요부안정화운동에 따른 산업체 만성요통환자의 운동능력의 변화

Objectives This study was to investigate the effects of lumbar stabilization exercise in using the simulation on pelvic movements and pain in the elderly patients with chronic low back pain. Methods In order to achieve the purpose of this study, 36 elderly patients with chronic low back pain at K located in C city, were selected at random and allocated 12 elderly women each for the Non Exercise Group (NEG/ n=12)and Deficient Exercise Group (DEG/n=12) and Over Exercise Group (OEG/n=12) the measured kinematic pelvic movements and pain before and after the experiment. The data obtained from this study were analyzed using the SPSS 24.0 statistical program the two-way repeated measures ANOVA and Bonferroni post-hoc test was performed. Results The lumbar stabilization exercise in using the simulation for 16 weeks. The results of this study were as follows: First, there were significantly increased in pelvic movements in OEG compared with DEG and NEG after 16 weeks. Second, there were significantly decreased in pain in OEG compared with DEG and NEG after 16 weeks. Conclusions As conclusions, this study confirmed that the lumbar stabilization exercise in using the simulation could improve the pelvic movements of elderly patients with chronic low back pain.

본 연구는 만성요통환자에서 PNF 기법을 이용한 요부안정화 운동이 요부 심부근의 두께 변화와 기능적 활동에 미치는 효과를 알아보고자 하였다. 연구대상은 만성 요통환자 30명을 대상으로 하였으며, 실험군을 세군으로 10명씩 무작위 할당하였다; 실험군I은 일반물리치료군(n=10), 실험군II는 일반 요부안정화운동군(n=10), 실험군III은 PNF 기법을 이용한 요부안정화운동군(n=10)으로 나누었다. VAS를 사용하여 통증 변화를 측정하였고, 초음파 장비를 사용하여 4주간의 각 운동에 따른 요부 심부근들(복횡근, 외복사근, 다열근)의 근 두께 변화를 알아보았고, ODQ, RMDQ를 사용하여 기능적 활동 수준 변화를 알아보았다. 그 결과, 실험 전 후에 실험군II와 실험군III의 비교에서 VAS와 근 두께의 변화에 유의한 차이를 보였으며, 각 실험군 간의 유의성 검정 결과, 실험군III에서 다른 군들에 비해 유의한 차이를 나타냈다. ODQ, RMDQ 검사 결과에서는 실험 전 후에 실험군II와 실험군III의 비교에서 유의한 차이를 보였으며, 각 실험군 간의 유의성 검정 결과, 실험군III에서 다른 군들에 비해 유의한 차이를 나타냈다. 이상의 결과로 보아, PNF 기법을 이용한 요부 안정화운동은 일반 요부안정화운동에 비해 통증경감 및 요부에 위치한 심부근들의 두께 향상에 더 효과적임을 알 수 있었으며, 이러한 결과는 기능적 활동수준에도 긍정적인 영향을 미치는 것을 확인할 수 있었다. The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.

To investigate the effects of lumbar stabilization exercises on pain severity, functional disability, and physical performance after two weeks following radiofrequency denervation in patients with lumbar facet joint syndrome (LFJS). Thirty-nine patients diagnosed with LFJS and had radiofrequency denervation were assigned to study and control groups. The study group (n=20) received a six-week stabilization exercise program and was informed about spine biomechanics, while the control group (n=19) received only informations about spine biomechanics. Pain severity with visual analogue scale, perceived disability with Oswestry disability index, physical performance with physical performance tests and gait speed test were applied before and after radiofrequency denervation, and after six weeks of intervention program. Despite the similar improvements were shown in terms of all outcomes in both groups following radiofrequency denervation (p > 0.05), the improvements were more in favor of study group after six week intervention program (p < 0.05). These results indicate that radiofrequency denervation is effective in improving the pain, disability, and physical performance in patients with LFJS and this effect is further enhanced by the stabilization exercises following this procedure. Adding stabilization exercises to radiofrequency denervation yielded positive outcomes and these exercise are strongly advised in physiotherapy and rehabilitation program.

This study aimed to compare the effects of lumbar stabilization exercise with those of the neurodynamic technique on low back pain in patients with lumbar instability.

Secular Mindfulness-Based Interventions: Efficacy and Neurobiology.

