• 제목/요약/키워드: chronic back pain

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Comparisons for the Abnormality of Breathing Pattern, Kinesiophobia and Flexion Relaxation Phenomenon in Patients with Chronic Low Back Pain and Healthy Person during Flexion and Extension of the Trunk

  • Yoon, Junggyu
    • 국제물리치료학회지
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    • 제10권2호
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    • pp.1750-1755
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    • 2019
  • Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

만성 허리통증 환자의 관성 센서 기반 허리 안정화 훈련이 몸통 근육 활성도와 두께에 미치는 영향 (Effect of IMU Sensor Based Trunk Stabilization Training on Muscle Activity and Thickness with Non-specific Chronic Low Back Pain)

  • 김상희;이현주;태기식
    • 대한의용생체공학회:의공학회지
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    • 제43권3호
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    • pp.177-184
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    • 2022
  • The purpose of this study was to present the IMU sensor based trunk stabilization exercise and to evaluate the changes in the muscle activity and thickness with non-specific low back pain patients (N=30). They were classified into two groups; lumbar stabilization exercise using IMU sensor (ILS), (n1=20) and general lumbar stabilization exercise (GLS), (n2=10). By comparing the difference between pre and post intervention via trunk muscle activity and muscle thickness, the significant differences were identified. Muscle activity was measured on external oblique (EO), internal oblique (IO), and multifidus (MF) by using surface electromyography (sEMG). Muslce thickness was measured on external oblique, internal oblique, transverse abdominis (TrA), and multifidus (MF) by using ultrasonography. sEMG activity was recorded at right side-bridge position. Each group performed the proposed lumbar stabilization exercise for 30 minutes a day, 5 times a week for 4 weeks. Trunk muscle activity was observed with a significant increase in the IO of ILS (p<.05) and a decrease in the MF of GLS (p<.05). Trunk muscle thickness was significantly increased in left EO and both IO of GLS (p<.05), and also significant increased right EO, both IO, both TrA, and both MF of the ILS (p<.05). In the future, a convergence approach of rehabilitation and engineering is needed to select a sensor suitable for rehabilitation purposes, study the validity and reliability of data, and produce appropriate rehabilitation contents.

중력을 이용한 요부안정화 운동이 만성요통을 가진 노인환자에게 미치는 영향 (The Effects of Spinal Stabilization Exercise using Gravity on patients with Degenerative Disc Disease)

  • 김희라;김윤신
    • The Journal of Korean Physical Therapy
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    • 제20권1호
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    • pp.23-31
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    • 2008
  • Purpose: The purpose of this study was finding out the effects of spinal stabilization exercise using Centaur which is a 3D spinal stabilization sports implement on Chronic low back pain patients over 8 weeks. Methods: 30 patients with DDD were observed during the study. Their average age was 66.88years, height was 152.12cm and average weight was 58.91kg, 4 males and 26 females were involved. 8 various investigations were performed and varied values were compared with reinvestigation done after having exercised 8 weeks using 3-D CENTAUR We used VAS(visual analog scale) in order to see the variation of pain intensity, MOI(modified oswestry index) in order to see limitation of daily life. Results: VAS was lessened from 7.57 to 2.63, limitation of routine life(MOS) from 23.48 to 11.30, there were remarkable differences statistically(p<0.05). As a result of muscular investigation for static spinal stabilization by 8 variations of body deflection, muscular strength were all increased and there were signigicant differences statistically(p<0.05). Conclusion: It has turned out that pain and limitation of routine life was lessened, as a result of 8 weeks exercise using CENTAUR, and deep muscular power was increased. Thus it has turned out that 3-D spinal stabilization exercise has an effect on the strengthening spinal muscles and alleviation of their pain for old patients with DDD.

