To evaluate test-retest reliability of trunk kinematics relative to the pelvis during gait in two groups (males and females) of patients with non-specific chronic low back pain (NCLBP) using three-dimensional motion capture system.
A convenience sample of 40 NCLBP participants (20 males and 20 females) was evaluated in two sessions. Participants were asked to walk with self-selected speed and kinematics of thorax and lumbar spine were captured using a 6-infrared-cameras motion-analyzer system. Peak amplitude of displacement and its measurement errors and minimal detectable change (MDC) were then calculated.
Intraclass correlation coefficients (ICCs) were relatively constant but small for certain variables (lower lumbar peak flexion in female: inter-session ICC=0.51 and intra-session ICC=0.68; peak extension in male: inter-session ICC=0.67 and intra-session ICC=0.66). The measurement error remained constant and standard error of measurement (SEM) difference was large between males (generally ≤4.8°) and females (generally ≤5.3°). Standard deviation (SD) was higher in females. In most segments, females exhibited higher MDCs except for lower lumbar sagittal movements.
Although ICCs were sufficiently reliable and constant in both genders during gait, there was difference in SEM due to difference in SD between genders caused by different gait disturbance in chronic low back pain. Due to the increasing tendency of measurement error in other areas of men and women, attention is needed when measuring lumbar motion using the method described in this study.
Citations
To investigate depressive symptoms and their related factors in patients with chronic low back pain in Korea.
A cross-sectional study using data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2009 was undertaken. The sample consisted of 1,426 participants with chronic low back pain. Multifactorial regression analysis was used to identify the association between depressive symptoms and socioeconomic demographics and other chronic diseases.
Among the 371 (26.0%) patients with depression, significant factors associated with depressive symptoms were female gender (odds ratio [OR], 2.691; 95% confidence interval [CI], 1.724-4.199), medical aid beneficiary (OR, 1.371; 95% CI, 1.039-1.810), a dependent group for activities of daily living (OR, 1.570; 95% CI, 1.180-2.087), 'not good' in the perceived health category (OR, 2.309; 95% CI, 1.730-3.081) and in a cancer group (OR, 1.803; 95% CI, 1.051-3.093).
This study provides the foundation for managing patients with chronic low back pain and depressive symptoms. Clinicians managing chronic low back pain should consider risk factors for depressive symptoms.
Citations
Objective: To evaluate the effects of back extensor strengthening exercise on improving the pain, activities of daily living (ADL) and bone mineral density in the chronic low back pain patients.
Method: 21 patients with chronic low back pain participated in back school program. Before program, measurement of lumbar extensor strength with MedXⰒ (Ocala, USA), visual analogue scale (VAS) for pain, level of ADL and bone mineral density (BMD) with DEXA (LunarⰒ, GE, USA) were done. For 12 weeks subjects had received the training for strengthening of back extensor and then, checked up with the above variables again.
Results: The results were as follows: 1) After 12 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased significantly (p＜0.01), 2) VAS and ADL were significantly improved from 5.1 to 3.3, and 8.1 to 9.9, respectively (p＜0.01), 3) BMD of lumbar spine were significantly improved from 1.1 to 0.8 (p＜0.05)
Conclusion: Twelve weeks lumbar extensor strengthening program with pelvic stabilization may be the effective therapeutic program for patients with chronic low back pain. (J Korean Acad Rehab Med 2002; 26: 576-580)
Objective: The purpose of this study is to evaluate concentric and eccentric trunk muscle strength in patients with chronic low back pain and compare it with healthy controls to determine the role of trunk muscle in chronic low back pain
Method: Subjects were 20 chronic low back pain patients with the duration at least 6 months and 20 normal adults. Concentric and eccentric isokinetic trunk muscle test was performed at specific speeds (30o, 60o, 120o/sec) with Cybex 770 machine in back pain patients and healthy control.
Results: The strength of trunk flexor and extensor muscles of chronic low back pain patients was significantly weaker than that of normal controls. Eccentric peak torque was significantly higher than concentric peak torque in both patients and healthy control. A concentric and eccentric ratio of patients was lower than that of normal controls. The correlation between concentric and eccentric variables was high. Our results show that concentric peak torque has the highest correlation with eccentric peak torque.
Conclusion: Isokinetic evaluations of the trunk muscle offer objective and quantitative data of patients with chronic low back pain and will be clinically useful in muscle power measurement of lumbar muscles.
Objective: To evaluate the effects of strengthening exercise for isolated lumbar extensor muscles on chronic low back pain patients.
Method: 28 patients with chronic low back pain in back school program participated in this study. Initially, isometric lumbar extensor strength, 10 point of Visual analog scale (VAS) and questionnaires related to self-experienced symptoms and daily activity (ADL) were checked. Isometric lumbar extensor strength test and strengthening exercise were performed with MedXTM lumbar extensor machine, which was designed to stabilize the pelvis. After 8 weeks of training program, isometric lumbar extensor strength & other pain related variables were checked again in the same way.
