• 대한정형도수물리치료학회지
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• 제23권2호
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• pp.33-44
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• 2017

Background: Lumbar stabilization exercise and gluteal muscle strengthening exercises are widely used to treat for lower back pain patient. The present study aimed to compare the effects of lumbar stabilization exercise and gluteal muscle strengthening exercises on chronic lower back pain with lumbar spine instability, with regard to pain intensity, disability, and psychosocial factors. Methods: Among 53 patients with chronic lower back pain, those with spine instability were selected using 5 examination tests. The selected 28 patients were randomly assigned to lumbar stabilization exercise group (LSE, n=15) and gluteal strengthening exercise group (GSE, n=13). Each group performed the corresponding exercise for 40 minutes, twice a week for 4 weeks. To analyze and compare the effects, pain intensity, the level of low back disability, and psychosocial factors were assessed before and after intervention. Results: There was significant difference in lower back pain intensity between the two groups before and after intervention. The change in low back disability was significant in the GSE group alone following intervention (p<.05), but no other significant difference was found between the groups. Among psychosocial factors, the changes in the fear-avoidance beliefs questionnaire (FABQ)-physical activity and FABQ-total were significant in the LSE group alone following intervention (p<.05). However, no significant difference were found in these factors between the two groups before and after intervention. Conclusions: LSE and GSE for lower back pain with lumbar spine instability showed no significant difference for pain intensity, physical disability, or psychosocial functioning.

• 대한물리치료과학회지
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• 제9권1호
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• pp.45-52
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• 2002

This study was intended to observe the relationship of pain alleviation between the group with needle electrode electrical stimulation applied on bach of head, lung, nasalis internae, shen-men, pharynx & larynx, and internal secretion which are the pants to regulate smoking and that, with no treatment of the kind among smokers and con-smokers with chronic low back pain. It also aimed to conduct a research of applying different treatment methods according to smoking, thus ultimately providing basic data needed by clinic therapists and to help achieve appropriate treatment effects considering the characteristics of each patient. The subject criteria were men who were in their 40's or 50's, smoking or non-smoking and came to the physical therapy of the hospital to cure the chronic low back pain which had lasted more than three months. The total 24 subjects were randomly divided into four groups according to smoking; the group of smokers with needle electrode electrical stimulation applied, that of smokers with no application of such treatment, that of non-smokers with the action of such treatment, and that of non-smokers with no application of such treatment Each group was measured in terms of four pain assessment methods of visual analogue scale(VAS), verbal rating scale(VRS), McGil pain questionnaire(MPQ), endorphin. And the results were as follows: 1. In terms of the effects of the needle electrode electrical stimulation in the auricular therapy on pain had by the smokers with low back pain, there was a statistical significance in VAS, VRS, and endorphin 1 between before and after the treatment. 2. In terms of the pain effects had by the smokers with low back pain when no needle electrode electrical stimulation in the auricular therapy was applied, there was a statistical significance in VRS and MPQ between before and after the treatment. 3. In terms of the effects of the needle electrode electrical stimulation in the auricular therapy on pain had by the non-smokers with low back pain, there was a statistical significance in VAS, VRS, and MPQ between before and after the treatment. In terms of the pain effects had by the non-smokers with low back pain when no needle electrode electrical stimulation in the auricular was applied, there was a statistical significance in VAS, VRS, and MPQ between before and after the treatment. 5. The smokers with low back pain were given the needle electrode electrical stimulation in the auricular therapy to see how it affected their pain. There was found pain reduction in number, but no statistical significance. 6. The subject suffering from low back pain were given the needle electrode electrical stimulation to see how it affected their pain according to smoking. There was found pain reduction in number, but no statistical significance. Based upon the results, it can be concluded that smokers with low back pain received the more effects of pain alleviation from the application of the needle electrode electrical stimulation in the auricular therapy compared to the rest of the groups who suffered from low back pain.

• 한방재활의학과학회지
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• 제24권4호
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• pp.137-143
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• 2014

Objectives Low back pain causes disability and incurs large socioeconomic burden. Many cases of acute low back pain progress into chronic conditions. As the treatment period extends, burden of socioeconomic expenses also rises. Thus this study is to investigate whether history period influences improvement rate of pain and disability in the patients who receive conservative Korean medicine treatment. Methods 447 inpatients who received conservative Korean Medicine treatment for the management of low back pain have been grouped into acute, sub-acute and chronic according to the length of history period. NRS, ODI and improvement rate of each group were investigated. Treatment every patient has received as follow; acupuncture, herbal medicine, Chuna manipulation, bee venom, and physical treatment. Results Acute patients showed improvement with NRS of $3.98{\pm}2.50$ and ODI of $28.04{\pm}21.54$. The NRS of sub-acute patients showed improvement with NRS of $2.81{\pm}2.07$, ODI also showed improvement with $11.64{\pm}13.94$. Statistically significant difference was observed in NRS, ODI and improvement for acute patients. Improvement in pain and disability was observed to be larger. Conclusions It demonstrated that receiving valid conservative Korean medicine treatment is beneficial for low back pain patients in improvement of their pain and disability.

