• Title, Summary, Keyword: Chronic low back pain

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The Effect of Horse-Riding Exercise on the Balance Ability in the Chronic Low Back Pain Patients (승마 운동이 만성 요통환자의 균형능력에 미치는 영향)

  • Lee, Chaewoo;Kim, Hyeonsu;Lee, Insil
    • Journal of The Korean Society of Integrative Medicine
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    • v.2 no.1
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    • pp.101-108
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    • 2014
  • Purpose : The purpose of this study was to investigate the effect of horse riding exercise for chronic low back pain patients. Method : 30 subjects in H-equestrian and N-equestrian, K & B hospital were randomly divided two group, instability support surface exercise group and horse-riding exercise group. Each group carried out 40 minutes exercise three times a week for 8 weeks. VAS were measured for sway path of COP movement during standing were measured for evaluation of static balance ability in balance performance monitor(BPM). Result : The results were as follows, scales of VAS between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The static balance scales of sway path between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horse-riding exercise was effective on VAS and static balance abiility of chronic low back pain patient so that these exercise can be new altematives for increase of stability ability in chronic low back pain patients.

Effectiveness of Proprioceptive Neuromuscular Facilitation of Chronic Low Back Pain -A Systematic Review and Meta-analysis of Studies in Korea- (만성허리통증의 고유수용성신경근촉진법 효과 -국내연구의 메타분석과 체계적 고찰-)

  • Kim, Beom-Ryong;Kang, Tae-Woo
    • PNF and Movement
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    • v.17 no.1
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    • pp.157-166
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    • 2019
  • Purpose: This study compares and examines the effects of proprioceptive neuromuscular facilitation (PNF) on patients with chronic low back pain through systematic literature review and meta-analysis. Methods: Domestic literature was searched with combinations of keywords including "proprioceptive neuromuscular facilitation," "PNF," "back pain," and "low back pain" using the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Korean Medical Database (KMbase). Six studies (n=148) were finally included in the analysis through a selection and exclusion process. The quality of the studies was evaluated using the PEDro scale. Results: According to the meta-analysis results, the low back pains of the PNF group and the contrast group showed a standardized mean difference (SMD) of 2.21 (95% CI: -3.35, -1.07, p=0.01, $I^2=83%$) after intervention. Thus, the PNF group showed a statistically significant decrease in low back pain compared with the control group. In addition, the SMDs of the Oswestry Disability Index (ODI), lung function, and the Roland and Morris Disability Questionnaire (RMDQ) were -1.34 (95% CI: -1.88, -0.79, p<0.01, $I^2=35%$), 1.14 (95% CI: 0.49, 1.79, p=0.01, $I^2=0%$), and -1.59 (95% CI: -2.56, -0.62, p=0.01, $I^2=46%$), respectively. Thus, the PNF group showed statistically significant differences from the control group. Conclusion: At present, there is some limit to obtaining definite results about effect sizes because there are relatively few randomized controlled experiments that analyze the effects of PNF exercise in patients with chronic low back pain. Therefore, continuous efforts should be made to conduct randomized clinical trials and long-term efficacy studies in the future.

Effect of Therapeutic Gymnastic Ball Exercise in Patients With Chronic Low Back Pain (만성 요통환자의 치료를 위한 치료용 볼 운동의 효과)

  • Lee, Eun-Young;Bang, Yoo-Soon;Ko, Ja-Kyung
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.109-126
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    • 2003
  • This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.

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Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial

  • Manchikanti, Laxmaiah;Pampati, Vidyasagar;Kaye, Alan D.;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.31 no.1
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    • pp.27-38
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    • 2018
  • Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received $5.6{\pm}2.6$ procedures over a period of 2 years, with average relief over a period of 2 years of $82.8{\pm}29.6$ weeks with $19{\pm}18.77$ weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.

Low-Level Laser Therapy including Laser Acupuncture for Non-Specific Chronic Low Back Pain : Protocol for a Systematic Review

  • Yeum, Hyewon;Nam, Dongwoo
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.251-255
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    • 2019
  • Background: Low-level laser therapy (LLLT) including laser acupuncture (LA) has been widely used to treat chronic low back pain (CLBP), but there is no critically appraised evidence of the potential benefits. The purpose of this protocol for a systematic review was to enable the evaluation of the effectiveness of LLLT including LA for non-specific CLBP to identify the potential benefits. Methods: The electronic databases MEDLINE (PubMed), Embase (Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), Korean medical databases (KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS), the Chinese database (CNKI), and Japanese databases (CiNII, J-STAGE) are recommended. Results: Randomized controlled trials in LLLT including LA should be included in the searches. All data synthesis and subgroup analyses should be conducted using a Review Manager software. The Cochrane risk of bias tool can be used to evaluate methodological quality of the studies. A risk ratio or mean difference with a 95% confidence interval will show the effects of LLLT including LA. Conclusion: The primary outcome would be pain intensity and functional status/disability due to low back pain. The secondary outcome would be a global measurement of recovery or improvement, quality of life and adverse event.

