• Journal of Korean Physical Therapy Science
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• v.26 no.3
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• pp.23-36
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• 2019

Background: The purpose of this study was to investigate the effect of Plank exercise on unstable support surfaces on flexibility, abdominal muscle thickness and pain in patients with chronic back pain. Design: Randomized controlled trial. Methods: This study was performed on 16 patients with chronic back pain of ◯◯ military unit. Sixteen subjects were randomly assigned into two groups, an upper extremity trainer group (group I, n=8) and a lower extremity trainer group (group II, n=8). The subjects in group I carried out Flank exercise applying the stability trainer to their upper extremities and ones in group II carried out the same exercise applying the stability trainer to their lower extremities for 4 weeks. In order to ascertain the difference between two groups, flexibility, abdominal muscle thickness and pain were measured before and after the exercise. The flexibility was measured by sit and reach test, the thickness of the abdominal muscle was measured by using ultrasonic imaging equipment, and the pain was measured by the visual analogue scale. A paired t-test was utilized to compare changes in pain, abdominal muscle thickness and flexibility before and after flank exercise on unstable support surfaces. Analysis of Covariance (ANCOVA) was performed for ascertaining the significant differences between groups. The significance level was set by α=.05. Results: 1) The flexibilities of two groups were increased after the exercise (p<0.05). 2) In both groups, the thicknesses of rectus abdominis, external oblique abdominis, internal oblique abdominis, and transverse abdominis were all increased after the exercise (p<0.05). 3) The pains in both groups were decreased after the exercise (p<0.05). 4) In the comparisons of two groups, there were no differences in the flexibility, thickness of external oblique abdominis, internal oblique abdominis and transverse abdominis and pain (p>0.05). Whereas only thickness of Rectus abdominis was larger in the group I than in the group II (p<0.05). Conclusion: Plank exercise on the unstable support surface for 4 weeks resulted in increased flexibility, abdominal muscle thickness and pain reduction in patients with chronic back pain. Therefore, it is considered that performing flank exercise on the unstable supporting surface is suitable for the reduction of the pain in patients with chronic back pain. However, in this study, it is considered that continuous and diverse studies are needed because there was not a large difference between the groups when the upper or lower limbs are provided unstable support surfaces.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.1
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• pp.101-108
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• 2014

Purpose : The purpose of this study was to investigate the effect of horse riding exercise for chronic low back pain patients. Method : 30 subjects in H-equestrian and N-equestrian, K & B hospital were randomly divided two group, instability support surface exercise group and horse-riding exercise group. Each group carried out 40 minutes exercise three times a week for 8 weeks. VAS were measured for sway path of COP movement during standing were measured for evaluation of static balance ability in balance performance monitor(BPM). Result : The results were as follows, scales of VAS between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The static balance scales of sway path between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horse-riding exercise was effective on VAS and static balance abiility of chronic low back pain patient so that these exercise can be new altematives for increase of stability ability in chronic low back pain patients.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.1
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• pp.661-667
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• 2014

This study is a cross-sectional study for conscripts with chronic low back pain, where it is designed to investigate general characteristics that conscripts with chronic low back pain carry, and it is also aimed to analyze the correlation as well as discrepancy within pain, depression and body mass index depending on their ranks. In this study, 90 Korean conscripts with chronic low back pain participated. And in order to analyze general characteristics as well as pain, depression and body mass index of the subjects, this study adopted a survey questionnaire upon general characteristics, and it also employed Visual Analogue Scacle(VAS) and Center for Epidemiological Studies Depression(CES-D) Scale which have proven their credibility, where BMI values for the subjects were calculated based on 'Asian Pacific standard' Body Mass Index(BMI). From the general characteristics exhibited by the subjects through this study, average age and average height of the subjects were $20.78{\pm}1.41$ and $175.97{\pm}5.34$ respectively; and corporals displayed the highest ratio of 42% with the chronic low back pain while 40% of the total subjects experienced the duration of the illness less than 6 to 9 months. Moreover, 57.8% of all subjects were reportedly suffering moderate pain, and 48% exhibited depression while 49% carried BMI value between 18.5 and $22.9kg/m^2$(normal range). Based on the analysis of correlation among pain, depression, discrepancy of BMI depending on the ranks and each independent variable, it appears that there is no significant difference amongst the ranks, and there is no correlation between independent variables; however, it was obvious that all groups divided by the ranks had a moderate pain(45-74mm), depression(${\geq}16$) and BMI value in normal range(18.5-22.9).

