노르딕워킹이 만성요통 여성노인의 체력 및 통증감소에 미치는 영향

이창수 ( Changsu Lee ),주동진 ( Dongjin Joo ) 한국특수체육학회 2017 한국특수체육학회지 Vol.25 No.1

노인의 요통 발병률과 유병률은 젊은 층에 비해 높으며, 약 20%의 노인들이 요통을 경험하고 있는 것으로 알려져 있다. 특히 여성노인이 남성노인에 비해 요통의 발병률과 유병률이 높다. 요통의 치료와 완화를 위한 방법으로 비용이 저렴하고, 약물의 투여와 수술이 필요하지 않은 것은 운동이다. 노르딕워킹은 폴을 이용, 저차원(low-tech)적이며, 누구나 쉽게 배울 수 있다는 장점이 있다. 본 연구의 목적은 만성요통 여성노인을 대상으로 10주 동안 노르딕워킹 프로그램을 실시하여 통증의 변인에 어떠한 영향을 미치는지를 알아보고자 한다. 연구의 대상자는 65세 이상 80세 미만 중 최근 6개월 동안 요통을 경험하고 있고, 운동 경험이 없는 대상자 30명(실험군 14명, 대조군 16명)을 선정하였다. 실험군과 대조군에게 인구통계학적 특성, 배근력, 유연성, 균형성 테스트를 실시하였으며, 시각적 통증 사상 척도에 대한 설문조사를 실시하였다. 실험군은 배근력, 유연성, 균형성이 증가하였으며, 통증 정도는 감소한 것으로 조사되었다. 대조군은 배근력, 유연성, 균형성은 감소되었으나 통증 정도는 실험 전·후와 비교하면 변화가 없는 것으로 조사되었다. 향후, 노르딕워킹은 요부의 근력 향상을 위한 재활운동 프로그램으로 사용될 수 있을 것이다. 임상현장에서 요통환자를 위한 최적의 재활운동 프로그램은 아직까지 확실하게 적립되지 못했다. 하지만, 노르딕워킹이 재활운동 프로그램 중 하나로 활용 될 수 있을 것이다. 노인 의료비 지출이 기하급수적으로 늘어나고 있는 현시점에서 노르딕워킹 프로그램이 저비용으로 시간과 장소의 구애를 적게 받으며, 요통의 완화에 효과가 있으므로, 의료비 지출을 줄일 수 있을 방법이 될 것으로 사료된다. In case of older adults, Chronic low back pain is a higher problem compared to the young generation. Approximately 20% of older adults have a Chronic low back pain. Especially, elderly women have more experienced than elderly men. Best way to reduce lower back pain is an exercise because it is less-expensive, low-tech, and easy to learn compared to surgery and treatment of medicine. The purpose of this study was to find out the relationship between Nordic Walking and pain. Participants were total 34 female older women at the age 65 over who were suffering Chronic low back pain. The experimental group was regularly participating Nordic Walking for 10 weeks, and the control group was doing normal life without exercise. Both groups were tested back muscle strength, balance, flexibility, and visual analog pain scale. After 10 weeks of Nordic walking program, the experimental group increased their back muscle strength, balance, flexibility and decreased visual analog pain scale. From the results, Nordic walking program will be used rehabilitation exercise program to improve back muscle strength for older adults who have severe lower back pain. Furthermore, Older adults` health care costs have risen sharply in the past several decades. Nordic walking program is not only a low-cost, don`t much care about time and space, but also effect reducing low back pain. Therefore, Nordic walking program is another counter plan for reducing government medical cost.

Chronic Low Back Pain in Young Korean Urban Males : The Life-Time Prevalence and Its Impact on Health Related Quality of Life

Shim, Jae-Hyun,Lee, Kyeong-Seok,Yoon, Sang-Young,Lee, Chang-Hoon,Doh, Jae-Won,Bae, Hack-Gun The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.56 No.6

Objective : We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods : A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results : The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion : In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health.

