The Effects of Active Stretching Exercise on Passive Stiffness of Rectus Femoris Muscle and Low Back Pain in Patients with Lumbar Extension Rotation Syndrome

박규남 KEMA학회 2017 근골격계과학기술학회 Vol.1 No.1

ABSTRACT Background A previous literature suggested that increased passive stiffness of rectus femoris muscle (RF) can cause compensatory lumbopelvic motion in sagittal plane or transverse plane during active knee flexion in patients with lumbar extension rotation syndrome (L-ext & rot syn), resulting low back pain. Purpose The purpose of this study was to investigate the effects of active stretching exercise of RF during 6-week on passive muscle stiffness of RF and low back pain in patients with L-ext & rot syn. Study design Pre/post-test design. Methods Twenty patients with L-ext & rot syn were recruited for this study. Passive RF stiffness was measured in pre- and post-stretching period using specially designed motorized pulling machine. Subjective stretch sensation and intensity of low back pain were measured using numeric rating scale. The subjects performed the active RF stretching exercise during 6-week. The significance of the difference between pre- and post-stretching exercises was assessed using repeated one-way analysis of variance. Results Passive RF stiffness and stretch sensation after RF stretching exercise was significantly reduced in subjects with L-ext & rot syn. However, pain intensity of low back during daily activity showed no significant difference between before and after stretching exercise. Conclusions Active RF stretching exercise during 6-week can decrease RF stiffness, but failed to decrease pain intensity of low back during daily activity in patients with L-ext & rot syn.

Reliability of Hamstring Flexibility Test with Hip Inferior Glide Mobilization in Patients with Low Back Pain

김준석,황의재,권오윤,박규남 KEMA학회 2019 근골격계과학기술학회 Vol.3 No.1

ABSTRACT Background Hamstring tightness is a major cause of low back pain (LBP). The active knee extension (AKE) test is frequently used to measure hamstring tightness in supine-positioned subjects. In patients with musculoskeletal pain, it is important to maintain the axis of rotation for accurate range of motion assessment. Purpose The purpose of this study was to investigate the intrarater test-retest reliability of an AKE test with belt-guided inferior gliding of the hip, which was designed to minimize excessive anterior-superior gliding of the hip in LBP patients with hamstring tightness. We also compared the range of AKE with versus without inferior gliding of the hip in this study population. Study design Reliability study. Methods Thirty-eight patients with LBP and hamstring tightness were recruited to this study. Hamstring tightness was measured in a supine AKE test, with and without inferior gliding of the hip, using the Smart KEMA device. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC). Significant differences in the range of AKE between the groups were detected using a paired sample t-test. Results The hamstring flexibility tests with and without inferior gliding of the hip exhibited good to excellent test-retest reliability (ICC=0.89 for both). The range of AKE with inferior gliding of the hip was significantly less than that of AKE without inferior gliding of the hip. Conclusions Assessment of hamstring flexibility via an AKE test with inferior gliding of the hip is reliable when applied to patients with LBP; the range of AKE was lower in this test compared to those that do not incorporate inferior gliding of the hip. ABSTRACT Background Hamstring tightness is a major cause of low back pain (LBP). The active knee extension (AKE) test is frequently used to measure hamstring tightness in supine-positioned subjects. In patients with musculoskeletal pain, it is important to maintain the axis of rotation for accurate range of motion assessment. Purpose The purpose of this study was to investigate the intrarater test-retest reliability of an AKE test with belt-guided inferior gliding of the hip, which was designed to minimize excessive anterior-superior gliding of the hip in LBP patients with hamstring tightness. We also compared the range of AKE with versus without inferior gliding of the hip in this study population. Study design Reliability study. Methods Thirty-eight patients with LBP and hamstring tightness were recruited to this study. Hamstring tightness was measured in a supine AKE test, with and without inferior gliding of the hip, using the Smart KEMA device. Test–retest reliability was assessed by the intraclass correlation coefficient (ICC). Significant differences in the range of AKE between the groups were detected using a paired sample t-test. Results The hamstring flexibility tests with and without inferior gliding of the hip exhibited good to excellent test-retest reliability (ICC=0.89 for both). The range of AKE with inferior gliding of the hip was significantly less than that of AKE without inferior gliding of the hip. Conclusions Assessment of hamstring flexibility via an AKE test with inferior gliding of the hip is reliable when applied to patients with LBP; the range of AKE was lower in this test compared to those that do not incorporate inferior gliding of the hip.

Effects of Exercise Using a Stick on Muscle Activity of Gluteus Maximus and Erector Spinae during Backward Return from Forward Bending

이원휘 KEMA학회 2019 근골격계과학기술학회 Vol.3 No.2

ABSTRACT Background Chronic lower back pain patients commonly present with impaired lumbar movement patterns, which may result in pain and excessive loads on the lumbar spine. A stick exercise can be effective to correct impaired movement patterns during forward bending in patients with lumbar flexion syndrome. Purpose This study investigated the effect of exercise using a stick on muscle activity of gluteus maximus and erector spinae during backward return from forward bending. Study design Comparative, repeated measures design. Methods A total of 25 male patients with lumbar extension syndrome were recruited to this study. All patients performed backward return from forward bending with and without a stick. Gluteus maximus and erector spinae surface electromyography activities during backward return from forward bending were measured. Results There was a significant difference in gluteus maximus and erector spinae muscle activities, on both sides, with versus without use of the stick. During backward return from forward bending with a stick, the activities of the right and left gluteus maximus increased significantly (p<0.05), and those of the right and left erector spinae decreased significantly (p<0.05), compared to without a stick. Conclusions This study suggests that use of a stick can minimize excessive lumbar extension during backward return from forward bending.

Effects of Same-Sided and Cross-Body Load Carrying on the Activity of the Upper Trapezius and Erector Spinae Muscles

이원휘 KEMA학회 2017 근골격계과학기술학회 Vol.1 No.1

ABSTRACT Background The preference of the bag varies according to age, shoulder bag is mostly used by adults. Shoulder bag can result in an asymmetrical load that has negative impacts on the body. Purpose The purpose of this study was to investigate the effects of same-sided and cross-body carrying on the activity of the upper trapezius and erector spinae muscles in standing position. Study design Controlled laboratory study, with a pretest-posttest design. Methods 20 healthy students were asked to carry the shoulder bag, placing it either on a shoulder on the same side of the body as the bag (same-sided load) or in cross-body fashion in standing position. We used surface electromyography to measure the activities of both upper trapezius and erector spinae muscles. We analyzed the data by using paired t-test and compared muscle activity in two methods. The alpha level was set at 0.05. Results The activity of the right upper trapezius and left erector spinae muscles differed significantly between the two carrying methods (p<0.05), showing significantly less activity under the cross-body condition. The activity of the left trapezius and right erector spinae muscles did not differ significantly between the two carrying methods (p>0.05). Conclusions We suggest that proper carrying method for shoulder bag is needed to help prevent musculoskeletal pain caused by asymmetrical muscle activity.