Results: The results were as follows: 1) After 8 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased at all the measured points significantly (p＜0.01). 2) VAS and ADL were improved from 6.7 to 3.7, and from 6.9 to 9.1 respectively (p＜0.05).
Conclusion: 8 weeks of lumbar extensor strengthening program with pelvic stabilization was effective therapeutic tools for patients with chronic low back pain.
Objective: The purpose of this study was to evaluate the whole spine of the patients with chronic low back pain.
Method: The cervico-thoraco-lumbar spine were evaluated in 128 patients with chronic low back pain. We analyzed radiologic and clinical findings of the cervico-lumbar spine and electrodiagnostic findings.
Results: Most of all cases showed abnormal findings in plain radiography and electrodiagnostic study. The radiologic findings were as follow: cervical X-ray with straightening of cervical lordotic curve in 85 cases; thoracic X-ray with scoliosis in 55 cases; lumbar X-ray with disc space narrowing in 85 cases. The electrodiagnostic study revealed lumbosacral radiculopathy in 87 cases. There were significant positive relationship between increased lumbosacral angle and straightening of cervical lordotic curve, and between lumbar scoliosis and thoracic scoliosis.
Conclusion: Cervico-thoracic spinal abnormalities were shown in most of the patients with chronic low back pain. Therefore, The evaluation of whole spine would be needed comprehensive rehabilitation approach for the patients with chronic low back pain.
Objective: To evaluate the effect of compensation or secondary gain on the pain behavior and psychometric characteristics.
Method: We examined 88 patients who complained of chronic low back pain by the various pain questionnaires, electrodiagnostic study and magnetic resonance imaging (MRI). Total patients were classified into two groups (46 patients who wanted disability evaluation and 42 patients who did not).
Results: Mean score of visual analogue scale, total sum of McGill pain questionnaire and pain rating index on sensory, affective and miscellaneous dimensions were significantly higher in patients related to disability compensation than those in patients without compensation. Mean scores of pain disability index and symptom checklist-90-revision were significantly higher on various subclass in patients with compensation. Various pain scales were significantly correlated to each other in both group but the severity of electrodiagnostic study and MRI findings were not related with the degree of pain index score in both group.
Conclusion: Compensation or secondary gain affect pain behavior and psychometric characteristics in chronic low back patients. So when we evaluate or treat the patients with chronic low back pain, we should consider above results.
The purpose of this study was to obtain the normative values for variable parameters of lumbar function with the isoinertial triaxial dynamometer in normal subjects and to compare these values with those of the patients with chronic low back pain.
In 82 normal subjects and 27 patients with chronic low back pain, the variable parameters including lumbar range of motion (ROM), maximum isometric torques, and maximum isoinertial velocities were measured with the isoinertial triaxial dynamometer in three axes (rotation, flexion-extension, and lateral flexion). In normal subjects, all parameters except lumbar ROM of all three axes were significantly higher in the male group than the female group. However, other anthropometric variables such as age, height, weight, and body mass index were little correlated with each parameter. Therefore, the normative values were obtained only in consideration of the gender. In patients with chronic low back pain, all parameters except the maximum isometric torques in the female group were significantly lower than those in normal subjects. In addition, the decrease of maximum velocities during the isoinertial exercise was highly correlated to verbal rating scales (VRS) in most axes, especially in the female patient group, but the duration of low back pain was little correlated with the various parameters measured with the isoinertial triaxial dynamometer.
In conclusion, all parameters measured with the isoinertial triaxial dynamometer in all three axes were significantly lower in patients with chronic low back pain than those in normal subjects except maximum isometric torques of female group. It was suggested that maximum isoinertial velocities were more reliable and significant than maximum isometric torques for the objective assessment of chronic low back pain.
The purpose of this study was to evaluate the effectiveness of topically applied capsaicin cream for the treatment of chronic low back and posterior neck pain. Fourty-one patients with chronic low back or posterior neck pain of more than 6 months despite comprehensive management in our rehabilitation department were selected for this study. Of these subjects, a group of 21 patients used capsaicin cream, and the other 21 patients used NSAID gel as a control group. Pain intensities in both groups were measured with the visual analogue scale(VAS) before the treatment, 2 weeks and 5 weeks after the treatment. McGill Pain Questionnaire(MPQ) was used before and 5 weeks after the treatment. According to followed-up VAS, MPQ-number of words chosen, and MPQ-pain rating index, there was an evidence of effective pain relief by capsaicin cream for the low back and posterior neck pain 5 weeks after the treatment. We conclude that continuous use of capsaicin cream for 5 weeks can be beneficial for the chronic pain patients in relieving pain and subsequently helping their rehabilitation process.
First
Prev
