• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.283-293
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• 2021

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.95-115
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• 2013

Objectives The aim of this review is to provide fundamental data for low back pain scales which can be used in clinical trial. Methods We investigated the latest studies on chronic low back pain via PubMed. And we also investigated domestic studies through "http://oasis.kiom.re.kr". 95 research papers were analyzed. Scales were classified into pain scale, function scale, generic health status scale and psychological scale. Results 1) According to foreign clinical studies, Visual Analog Scale (VAS) and Numerical Rating Scale (NRS) were used 18 times as pain scale. Oswestry Disability Index (ODI) was used 20 times as function scale, Roland-Morris Disability Questionnaire (RMDQ) was 17, and Hannover Functional Ability Questionnaire (HFAQ) was used 3 times. 36-item Short Form Health Survey (SF-36) was used 13 times as generic health status scale, Euroqol-5 Dimentions Questionnaire (EQ-5D) was 11, and 12-item Short Form Health Survey (SF-12) was used 3 times. Fear-Avoidance Beliefs Questionnaire (FABQ) was used 9 times as psychological scale, Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK-R) both were used 3 times. 2) According to domestic clinical studies, VAS was used 37 times as pain scale, NRS was 11, and Short Form McGill Pain Questionnaire (SF-MPQ) was used 6 times. ODI was used 30 times as function scale, RMDQ was 2 times only. SF-36 was used once as generic health status scale and Beck's Depression Inventory (BDI) was used 3 times as psychological scale. Conclusions We recommend VAS or NRS as a measure to evaluate pain, and ODI as a measure to evaluate functional disability. And we also recommend SF-36 or SF-12 and EQ-5D as a measure to evaluate generic health status. Finally, we recommend FABQ for use in measuring psychological scale.

• Journal of Digital Convergence
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• v.11 no.10
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• pp.571-576
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• 2013

The purpose of this study is to investigate work related diseases in Korean firefighters and to prepare the preventive measure for health management for the firefighters. Structured self-reported questionnaire was distributed to the firefighters. The result revealed that 37.7% of fire fighters had chronic diseases and 12.3% had chronic low back pains. The affected parts included lumbar region(41.5%), shoulder(33.0%), and neck(23.6%). The affected parts caused physical pain and work discomfort for more than a month. A total of 54.1% firefighters visited to the hospital within a year. This results suggest that it is necessary to develop the health promotion program for the prevention of musculoskeletal disease and regular health checkup for the acute disorders caused by workload.

• Physical Therapy Korea
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• v.12 no.2
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• pp.44-57
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• 2005

The objectives of this study were to examine the relative efficacy of three active exercise programs for work-related, chronic low back pain, and to observe to what extent the programs affected the mechanical stability of the lumbar region. The subjects were 64 employees who were randomly divided into three groups to match the three active exercise programs which were performed 3 times a week for 6 months. All subjects were assessed with the same measurements at a pre-study examination, and then were reassessed at 2 weeks, 3months and 6 months after the study. The pain intensity didn't show any significant difference among the three groups. However, the Oswestry Disability Index showed significant differences among the three groups at 6 months and the lumbar and thoracic exercise groups showed significant decreases compared to the general physiotherapy group (p<.05). Maximal stretching with both hands in the overhead direction showed a significant difference among the three groups at 3 months and 6 months, and the thoracic exercise group at 6 months showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The group that performed maximal stretching with both hands in the overhead direction showed the most significant among the 3 months and 6 months. At 6 months, the thoracic exercise group showed a significant increase in overhead stretching compared to the lumbar exercise and general physiotherapy groups (p<.05). The lumbar region angle of inclination showed significant differences among the three groups at 2 weeks 3 months, and 6 months, with the thoracic exercise group being decreased more significantly at 6 months than the lumbar exercise and general physiotherapy groups (p<.05). Exercise aimed at increasing thoracic mobility has an effect on lumbar stability. Furthermore, it is far more effective for lumbar stabilization than general physiotherapy and deep muscle strengthening lumbar exercise.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.1
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• pp.118-123
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• 2013

