• 한국전문물리치료학회지
• /
• 제13권2호
• /
• pp.61-69
• /
• 2006

The purpose of this study was to compare the electromyography (EMG) activities of the lumbar extensor muscles during motion of trunk flexion-extension and compare range of motion (ROM) with a 3-dimensional motion analysis system of the lumbar region between subjects with chronic low back pain (CLBP) and healthy subjects during the trunk flexion-extension, trunk rotation and trunk lateral flexion cycle. Thirty CLBP subjects and thirty healthy subjects were included. We measured the root mean square (RMS) value of the lumbar extensor muscles from resting, standing, lumbar flexion and return position. The RMS ratio was normalized from maximal EMG activity of the lumbar extensor muscles during trunk motion. The results of this study showed that the RMS ratio of the lumbar extensor was significantly higher in CLBP subjects than healthy subjects during all of trunk motion (p<.05). The ratio of the highest RMS value during flexion and extension was higher in CLBP subjects than in healthy subjects (p<.05). The ROM of the lumbar region was significantly lower in CLBP subjects than healthy subjects during trunk flexion-extension, trunk rotation and lateral flexion cycle. The relationship between the RMS ratio for full lumbar flexion and the ROM of lumbar flexion was not correlated significantly. CLBP subjects have both decreased ROM of the lumbar region and higher muscle activities of the lumbar extensor muscle than healthy subjects.

• The Korean Journal of Pain
• /
• 제30권1호
• /
• pp.51-58
• /
• 2017

Background: Recently symptoms-based screening questionnaires have gained attention for screening for a neuropathic pain component (NePC) in various chronic pain conditions. The present study assessed the usefulness of four commonly used NePC screening questionnaires including the Self-completed douleur neuropathique 4 (S-DN4), the ID Pain, the painDETECT questionnaire (PDQ), and the Self-completed Leeds Assessment of neuropathic Symptoms and Signs (S-LANSS) questionnaire in patients with chronic low back pain (CLBP) to assess the presence of NePC. Methods: This is a single-center cross-sectional study where patients with CLBP, with or without leg pain, were included. Participants were initially screened for NePC presence by a physician according to the regular practice, and later assessed using screening questionnaires. The diagnostic accuracy of these questionnaires was compared assuming the physician-made diagnosis as the gold standard. Results: A total of 215 patients with CLBP of which 164 (76.3%, 95% CI, 70.2-81.5) had a NePC were included. S-DN4, ID Pain, and PDQ have an area under the curve (AUC) > 0.8 indicating excellent discrimination. However, S-LANSS has an AUC of 0.69 (0.62-0.75), indicating low discrimination. S-DN4 has a significantly higher AUC as compared to ID Pain (d(AUC) = 0.063, P < 0.01) and S-LANSS (d(AUC) = 0.197, P < 0.01). But the AUC of S-DN4 does not significantly differ from that of PDQ (d(AUC) = 0.013, P = 0.62). Conclusions: S-DN4, ID Pain, and PDQ, but not S-LANSS, have good discriminant validity to screen for NePCs in patients with CLBP. Despite using all the tests, 20-30% of patients with an NePC were missed. Thus, these questionnaires can only be used as an initial clue in screening for NePCs, but do not replace clinical judgment.

• 대한물리치료과학회지
• /
• 제18권3호
• /
• pp.63-69
• /
• 2011

Purpose : The purpose of study is activation of lumbar multifidus muscle by needle EMG during shoulder flexion in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymtomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. The needle EMG were measured activation of multifidus. Needle electrode was used to 28 gauge. The shoulder flexion movement used to activate the multifidus was then measured. Results : Results of the analysis showed that asymptomatic subjects had significantly larger multifidus muscle activation compared with CLBP subjects during shoulder flexion. Conclusion : This study will be used as multifidus measurement method of patient with chronic LBP. The multifidus muscle in chronic LBP patient clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Therefore chronic LBP patients necessary multifidus activation measurement with needle EMG.

• PNF and Movement
• /
• 제18권3호
• /
• pp.415-424
• /
• 2020

Purpose: This study aimed to compare changes in abdominal muscle thickness in different standing postures with a handheld load between subjects with and without chronic low back pain (CLBP). Methods: Twenty subjects with CLBP and 20 controls participated in this study. Ultrasound imaging was used to assess the changes in the thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles. Muscle thickness in three different standing postures (standing at rest, standing with loads, standing with lifting loads) was compared with the muscle thickness at rest in the supine position and was expressed as a percentage of change in the thickness of the muscle. Results: While standing with loads, the change in IO muscle thickness in the CLBP patients increased more significantly than in the pain-free controls (p < 0.05). The standing with lifting loads posture showed a significant increase in the change in thickness of the TrA compared with the standing with loads posture (p < 0.05). In addition, the standing with lifting loads posture showed a significant decrease in the change in the thickness of the EO when compared with the standing with loads posture (p < 0.05). Conclusion: The automatic activity of the IO muscle in subjects with CLBP increased more than that of the pain-free controls in the standing with loads posture. These findings suggest that IO muscle function may be altered in those with CLBP while standing with loads. Additionally, TrA the activation level was found to be associated with increased postural demand caused by an elevated center of mass.