경피신경전기자극의 빈도-강도가 만성 요통 환자의 요통장애지수와 유연성에 미치는 영향

박정호(Jung-Ho Park),송브라이언병(Brian Byung Song) 한국콘텐츠학회 2012 한국콘텐츠학회논문지 Vol.12 No.6

이 연구의 목적은 경피신경전기자극을 저빈도-저강도, 저빈도-고강도, 고빈도-저강도, 고빈도-고강도 네개의 치료조건으로 나누어 만성요통환자에게 적용하였을 때 각기 다른 주파수 빈도와 강도가 만성요통환자의 미치는 영향을 알아보는 것이다. 연구대상은 평균연령 39.19(±12.96)세, 발병기간 8.57(±3.07)개월인 요통환자 32명이었다. 치료기간은 2주 횟수는 총 10회로 1일 1회 15분간 시행하였으며 치료부위는 통증이 가장 심한 요추주변 부위에 시행하였다. 치료 전·후의 변화를 평가하기 위해 요통정도(요통장애지수)와 요추부 유연성을 측정하였다. 각 군간 윌콕슨, 맨-휘트니 검정을 하였고, 통계적 유의성은 p< .05로 하였다. 결과는 다음과 같다. 네 군 모두 실험 후 요통장애지수와 요추부 유연성에 유의한 결과가 나왔으며, 저빈도군에서는 고강도가, 고빈도군에서는 고강도가 보다 효과적이었다. 고빈도-고강도가 요통장애지수와 요추부 유연성에 유의한 차이는 없었지만 가장 효과적이었다. The Purpose of this study was to find out the effects of frequency and intensity of transcutaneous electrical nerve stimulation(TENS) on the patients with chronic low back pain. The subjects were 32 patients with chronic low back pain average age 39.19 (± 12.96)years. The duration of chronic low back pain was 8.57 (± 3.07)months. The treatments were given 15 minutes once a day five a week for two weeks. to low back. Lumbar range of motion(ROM) and Oswestry Disabilitv Index(ODI)) was evaluated before and after TENS application. Each group was compared using Wilcoxon Mann-Whitney test. The results were as followings: Each group showed significant effect. High intensity group showed more effect in low frequency group. High intensity group showed more effect in high frequency group. Therefore, the high intensity can be used more effectively with high frequency for treating chronic low back pain.

기능성 신발을 활용한 보행운동이 만성 요통에 미치는 효과

구지영,이승훤,권기순,조성우,윤현민,장경전,송춘호,김철홍,홍상훈 대한침구의학회 2011 대한침구의학회지 Vol.28 No.3

Objectives : The purpose of this study is to evaluate the effect of 12 weeks-walking exercise with functional shoes on chronic low back pain. Methods : The subjects of this study were 18 females from thirty to sixty years old who had suffered from low back pain over 12 weeks. They wore S shoes with curved out-sole and soft material in arch of foot We asked them to walk wearing shoes for 1 hour a day over 4 days a week for 12 weeks. Improvement of the symptoms was evaluated by pain rating scale, Oswestry low-back pain disability index. We measured lumbar lordotic angle, Ferguson’s angle, bone mineral density, body composition. The measurements were checked before and after exercise. Results : This study showed significant improvement in pain rating scale, oswestry low-back pain disability index, and body composition. And lumbar lordotic angle, Ferguson’s angle and bone mineral density decreased. Conclusions : These results showed that walking exercise with functional shoes could decrease the symptoms of chronic low back pain. But, it’s too difficult to conclude whether the efficacy was due to functional shoes or walking exercise because we didn’t set the control group wearing general shoes.

Alternation of Topical Heat and Cold for Chronic Low Back Pain : A Randomized Controlled Pilot Trial

Choi, Young Doo,Jo, Su Jeong,Jung, Chan Yung,Kim, Kap Sung,Lee, Seung Deok Korean AcupunctureMoxibustion Medicine Society 2016 대한침구의학회지 Vol.19 No.3