This study was performed from April, 2007 to August, 2012 with female patients who were being treated for and suffering from chronic lumbar pain for periods of 6 months and over. The 53 female patients were diagnosed with osteoporosis by having a T-Score of <-2.5 in a bone mineral density(BMD), as well as showing signs of metabolic syndrome. This was deduced by taking measurements of blood pressure, carrying out blood-chemical examinations and physical measurements such as weight, height, waist measurement and body mass index(BMI). After 5 minutes rest, the patient's blood pressure, height and weight were measured. BMI was calculated using the equation BMI = weight (Kg)/height ($m^2$). The patients had their blood taken in a fasted state(more than 12hours), the fasting blood sugar, total cholesterol, triglyceride, HDL-cholesterol were measured. The average BMD and T-score were calculated by measuring BMD(mg/cc) of L1-L3 using QCT. In a correlation analysis of the physical examinations, clinical character of metabolic syndrome and T-score, the result showed that age and T-score had a negative correlation(r=-0.699, p<0.01) as did triglyceride and T-score (r=-0.047, p<0.01), where as weight(r=0.239, p<0.05) and height(r-=0.329, p<0.01) and T-score had a positive correlation. There was no significant correlation with total cholesterol, HDL cholesterol, blood sugar, blood pressure and T-score. This study showed that there are significant correlations with age, weight, height and T-score. But there are no significant correlations with total cholesterol, HDL cholesterol, blood sugar, blood pressure and T-score and that these did not influence bone density. Further research with more subjects is required to determine whether there is a correlation of clinical character of metabolic syndrome and T-score.

• Journal of Acupuncture Research
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• v.18 no.2
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• pp.237-244
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• 2001

Back pain has plagued humans for many thousands of years. The treatment of back pain is divided into operative treatment and conservative treatment. It is reported that cure rate of conservative treatment is 80~90 percent. Generally, the treatment of oriental medicine is mostly conservative treatment. But, surgery should not be used as a last resort in treatment; it is just one of many treatment options for various spinal conditions. In some instance, it can be to preferred choice; in other situations, alternative therapies may be superior. Selections of the operation in HIVD 1. Acute disc herniations with a protracted significant component af back pain. 2. Chronic disc degeneration with significant back pain and degeneration limited to one or two disc levels. 3. Sugical instability created during decompression. 4. The presence of neural arch defects coincident with disc disease. 5. Symptamatic and radiographically demonstrable segmental instability. Selections of the operation in stenosis 1. If it does not slowly progress in physical therapy and other nonoperative measures, many of these patients may ultimately need surgical decompression. 2. Absolute stenosis in an impression of CT, MRI.(under 10mm) 3. In patients with established symptoms of .neurogenic claudication. 4. In patients with bad influence of neurogenic derangement.(strength, sensory) Selections of the operation in spondylolisthesis 1. Persistence or recurrence of major symptoms for at least one year despite activity modification and physical therapy. 2. Tight hamstrings, persistently abnormal gait, or postural deformities unrelieved by physical therapy. 3. Sciatic scoliosis. 4. Progressive neurologic deficit. 5. Progressive slipping beyond 25 or 50 percent, even when asymptomatic. 6. A high slip angle (40 to 50 degrees) in a growing child, since it is likely to be associated with further progression and deformity. 7. Psychologic problems attributed to shortness of trunk, abnormal gait, and postural deformities characteristic of more severe slips.

• Physical Therapy Korea
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• v.22 no.2
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• pp.21-29
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• 2015

This study investigated the effect of a load of 15% body weight on trunk, pelvis and hip joint coordination and angle variability in subjects with and without chronic low back pain (CLBP) during an anterior load carriage task. Thirty volunteers participated in the study (15 without CLBP, 15 with CLBP). All participants were asked to perform an anterior carriage task with a load of 15% body weight. The outcome measures included the means and standard deviations for measurements of three-dimensional coordination and angle variability of the trunk, pelvis and hip joint. As CLBP patient group .06, control group .70, the correlation coefficient between the groups showed a significant difference only in trunk-pelvic in the sagittal plane (p<.05). Angle variability of CLBP patient group increased significantly in the trunk in frontal plane, the pelvis in all sagittal plane, frontal plane, transverse plane, and the hip in sagittal plane, the hip in frontal plane than angle variability of control group (p<.05). This results mean that the CLBP patient group showed a disconnected coordination pattern in the trunk-pelvis in the sagittal plane, an increased pelvic angle variability in all three planes, and hip angle variability in the sagittal, and frontal planes. The CLBP patient group may have developed a compensatory movement of the pelvis and hip joint arising from the changed stability due to the abnormal coordination patterns of the trunk-pelvic in the sagittal plane. Therefore, CLBP symptoms can potentially worsen in the pelvis and adjacent hip joint in CLBP patients who perform weight-related behaviors in their daily lives. Further research is needed to determine the three-dimensional characteristics of the electromyography and neuromuscular aspects of subjects with CLBP.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.59-62
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• 2017

