• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.33-42
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• 2017

PURPOSE: This study aims to identify the immediate effects of thoracic mobilization according to segment on disabling low-back pain and the range of motion in patients with chronic low-back pain. METHODS: The participants were divided randomly into two groups: a group (N=12) with pain and disability between the 5th and 9th thoracic vertebrae (T5-T9) and a group (N=12) with pain and disability between the 10th and 12th thoracic vertebrae (T10-T12). The same experiment was conducted in both groups: 10 minutes of thoracic mobilization and 10 minutes of functional massage. The visual analogue scale (VAS) and range of motion measurements were applied to the participants in both groups. All participants were measured again immediately after the program was completed. RESULTS: In both groups, the VAS and range of motion measurements showed statistically significant improvement after the experiment (p<.05). No statistically significant difference was revealed between the two groups (p>.05). CONCLUSION: The results of this study confirmed positive and immediate effects of thoracic mobilization of patients with chronic low-back pain. But, no significant difference in the thoracic mobilization by segment between the two groups. Based on these results, thoracic mobilization could help to improve pain control and functional activity in patients with chronic low-back pain.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.139-151
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• 2021

PURPOSE: This study examined the effects of wall-squat with short-foot exercise on pain, dysfunction, and pelvic alignment in chronic low back pain patients. METHODS: Thirty outpatients diagnosed with chronic low back pain and pronated foot were enrolled in this study. The patients were divided randomly into a wall-squat with short-foot exercise group (WS; n = 15) and a normal wall-squat exercise group (NW; n = 15). These groups performed their respective exercises 15 times, for three sets, three times a week over six weeks. The visual analogue scale (VAS) was used to measure the subjects' pain, and the Roland-Morris disability questionnaire (RMDQ) was used to measure the subjects' dysfunction. A navicular drop test (NDT) was used to measure the subjects' arch height. To assess the patients' pelvic alignment, their lordosis, sacral tilt, lumbar width, sacral width, ilium length, and ilium width were measured by X-ray imaging. RESULTS: Both the WS and NW groups exhibited significant decreases in their VAS and RMDQ scores after exercise (p < .05). The WS group exhibited significant increases in their arch height (p < .05). Significant differences in the VAS, sacral tilt, sacral width, and ilium length were observed between the WS and NW groups (p < .05). CONCLUSION: These results suggest that wall-squat exercise is effective in decreasing the level of pain and dysfunction in chronic low back pain patients. In addition, the wall-squat with short-foot exercise is considered more effective in improving the pelvic alignment than without short-foot exercise. This can be an effective method for the non-pharmacological and non-surgical treatment of chronic low back pain

• Journal of the Korean Society of Physical Medicine
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• v.4 no.1
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• pp.9-14
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• 2009

Purpose : The purpose of this study is change of lumbar multifidus muslce recorded simultaneously by ultrasound imaging during upper extremity functional movement in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. Multifidus size were measured from L4 vertebral segement. The ultrasound imaging apparatus(Sonoace 6000, Medison, Korea) was epuipped with a 5-MHz convex array transducer. The upper extremity lifting movement used to activate the multifidus was then measured. Results : Results of the analysis showed that at the L4 vertebral leves, healthy asymptomatic subjects had significantly larger multifidus muscle compared with chronic LBP subjects. Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Especially multifidus contraction in L4 vertebral segement. So chronic LBP patients necessary multifidus muscle release treatment.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.63-67
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• 2014

Background: Epiduroscopic laser neural decompression (ELND) has been performed as a treatment tool for chronic refractory low back pain and/or radicular pain. There are some studies about the usefulness of epiduroscopy for post lumbar surgery syndrome, however, few studies about the effectiveness of epiduroscopy for patients without back surgery. We compared the satisfaction of patients who underwent ELND for chronic low back pain and/or radicular pain after back surgery and for the same symptoms without surgery. Methods: We compared the degree of satisfaction of patients after ELND between who had underwent the lumbar spine surgery and who had not retrospectively by chart reviewing. We divided 39 patients who had received ELND into two groups, one is the group of patients who got the lumbar surgery (group 1), and the other is the group of patients who did not (group 2). Their medical records including age, sex, previous treatment, duration of illness, degree of symptom relief were investigated. We compared each items between two groups. Results: The number of patients in group 1 was 17, and group 2 was 22. In group 1, 16 patients (94.1%) showed more than 'Acceptable', and 19 patients (86.4%) showed more than 'Acceptable' in group 2. There is no significant differences statistically in percentage of patients who showed more than 'Acceptable' in the satisfaction after ELND between two groups. Conclusions: ELND provided satisfaction (more than 85%) for patients with chronic low back pain and/or leg pain regardless of previous back surgery history.