Objectives : This is a pilot study for a large randomized controlled trial to investigate the efficacy and safety of a newly developed contrast therapy device-- alternating topical heat and cold -- for patients with chronic low back pain. The main objective of this study is to confirm the feasibility of the study design. Methods : The design was a randomized, 2-arm, parallel-group, single-blind, placebo controlled trial. Patients in each group received real or sham contrast therapy in an acupuncture point 10 times over four weeks. The primary outcome measure was pain intensity on a 100-mm visual analogue scale (VAS). The secondary outcomes were back-related dysfunction based on the Oswestry Disability Index (ODI), the Roland-Morris disability questionnaire (RMDQ), and range of motion of lumbar spine based on the modified Schober test (mSchober test), Finger-to-Floor distance (FTF distance), and Finger-to-Thigh distraction (FTT distraction). Results : A total of 30 subjects with chronic low back pain were randomly assigned to a contrast therapy group (n=15) or a sham group (n=15). A repeated-measures analysis of variance showed statistically significant group time interaction for VAS, RMDQ, mSchober test and FTF distance (p<0.05). The treatment group showed significant improvement in pain intensity and functional disability as compared to the sham group. Conclusion : Contrast therapy may be an effective and safe treatment for chronic low back pain.

Alternation of Topical Heat and Cold for Chronic Low Back Pain : A Randomized Controlled Pilot Trial

Young Doo Choi,Su Jeong Jo,정찬영,Kap Sung Kim,Seung Deok Lee 대한침구의학회 2016 대한침구의학회지 Vol.33 No.2

Objectives : This is a pilot study for a large randomized controlled trial to investigate the efficacy and safety of a newly developed contrast therapy device-- alternating topical heat and cold -- for patients with chronic low back pain. The main objective of this study is to confirm the feasibility of the study design. Methods : The design was a randomized, 2-arm, parallel-group, single-blind, placebo controlled trial. Patients in each group received real or sham contrast therapy in an acupuncture point 10 times over four weeks. The primary outcome measure was pain intensity on a 100-mm visual analogue scale (VAS). The secondary outcomes were back-related dysfunction based on the Oswestry Disability Index (ODI), the Roland–Morris disability questionnaire (RMDQ), and range of motion of lumbar spine based on the modified Schober test (mSchober test), Fingerto- Floor distance (FTF distance), and Finger-to-Thigh distraction (FTT distraction). Results : A total of 30 subjects with chronic low back pain were randomly assigned to a contrast therapy group (n=15) or a sham group (n=15). A repeated-measures analysis of variance showed statistically significant group time interaction for VAS, RMDQ, mSchober test and FTF distance (p<0.05). The treatment group showed significant improvement in pain intensity and functional disability as compared to the sham group. Conclusion : Contrast therapy may be an effective and safe treatment for chronic low back pain.

분절별 등뼈 관절가동술이 만성허리통증환자의 통증과 관절가동범위에 미치는 즉시적 효과

심재헌 ( Jae-heon Sim ),정의철 ( Ui-cheol Jeong ),최희양 ( Hee-yang Choi ),김철용 ( Cheol-yong Kim ) 대한물리의학회 2017 대한물리의학회지 Vol.12 No.2

PURPOSE: This study aims to identify the immediate effects of thoracic mobilization according to segment on disabling low-back pain and the range of motion in patients with chronic low-back pain. METHODS: The participants were divided randomly into two groups: a group (N=12) with pain and disability between the 5th and 9th thoracic vertebrae (T5-T9) and a group (N=12) with pain and disability between the 10th and 12th thoracic vertebrae (T10-T12). The same experiment was conducted in both groups: 10 minutes of thoracic mobilization and 10 minutes of functional massage. The visual analogue scale (VAS) and range of motion measurements were applied to the participants in both groups. All participants were measured again immediately after the program was completed. RESULTS: In both groups, the VAS and range of motion measurements showed statistically significant improvement after the experiment (p< .05). No statistically significant difference was revealed between the two groups (p >.05). CONCLUSION: The results of this study confirmed positive and immediate effects of thoracic mobilization of patients with chronic low-back pain. But, no significant difference in the thoracic mobilization by segment between the two groups. Based on these results, thoracic mobilization could help to improve pain control and functional activity in patients with chronic low-back pain.

