Objective : There are differences in the clinical characteristics and surgical results between upper (L1-2 and L2-3) and lower (L3-4, L4-5, and L5-S1) lumbar disc herniations. We conducted this study to compare the clinical features and surgical outcomes between the two types of lumbar disc herniations. Methods : We retrospectively reviewed the clinical features of patients who underwent microdiscectomies from 2008 to 2012. We evaluated the clinical characteristics such as age, preoperative autonomic dysfunction, the presence or absence of previous lumbar surgery and fusion required during surgery. Visual Analogue Scale (VAS) scores about back pain and leg pain were evaluated preoperatively and at the final follow-up. Results : Upper lumbar group (n=15) was significantly older than lower lumbar group (n=148). The incidence of autonomic dysfunction was significantly higher in upper lumbar group. The number of patients with a previous lumbar surgery was significantly greater in upper lumbar group. There was no statistical significance for fusion required during surgery between two groups. Both groups showed a significant decrease in the VAS scores of leg pain. VAS scores of back pain were significantly decreased in lower lumbar group. But this was not seen in upper lumbar group. Both groups showed significant improvement of Oswestry Disability Index score. Conclusion : Upper lumbar group had different clinical characteristics from those of lower lumbar group and these include older age, a higher incidence of autonomic dysfunctions and a higher incidence of patients with previous lumbar surgery. There were no significant differences in surgical outcomes, except for back pain, between two groups.
This study aimed to assess the effects of progressive lumbar stability exercises and lumbar stability exercises on changes in the transversus abdominis muscle thickness and lower extremity muscle fatigue index in soccer players. Ten subjects were assigned to undergo training in each of the 2 groups, namely, the progressive lumbar stability exercise group and lumbar stability exercise group. Each intervention session lasted for 30 min, and 4 sessions were conducted in a week for 6 weeks for soccer players of S. University in Jeonnam, Korea. Changes in the transversus abdominis muscle thickness and lower extremity muscle fatigue index were measured using ultrasound and surface electromyogram. The results of the ultrasound measurement for the transversus abdominis muscle thickness indicated that progressive lumbar stability exercises were more effective than lumbar stability exercises. The results of the lower extremity muscle fatigue index measurements using surface electromyogram indicated that the fatigue index decreased in the progressive lumbar stability exercise group. Progressive lumbar stability exercise is believed to have put more workload during the shaking of the limbs, leading to increased stability and increased efficiency of the lower extremity muscle, thereby decreasing the fatigue index. Therefore, progressive lumbar stability exercises can be an effective measure for preventing injuries and improving the game performance of sports players by increasing the transversus abdominis muscle thickness and decreasing the lower extremity muscle fatigue index.
Journal of the Korean Society of Physical Medicine
/
v.6
no.3
/
pp.267-275
/
2011
Objective : This study aims to examine how lumbar stabilization exercise and resistive exercise affect lumbar and lower extremity muscular strength of the aged. Method : Randomly selected 15 female senior citizens aged 65 or older at S, Y, and J senior citizens' center located in D city who meet the requirements for the study were divided into a resistive exercise group of 7 and a stabilization exercise group of 8 for which 60-minute-exercise sessions were administered three times a week for 12 weeks. Measuring lumbar and lower extremity muscular strength was measured six weeks and 12 weeks after exercise, respectively. Results : First, both resistive exercises and stabilization exercises are effective to improve lumbar muscular strength. Second, resistive exercise is effective to improve flexural muscle strength as well as lower extremity muscular strength, and stabilization exercise is effective for both flexion and extensor muscle strength. Conclusion : The 12 week lumbar stabilization exercise program appeared to be effective to improve lumbar and lower extremity muscular strength of the aged. This indicates that applying this program to identify and prevent frequent risk factors of falling can lead to the prevention of secondary problem factors of falling accidents.
Kim, Si-Hyun;Park, Kyue-Nam;Kwon, Oh-Yun;Choi, Houng-Sik
Physical Therapy Korea
/
v.21
no.4
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pp.49-55
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2014
Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.
Journal of The Korean Society of Integrative Medicine
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v.3
no.2
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pp.47-54
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2015
Purpose: This study was to investigate the effects of lumbar stabilization exercise and lower extremity strengthening program on pain, lower extremity muscle in patients with chronic low back pain. Method: The subject were randomly divided two groups. 15 people who were conducted lower extremity exercises and lumbar stabilization exercises called the combined exercise group and other(15 people) who were only conducted lower extremity exercise group. The assessment tools were the pain level and the led muscle power. Exercise was conducted for eight weeks. Result: Pain of the combined exercise group showed significant differences in the change in pain level(p<.05). The leg muscle power showed significant differences within group which hip flexor, extensor muscles and abductor muscles. there were significant differences within combined exercise group (p<.05). But the knee joint in each group showed a significant difference within group (p<.05). Conclusion: This study suggest that the lumbar stabilization exercises and lower extremity exercises showed more efficient results in the pain levels and leg muscles power than only the lower extremity exercise for patients with lumbar instability.
