) is a very important factor of rehabilitative procedures, and Functional Independence Measure (FIM) is a useful standard of evaluation for it. The FIM is widely used in brain disorder research because it measures real functional activities of daily living. We applied the physical therapy exercise program twice per week (10~15 times repeatedly); a warm-up and cool down exercise performed every ten minutes by active & active-assistive ROM and stretching exercises. Main exercises were composed of getting up & laying down in bed, standing training, walking exercise in the room, and window or wall sliding exercise using affected upper limbs for a total duration of 30 minutes. We collected the data from 20 patients with chronic brain disorders at his/her home and analyzed by means of SPSS/PC+ program (Ver. 10.0). After the six week long physical therapy exercise program, the average was $56.10{\pm}22.59$ point compared with initial $50.55{\pm}19.12$ point by FIM, improved functional ADL ability about 5.55 point, and these changed scores were statistically significant (p=.000). We also studied another factor regarding patient's satisfaction. The majority of subjects (10 people) rated the program with the maximum score of ten points (50.0%), and three people rated it a seven point program (15.0%), the other two subjects gave a rating of nine and eight points (10.0%). Because the program was effective at improving the physical ADL ability and satisfaction of each subject, we suggest continual development and implementation of a home visiting physical therapy program. Further study should involve a longer period of observation with a larger population that is involved in an individually designed home physical therapy program.
Objectives The objective of this study is to interpretate Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu] in a modern kinesiologic approach. Methods Based on the interpretation of [Jebyungwonhuron Huhrobyungjehu] and implementation of its kinesiology, this study presents similar kinesiologies and their purposed, with the reference to various documents on modern kinesiology. Results 1) Exercises in Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu], which are similar to resistance exercise, can be used for isometric exercise of knee joint extensor and cervical extensor. 2) Exercises in Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu], which are similar to stretching exercise, has its purpose to stretch semitendinosus m., semimembranous m., gastrocnemius m., quadriceps femoris m., upper trapezius m., levator scapulae m., serratus m., and splenius capitis m. 3) Exercises in Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu], which are similar to active exercise, can be used for strengthen quadriceps femoris m.. 4) Yangsaeng-Doinibub also describes breathing methods, which help normalization of breathing exercised and increase the efficiency of spine and joint exercises. Conclusions The modern interpretation on kinesiology of Yangsaeng-Doinbub presented in [Jebyungwonhuron Huhrobyungjehu] leads to a conclusion that Yangsaeng-Doinbub consists of various exercises for knee joint, neck and upper extremity.
Background: Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management. Objects: The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS). Methods: Thirty-three women with SHS were randomly assigned to either group-1 ($n_1=17$) that underwent the neural mobilization technique or group-2 ($n_2=16$) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring's electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application). Results: There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): $69.70{\pm}8.14^{\circ}$ to $74.14{\pm}8.07^{\circ}$ and group-2: $68.66{\pm}7.42^{\circ}$ to $70.52{\pm}7.92^{\circ}$] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: $1.12{\pm}.30{\mu}N$ to $.69{\pm}.31{\mu}V$ and group-2: $1.19{\pm}.49{\mu}V$ to $1.13{\pm}.47{\mu}V$)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05). Conclusion: These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.
Background: The purpose of this study is to investigate the effect of the combined exercise program on the static balance ability of the lumbar instability of adults. Methods: The experimental group was divided into two groups and randomly. The experimental group 1 (Exp 1) applied the combined exercise program for the lumbar stabilization exercise and strengthening exercises and the experimental group 2 (Exp 2) applied the combined exercises program for the lumbar stabilization exercises and active stretching exercises. Each experiment group performed exercise program for 4 weeks, 3 times a week, 30 minutes a day. Static balance ability was measured using GOOD BALANCE system. Results: As the comparing results of static balance ability, normal standing eye open was Ant-Post and Med-Lat showed significant differences in Exp 1 (p<.05). One leg left eye open was velocity moment showed significant differences in Exp 1 (p<.05). and one leg right eye open was Med-Lat showed significant differences in Exp 1 (p<.05). Conclusion: These results show that thoracic self mobilization is immediate effective on balance and gait ability. Thus, thoracic self mobilization will help recovery of balance and gait ability in acute stroke patients.
