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Cost-Benefit Analysis of Back School Program for Occupational Low Back Pain Patients (직업성 요통환자에서 재활 프로그램(Back School Program) 도입의 비용-편익분석)

  • Ju, Yeong-Su;Ha, Mi-Na;Han, Sang-Hwan;Kwon, Ho-Jang;Cho, Soo-Hun;Kim, Chang-Yup;Kim, Sun-Min
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.347-357
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    • 1996
  • Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

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A Study of Risk Factors related to Back Pain in Bus Drivers (버스 운전기사의 요통발생 요인에 관한 연구)

  • Park, So-Yon
    • Physical Therapy Korea
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    • v.4 no.2
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    • pp.18-35
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    • 1997
  • The purpose of this study were to determine causes of low back pain in bus drivers who usually work in prolonged sitting position and to find the relationship of back pain with general characteristics and work environmental characteristics, stress symptoms, to com맹re lordosis angle of habitual driving posture and resting posture in low back pain group and non-low back pain group, and to use this result as a basis for improvement of work environment and comprehensive rehabilitative management of low back pain. Ninety-eight bus drivers were selected from the membership of an urban transit union in Seoul. These informations were collected from May 1, 1997 to May 25, 1997 by means of structured questionnaires and X-ray findings. These data were analyzed by $x^2$ test, t-test, logistic regression using SAS. The major results were as follows: 1. Of the respondents, 66.3% of bus drivers were found to be experiencing back pain. 2. Of the respondents of low back pain groups, 78.5% reported that major cause of low back pain was due to prolonged sitting. 3. The group with experiences of frequent or continuous vibration had more low back pain (p<0.05). There were no significant differences among other work environmental factors. 4. Average stress score was significantly higher in the group with low back pain than in the group without low back pain (p<0.05). 5. The results of the logistic regression analyses were statistically significant vibration from seat and stress score among the risk factors (p<0.05). 6. Averaged lordosis angle of habitual driving posture was $7.6{\pm}14.9$ degrees in low back pain group, $16.5{\pm}8.7$ degrees in non-low back pain and averaged lordosis angle of resting sitting posture was $10.8{\pm}13.7$ degrees in low back pain, $18.9{\pm}9.6$ degrees in non-low back pain group but the difference in mean lordosis angles of two groups was not statistically significant. The results of this study indicate that professional drivers developed chronicity of low back pain due to unfit seat, poor habitual posture and stress from vibration or other risk factors. Therefore, there is need to improve work environment, i.e. enough resting, to set a seat to support lumbar spine properly and to provide comprehensive rehabilitation program including early diagnosis, proper treatment and education for self help management.

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An Effect of Low Back Pain Relieving Program on the Back Muscle Strenght, Intensity of Pain, Disability Level in Elementary School Women Teacher (요통완화프로그램이 만성 요통호소 여교사의 배근력, 통증정도, 기능장애에 미치는 효과)

  • Choi, Soon-Young
    • Women's Health Nursing
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    • v.6 no.1
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    • pp.117-128
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    • 2000
  • The purpose of this study was to examine the effect of low back pain relieving program on back muscle strength, intensity of pain, low back disability level in elementary school teachers who have low back pain. subjects were elementary school women teachers who worked at eight elementary school located in Seoul. Intended subjects size were seventy consist of thirty-four experimental group(three schools) and thirty-six control group(five schools), but actual subjects size was forty-four. Among the forty-four patients subjects, twenty-three were experimental group receiving health education about right postures, etiologies of low back pain, diagnosis of low back pain and exercise program composed of muscle strengthening exercise, stretching exercises and twenty-one were control group. During the 8 weeks program, the subjects were received two times education and six times group exercise practices in 1st week and three times per week group exercise practices, two times education in other 7 weeks. This study as carried out from April 1, 1999 to June 30, 1999. Back muscle strength was measured by back muscle strength measuring machine and the intensity of pain were measured by the Visual Analogue Scale(VAS), and level of disability was measured by Oswestry low back pain disability scale. Study measurements were taken before and after 8 week exercise program. Data were analyzed using paired t-test, and ANCOVA. The results were summarized as follows. 1. After low back relieving program, back muscle strength was increased significantly(p=0.000) and there was significant difference in back muscle strength change between experimental group and control group(p=0.002). 2. After low back pain relieving program, pain on anterior bending, pain on posterior bending were decreased significantly than measurements before the program(p=0.000 p=0.000) and there was significant difference in pain on anterior bending and posterior bending change between experimental group and control group(p=0.000, p=0.000). 3. After low back pain relieving program, Oswestry disability scale scores were decreased significantly(p=0.000, p=0.000) but there was no significant difference in Oswestry disability score change between experimental group and control group.