Change of Pain, Lumbar Sagittal Alignment and Multifidus after Sling Exercise Therapy for Patients with Chronic Low Back Pain

  • Park, Seung Jin;Moon, Ji Hyun;Shin, Yun A
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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    • pp.173-180
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    • 2018
  • Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

The Study about the suitability of the translations of categories in the Questionnaire for Pattern Identification of Chronic Low Back Pain (만성 요통 한의진단 도구 개발을 위한 변증 항목 번역 적합성에 관한 연구)

  • Park, Chang-Hyun;Kang, Yong-Joong;Ko, Seong-Gyu;Song, Yun-Kyung
    • The Journal of Korea CHUNA Manual Medicine for Spine and Nerves
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    • v.11 no.2
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    • pp.45-56
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    • 2016
  • Objectives : The aim of this study is to verify if the translation of chronic low back pain questionary is done properly. Methods : We used pattern identification of chronic low back pain in the guideline suggested by Ministry of Food and Drug Safety when making the questionnaire. And we used expressions which four native korean speakers who have bachelor's degree on chinese and teach related subjects in university have agreed on for two times. Results : We examined translated sentences about 40 symptoms according to 9 large categories on the questionnaire and corrected them into agreed expressions. Conclusions : In this study, we carried out evaluations on the suitability of the translations of categories which identify symptoms of low back pain. From now on, it is necessary to verify the degree of accuracy of question items that have been subjected to translation verification in clinical diagnosis. Furthermore considering the characteristics of patients with low back pain, we think diagnostic tools which reflects objective diagnosis results other than diagnostic identification are needed in the clinical field.

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Epidural Steroid Therapy as a Treatment of Post-laminectomy Low Back Pain (추궁 절제술 후의 요하지통에 대한 경막외 Steroid 주입요법)

  • Choe, Huhn;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.162-167
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    • 1991
  • Epidural steroid therapy has been well-established for the treatment of sciatica and low back pain. Disappointing results following surgical decompression or discectomy pain owing for to nerve root compression have led to trials of corticosteroids injected either systemically or into the intrathecal or epidural space to treat intervertebral disc. Epidural steroid is less effective in the patients with low back pain who have a history of surgical operation, so that the use of epidural morphine and methylprednisolone has been advocated for the amelioration of chronic low back pain in the post-laminectomy pain("failed back") syndrome over the past several years. We treated 47 patients with low back pain who had a history of one or two surgical procedures. We concluded that epidural steroid therapy is less effective in the patients with "failed back" syndrome than in the virgin back furthermore, there is a greater risk of complication such as inadvertent dural puncture and corresponding motor paralysis and headache.

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The Relationship between Perceived Stress and Coping Strategies in Patients with Chronic Low Back Pain (만성요통 환자들에서 스트레스지각과 대응전략 간의 관계)

  • Shin, Yoon-Sik;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2002
  • Objectives : The object of this study was to investigate the relationship between coping strategies and perceived stress or pain discomfort in patients with chronic low back pain. 80 patients with chronic low back pain and 100 normal controls participated in this study. Methods: Global assessment of recent stress (GARS) scale and Stress Response Inventory (SRI) were used to measure perception for stressors and stress responses. Coping scale and pain discomfort scale were used to measure coping strategies and pain perception. Results : Scores of perceived stress related to work or job, interpersonal relationship, changes in relationship, sickness or illness and the total scores on the GARS scale were significantly higher in those with chronic low back pain than normal controls. Scores of the SRI fatigue subscale scored significantly higher in those with chronic low back pain than normal controls. No significant difference was found on total scores of the pain discomfort scale between those with chronic low back pain and normal controls. The patients with chronic low back pain scored significantly higher on planful problem solving and positive reappraisal than normal controls. In the patient group, pain perception had significant positive correlations with total scores of the SRI and scores of stress perception related to illness or injury. The extent of escape-avoidance showed significant negative correlations with age, whereas the extent of distancing or escape-avoidance had significant negative correlations with the level of education. Significant difference was also found in accepting responsibilities between male subjects and females. However, no significant correlations were found between coping strategies and perceived stressors, stress responses or pain perception. Conclusion : The results suggest that patients with chronic low back pain were more likely to use more active coping strategies than normal controls, though the former had more perception for stressors than the latter. It was also found that coping strategies used by the patients were associated with sociodemographic factors, but that they were not associated with perceived stressors, stress responses or pain perception.

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Meridian-Electromyograph Analysis on Features of Abdominal Muscles in Chronic Low Back Pain Patients (만성요통환자의 복부근육의 일상 동작에 대한 경근전도 분석)

  • Jung, Jae-Young;Lee, Jun-Hwan;Nam, Ki-Bong;Kim, Sung-Su
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.203-215
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    • 2008
  • Objectives : The purpose of this study was to investigate abdominal muscles in chronic low back pain patients by meridian-electromyograph. Methods : Sample group of 11 with from low back pain during three months and control group of 10 subjects without low back pain have been recruited. Outcomes were assessed using meridian-electromyograph, visual analogue scale, and oswestry disability index. Results : Contraction power of external oblique abdominalis in control group was significantly higher than sample group, but there was no significant difference in muscle fatigue. Conclusions : According to above results, there are correlations between abdominal muscles and low back pain.