• Korean Journal of Applied Biomechanics
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• v.15 no.2
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• pp.147-153
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• 2005

The purpose of this study were to compare the differences of isometric lumber extension strength and subjective pain degrees between obesity patients group and normal body fat group in disc surgical operated patients. The research purposed to indicate how isometric lumbar extension exercise for 12 weeks affected to lumbar strength and visual analogue scale of patients suffered by chronic back pain. The subjects were 65 low back pain patients(male 30, female 35)who had disease on lumbar in W hospital. The lumbar extension strength was measured at seven degrees of angles, which were $0^{\circ}$ $12^{\circ}$ $24^{\circ}$ $36^{\circ}$ $48^{\circ}$ $60^{\circ}$ and $72^{\circ}$ before and after the exercise program. We got the results of subjective pain degree using the modified visual analogue scale(VAS) of Lawlis et al(1989) and measured the maximal isometric lumbar strength of all subjects using MedX lumbar extension machine. Results were as follows; After the exercise, the lumbar extension strength of normal body fat patients groups included males and female were greater than that of the obesity patients groups in all angles(p<.05). The visual analogue scale of chronic back pain patients was decreased significantly after the exercise(p<.05). The results showed the significance between the lumbar extension strength and the visual analogue scale of chronic back pain patients and showed that the isometric lumbar extension exercise decreased the subjective pain degrees of visual analogue scale with and increased lumbar extension strength. The correlation between the visual analogue scale and the %body fat of chronic back pain patients was no significant after exercise. Therefore, the lumbar extension strength exercise is needed for improvement of back strength, decrease of %body fat.

• Journal of Korean Physical Therapy Science
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• v.21 no.1
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• pp.13-20
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• 2014

Purpose : The purpose of this study was to analyze and compare the surface electromyography(EMG) activity of trunk region muscle between normal subjects and chronic low back pain(CLBP) patients during one leg stance. Methods : The subjects were 27 people, were consisted of 12 subjects who don't have low back pain and 15 subjects who have low back pain from 19 to 28 year of age(mean age 22.22). We used surface EMG to evaluate the activity of the Rectus abdominis, External abdominal oblique, Quadratus lumborum, Gluteus medius muscle. We used independent two samples t-test for statistical data. Results : The result of this study showed that the maximal voluntary isometric contraction(%MVIC) ratio of the trunk muscles was higher in patients with CLBP than in normal subject. But there were no statistically significant differences. There were statistically significant differences of the activity of the Quadratus lumborum, Gluteus medius muscle(p<0.05).

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.1
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• pp.75-83
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• 2024

Background: This study conducted a comparative evaluation of the effects of Pilates stabilization exercise combined with pain neuroscience education (PNE) in patients with chronic low back pain. The evaluation was based on their visual analogue scale (VAS) scores, Korean Oswestry disability index (KODI) scores, and fear avoidance belief questionnaire (FABQ) scores. Methods: A total of 36 participants were recruited and randomly assigned to either a Pilates stabilization exercise group (PSE, n=18) or Pilates stabilization exercise combined with pain neuroscience education group (PPNE, n=18). Both the PSE and PPNE groups participated in 50-minute sessions of Pilates stabilization exercise, three times per week for six weeks. The VAS, KODI, and FABQ scores of the participants were measured before and after the intervention. Results: There were significant improvements in the VAS of the PSE and PPNE group, with significant difference found between them. Both groups showed a significant decline in KODI scores following the exercise interventions, with significant difference observed between the two groups. FABQ scores were significantly decline in both groups, with significant difference found between them. Conclusion: In this study, Pilates stabilization exercise combined with pain neuroscience education was found to be more effective than Pilates stabilization exercise alone in reducing the VAS, KODI, and FABQ scores of patients with chronic low back pain. Thus, Pilates stabilization exercise combined with pain neuroscience education can be used in clinical practice to treat and prevent chronic lower back pain.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.217-228
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• 2021

Background: The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain. Methods: Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients' visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3. Results: A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05). Conclusions: bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.73-84
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• 2023

Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.

• The Journal of Korean Physical Therapy
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• v.27 no.6
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• pp.400-406
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• 2015

Purpose: The purpose of the present study was to examine joint position senses and muscle activity in subjects with and without chronic low back pain and to determine the effects of different types of bridge exercises on their trunk muscle activity. Methods: Thrity-eight subjects with chronic low back pain and thrity healthy controls participated in the experiment. Joint position senses and trunk muscle activity levels were measured during the different bridge exercise methods. Results: The joint position senses of the healthy group and chronic low back pain group showed significant differences during lumbar flexion, lumbar extension, lumbar lateral flexion, and lumbar rotation. The muscle activity levels of the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) were highest in the prone bridge exercise (PBE) group, followed by the supine bridge swiss ball exercise (SBSE) group and supine bridge exercise (SBE) group in order of precedence. The muscle activity level of the erector spinae (ES) was highest in the SBSE group, followed by the SBE and PBE groups in order of precedence. Conclusion: Overall, the results suggest that chronic low back pain is associated with declines in joint position senses and that PBEs increase trunk muscle activity more than conventional bridge exercises.