• 한국전문물리치료학회지
• /
• 제26권1호
• /
• pp.51-59
• /
• 2019

Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

• 산업경영시스템학회지
• /
• 제44권4호
• /
• pp.23-31
• /
• 2021

Treatment and management of chronic low back pain (CLBP) should be tailored to the patient's individual context. However, there are limited resources available in which to find and manage the causes and mechanisms for each patient. In this study, we designed and developed a personalized context awareness system that uses machine learning techniques to understand the relationship between a patient's lower back pain and the surrounding environment. A pilot study was conducted to verify the context awareness model. The performance of the lower back pain prediction model was successful enough to be practically usable. It was possible to use the information from the model to understand how the variables influence the occurrence of lower back pain.

• 대한물리의학회지
• /
• 제15권2호
• /
• pp.109-120
• /
• 2020

PURPOSE: This study was conducted to verify the effects of a functional correction of the pain of patients with chronic low back pain(CLBP), and to examine the effect of dysfunctional factors on health-related quality of life. METHODS: A preliminary survey was first conducted on 90 patients with CLBP after functional orthodontic treatment. Some revised questionnaires were also prepared. The survey was distributed for approximately eight weeks, and 215 copies were used as the final analysis data, except for questionnaires that were inadequate, error or non-response. RESULTS: Path analysis using the structural equation model of CLBP patients showed a positive correlation between all the path coefficients and the potential factors. The multidimensional relationship between pain and dysfunction after orthognathic treatment was confirmed using three subdivisions of the pain variables as independent variables and the dysfunctional variables as the dependent variables. Multiple regression analysis was performed to examine the effects of pain on the dysfunction. To identify the multidimensional relationship between dysfunction and the health-related quality of life, eight sub-factors of dysfunctional variables were set as the independent variables, and multiple regression was analyses were performed with the dependent variables of the health-related quality of life. CONCLUSION: This study examined the structural and influence relationships of the functional correction with pain, dysfunction, and health-related quality of life. The results, suggest that a functional orthodontic treatment can be used as a positive program for the health-related quality of life. In addition, this study is meaningful in that it provieds useful information for intervention such as psychosocial change of patients.

• The Journal of Korean Physical Therapy
• /
• 제30권5호
• /
• pp.166-172
• /
• 2018

Purpose: This study compared the different sling and resistance exercises on pelvic rotation during active straight leg raises (ASLR) and on pain in patients with chronic low back pain (CLBP). Methods: Twenty subjects were divided randomly into a sling group (SG) and a resistance exercise group (REG). Internal oblique (IO), external oblique (EO), rectus abdominis (RA), and rectus femoris (RF) muscle activity; pelvic rotation angle during ASLR; and visual analogue scale, pressure pain threshold were measured. Sling and resistance exercises were then performed for 30 minutes and the measurements taken again. Results: Both groups showed significantly lower RF muscle activity and significantly higher EO and IO muscle activity (p<0.05). The RA muscle activity decreased significantly in the SG, but increased significantly in the REG (p<0.05). The pelvic rotation angle was significantly lower in the SG (p<0.05). The pain press threshold increased significantly in both groups (p<0.05). The visual analogue scale decreased significantly in the SG (p<0.05). Conclusion: Both exercises appear to be beneficial for modifying the muscle activity and pain control in the intervention of CLBP. On the other hand, the sling was more effective in increasing the pressure threshold than resistance exercise, and the pelvic rotation angle was reduced. Therefore, both exercises can help patients with CLBP change their muscle activity and control pain. CLBP patients should use a sling for short periods of time to learn to reduce the pain and control pelvic rotation.

• 대한물리의학회지
• /
• 제3권3호
• /
• pp.193-202
• /
• 2008

Purpose : This study was performed for effects of intervention of mat & ball exercise, sling exercise, and general intervention. The purpose of this study was to know influenced on the change of Oswestry back pain disability index (OBPDI) with chronic low back pain(CLBP) patients. Methods : Three groups of CLBP patients(n=53) were allocated randomly in this study experimental group I (mat & ball exercise group MBE, n=18), experimental group II(sling exercise group SE, n=18) and control group(general intervention, n=17). Intervention was provided 6 weeks(S days a week). Experimental group was provided 3 set a day(10 time/ 1 set, 10sec holding and 10sec resting/ 1 time). The following was the result of the data analysis about OBPDI experiment that had been carried on a week, 2 weeks, 3 weeks, 4 weeks, S weeks, 6 weeks after, and even comparing with pre-experimental state. Results : The results were as follows. OBPDI about intervention period had decrease in the MBE and the SE groups. but there was no difference in the control group. Among three groups, The MBE and the SE groups had difference compare with control group. This shows that the MBE and the SE groups had effective decrease pain and disability. Conclusion : Therefore, this study shows that trunk stabilization exercise program influenced on the change of OBPDI with CLBP patients.

• 국제물리치료학회지
• /
• 제10권2호
• /
• pp.1750-1755
• /
• 2019

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.