• Physical Therapy Korea
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• v.29 no.1
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• pp.54-63
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• 2022

Background: Low back and neck pain are two of the most common medical problems in the adult population. It is estimated that between 70% and 80% adults experience an episode of low back pain at least once during their lifetime. Objects: This study aimed to compare the effects of various stretching exercises and muscle energy techniques used for treatment of iliopsoas, quadratus lumborum, and hamstrings of patients with low back pain. Methods: A total of 52 subjects were randomly assigned to the control group (n = 17), the muscle energy technology group (METG, n = 19), and the stretching exercise group (SEG, n = 16). Interventions were performed twice a week for 4 weeks. Outcomes were measured before and after 4 weeks of treatment in the three groups, using the Korean version of the Oswestry Disability Index, the Visual Analogue Scale (VAS), the Fear Avoidance Belief Questionnaire (FABQ), the Finger to Floor test (FTF), the Modified-Modified Schober Test (MMS), and the Trunk Flexion Range of Motion test. Results: This study showed significant reduction in the pre-test and post-test KODI, VAS, and FABQ scores in all the three groups (p < 0.05). The KODI, VAS, FABQ and FTF assessed in this study showed interactions between the groups and the measurement time point (p < 0.01). After intervention, the KODI, VAS, FABQ and FTF in the SEG and METG were significantly higher (p < 0.05), and there was no difference between the METG and SEG. MMS and HFROM test showed no difference between the three groups (p > 0.05). Conclusion: KODI, VAS, FABQ and FTF showed significant improvement after basic physical therapy, muscle energy technique, and stretching exercise intervention. And there was no significant difference in the intervention effect between the muscle energy group and the stretching exercise group.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.81-93
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• 2023

Purpose: The current case study focuses on identifying the effects of manual therapy and home self-therapeutic exercise including on mouth opening and pain relief in patients with continuous neck pain with myofascial temporomandibular disorders (TMDs) accompanied by headache induced by masticatory myalgia Subjects: The study participant was a 27-year-old woman who was treated a year ago for pain related to TMDs accompanied by a headache. Methods: Manual therapy of the cervical spine with upper cervical spine posterior-to-anterior mobilization (C1~C2), upper cervical spine flexion mobilization (C0~C2), upper cervical spine lateral flexion mobilization (C0~C1), upper cervical spine thrust manual therapy (C1~C2) and manual therapy of the temporomandibular joint and muscles with transverse medial accessory temporomandibular joint mobilization, manual therapies for the temporal, the masseter, and medial pterygoid muscles were performed twice a week for about 30 minutes for 4 weeks. This protocol included 3 sessions in total. The home self-therapeutic exercise was to be performed two to three times a day. Results: The values more improved MMO increased to 41.4 mm, left masseter muscle PPT to 2.9 kgf/cm², right masseter muscle PPT to 3.1 kgf/cm², KHIT-6 to 46 points, neck pain intensity (by NRS) to 2 points, headache frequency to per weeks, cervical kyphotic angle to -8.06%, and GCPS to grade 1 (low-intensity pain without pain-related disorder). Conclusion: Manual therapy and home self-therapeutic exercise can be helpful for mouth opening and pain relief in patients with myofascial TMDs accompanied by secondary headaches induced by masticatory myalgia.

• The Journal of the Convergence on Culture Technology
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• v.6 no.2
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• pp.289-297
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• 2020

The purpose of this study was to investigate the prevalence of back pain and the variables related to back pain in physiotherapists. In order to investigate the variables related to the incidence of back pain, The results were as follows : 1. Physical therapists' low back pain occurrence possibility appeared by whole 55.0% by male 11.0% and female 44.0%. 2. A day by people's work environmental special quality with low back pain treat morbidity to 31~40 people 40.0%, office hours per week by 45~49 hours 49.1%, a day stand-up tome be less than 5~7 hours 36.4% and appeared the highest. 3. Case that respond "Do dissatisfaction" to profession which is physical therapists' special psychological quality examined by people's 67.0% which low back pain. 4. Cause of low back pain in special active quality to get low back pain is the highest by case 38.2% that respond is "Special cause does not know, it is because for a long time worked to physical-therapy, and the reason that play waist softness gymnastics examined the highest by case 45.4% that respond is "Because present low back pain serves to be or prevents flare-up." According to result of this research, we could Know physical therapists are professionally endanger of getting low back pain. Specially, we could say physical therapists' low back pain occurrence possibility is high because of their having an experience or regarding work environmental special quality such as a day treatment morbidity, office hours per week, stand-up time for a day. There, educational programs need to improve of work environment and prevent the recurrence of low back pain. In this research, we recognized various variables of physical therapists' low back pain occurrence possibility are related to direct causal connection of low back pain occurrence, but we think continuous research should be tired forward in reply.

