• The Korean Journal of Pain
• /
• 제20권1호
• /
• pp.54-59
• /
• 2007

Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.

• The Korean Journal of Pain
• /
• 제32권2호
• /
• pp.113-119
• /
• 2019

Background: Discogenic pain is a common cause of disability and is assumed to be a major cause of non-specific low back pain. Various treatment methods have been used for the treatment of discogenic pain. This study was conducted to compare the therapeutic success of radiofrequency (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Methods: This single-center study included 80 patients and followed them for 6 months. Transforaminal laser annuloplasty (TFLA, 37 patients) or intradiscal radiofrequency annuloplasty (IDRA, 43 patients) was performed. The main outcomes included pain scores, determined by the numeric rating scale (NRS), and Oswestry disability index (ODI), at pre-treatment and at post-treatment months 1 and 6. Results: The patients were grouped according to procedure. In all procedures, NRS and ODI scores were significantly decreased over time. Mean post-treatment pain scores at months 1 and 6 were significantly lower (P < 0.01) in both groups, and between-group differences were not significant. The ODI score was also significantly decreased compared with baseline. Among patients undergoing TFLA, 70.3% (n = 26) reported pain relief (NRS scores < 50% of baseline) at post-treatment 6 months, vs. 58.1% (n = 25) of those undergoing IDRA. There were no statistically significant differences between the groups in ODI reduction of > 40%. Conclusions: Our results indicate that annuloplasty is a reasonable treatment option for carefully selected patients with lower back and radicular pain of discogenic origin, and TFLA might be superior to IDRA in patients with discogenic low back pain.

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

• 한방재활의학과학회지
• /
• 제20권4호
• /
• pp.171-183
• /
• 2010

Objectives : The biomechanical relationship of leg length discrepancy(LLD), Lumbar lordosis, pelvic variance and degenerative scoliosis is one of the most important parameters when treat musculoskeletal disorders, however the reports are still controversial. The purpose of this study was to compare the relationships between the parameters and bothersomeness in subject with chronic ow back pain. Methods : Sixty female and eight male adults with non specific low back pain over 3 months were recruited. LLD was measured by tape measure method. Lumbar lordosis, lumbosacral angle and related pelvic parameters were measured using simple radiologic films of lumbosacral view. Results : Lumbar lordosis was significantly correlated to the lumbosacral angle, pelvic incidence and difference of the both iliac widths. Pelvic incidence had significant correlation with difference of the both iliac widths. And difference of both iliac widths was related with LLD by radiologic film. There was also significant correlation between the LLD by radiologic film and tape measurement. Visual analogue scale(chronic low back pain) of normal lordosis group was greater than hyperlordosis group. Conclusions : There were close biomechanical relationships between lumbar, pelvis, and lower extremity. But in order to determine the effect of structure on the chronic low back pain, global balance of musculoskeletal structure seems to be worth further researching.

• Journal of Preventive Medicine and Public Health
• /
• 제55권4호
• /
• pp.389-397
• /
• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• 대한정형도수물리치료학회지
• /
• 제14권2호
• /
• pp.68-77
• /
• 2008

Purpose : The purpose of this study was to investigate effects of movement with mobilization(MWM) and stabilization exercise on pain and range of motion of patients with acute low back pain. Methods : The subjects were consisted of 24 patients who had non specific acute low back pain. All subjects randomly assigned to the MWM group and the stabilization exercise group. The MWM group received sustained natural apophyseal glides(SNAGs) with modality treatment and stabilization exercise group received stabilization exercise with modality treatment. The remodified schober test(RST) was used to measure forward flexion and lateral flexion range of motion of lumbar segment. Visual Analogue Scale(VAS) was used to measure subjective pain level of the patients. The Oswestry Low Back Pain Disability Scale was used to measure functional disability level of the patients. Results : The lumbar flexion range of motion of MWM group was significantly increased compared with stabilization exercise group(p<.01). The range of motion of lumbar segment of MWM group was significantly decreased compared with stabilization exercise group(p<.01). The left lateral flexion range of motion of lumbar of MWM group was significantly decreased compared with stabilization exercise group(p<.05). The right lateral flexion range of motion of lumbar of MWM group was significantly decreased compared with stabilization exercise group(p<.05). The VAS of both MWM group and stabilization exercise group was significantly decreased(p<.001). The Oswestry Low Back Pain Disability Scale of stabilization exercise group was significantly increased compared with mobilization group(p<.001). Conclusion : In the result of this study, mobilization with movement and stabilization exercise had significant difference on pain and flexibility of patients with acute low back pain.

• 대한의용생체공학회:의공학회지
• /
• 제43권3호
• /
• pp.177-184
• /
• 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.

• 대한물리의학회지
• /
• 제11권1호
• /
• pp.53-60
• /
• 2016

PURPOSE: This study aimed to identify differences in the thickness of the transverse abdominis (TrA) and pelvic floor muscles (PFM) between those with (LBP) and without low back pain (non-LBP). The standardized methods of contraction for the TrA and PFM were used to perform the abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC), respectively. METHODS: This study included 27 young men and women, who were verbally instructed regarding the maneuvers (LBP, n=14; non-LBP, n=13). For all subjects, TrA and PFM thickness were evaluated by ultrasonography during ADIM and PFC. RESULTS: The results of this study showed that TrA thickness increased during ADIM and PFC to a greater degree in the non-LBP group than in the LBP group (p < 0.01). PFM thickness increased more during PFC in the non-LBP group than in the LBP group (p < 0.05). Both groups showed greater increases in TrA thickness during ADIM than during PFC (p < 0.01), and greater increases in PFM thickness during PFC than during ADIM (p < 0.05). CONCLUSION: These results suggest that receiving verbal instructions on how to use each muscle for a specific maneuver was more beneficial than other verbal instruction. Further studies are needed determine how our results may be applied beneficially in research on this topic.

• 디지털정책학회지
• /
• 제3권1호
• /
• pp.21-25
• /
• 2024

본 연구는 엉치엉덩관절의 불안정성에 초점을 맞춘 테이핑 방법이 요통에 도움이 될 수 있는 잠재 중재 방법인지에 대해 고려해 보고자 한 사례연구이다. 해당 사례는 58세 과거 디스크탈출증 및 협착증으로 인해 허리 수술 병력이 있는 남성이 지속적인 통증 감소를 위해 참여한 테이핑 교육 세션에서 나타난 주목할 만한 결과를 사례로 정리하였다. 중재 방법으로 테잎을 엉치뼈 2~4사이에 가시결절로부터 양쪽으로 80%< 장력으로 늘려 엉치엉덩관절을 지나게 붙이고 이후 끝 쪽은 양쪽 약 45° 방향으로 올려 중간볼기근(gluteus medius m.) 쪽으로 향하게 붙였다. 그 다음 엉덩뼈능선(iliac crest)로부터 척추기립근을 따라 10번째 갈비뼈 수준까지 이르는 양쪽 테이핑 방법이 적용되었다. 해당 중재를 통해 VAS와 ODI 두 검사도구로부터 VAS는 5에서 0, 장애지수는 13에서 0으로 각각 기록되는 긍정적 사례 결과를 관찰할 수 있었다.

• Annals of Rehabilitation Medicine
• /
• 제42권6호
• /
• pp.888-888
• /
• 2018