• Physical Therapy Korea
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• v.10 no.3
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• pp.109-126
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• 2003

This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.10
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• pp.4564-4571
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• 2012

This study performed a virtual reality exercise program for self-back pain control of industrial workers with chronic back pain and analysed their physical function and health-related quality of life relating to industrial chronic back pain. The subjects of the study were thirty chronic back pain patients working for K company and were divided into Nintendo Wii Sports Group made of 15 subjects and Physical Therapy Group made of 15. As variables for physical functions, back strength, flexibility, balance and pain were measured and for the health-related quality of life, SF-36 of each group was measured before and after the exercise program. To compare differences before and after the program, a paired t-test was used and to compare differences between both groups, an independent samples t-test was used. As a result of the test, it was discovered that balance and pain of the both groups were improved statistically significantly. Physical functions of the Nintendo Wii Sports Group were improved statistically significantly in comparison with those of the Physical Therapy Group. The health-related quality of life was improved statistically significantly only for the Nintendo Wii Sports Group. In conclusion, it is suggested that as the virtual reality exercise program had a positive influence on chronic back pain of industrial workers, it should be considered as a home exercise program for back pain control.

• The Korean Journal of Pain
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• v.31 no.1
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• pp.27-38
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• 2018

Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.31-42
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• 2023

Background: This study aimed to investigate the effects of combining the lumbar stabilization exercise with the gluteal muscle strength exercise on pain, the dysfunction index, and postnatal depression in women experiencing chronic low back pain after a cesarean section. Methods: The study used a randomized design with two groups: one group (n=15) performed the lumbar stabilization exercise along with the gluteal muscle strength exercise, while the other group (n=15) only did the lumbar stabilization exercise. The intervention consisted of 30 minute exercise sessions, twice a week, for 6 weeks. The pain was assessed using the visual analog scale (VAS), the dysfunction index with the Oswestry disability index (ODI), and postnatal depression using the edinburgh postnatal depression scale-Korean version (EPDS-K). Results: Both groups showed significant improvements in their VAS, ODI, and EPDS-K scores within their respective groups (p<.05). Additionally, the between-group analysis revealed significant differences in post-test results (p<.05). Conclusion: The combination of the lumbar stabilization exercise and the gluteal muscle strength exercise proved to be more effective in reducing pain, improving the dysfunction index, and alleviating postnatal depression in women with chronic low back pain after a cesarean section. Therefore, incorporating these exercises could be beneficial as an intervention program for women experiencing chronic low back pain after a cesarean section.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.1
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• pp.18-26
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• 2002

Objectives : The object of this study was to investigate the relationship between coping strategies and perceived stress or pain discomfort in patients with chronic low back pain. 80 patients with chronic low back pain and 100 normal controls participated in this study. Methods: Global assessment of recent stress (GARS) scale and Stress Response Inventory (SRI) were used to measure perception for stressors and stress responses. Coping scale and pain discomfort scale were used to measure coping strategies and pain perception. Results : Scores of perceived stress related to work or job, interpersonal relationship, changes in relationship, sickness or illness and the total scores on the GARS scale were significantly higher in those with chronic low back pain than normal controls. Scores of the SRI fatigue subscale scored significantly higher in those with chronic low back pain than normal controls. No significant difference was found on total scores of the pain discomfort scale between those with chronic low back pain and normal controls. The patients with chronic low back pain scored significantly higher on planful problem solving and positive reappraisal than normal controls. In the patient group, pain perception had significant positive correlations with total scores of the SRI and scores of stress perception related to illness or injury. The extent of escape-avoidance showed significant negative correlations with age, whereas the extent of distancing or escape-avoidance had significant negative correlations with the level of education. Significant difference was also found in accepting responsibilities between male subjects and females. However, no significant correlations were found between coping strategies and perceived stressors, stress responses or pain perception. Conclusion : The results suggest that patients with chronic low back pain were more likely to use more active coping strategies than normal controls, though the former had more perception for stressors than the latter. It was also found that coping strategies used by the patients were associated with sociodemographic factors, but that they were not associated with perceived stressors, stress responses or pain perception.

• PNF and Movement
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• v.19 no.1
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• pp.57-65
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• 2021

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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.31-38
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• 2019

Background: The purpose of this study was to investigate the effects of Progressive muscle relaxation training on pain, Korean version of Oswestry disability index (ODI) and psychological level in chronic low back pain patients with somatization. Methods: A total of 30 subjects were treated with the experimental group (n=15) and conservative physical therapy (n=15). The experimental group was trained with progressive muscle relaxation (PMR), and the control group was treated with conservative physical therapy. Physical factor treatment was applied for 60 minutes by hot pack, electrotherapy and ultrasound. Both groups performed three times a week for six weeks. VAS, ODI, psychological level measurements were taken before and after intervention. Results: There was a significant difference in VAS (p<.05) and ODI (p<.01) between experimental and control group. At the psychological level, there were significant differences in somatization (p<0.01) and depression scales (p<.01), but not in anxiety. Conclusion: As a result of this study, the degree of pain was decreased, the level of back pain dysfunction was improved, and the somatization scale and depression scale were decreased by gradual muscle relaxation therapy.