요통은 산업화된 현대사회에서 흔히 발생하는 질환이다. 요통의 다양한 원인 중에서도 척추의 정상 가동범위를 넘은 불안정성이 요통의 한 원인으로 보고되고 있다. 이 문헌고찰의 목적은 요추 부위의 안정성을 부여하는 운동 프로그램 후 근육 기능의 강화, 통증의 감소를 보고한 논문들을 비교, 분석하는 것이다. 그리하여 요통의 한 원인인 척추의 안정성을 증가시켜 요추 부위의 통증을 감소시키고 기능을 향상시키는 운동 프로그램의 효과를 입증하는 것이다.

이 연구의 목적은 만성요통 여성 환자들에서 나타나는 자세 이상을 평가하고 방사선적 변수들과 임상적인 변수들과의 상관성을 알아보는 것이다. 이 연구의 대상자는 만성요통 여성 환자 38명과 대조군 32명이었다. 변수의 측정은 모든 대상자들이 이완된 자세로 기립한 상태에서 방사선 검사를 실시한 후 경추전만각, 흉추후만각, 요추전만각, 그리고 요추경사각을 측정하였다. 대상자들의 연령과 통증기간은 의무기록지를 참고하였다. 자료분석은 요통군과 대조군의 방사선적 변

The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.

The purpose of this study were to determine causes of low back pain in bus drivers who usually work in prolonged sitting position and to find the relationship of back pain with general characteristics and work environmental characteristics, stress symptoms, to com맹re lordosis angle of habitual driving posture and resting posture in low back pain group and non-low back pain group, and to use this result as a basis for improvement of work environment and comprehensive rehabilitative management of low back pain. Ninety-eight bus drivers were selected from the membership of an urban transit union in Seoul. These informations were collected from May 1, 1997 to May 25, 1997 by means of structured questionnaires and X-ray findings. These data were analyzed by test, t-test, logistic regression using SAS. The major results were as follows: 1. Of the respondents, 66.3% of bus drivers were found to be experiencing back pain. 2. Of the respondents of low back pain groups, 78.5% reported that major cause of low back pain was due to prolonged sitting. 3. The group with experiences of frequent or continuous vibration had more low back pain (p<0.05). There were no significant differences among other work environmental factors. 4. Average stress score was significantly higher in the group with low back pain than in the group without low back pain (p<0.05). 5. The results of the logistic regression analyses were statistically significant vibration from seat and stress score among the risk factors (p<0.05). 6. Averaged lordosis angle of habitual driving posture was degrees in low back pain group, degrees in non-low back pain and averaged lordosis angle of resting sitting posture was degrees in low back pain, degrees in non-low back pain group but the difference in mean lordosis angles of two groups was not statistically significant. The results of this study indicate that professional drivers developed chronicity of low back pain due to unfit seat, poor habitual posture and stress from vibration or other risk factors. Therefore, there is need to improve work environment, i.e. enough resting, to set a seat to support lumbar spine properly and to provide comprehensive rehabilitation program including early diagnosis, proper treatment and education for self help management.

The purpose of this study was to assess the biomechanical effects of corset and back brace for low back pain syndroms patients. The subjects of this study were 69 patients with low back pain syndroms who had been hospitalized or were visited out-patient department of the rehabilitation hospital, college of medicine, Yonsei University, from October 5, 1995 through November 5, 1995. Clinical results and datum were obtained by phone calls and chart reviews of low back pain patients. The results were as follows: 1) Fifty - nine subjects recovered over a good grade (85.6%). 2) The standing workers had a little effect of brace for low back pain. 3) After using a corset and back brace, the test of SLR increased from 36.23% to 72.47%, and the ability of ambulation improved from 40.57% to 85.5%. In conclusion, the biomechanical effects of corset and back brace for low back pain patients were found to be decrease pains and improve posture and ADL function.

Measures of radiographic pelvic and spinal parameters of sagittal balance analysis have become of considerable importance for reconstructive surgery of the spine, particularly in cases of degenerative spondylolisthesis. The authors conducted a retrospective study of clinical outcomes and a radiological review on 231 patients with one or two level degenerative spondylolisthesis. First, patients were classified using preoperative pelvic parameters and evaluations were conducted using mean values of pre- and postoperative spinopelvic parameters. Second, patients were divided into two study groups, that is, Group A (n=105; exhibited no improvement (increase or no change) in pelvic tilt postoperatively) and Group B (n=126; exhibited pelvic tilt improvement (decrease) postoperatively). Clinical outcomes in the two groups were compared using Visual Analogue Pain Scores (VAS) and Oswestry disability index (ODI). All preoperative pelvic parameters show restoration tendency after PLIF surgery for spondylolisthesis, and greater deviations of preoperative pelvic parameters from normality showed greater recovery postoperatively. VAS and ODI improvements at follow-up were poorer in group A than in group B.

