• Title/Summary/Keyword: Nonspecific low back pain

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Effect of Taping on Lumbar Kinematics and Muscle Activities During Typing in Individuals With Nonspecific Chronic Low Back Pain

  • Kim, Hyun-A;Kwon, Oh-Yun;Ahn, Sun-Hee;Jeon, In-Cheol;Choung, Sung-Dae
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.93-102
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    • 2015
  • Prolonged sitting can contribute to low back pain. The lumbar taping can be applied to correct the sitting posture. This study aimed to investigate the effect of lumbar taping on lumbar kinematics and the muscle activities of multifidus (MF) and internal oblique in the individuals with nonspecific chronic low back pain (NSCLBP) as they type for 30 minutes. Nineteen subjects with NSCLBP (9 people in non taping group and 10 people in taping group) were recruited. Lumbar taping was applied to the taping group before typing. Both groups started typing in a neutral sitting position with their feet on the floor. The change of posture and S2 posterior tilting (S2P) were measured to investigate kinematic data. Three sensors were attached on T12, L3, and S2 to identify the change of posture. Surface electromyography was used to measure the muscle activities. Palpation meter was used to standardize the angle of pelvic tilt in sagittal plane before typing. All instruments were used to measure each data before and after typing. Independent t-test was used to compare the changing values of lumbar kinematics and muscle activities before and after typing between both groups. The changing values of S2P and change of posture of L3 and S2 were significantly smaller in the taping group compared to the non taping group (p<.05). The changing value of muscle activities of MF between before and after typing was significantly smaller in the taping group compared to the non taping group (p<.05). In conclusion, the lumbar taping during the 30-minute typing task can be applied to maintain correct sitting posture in the lumbar and pelvis and to maintain activation of MF.

A New More Reliable Indicator for Confirmation of the Medial Branch in Radiofrequency Neurotomy -Case report- (고주파열응고술을 이용한 척수신경 후내측지 신경절제술에서 후내측지를 확인하는 새로운 기준 -증례 보고-)

  • Shin, Keun-Man;Choi, Sang-Eun;Yun, Seon-Hye;Lim, So-Young;Jung, Bae-Hee;Lee, Kee-Heon;Hong, Soon-Yong;Choi, Young-Ryong
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.242-246
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    • 2000
  • Radiofrequency medial branch neurotomy is an effective way of controlling pain in the posterior compartment of the spine such as the facet joint, and the interspinous ligament. However, it is difficult to determine the exact location of the medial branch. Up until now we have relied on sensory response provoked by 50 Hz stimulation. The responses elicited using this method are quite subjective and can originate from sources other than the medial branch such as the periosteum, the intermediate or lateral branch. We need a confirmed indicator to locate the medial branch reliably. We applied 2 Hz stimulation under 0.4 volts to locate the medial branch and elicited a motor response. Twitching of multifidus and muscles around the SI joint was observed. The observation of these muscles provides a much more reliable method for confirmation of the medial branch. We have treated 45 chronic nonspecific low back pain patients using radiofrequency medial branch neurotomy with this method of confirming the medial branch.

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The Effect of Stabilization Exercise and Strength Exercise on Pain, ROM, Strength, Muscle Thickness of Non-Specific Low Back Patients (안정화 운동과 근력운동이 비특이성 요통환자의 통증, 관절가동범위, 근력, 근 두께에 미치는 영향)

  • Jeong, Chanju;Yang, Hoesong;Yoo, Youngdae;Kno, Hynujun;Jang, Yunhyung;Moon, Kyoungae;Yi, Yunkyong;Lim, Changwoo;Cho, Silgeum
    • Journal of The Korean Society of Integrative Medicine
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    • v.2 no.1
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    • pp.35-49
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    • 2014
  • Purpose : The purpose of this study was to find the effects of the lumbar stabilization exercise and strength exercise on pain, ROM, strength, muscle thickness of low back pain(LBP) patients. Method : The subjects were consisted of twelve patients who had nonspecific LBP. All subjects randomly assigned to lumbar stabilization exercise group(N=6) and strength exercise group(N=6). We measured muscular strength, ROM by using Tergumed-extension, rotation and muscle thickness by using ultrasonography and pain score by using Visual analog scale(VAS). The lumbar stabilization exercise group received TOGU exercise, strength exercise group received Tergumed exercise. The data analyzed by repeated measure of Independent t-test, paired t-test, reliability test. Result : The results were as follows. The result which measured of the change of pain score was a significant decrease. The result which measured of the change of ROM and strength was a significant increase. The result which measured of the change of the Internal abdominal oblique, External abdominal oblique on muscle thickness was a significant increase. Stabilization exercise group and Strength exercise group showed the significant difference in muscle thickness on Transversus abdominis, Multifidus. Stabilization exercise group was more increased in muscle thickness. Conclusion : Therefore, we suggest that stabilization exercise is effective for non-specific low back pain.

