• Title, Summary, Keyword: Chronic low back pain

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Diagnosis and Management of Low Back Pain (요통의 진단과 치료)

  • Jang, Jae Hong;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.14 no.1
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    • pp.1-6
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    • 2012
  • Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

A comparative study on the cardiovascular function response to maximal exercise of chronic low back pain patients and normal group (최대운동부하시 정상인과 만성요통환자의 심폐계 반응에 대한 비교연구)

  • Um Ki-Mai;Kim Gun-Do;Hwang Myoung-Hoon
    • The Journal of Korean Physical Therapy
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    • v.12 no.3
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    • pp.379-386
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    • 2000
  • This study is aimed to determine the cardiovascular function response to maximal exercise of chronic low back pain patients(N=13) and normal group(N=13). by using BRUCE PROTOCOL, subjects underwent tredmill exercise test. Their cardiovascular function responses during rest and after maximal exercise were compared The responses were analyzed using t-test for SPSS 7.0 program. The Cardiovascular function variables employed at rest time(Vo2, HR. Vo2/kg, VE, Vco2.) and all out time(Vo2peak. HRpeak, Vo2peak/kg, VEpeak. Vco2peak). Result show that : 1 There was no significant difference in Vo2 between chronic low back pain patients and normal group at rest time. However significant difference in Volpeak was observed after maximal exercise( p<.05). 2. There was no significant difference in HR between chronic low back pain patients and normal group at rest time. No significant difference in HRpeak likewise observed. 3. There was no significant difference in Vo2/kg between chronic low back pain patients and normal group at rest time. However significant difference in Vo2peak/kg was observed after maximal exercise load(p<.05). 4. There was no significance in VE between chronic low bark pain patients and normal group at rest time. However significant difference in VEpeak observed after maximal exercise load(p<.05).

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Comparison of the Effects of Joint Mobilization, Gym Ball Exercises, and Breathing Exercises on Flexion Relaxation Phenomenon and Pain in Patients with Chronic Low Back Pain

  • Lim, Chaegil
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.1
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    • pp.1981-1991
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    • 2020
  • Background: Although various exercises have been performed for patients with chronic low back pain (CLBP), the effects of these exercises including joint mobilization, gym ball exercises, and breathing exercises on flexion relaxation ratio (FRR) have not been compared. Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on the flexion relaxation phenomenon (FRP) and pain in patients with chronic low back pain. Design: Randomized pretest-posttest control group design. Methods: Thirty-six patients with chronic low back pain who were undergoing rehabilitation at a rehabilitation center were included. The patients were randomly divided into three groups: joint mobilization group (JMG; n=12), gym ball exercise group (GBG; n=12), and breathing exercise group (BEG; n=12). The exercises were performed for 40 minutes a day, twice a week, for a total of 12 weeks. Results: There were no significant differences in FRR between the three groups (P>.05). Significant decreases in the modified visual analog scale (MVAS) scores after intervention between the groups were found (P<.05). The GBG was significantly decreases from the JMG in the MVAS (P<.05). However, there were significant improvements between the pre- and post-interventional findings on FRR and MVAS in the three groups (P<.05). Conclusion: We demonstrated that intervention using joint mobilization, gym ball exercises, and breathing exercises improve FRP and pain in patients with CLBP.

Pain, Depression, Body Mass Index in Conscripts with Chronic Low Back Pain in South Korea

  • Lee, Ju Hwan;Um, Ki Mai;Wang, Jung San;Lee, Sa Gyeom;Park, Joo Hyun;Koo, Ja Pung;Kim, Jung Hee;Lee, Suk Hee;Moon, Ok Kon
    • Journal of International Academy of Physical Therapy Research
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    • v.5 no.1
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    • pp.661-667
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    • 2014
  • This study is a cross-sectional study for conscripts with chronic low back pain, where it is designed to investigate general characteristics that conscripts with chronic low back pain carry, and it is also aimed to analyze the correlation as well as discrepancy within pain, depression and body mass index depending on their ranks. In this study, 90 Korean conscripts with chronic low back pain participated. And in order to analyze general characteristics as well as pain, depression and body mass index of the subjects, this study adopted a survey questionnaire upon general characteristics, and it also employed Visual Analogue Scacle(VAS) and Center for Epidemiological Studies Depression(CES-D) Scale which have proven their credibility, where BMI values for the subjects were calculated based on 'Asian Pacific standard' Body Mass Index(BMI). From the general characteristics exhibited by the subjects through this study, average age and average height of the subjects were $20.78{\pm}1.41$ and $175.97{\pm}5.34$ respectively; and corporals displayed the highest ratio of 42% with the chronic low back pain while 40% of the total subjects experienced the duration of the illness less than 6 to 9 months. Moreover, 57.8% of all subjects were reportedly suffering moderate pain, and 48% exhibited depression while 49% carried BMI value between 18.5 and $22.9kg/m^2$(normal range). Based on the analysis of correlation among pain, depression, discrepancy of BMI depending on the ranks and each independent variable, it appears that there is no significant difference amongst the ranks, and there is no correlation between independent variables; however, it was obvious that all groups divided by the ranks had a moderate pain(45-74mm), depression(${\geq}16$) and BMI value in normal range(18.5-22.9).

Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain

  • Semeru, Gracia Mayuni;Halim, Magdalena S.
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.22-29
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    • 2019
  • Background: The aim of this study was to investigate the relationship between pain catastrophizing, acceptance, and quality of life in relation to chronic low back pain in Jakarta, the capital city of Indonesia. We also analyze the effect of personality in catastrophizing and acceptance. Methods: A total of 52 chronic low back pain patients were enrolled as participants from 2 hospitals in Jakarta (43 females, 9 males, mean age 54.38 years). Participants completed a set of self-reported questionnaires: the NEO Five Factor Inventory (NEO-FFI), Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), Pain Catastrophizing Scale (PCS), and Pain Discomfort Module (PDM). Results: This study showed that acceptance increased the patient's quality of life by giving physical relief from pain. In contrast, pain catastrophizing decreased the quality of life, and increased the patients' tendency to get frustrated, irritated, and anxious about the pain. From a personality perspective, the trait neuroticism may lead to a higher level of pain catastrophizing. Conclusions: This study showed that catastrophizing, compared with acceptance, had a greater impact on the patient's life by reducing its quality.

Effects of Manual Therapy and Theraputic Exercise on Chronic Pain and Body Function in Elder Women with Chronic Low Back Pain (도수치료와 치료적 운동이 만성 요통의 여성 노인의 만성 통증과 신체 기능에 미치는 영향)

  • Shim, Yong-hyun;Park, Jae-myoung;Yu, Seong-hun
    • The Journal of Korean of Orthopedic Manual Physical Therapy
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    • v.23 no.2
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    • pp.51-57
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    • 2017
  • Background: The purpose of this study is to examine the effects of manual therapy and therapeutic exercise on pain and body function in elder women with chronic low back pain. Methods: The patients with chronic low back pain were randomly divided 2 group. The experiment group (n=11) was taken manual therapy and therapeutic exercise program. The control group (n=10) was taken physical therapy program(hot pack with 30 minutes and ICT with 15 minutes and ultra sound with 15 minutes). Both groups intervention performed 3 session during 6 weeks. We measured the quadruple visual analogue scale, flexibility, static balance, leg strength subject of symptom before and after experiment. The significant test pared t-test according to applying the manual therapy and therapeutic exercise group and control group between group used independent t-test. Results: Pain assessment in the experimental group was significantly different between time and group. Flexibility test groups were not significantly different between time and group. The static balance was not significantly different for the time. Strength tests were also not significantly different for the time. Conclusions: According to the results, manual therapy and therapeutic exercise group it was found to be helpful in pain, flexibility, static balance, not strength in elderly patients with chronic low back pain.

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The Study on the Characteristics of Ryodoraku Score in the Chronic Low Back Pain Patients (만성요통을 호소하는 환자들의 양도락 특성에 관한 연구)

  • Kim, Kyoung-Seok;Chung, Seok-Hee;Kim, Sung-Su;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.1
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    • pp.145-154
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    • 2009
  • Objectives : The aim of this study was to investigate the characteristic of ryodoraku in the chronic low back pain patients who visited department of oriental rehabilitation medicine. Methods : Subjects were 32 patients who visited department of oriental rehabilitation medicine(<60 years old). The low back pain patients were measured points of twelve meridians by ryodoraku diagnosis and checked the duration of low back pain. We compared the mean ryodoraku and the percentage of each points beyond the physiological range. Results : The score of H1(LU9), H2(PC7), H3(HT7), H5(TE4) and F5(GB40) had statistical differences compared with mean ryodoraku. And the correlation between duration of pain and mean ryodoraku showed statistically significant negative correlation(r=-0.353). Conclusions : These results suggest that ryodoraku maybe used to evaluate chronic low back pain patients.