Introduction Chronic low back pain (LBP) affects over 10% of the adult population and seriously decreases quality of life. The aging intervertebral disk (IVD) is prone to degeneration, which is associated with an increased risk of LBP. (Luoma et al., 2000) Physical activity influences IVD physiology. Animal studies show that cyclic loading increases proteoglycan synthesis in the disk suggesting a role for running exercise in disk repair. (Brisby et al., 2010) Additionally, an active lifestyle has been shown to either contribute to the onset of chronic pain onset or to be protective against chronic pain depending on the circumstances. Our laboratory has validated a rodent model of LBP, the aging SPARC-null mouse. These mice demonstrate accelerated lumbar disk degeneration as they age, similar to the degeneration observed in human subjects with LBP. SPARC-null mice also display axial and radiating pain that mirrors LBP in humans and is pharmacologically reversible. (Millecamps, Tajerian, Sage, &amp; Stone, 2011) Hypothesis Habitual running exercise will delay disk degeneration and decrease pain behavior in aging SPARC-null mice. Materials and Methods Total 2- to 3-month-old male SPARC-null and C57B wild type mice were used in this study. After recording baseline behavioral measurements, animals had free access to either a circular treadmill (exercise group) or a fixed nonrotating treadmill (control group) in their home cages. Axial LBP was assessed using the tail suspension test and radiating LBP was assessed using the acetone test for cold hypersensitivity in the hindpaw. SPARC-null mice exhibit signs of both axial and radiating LBP in these assays that is sensitive to pharmacological manipulation. Additional assays included tests for mechanical sensory thresholds and motor capacity. Tests were performed at 2 weeks and monthly thereafter. Results After 2 months with access to running wheels, SPARC-null mice show significantly reduced cold sensitivity in the hindpaw compared to baseline ( p &lt; 0.05) and control group ( p &lt; 0.01) with no accompanying change in mechanical sensitivity, indicating a reduction of radiating pain. No effect on axial pain was detected in the tail suspension test, suggesting an effect specific to radiating pain. Conclusion Total 2 months of voluntary running exercise partially reversed the development of radiating LBP in SPARC-null mice. Reversal of axial pain may require longer exposure. Future studies These mice will be followed for 6 months postwheel exposure. Following sacrifice, disk degeneration will be assessed using radiographic and histological methods. Disk innervation will be determined by immunohistochemistry, and the relationships between anatomical and behavioral measures will be determined. I confirm having declared any potential conflict of interest for all authors listed on this abstract No Disclosure of Interest None declared Brisby, H., Wei, A. Q., Molloy, T., Chung, S. A., Murrell, G. A., Diwan, A. D. The effect of running exercise on intervertebral disk extracellular matrix production in a rat model Spine 2010;35(15):1429–1436 Luoma, K., Riihimäki, H., Luukkonen, R., Raininko, R., Viikari-Juntura, E., Lamminen, A. Low back pain in relation to lumbar disk degeneration Spine 2000;25(4):487–492 Millecamps, M., Tajerian, M., Sage, E. H., Stone, L. S. Behavioral signs of chronic back pain in the SPARC-null mouse Spine 2011;36(2):95–102

Objective: This study was aimed at investigating the effects of lumbar stabilization exercise according to correct verbal instructions in pain and muscle strengthening of the low back pain patients. Design: A randomized controlled trial. Methods: Twenty subjects with low back pain were selected. They were randomly assigned to one of two groups (10 in each group): namely the lumbar stabilization exercise and lumbar stabilization exercise according to the correct verbal instructions group. The lumbar stabilization exercise group performed lumbar stabilization exercises for 6 weeks (5 times a week). The lumbar stabilization exercise according to correct verbal instructions group performed lumbar stabilization exercise according to correct verbal instructions for 6 weeks (5 times a week). We measured pain, muscle power, proprioception, and body balance before and after exercise by using visual analog scale (VAS), digital handheld dynanometer, Joint repositioning error, time up and go test respectively. Results: We found statistically significant differences in pain, muscle power, proprioception, and body balance in lumbar stabilization exercise and lumbar stabilization exercise according to correct verbal instructions group, before and after (p<0.05). Conclusions: We confirmed the effect of lumbar stabilization exercise according to correct verbal instructions. Thus we thought these results could be used as basic data and reference for low back pain. But we need more study effect of correct verbal instructions on other exercises.

Although the association of chronic pain (CP) with a poor work-life balance has been well studied, the interaction effect of multiple pain sites on work-life balance is unknown. To evaluate the most prevalent CP site among healthcare workers, the demographic characteristics of the individuals with the predominant pain type, and to assess the interaction of multiple pain sites on work-life balance. Using data from the National Health Interview Survey, 2,458 healthcare works were identified for this study. The independent variables were chronic low back and hip pain. The dependent variables were (1) if pain affected their family or significant other, (2) if pain limited their life or work activities, and (3) Usually working >35 hours/week. Multiple logistic regression and an interaction analysis were used to analyze the impact of different pain sites on work-life balance. Among healthcare workers, chronic low back pain was more prevalent than chronic hip pain (69.4% vs 61.4%, p-value<0.001). Respondents with chronic low back pain were mostly 40 - 64 years of age (49.6%), females (71.2%), white (77.6%), married (55.5%), had no college degree (85.4%), earn greater than $75,000 (50.0%). In the interaction analysis, in the presence of chronic hip pain, those with chronic low back pain had an AOR of 2.20 (1.05 - 4.64), p-value 0.038 of chronic low back pain affecting their family and significant others, and an AOR of 2.18 (1.17- 4.05), p-value 0.014 of chronic low back pain affecting their life or work. Chronic low back pain was more prevalent than chronic hip pain among healthcare workers. Together both pain sites had a significant impact on the work-life balance of this population. Further studies should assess other dimensions of work-life balance and chronic pain.

