• 제목/요약/키워드: Pain Beliefs

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Effect of Neuromuscular Stabilization Exercise Program Using Whole Body Vibration on Patients with Low Back Pain

  • Park, Sam-Ho;Seo, Jin-Hyuk;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • 제10권3호
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    • pp.278-288
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    • 2021
  • Objective: The purpose of this study is to investigate the effect of stabilization exercise on whole-body vibration on pain, dysfunction, psychosocial factors, balance ability, and abdominal contraction with patients with low back pain. Design: A randomized controlled trial Methods: A total of 34 patients with low back pain were assigned randomly to experimental group (n=17) and control group (n=17). Both groups underwent a neuromuscular stabilization exercise program. In addition, the experimental group implemented the neuromuscular stabilization exercise program using whole-body vibration. All interventions were applied 60 min per session, 3 times per week for total 4 weeks. Numeric Rating Scale (NRS), Korean version of Oswestry Disability Index (K-ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), balance ability, muscle thickness and contraction ratio were compared to evaluate the effect on intervention. Results: Both groups showed significant differences in NRS, balance ability, and muscle thickness in contraction, contraction ratio before and after intervention (p<0.05). In addition, the experimental group showed significant difference in the amount of change in NRS, balance ability and muscle thickness in contraction, contraction ratio values than the control group (p<0.05). Conclusions: Neuromuscular stabilization exercise program combined with whole-body vibration stimulation has been proven to be an effective and clinically useful method to decrease pain, dysfunction, increase balance ablilty, and transverse abdominis muscle thickness in contraction and contraction ratio for patients with low back pain.

회귀분석을 이용한 만성요통환자의 통증 및 기능장애수준과 심리사회학적 요인의 상관성 연구 (Regression Analysis of the Relationship Among the Level of Pain and Dysfunction and Psychosocial Factors in Patients With Chronic Back Pain)

  • 최임순;장현정;김선엽
    • 한국전문물리치료학회지
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    • 제23권1호
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    • pp.38-45
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    • 2016
  • Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

만성통증 노인의 삶의 질에 대한 심리적 영향요인에 관한 연구 (A Study of Psychological Factors on the Quality of Life in the Elderly with Chronic Pain)

  • 이수인;이은주
    • 한국산학기술학회논문지
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    • 제20권10호
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    • pp.209-217
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    • 2019
  • 본 연구는 만성통증 노인의 우울, 두려움-회피신념, 파국적사고와 삶의 질의 관계를 확인하고 우울, 두려움-회피신념, 파국적사고와 같은 심리적 요인이 만성통증 노인의 삶의 질에 어떠한 영향을 미치는지 확인하기 위한 서술적 조사연구이다. 대상자는 2019년 3월 4일부터 2019년 3월 18일까지 A시 소재의 일개 신경과통증의학과 의원을 방문한 65세 이상 만성통증 노인 147명을 대상으로 하였다. 통계처리는 SPSS/WIN 22.0 프로그램을 이용하여 t-test와 ANOVA, Pearson's correlation coefficients, 다중 회귀분석을 사용하였다. 만성통증 노인의 일반적 특성에 따른 삶의 질 차이에서 연령(F=3.464, p<.001), 배우자(t=4.545, p<.001), 건강상태(F=31.04, p<.001), 통증정도(F=14.76, p<.001)에서 유의한 차이가 나타났다. 만성통증 노인의 삶에 질 예측요인을 분석한 결과 우울(${\beta}=-.25$, p<.001) 통증정도(${\beta}=.25$, p<.001), 파국적사고(${\beta}=-.28$, p<.001), 건강상태(${\beta}=-.19$, p<.001)가 영향요인으로 나타났고 전체설명력은 49 %이다. 따라서 만성통증 노인의 삶의 질 향상을 위해서 우울, 파국적사고와 같은 부정적인 심리적 영향 요인에 대한 연구가 더욱 필요할 것으로 판단된다. 또한, 적극적인 통증조절 및 건강상태를 긍정적으로 인식할 수 있도록 체계화된 간호중재 프로그램 개발이 필요할 것으로 사료된다.

Effect of High-Intensity Complex Exercise Program Using Whole-Body Vibration and Respiratory Resistance for Low Back Pain Patients with High Obesity

  • Park, Sam-Ho;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • 제11권1호
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    • pp.78-87
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of high-intensity complex exercise program using whole-body vibration (WBV) and respiratory resistance on pain and dysfunction, psychosocial level, balance ability, and pulmonary function in low back pain (LBP) patients with high obesity. Design: A randomized controlled trial Methods: A total of 44 LBP patients withhigh obesity (body mass index, BMI≥30kg/m2) were randomly assigned to an experimental group (n=22) and a control group (n=22). Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the high-intensity complex exercise program combined with WBV and respiratory resistance. In order to compare the effects depending on the intervention methods, numeric pain rating scale (NRPS), Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire (FABQ), balance ability, and pulmonary function were used for measurement. Results: Both groups showed significant differences in NRPS, RMDQ, FABQ, balance ability before and after intervention (p<0.05). In addition, the experimental groupshowed significant difference in the amount of change in RMDQ, balance ability and pulmonary function values than the control group (p<0.05). Conclusions: High-intensity complex exercise program using WBV and respiratory resistance has been proven to be an effective and clinically useful method to decrease dysfunction, increase balance ablilty, and pulmonary function for LBP patients with high obesity.

