• 한국정밀공학회지
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• 제26권10호
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• pp.116-121
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• 2009

It is important to consider lumbar lordotic angle for setup of training program in field of sports and rehabilitaton to prevent unexpected posture deviation and back pain. The purpose of this study was to analyze the biomechanical impact of the level of lumbar lordosis angle during isokinetic exercise through dynamic analysis using a 3-dimensional musculoskeletal model. We made each models for normal lordosis, excessive lordosis, lumbar kyphosis, and hypo-lordosis according to lordotic angle and inputted experimental data as initial values to perform inverse dynamic analysis. Comparing the joint torques, the largest torque of excessive lordosis was 16.6% larger and lumbar kyphosis was 11.7% less than normal lordosis. There existed no significant difference in the compressive intervertebral forces of each lumbar joint (p>0.05), but statistically significant difference in the anterioposterior shear force (p<0.05). For system energy lumbar kyphosis required the least and most energy during flexion and extension respectively. Therefore during the rehabilitation process, more efficient training will be possible by taking into consideration not simply weight and height but biomechanical effects on the skeletal muscle system according to lumbar lordosis angles.

• 한국전문물리치료학회지
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• 제25권4호
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• 한국운동역학회지
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• 제17권3호
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• pp.155-164
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• 2007

This study is aimed at determining the effects of rehabilitation training on lumbar extension strength and relief of back pain in middle-aged women of low back pain. Twenty-nine subjects(total 29 people; CLBP 16, HLD 13) were trained twice per week for eight weeks and completed a maximum isometric test at various flexion angle(the degree of $0^{\circ}$, $12^{\circ}$, $24^{\circ}$, $36^{\icrc}$, $48^{\circ}$, $60^{\circ}$, $72^{\circ}$) by lumbar extension machine. The result showed that. 1. Patient group of CLBP were increased the maximum lumbar extension strength at a range of 7 flexion angles after rehabilitation rather than no rehabilitation(on the average 60.75%). The operated patient group in HLD also showed an increase of 56.55%. In view of these cases, all of two groups showed a significant increase of muscle strength(p<.05). But there is no difference between pre-exercise and post-exercise groups. 2. Patient group of CLBP were increased higher rate than 41% for maximum lumbar extension strength(91.79% at $0^{\circ}$, 79.41% at $12^{\circ}$, 65.89% at $24^{\circ}$) at all angles after 8 weeks training. Both groups indicated a significant increase(p<.05) of lumbar extension strength at all degrees. There is no difference between pre-exercise and post-exercise groups. 3. Relief of back pain in Patient group of CLBP showed a decrease of average 105.2% and patient group of HLD indicated a decrease of average 64.57% two groups showed a significant reduction (p<.05, p<.05). But in case of a decrease of pain, CLBP group got 3.44 points and HLD group got 4.77 points. In view of these results, two groups showed remarkable reduction of back pain, however HLD group had residual pain relatively.

• Journal of Acupuncture Research
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• 제27권3호
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• pp.93-104
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• 2010

Objectives : The purpose of this study is to observe the effects of work environment and low back pain on the structural and muscle strength changes in lumbar spine to helpful for preventation and cure of low back pain. Methods : Through measuring of lumbosacral angle, lumbar lordotic angle, lumbar gravity line ratio analyzed structure of lumbar spine and using Trunk Extension Flexion Program of CYBEX NORM System(cybex770+TMC, USA) analyzed Flex. PT, Ext. PT, E/F ratio of lumbar spine of company employees given a medical examination. Results : According to work environment, lumbar gravity line ratio is higher in white collar group than in blue collar group, Ext. PT is significantly lower in white collar group than in blue collar group. According to low back pain or not, lumbar gravity line ratio, Ext. PT is lower in low back pain group than in non-low back pain group. Conclusions : Work environment and low back pain effects on the structural and muscle strength changes in lumbar spine.

