DOI QR코드

DOI QR Code

Effect of Spinal Stabilization Exercise and Manual Therapy on Visual Analogue Scale and Oswestry Disability Index in Acute or Subacute Patients with Low Back Pain

척추안정화운동과 도수치료가 급성기 또는 아급성기 허리통증 환자의 통증지수와 오스웨스트리 장애지수에 미치는 영향

  • Park, Eun-Young (Dept. of Secondary Special Education, College of Education, Jeonju University) ;
  • Kim, Won-Ho (Dept. of Physical Therapy, College of Ulsan)
  • 박은영 (전주대학교 사범대학 중등특수교육과) ;
  • 김원호 (울산과학대학교 물리치료과)
  • Received : 2012.11.26
  • Accepted : 2013.04.11
  • Published : 2013.04.30

Abstract

The purpose of this study was to investigate effect of type of physical therapy (spinal stabilization exercise and manual therapy) on pain index and disability index in acute and subacute patients with low back pain (LBP). 23 patients with LBP participated and were randomly assigned. Manual therapy and spinal stabilization exercise was applied for 15-minute sessions occurred 3 sessions a week, for 4 weeks. All subjects received conservative therapy for 30-minute. Visual analogue scale (VAS) and Korean version of Oswestry disability index (ODI-K) were measured before and after treatment. There was significant difference in VAS and ODI-K between before and after both treatment (p<.05). There was significant difference in change rate of VAS between manual therapy and spinal sabilization exercise (p<.05), but not in change rate of ODI-K (p>.05). Thus, it is suggested that spinal stabilization exercise is helpful to reduce pain safely in acute and subacute patients with LBP.

이 연구는 척추안정화운동과 도수치료가 급성기 또는 아급성기 허리통증 환자의 통증지수와 장애지수에 미치는 영향을 알아보기 위해 시행되었다. 23명의 허리통증 환자가 자발적으로 참여하였고 무작위로 분류되었다. 도수치료(10명)와 척추안정화운동(13명)은 총 4주간 주 3회, 15분/1회 적용되었다. 각각의 치료 전에 전통적인 치료를 30분간 적용하였다. 치료 전과 후에 시각사상척도와 한국어판 오스웨스트리를 측정하였다. 치료 전에 비해 치료 후 두 치료 모두에서 통중지수와 장애지수가 유의하게 감소하였다(p<.05). 통증지수의 변화율은 도수치료보다 척추안정화운동 시 유의하게 높았지만(p<.05), 장애지수의 변화율은 유의한 차이가 없었다(p>.05). 이상으로 볼 때, 척추안정화운동은 아급성기 또는 급성기 허리통증 환자에서도 통증을 안전하게 줄이는데 도움이 됨을 확인하였다. 따라서 아급성기 이하의 허리통증 환자에서도 통증과 장애를 줄이는데 척추안정화운동이 유용하리라 사료된다.