요통 환자의 심박변이도 특성에 대한 임상적 연구

류지미 ( Ji Mi Ryu ),김성수 ( Sung Su Kim ),정석희 ( Seok Hee Chung ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.2

Objectives: To study autonomic nervous system dysfunction of Low Back Pain(LBP) patients, using spectral analysis of Heart Rate Variability(HRV). Methods: HRV of 190 patients was measured and seperated into two groups, those with LBP(n=95) and healthy controls(n=95). HRV was measured by SA-6000(Medicore, Korea) for 5 minutes after 5 minutes` resting. Results: 1. Mean heart rate(MHRT) of the experimental group was slightly higher than that of the control group, but did not show significant difference(P=0.428). The square root of the mean squared differences of successive normal-to-normal intervals(RMSSD), logarithmic very low frequency power(Ln VLF) and low frequency power/high frequency power ratio(LH/HF ratio) were not significantly low between experimental group and control group(P=0.16, 0.130, 0.537). 2. The standard deviation of all the normal-to-normal intervals(SDNN), logarithmic total power(Ln TP), logarithmic low frequency power(Ln LF) and logarithmic high frequency power(Ln HF) were significantly low between experimental group and control group(P=0.03, 0.005, 0.001, 0.007). 3. Ln LF of acute group was significantly low compared with those of chronic group(P= 0.039). Conclusions: This study suggests the activity and imbalance of autonomic nervous system in LBP is low. Also sympathetic nervous system of acute LBP is lower than that of chronic LBP. Further study of HRV related to LBP is needed in the clinical medicine.

만성요통환자가 지각하는 낙관성과 우울에 관한 연구

박현숙,손정태 대한간호학회정신간호학회 2001 정신간호학회지 Vol.10 No.2

This study was conducted using a descriptive correlational survey design to identify how the patients with chronic low-back pain perceived depression and to examine the relationship between optimism and depression. The participants of the study were 116 patients with chronic low-back pain patient who were having follow-p treatment in a local pain clinic, located in Daegu. A structured questionnaire was filled out participants themselves and the structured interview was given during January and February, 2000. The data collection instrument were Scheier & Carver's Life Orientation Test(1985) and Beck's Depression Inventory(1983). The data collected were analysed using mean, S.D.,t-test, F-test, Duncan test, Pearson correlation coefficient, and Multiple regression, aided with SAS. The results were as follows: 1. For the depression regarding demographic characteristics, there were significant differences in age, sex, marriage status, educational level, spouse and extended family, job, and care money giver. 2. For the depression regarding pain characteristics, there were significant differences in additional pain with low-back pain, pain degree, and daily activity impediment. 3. Mean of respondents' perceived optimism marks was 26.12±4.56. 4. Mean of respondents' perceived depression marks was 17.53±8.76. 5. There was significant negative correlation between optimism and depression(r=-0.6082, p=.0001). 6. Optimism was the highest factor predicting depression of the patients with chronic low-back pain(R^2=0.3699).

Beck 우울 척도 점수가 요통 환자의 한방 치료 초기에 미치는 영향에 대한 후향적 연구

홍남중 ( Nam Jung Hong ),이제균 ( Je Kyun Lee ),이태규 ( Tae Gyu Lee ),박종훈 ( Jong Hoon Park ) 대한한방신경정신과학회 2011 동의신경정신과학회지 Vol.22 No.4

Objectives: The purpose of this study is to know that Beck Depression Inventory(BDI) score to effect on improvement degree of low back pain after oriental medical treatment. Methods: We analyzed charts of 33 inpatients who were treated in Ja-Seng Hospital of Oriental Medicine and Bu-Cheon Ja-seng Hospital of Oriental Medicine. Subject is divided into Group A(BDI<10) and Group B(BDI≥10). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were checked on admission, after 1 week, NES and OUT were rechecked o estimate the efficacy of treatments. Results: 1. In both groups, NES was significantly decreased(p<0.05). Analyzed result of the interaction between the two groups didn`t show significant difference(p=0.197). 2. In Group A, ODI was significantly decresed(p<0.05). In Group B, ODI wasn`t significantly decreased(p=0.058). The interaction analysis between the two groups didn`t show significant difference(p=0.173). 3. Analyzing patients with chronic back pain longer than 6 months by the presence of depression tendency and NRS, ODI decrease after 1 week of ambulation, while the NRS reduction showed relevancy by the depression tendency (p<0.05), the ODI reduction didn`t(p=0.272). Conclusions: 1. Although improvement of pain before and after the treatment and degree of functional recovery in high level BDI group was less than low-level BDI group, but it was stastically insignificant. 2. High BDI score of patients with chronic low back pain is the factor of disturbing pain improvement.