• 대한물리의학회지
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• 제10권4호
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• pp.39-48
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• 2015

PURPOSE: This study aimed to compare the degree of lumbopelvic rotation during the active straight leg raise (ASLR) test in chronic low back pain with and without lumbar segmental instability. METHODS: A total of 71 patients with chronic low back pain were recruited for this study. The subjects who tested positive for more than three of the five lumbar segmental instability tests (prone lumbar instability, lumbar passive extension test, anterior posterior mobility test, passive straight leg raise, age) were categorized into the lumbar segmental instability positive group. Patients who tested positive for less than three of the five tests were categorized into the lumbar segmental instability negative group. The lumbopelvic rotation was measured three times during ASLR and a mean was determined. Subjective heaviness during the ASLR was measured on 6 point scale. RESULTS: There was a statistically significant difference in the lumbopelvic rotation angle between the groups with and without lumbar segmental instability (p<.01). There was no significant difference in the subjective heaviness during ASLR. The mean lumbopelvic rotation angle during ASLR was $13.54{\pm}2.86^{\circ}$, and $8.81{\pm}2.47^{\circ}$ in the positive and negative groups, respectively (p<.01). The cut-off value of the lumbopelvic rotation during was $10.5^{\circ}$, the sensitivity was 82.9%, and the specificity was 80.6%. CONCLUSION: These results suggest that lumbopelvic rotation is more prevalent in patients without lumbar segmental instability. Clinically, this important when diagnosing chronic low back pain with lumbar segmental instability, as the lumbopelvic rotation angle during the ASLR test can be used to aid in diagnosis.

• 대한정형도수물리치료학회지
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• 제9권1호
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• pp.29-38
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• 2003

The purpose of this study was to investigate relationship of lumbar extensor muscle power & spinal column curve for old female patients with LDK(Lumbar degenerative kyphosis). Subjects were composed of 37 old female with LDK. The subjects were tested in their spinal segment movement and spinal column curve with Spinal-$Mouse^{\leq}$ in $1^{st}$ loaded test and $2^{nd}$ loaded test and then tested lumbar extensor muscle power with $Medx^{\leq}$ lumbar extension machine. The results of this study, were as follow; There were statistically significant difference $1^{st}$ loaded test and $2^{nd}$ loaded test in upright position increase spinal column forwardly(p<0.01) and decrease lumbar lordosis angle(p<0.01), but no statistically significant difference $1^{st}$ loaded test and $2^{nd}$ loaded test thoracic and hip & sacrum curve angle. Their lumbar extensor muscle poser is very weakness, 61.4% of normal people.

• 대한정형도수물리치료학회지
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• 제13권2호
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• pp.12-20
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• 2007

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• 대한물리치료과학회지
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• 제13권4호
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• pp.7-16
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• 2006

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.79-88
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• 2024

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

• 한국운동역학회지
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• 제17권2호
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• pp.123-130
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• 2007

This study is that the elderly female patients having low back pain(34 people) show a change of stabilization ratio after isotonic rehabilitation of 4 types(before exercise, after 4weeks, 8weeks, 12weeks). Under the cover of lumbar extension machine, isometric extension strength and stabilization ratio is measured and analyzed at some flexion angles(the degree of $0^{\circ}$, $12^{\circ}$, $24^{\circ}$, $36^{\circ}$, $48^{\circ}$, $60^{\circ}$, $72^{\circ}$). The conclusion is as follows. 1. The maximum lumbar extension strength at a range of 7 angles have an increase of 73.92% in case of 12weeks isotonic exercise(p<.001). 2. After 12weeks exercise, the lumbar flexion angle maximum extension strength, have an higher increase than 54% on the average at all angles(p<.001). These statistically show a meaningful increase of muscular strength. 3. After 12weeks isotonic exercise, the lumbar stabilization ratio have a decrease of 50.27% at a statistically meaningful level(p<.001). In case of 12weeks exercise comparing with 8weeks, the stabilization ratio decrease at the level of 1.85 versus 1. This figure is similar to that of a normal person. In view of this study, 12weeks exercise for the elderly female patients having low back pain has much influence on the change of lumbar stabilization ratio and this is the scientifically verified result of a long term exercise.