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A Study of Risk Factors Related to Low Back Pain in Civil Airmen (공중 근무자의 요통 발생 요인에 관한 연구)

  • Cheong, Mee-Sun;Kim, Young-Rok
    • Physical Therapy Korea
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    • v.8 no.1
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    • pp.59-75
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    • 2001
  • The purposes of this study were to investigate risk factors of low back pain in civil airmen and to use this information as basis for the back rehabilitation. Subjects of this study were randomly selected 276 civil airmen who had been employed at four airports in Seoul. These data were analyzed by $X^2$ test, t-test, ANOVA, and multiple logistic regression using SAS. The results were as follows: 1) The prevalence of low back pain among 276 civil airmen was 64.9%. 2) The most common cause of low back pain was load lifting (stewardess), long sitting (aircrew A), and long sitting plus training (aircrew B). 3) There were no statistically significant associations among age, height, body weight, and low back pain. 4) No statistically significant relationships were found among the average monthly working time, total working time, average monthly rest time, working year and low back pain. 5) There was statistically significant relation ship between abnormal posture and low back pain (p<.01). 6) There was statistically significant relation ship between fatigue and low back pain among stewardess and aircrew B. 7) There was a statistically significant relationship between job satisfaction and job-related stress (p<.05). 8) In stewardess, higher satisfaction score was associated with less likelihood of low back pain (odds ratio = .80). The results of this study indicate that civil airmen developed chronicity of low back pain due to unfit seat, poor habitual posture, fatigue symptom, and stress or other risk factors. Therefore, there is a need to improve the working environment for the prevention of posture-related low back pain.

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Quantification of the tug-back by measuring the pulling force and micro computed tomographic evaluation

  • Jeon, Su-Jin;Moon, Young-Mi;Seo, Min-Seock
    • Restorative Dentistry and Endodontics
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    • v.42 no.4
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    • pp.273-281
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    • 2017
  • Objectives: The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (${\mu}CT$). Materials and Methods: Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF (n = 14). The degree of tug-back was scored after selecting taper-matched GP cones. A novel method using a spring balance was designed to quantify the tug-back by measuring the pulling force. The correlation between tug-back scores, pulling force, and percentage of the gutta-percha occupied area (pGPOA) within apical 3 mm was investigated using ${\mu}CT$. The data were analyzed using Pearson's correlation analysis, one-way analysis of variance (ANOVA) and Tukey's test. Results: Specimens with a strong tug-back had a mean pulling force of 1.24 N (range, 0.15-1.70 N). This study showed a positive correlation between tug-back score, pulling force, and pGPOA. However, there was no significant difference in these factors between the PTN and PF groups. Regardless of the groups, pGPOA and pulling force were significantly higher in the specimens with a higher tug-back score (p < 0.05). Conclusions: The degree of subjective tug-back was a definitive determinant for master cone adaptation in the root canal. The use of the tug-back scoring system and pulling force allows the interpretation of subjective tug-back in a more objective and quantitative manner.

A Study on Design for Relay Station Antennas with U-shaped Back Plate Structure (ㄷ자형 Back Plate를 가진 중계국안테나의 설계에 관한 연구)

  • 민경식;임정남;김동일;정세모;이돈신
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.2 no.4
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    • pp.643-652
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    • 1998
  • This paper presents the characteristics of a relay station antenna with the newly designed back-plate structure which is composed of the U-shaped metal plate for suppression of the back lobe by edge diffraction. The back lobe level of the conventional type was about -20 dB in the -z direction ( 180 ) . In order to improve the characteristics, the U-shaped mesh type metal plate is considered, where the design condition of the model antenna satisfies the wide null point angle range with the back lobe level of -30 dB below in the -z direction. The design parameters with the minimum back lobe level such as the dipole length, the distance between dipole elements and the back plate size have been found by using the released NEC Win Pro code. The calculated and measured back lobe Bevel of model antenna have been obtained 48.48 dB and -45 dB at 325 MHz, respectively.

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Taping Therapy for the Low Back Pain based on Postural Reflexes (자세반사에 기초한 요통의 테이핑 치료)

  • Kim, Yong-Kwon
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.1023-1032
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    • 2001
  • The muscles relating to movement of painful low back was analyzed kinematically, by method of applying elastic tapes and putting non-elastic tapes on muscles involving those movements which cause pain and limitation of range of motion (ROM) in low back and trunk. Taping therapy which is effective for improvement of painful low back and which is supposed to facilitate the total and continual movement based on the postural reflexes will be presented in this paper. Fifty cases who had painful low back were investigated. Patients with painful low back were at first asked pain point and direction of painful movement, and then tested the muscles which are cause of those pain and limited motion. Before attaching tape, all subjects were divided into two groups, flexor pattern and extensor pattern, according to direction of increasing pain. Elastic tapes were applied from origin to insertion of objective muscles and non-elastic tapes were put on effective points of the muscles which were associated with respect to pain and limited ROM. As a result of this study, all subjects with low back pain significantly improved in pain and ROM at the low back. The longest treatment duration group for the low back pain cases was herniated lumbar disc(10.4 days) group. Low back pain have been treated by so many ways. muscles factor should be emphasized to be distinguish1y important to reduce low back pain. The muscles relating to make directly painful motion in low back and trunk should be confirmed by means of taping and painful motion should be analyzed by point of view of postural reflexes.