Introduction: Lumbar stabilization and McKenzie exercises are becoming a popular trend for managing chronic low back pain though it is currently not known whether lumbar stabilization exercises produce better results in improving functional status compared to McKenzie approach. The purpose of this study was to determine the effectiveness of the McKenzie approach versus lumbar stabilization in the treatment of chronic low back pain. Material &amp; Methods: This was a randomized controlled trial. Lottery method was used to randomly divide individuals who fulfilled inclusion criteria into 2 groups. Assessments of the patients were done in OPD. Baseline assessment was done on day 1 and post intervention assessment was done after 2 weeks. A total of 8 treatment sessions spread across 2 weeks were given (4 days per week). Data were assessed at baseline level and post intervention. Data was entered and analysed by SPSS version 21. Results: A total of 28 females and 02 males (mean age of 50.88 ±12.29) participated in the study. After 02 weeks of intervention, both treatment groups showed improvement in decreasing pain and improving functional status. The lumber stabilization group showed significant gains on Numeric Pain Rating Scale and (p=0.001) and Modified Oswestry Disability Index (p=0.001) compared to the Mckenzie group. Conclusion: Patients in both lumber stabilisation and McKenzie groups showed significant improvement, however, the patients in lumbar stabilization group were superior than the patients in McKenzie group on the selected outcomes.

Background and Objectives Chronic non-specific back pain is one of the causes of disability in people, and chronic pain is one of the most important medical problems in the world.The aim of this study was to the effectiveness of Pilates exercises on pain, Disability, in patients with chronic nonspecific low back pain. Subjects and Methods From internal and external search engines Scopus, Semantic Scholar, Google Scholar, Pubmed, ISC SID, Magiran, Irandoc, Doaj with time limit 2010 to 2024 and the keywords Pilates,Pain, Disability, Non-Specific, Chronic Low Back The present study was Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). Results Eleven articles were selected based on inclusion criteria. A systematic review on the effectiveness of Pilates exercises on Pain, Disability, in people with non-specific chronic low back pain. Conclusion According to the research conducted in the present study, Pilates exercises can increase the cross-sectional area of ​​the lumbar multifidus muscle and increase the strength of the abdominal muscle. it seems that Pilates exercises improve pain and disability in patients with chronic low back pain.

