Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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The Effect of Sling Exercise and Conservative Treatment on Cross-section Area Change of Lumbar Muscles

슬링 운동과 보존적 치료가 요부근육의 횡단면적 변화에 미치는 영향

  • Lee, Woo-Hyung (Physical Therapy, Department of Rehabilitation Science, Graduate School of Daegu University) ;
  • Jeong, Seong-Gwan (Physical Therapy, Department of Rehabilitation Science, Graduate School of Daegu University) ;
  • Park, Rae-Jun (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
  • 이우형 (대구대학교 대학원 재활과학과) ;
  • 정성관 (대구대학교 대학원 재활과학과) ;
  • 박래준 (대구대학교 재활과학대학 물리치료학과)
  • Received : 2010.03.31
  • Accepted : 2010.05.21
  • Published : 2010.05.31
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Abstract

Purpose : This study aimed to examine the effects of sling exercise therapy on the relief of low back pain and the cross-sectional area change of lumbar muscles by CT analysis for chronic low back pain patients. Methods : Forty-one patients with diagnosis of chronic low back pain was divided sling exercise therapy group(SEG) 19 subjects and conservative physical therapy group(CPG) 22 subjects. we randomized and treated them(subjects) for 12 weeks. As using visual analogue scale(VAS), we evaluated recovery accuracy of pain, and for investigating cross-section area change of lumbar muscles for before and after treatment we used computed tomography(CT). Results : This study were summarized as follows : 1) As treatment period, in each compared testing on VAS of SEG and CPG, the both group was significantly different(p<.05). 2) Compared testing on VAS of between-subject groups(SEG and CPG) were not significantly different(p>.05). 3) At SEG of before and after treatment, in compared testing on cross-section area size of lumbar muscles, All muscles of psoas major, quadratus lumborum, erector spinae and multifidus were significantly different(p<.05). At CPG, psoas major was significantly different(p<.05). But other muscles were not significantly different(p>.05). Conclusion : From this result, both sling exercise therapy and the conservative physical therapy are effect on decrease of pain for chronic low back pain patients. but Increasing of the cross-section area being proportioned with muscular strengthening of low back muscle is noticeable difference in SEG. Therefore, sling exercise therapy have affect both decreasing of pain for chronic low back pain patients and lumbar muscles strengthening.

