본 연구의 목적은 골반 교정이 중년 여성의 만성 요통과 척추 골반 지표들에 미치는 영향을 규명하는데 있다. 이를 위하여 만성 요통이 있는 중년 여성 38명을 실험군(20명)과 무처치 대조군(18명)에 무선 할당하여 실험군에게는 골반 교정을 주 4회, 8주 간 시술하였다. 시술 전과 8주 후에 요통은 시각적 상사 척도와 Oswestry 요통 장애 지수로 측정하였고, 그 외 요부 유연성, 염증인자인 혈중 C-reactive protein (CRP) 및 척추 골반 지표들을 평가하였다. 처치 8주 후 대조군에 비하여 골반 교정군에서 요통 강도, 요통 장애 지수 및 요부 유연성 모두가 유의하게 향상되었으며, 혈중 CRP의 유의한 변화는 없었다. 척추 골반 지표들을 분석한 결과 골반 교정군에서 대조군에 비해 요추전만각, 천골경사 및 골반균형지표는 유의하게 변화된 반면, 골반입사각의 변화가 뚜렷하지 않았다. 따라서 골반 교정은 요통 환자의 통증 경감과 기능 향상에 효과적일 것이며, 척추 골반 정렬의 변화의 결과일 것이다.
본 연구의 목적은 골반 교정이 중년 여성의 만성 요통과 척추 골반 지표들에 미치는 영향을 규명하는데 있다. 이를 위하여 만성 요통이 있는 중년 여성 38명을 실험군(20명)과 무처치 대조군(18명)에 무선 할당하여 실험군에게는 골반 교정을 주 4회, 8주 간 시술하였다. 시술 전과 8주 후에 요통은 시각적 상사 척도와 Oswestry 요통 장애 지수로 측정하였고, 그 외 요부 유연성, 염증인자인 혈중 C-reactive protein (CRP) 및 척추 골반 지표들을 평가하였다. 처치 8주 후 대조군에 비하여 골반 교정군에서 요통 강도, 요통 장애 지수 및 요부 유연성 모두가 유의하게 향상되었으며, 혈중 CRP의 유의한 변화는 없었다. 척추 골반 지표들을 분석한 결과 골반 교정군에서 대조군에 비해 요추전만각, 천골경사 및 골반균형지표는 유의하게 변화된 반면, 골반입사각의 변화가 뚜렷하지 않았다. 따라서 골반 교정은 요통 환자의 통증 경감과 기능 향상에 효과적일 것이며, 척추 골반 정렬의 변화의 결과일 것이다.
The purpose of this study was to investigate the effects of pelvic adjustment on low back pain and spino-pelvic parameters in middle-aged women. Thirty-eight middle-aged women with chronic low back pain were randomly assigned to the pelvic adjustment (n = 20) oruntreated control (n = 18) group. Pelv...
The purpose of this study was to investigate the effects of pelvic adjustment on low back pain and spino-pelvic parameters in middle-aged women. Thirty-eight middle-aged women with chronic low back pain were randomly assigned to the pelvic adjustment (n = 20) oruntreated control (n = 18) group. Pelvic adjustment interventionswereperformed four times a week for 8 weeksin the former group. At baseline and after 8 weeks, the back pain and back function were evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and back flexibility. Additionally, the spino-pelvic radiographic parameters and serum C-reactive protein (CRP) levels were assessed. After 8 weeks, the VAS, ODI, and back flexibility significantly improved in the pelvic adjustment group compared with the control group. It was found that the changes from baseline in the lumbar lordotic angle, sacral slope, pelvic crest unleveling, and femoral head height inequality were significantly greater in the pelvic adjustment group than in the control group. There were no significant changes in the pelvic incidence or serum CRP levels in either group. In conclusion, pelvic adjustment has beneficial effects on chronic low back pain and back function, suggesting that the effects of pelvic adjustment on back pain may at least in part result from changes in the spino-pelvic alignment.
The purpose of this study was to investigate the effects of pelvic adjustment on low back pain and spino-pelvic parameters in middle-aged women. Thirty-eight middle-aged women with chronic low back pain were randomly assigned to the pelvic adjustment (n = 20) oruntreated control (n = 18) group. Pelvic adjustment interventionswereperformed four times a week for 8 weeksin the former group. At baseline and after 8 weeks, the back pain and back function were evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and back flexibility. Additionally, the spino-pelvic radiographic parameters and serum C-reactive protein (CRP) levels were assessed. After 8 weeks, the VAS, ODI, and back flexibility significantly improved in the pelvic adjustment group compared with the control group. It was found that the changes from baseline in the lumbar lordotic angle, sacral slope, pelvic crest unleveling, and femoral head height inequality were significantly greater in the pelvic adjustment group than in the control group. There were no significant changes in the pelvic incidence or serum CRP levels in either group. In conclusion, pelvic adjustment has beneficial effects on chronic low back pain and back function, suggesting that the effects of pelvic adjustment on back pain may at least in part result from changes in the spino-pelvic alignment.