Dear Editor I read the article entitled Effect of Lumbar Stabilization and Dynamic Lumbar Strengthening Exercises in Patients With Chronic Low Back Pain by Moon et al. [1] with interest. However, I would like to offer some comments regarding its results and methodology reported. Moon et al. [1] compared 'Lumbar Stabilization' exercises with 'Dynamic Lumbar Strengthening' exercises. However the exercises pictured for each are very similar (i.e., both are a selection of floor- and ball-based exercises). This similarity of training protocols is highlighted by the authors when they stated Although no formal definition of lumbar stabilization exercises exists, the approach is aimed at improving the neuromuscular control, strength [our emphasis], and endurance of the muscles that are central to maintaining the dynamic spinal and trunk stability. The similarity between what should have been protocols aimed at different aspects of lumbar spine function (strength OR stabilization) may explain the lack of differences for most outcomes between the two. Exercises to conditioning lumbar extensor musculature (erector spinae and multifidus) have been recently reviewed [2]. Muscular activation for floor- and ball-based exercises is highly variable between those selected by Moon et al. [1]. In addition, there is little evidence that these exercises offer conditioning effect for these muscles. However, asymptomatic participants were considered in the recent review [2]. The study by Moon et al. [1] suggests that these exercises in both groups may condition the lumbar extensors. However, the recent review [2] reported that isolated lumbar extension (ILEX) training using machines to provide appropriate pelvic restraint may be optimal. In symptomatic participants, Udermann et al. [3] examined the effect of similar exercises as used by Moon et al. [1] using McKenzie techniques in comparison to combined McKenzie and ILEX over a 4-week intervention and reported no significance difference in the improvements of ILEX strength. However, they did note that acute pain relief might explain such findings. Moon et al. [1] utilised a longer intervention (8 weeks). Therefore, it is reasonable to conclude at least some improvement in ILEX strength might be due to lumbar extensors conditioning. In another study by Helmhout et al. [4] who compared ILEX to regular physical therapy (PT) which included stability based exercises, it was reported that similar significant increases in ILEX strength were found in both groups after treatment as well as after 6 and 12 months follow-up. However, in their analysis, they noted that the inclusion of between-group co-interventions (i.e., some of the PT group accidently utilised the ILEX device) might have affected the results. In contrast, Smith et al. [5] conducted a randomised controlled trial and compared exercise using an ILEX device with and without pelvic restraints. Their results showed that only training with the use of restraints (i.e., ILEX) improved ILEX strength, pain, and disability. The authors explained that the use of pejorative terms regarding the unrestrained condition were avoided and participants were informed that the researchers did not know which training would be most effective (hence the purpose of the study, 2012 personal communication from D. Smith; unreferenced). This has been noted as a potentially confounding factor in another study [6], considering the potentially confounding effect of instruction upon outcomes might have helped avoid 'nocebo' effects in the unrestrained group [7]. Thus, these results likely represent the effects of ILEX upon the lumbar extensors as opposed to a placebo effect. This suggests that, although other studies demonstrate benefit in clinical outcomes from any kind of active rehabilitation, the greatest benefits may be achieved from specific ILEX training. Indeed, a recent research study also reported improvements in ILEX strength after an ILEX intervention correlated with improved pain and disability [8]. Recent review [2] suggests that the exercises chosen by Moon et al. [1] could provide poor effect of lumbar extensor conditioning in asymptomatic participants. However, ILEX might be the most effective one. It will be of interest to compare these two approaches. Moon et al. [1] had access to a machine allowing ILEX to be performed (and was used to test ILEX strength as an outcome measure). Thus, a better comparison may have been to include a group performing ILEX exercise using this machine. There is evidently contrasting evidence in this regard. Much is still to be learnt about the 'black box' of mechanisms with which exercise exerts positive effects on those suffering from chronic low back pain [9]. The present letter highlights a number of questions that still require further clarification: 1) Can exercise other than ILEX condition the lumbar extensors (e.g., improve ILEX strength) in symptomatic participants? 2) Does ILEX provide greater improvements in ILEX strength, pain, and disability than other exercise in symptomatic participants? and 3) Is there indeed any relationship between improved ILEX strength as a result of exercise interventions and changes in pain and disability?

Association Between Clinical Tests Related to Motor Control Dysfunction and Changes in Pain and Disability After Lumbar Stabilization Exercises in Individuals With Chronic Low Back Pain

Subcutaneous Stimulation as an Additional Therapy to Spinal Cord Stimulation for the Treatment of Lower Limb Pain and/or Back Pain: A Feasibility Study

Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study with minimum 1‐year follow‐up. (SOAR, Physiatry Medical Group, Menlo Park, CA) <i>Spine</i> 2000;25:2622–2627.

In China, the number of chronic pain patients has exceeded 300 million, making chronic pain the third major health problem after tumors and cardiovascular diseases. Particularly concerning is the gradual emergence of hypertension and chronic low back pain as public health problems that threaten public health and increase the global economic burden. Modern research shows that the incidence of coexisting hypertension is higher among patients with chronic low back pain. Additionally, evidence indicates that the use of NSAIDs for pain relief can have adverse effects on blood pressure, and some antihypertensive medications may trigger symptoms of low back pain. Thus, addressing chronic pain in hypertensive patients while stabilizing blood pressure is one of the important research questions in the modern treatment of hypertension among middle-aged and elderly individuals. From ancient to modern traditional Chinese medicine(TCM) theory, kidney deficiency has been regarded as the core pathogenesis of low back pain. Recent clinical practices and literature indicate that kidney deficiency plays a crucial role in the modern pathogenesis of hypertension. Both hypertension and chronic low back pain are closely associated with kidney deficiency in TCM theory, revealing a potential mechanism linking the two conditions. Combining the theories of &quot; kidney-essence-marrow&quot; and &quot; nourishing water to moisten wood&quot;, a therapeutic strategy centered on tobifying kidney was proposed, including selecting single drugs with kidney-tonifying effects as well as compound formulations and elaborating modern research evidence. The aim is to achieve stable blood pressure control in hypertension patients with chronic low back pain while providing a new treatment perspective for chronic low back pain. This article systematically elaborates on the understanding of hypertension combined with chronic low back pain from both TCM and modern medicine, as well as the therapeutic strategy involving kidney-tonifying drugs, to offer useful references for clinical practice.