Purpose: The purpose of this study was to determine the effects of contract relaxation and a combination of isotonics in proprioceptive neuromucular facilitation (PNF) on hip and lumbopelvic motions of male patients with chronic low back pain. Methods: As the subjects of this study, a total of 45 male patients with chronic low back pain were divided into groups: 15 who underwent contract relaxation (CR) of the PNF of their hip joints, 15 who underwent a combination of isotonics (CI) of the PNF, and 15 who underwent both techniques. A device for analyzing three-dimensional motion was used to measure hip medial rotation angles, lumbopelvic rotation angles, and hip medial rotation angles at the start of lumbopelvic rotation during hip medial rotation. A two-way repeated measures ANOVA was used to compare the average values. Results: There were interactions in the hip medial rotation angles, lumbopelvic rotation angles and hip medial rotation angles at the start of lumbopelvic rotation based on the methods and periods of exercise (p < 0.05). The CR and the CR+CI groups displayed more increased hip medial angles when compared to the CI group. The CR+CI group had more decreased lumbopelvic rotation angles when compared to the CR and the CI groups. The CR+CI group had more increased hip medial rotation angles at the start of lumbopelvic rotation when compared to the CR and the CI groups. Conclusion: It can be concluded that the combination of stretching and stability exercises was effective in male patients with chronic low back pain who showed limited hip medial rotation.
Objective: The purpose of this study was to investigate the muscle activity ratio of the lower limb according to changes in straight leg raise (SLR) test angles on hamstring muscle shortening during squat exercises. Design: Randomized controlled trial. Methods: The subjects were 14 healthy adults who were informed of and agreed to the method and purpose of the study. The participants were classified into SLR groups according to two angles (over $80^{\circ}$ or under $80^{\circ}$) assessed using the SLR tests. After training and practicing the wall squat posture to be applied to the experiment, electromyography (EMG) was used to measure changes in muscle activity during the performance of a wall squat. After stretching, a sequence of pre-stretch tests were performed again, and the active and passive SLR tests were also reconducted; thereafter, a wall squat was performed again by attaching EMG electrodes. The EMG results before and after stretching were compared. Results: The muscle activity of the vastus lateralis oblique muscle increased in both groups. The muscle activity of the vastus medialis oblique muscle decreased in over both group. Rectus femorus activity increased in the under 80-degree groups but decreased in the over 80-degree group. The muscle activity of the biceps femoris muscle decreased after stretching in the over 80-degree group and increased in the under 80-degree group, and the semitendinosus muscle activity after stretching was decreased. The quadriceps-to-hamstring muscle (Q:H) ratio before and after stretching between groups showed that the hamstring muscle ratio decreased after stretching in both groups. Conclusions: The results of this study showed that the Q:H ratio before and after stretching between groups was not significantly different.
Purpose : The purpose of the study was to investigate the effects of sustained natural appophyseal glides (SNAGS) on pain and lumbar stability in patients with chronic low back pain. Methods : The subjects were assigned randomly devided SNAGS group(n=18) and control group(n=18). The SNAGS group received Infrared(IR) used thermal therapy for 20minutes, Interference current therapy(ICT) used electrical therapy for 10minutes and SNAGS for 10minutes to 15minutes. The control group received IR used thermal therapy for 20minutes, ICT used electrical therapy for 10minutes and active stretching exercise for 10minutes to 15minutes. The visual analogue scale(VAS) and lumbar stability were measured at pre-treatment and post-treatment. Results : The results of this study were summarized as follows : 1. The VAS score of SNAGS group and control group was significantly within-subjects pre-test and post-test (p<.05), there was significantly difference between-subjects on each groups(p<.05). 2. The SNAGS group was significantly increased in variation of lumbar stability on $0^{\circ}$, $180^{\circ}$, $90^{\circ}$, $-90^{\circ}$, $45^{\circ}$, $-45^{\circ}$, $135^{\circ}$ and $-135^{\circ}$ within-subjects pre-test and post-test(p<.05), but The control group wasn't significantly increased in variation of lumbar stability on $0^{\circ}$, $180^{\circ}$, $90^{\circ}$, $-90^{\circ}$, $45^{\circ}$, $-45^{\circ}$, $135^{\circ}$ and $-135^{\circ}$ within-subjects pre-test and post-test(p>.05). There was significantly difference between-subjects on each groups(p<.05). Conclusion : In conclusion, SNAGS found that effective to decrease of pain and increase of lumbar stability. Therefore, the results of this study suggests that SNAGS is beneficial treatment for chronic low back pain.
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