Keywords

References

  1. 구희서, 정진우 공역. 메킨지에 의한 요통의 진단과 치료. 대학서림. 1992;15-23.
  2. 김선엽, 권재확. 슬링 시스템을 이용한 요부 안정화 운동. 대한정형물리치료학회지. 2001;7(2):1-15.
  3. 김선엽. 요통의 요골반부 안정화 접근법. 대한정형물리치료학회지. 1998;4(1):7-20.
  4. 김선엽, 김택연. 슬링운동치료를 이용한 Neurac 기법의 이론적 근거와 적용방법. 대한정형도수치료학회지. 2006;12(2):52-65.
  5. 김형일, 신동규. 만성요통의 원인과 진단의 전략. 대한의사협회지. 2007;50(6):482-93.
  6. 박승균, 이정필, 천성용 등. Gym Ball 운동이 만성요통환자의 요부 근 활성도에 미치는 영향. 한국스포츠리서치 2007;18(2):757-66.
  7. 박혜상, 함용운. 슬링 운동이 요통환자의 통증정도와 근활성도에 미치는 영향. 한국사회체육학회지. 2009;36(2):655-61.
  8. 안승헌. 만성 요통환자의 치료적 접근. 코칭능력개발지. 2005;7(3):3-13.
  9. 양승훈. 요부안정화 운동이 요통 환자의 요추부 기능 개선에 미치는 영향. 미간행 석사학위논문. 2004.
  10. 왕진만, 김동준. Visual Analogue Scale(VAS)을 이용한 동통평가의 유용성. 대한척추외과학회지. 1995; 2(2):177-84.
  11. 이석민, 이명희. 요부신전운동에 의한 효과에 관한 연구, 대한물리치료학회지. 2002;9(2):37-48.
  12. 이현종, 남상수, 이윤호. 요통의 통증과 기능장애 평가에 관한 고찰. 대한침구학회지. 2002;19(2):137-48.
  13. 장태안. 만성요통의 수술적 치료. 대한의사협회지. 2007;50(6):523-32.
  14. 최희남, 유재헌, 김명화 등. 8주간의 등장성 요부신전운동 프로그램이 만성요통환자의 요부근력과 주관적 통증 정도에 미치는 영향. 한국운동생리학회지. 2000;9(1):101-13.
  15. 최희수. 요부 안정화 운동에 따른 몸통 근육들의 근활성도 비교. 한국전문물리치료학회지. 2005;12(1):1-10.
  16. 홍성림. 초음파 영상을 통한 요부-골반 안정화 운동이 만성요통 운동선수의 복횡근과 다열근에 미치는 영향. 한국스포츠리서치. 2007;18(2):563-72.
  17. 황종헌. 만성요통 환자에서 척추 주위 근육의 위축에 관한 관찰. 중앙대학교 대학원 의학과 신경외과학 전공, 석사학위 청구논문. 1995.
  18. Anthony HW. Diagnosis and management of low back pain and sciatica. American Family Physician. 1995;52(5):1333-41.
  19. Assendelft WJ., Morton SC, Yu, EI et al. Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies. Ann. Int. Med., 2003;138(11):871-81. https://doi.org/10.7326/0003-4819-138-11-200306030-00008
  20. Bishop KN., Durrant, E, Allsen PE et al. The effect of eccentric strength training at various speeds on concentric Physical Therapy. 1991;13(5):226-30.
  21. Cooper RG, Forbes W, Jayson MIV. Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain. Br J Rheumatol 1992;31:389-94. https://doi.org/10.1093/rheumatology/31.6.389
  22. Danneels LA, Cagnie BJ, Cools AM et al. Intraoperator and inter-operator reliability of surface electromyography in the clinical evaluation of back muscles. Manual Therapy. 2001;6(3):145-53. https://doi.org/10.1054/math.2001.0396
  23. Delsia J. Rehabilitation Medicine : Principles and Practice(2nd), Philadelphia : Lippincott. 1993.
  24. Deyo RA, Walsh NE, Martin DC. A controlled trial of trancutaneuous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N. Engl. J. Med. 1990; 322b:1627-34. https://doi.org/10.1056/NEJM199006073222303
  25. Felici F, Colace L, Sbriccoli P. Surface EMG modification after eccentric exercise. J Electromyogr Kinesiol. 1997;7(3):193-202. https://doi.org/10.1016/S1050-6411(96)00034-X
  26. Foster D, Fulton M. Fack pain and the exercise prescription. Clinics in Sports Medicine. 1991;10(1):197-209.
  27. Ghena DR, Kurth AL, Thomas M et al. Torque characteristic of the quadriceps and hamstring muscle during conentric and eccentric loading. Journal of Orthopaedic and Sports Physical Therapy. 1991; 14(4):149-54.
  28. Hides JA, Richardson CA, Jull GA. Multifidus Muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine. 1996; 21(23):2763-9. https://doi.org/10.1097/00007632-199612010-00011
  29. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transverse abdominis. Spine. 1996;21(22):2640-50. https://doi.org/10.1097/00007632-199611150-00014
  30. Hodges, Paul W, Richardson et al. Contraction of the abdominal muscles associated with movement of the lower limb. Physical Therapy. Washington. 1997;77(2):132-44.
  31. Kankaanpaa M, Colier WN, Taimela S et al. Back extensor muscle oxygenation and fatigability in healthy subjects and low back pain patients during dynamic back extension exertion. Pathophysiology, 7, Epub ahead of print. 2005.
