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A Study on the Usefulness of Subjective Lumbar Instability Factor for Respiratory Pattern Change and Abdominal Mobility in Peoples with CLBP

만성허리통증자의 호흡 패턴과 배부 운동성 변화에 대한 주관적 허리부위 불안정성 요소의 유용성에 관한 연구

  • 기철 (광주 M트레이닝 센터) ;
  • 이관우 (울산과학대학교 물리치료학과)
  • Received : 2019.11.01
  • Accepted : 2020.03.06
  • Published : 2020.03.31

Abstract

This study examined the correlation between the respiratory pattern change (RPC) and abdominal mobility (AM) according to the positive result of the subjective lumbar instability factor (SLIF) in people with chronic low back pain (CLBP). Thirty-six adults with CLBP participated in this study. Twenty-eight items of the SLIFs were examined, and the subjects were divided into three groups according to the positive response numbers (PRN). After the change lists were scored, three RPC scores [costo-diaphragmatic RPC (CDRPC), breath hold change (BHC), and total RPC (TRPC)] were obtained. The abdominal mobility (AM) was measured between the maximal inspiration and exhalation at the xiphoid (AM1) and the 10th rib (AM2) level of the trunk. The results showed that the RPC score and AM were compared according to the positive response number of SLIF, and the relationship between them was analyzed. A positive correlation was observed between the SLIF positive response number and CDRPC score, BHC score, and total RPC score, and a negative correlation was observed between the SLIFs positive response number and AM1 and AM2. Based on the results of this study, the combination of SLIF positive responses can be a predictor of non-physiological respiratory pattern changes in people with CLBP. Clinically, this prediction is expected to help save time for screening and improve the efficiency of therapy.

