• Title/Summary/Keyword: Pain (LBP)

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A Review of Studies on Chuna Manual Therapy for Low Back Pain through Korean Database Search (국내 데이터베이스 검색을 통한 요통의 추나의학적 치료에 대한 연구동향 분석)

  • Yim, Min-Young;Park, Han-Byeol;Kim, Jae-Soo;Lee, Hyun-Jong;Lim, Sung-Chul;Lee, Yun-Kyu
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.55-67
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    • 2021
  • Objectives This review aimed to investigate studies of Chuna manual therapy (CMT) for low back pain and the evidence of their effects in order to suggest a better research method in the future. Methods We investigated studies on CMT for low back pain by searching Korean web databases from 2020 to 2021. As a result, 72 research papers were analyzed according to their published year, the titles of journals, the types of studies, the techniques of Chuna, and the instruments used for assessment. Results The results were as follows: 1. There were three papers published initially in 2000. this number showed a steady increase, and a total of 72 papers were published that year. 2. Studies on CMT were mainly published in the Journal of Korea Chuna Manual Medicine for Spine and Nerves. 3. When categorized according to the methods of studies, a simple case report was used more often than the sum of randomized controlled trials (RCTs) and non-RCTs. 4. The most frequently adopted technique of Chuna in the examined studies was the COX flexion and distraction technique. 5. The Visual Analog Scale and Oswestry Disability Index were used as primary means of assessment. Conclusions Based on the analysis, it was observed that this review provided limited evidence of CMT use in patients with LBP. Therefore, further investigation using well-designed RCTs is required to obtain higher evidence.

Adverse Event Study on Ojeok-san Extract Powders RCT in Low Back Pain Patients (요통환자 대상 오적산 엑스산 투여 임상시험 이상반응 연구)

  • Yoon, Eun-Hye;Jang, Min-Gee;Hwang, Ji-Hoo;Lee, Seung-Hoon;Jeong, Won-Je;Lee, Jae-Dong;Lee, Seung-Deok;Kim, Kyung-Ho;Kim, Kap-Sung;Kim, Eun-Jung
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.195-202
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    • 2010
  • Objectives : This study was performed to report adverse events in Ojeok-san extract powders RCT. Methods : 180 patients with LBP were randomized into groups for a double blind, placebo-controlled clinical study. They received Ojeok-san simple Extract, Ojeok-san complex Extract or placebo in powders, orally dissolved 3times a day for 4weeks. During 4weeks, we researched the symptoms and duration of adverse events and Digest ability, Milk hypersensitivity, Starch hypersensitivity, Caramel hypersensitivity, West-med hypersensitivity, Herb-med hypersensitivity in patients who had adverse events. Results : 52patients(28.9%) had adverse events and of them 44patients(28.9%) had lost adverse events naturally. But 5patients(2.8%) were withdrawn from the research because of the adverse events. Most of the symptoms of adverse event was Gastrointestinal symptom(88.3%) and adverse events frequency was not different from Ojeok-san simple Extract, Ojeok-san complex Extract and placebo. Conclusions : Ojeok-san extract powders had adverse events no different from the placebo, which shows that it is a safe drug.

Analysis of Spinal Stability Affected by Working Height, Safety Handrail and Work Experience in Using Movable Scaffold (이동식 틀비계 사용 작업 시 작업대 높이, 안전난간 유무, 숙련도에 따른 척추 안정성 분석)

