[논문]Effects of Lumbar Stabilization Using Pressure Biofeedback Unit During Hip Abduction in Side-Lying in Patients With Low Back Pain

Seo, Young-taek; Chon, Seung-chul

doi:10.12674/ptk.2016.23.2.067

Effects of Lumbar Stabilization Using Pressure Biofeedback Unit During Hip Abduction in Side-Lying in Patients With Low Back Pain 원문보기

한국전문물리치료학회지 = Physical Therapy Korea, v.23 no.2, 2016년, pp.67 - 74

Seo, Young-taek (Dept. of Physical Therapy, College of Medical Science, Konyang University) , Chon, Seung-chul (Dept. of Physical Therapy, College of Medical Science, Konyang University)

Abstract ▼ AI-Helper

Background: Lumbar stabilization (LS) improve the thickness of the quadratus lumborum (QL) muscle and muscle activity of the gluteus medius (GM) muscle during hip abduction in a side-lying position in patients with low back pain (LBP). Objects: The purpose of this study was to assess the effects of LS on muscle thickness of QL and muscle activity of GM during hip abduction in side-lying in patients with LBP. Methods: The study included 32 patients with LBP, who were randomly divided into the control group and experimental group, each with 16 patients. All subjects performed $35^{\circ}$ preferred hip abduction (control group) and $35^{\circ}$ hip abduction with LS (experimental group) during side-lying. An ultrasonography and a surface electromyography were used to measure the thickness of the QL muscle, and the muscle activities of the GM muscle respectively. Independent t-test was used to compare the muscle thickness of the QL and the muscle activity of the GM muscle, respectively. Results: Anterio-posterior diameter in the muscle thickness of QL muscle was decreased significantly in hip abduction with LS more than in preferred hip abduction (p<.001), but medio-lateral diameter in the muscle thickness of QL muscle was not significantly different between in preferred hip abduction and in hip abduction with LS (p=.06). The muscle activity of GM was increased significantly in hip abduction with LS more than in preferred hip abduction (p<.001). Conclusion: These findings suggest that hip abduction with LS could be recommended as a hip abduction for LS and a prevention unwanted compensatory pelvic lateral tilting movement.

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문제 정의

This study was designed to examine the effect of HALS method of core stabilized without compensatory movement in patients with LBP. The results show that the thickness of the QL muscle was decreased and the activity of the GM muscle was increased during the performance of hip abduction in the side-lying position in patients with LBP with core stabilization achieved using a PBU.
This study was undertaken to determine the additive effect of core stability and hip abduction in a side-lying position for LBP patients. To quantitatively investigate the mechanism of core stability on muscle thickness and associated muscle activity, our study has been undertaken for patients with LBP using the real-time ultrasound (US) imaging technique and electromyography (EMG) technique.

가설 설정

Second, the US image technique used to measure the entire shape of the muscle had a limited viewing angle as measured; when the QL muscle was not flexed there is some difficulty in obtaining an image in the same position when the measuring position is moved. Third, US images were not measured between men and women in this research despite of sex difference on the thickness of QL muscle. Lastly, the results of this study cannot be generalized to other populations due to the limited sample size and research design.

제안 방법

The non-dominant lower extremity could be slightly flexed at the knee joints. The subject was asked to perform a hip abduction while side-lying with the dominant lower extremity in the preferred condition, with and without the PBU. A digital inclinometer (Dualer IQ Inclinometer, J-Tech Medical, Heber city, USA) was used to determine the 35° angle for hip abduction.
EMG channel recorded the muscle activity of the dominant side GM muscle. The surface EMG measurement for the GM muscle was used due to the superficial location in this study. The skin was shaved with a razor and cleaned with rubbing alcohol to minimize the effects of contamination.
5 ㎒ convex transducer, the thicknesses of the QL muscle on the dominant side was measured during the PHA and HALS periods. The thickness of the QL muscle was measured by US imaging due to muscle depth in this study. To measure the QL muscle, the transducer was moved laterally from the transverse plane at the L3 level until an image was obtained (Reeve and Dilley, 2009).

대상 데이터

A convenience sample of thirty-two patients with LBP was recruited from local private center (Daejeon, South Korea). All the procedures were explained to the subjects, and each subject signed an informed consent form.
This study used US equipment (Achievo CST, V2U Healthcare, Pte, Ltd. Midview city, Singapore). Using a 3.

성능/효과

Our results confirm the hypothesis that core stabilization during hip abduction in a side-lying position can reduce QL muscle activity and ipsilateral pelvic tilt, resulting in increased the muscle activity of the GM muscle. Previous studies have recommended a treatment protocol that includes relaxation to decrease the activity of the QL muscle and exercise to facilitate the recruitment of the GM muscle (Cynn et al, 2006).
This study was designed to examine the effect of HALS method of core stabilized without compensatory movement in patients with LBP. The results show that the thickness of the QL muscle was decreased and the activity of the GM muscle was increased during the performance of hip abduction in the side-lying position in patients with LBP with core stabilization achieved using a PBU. Our findings suggest that hip abduction movements require core stabilization to prevent unwanted compensatory action by the QL muscle and to selectively facilitate the GM muscle.

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Effects of Lumbar Stabilization Using Pressure Biofeedback Unit During Hip Abduction in Side-Lying in Patients With Low Back Pain 원문보기

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Effects of Lumbar Stabilization Using Pressure Biofeedback Unit During Hip Abduction in Side-Lying in Patients With Low Back Pain 원문보기

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