References

  1. L. Vogt, K. Pfeifer, W. Banzer, "Neuromuscular control of walking with chronic low back pain", Man Ther, vol.8, No.1, pp.21-28, Feb. 2003. DOI: https://doi.org/10.1054/math.2002.0476 https://doi.org/10.1054/math.2002.0476
  2. J. P. Lawrence, H. S. Greene, J. N. Grauner, "Back pain in athletes", J Am Acad Orthp Surg, vol.14, No.13, pp.726-735, Dec. 2006. PMID: 17148620 https://doi.org/10.5435/00124635-200612000-00004
  3. H. O. Lee, "Activation of trunk muscle during stabilization exercises in four‐point kneeling", J Kor Soc Phys Ther, vol.22, No.5, pp.33-38, Oct. 2010.
  4. M. M. Panjabi, "Clinical spinal instability and low back pain", J Electromyog Kinesiol, vol.13, No.4, pp.371-379, Aug. 2003. DOI: https://doi.org/10.1016/S1050-6411(03)00044-0 https://doi.org/10.1016/S1050-6411(03)00044-0
  5. J. A. Hides, G. A. Jull, C. A. Richardson, "Long-term effects of specific stabilizing exercises for first-episode low back pain", Spine, vol.26, No.11, pp.e243-e248, Jun. 2001. DOI: https://doi.org/10.1097/00007632-200106010-00004 https://doi.org/10.1097/00007632-200106010-00004
  6. A. N. SjOlie, A. E. Ljunggren, "The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents", Spine, vol.26, No.23, pp.2629-2636, Dec. 2001. DOI: https://doi.org/10.1097/00007632-200112010-00019 https://doi.org/10.1097/00007632-200112010-00019
  7. C. Cook, J. M. Brismee, P. S. J Sizer, "Subjective and objective descriptors of clinical lumbar spine instability: a Delphi study", Man Ther, vol.11, No.1, pp.11-21, Feb. 2006. DOI: https://doi.org/10.1016/j.math.2005.01.002 https://doi.org/10.1016/j.math.2005.01.002
  8. N. J. Petty, Neuromusculoskeletal Examination and assessment, p.406, Elsevier Publishers, 2009, pp.5-38
  9. F. M. Kaltenborn, Manual mobilization of the joint, Vol II. The Spine, p.287, Yeong Mun Publishers, 2001, pp.113-162.
  10. J. Schomacher, Orthopedic Manual Therapy Assessment and Management, p.317, Yeong Mun Publisher, 2014, pp.8-26.
  11. H. Bradley, J. Esformes, "Breathing pattern disorders and functional movement", Int J Sports Phys Ther, vol.9, No.1, pp.28-39, Feb. 2014. PMID: 24567853
  12. M. Perri, Rehabilitation of breathing pattern disorders. In C. Liebenson Rehabilitation of the Spine: a practitioner's manual, Lippincott Williams & Wilkins Publishers, 2007, p.369-387.
  13. R. Gilbert, J. H. Jr Auchincloss, D. Peppi, "Relationship of rib cage and abdomen motion to diaphragm function during quiet breathing", Chest, vol.80, No.5, pp.607-612, Nov. 1981. DOI: https://doi.org/10.1378/chest.80.5.607 https://doi.org/10.1378/chest.80.5.607
  14. R. Courtney, J. Van Dixhoorn, M. Cohen, "Evaluation of breathing pattern: comparison of a Manual Assessment of Respiratory Motion(MARM) and respiratory induction plethysmography", Appl Psychophysiol Biofeedback, vol.33, No.2, pp.91-100, Jun. 2008. DOI: https://doi.org/10.1007/s10484-008-9052-3 https://doi.org/10.1007/s10484-008-9052-3
  15. P. W. Hodges, J. E. Butler, D. K. Mckenzie, S. C. Gandevia, "Contraction of the human diaphragm during rapid postural adjustment", J physiol. vol.505, No.2, pp.539-548, Dec. 1997. DOI: https://doi.org/10.1111/j.1469-7793.1997.539bb.x https://doi.org/10.1111/j.1469-7793.1997.539bb.x
  16. P. W. Hodges, S. C. Gandevia, "Activation of the human diaphragm during a repetitive postural task", J Physiol, vol.522, No.1, pp.165-175, Jan. 2000. DOI: https://doi.org/10.1111/j.1469-7793.2000.t01-1-00165.xm https://doi.org/10.1111/j.1469-7793.2000.t01-1-00165.xm
  17. P. W. Hodges, I. Heinjnen, S. C. Gandevia, "Postural activity of the diaphragm is reduced in human when respiratory demand increases" J Physiol. vol.537, No.3, pp.999-1008, Aug. 2001. DOI: https://doi.org/10.1111/j.1469-7793.2001.00999. https://doi.org/10.1113/jphysiol.2001.012648
  18. P. W. Hodges, V. S. Gurfinkel, S. Brumagne, T. C. Smith, P. C. Cordo, "Coexistence of stability and mobility in postural control: evidence from postural compensation for respiration", Exp Brain Res. vol.144, No.3, pp.293-302, Jun. 2002. DOI: https://doi.org/10.1007/s00221-002-1040-x https://doi.org/10.1007/s00221-002-1040-x
  19. P. Kolar, J. Sulc, M. Kyncl, J. Sanda, O. Cakrt et. al, "Postural function of the diaphragm in persons with and without chronic low back pain", J of orthopedic & sports physical therapy, vol.42, No.4, pp.352-362, Apr. 2012. DOI: https://doi.org/10.2519/jospt.2012.3830 https://doi.org/10.2519/jospt.2012.3830
  20. S. K. Grimstone, P. W. Hodges, "Impaired postural compensation for respiration in people with recurrent low back pain", Exp Brain Res, vol. 151, No.2, pp.218-224, Jul. 2003. DOI: https://doi.org/10.1007/s00221-003-1433-5 https://doi.org/10.1007/s00221-003-1433-5
  21. A. Hamaoui, M. C. Do, L. Poupard, S. Bouisset, "Does respiration perturb body balance more in chronic low back pain subjects than in healthy subjects?", Clinical Biomechan, vol.17, No.7, pp.548-550, Aug. 2002. DOI: https://doi.org/10.1016/s0268-0033(02)00042-6 https://doi.org/10.1016/S0268-0033(02)00042-6
  22. L. Chaitow, "Breathing pattern disorders, motor control and low back pain", Journal of Osteopathic Medicine, vol.7, No.1, pp.33-40, Apr. 2004. DOI: https://doi.org/10.1016/S1443-8461(04)80007-8 https://doi.org/10.1016/S1443-8461(04)80007-8