요추부 불안정성을 가진 요통환자의 요추부 안정화 운동과 둔근 강화 운동이 통증, 기능장애 및 심리사회수준에 미치는 효과 비교연구 (Comparison of Lumbar Stabilization Exercises and Gluteal Strengthening Exercises on Pain, Disability and Psychosocial Factors in Low Back Pain Patients with Lumbar Instability)

  • 전지혜;김선엽
    • 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.

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한국 엘리트 양궁선수들의 성별과 부상, 통증 경험에 따른 상지의 관절위치 감각과 힘감각, 경기력 수준의 차이 (Differences In Joint Position Sense, Force Sense, and Performance Level of the Upper Extremities According to the Sex, Injury and Pain Experiences of Korean Elite Archers)

  • 김문교;김선엽
    • 대한정형도수물리치료학회지
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    • 제27권3호
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    • pp.1-15
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    • 2021
  • Objective: The purpose of this study was to examine the differences in joint position sense (JPS), force sense (FS), and performance level of the upper extremities according to the injury and pain experiences of Korean elite archers. Methods: A total of 15 subjects were briefed about the purpose of this study and agreed to participate voluntarily. JPS was evaluated using the laser-point attached to the wrist while aiming at the target. The difference when relocating while aiming was used as JPS factor. FS was evaluated using load cell through reproduces same muscle strength. Fear-Avoidance Beliefs Questionnaire (FABQ) was used to evaluate psychosocial factors, Kerlan-Jobe Orthopedic Clinic overhead athlete scores (KJOC) and numerical rating scale (NRS) was used to evaluate pain. and performance was evaluated by tournament match score. Results: There is a strong correlation between the current pain and KJOC. Moreover, moderate correlation between KJOC and FABQ also current pain and both upper trapezius and lower trapezius in elite archers. The mean (SD) between groups based on current pain display relatively large margin in force sense than without pain group. The result presents that there is a significant difference in performance and pain. There is a significant difference in the force sense of the upper and lower trapezius and pain. Conclusions: Result present there is a significant difference in functional level in the average comparison between groups according to the presence of absence of current pain. There is a significant difference in the force sense of the upper trapezius as well as lower trapezius and without pain group present a relatively low joint position sense error compared to the groups.

PNF 패턴 운동이 만성 요통 환자의 통증과 기능 장애 및 공포 회피 반응에 미치는 효과 (Effects of PNF Patterns Exercise on Pain, Functional Disability and Fear Avoidance Belief in Chronic Low Back Pain Patients)

  • 김경;김은경;이동규
    • The Journal of Korean Physical Therapy
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    • 제26권2호
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    • pp.110-116
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    • 2014
  • Purpose: The purpose of study was to investigate the effects of combination patterns exercise of Proprioceptive Neuromuscular Facilitation (PNF) on unstable surfaces on pain, functional disability, and fear avoidance belief in patients with chronic low back pain. Methods: Twenty four patients were assigned to either the experimental group (n=12) or the control group (n=12). Patients in the experimental group performed combination patterns exercise of PNF on unstable surfaces. Patients in the control group performed combination patterns exercise of PNF on stable surfaces. Both exercises were performed for five days per week, for a period of six weeks. Pain was measured by the Visual Analogue Scale (VAS) and University of Alabama at Birmingham (UAB). Functional disability was measured using the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ). Fear avoidance belief was measured using the Fear Avoidance Beliefs Questionnaire (FABQ). A paired t-test was used for determination of differences before and after treatment, and an independent t-test was used for determination of differences between treatment groups. Results: In within group comparison, the experimental group showed statistically significant difference for all variables (p<0.05). In comparison between two groups, the experimental group showed relatively greater significant difference for all variables (p<0.05). Conclusion: Based on such results, it can be said that combination patterns exercise of PNF on unstable surfaces has an effect on pain, functional disability, and fear avoidance belief in patients with chronic low back pain.

수술 중 예상치 못한 과출혈이 발생한 여호와의 증인 환자의 마취 1 예 (Anesthesia for a Jehovah's Witness Patient Experiencing Unexpected Perioperative Hemorrhage - A Case Report -)

  • 임승기;지대림
    • Journal of Yeungnam Medical Science
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    • 제23권1호
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    • pp.96-102
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    • 2006
  • Jehovah's Witnesses refuse a transfusion of blood or blood products because of religious beliefs; this refusal at times presents a dilemma for the treating physician. We report a case of a 25-year-old Jehovah's Witness patient who underwent a reoperation for a previous proximal humerus shaft fracture and experienced unexpected massive hemorrhage intraoperatively and postoperatively. The postoperative lowest hemoglobin level was 2.9 g/dl. The patient recovered from the severe anemia without any clinical sequala. We review the legal, ethical and religious issues and suggest the best possible medical care that Jehovah's Witness patient would permit.

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허리 불안정성이 있는 만성 허리통증 환자의 중간볼기근 약화 유무에 따른 허리 안정화 운동의 효과 비교 (Comparison of the Effects of Lumbar Stabilization Exercise According to the Presence or Absence of Gluteus Medius Muscle Weakness in Chronic Lower Back Pain Patients with Lumbar Instability)

  • 김대호;김선엽
    • 대한물리의학회지
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    • 제19권2호
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    • pp.29-45
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    • 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.

Effects of Spinal Mobilization with Leg Movement and Neural Mobilization on Pain, Mobility, and Psychosocial Functioning of Patients with Lumbar Disc Herniation: A Randomized Controlled Study

  • Seung Jin Kim;Ho Young Jang;Suk-Min Lee
    • Physical Therapy Rehabilitation Science
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    • 제12권2호
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    • pp.92-104
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    • 2023
  • Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.