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요부 안정화운동이 만성요통환자의 다열근 단면적, 정적자세조절, 통증에 미치는 영향 (Effects of lumbar stabilization exercise on multifidus muscle cross-sectional area, static posture control and pain in patient's with chronic low back pain)

  • 김대훈
    • 융합정보논문지
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    • 제11권10호
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    • pp.223-229
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    • 2021
  • 만성요통환자를 대상으로 요추의 구조와 기능적 안정성에 미치는 영향을 알아보기 위하여 요부 안정화운동과 근력강화운동을 병행한 운동 프로그램과 요부 근력강화운동만 적용한 운동 프로그램의 다열근 단면적, 정적자세조절, 요부통증에 미치는 영향을 알아보았다. 연구방법은 만성요통환자 28명을 대상으로 각각의 운동그룹으로 나누워 주 3회씩 8주간 운동프로그램을 실시하였다. 본 연구의 자료분석은 t-test를 활용하여 그룹 운동프로그램 적용전과 적용후, 그리고 각각의 그룹간을 비교하였다. 연구결과 다열근 단면적, 정적자세조절, 요부통증 등 각각의 그룹내 운동프로그램 적용전과 적용후에 유의한 결과가 나타났으나 (p<.05), 각각의 그룹간에는 요부 안정화운동과 근력강화운동을 병행한 운동 프로그램이 더 효과적인 것으로 나타났다 (p<.05). 결론적으로 요부 안정화운동을 추가적으로 실시한 운동 프로그램이 다양한 요추의 구조와 기능을 향상시키고, 요부통증을 감소시키는 것으로 나타났다.

요부안정화 운동프로그램이 요양보호사의 만성요통에 미치는 영향 (The Effect of Lumbar Stabilization Exercise For Caregivers With Chronic Low Back Pain)

  • 이재문;이충휘;권오윤;전혜선
    • 한국전문물리치료학회지
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    • 제18권2호
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    • pp.9-17
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    • 2011
  • The objective of this research was to examine the effects of lumber stabilization exercise and a general physiotherapy program for caregivers with chronic low back pain. Sixteen people participated in this study and were randomly assigned to two groups for either lumbar stabilization exercise or for general physiotherapy, respectively. The experiment was performed for eight weeks. To examine the general as well as the medical characteristics of the participants, the following measurements were used: Visual Analogue Scale (VAS); Oswestry Disability Index (ODI); Back Performance Scale (BPS); Roland - Morris Disability Questionnaire (RMDQ); and Beck Depression Index (BDI). To compare the general and medical characteristics of the participants in the two groups, an independent t test were used. During the experiment, a paired t test was conducted to determine whether there was a significant difference in the values of VAS, ODI, BPS, RMDQ, and BDI before and after the experiment. To examine the difference in the VAS, ODI, BPS, RMDQ, and BDI values in the two groups, ANCOVA was used with pre test values as a covariate. According to the test results, in the lumbar stabilization exercise group, the VAS, ODI, BPS, RMDQ, and BDI values showed a statistically significant difference before and after the test (p<.05). In comparison, in the general physiotherapy program group, only the ODI and BPS values showed a statistically significant level of improvement. Regarding the degree of improvement, participants in the lumbar stabilization exercise group showed statistically significant progress compared to those in the general physiotherapy group. In summary, lumbar stabilization exercise is regarded as more effective than general physiotherapy for treating caregivers with chronic low back pain. In future studies, it will be useful to expand the research and to examine the long term effects of lumbar stabilization exercise on workers.