Comparison Study of Static and Dynamic Plantar Foot Pressure between Chronic Low Back Pain Patients and Normal Adults (만성 요통 환자와 정상 성인의 정적, 동적 족저압 비교 연구)

  • Lee, Jeon-Hyeong;Kim, Gi-Chul;Seo, Hyun-Kyu;Park, Youn-Ki
    • The Journal of Korean of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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    • pp.49-54
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    • 2013
  • Background: The purposed of this study is to examine the static and dynamic plantar foot pressure in chronic low back pain patients and normal adults. Methods: The subjects were divided into a group of 30 patients with chronic low back pain and a control group of 30 healthy persons. While static posture and dynamic posture at comfortable walking speeds, the low back pain group and the control group measured their plantar foot pressure and the trajectory of their center of pressure (COP) using the Matscan(R) system. Independent t-tests were measured to compare differences in plantar foot pressure characteristics between the left side and right side of the low back pain group and the control group. Results: In the comparison of differences in plantar foot pressure characteristics between the left side and right side of the low back pain group and the control group, the anteroposterior (AP) displacement of COP showed significant differences (p<.05). Although the low back pain group and the control group did not show any significant differences in leg length, weight distribution, mediolateral (ML) displacement of COP, static contract area, dynamic contract areas (p>.05), increases in the contract area values were shown in the hind foot in general. Conclusion: In this study, it was shown that patients with chronic low back pain were walking with short AP displacement of the COP as a compensatory action to avoid pain.

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Review of Various Treatments Applied to Patients with Chronic Low Back Pain (만성 요통환자들에게 적용하는 다양한 치료법들에 대한 고찰)

  • Ma, Sang-Yeol;Kim, Eun-Mi;Kim, Hye Lee;Lee, Jae-Hong
    • PNF and Movement
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    • v.10 no.2
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    • pp.47-54
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    • 2012
  • Purpose : The purpose of this study was investigated to find the approach in the various method for patients with chronic low back pain. Methods : For research purposes that meet the search was focused papers. Treatments include PNF, chiropractic, joint mobilization, microcurrent, electroacupuncture, stabilizing exercise, resistance exercise, aquatic rehabilitation exercise, lumbar flexion and extension exercise were included as Gymball exercise. Results : Treatment with the three major manual therapy, electrical therapy and therapeutic exercise were divided. The result of applying manual therapy increased balance, increased strength, stability increased and decreased pain. The result of applying the electrical therapy increased flexibility, and decreased pain. The result of applying therapeutic exercise increases muscle strength, reduced pain, and decreased body fat. Conclusion : Previous studies by examining the effects of chronic low back pain treatment was intended to help in the selection and application Aquatic therapy, manual therapy, electrical therapy for patients with chronic low back pain with pain reduction was found to be effective.

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Immediate Effects of Interferential Current Stimulation which Affects Pain, Balance and Walking Ability of Elderly Patients with Chronic Low Back Pain (간섭전류전기자극이 만성요통 노인 환자의 통증, 균형 및 보행능력에 미치는 즉각적인 효과)

  • Lee, Jin;Kim, Do-Hyung;In, Tae-Seong
    • Journal of Korean Physical Therapy Science
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    • v.25 no.2
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    • pp.15-23
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    • 2018
  • Purpose: The purpose of this study was to investigate the effects of Interferential current stimulation therapy(ICT) on pain, balance, and walking ability of elderly patients with chronic low back pain. Methods: Twenty participants were randomly assigned to ICT group (2 males and 8 females) and placebo ICT group (3 males and 7 females). Participants were ICT and placebo ICT for 20 minutes, and the pre- and post-VAS, TUG and postural balance were measured. Results: The ICT group showed significantly decreased pain scores in the elderly patients with chronic low back pain (p<.05) than the placebo ICT group. The postural fluctuation with eyes opened and closed was significantly lower than the placebo ICT group(p<.05), and the ICT group showed remarkable improvement (p<.05). Conclusion: ICT was expected to improve decrease pain, improve postureal sway and walking ability remarkably. Therefore, It was expected that the application or ICT would be an effective method for elderly patients with Chronic Low Back Pain.