• The Korean Journal of Pain
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• 제29권4호
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• pp.274-276
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• 2016

Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

• 대한물리치료과학회지
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• 제11권1호
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• pp.14-19
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• 2004

Objective : This study obtained normative values for variable parameters of lumbar function with the isoinertial triaxial dynamometer in patients with chronic low back pain. Subjects and Methods : 30 patients(male 15, female 15) with chronic low back pain in this study. Variable parameters that were measured with the Isostation B-200 were lumbar range of motion, isometric maximum torques, and maximum velocities in three axis. Results : In patient male group mean R.O.M. was $82.9{\pm}12.5$ degrees in lumbar rotation, $76.5{\pm}17.1$ degrees in lumbar flexion/extension, and $64.3{\pm}14.5$ degrees in lumbar lateral flexion. In patient female group mean R.O.M. was $78.4{\pm}18.5$ degrees in lumbar rotation, $71.7{\pm}20.4$ degrees in lumbar flexion/extension, and $63.2{\pm}14.4$ degrees in lumbar lateral flexion. In patient male group mean isometric maximum torques was $64.7{\pm}23.8ft-lbs$ in lumbar rotation, $81.1{\pm}42.0ft-lbs$ in lumbar flexion, $122.2{\pm}43.6ft-lbs$ in lumbar extension, and $101.0{\pm}37.0ft-lbs$ in lumbar lateral flexion. In patient female group mean isometric maximum torques was $41.9{\pm}9.2ft-lbs$ in lumbar rotation, $49.9{\pm}23.9ft-lbs$ in lumbar flexion, $90.1{\pm}26.8ft-lbs$ in lumbar extension, and $62.0{\pm}16.7ft-lbs$ in lumbar lateral flexion. In patient male group mean maximum velocity of isoinertial exercise with low (25%) resistance was $102.4{\pm}28.8deg/sec$ in lumbar rotation, $108.9{\pm}32.2deg/sec$ in lumbar flexion/extension, and $103.5{\pm}30.4deg/sec$ in lumbar lateral flexion. In patient female group mean maximum velocity of isoinertial exercise with low (25%) resistance was $84.1{\pm}24.4deg/sec$ in lumbar rotation, $93.2{\pm}32.9deg/sec$ in lumbar flexion/extension, and $98.5{\pm}33.7deg/sec$ in lumbar lateral flexion. In patient male group mean maximum velocity of isoinertial exercise with high (50%) resistance was $74.0{\pm}20.9deg/sec$ in lumbar rotation, $98.7{\pm}32.8deg/sec$ in lumbar flexion/extension, and $85.0{\pm}25.8deg/sec$ in lumbar lateral flexion. In patient female group mean maximum velocity of isoinertial exercise with high (50%) resistance was $67.3{\pm}26.4deg/sec$ in lumbar rotation, $82.5{\pm}31.0deg/sec$ in lumbar flexion/extension, and $79.7{\pm}23.9deg/sec$ in lumbar lateral flexion. Conclusion : Maximum isoinertial velocities were more reliable and more significant than isometric maximum torque for the objective assessment of chronic low hack pain.

• 정신신체의학
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• 제10권1호
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• pp.18-26
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• 2002

연구목적: 본 연구의 목적은 만성요통 환자에서 스트레스지각 및 통증지각과 대응전략 간의 관계를 알아보고자 하는데 있다. 본 연구에는 만성요통 환자 80명과 정상대조군 100명이 참여하였다. 방법: 스트레스인자 및 스트레스반응에 대한 지각은 각각 스트레스인자 지각척도 (Global Assessment of Recent Stress Scale) 및 스트레스반응 척도(Stress Response Inventory)를, 대응전략 및 통증지각은 각각 대응척도(The Way of Coping-revised) 및 통증지각척도(Pain Discomfort Scale)를 이용하여 평가하였다. 결과: 만성요통환자들이 정상대조군보다 일 및 직장, 대인관계, 대인관계의 변화, 질병 및 상해에 관련된 스트레스인자 지각점수, 전체 스트레스인자지각 정수가 각각 유의하게 더 높았다. 스트레스반응점수에서는 피로점수가 정상대조군보다 환자군에서 유의하게 더 높았으나, 통증지각에서는 양군 간에 유의한 차이를 보이지 않았다. 대응전략에서는 환자군이 정상대조군에 비해 계획적 문제해결 및 긍정적 재평가를 더 많이 사용하였다. 환자군에서 통증지각은 전체 스트레스반응 점수, 질병 및 상해에 관련한 스트레스인자지각 점수와 각각 유의한 양상관성을 보였다. 도피 회피 점수는 연령과 유의한 음상관성을, 거리감두기 및 도피-회피 점수는 유의한 양상관성을 보였다. 한편 책임수용은 여자가 남자보다 더 유의하게 많이 사용하였다. 그러나 대응전략과 스트레스인자지각 및 스트레스반응 통증지각 간에는 각각 유의한 상관성을 보이지 않았다. 결론: 이상의 결과들은 만성요통환자들이 정상인에 비해 스트레스인자에 대한 지각이 더 높으나, 더 적극적인 대응을 하고 있음을 시사한다. 또한 환자군에서 사용하는 대응전략은 스트레스인자지각, 스트레스반응, 통증지각과 연관성을 보이지 않는 반면 사회인구학적 특정들과 연광성이 높음을 시사한다.

