• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.19-25
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• 2023

Objective: Patients with scoliosis complain of various symptoms such as muscle imbalance, dysfunction, back pain, abnormal posture and gait abnormality. The most basic treatment for scoliosis is to observe the progress based on conservative treatment. Therefore, in this case report, the effect of cytoskeletal manual therapy (CMT), a soft tissue mobilization technique, on pain intensity, muscle thickness, and pressure pain threshold (PPT) in a patient with scoliosis was investigated. Design: A case report Methods: A 25-year-old male diagnosed with scoliosis visited the Neuromusculoskeletal Science Laboratory with chronic back pain. In the laboratory, scoliosis was confirmed through the X-ray image used for his diagnosis, and it was confirmed again through Adam's forward bending test. Pain, pressure pain threshold and muscle thickness were measured to compare the immediate effects of CMT applied in the laboratory for 40 minutes. Treatments were visited two weeks after the first visit and outcome measures were assessed after a total of two visits. Results: After receiving CMT up to the second session, the pain intensity decreased by 4 points and the screening angle decreased by 15 degrees. Muscle thickness decreased in all but 10 mm on the dominant side of the thoracic spine. All of the PPTs increased, and the greatest increase was 3.1 lb on the dominant side of the thoracic spine. Conclusions: CMT showed positive improvement in pain during trunk flexion, spinal curvature, muscle imbalance, and pressure pain, which is considered as an ancillary treatment option for scoliosis management.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.804-813
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• 2018

Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

• PNF and Movement
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• 제18권3호
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• pp.415-424
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• 2020

Purpose: This study aimed to compare changes in abdominal muscle thickness in different standing postures with a handheld load between subjects with and without chronic low back pain (CLBP). Methods: Twenty subjects with CLBP and 20 controls participated in this study. Ultrasound imaging was used to assess the changes in the thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles. Muscle thickness in three different standing postures (standing at rest, standing with loads, standing with lifting loads) was compared with the muscle thickness at rest in the supine position and was expressed as a percentage of change in the thickness of the muscle. Results: While standing with loads, the change in IO muscle thickness in the CLBP patients increased more significantly than in the pain-free controls (p < 0.05). The standing with lifting loads posture showed a significant increase in the change in thickness of the TrA compared with the standing with loads posture (p < 0.05). In addition, the standing with lifting loads posture showed a significant decrease in the change in the thickness of the EO when compared with the standing with loads posture (p < 0.05). Conclusion: The automatic activity of the IO muscle in subjects with CLBP increased more than that of the pain-free controls in the standing with loads posture. These findings suggest that IO muscle function may be altered in those with CLBP while standing with loads. Additionally, TrA the activation level was found to be associated with increased postural demand caused by an elevated center of mass.

• Journal of Acupuncture Research
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• 제28권1호
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• pp.93-100
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• 2011

Objectives : The purpose of this study is to observe the general distribution that was medicated with Cheonga-won. Methods : The 278 patients who were medicated with Cheonga-won more than two weeks in Cheonan oriental hospital, Daejeon university from December 2007 to December 2010 were observed. The other general oriental therapys were also carried out according to individual condition. The 278 patients were analyzed according to the distribution of sex, age, the period of medication, symptoms, the change of VAS score and T-score, side effects and abnormal reactions. Results : 1. Cheonga-won was mostly used for Shin-huh, which induces lower back pain, knee pain, vertigo, dysuria, tinnitus. 2. More patients in their fifties, sixties and seventies were prescribed with the medication than those in their thirties and forties. 3. After medication with Cheonga-won, there are tendency in reduce chronic pain. 4. After medication with Cheonga-won, there are tendency in increase BMD(bone mineral density). 5. There are no side effects and abnormal reaction cases that related with Cheonga-won. Conclusions : Cheonga-won was used in Shin-huh symptoms, and may be effective in reduce chronic pain, improve Shin-huh symptoms and increase BMD.

• 디지털융복합연구
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• 제11권4호
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• pp.361-368
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• 2013

본 연구에서는 스프린터와 스케이터 패턴을 통합한 PNF 통합 패턴 운동이 만성 요통 노인 환자의 정적 균형과 동적 균형의 변화를 알아보고자 실시하였다. 본 연구는 만성 요통의 질환이 있는 노인 환자 34명을 대상으로 하였고, 34명을 무작위로 각각 PNF 통합 패턴 운동군(17명)과 스위스볼 운동군(17명)으로 나누었다. 운동전후에 정적 균형 능력 측정을 위해 GOOD BALANCE system(Metitur Oy, Palokka, Finland, 2003)을 사용하였다. 동적 균형 능력 측정을 위해 기능적 팔 뻗기 검사(functional reach test; FRT)와 일어나 걸어가기 검사(timed up and go test; TUG)를 시행하였다. 정적 균형 능력과 동적 균형 능력의 거의 대부분의 항목에서 유의한 차이를 나타내었다(p<.05). 군간 비교에서도 다수의 항목에서 스위스볼 운동군과 PNF 통합 패턴 운동군 사이에 유의한 차이를 나타내었다(p<.05). 이와 같은 연구 결과로 볼 때 PNF 통합 패턴 운동은 만성 요통 노인 환자의 균형 능력을 개선시키는데 효과적임을 알 수 있었으며, 임상에서 PNF 통합 패턴 운동을 이용할 수 있는 기초 자료를 충분히 제공하였다고 할 수 있을 것이다.