  • Kim, Jung-Yong;Min, Seung-Nam;Sung, Si-Hoon
    • Journal of the Ergonomics Society of Korea
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    • v.29 no.3
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    • pp.347-356
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    • 2010
  • The purpose of this study is to analyze the spine stability by comparing muscle activation in various scaffold working conditions. The independent working conditions were designed by two levels of working height, existence and absence of safety handrail, and the two levels of expertise. The corresponding activities of the agonist and antagonist muscles of spine were simultaneously recorded by using EMG. As results, novice worker showed increased muscle activity while doing the task on the 2nd floor, absence of handrail. And expert showed the increase of co-contraction while working on the 2nd floor without handrail. Such co-contraction was found to increase the spine stability when the working condition become risky. On the other hand, the co-contraction was prolonged, the spine muscle fatique and disc pressure could be increased, which would increase the risk of musculo-skeletal disorder. The results of co-contraction in this study indicates that the motor control system responds to maintain the stability of the spine particularly when workers cognitively recognize the danger of falling or imbalance. This study also quantitatively accounted for the biomechanical cause of LBP among workers who has to prevent themselves from falling. Therefore, if can be said that safe environment preventing falling can also prevent workers from MSDs as well. Such knowledge can be applied to design ergonomic workplace environment as well as movable scaffold.

Lumbar Spine Kinematics during Anterior and Posterior Pelvic Tilting in Supine and Prone Positions

  • Park, So-Hyun;Yuk, Goon-Chang;Ahn, Sang-Ho;Lee, Dong-Gyu;Choi, Jin-Ho;Oh, Hyun-Ju;Park, Kwan-Yong
    • The Journal of Korean Physical Therapy
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    • v.23 no.6
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    • pp.9-14
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    • 2011
  • Purpose: The pelvic tilting exercise is a well recognized rehabilitation maneuver. However, little information is available on the changes of lumbar segmental motion during pelvic tilting. This study was conducted to measure the kinematics of the pelvic tilting exercise on the supine and prone positions via fluoroscopy. Methods: A total of 10 female subjects were enrolled. During anterior, neutral, and posterior pelvic tilting, radiographs were taken in each exercise via fluoroscopy (ARCADIS Orbic, Siemens, USA). Images were sent to the picture archiving communication system (PACS), and the digitized images were analyzed using LabVIEW software (National Instruments, USA). Lumbosacral lordosis and the intervertebral body angle, intervertebral disc angle, and intervertebral displacement were analyzed. Results: The results of lumbar kinematic analysis during three tilting postures in the supine and prone positions demonstrated that lumbosacral lordosis and the intervertebral body angle and intervertebral disc angle were significantly higher when the pelvis was tilted anteriorly (p>0.05). However, there was no significant difference between anterior and neutral tilting in the intervertebral disc angle at the L3/4 level in the prone position (p>0.05), and there was no significant difference among tilting positions in intervertebral body displacement in the prone position (p>0.05). Conclusion: This study provides scientific evidence about the pelvic tilting exercise in lumbosacral segmental motion. Depending on the pelvic tilting exercise, kinematic changes were demonstrated in both positions, especially in the supine position. It is suggested that the supine position is effective for mobility, but it should be used carefully for the LBP (Low back pain) patient with hypermobility.

Comparison of Abdominal Muscle Activity during Exercises Using a Sling and Swiss-ball

  • Kim, Byung-Kon;Lee, Myoung-Hee;Kim, Gi-Chul
    • The Journal of Korean Physical Therapy
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    • v.25 no.3
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    • pp.149-154
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    • 2013
  • Purpose: Spinal instability due to weakness of abdominal muscles is one of the major causes that induces low back pain (LBP). The purpose of this study was to investigate any differences in abdominal muscle activity during curl up, roll out, and jack knife exercises using a swiss-ball or sling. Methods: Twenty healthy subjects were randomly assigned into either a swiss-ball exercise group (SBEG) or a sling exercise group (SEG). Subjects performed curl up, roll out and jack knife exercises using the swiss ball or sling. Activity of abdominal muscles (rectus abdominis and external oblique muscle) was assessed using surface EMG and normalized maximal voluntary isometric contraction (MVIC). The significance of differences between the sling exercise group and the swiss-ball exercise group was evaluated by the independent t-test. Results: These Results indicated that activities of rectus abdominis on right and left of the SEG during the curl up exercise were significantly greater than the SBEG. During the roll out exercise, activity of the abdominal muscle was not significantly different between the SEG and SBEG. In addition, during the jack knife exercise, activities of the right rectus abdominis and left external oblique muscle in the SEG were significantly greater than the SBEG. Conclusion: In conclusion, activity of the abdominal muscles was maximized when curl up and jack knife exercise were performed using the sling rather than the swiss-ball. Therefore, if increased activation of the abdominal muscle is the goal of an exercise program, curl up and jack knife exercises may be useful.