The purpose of this study were to measured peak torque of lumbar extensor at various degrees and to compare with the choronic low back pain patients and healthy subjects back extensor peak torque. Research subject are fifty choronic low back pain patients and fifty healthy subjects are Dong-a university hospital visited to 2000, January since 1999, august none lumbosacral traumal past history and neurologic disorder that is twenty generation, thirty generation, forty generation, fifty generation, sixty generation in healthy subjects and twenty generation, thirty generation, forty generation, fifty generation, sixty generation in cause choronic low back pain patients. The result were as follows. 1. There were each generation choronic low back pain patients and healthy subjects back extensor peak torque are consideration (p<.05). 2. Twenty generation was all degree of angle in lumbar extention peak torque in choronic low back pain patients back extensor are lower than healthy subjects(p<.05). 3. Thirty generation was all degree of angle in lumbar extention peak torque in choronic low back pain patients back extensor are lower than healthy subjects(p<.05). 4. Forty generation was all degree of angle in lumbar extention peak torque in choronic low back pain patients back extensor are lower than healthy subjects(p<;.05). 5. Fifty generation was all degree of angle in lumbar extention peak torque in choronic low back pain patients back extensor are lower than healthy subjects(p<.05). 6. Sixty generation was all degree of angle in lumbar extention peak torque in choronic low back pain patients back extensor are lower than healthy subjects(p<.05).
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.23
no.2
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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.
Journal of the Korean Society of Physical Medicine
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v.19
no.2
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pp.29-45
/
2024
PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.
Background: Flat-back posture refers to a posture in which the pelvis is tilted backward, the lumbar spine is bent, the upper thoracic spine is increasingly bent, and the lower thoracic spine is straight. Given that most of the day is spent sitting, we need to develop exercise programs and devices that are suitable for people who spend less time exercising than sitting. Objects: This study investigated the effects of resistance footrest exercise on spine posture angles in visual display terminal (VDT) workers with flat back. Methods: We measured the upper lumbar angle (ULA) and lower lumbar angle (LLA) using a flexible ruler for the ULA and LLA. Then, after 1 week of resistance footrest exercise designed to strengthen the lumbar spine musculature, we measured these angles again. We measured each angle three times and then compared measurements from before and after exercise. Results: There were no significant differences in the ULA following the strengthening exercise, but significant differences were observed in LLA. Conclusion: The resistance footrest exercise strengthened the muscles affecting the pelvic and lumbar lordotic angles, and increases in the LLA were changed. This suggests that the role of the lower lumbar spine in the lumbar lordotic curve is greater than that of the upper lumbar spine. In addition, considering the contemporary tendency to lead fairly sedentary lives, these results indicate that exercising while seated can be effective.
Journal of the Korean Academy of Clinical Electrophysiology
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v.9
no.2
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pp.39-46
/
2011
Purpose : The purpose of this study was to compare the effect of three types of therapeutic exercises by applying them to lower back pain patients. Methods : This program was conducted for 30 patients 30 to 55 years old, who visited a rehabilitation center due to lower back pain. We separated participants into three groups with different therapeutic exercises: one with lumbar stabilization exercises, another with stretching exercises, and the other with both exercises. Each exercise was held once a day, 3 days a week, for 6 weeks. We analyzed the effect of these exercises by checking the change of lumbar muscle strength and pain relief. Lumbar muscle strength was measured by AS-Med and pain strength was estimated by VAS. Results : The result of the programs was established according to the following list: 1) Lumbar stabilization exercises and stretching exercises lead to higher lumbar muscle strength and pain relief (p<0.05). 2) Lumbar muscle strength in the lumbar stabilization exercise group was significantly higher than the stretching exercise group (p<0.05). 3) Pain relief in the stretching exercise group was significantly higher than the lumbar stabilization exercise group (p<0.05). Conclusion : This study shows all of the groups experienced higher lumbar muscle strength and pain relief. Specifically, there was higher lumbar muscle strength in the lumbar stabilization exercise group and higher pain relief in the stretching exercise group. Therefore the ideal intervention to improve lumbar muscle strength and pain relief for patients is to implement both lumbar stabilization exercises and stretching exercises.
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