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.

This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.

The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.

This research was performed to compare spinal segment motion angle between low back pain (LBP) group and painless group during trunk flexion-extension and to investigate the effect of transversus abdominis strengthening exercise on spinal segment motion angle in LBP group. Nine subjects with LBP and ten subjects without LBP participated. Transversus abdominis strengthening exercise was performed in LBP group for three weeks, and spinal segment motion angles were compared before and after the exercise performance. Spinal segment motion angles were measured both in sitting and standing position. Results were as followed: 1) Subjects' average age was 24.79 years, height was 167.84 cm, and weight was 59.95 kg. 2) Spinal segment motion angle of T10/l1 was significantly higher in LBP group compared with painless group (p<.05) in sitting position during trunk flexion-extension. 3) In sitting position, whereas entire lumbar segment motion angles were lower in LBP group compared with painless group (p<.05), angle of L4/5 was higher in LBP group compared with painless group (p<.05). 4) There was no significant difference in thoracic segment motion angle in standing position. 5) After three weeks of transversus abdominis strengthening exercise, thoracic segment motion angle increased both in sitting and standing position (p<.05). 6) In painless group, there was no significant difference in entire spinal segment motion angles in sitting and standing position (p>.05). When spinal segment motion angles were compared between sitting and standing position, there were slight differences. In sitting position, there was no difference in spinal segment motion angle between LBP group and painless group while hip joint motion angle and sacral inclination angle of LBP group was lower than those of painless group (p<.05). In standing position, lumbar segment motion angle was significantly lower in LBP group than that of painless group. Transversus abdominis strengthening exercise influenced thoracic segment motion angle more significantly than lumbar segment motion angle.

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in hamstring gluteus maximus, and lumbar erector spinae muscle during active hip extension between subjects with low back pain (LBP) and healthy subjects. Thirty subjects, 15 with LBP and 15 healthy subjects, participated in this study. Electromyographic activity was recorded during active hip extension in prone and standing position. Relative onset times of these muscle activities were determined. Similar muscle firing order in hamstring, gluteus maximus, and lumbar erector spinae muscle showed in both groups and positions. However, the onset time of gluteus maximus was significantly later in prone and standing active hip extension in subjects with LBP than in healthy subjects. The onset time of lumber erector spinae muscle activity was significantly delayed in subjects with LBP in standing active hip extension, The delayed onset times of gluteus maximus and lumbar erector spinae muscles' activities were probably related to LBP. Further studies are needed to identify whether the delayed onset times of gluteus maximus and lumbar erector spinae muscle activities are the contributing factors to LBP.

The purpose of this study was to identify the differences of the static and the dynamic balance reactions in the flexion syndrome (FS) and the extension syndrome (ES) group of the patients with chronic lowback pain (LBP) and healthy subjects. Twenty subjects were included in each group. By using EquiTest 5.02, the static balance was measured by the equilibrium score and the strategy score of sensory organization test (SOT), while the dynamic balance was measured by the latency of motor control test (MCT) and the sway energy of adaptation test (ADT). Oswestry Disability Index (OSI) was used to measure level of the disability in patients with chronic LBP. The equilibrium scores, the strategies of SOT, and thelatencies of MCT of three groups were compared with one way ANOVA, while the sway energy of ADT was compared with repeated measures one way ANOVA. The results of this study showed that the equilibrium scores and the strategy scores of SOT were significantly lower in patients with chronic LBP than in healthy subjects. The equilibrium scores and the strategy scores of SOT were significantly differences between the FS and ES groups in condition 5 (support surface was sway-referenced and visual information waseliminated by eye closure), and 6 (support surface was sway-referenced and visual information was altered by sway-referencing). The FS group showed delayed average reaction time at large posterior translation, however, the ES group showed delayed average reaction time at large anterior translation, Even though the sway energy of the patients with chronic LBP were greater than that of healthy subjects during the toe down (plantar flexion rotation), the values between the FS and ES groups didn't show any significant difference. The disability level showed highly correlation with the equilibrium score of the condition 5. As the results, the FS and ES groups divided by the their symptoms and signs in patients with chronic LBP showed different balance reaction. Therefore, more accurate evaluation and balance treatments are needed to focus on their symptoms and signs in patients with chronic LBP.

Many pregnant women have experienced low back pain (LBP) during pregnancy and after delivery, and it has been an important component in women health. This study was designed to investigate the characteristics and management of the LBP in postpartum women. Eighty-five postpartum women were participated in this survey. Mean age of 85 women was 28.1 years. Of 85 postpartum women, 55.3% (n=47) had LBP after pregnancy. Thirty of 47 women had pain on lumbar region, 17 postpartum women had pain on sacroilium region. Of 85 postpartum women, 74% (n=54) had LBP before pregnancy and 71.8% (n=61) had LBP during pregnancy. Of 47 postpartum women who had LBP, 83% (n=39) had not received medical management for LBP, 12.8% (n=6) took medication, and 4.3% (n=2) performed self-exercise. None of postpartum women had received physical therapy during pregnancy and after delivery for treatment low back pain. The pain in SI region was more severe than in lumbar region after pregnancy according to VAS (visual analog scale) (p<.05). However, there was no significant difference in VAS scores between SI pain and lumbar pain before and during pregnancy (p>.05). Pain region after delivery was related to pain region of pre-pregnancy and during pregnancy (p<.01). Pain level after delivery was related to the pain and night pain level during pregnancy (p<.01).

The purposes of this study were to investigate risk factors of low back pain in civil airmen and to use this information as basis for the back rehabilitation. Subjects of this study were randomly selected 276 civil airmen who had been employed at four airports in Seoul. These data were analyzed by test, t-test, ANOVA, and multiple logistic regression using SAS. The results were as follows: 1) The prevalence of low back pain among 276 civil airmen was 64.9%. 2) The most common cause of low back pain was load lifting (stewardess), long sitting (aircrew A), and long sitting plus training (aircrew B). 3) There were no statistically significant associations among age, height, body weight, and low back pain. 4) No statistically significant relationships were found among the average monthly working time, total working time, average monthly rest time, working year and low back pain. 5) There was statistically significant relation ship between abnormal posture and low back pain (p<.01). 6) There was statistically significant relation ship between fatigue and low back pain among stewardess and aircrew B. 7) There was a statistically significant relationship between job satisfaction and job-related stress (p<.05). 8) In stewardess, higher satisfaction score was associated with less likelihood of low back pain (odds ratio = .80). The results of this study indicate that civil airmen developed chronicity of low back pain due to unfit seat, poor habitual posture, fatigue symptom, and stress or other risk factors. Therefore, there is a need to improve the working environment for the prevention of posture-related low back pain.

The purpose of this study was to compare the differences of weight-bearing distribution between subjects with low back pain and healthy subjects. Fifty-one subjects (22 men, 29 women; mean age = 42.9 years) with low back pain and 31 healthy subjects (11 men, 20 women; mean age = 35.4 years) were evaluated. The weight-bearing distribution was measured by two commercial scales during comfortable standing. The difference of weight-bearing distribution between right and left side was calculated for each subject. The differences of weight-bearing distribution in subjects with low back pain and healthy subjects were 6.0 kg and 4.5 kg, respectively. However, there were no significant differences in the weight-bearing distribution between subjects with low back pain and healthy subjects.

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.

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.

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)