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제안 방법
All subjects had sagittal radiography of the lumbar and pelvis while standing and anterior pelvic radiography in supine position. On each sagittal radiograph three spino-pelvic parameters including sacral slope, pelvic incidence, and lumbar lordosis were measured as previously described[19,34,35].
At baseline and after 8 weeks, back pain and function were measured and radiographs of the lumbar and pelvis were obtained in both groups. Body weight and height were measured, and BMI was calculated to estimate obesity. Duration of back pain and diagnosed diseases from doctors were surveyed.
Subjects in the PM group received the 15-minute session, four times a week for 8 weeks by one manipulative therapist at the T oriental medical hospital. Pelvic adjustments were performed utilizing a drop table technique[29] with modifications to enhance the forces transmitted in the area to be adjusted. The drop table has sections that can be raised and then dropped down.
Subjects in the PM group received the 15-minute session, four times a week for 8 weeks by one manipulative therapist at the T oriental medical hospital. Pelvic adjustments were performed utilizing a drop table technique[29] with modifications to enhance the forces transmitted in the area to be adjusted.
대상 데이터
Thirty-eight women completed the study. Eight subjects dropped out of the study due to personal reasons. Attrition rate was 87% in the PM and 78% in the control group, respectively.
Forty-six women with chronic low back pain were recruited from outpatients at the T oriental medical hospital in the Daegu city, South Korea and randomly assigned into PM and untreated control groups. PM group underwent an 8-week intervention program.
Serum samples were prepared by centrifuging the samples at 3000 rpm for 10 minutes and were stored at –70°C until analysis. Serum CRP levels were analyzed by the Green Cross Reference Laboratory in South Korea. Serum high-sensitivity CRP levels were assessed by latex-enhanced immunoturbidimetric assay (ADVIA 2400, Siemens, USA) using CRP-Latex (II) X2 kit (Denka-Seiken, Japan).
데이터처리
When data were not normally distributed, non-parametric statistics were used to test statistical significance. Accordingly, an independent t-test or Mann-Whitney test was performed to evaluate the significance of the difference between means of two groups in all variables (age, BMI, VAS, ODI, back flexibility, radiographic variables, and serum CRP) at baseline. Significance of difference from baseline in VAS, ODI, back flexibility, radiographic variables, and serum CRP was tested by paired t-test or Wilcoxon signed ranks test depending on data distribution in each group.
All variables were tested for the normality of distribution using Shapiro-Wilk test. When data were not normally distributed, non-parametric statistics were used to test statistical significance.
Accordingly, an independent t-test or Mann-Whitney test was performed to evaluate the significance of the difference between means of two groups in all variables (age, BMI, VAS, ODI, back flexibility, radiographic variables, and serum CRP) at baseline. Significance of difference from baseline in VAS, ODI, back flexibility, radiographic variables, and serum CRP was tested by paired t-test or Wilcoxon signed ranks test depending on data distribution in each group. The independent t-test or Mann-Whitney test was used to test whether or not changes from baseline in the PM group significantly differ from those in the control group.
이론/모형
Back pain intensity was evaluated with the visual analogue scale (VAS). Patients estimated their intensity of pain and marked a vertical dash on a 10-cm horizontal line with no markings, except “no pain” at the left and “very severe pain” at the right end of the line[30].
성능/효과
After 8 weeks, the mean change from baseline in VAS in the PM group was significantly greater than that of the control group (p < 0.001) indicating that PM reduced pain intensity.
After 8-week intervention, VAS significantly decreased in the PM group (p < 0.001), whereas it significantly increased in the control group (p < 0.05).
There were no significant differences between two groups at baseline in age, BMI, ODI, back flexibility, serum CRP, and all spino-pelvic parameters except VAS (p < 0.05).
후속연구
We propose that pelvic adjustment may be effective for chronic low back pain at least in part resulting from changes in spino-pelvic alignment. Future studies with a larger sample size will be needed to confirm our findings.
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