• Journal of the Korean Society of Physical Medicine
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• v.10 no.1
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• pp.71-82
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• 2015

PURPOSE: The aim of this study is to compare changes in the thickness of the gluteus medius muscle fiber between chronic low back pain(clbp) with gluteus medius weakness and healthy subject. METHODS: Ultrasound imaging was used to measure in the thickness of each fiber of the gluteus medius muscle based on maximal muscle contraction during abduction motion of the hip joint in a healthy group (11 subjects) and a chronic CLBP group (21 subjects). An independent t-test was performed to analyze the difference of thickness in each fiber of the gluteus medius muscle and the rate of changes in the fibers in the two groups. RESULTS: The fiber thickness changes in the gluteus medius muscle were significantly lower for the posterior fiber in the CLBP group compared to the healthy group (p<0.01). The changes in rate of difference of thickness the posterior part of the gluteus medius muscle was significantly lower in the CLBP group than in the healthy group (p<0.05). CONCLUSION: The findings of this study CLBP patients with weakness of the gluteus medius muscle that lower for the posterior fiber's difference of thickness and rate of change in the CLBP group compared to the healthy group. Indicate that rehabilitation of CLBP patients with weakness of the gluteus medius muscle should consider the functions of posterior fiber of the gluteus medius muscle.

• Safety and Health at Work
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• v.10 no.1
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• pp.39-46
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• 2019

Background: As of now, the impact of low back pain (LBP) and its chronic state, chronic low back pain (CLBP), on mental health-related quality of life (HRQOL) has never been investigated among police officers. The present investigation aims at studying this relationship using a biopsychosocial model. Methods: Between May and October 2014, a Web-based cross-sectional study was conducted among Quebec police officers (Quebec, Canada). Mental HRQOL was measured using the role emotional (RE) and the mental health (MH) domains of the SF-12v2 Health Survey. The impact of CLBP on mental HRQOL (as opposed to acute/subacute LBP or no LBP) was studied with a multivariate linear regression model. Results: Of the 3,589 police officers who participated in the study, 1,013 (28.4%) reported CLBP. The mean age of respondents was $38.5{\pm}8.7years$, and 32.0% were females. The RE (44.1/100) and MH (49.0/100) mean scores of the CLBP group were comparable with the scores found in populations suffering from cancer or heart diseases. Compared to officers without LBP, the presence of CLBP was significantly associated with lower RE (${\beta}$: -0.068; p = 0.003) and MH (${\beta}$: -0.062; p = 0.002) scores. These relationships were not found in the acute/subacute LBP group. Conclusion: Our results underscore how frequent CLBP is among police officers and how burdensome it is. Considering the importance of good physical and mental health for this occupational population, police organizations should be aware of this issue and contribute to the efforts toward CLBP prevention and management in the workplace.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.20 no.1
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• pp.47-52
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• 2014

Background: This case study is to describe the manual therapy for the patient with posttraumatic stress (PTSD), sleep disturbance, and pain such as chronic low back pain (CLBP). Methods: The patient who participated in this study was a 60 year-old male PTSD patient with CLBP. His CLBP is not from any genetic or family history but a sequelae of torture that he had gone through about 30 years ago. Prior to the intervention, it was assessed that the PDS-K score was 16, PQSI-K was 12, SLR-90-R was low, VAS score was 10, and KODI socre was 25. The intervention was conducted through manual therapy (myofascial release, muscle energy technique, lumbar stabilization) twice a week for eight weeks in total. Results: After eight week-intervention, the PDS-K, SLR-90-R, VAS, and KODI score were improved whereas PQSI-K was not sufficiently fast improved. Conclusions: The manual therapy is substantially effective in dealing with PTSD and CLBP.

• PNF and Movement
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• v.12 no.1
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• pp.39-43
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• 2014

Purpose: This study was to examine lateral abdominal muscle activation during maximum expiration exercise between healthy and chronic low back pain(CLBP) patients. Methods: The subjects were 16 CLBP patients and 16 healthy people between the ages of 22 and 53. The thickness of the abdominal muscles was measured using ultrasonography(LOGIQ Book XP, GE, USA). We instructed the subjects how to perform the exercises and measured changes in thickness of the transversus abdominis(TrA) and internal oblique(IO) muscles during the maximum expiration. The main outcome variables were the ratios of the TrA and IO thickness during the exercise versus in the relaxed position(TrA and IO activation ratios). Results: There were significant differences between CLBP patients and healthy subjects for TrA in the relaxed position. However there was no difference in the ratio of change in the muscle activity(TrA, IO). Conclusion: These findings, CLBP patients exhibited atrophy of the TrA muscle, but voluntary TrA muscle activation was similar to that of the normal subjects. Therefore, this exercise could be used during core strengthening in CLBP patients.

