• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.39-47
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• 2010

Purpose: The purpose of this study was to characterize changes in back muscles in patients with chronic back pain. Accordingly, we studied 154 patients with chronic low back pain with regard to area, aspect and triggering position of the pain. We also determined muscle atrophy in painful areas. Methods: Subjects were questioned about pain and a pain provoking test was done. On Magnetic Resonance Imaging (MRI), we measured cross sections of the multifidus, erector spinae, iliopsoas and quadratus lumborum muscles at each spinal level. Results: Muscles in painful regions (multifidus and erector spinae muscles) decreased in area significantly more than nonpainful regions, and showed a significant difference (p<0.05) at levels L3, L4, and L5. Painful regions of the iliopsoas and quadratus lumborum did not change significantly more than non-painful regionsexcept at L5 (p<0.05). The group that had unilateral low back pain showed a significant decrease in cross section compared to the group that had central or bilateral pain (p<0.05). Conclusion: Chronic low back pain causes variable decreases in cross-sectional areas of some but not all back muscles, and at some but not all spinal levels.

• Journal of Korean Physical Therapy Science
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• v.13 no.2
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• pp.17-26
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• 2006

The purpose of this study was to evaluate effect of balance control therapy on low back pain patient's pain and flexibility. The subjects were consisted of 45 patients (15 males, 30 females) who had limited flexion range of motion of full spine with low back pain. All patients were one time treated the balance control therapy. Visual Analogue Scale(VAS) and Finger-to-Floor test(F-T-FT) were measured at pre-treatment, post-treatment and next day. VAS was used to measure subjective pain level. F-T-FT was used to measure forward flexion range of motion of full spine of low back pain patients. The results of this study were summarized as follow: 1. The VAS was significantly reduced between pre-treatment, post-treatment and next day (p<0.001). 2. The F-T-FT was significantly reduced between pre-treatment, post-treatment and next day (p<0.001). 3. The changes of pain decrease were related with pain duration(p<0.05), satisfaction for previous treatment(p<0.001). 4. The changes of flexibility increase were related with satisfaction for previous treatment(p<0.05).

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.69-75
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• 2021

Objective: This study was aimed at investigating the effects of lumbar stabilization exercise according to correct verbal instructions in pain and muscle strengthening of the low back pain patients. Design: A randomized controlled trial. Methods: Twenty subjects with low back pain were selected. They were randomly assigned to one of two groups (10 in each group): namely the lumbar stabilization exercise and lumbar stabilization exercise according to the correct verbal instructions group. The lumbar stabilization exercise group performed lumbar stabilization exercises for 6 weeks (5 times a week). The lumbar stabilization exercise according to correct verbal instructions group performed lumbar stabilization exercise according to correct verbal instructions for 6 weeks (5 times a week). We measured pain, muscle power, proprioception, and body balance before and after exercise by using visual analog scale (VAS), digital handheld dynanometer, Joint repositioning error, time up and go test respectively. Results: We found statistically significant differences in pain, muscle power, proprioception, and body balance in lumbar stabilization exercise and lumbar stabilization exercise according to correct verbal instructions group, before and after (p<0.05). Conclusions: We confirmed the effect of lumbar stabilization exercise according to correct verbal instructions. Thus we thought these results could be used as basic data and reference for low back pain. But we need more study effect of correct verbal instructions on other exercises.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.15-20
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• 2021

PURPOSE: This study examined the influence of treadmill exercise with initial pain control using transcutaneous electrical nerve stimulation (TENS) on induced pain of knee osteoarthritis in rats. METHODS: Thirty adult male Sprague - Dawley rats were divided randomly into the TENS Group (TG, n = 10), Treadmill Exercise Group (TEG, n = 10), and Treadmill with TENS Group (TTG, n = 10). In the TG, TENS was performed for 20 min per day for two weeks with a TENS program at the knee joint. The TEG performed treadmill exercise 15 m/min for 20 min per day for two weeks. The TTG performed initial pain control by TENS program during the 1st ~ 3rd days, and treadmill exercise was performed using the TEG methods from the 4th day. The lumbar spine was extracted and processed using western blot analysis to evaluate pain (c-fos expression). RESULTS: The results showed that c-fos expression was decreased significantly in all groups after each intervention (p < .05). In particular, TTG produced the most significant decrease compared to the other groups. CONCLUSION: These results suggest that treadmill exercise with initial pain control using TENS is a suitable method for relieving pain in knee osteoarthritis.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.335-343
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• 2022

Objective: This study aimed to investigate the effects of ischemic compression treatment (ICT) or low-level laser therapy (LLLT) applied to the trigger points of the infraspinatus muscle on shoulder pain and function in patients with shoulder pain. Design: A randomized clinical trial Methods: Thirty patients with shoulder pain were randomly allocated into the ICT group (n=15) or LLLT groups (n=15). ICT was performed on three myofascial trigger points (MTrPs) of the infraspinatus muscle twice a week for 4 weeks (eight sessions), with 5 minutes of treatment per trigger point. LLLT was performed similarly. Shoulder pain was assessed using the visual analogue scale (VAS) and pain pressure threshold (PPT), and shoulder function was assessed using the Korean Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, rotator cuff strength, and range of motion (ROM) of shoulder flexion and abduction. Results: Significant changes in VAS score and PPT were found after the intervention in both groups (p<0.05). Significant changes were observed in the Korean DASH score, rotator cuff strength, and ROM of shoulder flexion (p<0.05) but not in the ROM of shoulder abduction (p<0.05). There were no significant differences between the two groups. Conclusions: This study showed that both ICT and LLLT applied on the MTrPs of the infraspinatus muscle were effective for relieving shoulder pain and improving shoulder functions in patients with shoulder pain.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.370-375
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• 2022