  23. P. B. O'Sullivan, "Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism", Man Ther, vol.10, No.4, pp.242-255, Nov. 2005. DOI: https://doi.org/10.1016/j.math.2005.07.001 https://doi.org/10.1016/j.math.2005.07.001
  24. N. Roussel, J. Nijs, S. Truijen, L. Vervecken, S. Mottram, et al. "Altered breathing patterns during lumbopelvic motor control tests in chronic low back pain: a case-control study", Eur Spine J, vol.18, No.7, pp.1066-1073, Jul. 2009. DOI: https://doi.org/10.1007/s00586-009-1020-y https://doi.org/10.1007/s00586-009-1020-y
  25. K. S. Kim, O. Y. Kwon, C. H. Yi, "Effect of abdominal drawing-in maneuver on peak expiratory flow, forced expiratory volume in 1 second and pain during forced expiratory pulmonary function test in patients with chronic low back pain", Physical Therapy Korea, vol.16, No.1, pp.10-17, Feb. 2009.
  26. D. J. Park, Altered Respiratory Pattern of individual with LBP and Effects of Abdominal Exhalation Maneuver, Doctor's Degree, University of Pusan Catholic, Pusan, Korea, pp.37-46, 2013.
  27. C. Ki, The effect of breathing pattern correction and strengthening exercise on trunk of lumbar instability patients. Doctor's Degree. Dong shin University, Naju, Korea, pp.50-63, 2018.
  28. M. A. Perri, E. Halford, "Pain and faulty breathing: a pilot study", J Bodyw Mov Ther, vol.8, No.4, pp.297-306, Oct. 2004. DOI: https://doi.org/10.1016/s1360-8592(03)00085-8 https://doi.org/10.1016/S1360-8592(03)00085-8
  29. J. M Fritz, S. R. Piva, J. D. Childs, "Accuracy of the clinical examination to predict radiographic instability of the lumbar spine", Eur Spine J, vol.14, No.8, pp.743-750, Oct. 2005. DOI: https://dx.doi.org/10.1007/s00586-004-0828-8 https://doi.org/10.1007/s00586-004-0803-4
  30. G. E. Hicks, J. M. Fritz, A. Delitto, S. M. Mc Gill, "Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program", Arch Phys Med Rehabil, vol.86, No.9, pp.1753-1762, Sep. 2005. DOI: https://doi.org/10.1016/j.apmr.2005.03.033 https://doi.org/10.1016/j.apmr.2005.03.033
  31. S. L. Koppenhaver, J. M. Fritz, J. J. Hebert JJ, G. N. Kawchuk, E. C. Parent, et al, "Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain", J Electromyog Kinesiol, vol.22, No.5, pp.724-731, Oct. 2012. DOI: https://doi.org/10.1016/j.jelekin.2012.03.004 https://doi.org/10.1016/j.jelekin.2012.03.004
  32. J. J. Hebert, S. L. Koppenhaver, J. S. Magel, J. M. Fritz, "The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a cross-sectional study", Arch Phys Med Rehabil, vol.91, No.1, pp.78-85, Jan. 2010. DOI: https://doi.org/10.1016/j.apmr.2009.08.146 https://doi.org/10.1016/j.apmr.2009.08.146
  33. J. K. Seo, S. Y. Kim, "The relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain", J Kor Soc Phys Ther, vol.23, No.4, pp.15-21, Aug. 2011.
  34. P. P. Ostwal, S. K. Wani, "Breathing pattern in patients with low back pain", International Journal of Physiotherapy and Research, vol.2, No.1, pp. 347-353, Feb. 2014. www.ijmhr.org/ijpr.html
  35. C. Ki, K. W. Nam, "Correlation Analysis between Lumbar Instability Test Positive Response Number and Breathing Pattern Change Rate and Pain in Young Peoples with Chronic Low Back Pain", J Korean Soc Phys Med, vol.14, No.3, pp.73-80, Aug. 2019. DOI: https://doi.org/10.13066/kspm.2019.14.3.73 https://doi.org/10.13066/kspm.2019.14.3.73
  36. M. J. Comerford, S. L. Mottram, "Functional stability retraining: principles and strategies for managing mechanical dysfunction", Man Ther, vol.6, No.1, pp. 3-14, Feb. 2001. DOI: https://doi.org/10.1054/math.2000.0389 https://doi.org/10.1054/math.2000.0389
  37. A. M. Davis, P. Bridge, J. Miller, E. Nelson-Wong, "Interrater and intrarater reliability of the active hip abduction test", J Orthop Sports Phys Ther, vol.41, No.12, pp.953-960, Dec. 2011. DOI: https://doi.org/10.2519/jospt.2011.3684 https://doi.org/10.2519/jospt.2011.3684
  38. J. H. Lee, S. Y. Kim, "Comparative effectiveness of Schroth therapeutic exercise versus sling therapeutic exercise in flexibility, balance, spine angle and chest expansion in patient with scoliosis", J Korean Soc Phys Med, vol.9, No.1, pp.11-23, Feb. 2014. DOI: http://dx.doi.org/10.13066/kspm.2014.9.1.11 https://doi.org/10.13066/kspm.2014.9.1.11
  39. P.B. O'Sullivan, D. J. Beales, "Changes in pelvic floor and diaphragm kinematics and respiratory patterns in subjects with sacroiliac joint pain following a motor learning intervention: a case series", Man The. vol.12, No.3, pp.209-218, Aug. 2007. DOI: https://doi.org/10.1016/j.math.2006.06.006 https://doi.org/10.1016/j.math.2006.06.006
  40. J. R. Beazell, M. Mullins, T. L. Grindstaff, "Lumbar instability: an evolving and challenging concept", J Man Manip Ther, vol.18, No.1, pp.9-14, 2010. DOI: https://doi.org/10.1179/106698110X12595770849443 https://doi.org/10.1179/106698110X12595770849443
  41. E. Nelson-Wong, T. Flynn, J. P. Callaghan, "Development of active hip abduction as a screening test for identifying occupational low back pain", J Orthop Sports Phys Ther, vol.39, No.9, pp.649-657, Sep. 2009. DOI: https://doi.org/10.2519/jospt.2009.3093 https://doi.org/10.2519/jospt.2009.3093