Strategical Postures for Relieving EMG Amplitude Discrepancy on Bilateral Low Back Muscles and Total Low Back Muscle Fatigue while Lifting Asymmetric Load Dynamically (비대칭무게중심 물체의 동적 들기 작업시 좌.우 허리 근육의 EMG 진폭차이와 피로를 줄이기 위한 자세 연구)

  • Kim, Sun-Uk;Han, Seung-Jo
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.35 no.3
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    • pp.103-109
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    • 2012
  • The purpose of this paper is to suggest the strategical lifting postures able to alleviate imbalanced EMG amplitude leading to an increase in low back muscle fatigue while lifting asymmetric load dynamically. Eleven male subjects are required to lift symmetrically an external load with 15.8kg and load center of gravity (LCG) deviated 10cm to the right from the floor to the waist height at the speed of about 25cm/sec. The EMG amplitudes on bilateral low back muscles (Longissimus, Iliocostalis, and Multifidus) are recorded during 2sec and analyzed. Independent variables are trunk postures (No bending vs. Bending to the LCG) and feet placements (Parallel vs. Right foot in front of the other vs. Right foot behind the other). Dependent variables are EMG amplitude average on six muscles and the EMG amplitude difference between right and left muscle group. Results indicate the phenomenon showing an amplitude increase in the left muscle group is equal to an decrease in the right one is observed in dynamic as well as static lifts, bending the trunk to the LCG increases amplitude discrepancy more than no trunk bending, and the amplitude discrepancy in one foot ipsilateral to LCG in front of the other foot is lowest among other foot postures. As bilateral EMG amplitude discrepancy increases total low back muscle fatigue, the strategical combination of no trunk bending and one foot close to LCG in front of the other is recommended for preventing elevated incidence of low back pain (LBP).

The effect of MedX exercise program on lumbar extensor strength in the elderly with chronic LBP (메덱스 척추강화운동 프로그램이 만성 요통 노인 환자들의 요부 신전 근력에 미치는 영향)

  • Cho, Hyun-Woo;Park, Sung-Kwang;Choi, Eun-Young;Kim, Myung-Joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.2
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    • pp.33-43
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    • 2004
  • The purpose of this study was to compare the lumbar extensor strength between before exercise and after 8 weeks exercise in the elderly. To evaluate lumbar extensor strength of total 18 patients (above 59 age) with low back pain or have experienced surgical operation. Lumbar extensor strength was measured in 8 male patients and 10 female patients (9 op group and 9 non-op group) by Medx lumbar extension machine. The data were analyzed with paired t-test compared to muscle strength, with repeated measured ANOVA compared to amount increase of muscle strength, using SPSS ver. 10.0 program. The results of this study were as follows: 1. There were significantly increased total lumbar extension strength was appear $6918.7{\pm}2802.77$ft-lbs in before exercise, $10432.83{\pm}2802.773397.1$ft-lbs in after 8 weeks exercise (p<. 05). 2. There were significantly increased total lumbar extension strength was increased to compared before exercise with after 8 weeks exercise in sex (p<. 05), op/non-op group (p<. 05).

