Jeong, Eun Dong
(Korea University Medical Center Anam Hospital)
,
Chae, Chang Woo
(Korea University Medical Center Anam Hospital)
,
Yun, Hong Kyu
(Korea University Medical Center Anam Hospital)
,
Woo, Kwang Seog
(Korea University Medical Center Anam Hospital)
,
Kim, Dong Hyun
(Daegu University)
,
Kim, Seung Min
(Korea University Medical Center Anam Hospital)
Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been s...
Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.
Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.
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문제 정의
The purpose of this research is to study the effect of the sling, integrated with spinal stabilization exercise and the latest theories on exercise therapy, on the pain reduction and trunk muscle activity in patients of chronic low back pain. With these results, it aims to provide an effective exercise program to the patients.
However, research on the effect of using slings during bridging exercise, one of the most commonly employed exercise programs, on the activity level of trunk muscles is insufficient. Therefore, by conducting four weeks of sling exercise program on patients with chronic low back pain, this research aims to study the resulting effect on the activity of trunk muscles and the degree of pain.
This research aims examine the effect of sling bridging exercise program, conducted in various positions, on the pain and muscle activity in patients of chronic low back pain. In order to achieve the purpose of this study, an analysis was done to compare the experimental group, which underwent the sling bridging exercise program, versus the control group and the normal group both of which did not take part in the exercise program.
제안 방법
C, USA) were used on all subjects for 20 minutes in order to evenly set their skin temperature at a constant level. After their skin was cleaned with alcohol swab, surface EMG pads were attached to the right side of the patients for the duration of sling bridge exercises, and muscle activity levels were measured. The raw surface EMG signals were band pass-filtered between 10 and 500㎐ and amplified using a differential amplifier(MyoSystem 1,400, Noraxon Inc, Scottsdale, AZ).
This research aims examine the effect of sling bridging exercise program, conducted in various positions, on the pain and muscle activity in patients of chronic low back pain. In order to achieve the purpose of this study, an analysis was done to compare the experimental group, which underwent the sling bridging exercise program, versus the control group and the normal group both of which did not take part in the exercise program.
In order to measure the level of subjective pain felt by patients before the sling bridging exercise, they were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt(no pain:0 point, severe pain: 10 points). Then, depending on the level of subjective pain, the patients were divided into four groups.
The participants of the experimental group were patients of chronic low back pain, who received four weeks of sling bridge exercise in various positions. The control group consisted of patients of chronic low back pain who did not receive sling bridge exercise. The physical characteristics of the study participants are as showing Table 1.
The subjects of this study were limited to Group I∼III, and the pain level of the patients in these three chosen groups were measured in the same method after four weeks of exercise.
대상 데이터
These 38 participants were divided into three groups:10 people in the normal group, 14 people in the experimental group, and 14 people in the control group. The participants of the experimental group were patients of chronic low back pain, who received four weeks of sling bridge exercise in various positions. The control group consisted of patients of chronic low back pain who did not receive sling bridge exercise.
The subjects of this study were currently enrolled students and patients of University and Hospital (Seoul, South Korea)–a total of 38 participants.
데이터처리
Paired t-test was used to find the average and standard deviation of each measured item, as well as the difference between the before and after of the study among the groups for each position. In addition, two-way ANOVA was used to analyze the difference among the groups in each position for change variation in trunk muscle activity level. For statistical processing of the data, Statistical Package for the Social Science(SPSS), Windows version 12.
성능/효과
It is further stated that neuromuscular activation rehabilitation exercise recovers the function of stabilizer and abdominal muscle, which aids postural stability of trunk muscles, and increases and strengthens the muscles in damaged parts(12). In conclusion, while this research needed more time in order to completely relieve low back pain, during the 4 weeks it was able to confirm the significant effect that exercise conducted on the sling has on pain relief and muscle activity level at various positions, as well as the role of trunk muscle as an agonist muscle at various positions.
The experimental group with four weeks of sling bridge exercise experienced a statistically significant(p<.05) increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position.
The experimental group, which received sling bridging exercise, showed a statistical significance (p<.05) in the decrease of subjective pain level from 5.8±0.7 to 3.1±0.6 after 4 weeks.
The research by Stevens and Imai shows that bridging exercise on a stable support surface had no effect on the proportion of erector spinae muscle in trunk muscles activity(28, 29). The findings of this research is able to confirm that erector spinae muscle is activated at a relatively greater proportion in all groups, when the exercise is conducted in supine position.
While another research has stated that there was no relevant difference between the muscle activity level in rectus abdominis and external oblique during bridging exercise of chronic low back pain patient, this research shows that the RMS level has increased overall, but statistical significance was observed for only the experimental group. The results show that in supine position, the RMS level increased for erector spinae; in sidelying position, RMS increased for internal oblique; in prone position, RMS increased for rectus abdominis. However, findings also indicate that when bridging exercise is conducted in supine position, muscle activity levels in rectus abdominis and external oblique are low, concurring with the aforementioned research.
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