• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.21-28
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• 2020

PURPOSE: The main purpose of this meta-analysis study was to identify the degree-of-effect size and the variables for the effects of manual physical therapy on myofascial pain syndrome. METHODS: This study collected six studies published between 2015.01.01 and 2019.12.31. The analysis result verified nine effect size data. The random-effect model was chosen because of the heterogeneity of the data. RESULTS: First, the full case showed the largest mean effect size of 2.297 (p < .001). Second, the size of the effect based on the fascial distortion model (FDM) intervention showed an effect size of 4.654 (p < .001). Third, the number of participants showed a 15 or less effect size of 2.612 (p > .058). The number of treatments showed a 10 less effect size of 2.844 (p > .129). The publication type showed a thesis effect size of 3.095 (p < .002). CONCLUSION: Manual physical therapy has a great effect on myofascial pain syndrome in the neck and shoulders, and that the effects differ according to the methods of intervention.

• The Journal of Korean Physical Therapy
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• v.32 no.2
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• pp.80-87
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• 2020

Purpose: Some patients who have undergone surgery due to lumbar disc herniation still complain of leg pain and other abnormal sensations. Therefore, the study examined the effects of the neurodynamics on pain and other abnormal nerve sensations in post-operated patients with lumbar disc herniation. Methods: The participants of this study comprised 20 adults (10 males and 10 females) who were diagnosed with lumbar disc herniation. The subjects were classified into two groups of 10 patients each in the lower extremity neurodynamics (LEN) and lumbar stabilization exercise (LSE) groups. Each intervention was applied twice a day for one week and was composed of two different exercise patterns; one was applied by a therapist, and the other was performed by the patients themselves. The data were analyzed using assessment methods of Digital Infrared Thermal Imaging (DITI), Toronto clinical neuropathy scoring system (TCNSS), Sympathetic Skin Response (SSR) test, and Oswestry Disability Index (ODI) scale. Results: Significant differences in TCNSS, DITI, ODI scale were observed between the LEN and LSE group (p<0.01). On the other hand, there was no significant difference in the SSR test between pre and post-treatment (p>0.05). Conclusion: The results indicated that neurodynamics treatment is effective in pain reduction and abnormal sensations, such as leg muscle cramps, in post-operated patients with lumbar disc herniation.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1785-1790
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• 2019

Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.2
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• pp.25-34
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• 2022

Background: Cervical headache (CGH) is a common condition that causes serious damage. Mulligan described a sustained natural apophyseal glides (SNAGs) as a manual therapy approach to treat this dysfunction. Although there have been several case studies to evaluate the effectiveness of SNAG, the efficacy of SNAG for cervical headaches is still controversial. Therefore, this study examined the effects of Mulligan's SNAG technique on cervical headache and pain intensity to present basic clinical data. Methods: Thirty-two subjects participated in this study, 16 each in the experimental and control groups. The experimental group applied Mulligan's SNAGs technique and the control group applied the placebo SNAGs technique. Results: Significant differences (p<.05) in the changes in pain, neck disability index (NDI) and Hamilton rating scale for depression (HRSD) were observed between the two groups. Conclusion: The application of Mulligan's SNAG technique to patients with cervical headaches effectively reduced headache, depression, and neck dysfunction. Based on this study, Mulligan's SNAGs technique can be used as an objective research method for additional studies targeting cervical headache patients in the future.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.93-101
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• 2023

PURPOSE: The Western Ontario and McMaster Universities Arthritis (WOMAC) index has been used to measure the outcome of total knee replacement (TKR), but studies on its reliability and validity are limited. The present study examined the reliability and validity of this index for patients with knee osteoarthritis who underwent TKR. METHODS: Seventy-one inpatients and outpatients who underwent bilateral TKR for knee osteoarthritis were included in this study. The pain assessment scale and WOMAC index were used to evaluate the participants every two weeks to examine the test-retest reliability, internal consistency, and construct validity. RESULTS: The test-retest reliability scores for pain, stiffness, and physical function were .75-.92, .85-.90, and .75-.95, respectively. The corresponding intraclass correlation coefficients were .75-.88, .76-.88, and .71-.95, respectively. The internal consistency score in the first and second examinations was .92. Furthermore, the construct validity scores for pain, stiffness, and physical function were .83, .41, and .58, respectively. CONCLUSION: The application of the WOMAC index in patients who underwent TKR showed high test-retest reliability and internal consistency with the use of the WOMAC index and good validity with the use of the pain assessment scale.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.10 no.1
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• pp.103-116
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• 2004