• 한국전문물리치료학회지
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• 제18권1호
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• pp.74-82
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• 2011

The purpose of this study was to compare the anaerobic threshold (AT) between subjects with and without non-specific chronic low back pain (NCLBP). The patient group included 15 women with NCLBP. The normal group included 15 women without NCLBP who were age-, height-, weight-, and activity level-matched. The subjects performed a Balke treadmill protocol which was symptom-limited progressive loading test. Their heart rate (HR), ventilatory gas and metabolic equivalents (METs) were measured using the automatic breath gas analyzing system. After the test, each subjects' ratings of perceived exertion (RPE) were evaluated. The visual analog scale (VAS) was assessed pre- and post-test. The independent t-test and Wilcoxon's signed-rank test were used for analysis of the data. Time, HR, the volume of oxygen consumption ($VO_2$), relative $VO_2$, and METs at the AT level of the patient group were significantly lower than those of the healthy group (p<.05). However, there were no significant differences in RPE, VAS, and breathing frequency at the AT level (p>.05). The findings of this study indicate that patients with NCLBP had a lower aerobic fitness than healthy subjects. Thus, implementation of rehabilitation program to increase aerobic fitness may be considered in patietns with NCLBP, and further studies are required to determine the etiological factors of decreased aerobic fitness.

• 한국전문물리치료학회지
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• 제14권2호
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• pp.21-28
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• 2007

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in erector spinae, multifidus, rectus abdominis and biceps brachii during perturbation between subjects with and without work-related chronic low back pain (LBP). Twenty-nine subjects, 14 with and 15 without LBP, participated in this study. The muscle responses were measured by surface EMG (electromyography) during perturbation in eye opened and eye closed conditions. The EMG onset times of the erector spinae, multifidus, rectus abdominis and biceps brachii were similar between groups in eye closed condition. But the onset times of the erector spinae, multifidus, rectus abdominis were significantly delayed in subjects with LBP in eye opened condition. The results provide an evidence for impaired feed-forward control of the trunk muscles in subjects with LBP. Further studies are needed to identify whether the impaired feed-forward control of the trunk muscles is the contributing factor to LBP.

• Korean Journal of Acupuncture
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• 제27권2호
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• pp.183-201
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• 2010

Objective : To explore and describe chronic low back pain (cLBP) patients' experience of acupuncture treatment Methods : Eleven patients with cLBP who agreed and completed the informed consent to take part in this qualitative study were interviewed thoroughly and tape-recorded. Transcribed data were read independently by 4 researchers and analysed thematically with ground theory. Results : All participants chose acupuncture treatment for their cLBP because either they preferred, other people recommended, or felt conventional treatment being more comfortable. Most of the participants experienced improvement during acupuncture treatment and continued treatment motivated by mere expectations. Participants also expressed the specific physical responses/sensations to the effect of acupuncture; various adverse effects during the course of acupuncture treatment. Economic burden was another concern when combined with other therapies in Korean Medicine hospitals. It is considered as a specifically important to those who give acupuncture treatment to obtain a full treatment effect. Conclusions : The emotional facts that Korean patients with cLBP receiving acupuncture treatment benefited by the treatment and considering specific sensations from doctor-patient relationship were turned out to be important to have the maximum treatment effect. Findings from this study should be considered in both acupuncture research and practice.

• 한국전문물리치료학회지
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• 제26권1호
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• pp.51-59
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• 2019

Background: Chronic low back pain (CLBP) causes morphological changes in muscles, reduces muscle strength, endurance and flexibility, negatively affects lumbar stability, and limits functional activity. Plank exercise strengthens core muscles, activates abdominal muscles, and improves intra-abdominal pressure to stabilize the trunk in patients with CLBP. Objects: We investigated the effect of plank exercise on abdominal muscle thickness and disability in patients with CLBP. Methods: We classified 33 subjects into 2 groups: An experimental (n1=17) and a control group (n2=16). Patients in the experimental group participated in plank exercise and those in the control group participated in stretching exercise. Patients in both groups attended 20-minute exercise sessions thrice a week for 4 weeks. Abdominal muscle thickness in each subject was evaluated ultrasonographically, and disabilities were assessed using the Oswestry disability index (ODI). Results: Four weeks later, abdominal muscle thickness showed a significant increase over baseline values in both groups (p<.05). Patients in the experimental group reported a more significant increase in the thickness of the external oblique muscle than that in the control group (p<.05). ODI scores in the experimental group were significantly lower after intervention than before intervention (p<.05). Conclusion: Plank exercise increases the thickness of the external oblique muscle and reduces disability secondary to mild CLBP. Therefore, plank exercise is needed to improve lumbar stability and functional activity in patients with mild CLBP.

• The Korean Journal of Pain
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• 제36권2호
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• pp.184-194
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• 2023

Background: Degenerative lumbar spondylolisthesis (DLS) is frequently associated with lumbar spinal stenosis (LSS) and conservative treatments such as epidural steroid injection do not have long-term benefits in LSS patients with DLS. This study evaluated the effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with LSS and DLS. Methods: Patients' sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. At 1, 3, and 6 months following the procedure, data on pain severity, medication usage, and physical functional status were analyzed. A generalized estimating equations model was used at the six-month follow-up. Patients were divided into those with DLS (the spondylolisthesis group) and those without DLS (the no spondylolisthesis group) to evaluate whether the effects of percutaneous epidural neuroplasty using a balloon catheter were different. Results: A total of 826 patients were included (spondylolisthesis: 433 patients, 52.4%; no spondylolisthesis: 393 patients, 47.6%). Age, body mass index, hypertension, pain location, and stenosis grading were statistically different between the two groups. The generalized estimating equations analyses with unadjusted and adjusted estimation revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P < 0.001). Any adverse events that occurred were minor and temporary. Conclusions: Percutaneous epidural neuroplasty using a balloon catheter may be an alternative treatment option for patients with chronic LSS, regardless of accompanying DLS, who have had failed conservative management.