• Physical Therapy Korea
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• v.23 no.1
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• pp.1-10
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• 2016

Background: Patients with chronic low back pain (CLBP) functionally adapt to decreased postural control due to impaired processing of sensory information. Standing postural control has been the focus of recent research in CLBP. Change in postural control may be a risk factor for CLBP, although available studies are not conclusive. Objects: This study aimed to identify the role of partial weight supported treadmill training (PWSTT) in improving balance, dysfunction, and pain in patients with chronic low back pain. Methods: The study included 22 patients with CLBP. Patients in the control group ($n_1=8$) performed three 20 min stabilization exercise sessions per week, for 4 weeks. Patients in the full weight treadmill training group ($n_2=7$) performed treadmill training for 30 min after stabilization exercise. Patients in the PWSTT group ($n_3=7$) performed PWSTT with 20% of their body weight unloaded after stabilization exercises. By using the Biodex balance system, the dynamic balance abilities of the patients in the three groups were assessed in the quiet standing position under combined conditions of visual feedback (eyes open and closed) and platform stability (level 8). The Korean version of the Oswestry Disability Index and visual analogue scale score were used as the main measure. Results: The results of this study showed that dysfunction and pain were significantly improved in all groups. Although dynamic postural stability with eyes closed was significantly improved only in the PWSTT group (p<.05), no significant difference was found in the other groups. Conclusion: The results of this study indicate that PWSTT improved balance, dysfunction and pain in the patients with CLBP. Thus, this intervention is necessary for patients with CLBP with decreased postural control.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.3
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• pp.206-214
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• 2020

This study examined the correlation between the respiratory pattern change (RPC) and abdominal mobility (AM) according to the positive result of the subjective lumbar instability factor (SLIF) in people with chronic low back pain (CLBP). Thirty-six adults with CLBP participated in this study. Twenty-eight items of the SLIFs were examined, and the subjects were divided into three groups according to the positive response numbers (PRN). After the change lists were scored, three RPC scores [costo-diaphragmatic RPC (CDRPC), breath hold change (BHC), and total RPC (TRPC)] were obtained. The abdominal mobility (AM) was measured between the maximal inspiration and exhalation at the xiphoid (AM1) and the 10^th rib (AM2) level of the trunk. The results showed that the RPC score and AM were compared according to the positive response number of SLIF, and the relationship between them was analyzed. A positive correlation was observed between the SLIF positive response number and CDRPC score, BHC score, and total RPC score, and a negative correlation was observed between the SLIFs positive response number and AM1 and AM2. Based on the results of this study, the combination of SLIF positive responses can be a predictor of non-physiological respiratory pattern changes in people with CLBP. Clinically, this prediction is expected to help save time for screening and improve the efficiency of therapy.

• Korean Journal of Applied Biomechanics
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• v.16 no.1
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• pp.159-166
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• 2006

The purpose of this study were analysed fatigue character of lumbar extension Muscle during repeated trunk flexion-extension motion we used EMG multi-telemeter (WEB 5000, Nihon Koden, Japan), Medex lumbar extension machine(Ocala, USA). We evaluated 20 persons on chronic low back pain group and 20 persons on control group. We analysed the quantitative variables IMF, MF, decreased ratios of MF to investigate fatigue. As a result, the following conclusion was drawn : 1. Each lumbar IMF of CLBP was L5> L3> L1 in the order of their size. CON group was similar quantitative and same order. But the relationship of two groups were not significantly. 2 The IMF within lumbar position(L1-L3, L1-L5, L3-L5) of two groups was significantly all positions(p<.05). 3. The MF shifting at lumbar position of two groups during repeated trunk flexion-extension motion was decrease shifting pattern with increase repeating motion, especially CLBP group was suddenly dropping than CON at all lumbar positions(L1, L3, L5) on early stage motion(34 set). 4. The lumbar fatigue of CLBP was higher than CON during repeated trunk flexion-extention motion, so CLBP supposed more tired than CON. And it was significantly within two groups at lumbar positions(L1, L3 : p<.05, L5 : P<.01).

• Journal of Korean Biological Nursing Science
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• v.21 no.1
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• pp.77-84
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• 2019

Purpose: This study aimed to identify pain, disability, anxiety, depression and educational needs between acute and chronic low back pain groups. Methods: A total of 153 patients aged 18 to 64, recruited from S-neurosurgical clinic for low back pain in Gyeonggi-do. Out of 153 subjects, 70 were Acute Low Back Pain (ALBP) group and 83 were Chronic Low Back Pain (CLBP) group. The collected data was analyzed using the SAS System V 9.4 program by chi-square test/Fisher's exact test and t-test. Results: The pain and disability scores were higher in ALBP group while the depression score was higher in CLBP group. The educational needs score in the area for the time for lumbar operation was higher in CLBP group. In the Low Back Pain (LBP) treatment management, ALBP group visited clinic (60.0%) most frequently and CLBP group visited both clinic & traditional medicine (66.3%) regularly. Conclusion: In order to minimize the progression from acute to chronic LBP, it is necessary for patients who visited the clinic to be accompanied with an education program that reflects educational needs of patients and with proven alternative therapy.

• Physical Therapy Rehabilitation Science
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• v.8 no.4
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• pp.175-186
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• 2019

Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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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.