  32. Kirkesola G. Advanced musculo-skeletal course The S-E-T concept using the terapimaster system Course book Norway. 2001.
  33. Knapik JJ, Wright JE, Hawdsley RH et al. Isometric, Isotonic, and Isokinetic Torque variation in four muscle groups through range of joint motion. Physical Therapy. 1983;63:938-47.
  34. Mather CG. Effective physical trearement for chronic low back pain. Orthop Clin North Am. 2004;35 (1):57-64. https://doi.org/10.1016/S0030-5898(03)00088-9
  35. Maurits NM, Beenakker EA, van Schaik DE et al. Muscle ultrasound in children: Normal values and application to neuromuscular disorders. Ultrasound Med Biol. 2004;30(8):1017-27. https://doi.org/10.1016/j.ultrasmedbio.2004.05.013
  36. Maurits NM, Bollen AE, Windhausen A et al. Muscle ultrasound analysis: Normal values and differentiation between myopathies and neuropathies. Ultrasound Med Biol. 2003;29(2):215-25. https://doi.org/10.1016/S0301-5629(02)00758-5
  37. Molczyk L, Thighpen LK, Eickhoff J. et al. Rehability of testing the knee extensors and flexors in healthy adult women using a Cybex 11 isokinetic dynamometer. Journal of Orthopaedic and Sports Physical Therapy. 1991;14(1):37-41.
  38. Moore BD, Drouin J, Gansneder BM et al. The differential effects of fatigue on reflex response timing and amplitude in males and females J Electromyogr Kinesiol. 2002;12(5):351-60. https://doi.org/10.1016/S1050-6411(02)00032-9
  39. Moseley GL, Hodges PW, andvia SC. Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements. Spine. 2002;27(2):29-36. https://doi.org/10.1097/00007632-200201150-00013
  40. Nielsen PK, Jasen BR, Darvann T et al. Quantitative ultrasound image analysis of the supraspinatus muscle. Clin Biomech. 2000;15:S13-6. https://doi.org/10.1016/S0268-0033(00)00053-X
  41. O'sulivan PB, Twomey LT, Allison GT. Dynamic stabilization of the lumbar spine. Critical Reviews in Physical and Rehabilitation Medicine. 1997;9: 315-30.
  42. O'sullivan PB, Twomey LT, Allison GT. Evaluation of specific stabilization exercise in the treatment of chronic low-back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 1997; 22(24):2959-67. https://doi.org/10.1097/00007632-199712150-00020
  43. O'sullivan PB, Burnett A, Floyd AN et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10):1074-9.
  44. Poiraudeau S, Revel M. Rehabilitation therapy in chronic low back pain. Joint Bone Spine. 2000; 67(6):582-7. https://doi.org/10.1016/S1297-319X(00)00210-4
  45. Ryan LM, Magidow P.S, Duncan PW. Velocityspecific and mode-specific effects of eccentric isokinetic training of the hamstring. Journal of Orthopaedic and Sports Physical Therapy. 1991; 13(1):33-9.
  46. Sapsford RR, Hodges PW, Richardson CA et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31-42. https://doi.org/10.1002/1520-6777(2001)20:1<31::AID-NAU5>3.0.CO;2-P
  47. Sbriccoli P, Felici F, Rosponi A et al. Exercise induced muscle damage and recovery assessed by means of linear and non-linear sEMG analysis and ultrasonography. J Electromyogr Kinesiol. 12001;1(2):73-83.
  48. Svantesson U, Osterberg U, Thomee R et al. Fatigue during repeated eccentric-concentric and pure concentric muscle action of the plantar flexors. Clin Biomech. 1998;13:336-48. https://doi.org/10.1016/S0268-0033(98)00099-0
  49. Van Tulder MW, koes BW, Bouter LM. Conservative treatment of acute and chronic non specific low back pain. A systemic review of randomized controlled trials of the most common interventions. Spine. 1997;22(18):2128-56. https://doi.org/10.1097/00007632-199709150-00012
  50. Wilhite MR, Cohen ER, Wilhite SC. Rehability of concentric and eccentric measurements of quadriceps perfomance using the KIN-COM dynamometer: The effect of testing order for three different speeds. Journal of Orthopaedic and Sports Physical Therapy. 1992;15(4):175-82