The Effects of Maintained Muscle Contraction of Abdominal and Pelvic Floor Muscles on 3D Pelvic Stability in Individuals with Chronic Low Back Pain During Gait

  • Yu, Min;Choi, Yu-Ri;Choi, Jeong-Eun;Jeon, Seong-Yeon;Kim, Yong-Wook
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.3
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    • pp.23-30
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    • 2022
  • PURPOSE: This study was designed to investigate the effects of keeping contraction of abdominal and pelvic floor muscles on 3D pelvic stability in individuals with nonspecific chronic low back pain (CLBP) during normal speed walking. METHODS: The subjects were 20 adults with CLBP deformity and had moderate pain intensity of the visual analog scale. A three-dimensional camera capture system was used to collect kinematic pelvic motion data with and without contraction of the abdominal and pelvic floor muscles during gait. The subjects were asked to walk on a walkway in the lab room and they were attached 40 reflective markers to their pelvic segment and lower extremities. A Visual3D Professional V6 program and Vicon Nexus software were used to analyze 3D pelvic kinematic data. RESULTS: There were significant differences between with and without contraction of the abdominal and pelvic floor muscles of the pelvic depression and the total pelvic motion in coronal plane during gait (p < .05). However, there were no significant differences in any of the maximal motion of the pelvic segment in sagittal and transverse motion plane according to the different muscle contraction conditions (p > .05). CONCLUSION: The results of this study suggest that maintaining co-contraction of the abdominal and pelvic floor muscles in individuals with CLBP increased pelvic stability and contributed to preventing excessive pelvic movements during gait.

Comparison of postural control between subgroups of persons with nonspecific chronic low back and healthy controls during the modified Star Excursion Balance Test

  • Shallan, Amjad;Lohman, Everett;Alshammari, Faris;Dudley, Robert;Gharisia, Omar;Al-Marzouki, Rana;Hsu, Helen;Daher, Noha
    • Physical Therapy Rehabilitation Science
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    • v.8 no.3
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    • pp.125-133
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    • 2019
  • Objective: To compare the postural control between non-specific chronic low back pain (NSCLBP) subgroups and healthy people during dynamic balance performance using a modified Star Excursion Balance Test (mSEBT). Design: Cross-sectional study. Methods: Eighteen NSCLBP subjects (9 active extension pattern [AEP], 9 flexion pattern [FP]), and 10 healthy controls were enrolled in this study. All subjects performed mSEBT on their dominant leg on a force plate. Normalized reach distance and balance parameters, including the center of pressure (COP) displacement and velocity, were recorded. Results: There were significant differences in mean reach distances in both posterolateral and posteromedial (PM) reach directions between AEP and healthy subjects (p<0.001) and between FP and healthy subjects (p<0.001). However, there were no significant differences among the three groups in the anterior reach direction. Also, the results showed no significant differences in mean COP variables (velocity and displacement) between pooled NSCLBP and healthy subjects. However, the subjects were reclassified into AEP, FP and healthy groups and the results showed a significant difference in mean COP velocity in the PM direction between AEP and FP subjects (p=0.048), and between AEP and healthy subjects (p=0.024). Conclusions: The findings in this study highlight the heterogeneity of the individuals with NSCLBP and the importance of identifying the homogenous subgroups. Individuals with AEP and FP experience deficits in dynamic postural control compared to healthy controls. In addition, the findings of this study support the concept of the Multidimensional Classification System.

Two Cases of Spinal Epidural Abscess in Hemodialysis Patients

  • Kim, Young Hwan;Yoo, Jin Taek;Jung, Soon Myung;Kwon, Sang Chang;Ryu, Seung Min;Jang, Mun;Choi, Jung
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.36-38
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    • 2013
  • While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.

Idiopathic Hypertrophic Spinal Pachymeningitis : Report of Two Cases and Review of the Literature

  • Kim, Jee-Hee;Park, Young-Mok;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.392-395
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    • 2011
  • Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

Suspected Upper Gastrointestinal Bleeding by Interaction of Clozapine and Buspirone (상부위장관 출혈이 의심되는 클로자핀과 부스피론의 상호작용)

  • Sung, Yu-Mi;Kim, Soo-In;Yun, Kyu-Wol;Lim, Weon-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.62-66
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    • 2006
  • Introduction: Unexpected serious and lethal drug interactions can be occurred by polypharmacy for treatment-resistant psychiatric disorders. We report a case who has suspected upper gastrointestinal bleeding after the combination of clozapine and buspirone. Case : A 69-year-old woman with DSM-IV schizophrenia who was admitted to our hospital had no previous medical problems. Findings on physical exam, laboratory values, EEG, and a magnetic reso-nance imaging scans were no abnormality, except for slightly low level of hemoglobin at admission. Because of aggravating anxiety symptom, a trial of buspirone was begun from 15mg, in addition to olanzapine 30mg. And then olanzapine was switched to clozapine due to her treatment-refractory his-tory and poor response on this admission. Moreover, At the admission 11 weeks later, after 4 weeks of starting buspirone and clozapine, she was placed on a regimen of clozapine 300mg and buspirone 60mg. At this point, she started to complaint nonspecific abdominal pain for 4 days and then hematemesis, melena and hypotension were developed suddenly with negative findings in gastroduodenoscopy. After stopping all medication, the suspected upper gastrointestinal bleeding was subsided. After the regimen was switched back to clozapine only, psychotic symptoms were improved without the recurrence of the adverse events. Conclusion : We concluded that the upper gastrointestinal bleeding in this case was attributed to the drug interaction with clozapine and buspirone, although the definite mechanism is not clear. The clini-cians should be very cautious to prescribe the combination of clozapine and buspirone due to a possible lethal adverse effect.

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