만성 요통 환자의 자가 관리 요법에 따른 통증 및 기능의 변화 (Self-management techniques and subsequent changes in pain and function in patients with chronic low back pain)

  • 최준현;김은실;윤용순;김가은;이미현;장홍영
    • 디지털융복합연구
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    • 제18권10호
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    • pp.547-555
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    • 2020
  • 재활치료를 받고 호전된 만성 요통 환자들이 집에서 수행하는 자가 관리 프로그램의 효과를 알아보고자 63명을 자가 운동 (SEG), 핫팩 및 저주파 전기 자극 (HEG) 및 온열 마사지 (TMG) 3개 그룹으로 나누었다. 통증장애 지표로 통증 수치 등급 척도 (PNRS), Oswestry 장애 지수 (ODI) 및 Roland Morris 장애 설문지 (RMDQ)를 병원 내원시, 치료 후 및 가정에서 자가 관리 6 개월 후에 평가하였고 재발 빈도 (RF)를 내원 전 6 개월 전과 자가관리 6 개월 후에 평가하였다. 각 그룹 내의 비교에서 SEG 및 TMG의 PNRS, ODI, RMDQ는 6개월 후에도 효과가 유지되었으나, HEG에서는 치료 후 개선되었던 PNRS가 6개월 후에 악화되었다. 그룹간 비교에서 SEG 및 TMG의 PNRS, ODI, RMDQ 및 RF는 6개월 후에 HEG에 비해 더 좋았다. 운동과 온열 마사지는 요통 자가 관리 방법으로 고려볼 수 있으나, 향후 더 많은 환자들과 다양한 연령, 직업들을 고려하여 추가 연구가 필요하다.

만성요통환자와 정상인의 체간 운동시 요추 신전근의 근활성도와 관절운동범위의 변화 (The Changes of Range of Motion of Lumbar Region and Muscle Activities of Lumbar Extensor During Trunk Motions Between Subjects With Low Back Pain and Healthy Subjects)

  • 김태호
    • 한국전문물리치료학회지
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    • 제13권2호
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    • pp.61-69
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    • 2006
  • The purpose of this study was to compare the electromyography (EMG) activities of the lumbar extensor muscles during motion of trunk flexion-extension and compare range of motion (ROM) with a 3-dimensional motion analysis system of the lumbar region between subjects with chronic low back pain (CLBP) and healthy subjects during the trunk flexion-extension, trunk rotation and trunk lateral flexion cycle. Thirty CLBP subjects and thirty healthy subjects were included. We measured the root mean square (RMS) value of the lumbar extensor muscles from resting, standing, lumbar flexion and return position. The RMS ratio was normalized from maximal EMG activity of the lumbar extensor muscles during trunk motion. The results of this study showed that the RMS ratio of the lumbar extensor was significantly higher in CLBP subjects than healthy subjects during all of trunk motion (p<.05). The ratio of the highest RMS value during flexion and extension was higher in CLBP subjects than in healthy subjects (p<.05). The ROM of the lumbar region was significantly lower in CLBP subjects than healthy subjects during trunk flexion-extension, trunk rotation and lateral flexion cycle. The relationship between the RMS ratio for full lumbar flexion and the ROM of lumbar flexion was not correlated significantly. CLBP subjects have both decreased ROM of the lumbar region and higher muscle activities of the lumbar extensor muscle than healthy subjects.

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요통의 예후와 수술적응증 판단 (Presumption of low hack pain and symptoms for surgical treatment)

  • 이건목
    • Journal of Acupuncture Research
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    • 제18권2호
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    • pp.237-244
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    • 2001
  • Back pain has plagued humans for many thousands of years. The treatment of back pain is divided into operative treatment and conservative treatment. It is reported that cure rate of conservative treatment is 80~90 percent. Generally, the treatment of oriental medicine is mostly conservative treatment. But, surgery should not be used as a last resort in treatment; it is just one of many treatment options for various spinal conditions. In some instance, it can be to preferred choice; in other situations, alternative therapies may be superior. Selections of the operation in HIVD 1. Acute disc herniations with a protracted significant component af back pain. 2. Chronic disc degeneration with significant back pain and degeneration limited to one or two disc levels. 3. Sugical instability created during decompression. 4. The presence of neural arch defects coincident with disc disease. 5. Symptamatic and radiographically demonstrable segmental instability. Selections of the operation in stenosis 1. If it does not slowly progress in physical therapy and other nonoperative measures, many of these patients may ultimately need surgical decompression. 2. Absolute stenosis in an impression of CT, MRI.(under 10mm) 3. In patients with established symptoms of .neurogenic claudication. 4. In patients with bad influence of neurogenic derangement.(strength, sensory) Selections of the operation in spondylolisthesis 1. Persistence or recurrence of major symptoms for at least one year despite activity modification and physical therapy. 2. Tight hamstrings, persistently abnormal gait, or postural deformities unrelieved by physical therapy. 3. Sciatic scoliosis. 4. Progressive neurologic deficit. 5. Progressive slipping beyond 25 or 50 percent, even when asymptomatic. 6. A high slip angle (40 to 50 degrees) in a growing child, since it is likely to be associated with further progression and deformity. 7. Psychologic problems attributed to shortness of trunk, abnormal gait, and postural deformities characteristic of more severe slips.

