Background: The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods: Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results: Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions: The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.
Purpose: The purpose of this study was to evaluate the impact of active vibration exercise on the neck pain, disability index, and muscle activity of patients with forward head posture. Methods: A total of 24 patients were randomly assigned to an experimental group or a control group (n=12 each). The experimental group performed active vibration exercise using a flexi-bar for 20 minutes a day, five times a week for four weeks. The study measured patient neck pain using a visual analog scale, neck pain related disability using the neck disability index, and muscle activity using electromyography. Results: The intragroup comparison showed significant differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values among patients in the experimental group. The intergroup comparison showed that differences in the visual analog scale score, neck disability index score and upper trapezius, lower trapezius and serratus anterior muscle activity values in the control group. Conclusion: This study showed that active vibration exercise was effective in improving the neck pain, disability index, and muscle activity of patients with forward head posture.
Purpose: The goals of this research are to find out factors influencing the duration of work-related disability and to present implications for policies to prevent delayed recovery. Method: The subjects of this study were 238 workers who had been proved to be industrial disaster victims for occupational low back pain between January 1 2000 and December 31 2003. Kaplan-Meier method was used to estimate the proportion of duration of disability associated with low back pain, and Cox proportional hazards analysis was used to identify factors predicting it. The model distinguished main symptom variables affecting acute(${\leq}90\;days$) and chronic phase of disability (>90 days). Result: Fifty percent of the workers had not recovered in 408 days. The results of Cox regression show that delayed duration of disability was predicted by diagnosis, pain radiation (in chronic phase), sex, the size and labor union of the workplace, scheduled rest, compensation from the company, and operation. Conclusion: Duration of disability associated with compensated low back pain is influenced not only by factors related to the company and compensation system but also by individual factors. Thus, future efforts to reduce duration of disability may need to take into account all these factors.
Objective: Carpal tunnel syndrome is one of the most common upper extremity compressive nerve disorders in modern people. Various conservative treatments such as taping, exercise, and electrotherapy have been applied to carpal tunnel syndrome and their effectiveness has been proven. This study aims to determine whether home exercise combined with taping is effective for pain and functional disability in patients with carpal tunnel syndrome. Design: Randomized controlled study Methods: 21 patients were recruited and were randomly divided into HEx+T (Home exercise+taping) group (n=10) and HEx (Home exercise) group (n=11). All participants performed Home exercise(tendon and neural gliding exercise) 5 times a week for 6 weeks. Additionally, subject in the HEx group, taping was applied over the wrist and forearm during the training period. Wrist pain was measured by VAS (Visual Analogue Scale). Functional disability was measured using a BCTSQ(The Boston Carpal Tunnel Syndrome Questionnaire). Results: Both the HEx+T group and the HEx group showed a significant improvement in wrist pain(p<0.05), and the HEx+T group showed a more significant decrease in pain than the HEx group(p<0.05). There was a significant improvement in both groups in functional disability (p<0.05), and the HEX+T group showed more improvement than the HEX group(p<0.05). Conclusions: This study suggests that home exercise combined with taping is effective for pain and functional disability in patients with carpal tunnel syndrome.
Purpose: We investigated the effects of multimodal vs. stabilization exercises on chronic low back pain. Methods: Study participants were randomly assigned to a multimodal exercise (n = 20) or a stabilization exercise group (n = 20). Participants in the multimodal exercise group performed stabilization, stretching, and endurance exercises, whereas those in the stabilization exercise group performed only stabilization exercises. Participants in both groups performed the exercises for 1 hour thrice a week for 5 weeks. The following outcomes were evaluated: pain intensity (numeric rating scale), disability (the Oswestry Disability Index [ODI] and the Roland-Morris Disability Questionnaire [RMDQ]), pain-induced fear (the Fear of Daily Activities Questionnaire [FDAQ], the Fear-Avoidance Belief Questionnaire [FABQ], and the Tampa scale for kinesiophobia-11 [TSK-11]). Outcome measures were evaluated at baseline and after intervention. Results: Significant post-intervention improvement was observed in pain intensity and the RMDQ and FDAQ scores in both groups (p < 0.01). The post-intervention ODI, FABQ, and TSK-11 scores were improved in the multimodal exercise group (p < 0.01). Additionally, significant differences were observed in pain intensity, as well as in the ODI, FDAQ, and FABQ scores in the multimodal exercise group compared with these findings in the stabilization exercise group (p < 0.01). Conclusion: The multimodal and stabilization exercise programs reduced pain intensity, disability, and pain-induced fear. Compared with stabilization exercises, multimodal exercises more effectively reduced pain intensity, disability, and pain-induced fear. This study highlights that musculoskeletal rehabilitation for people with chronic low back pain should include a multimodal exercise program.