Keywords

References

  1. S. Haldeman, et al., "North American Spine Society: failure of the pathology model to predict back pain", Spine, Vol.15, pp.718-24, 1990. DOI: http://dx.doi.org/10.1097/00007632-199007000-00019
  2. J. W. Frymoyer, "Back pain and sciatica", Journal of Medicine, Vol.318, pp.291-300, 1988.
  3. M. I. Hasenbring, et al., "Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ)", European Journal of Pain, Vol.13, pp.620-628, 2009. DOI: http://dx.doi.org/10.1016/j.ejpain.2008.11.001
  4. J. Park. "Review: diagnosis and treatment of low back pain', Journal of Korean Academy Family Medicine, Vol. 22, pp.1349-1360, 2001.
  5. J. H. Seo, et al. "Rehabilitation and Medicine: Low back pain and neck pain", pp.761, Koonja, 2008.
  6. H. Yang, et al., "Effects of the physical treatment for nonspecific low back pain: a literature review", Journal of Coaching Development, Vol.7, pp.15-25, 2005.
  7. M. E. Geisser, et al., "A randomized, controlled trial of manual therapy and specific adjuvant exercise for chronic low back pain", Clinical Journal of Pain, Vol.21, pp.463-470, 2005. DOI: http://dx.doi.org/10.1097/01.ajp.0000135237.89834.23
  8. I. Hyong et al., "Effect of immediate dynamic balance ability of chronic low back pain on Maitland's manual therapy", Journal of Korea Contents Association, Vol.9, pp.207-215, 2009. DOI: http://dx.doi.org/10.5392/JKCA.2009.9.6.207
  9. C. E. Cook, et al., "Can a within/between-session change in pain during reassessment predict outcome using a manual therapy intervention in patients with mechanical low back pain?", Manual Therapy, Vol.17, pp.325-329, 2012. DOI: http://dx.doi.org/10.1016/j.math.2012.02.020
  10. E. Hough E, et al., "A comparison of manual therapy and active rehabilitation in the treatment of non specific low back pain with particular reference to a patient's Linton & Hallden psychological screening score: a pilot study", BMC Musculoskeletal Disorders. Vol.1, pp.106-116, 2007. DOI: http://dx.doi.org/10.1186/1471-2474-8-10
  11. C. C. Kisner, et al.., Therapeutic Exercise Foundations and Techniques, pp.407-414, F.A.. Davis, 1989.
  12. J. A. Hides et al., "Multifidus muscle recovery is not automatic following resolution of acute first-episode low back pain", Spine, Vol.21, pp.2763-2769, 1996. DOI: http://dx.doi.org/10.1097/00007632-199612010-00011
  13. P. H. Ferreira, et al., "Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain", British Journal of Sports Medicine. Vol.44, pp.1166-1172, 2010. DOI: http://dx.doi.org/10.1136/bjsm.2009.061515
  14. P. S. Sung, "Multifidi muscles median frequency before and after spinal stabilization exercises", Archives of Physical Medicine and Rehabilitation, Vol.84, pp.1313-1318, 2003. DOI: http://dx.doi.org/10.1016/S0003-9993(03)00139-4
  15. J. Lee, et al., "The effect of lumbar stabilization exercise for caregivers with chronic low back pain", Physical Therapy Korea, Vol.18, pp.9-17, 2011.
  16. B. Koes, et al., "Clinical guidelines for the management of low back pain in primary care: an international comparison", Spine, Vol.26, pp.2504-2514, 2001. DOI: http://dx.doi.org/10.1097/00007632-200111150-00022
  17. R. J. Smeets, et al., "Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]", BMC Musculoskeletal Disorders, Vol.20, pp.5, 2006. DOI: http://dx.doi.org/10.1186/1471-2474-7-5
  18. L. J. Goldby, et al., "A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder", Spine, Vol.31, pp.1083-1093, 2006. DOI: http://dx.doi.org/10.1097/01.brs.0000216464.37504.64
  19. O. F. Aure, et al., "Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up", Spine, Vol.28, pp.525-531, 2003. DOI: http://dx.doi.org/10.1097/00007632-200303150-00002
  20. E. Denison, et al., "Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care". Pain, Vol.111, pp.245-252, 2004. DOI: http://dx.doi.org/10.1016/j.pain.2004.07.001
  21. M. I. Grunnesjö, et al., "A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to 'stay active' care on health-related quality of life in acute or subacute low back pain", Clinical Rehabilitation, Vol.25, pp.999-1010, 2011. DOI: http://dx.doi.org/10.1177/0269215511403512
  22. C. E. Ladeira, "Evidence based practice guidelines for management of low back pain: physical therapy implications", Revista brasileira de fisioterapia, Vol.15, pp.190-199, 2011. DOI: http://dx.doi.org/10.1590/S1413-35552011000300004
  23. D. C. Cherkin, et al., "A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain", New England Journal of Medicine, Vol.339, pp.1021-1029, 1998. DOI: http://dx.doi.org/10.1056/NEJM199810083391502
  24. R. B. Brokelman, et al., "The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty", European orthopaedics and traumatology, Vol.3, pp.101-105, 2012. DOI: http://dx.doi.org/10.1007/s12570-012-0100-3
  25. M. P. Jensen, et al., "Pain site and the effects of amputation pain: further clarification of the meaning of mild, moderate, and severe pain", Pain, Vol.91, pp.317-322, 2001. DOI: http://dx.doi.org/10.1016/S0304-3959(00)00459-0
  26. C. H. Jeon, et al., "Cross-cultural Adaptation of the Korean Version Of the Oswestry Disability Index (ODI)", Journal of Korean Spine Surgery, Vol.12, pp.146-152, 2005. DOI: http://dx.doi.org/10.4184/jkss.2005.12.2.146
  27. J. A. Verbunt, et al., "A new episode of low back pain: who relies on bed rest?". European Journal of Pain, Vol.12, pp.508-516, 2008. DOI: http://dx.doi.org/10.1016/j.ejpain.2007.08.001
  28. K. G. Davis, et al., "The impact of mental processing and pacing on spine loading: 2002 Volvo Award in biomechanics", Spine, Vol. 27, pp.2645-2553, 2002. DOI: http://dx.doi.org/10.1097/00007632-200212010-00003
  29. K. Matsudaira, et al., "Comparison of physician's advice for non-specific acute low back pain in Japanese workers: advice to rest versus advice to stay active", Industrial Health, Vol.49, pp.203-208, 2011. DOI: http://dx.doi.org/10.2486/indhealth.MS1193
  30. L. C. Li, et al.,, "Physical therapy management of low back pain: an exploratory survey of therapist approaches", Physical Therapy, Vol.81, pp.1018-1028, 2001.
  31. J. H. Choi, "Effects of Ultrasound and Laser Therapy in Patients With Sub-Acute Lower Back Pain", Physical Therapy Korea, Vol.14, pp.76-84, 2007.
  32. Y. W. Jung, et al. "The effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients", The Korean Society of Physical Therapy, Vol.16, pp.153-169, 2004.
  33. J. M. Fritz, et al.,, "A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale", Physical Therapy, Vol.81, pp.776-788, 2001. https://doi.org/10.1093/ptj/81.2.776
  34. F. R. França, et al., "Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study", Clinics, Vol.65, pp.1013-1017, 2010. DOI: http://dx.doi.org/10.1590/S1807-59322010001000015
  35. J. K. Ko, et al., "Comparing the effects of drug therapy, physical therapy, and exercise on pain, disability and depression in patients with chronic low back pain", Journal of Korean Academic Nursing, Vol37, pp.645-654, 2007. https://doi.org/10.4040/jkan.2007.37.5.645