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Trends in the prescription of opioids and gabapentinoids in patients with failed back surgery syndrome in Korea: a population-based study

  • Jinyoung Oh;Jinseok Yeo
    • The Korean Journal of Pain
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    • 제37권1호
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    • pp.73-83
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    • 2024
  • Background: Failed back surgery syndrome (FBSS) is a chronic condition that is characterized by persistent back pain following one or more spinal surgeries. Pharmacological interventions, such as the use of opioids and gabapentinoids, are frequently used in the treatment of FBSS. However, prolonged and excessive use of these medications can lead to dependence and adverse effects. This study investigates trends in opioid and gabapentinoid prescriptions among patients with FBSS in Korea from 2016 to 2020. Methods: Data from the Health Insurance and Review Agency were analyzed, and claims listing FBSS were selected for the study. Prescription patterns of opioids and gabapentinoids were classified based on the number of days prescribed per year. Results: Of the 390,095 patients diagnosed with FBSS, 41.6% of the patients were prescribed gabapentinoids, and 42.0% of them were prescribed opioids, while 10.6% of the patients were classified as long-term gabapentinoid users, 11.4% as long-term opioid users, and 7.4% of the patients were found to have long-term prescriptions for both drugs. The proportion of patients who received both gabapentinoid and opioid prescriptions increased annually. The doses of opioids prescribed have also increased along with the increase in the number of patients receiving opioid prescriptions. Conclusions: The prescription rates of opioids and gabapentinoids among patients with FBSS in Korea continue to increase steadily, posing potential risks of addiction and adverse effects. Further research is needed to better understand the actual status of addiction in patients with FBSS.

고유수용성감각 운동프로그램이 편마비 환자의 균형 수행력에 미치는 효과 (The Effect of Proprioceptive Exercise Program on Balance Performance in Hemiplegic Patients)

  • 김희권
    • PNF and Movement
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    • 제11권1호
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    • pp.7-16
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    • 2013
  • Purpose : The purpose of this study is to analyze the effect of the proprioceptive exercise program on balance performance in order to the suggest hemiplegic patients the therapeutic intervention. Methods : In this study, Proprioceptive exercise program was applied to 11 hemiplegic patients for 6 weeks as follows: First of all, hemi leg flexion-extension pattern was applied in a supine position. Secondly, alternated leg flexion pattern was applied in a standing posture with one hand support on the unstable platform. Thirdly, rhythmic stabilization techniques were applied in a standing posture on the unstable platform. Results : Significant differences were observed the chronic low back pain patient for VAS, BBS. Chronic low back pain patient improved all test. The results of this study were summarized as follows: 1. After intervention, there was a statistically significant change in the dynamic balance (FSST, TUG, FRT) performance(p<.05). 2. After intervention, there was also a statistically significant change in the static balance (FICSIT-4) performance(p<.05). Conclusion : The result of the study suggests that muscle strength exercise by the intervention of proprioceptive exercise program improves the hemiplegic patients' static and dynamic balance performance.