Objectives : It was to translate three neck and spinal pain disability questionnaires - the Neck Disability Index (NDI), the Neck Pain and Disability Scale (NPDS), and the Functional Rating Index (FRI) - into Korean language, and evaluate the psychometric properties of Korean versions of questionnaires to achieve a good cross-cultural adaptation. Methods : Forty (23 males, 17 females) subjects aged from 15 to 64 years old, participated to examine test-retest reliability. One hundred and eighty (76 males, 104 females) subjects with a primary diagnosis of non-specific neck pain and 81 healthy volunteers were undertaken to examine internal consistemcy, discriminative validity and longitudinal construct validity. Versions of each questionnaire in idiomatic modern Korean were developed using a procedure proposed by Beaton et al. (2000). To assess reliability, the Intraclass Correlation Coefficient (ICC $_{(2,1)}$) was calculated. Internal consistency was evaluated by Cronbach's alpha. Discriminative validity was examined with independent-group t-tests. Responsiveness was tested by calculating the effect size and standardized response mean for each questionnaire and using Pearson' s r and the area under the receiver operating characteristic curve analysis. Results : Test-retest reliability ofthe translated versions of the three disability questionnaires was excellent (ICC $_{(2,1)$ = 0.86-0.90). High internal consistency was found in the three disability questionnaires (Cronbach's alpha ranged from ${\alpha}=0.88$ for the FRI to ${\alpha}=0.96$ for the NPDS and 0.82 for the Short Form McGill Pain Questionnaire(SFMPQ)). the VAS subscale of the SFMPQ was found to be the most responsive of the subscales (ES=1.44, SRM=1.37). The VAS was also the most responsive pain and disability index in internal responsiveness analysis, although disability indices showed marginally better responsiveness when compared with external standards. No floor or ceiling effects were observed. Conclusions : It is concluded that the questionnaires were successfully translated and exhibit acceptable measurement properties, and may suggest that they are suitable for use in clinical and research application.
Objective: Nonspecific low back pain (NS-LBP) causes pain and disability, affecting the neuromuscular system and altering gait patterns. The purpose of this study is to investigate the effect of improvement of low back pain symptoms through physical therapy on foot pressure and spatiotemporal gait parameters. Design: A pilot study. Methods: Participants received manual therapy and supervised therapeutic exercise, which consisted of 12 sessions for 6 weeks. Participants were assessed for pain intensity (a numeric pain rating scale), disability index (oswestry disability index), and spatiotemporal gait parameters before and after intervention. Wilcoxon signed rank test was used to analyze the before-and-after differences in a single group. Results: All seven NS-LBP patients completed the study without dropout. After six weeks of physical therapy, the numeric pain rating scale and oswestry disability index showed significant improvement (Z= -2.388, P=0.017). There was no significant improvement in both static and dynamic conditions in foot pressure (P>0.05). However, in the spatiotemporal gait parameters, there were significant differences in all variables except the right stance phase and left mid stance (P<0.05). Conclusions: In our pilot study, 12 sessions of physical therapy in NS-LBP patients improved gait quilty in spatiotemporal gait parameters. Similarly, it has resulted in clinically positive improvements in pain and disability.
Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) respiratory muscle strengthening exercise on the pulmonary function, back pain, and disability level of patients with chronic low back pain (CLBP). Methods: There were 24 CLBP patients randomly divided into the experimental group (n = 12) who took part in PNF respiratory muscle strengthening exercise and the control group (n = 12) who performed a mock treatment. Both groups performed their respective interventions for 15 min five times per week for four weeks. The pulmonary function was measured using a portable spirometer. The back pain of the participants was assessed using a visual analogue scale. The Oswestry disability index was conducted to measure disability level. A paired t-test was performed to compare within-group changes before and after the PNF respiratory muscle strengthening exercise. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: The within-group change in pulmonary function was significantly different in the experimental group (p < 0.05), and the levels of back pain and disability were significantly different between the groups (p < 0.05). There was also a significant between-group difference in pulmonary function, back pain, and disability level after intervention (p < 0.05). Conclusion: These results suggest that PNF respiratory muscle strengthening exercise enhances pulmonary function and reduces levels of back pain and disability in patients with CLBP.
Purpose: The purpose of this study was to determine the effect of TENS by physiotherapist versus home based TENS intervention to reduce pain and improve disability in patients with mechanical neck disorder. Methods: The subjects of the study were 30 selected patients who had been diagnosed with subacute or chronic neck disorders without neurological damage, during the period of four weeks, three times a week, and thirty minutes for one session, 15 patients received TENS by physiotherapist. 15 patients received home based TENS intervention. The primary outcome was pain intensity measured in using the Visual Analog Scale(VAS). The second outcome was Neck Disability Index to patient's disability. Results: The change in the pain perception degree were statistically significant in both group(p<0.05). TENS by physiotherapist group showed significantly improvement in disability, but, Home based TENS intervention group is not. TENS by physiotherapist group showed significantly greater improvement in pain intensity and patient's disability than the home based TENS intervention group. Conclusion: This study shows that received TENS by physiotherapist was effective in reducing pain, improving disability for mechanical neck disorder patient, physiotherapist' knowledge need to improve patient's pain and disability.
Background: The International Classification of Functioning, Disability and Health (ICF) model, created by the World Health Organization, provides a theoretical framework that can be applied in the diagnosis and treatment of various disorders. Objects: Our research purposed to ascertain the relationship between structure/function, activity, and participation domain variables of the ICF and pain, pain-associated disability, activities of daily living (ADL), and quality of life in patients with chronic low back pain (LBP). Methods: Two-hundred patients with chronic LBP (mean age: 35.5 ± 8.8 years, females, n = 40) were recruited from hospital and community settings. We evaluated the body structure/function domain variable using the Numeric Pain Rating Scale (NPRS) and Roland-Morris disability (RMD) questionnaire. To evaluate the activity domain variable, we used the Oswestry Disability Index (ODI) and Quebec Back Pain Disability Scale (QBDS). For clinical outcome measures, we used Short-form 12 (SF-12). Pearson's correlation coefficient was used to ascertain the relationships among the variables (p < 0.05). All the participants with LBP received 30 minutes of conventional physical therapy 3 days/week for 4 weeks. Results: There were significant correlations between the body structure/function domain (NPRS and RMD questionnaire), activity domain (ODI and QBDS), and participation domain variables (SF-12), rending from pre-intervention (r = -0.723 to 0.783) and postintervention (r = -0.742 to 0.757, p < 0.05). Conclusion: The identification of a significant difference between these domain variables point to important relationships between pain, disability, performance of ADL, and quality in participants with LBP.
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