Objective: The purpose of this study was to compare the hip joint muscle strength of patients with chronic back pain with lumbar instability and normal subjects. Design: A case control study. Methods: Five types of lumbar instability test were conducted on forty young women with chronic low back pain for more than six months, and those who had 3 or more positive tests were selected as subjects. To select chronic back pain patients with lumbar instability group, aberrant movement patterns during lumbar flexion test (FMT), prone instability test (PIT), posterior-anterior mobility test (PAT), passive lumbar extension test (PLE), and pressure bio-feedback (PBF) were applied. In addition, a digital muscle strength meter was used to measure the hip flexor, extensor, adductor, and abductor muscles of chronic low back pain patients with lumbar instability group (n=20) and normal subject group (n=20). Results: As a result of comparing the hip joint muscle strength between the chronic back pain patient group with lumbar instability and the normal group, there were significant differences in the hip extensor, abductor, and adductor muscles (p<0.05). Conclusions: Patients of chronic back pain with lumbar instability were found to have weak hip joint muscle strength. Therefore, this study suggest that include hip joint strength exercise for functional recovery of chronic back pain patients.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.71-82
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• 2023

PURPOSE: This study examined the effect of training using video content on abdominal muscle thickness, Oswestry disability index (ODI), and pain in college students with chronic back pain. METHODS: Twenty-nine college students with chronic back pain participated in this study. The subjects were assigned randomly to 15 experimental groups who trained using video content and 14 control groups who exercised voluntarily using back exercise leaflets. The video used for the intervention was obtained from YouTube, and the difficulty level of the video was classified into six levels. Both groups participated in the intervention for 40 minutes/day, three times a week for six weeks, and the variables of abdominal muscle thickness, ODI, and pain were compared before and after the intervention. RESULTS: In the experimental group, there were statistically significant changes in the thickness of the internal oblique and transverse abdominis muscles, ODI, and pain after the intervention, except for the external oblique muscle (p < .05). In the control group, there was no statistically significant difference in all variables after the intervention (p > .05). A statistically significant difference in all variables was observed between the experimental group and the control group after the intervention except for the external oblique muscle (p < .05). CONCLUSION: Treatment of chronic low back pain using video content is a possible alternative treatment if quality images are selected and the difficulty levels are adjusted.

• Physical Therapy Korea
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• v.24 no.3
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• pp.30-39
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• 2017

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.85-94
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• 2020

PURPOSE: This study examined the effects of the meridian muscle release technique on the pain and functional movement of patients with myofascial pain syndrome (MPS) of the shoulder joint. METHODS: The subjects of this study included 45 patients with MPS of the shoulder joint. The subjects were divided randomly into the following groups; the meridian muscle release technique group (n=15), the Graston technique group (n=15), and the control group (n=15). Both the meridian muscle release group and the Graston technique group received conventional therapy for 35 minutes initially and were then treated using the meridian muscle releases technique and Graston technique for 10 minutes, respectively. The control group received only conventional therapy for 35 minutes. All three groups underwent treatments three times a week for four weeks. Each subject was evaluated randomly using the VAS, PPT, SPADI and ROM both before and after treatment. RESULTS: The Graston technique group showed a significantly more substantial increase in functional movement (p<.05) than the meridian muscle release technique and control groups. The meridian muscle release technique group had significantly less pain (p<.05) compared to the Graston technique and control groups. CONCLUSION: These findings suggest that the meridian muscle release technique can be useful for decreasing pain and increasing the functional movement of patients with MPS of the shoulder joint.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.76-80
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• 2013

Purpose: The objective of this study was to offer primary clinical data examining whether change of imaging structure and quantitative evaluation of muscle activity on myofascial trigger points can lead to implementation of an analytical technique for evaluation of myofascial pain diagnoses. In addition, we examined the effect of a variety of mediation techniques, in order to examine neuromuscular physiological characteristics of myofascial trigger points muscle by comparing differences in pressure pain threshold and ultrasound imaging. Methods: Participants in the study included 30 adults in their twenties. The subjects were divided into the normal and myofascial trigger points groups. Clinical outcomes were evaluated by pressure pain threshold for pain and ultrasound imaging was performed for evaluation of the structural characteristics of muscle. Independent t-test was used for statistical analysis. Results: The two groups showed statistical significance in the change in pressure pain threshold (p<0.05). Findings of ultrasound imaging analysis showed no significant differences, increased muscle thickness was observed (p>0.05). Findings of ultrasound imaging analysis showed significant differences, increased muscle echodensity was observed (p<0.05). Findings on ultrasound imaging analysis showed significant differences, increased muscle white area index was observed (p<0.05). Conclusion: From these results, active myofascial trigger points muscle showed quality deterioration on ultrasound imaging. Thorough evaluation of imaging structure and physiological characteristics can be useful quantitative analytical techniques for diagnosis of myofascial pain syndrome and a primary factor reflected in physical therapy intervention.