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Development of tight-fit patterns for adult males according to the 3D body surface segment method (3D 체표면 분할 전개방법에 의한 성인 남성 밀착원형 설계)

  • Hong, Eun-Hee
    • The Research Journal of the Costume Culture
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    • v.28 no.1
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    • pp.1-14
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    • 2020
  • This study is based on a representative body shape drawn from previous studies that classify adult male torso shapes. In this study, a design method is proposed by developing a tight-fit pattern that can be easily developed into various items and designs using the body surface development figure. This is obtained by converting the 3D body shape of the model representing the representative body shape. The specific design method was conducted as follows. Actual measurement values were used for waist back length, waist-to-hip length, shoulder length. The scye depth was determined as C/4-1.7 cm, and the front and back Interscye was set at (1/2 × actual measurements)-0.2 cm. The front-back neck breadth was set to (1/5 × base neck circumference)-1.3 cm and (1/5 × base neck circumference) cm. The front-back neck depth was set to (1/5 × base neck circumference)-1.2 cm and 3.5 cm. Front chest circumference was C/4-1 (front-back difference)cm; (1/4 × back chest circumference) was C/4 + 1 (front-back difference) + 0.3 (dart amount) cm. Front waist circumference was W/4-0.2 (front-back difference) + 2.2 (dart amount) cm; back waist circumference was W/4 + 0.2 (front-back difference) + 2.5 (dartamount) cm; front hip circumference was H/4 + 0.2 (ease) + 0.2 (front-back difference) cm; and back hip circumference was H/4 + 0.2 (ease)-0.2 (front-back difference) cm; Front droop was 1.6 cm. The newly developed tight-fit pattern is expected to be of great use as a basis for garment construction.

The Effect of Dynamic Lumbar Stabilization Exercise on Low Back Pain Patients (동적 요부 안정화 운동 치료법이 요통 환자에 미치는 영향)

  • Kim, Jong-Soon;Ju, Mu-Yeol;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.495-507
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    • 2001
  • The purpose of this study was to find the effects of the dynamic lumbar stabilization exercise on functional recovery of low back pain patients. The subjects were consisted of sixty patients who had nonspecific subacute low back pain. All subjects randomly assigned to dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group. The dynamic lumbar stabilization exercise group received modalities treatment with dynamic lumbar stabilization exercise. Williams exercise group received modalities treatment with Williams flexion exercise and modalities treatment group received modalities treatment without exercise. The Oswestry low back pain disability questionnaire was used to measure disability of low back pain. Assessment was carried out before treatment fur obtain baseline measurement of low back pain and reassessment were carried out at after 20 and 40 treatment sessions. The results of this study were as following: 1. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in dynamic lumber stabilization exercise group(p<.05). 2. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in Williams exercise group(p<.05). 3. The Oswestry low back pain disability questionnaire scores were significantly decreased after 20th and 40th treatment in modalities treatment group(<.05). 4. There were no statistical difference between the 3 groups at pre-treatment with Oswestry low back pain disability questionnaire scores(p>.05). 5. There were no statistical difference between the 3 groups after 20th treatment with Oswestry low back pain disability questionnaire scores(p>.05). 6. There were statistical difference between the 3 groups after 40th treatment with Oswestry low back pain disability questionnaire scores(p<.05). 7. The Oswestry low back pain disability questionnaire scores were significantly decreased after 40th treatment in all 3 groups and the decrement were greater in order of dynamic lumbar stabilization exercise group. Williams exercise group and modalities treatment group.

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A Survey on Low Back Pain of General Hospital Nurses (종합병원 간호사의 요통발생 실태와 관련요인)

  • Kwon, Young-Sook;Kim, Chung-Nam
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.100-117
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    • 1996
  • The purpose of the survey was to find out the prevalence rate and related factors for low back pain of nurses and to develop educational program for prevention of the low back pain. The subjects of the survey were 593 nurses of general hospitals in Tae-gu City. The survey was conducted from June 10, 1994 to October 3, 1994. The questionnaire included 34 question items concerning general characteristics, factors related to low back pain, physical nursing activities, and characteristics of low back pain. The results were as follows : 1. Among 593 of subjects, the prevalence rate of low back pain showed 62.1%. 2. In relation of health related life activities and low back pain prevalence, self-reported health state was highly significant(P=.000). 3. In relation of work environmental factors and low back pain prevalence, job satisfaction (P=.026), job stress(P=.020), and workload(P=.002) were significant. 4. In relation of physical nursing activities and low back pain prevalence, bending (P=.000), trunk twisting(P=.003), stretching(P=.006), and pulling and pushing(P=.046) were significant. 5. Physical nursing activities inducing back stress was varicant according to wards. The results of this study pointed out that the subjects' low back pain prevalence was related to the work-related physiologic and psychologic factors. Therefore, for the effective prevention of low back pain, both practicing the body mechanics and raising the morale of the nurses are needed in educational program.

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