• 한국전문물리치료학회지
• /
• 제24권4호
• /
• pp.68-76
• /
• 2017

Background: Abdominal bracing exercise (ABE) and abdominal hollowing exercise (AHE) improve the lumbar flexibility and pulmonary function in various patients, yet the efficacy of ABE or AHE have not yet been evaluated. Objects: The purpose of this study was to compare the lumbar flexibility and pulmonary function during both ABE and AHE in healthy adults. Methods: The study included 40 healthy adults, who were randomly divided into the experimental group and control group, each with 20 subjects. All subjects performed ABE (experimental group) and AHE (control group). The lumbar flexibility such as trunk flexion test (sitting and standing position) and schober test and pulmonary function such as the spirometer including forced vital capacity (FVC) and force expiratory volume in one second ($FEV_1$) and chest circumference measurement (middle and lower chest) were measured, respectively. Two-way repeated analysis of variance was used to compare the lumbar flexibility and pulmonary function, respectively. Results: No significant effects of lumbar flexibility were observed on trunk flexion test from the sitting position (P=.478) and standing position (P=.096) in the ABE than in the AHE. However, the length of ABE was longer significantly than it of AHE (P=.024). No significant effects of lung function were observed on the FVC (P=.410) and $FEV_1$ (P=.072) in the ABE group than in the AHE group. And also, no significant effects of chest circumference measurement were observed on the inspiration (P=.468) and expiration (P=.563) in middle chest circumference and inspiration (P=.104) and expiration (P=.346) in lower chest circumference. Conclusion: This study indicated that the ABE is only more effective in lumbar flexibility by lumbar length difference than AHE in healthy adults.

• Journal of Korean Neurosurgical Society
• /
• 제51권1호
• /
• pp.20-23
• /
• 2012

Objective : To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor. Methods : Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.8 years. An independent observer assessed whole lumbar lordosis (WL) and segmental lordosis (SL) between L1 and S1 using the Cobb's angle on lateral radiographs of the lumbar spine obtained from normal individuals when standing, sitting on a chair, and sitting on the floor. WL and SL at each segment were compared for each position. Results : WL when sitting on the floor was reduced by 72.9% than the average of that in the standing position. Of the total decrease in WL, 78% occurred between L4 to S1. There were significant decreases in SL at all lumbar spinal levels, except L1-2, when sitting on the floor as compared to when standing and sitting on a chair. Changes in WL between the positions when sitting on a chair and when sitting on the floor were mostly contributed by the loss of SL at the L4-5 and L5-S1 levels. Conclusion : When sitting on the floor, WL is relatively low; this is mostly because of decreasing lordosis at the L4-5 and L5-S1 levels. In the case of lower lumbar fusion, hyperflexion is expected at the adjacent segment when sitting on the floor. To avoid this, sitting with a lordotic lumbar curve is important. Surgeons should remember to create sufficient lordosis when performing lower lumbar fusion surgery in patients with an oriental life style.

• 대한척추외과학회지
• /
• 제25권4호
• /
• pp.175-179
• /
• 2018

연구 계획: 증례 보고 목적: 탈출된 요추 추간판이 자연 소실된 이후 추간판 간격이 감소된 증례를 보고하고자 한다. 선행 문헌의 요약: 보존적 치료를 통한 탈출된 요추 추간판의 자연 소실이 보고되었다. 대상 및 방법: 요추 추간판 탈출증으로 진단된 3명의 환자를 외래 추시를 통해 보존적 치료를 시행하였다. 내원 당시에 관찰되었던 방사통은 호전 되었으나, 만성적인 요통을 호소하였다. 원인 파악을 위해 MRI 촬영을 다시 시행하였다. 결과: 보존적 치료로 탈출된 요추 추간판이 자연 소실 되었지만, 추간판 간격의 현저한 감소가 관찰되었다. 결론: 요추 추간판 탈출증이 추간판 간격 감소의 위험요인 중 하나일 수 있다. 요추 추간판 탈출증을 진단 받은 환자의 경우 탈출된 요추 추간판이 자연 소실되더라도 만성 요통이 발생 할 수 있음을 인지하는 것이 중요하다.