• Journal of Korean Physical Therapy Science
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• v.3 no.4
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• pp.207-214
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• 1996

Main cause of low back pain is a poor posture. Most low back pains are due to a poor posture. The poor posture induces muscle tension and finaliy low back pain. The poor posture arehabitually trained from the childhood by the environmetal factors. In general, maintaining good posture during working and sleeping hours are the first line of defence against back pam. (1) Supine posture is the easiest posture that relaxes and fixes muscles. Supine posture is thus a starting position for on exercise. Lying down releases the weight pressures of head and shoulder and thus body can be relaxed and extended which are helpful for treating back pain. However, supine posture can increase the pressure in ribcage posture aspect and disphragram due to visceral oragans. (2) Sitting in one position for a long time results in fatigue and relaxation of spinal muscies. Finally, body strength is weakened and sitting posture will become poor. If this poor posture continues for a longer time, pain will be accompanied due to overelongation of muscle ligaments. The habitual poor posture could induce intervertebral disc distortion. If the intervertebral disc is damaged, sitting in one position or movement causes pain. (3) Abnormal lumbar curve induces the tention of abdominal muscle and paravertebral muscle groups as well as tention of lower limb muscle group connected to pelvis. For a person with weak body strength, muscle relaxation increases curvature in lumbar, chest and cervical regions. This will induce a pelvic anterior tilting of the imaginary line between A. S. I. S. and P. S. I. S. Hip joint extensor muscle acts on releasing the pelvic anterior tilting. Contrections of hamstring muscle and femoral muscle recover the imaginary line between A.S.LS. and P.S.I.S. from pelvic anterior tilting. thus, contraction of rectus abdominis muscle are required to maintain the normal lumbar curve.

• Physical Therapy Korea
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• v.25 no.4
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• The Journal of Korean Physical Therapy
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• v.26 no.6
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• pp.379-385
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• 2014

Purpose: This study was to determine the immediate effects of pulsed magnetic field (PMF) in subjects with upper trapezius (UT) trigger point (TrP). Methods: Fifteen subjects with UT TrP were recruited for the study's PMF group (pain threshold=$2.29kg/cm^2$), and 15 age-, weight-, and gender-matched subjects with UT TrP were recruited for control group (pain threshold=$2.25kg/cm^2$). Pressure algometer was used to measure pressure pain threshold on UT TrP and, cervical range of motion (ROM) inclinometer was used to measure cervical ROM. Surface electromyography was used to record UT, lower trapezius, and serratus anterior muscle activity and relative ratio during scapular plane abduction between pre- and post-treatment. Results: The PMF effectively improved pain threshold and concurrently increased ROM (rotation to the painful side, lateral flexion to the nonpainful side). In addition, the PMF may effectively deactivate UT activity during abduction and the muscle activity ratio between UT and serratus anterior. Conclusion: These findings provided empirical evidence that PMF can be an effective treatment method to reduce pain threshold, to increase cervical ROM, and deactivate UT activity in individuals with TrP.

• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.97-105
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• 2021

Purpose: This study examined the effects of the application of Schroth exercise-based instrument Pilates exercise on the Cobb's angle, angle of trunk rotation, and low back pain of female patients with idiopathic scoliosis. Methods: Three patients with idiopathic scoliosis at a Cobb's angle of 20° or more participated in this study. Among the single-subject experimental research designs, a reversal (ABA) design was performed. In particular, Schroth exercise-based instrument, Pilates exercise, was performed for 10 weeks, consisting of five weeks between the baseline and intervention one period and five weeks between the intervention 1 and intervention 2 periods, and then followed up for five weeks. Results: After the Schroth exercise-based instrument, Pilates exercise, was applied, the Cobb's angle and the angle of trunk rotation decreased compared to the baseline in all subjects, and the follow-up period also showed a continuous decline. After Pilates exercise was performed, low back pain in subjects 1 and 2 was decreased in the intervention 1 period compared to the baseline. The level of low back pain in the intervention 2 period increased compared to the intervention 1 period, but a reduction was noted in the follow-up period. The low back pain in the subject was decreased in all intervention periods and the follow-up period. Conclusion: Schroth exercise-based Pilates exercise improves the Cobb's angle and the angle of trunk rotation for female patients with idiopathic scoliosis in their teens and 20s, and an effective intervention method is proposed for low back pain.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.92-104
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• 2023

Objective: The purpose of this study was to investigate the effect of spinal mobilization with leg movement (SMWLM) and neural mobilization (NM) in patients with lumbar disc herniation (LDH) accompanied by radiating pain. Design: Three-group pre-test-post-test control group design. Methods: We enrolled 48 participants, whom we randomly assigned to three groups. The SMWLM group (n=16) underwent 20 min of conventional physical therapy (CT) and 20 min of SMWLM. The NM group (n=16) underwent 20 min of CT and 20 min of NM. The control group (n=16) underwent 20 min of CT. These interventions in all the groups were performed three times a week for 4 weeks. Numeric pain rating score (NPRS), body grid chart score (BGCS), passive straight leg raise (PSLR), active lumbar flexion range of motion (ALFROM), korean version oswestry disability index (KODI), and korean version fear avoidance beliefs questionnaire (KFABQ) were measured pre- and post-intervention. Results: In all three groups, the NPRS, PSLR, KODI, and KFABQ scores were significantly different pre- and post-intervention (p<0.05). Significant differences were observed in BGCS and ALFROM in the SMWLM and NM groups pre- and post-intervention (p<0.05). The SMWLM group showed more improvement in the NPRS of leg pain, ALFROM, and KFABQ score than that exhibited by the NM and control groups (p<0.05). Conclusions: Both SMWLM and NM were effective for improving back and leg pain, centralization of symptoms, mechanical sensitivity, lumbar mobility, lumbar functional disability, and psychosocial functioning in patients with LDH with radiating pain.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.309-317
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• 2020

Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ²=21.18, df=7, I²=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ²=47.42, df=7, I²=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.