The purpose of this study was to investigate between low back pain scale and disability index owing to gait pattern. For the period of February 1 to February 29, 2004, we had conducted a questionnaire and direct interview with 100 persons lived in Daejeon. The result were as follows: 1. The stride length of experimental group. the male was $49.9{\pm}12.9cm$. the female $45.7{\pm}12.9cm$ and the width of feet, the male was $13.5{\pm}5.7cm$, the female $12.2{\pm}4.8cm$. 2. The Fick angle of all subjects was showed in external disposition, the left angle showed in asymmetry, the male was $11.0{\pm}5.7^{\circ}$, the female $8.5{\pm}1.3^{\circ}$. 3. The foot arch was similar to sex as a weight bearing and non-weight bearing, the male was $1.3{\pm}0.8cm$, the female $1.3{\pm}0.9cm$. 4. The impedimental index according to back pain grade, men was a lower than women, the male was $5.7{\pm}6.9$ and the female $7.2{\pm}5.3$. 5. The relation to difference between foot arch and disability index according to back pain grade as a weight bearing and non-weight bearing, the higher foot arch, the higher back pain grade was statistically significance(p<.05). 6. The relation between width of feet and disability index according to back pain grade, the wider width of feet, the higher back pain grade was statistically significance(p<.01). 7. The relation between stride length and disability index according to back pain grade, the wider stride length, the higher back pain grade was statistically significance(p<.05).

• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.36-41
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• 2013

Purpose: To investigate whether the long-term use of a cane induces pain in the unaffected lower limb of stroke patients. Methods: A total of 107 stroke patients with chronic hemiparesis were recruited in this study and classified into two groups; a cane-use group (n=49) and non-cane-use group (n=58). The existence of pain in the unaffected lower limb was assessed on a visual analog scale in the hip, knee, and ankle joint, and the University of Alabama pain behaviors scale (UAB pain behavior scale) used to measure the intensity of pain. In addition, the Motricity Index (MI) was tested in the upper and lower extremities. Results: The proportion of pain in each joint of the lower limb was significantly higher in the cane-use group, compared to the non-cane-use group (p<0.05). In addition, significant differences were observed on the UAB pain behavior scale between the two groups. The lower MI score was significantly lower in the cane-use group, compared with the control group. However, no difference was observed in MI scores of the upper limb between the two groups. Conclusion: These findings reveal that long-term cane usage can induce pain in the unaffected lower limb of stroke patients. We suggest careful consideration when prescribing a cane, depending on functional ability in hemiparetic patients, and recommend continuous evaluation for pain in the affected lower limb.

• PNF and Movement
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• v.14 no.1
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• pp.15-21
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• 2016

Purpose: The purpose of the present study was to compare the effects of both general hold-relax techniques and hold-relax techniques using pumping on pain due to delayed muscle pain and on the range of motion (ROM) of joints. Methods: Thirty-nine young adult males and females were randomly assigned either to a hold-relax technique application group of 20 subjects or to a group of 19 subjects with hold-relax techniques applied using a pumping application. Tenderness thresholds, the ROM of joints, and pain intensities were measured on the biceps of the nondominant arm of the subjects in both groups before exercises were performed to induce delayed muscle pain. Tenderness thresholds were again measured 24hours, 48hours, and 72 hours after inducing delayed muscle pain. The relevant intervention methods were applied to the two groups after conducting the measurement at 48hours. As a statistical analysis method, repeated measure ANOVAs were conducted to examine the tenderness thresholds, ROMs of elbow joints, and pain intensities in the individual groups at the time points. Results: At 48 hours and 72 hours after application of the interventions, the general hold-relax technique application group showed greater changes in the tenderness thresholds, the ROMs of elbow joints, and the pain intensities than did the group applying hold-relax techniques using a pumping application (p>0.05). Conclusion: Based on the results of the present study, the application of hold-relax techniques is thought to have beneficial effects on pain resulting from delayed muscle pain and on limited ROMs of joints.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.1
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• pp.523-531
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• 2013

Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1683-1686
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• 2018

Low back pain (LBP) is the most common reason for seeking physical therapy (PT) care. Recent studies suggest that axial loading can have a positive impact on the intervertebral disc by improving its tensile strength. Further, whole body vibration (WBV) appears to improve spinal muscle relaxation. Therefore, this case study describes the use of axial loading using a mini-trampoline in a female with chronic LBP. This case report is a single subject design. This patient is a 29-year-old female with a six-month history of low back pain following a motor vehicle accident. MRI found herniated discs at L4 and L5, clinical tests were positive for pain in the L4 and L5 dermatome and myotome the slump test was positive for neural tension, and LBP was constant at 4-6/10 over the past four months. She received axial loading exercises using a mini-trampoline and performed six sessions that were, scheduled twice a week for three weeks. Her Oswestry Disability Index (ODI) score improved from 40% at the time of her first visit to 22% at her final visit. Pain measure on the Numeric Pain Rating Scale (NPRS) after the first treatment was 7/10, and her pain after the final treatment was 0/10. These changes in the pain scores are clinically significant and exceed the minimal clinically important difference (MCID). This patient had a significant improvement in her pain using the NPRS and the ODI. This case study suggests that axial loading may be an effective treatment for some individuals with discogenic chronic low back pain.