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The Effects of Hip Joint Movement on the Lumbo-pelvic Muscle Activities and Pelvic Rotation During Four-point Kneeling Arm and Leg Lift Exercise in Healthy Subjects

  • Nam-goo Kang;Won-jeong Jeong;Min-ju Ko;Jae-seop ,Oh
    • Physical Therapy Korea
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    • v.30 no.2
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    • pp.144-151
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    • 2023
  • Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

Correlation Analysis Between Lumbar Scoliosis of X-ray and HIVD of L-spine MRI in LBP Patients who Visit Korean Medicine Hospital (한방병원에 요통으로 내원한 환자에서 X-ray상 요추측만과 MRI상 HIVD와의 연관성 분석)

  • Kim, Kil-Hwan;Choi, Young-Jun;Kwon, Ok-Jun;Joo, Young-Kuk;Song, Seung-Bae;Song, Gwang-Chan;Seo, Ji-Yeon;Choo, Won-Jung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.41-51
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    • 2016
  • Objectives : This study is planned to classify Correlation between Cobbs Angle of Lumbar scoliosis and prevalence of Lumbar Intervertebral Disc. Methods : We Measured the lumbar scoliosis angle of the 114men and 91 women patients with lumbar pain in Bucheon Jaseng Korean Medicine Hospital. We use Cobb's angle method for measuring the lumbar scoliosis. And We use Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results : 1.There was no statistical relation between the Cobbs angle and gender(P>0.05) 2.There was no statistical relation between the Cobbs angle and age(P>0.05) 3.There was significant relation between the direction of lumbar scoliosis and the direction of disc herniation(P<0.05) 4.There was no statistical relation between on the Cobbs angle and disc herniation. The more severe of lumbar scoliosis has not tendency of disc herniation. 5.There was no statistical relation between lumbar scoliosis Cobbs Angle on HIVD of L-spine patient and direction of disc herniation on horizontal plane. Conclusions : The direction of disc herniation has tendency of the opposite direction of lumbar scoliosis. When disc herniation, opposite side bending broad intervertebral foramen and reduce pressure.

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The Study on Correlation between the Degree of Herniated Intervertebral Lumbar Disc at L4~5 Level and Improvement of Low Back Pain Treated by Korean Medicine Therapy (제 4~5번 요추 추간판 탈출 정도와 요통의 한의학적 치료 효과의 상관성 연구)

  • Yoo, Hyung-jin;Lee, Hyun-ho;Jeong, Seong-hyun;Jo, Kyeong-sang;Lee, Gie-on;Lee, Dong-hyun;Kim, Sang-min
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.2
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    • pp.105-121
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    • 2016
  • Objectives The purpose of this study was to compare the effects between the degree of herniated intervertebral lumbar disc (HIVD) at L4-5 level and improvement of low back pain treated by Korean Medicine therapy. Methods 567 patients who received inpatient treatment from May 2014 to December 2015 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 6 groups by the degree of HIVD at L4-5 level confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, Normal stage on Intervertebral Lumbar Disc at L4-5 level group's Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) improvement was $1.30{\pm}1.62$, $4.52{\pm}11.82$ and $0.04{\pm}0.11$ respectively. Bulging group's improvement was $3.25{\pm}2.81$, $8.28{\pm}13.02$ and $0.09{\pm}0.17$ respectively. Spinal canal occupying ratio (SOR) less than 20 group's improvement was $2.15{\pm}1.92$, $11.79{\pm}17.81$ and $0.13{\pm}0.23$ respectively. SOR 20 to less than 40 stage group's improvement was $2.13{\pm}1.92$. $10.79{\pm}15.93$ and $0.10{\pm}0.26$ respectively. SOR 40 to less than 60 group's improvement was $2.16{\pm}2.24$, $9.80{\pm}16.62$ and $0.15{\pm}0.25$ respectively. Surgery group's improvement was $2.47{\pm}2.21$, $11.64{\pm}18.53$ and $0.15{\pm}0.27$ respectively (p<0.03). But there was no statistically significance between 6 group's improvement after treatment (p>0.05). Conclusions After inpatient treatment by Korean Medicine therapy, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically correlation between the degree of HIVD at L4-5 level and improvement of low back pain. So We think that future research of higher quality and correct statistics shall be necessary.