• 대한물리치료과학회지
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• 제2권4호
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• pp.763-770
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• 1995

The primary purpose of this study was to determine the reliability of lumbar flexion and extension range-of -motion measurements obtained with the modified -modified $Sch{\ddot{o}}ber$ methods on normal and subjects with low back pain. Sixty two, aged 20 to 30 years(x = 22.0, SD = 2.07), with normal and twenty two, aged 14 to 66 years(x = 35.6, SD = 15.88) with chronic low back pain were measured by two physical therapist with 3 to 10 years (x = 6.5) of clinical experience. The therapist used the modified-modified $Sch{\ddot{o}}ber$(MMS) techniques to measure, in random order and on two occasions, the subjects' lumbar flexion and extension. For therapist 1, Intraclass correlation coefficients(ICC) for test-retest reliability for normal varied .9923, .8802(flexion, extension). and low back pain pateint varied .9950, .9313(flexion, extension). For therapist 2. ICC. for test-retest reliability for normal varied .9903, .8921(flexion, extension). and low back pain pateint varied .9843, .9551(flexion, extension). Interrater reliability for normal varied .9477, .6960(flexion, extension) and low back pain pateint varied. 9776, .7576(flexion, extension). Thus the MMS. method appears to be a reliable method for normal and patient with low back pain.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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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.

• 대한통합의학회지
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• 제10권3호
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• pp.37-52
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• 2022

Purpose : The purpose of this meta-analysis was to evaluate the effects of electrical stimulation on patients with non-specific low back pain. Methods : Domestic databases were gathered from studies that conducted clinical trials associated with electrical stimulation and its impact on pain of non-specific low back patients. A total of 681 studies were identified, with 12 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, outcome, and study design (PICO-SD). The search outcomes were items associated with low back pain. Cochrane risk of bias 2 (RoB 2) was used to evaluate the quality of 12 randomized controlled trials. Effect sizes (Hedges's g) in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were conducted to analyze the effect according to the sample size and the consistency of the effect size. Results : The following factors had a large overall effect size (Hedges's g=1.28, 95 % CI=.20~2.36) involving electrical stimulation on non-specific low back pain. The subgroup analysis all showed a statistical difference in the types of study design, electrical stimulation, and assessment tool. No statistically significant difference was found in the meta-regression analysis. Publican bias was found in the data. Conclusion : The findings in this study indicate that electrical stimulation interventions have a positive effect on patients with non-specific low back pain. However, due to the low quality of studies and publication bias, the results of our study should be interpreted cautiously.

• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.65-68
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• 2007

Objective : A new point of view on the chronic back pain proposed which is, named neuropathic back pain[NBP]. Some proposed a certain pain scale as an useful diagnostic tool. Before scientific verification, some doctors prescribed a new anticonvulsant for the NBP. We investigated diagnostic tools for NBP by a review of the literature. Methods : A comprehensive computer search of the English literature concerning neuropathic low back pain was performed using the key words such as neuropathic back pain and diagnosis in the PubMed. Results : In 1998, the term NBP was first used in a patient with lung cancer. In the English literature, there were two diagnostic methods for the NBP, Neuropathic pain scale[NPS] and a pharmacological test. NPS is a pain questionnaire, which depends on the patients' subjective reports on the given questions, such as 'how hot is your pain feel'. By the pharmacological test, NBP was defined as 50% or more decrease of pain on intravenous lidocaine and on local anesthetic epidurally. It also depends on the patients' subjective response to the therapy. Conclusion : There were still no reliable objective diagnostic criteria for the NBP. It seems to be better to reserve the new anticonvulsants for the NBP till scientific approval.