척추 안정화 운동과 등뼈가동술이 만성 허리통증환자의 척추 유연성에 미치는 영향 = Effects of Trunk Stability Exercises and Thoracic Manipulation on Spine Flexibility in Chronic Low Back Pain Patients

다국어 초록 (Multilingual Abstract)

PURPOSE: This study aimed to investigate the benefits of thoracic manipulation and the trunk stability exercises on spine trunk flexibility and the pain index of chronic low back pain patients.
METHODS: The study included 44 patients suffering from chronic low back pain. The participants were divided into two groups: the first group was assigned for trunk stability exercises (TSE), and the second group was randomly assigned TSE and thoracic manipulation at the same time (TSE+TM). Both groups carried out each assigned treatment thrice a week for 8 weeks. The study outcome was based on assessment of spine trunk flexibility and the pain index. Spine trunk flexibility was measured by spine flexion and extension through a range of motion and thoracic cage circumference. The pain index was measured using a visual analog scale (VAS).
RESULTS: Spine flexion and extension range of motion showed a significant difference within each group and between the groups before and after the treatment. The measurement of the thoracic cage circumference also showed a notable difference within each group and between the groups before and after the treatment. There was no change in the pain index.
CONCLUSION: These results indicate that thoracic manipulation with the trunk stability exercises is an efficient treatment for improving the spine trunk flexibility and soothing pain for chronic low back pain patients.

참고문헌 (Reference)

1 고태성, "흉추 관절가동술이 만성요통환자의 통증, 장애지수 및 척추 운동성에 미치는 효과" 특수교육재활과학연구소 48 (48): 115-137, 2009

2 양진모, "흉추 관절가동술이 만성요통환자의 통증, 고유수용감각 및 균형수준에 미치는 효과" 한국전문물리치료학회 22 (22): 1-11, 2015

3 김선엽, "복횡근 강화운동이 체간 신전-굴곡 시척추 분절 운동에 미치는 영향" 한국전문물리치료학회 10 (10): 63-76, 2003

4 허진강, "만성 요통근로자의 흉추운동프로그램 효과" 한국전문물리치료학회 12 (12): 44-57, 2005

5 김종순, "동적 요부 안정화 운동 치료법이 요통 환자에 미치는 영향" 대한물리치료학회 13 (13): 495-507, 2001

6 Krauss J, "Translatoric spinal manipulation for physical therapists"

7 Edmondston SJ, "Thoracic spine : anatomical and biomechanical considerations for manual therapy" 2 (2): 132-143, 1997

8 Rasmussen-Barr E, "Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain" 8 (8): 233-241, 2003

9 Cleland JA, "Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain : a randomized clinical trial" 87 (87): 431-440, 2007

10 Seichert N, "Sagittal shape and mobility of the spine validity and reliability of the new MediMouse/SpinalMouse" 9 (9): 331-, 2000

11 Bijur PE, "Reliability of the visual analog scale for measurement of acute pain" 8 (8): 1153-1157, 2001

12 Cairns MC, "Pressure biofeedback : a useful tool in the quantification of abdominal muscular dysfunction?" 86 (86): 127-138, 2000

13 Queiroz BC, "Muscle activation during four Pilates core stability exercises in quadruped position" 91 (91): 86-92, 2010

14 Evjenth O, "Muscle Stretching in Manual Therapy : The spinal column and the temporo-mandibular joint" Alfta Rehab 1984

15 Hodges PW, "Measurement of muscle contraction with ultrasound imaging" 27 (27): 682-692, 2003

16 Singer KP, "Manual therapy considerations at the thoracolumbar junction : an anatomical and functional perspective" 13 (13): 83-88, 1990

17 Aure OF, "Manual therapy and exercise therapy in patients with chronic low back pain : a randomized, controlled trial with 1-year follow-up" 28 (28): 525-531, 2003

18 Olson KA, "Manual Physical Therapy of the Spine-E-Book" Elsevier Health Sciences 2015

19 Kaltenborn FM, "Manual Mobilization of the Joints: The Kaltenborn Method of Joint Examination and Treatment:Traction-Manipulation of the Extremities and Spine: Basic Thrust Techniques" Norli 2008

20 Fritz JM, "Lumbar spine segmental mobility assessment : an examination of validity for determining intervention strategies in patients with low back pain" 86 (86): 1745-1752, 2005

21 O'Sullivan PB, "Lumbar repositioning deficit in a specific low back pain population" 28 (28): 1074-1079, 2003

22 Delitto A, "Low back pain" 42 (42): A1-57, 2012

23 Hides JA, "Long-term effects of specific stabilizing exercises for first-episode low back pain" 26 (26): E243-8, 2001

24 Descarreaux M, "Learning spinal manipulation : the importance of augmented feedback relating to various kinetic parameters" 6 (6): 138-145, 2006

25 Levangie PK, "Joint structure and function : a comprehensive analysis" FA Davis 2011

26 Skyba D, "Joint manipulation reduces hyperalgesia by activation of monoamine receptors but not opioid or GABA receptors in the spinal cord" 106 : 159-168, 2003

27 Levangie PK, "Joint Structure and Function;A Comprehensive Analysis" FA. Davis Company 2000

28 Cleland JA, "Immediate effects of thoracic manipulation in patients with neck pain : a randomized clinical trial" 10 (10): 127-135, 2005

29 Bicalho E, "Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects" 15 (15): 469-475, 2010

30 Lederman E, "Fundamentals of manual therapy : physiology, neurology and psychology" Churchill Livingstone 1997

31 Ki C, "Effects of Forced Breathing Exercise on the Trunk Functions of Chronic Low Back Pain Patients" Daegu University 2013

32 Hoeksma HL, "Comparison of manual therapy and exercise therapy in osteoarthritis of the hip : a randomized clinical trial" 51 (51): 722-729, 2004

33 Airaksinen O, "Chapter 4. European guidelines for the management of chronic nonspecific low back pain" 15 (15): S192-300, 2006

34 Arokoski JP, "Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients" 85 (85): 823-832, 2004

35 Niemistö L, "A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain" 28 (28): 2185-2191, 2003

36 Goldby LJ, "A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder" 31 (31): 1083-1093, 2006

37 Mannion AF, "A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine : reliability of measurements and comparison with data reviewed from the literature" 13 (13): 122-136, 2004