Background: Positional release muscle energy technique (PRMET) is a method joined positional release technique and muscle energy technique. Methods: Subjects those who have low back pain from the acute to chronic phase, were applied PRMET method on psoas major muscle and measured the changes in pain and disfunction. Results: PRMET method is effective for reducing pain and disfunction on psoas major muscle. Conclusions: The advantages of PRMET method are minimized patient inconvenience, shortening of treatment time and effective for improvement. In the future research, methods need to be improved so that this can be applied to other muscles.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.1
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• pp.101-109
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• 2014

Objectives The relationship between metabolic syndrome causes and bone mineral density (BMD) was explored by taking 60 female chronic low back pain patients with age 61 years old or elder having metabolic syndrome and osteoporosis as study subjects. Methods Fasting blood glucose, serum total-cholesterol, triglyceride and HDL were measured by biochemical tests. Anthropometric elements and blood pressure were measured. Results Average BMD and T-score of part number 1 to 3 of lumbar vertebra were estimated by Quantitative Computed Tomography (QCT). In order to find the relationship between clinical factors and osteoporosis, correlation analysis was done on T-score. Age (r=0.679, p<0.01) had significant negative correlation and weight (r=0.342, p<0.01) and height (r=0.475, p<0.01) had significant positive correlation. Blood glucose, blood pressure, total cholesterol, triglyceride, HDL and body mass index did not have significant correlation. BMD had negative correlation with age (r=0.317, p<0.05). Regression analysis was done by taking T-score as independent variables and taking other factors as dependent variables. It was possible to know that age ($\beta$=-0.471, t=-7.050) with p<0.001, height ($\beta$=0.277, t=4.120) and weight ($\beta$=2.856, t=2.780) with p<0.05 have significant impact on osteoporosis. Conclusions Therefore, it was possible to know that T-score and BMD decrease as one gets older and T-score and BMD increase as one is taller and heavier.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.216-226
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• 2000

Objectives : The aim of this clinical experiment was to investigate the effect of KamiWooseul-tang on low back pain and kidney function. Methods: We investigated 64 low back pain patients. We treated the patients with acupuncture, bed rest, herbal medicine, physical therapy. The patients were divided into two groups as follows, 32 patients (with normal renal function) were treated with only KamiWooseul-tang. Another 32 patients were treated with a commonly used herbal medicine. Results : The obtained results are summarized as follows. The patients were 43.8% male and 56.2% female. Their age were 20s 15.6%, 30s 25%, 40s 17.2%, 50s 9.3%, 60s 18.8% 70s 12.5% and 80s1.6%. Duration is most common in the most acute stage (< 1 week), next was chronic stage ( >6 months ), acute stage (1 week ~ 1 month) and subacute stage(l months ~ 6 months) in turn. Cure rate increased step by step after herb-medicine administration. Duration of patients had no relation with cure rate(P>0.05). The KamiWooseul-tang was more effective than the commonly used herbal medicine after 3 weeks therapy (P<0.05). Serum BUN and Creatinine level in KamiWooseul-tang group changed from $14.69{\pm}4.0,{\;}0.76{\pm}0.19(mg/dl)$ before adminstration to $13.64{\pm}3.92{\;}0.77{\pm}0.19,{\;}13.48{\pm}3.00{\;}0.82{\pm}0.21,{\;}13.26{\pm}3.73{\;}0.87{\pm}0.21(mg/dl)$ at 7th, 14th, and 21st days of administration respectively. Urinalysis showed no specific change in the KamiWooseul-tang group. During medication serum-electrolyte was within normal range. Conclusion : Therefore KamiWooseul-tang was more effective than the commonly used herbal medicine and there was no clinically remarkable difference in the serum BUN, Creatinine level, urinalysis and serum electrolyte between pre-medication and post-medication in the KamiWooseul-tang group.