• 국제물리치료학회지
• /
• 제8권1호
• /
• pp.1105-1113
• /
• 2017

The Purpose of this study was to determine the effects of sciatic nerve mobilization on pain and lower back muscle strength in female patients in their 40s who have been diagnosed with lumbar radiculopathy. Using a simple blinded method, 20 female patients with neuropathy in the nerve segments between L4-S1 were randomly divided into one group (n=10) that would undergo sciatic nerve mobilization, and another group (n=10) that would perform lower back segment stabilization exercises. The two groups attended 3 sessions per week, with each session taking 30 minutes, for a duration of 4 weeks. In the preliminary examinations, the pain index as well as the isometric muscle strength of the lower back extensor and flexor muscles were measured. After the passing of 4 weeks. The same method of measurement was used for the concluding examinations. Comparison of the pain indices in the two groups revealed that they both experienced a statistically significant decrease, and further inspection revealed that the there was a more substantial difference in the sciatic nerve mobilization group. Results of comparing changes in the Isometric Muscle Strength lower back muscle and bending muscle by group, In comparison between groups, the isometric strength of the lower back extensor showed a more significant difference in the sciatic nerve mobilization group (p <.05). Conclulsion, it can be inferred that application of sciatic nerve mobilization has a positive effect on the pain index and isometric muscle strength of the lower back in female patients with lumbar radiculopathy in their 40s.

• 대한물리치료과학회지
• /
• 제24권3호
• /
• pp.48-55
• /
• 2017

Purpose: this study was conducted on female university students in supine position and preformed the 2 bridge positions exercises, which are the bridge position exercise and the bridge exercise preformed with form rollers attached between their knees, in order to research the effects lumbar stabilization exercise has on lower extremity muscular strength. Method: In order for the participants to fully understand the topic and procedures of the experiment, they were given a 20 minutes of briefing and practice before the experiment. Result: Bridge exercise group and foam roller group were improved the knee flexion and extension strength. Conclusion: This research studied the difference of each lumbar stabilization positions and the effects they have on the fortification of the leg's flexion extension muscular strength, and by comparing which different exercise methods increase muscular strength the most works to plan a more optimal exercise method for lumbar stabilization.

• The Korean Journal of Pain
• /
• 제19권2호
• /
• pp.237-240
• /
• 2006

This report describes a case of spinal cord infarction after acupuncture. The patient was treated with lumbar sympathetic block with using C-arm fluoroscopy. A 66-year-old patient with chronic low back pain and radiating pain in the lower limb was treated with acupuncture and he suddenly had a loss of motor and sensory of both lower extremities. His clinical presentaion and neuroimaging studies were consistent with spinal cord infarction. He was treated with steroid megatherapy and he showed improved in motor function, but there was no pain relief despite the phamacological treatments that were combined with caudal blockade. He visited to our hospital and had lumbar sympathetic blockade performed. The pain was relieved without any related complication after 1 month (VAS $9/10{\rightarrow}2/10$), and he has been content with the results of treatment.

• The Korean Journal of Pain
• /
• 제28권2호
• /
• pp.75-87
• /
• 2015

Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

• Clinical Pain
• /
• 제20권2호
• /
• pp.93-98
• /
• 2021

The use of ultrasonography has recently been increasing in musculoskeletal diagnosis or intervention treatment. Ultrasound guided procedure offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch block, facet joint block and peripheral nerves of lower extremity. Further, there is no exposure to radiation and additional equipment necessary for the protection against radiation is required. And ultrasound guided procedure needs smaller space than fluoroscopy guided procedure with real time images in the outpatient department. This article reviews ultrasound guided procedure at lumbar vertebra and peripheral nerves of lower extremity.

• The Korean Journal of Pain
• /
• 제14권2호
• /
• pp.199-206
• /
• 2001

Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

• 한국전문물리치료학회지
• /
• 제22권3호
• /
• pp.1-11
• /
• 2015

The purpose of this study was to investigate the effect of lumbar stabilization training and additional thoracic mobilization on pain, proprioception and static balance in patients with chronic low back pain. The subjects of this study were 48 chronic low back pain patients who were randomly allocated to an experimental group 1 ($n_1=16$, lumbar stabilization and thoracic mobilization, thoracic hypomobility), experimental group 2 ($n_2=16$, lumbar stabilization and thoracic mobilization, thoracic normal mobility), and a control group ($n_3=16$, lumbar stabilization, thoracic hypomobility) after a thoracic mobility test. Both experimental groups underwent lumbar stabilization training and additional thoracic mobilization. The control group underwent only lumbar stabilization training. The intervention was performed 3 times per week, 30 minutes each time, for a total of 6 weeks. Thoraco-lumbar joint reposition error was measured using an electrogoniometer and static balance ability was measured using the Tetrax posture analysis system. Subjects' pain level was measured using a 100 mm visual analogue scale. Statistical analyses were performed using a one-way analysis of variance and a paired t-test. Post-hoc testing was carried out with a Bonferroni test. The pain level was significantly lower in both experimental groups compared to the control group. Both experimental groups showed significant reductions in joint reposition error angle (flexion, extension, and side bending) compared to the control group. The static balance level was significantly lower in both experimental groups than in the control group. In summary, lumbar stabilization exercises and additional thoracic mobilization significantly improved the pain level, proprioception, and static balance in patients with chronic low back pain.