The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections

요부운동 프로그램이 경막외 신경차단술을 받은 만성요통 환자의 통증, 일상생활제한 및 우울 감소에 미치는 효과

  • Received : 2013.02.08
  • Accepted : 2013.08.17
  • Published : 2013.08.31


Purpose: This study aimed to evaluate the effects of exercise program on chronic low back pain, daily living disability and depression in chronic low back pain patients treated with epidural injections. Methods: The design of this study was a nonequivalent control group pretest-posttest experiment. The sample was recruited among low back pain patients treated with epidural injections from an orthopedic specialty hospital. Participants were randomly assigned to a treatment group (n=25) or a comparison group (n=27). The treatment was a six week exercise program for low back pain. Data were collected from September to November 2011, and were analyzed using descriptive statistics, $x^2$-test, one-tailed t-test for independent samples, and Mann-Whitney U test using the SPSS/WIN 12.0 program. Results: Patients in the treatment group reported statistically significantly lower levels of back pain on flexion and extension, less daily living disability, and less depression than those in the comparison group. Conclusion: The back pain relief exercise program could be an effective adjunct nursing intervention for low back pain patients treated with epidural injections.


  1. Aceves-Gonzalez, C., & Prado-Leon, L. R. (2008). Low back pain and depression: A study in a population of Mexican workers. Work, 31 (2), 159-166.
  2. Benzon, H. T. (1986). Epidural steroid injections for low back pain and lumbosacral radiculopathy. Pain, 3, 277-295. (86)90115-6
  3. Choi, D., & Choi, K. (2010). The effect of lumbar exercise by gym-ball and elastic band on lumbar strength in chronic low back pain patients. The Korean Journal of Ideal Body & Meridian Pathways, 2 (1), 1-7.
  4. Choi, S. Y. (2001). Relieving program on the back muscle strength, intensity of pain, disability level in elementary school women teacher. Korean Journal of Women Health Nursing, 7 (2), 169-187.
  5. Crowley, L. (2009). The effectiveness of home exercise programmes for patients with rheumatoid arthritis: A review of the literature. Physical Therapy Reviews, 14 (3), 149-159.
  6. Fairbank, J. K., & Pynsent, P. B. (2000). The Oswestry Disability Index. Spine, 25, 2940-2952.
  7. Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160.
  8. Gard, G., Gille, K. A., & Grahn, B. (2000). Functional activities and psychosocial factors in the rehabilitation of patients with low back pain. Scandinavian Journal of Caring Sciences, 14 (2), 75-81.
  9. Gaskell, L., Enright, S., & Tyson, S. (2007). The effects of a back rehabilitation programme for patients with chronic low back pain. Journal of Evaluation in Clinical Practice, 13 (5), 795-800.
  10. Gatchel, R. J., Bernstein, D., Stowell, A. W., & Pransky, G. (2008). Psychosocial differences between high risk acute vs. chronic low back pain patients. Pain Practice, 8 (2), 91-97.
  11. Hagen, E. M., Grasdal, A., & Eriksen, H. R. (2003). Does early intervention with a light mobilization program reduce longterm sick leave for low back pain: A 3 year follow up study. Spine, 28 (20), 2309-2315.
  12. Holmes, S. (1985). Pursuit of happiness. Nursing Mirror, 161 (3), 43-45.
  13. Itz, C., Geurts, J., van Kleef, M., & Nelemans, P. (2013). Clinical course of non-specific low back pain: A systematic review of prospective cohort studies set in primary care. European Journal Of Pain, 17 (1), 5-15.
  14. Jeon, C. H., Kim, D. J., Kim, D. J., Lee, H. M., & Park, H. J. (2005) Cross-cultural adaptation of the Korean version of the Oswestry Disability Index (ODI). Korean Society of Spine Surgery, 12 (2), 146-152.
  15. Jette, A. M. (1980). Functional status index: Reliability of a chronic disease evaluation instrument. Archives Physical Medicine & Rehabilitation, 61 (9), 395-401.
  16. Kim, D. Y., Oh, S. G., & Park, J. H. (2003). Caudal epidural steroid injections for the treatment of chronic lower back pain. Korean Journal of Family Medicine, 24, 260-264.
  17. Kim, J. C., Kim, H. B., Kim, M. J., & Lee, S. G. (2000). Evaluation of epidural injection with modified Dallas Pain Questionnaire in patients with low back pain. Journal of Korean Academy of Rehabilitation Medicine, 24 (1), 108-116.
  18. Kwon, B. A. (2009). Effects of spinal stabilization exercise on cross-sectional areas and recovery of function in patients with chronic low back pain. Unpublished doctoral dissertation, Hanyang University, Seoul.
  19. Lee, J. K. (1997). A study on construction of exercise prediction model for the low back pain patients. Unpublished doctoral dissertation, Yonsei University, Seoul.
  20. McKenzie, R. A. (1979). Prophylaxis in recurrent low back pain. The New Zealand Medical Journal, 89 (627), 22-23.
  21. Nam, K. H. (2004). The effect of back pain relief exercise on pain from daily activities, low back pain and depression of the patients with chronic back pain. Unpublished master's thesis, Kangwon University, Chuncheon.
  22. National Evidence-based Healthcare Collaborating Agency. (2010). The effect of injection treatment on pain in chronic low back pain. Retrieved January 9, 2013, from kr/ktic/publication/disease_view.jsp?runMode=boardView &seq=18&t=20130110022819776&boardNo=GA&cpage=5& range=10&block=10&searchCol=&searchVal=&condition=&menuName=&named=
  23. Park, H. S., & Son, J. T. (2001). A study on the relationship between optimism and depression in chronic low-back pain patients. Korean Academy of Psychiatric and Mental Health Nursing, 10 (2), 125-136.
  24. Park, J. Y. (2007). Nonsurgical management of chronic low back pain. Journal of the Korean Medical Association, 50 (6), 507-522.
  25. Risch, S. V., Norvell, N. K., Pollock, M. L., Risch, E. D., Langer, H., Fulton, M., et al. (1993). Lumbar strengthening in chronic low back pain patients. Physiologic and psychological benefits. Spine, 18 (2), 232-238.
  26. Rittweger, J., Just, K., Kautzch, K., Reeg, P., & Felsenberg, D. (2002). Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: A randomized controlled trial. Spine, 27 (17), 1829-1834.
  27. Scott, J., & Huskinsson, E. C. (1979). Vertical or horizontal visual analogue scales. Annals of the Rheumatic Diseases, 38 (6), 560.
  28. Williams, P. C. (1965). The lumbosacral spine: Emphasizing conservative management. New York, NY: McGraw-Hill Book Company.

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