본 연구에서는 통증제어가 거의 불가능한 급성요통 환자를 대상으로 바로 누운 자세를 할 수 없는 환자에게 불가피하게 자기공명검사를 받아야할 환자를 위해 기존촬영방법인 정상 체위 바로 누운 자세 대신 변형된 옆으로 누운 자세를 취하게 하여 기존 척추 전용 코일과 복부 전용 코일을 이용하여 요통을 경감시키고 불안정한 자세 보정과 움직임에 의한 인공물을 줄여 장시간 검사를 받는 환자에게 피로감을 감소시켜 자기공명검사의 성공률을 높이고자 한다. 평가방법으로는 영상의 질을 정성적 평가로 하였으며 결과로는 정상인 연구대상자 기존촬영방법인 바로 누운 자세의 평균 점수는 4.64점, 정상인 연구대상자 옆으로 누운 자세(A군)는 3.44점, 극심한 요통을 호소하는 비정상인 연구대상자 옆으로 누운 자세(B군)는 3.40점으로 나타났다. 결론적으로 정상인 연구대상자의 기존촬영방법인 바로 누운 자세에서 검사한 정성적인 평가는 예상대로 높게 나타났으나 정상인 연구대상자 옆으로 누운 자세와 극심한 요통을 호소하는 비정상인 연구대상자 옆으로 누운 자세로 검사한 영상의 정성적 평가는 거의 비슷하게 나타났다. 또한 극심한 요통을 호소하는 비정상인 연구대상자 옆으로 누운 자세(B군)의 영상평가에서 영상의학과 전문의의 영상판독에도 문제가 없는 것으로 나타났다. 이에 바로 누운 자세에서 검사를 진행함에 불편을 겪는 환자에게 이러한 기법이 보편화 된다면 임상에서 많이 활용될 것으로 사료된다.

앉은 자세를 장시간 유지하면 허리의 만곡에 변화가 오면서 통증이 발생하게 된다. 본 연구에서는 양반 앉은자세에 서 SPINE-GUARD(허리 안정화 벨트) 착용이 허리뼈의 코브각과 허리통증 그리고 몸통 굽힘각도의 변화에 미치는 영 향에 대해 알아보았다. 대상자 15명(남자)은 2주 동안 주 5회 매회 90분씩 벨트를 착용한 채로 영화를 감상하거나 강 의를 들었다. 허리뼈의 코브각은 착용전 48.36±14.57에서 착용후 28.09±11.63로 유의한 감소를 보였다(p<0.05). 통 증은 착용전 4.53±2.36이고, 착용후 2.733±2.153로 유의하게 감소하였다(p<0.05). 몸통의 굽힘각도 또한 착용전 82.33±20.30에서 착용 후 70.2±19.43로 유의한 감소를 보였다(p<0.05). 이것으로 보아 SPINE-GUARD의 착용은 허리뼈의 코브각 및 몸통굽힘각도의 변화 그리고 통증의 감소에 영향을 주는 것으로 사료된다.

The purpose of this study is to provide basic date on the causes and factors related with the workload on board for Korea Seaman's Low Back Pain. The date had been acquisited through the questionaires of those and analysed in Korea Institute of Maritime and Fisheries Technology from February 10 to April 10 in 1999. The results of this study are as follows: 1. The incidence of Occupational low back pain for the recent 12 months has been recorded as 56.2% of the subject. 2. The highter Occupational satisfaction has the lower incidence of low back pain(p＜0.01). and the person who takes a rest(p＜0.05) and physical exercise regularly(p＜0.01) has lower experience of the incidence. 3. The incidence of low back pain by charateristics of vessel was turn out as 59.3% of the fishing vessel, 55.3% merchantmarine and 52.9% of the vessel of special purpose. The incidence of each department of a ship has recorded as 54.3% of Deck Dept. 59.2% of engine Dept but there was little relationship between those. And the longer period of work and on-board service has the hither incidence of the higher incdence(p＜0.01). 4. The fittness of the working table (p＜0.01) and chair(p＜0.01) has affeced the incidence of low back pain significantly 5. The higher incidence of low back pain has been experienced in case of working: in back posture, and lifting up or carrying a heavy load(p＜0.01) 6. The major cause of low back pain was turned out as excessive workload(26.5%) and stress (18.5%) ; the stress(24.1%) and excessive overwork(22.4%) for Deck dept. and excessive workload(32.3%) and bad position(21.7%) for Engine Dept(P＜0.01)