침 근전도로 측정한 만성 요통 환자의 어깨 굴곡시 나타나는 다열근 활성도 비교

장원석,Jang, Won-Seok 대한물리치료과학회 2011 대한물리치료과학회지 Vol.18 No.3

Purpose : The purpose of study is activation of lumbar multifidus muscle by needle EMG during shoulder flexion in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymtomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. The needle EMG were measured activation of multifidus. Needle electrode was used to 28 gauge. The shoulder flexion movement used to activate the multifidus was then measured. Results : Results of the analysis showed that asymptomatic subjects had significantly larger multifidus muscle activation compared with CLBP subjects during shoulder flexion. Conclusion : This study will be used as multifidus measurement method of patient with chronic LBP. The multifidus muscle in chronic LBP patient clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Therefore chronic LBP patients necessary multifidus activation measurement with needle EMG.

PNF 상지 운동이 다열근에 미치는 영향

구봉오 ( Bong Oh Goo ) 대한물리의학회 2012 대한물리의학회지 Vol.7 No.3

Purpose The purpose of this study is to define the change of lumbar asymmetry multifidus muscles when upper extremity PNF pattern. Methods For this research, twenty-nine asymptomatic participants were voluntary attended. Under the identical conditions, Multifidus muscles were measured standing position and on L4,L5 vertebral level by MyLabOne (ESAOTE, Netherland with a 3.5MHz covex array transducer). The upper extrimity PNF pattern used to activate the multifidus ipsilateral and cotralateral. Results Results of analysis showed that at the L4, L5 vertebral level, healthy asymtomativ subjects had asymmetry multifidus muscles size. The depth of the multifidus muscles were significantly increased at contralateral upper extrimity PNF pattern, but no significant differences were comparison ipsilateral with contralateral. Conclusion The multifidus muscle in asymptomatic subjects clinical significance asymmetry. Contralateral upper extrimity PNF pattern seems to be the most suitable exercise for strenthen the smaller size of the multifidus. This study will be used as a prevention method of LBP.

Back Muscle Changes after Pedicle Based Dynamic Stabilization

Moon, Kyung Yun,Lee, Soo-Eon,Kim, Ki-Jeong,Hyun, Seung-Jae,Kim, Hyun-Jib,Jahng, Tae-Ahn The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.53 No.3

Objective : Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. Methods : Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. Results : Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. Conclusion : Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.

미세현미경디스크 제거술 후 초기 분절안정화 운동이 배가로근과 뭇갈래근의 활성도 및 통증에 미치는 영향

설동일,박우영,안근옥 대한운동학회 2015 아시아 운동학 학술지 Vol.17 No.1

[PURPOSE] This study is to evaluate the effects of lumbar segmental stabilizing exercise on the local muscle activities of patients who underwent Laser microdiscectomy. [METHODS] Twenty-four patients who underwent Laser Microdiscectomy, were divided into two groups including an experimental group who would take lumbar segmental stabilizing exercise and a control group. The exercise therapy was applied for 8weeks after a 6-week postoperative resting period. The experimental group performed an exercise regimen for 30minutes per day, 3times a week for 8weeks, whereas the control group received ordinary physical therapies. Their pains were measured by the visual analog scale(VAS), and echographic measurements were made on changes in the thicknesses o f transversus abdominis and multifidus. The activities of transversus abdominis and multifidus were analyzed 8weeks before and after the exercise, along with VAS. [RESULTS] The results of this study are as in the following: First, the activity of transversus abdominis muscle was enhanced significantly as the period of measurement elapsed. There was no significant inter-group difference, but it appeared that an interaction occurred between a period of measurement and a group. Second, the activity of multifidus muscle was enhanced significantly as the period of measurement elapsed. There was no significant inter-group difference, and more over there was no interaction between a period of measurement and a group. Third, the visual analogue scale showed a significant fall as the period of measurement elapsed, and there were interactions between a period of measurement and a group. [CONCLUSIONS] As regards early rehabilitation for patients who underwent, Laser Microdiscectomy segmental stabilizing exercise, known to strengthen deep spinal muscles, has positive effects on muscular activity and pain and thus is crucial to securing lumbar stability.

자기공명영상 (Magnetic Resonance Image)을 통한 요통 환자의 다열근 위축에 대한 후향적 연구

이길준 ( Kil Joon Lee ),박영회 ( Young Hoi Park ),금동호 ( Dong Ho Keum ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.4

Objectives: In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods: The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results: The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient`s age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot`s of information about spinal neuropathy problems. Conclusions: Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

대학생의 배가로근과 뭇갈래근 두께와 척추정렬간의 상관관계

임재헌,Lim, Jae-Heon 대한고유수용성신경근촉진법학회 2014 PNF and Movement Vol.12 No.4

Purpose: The transverse abdominis and themultifidus muscle are located in the core. They surround one's trunk and help in body stabilization. Specifically, they control spine articulation to maintain posture and balance. Therefore, weakened deep muscle in the trunk may cause spinal malalignment. This study aims to compare the correlation between the thickness of the transverse abdominis and the multifidus muscle and the spine alignment among college students in their 20s. Methods: This study measured the thickness of the transverse abdominis and the multifidus muscle of 42 healthy college students in their 20s using ultrasonic waves. The thickness of the muscle was measured for the length of the cross-section except for fascia. The thickness of the left and right muscles was measured, and the mean value was calculated. As the thickness of the transverse abdominis can increase because of pressure during exhalation, it was measured at the last moment of exhalation. Spinal alignment was measured by the kyphosis angle, lordosis angle, pelvic tilt, trunk inclination, lateral deviation, trunk imbalance, and surface rotation using Formetric III, which is a three-dimensional imaging equipment. They were measured for three times, and the mean values were calculated. The general characteristics of the subjects were analyzed using descriptive statistics. The correlations between each factor were analyzed using Pearson's correlation analysis. Results: The transverse abdominis showed asignificant correlation with trunk inclination (p<.05). The multifidus muscle showed a significant positive correlation with pelvic tilt and a negative correlation with surface rotation (p<.05). Conclusion: The thickness of transverse abdominis and the multifidus muscle appears to influence spinal alignment. Specifically, the multifidus muscle, which plays an important role on the sagittal plane, influences surface rotation, thus making it an important muscle for scoliosis patients. Therefore, a strengthening training program for the transverse abdominis and the multifidus muscle is necessary according to specific purposes among adults with spinal malalignment.

척추 운동 평가를 위한 요추 다열근의 동적 초음파 영상의 타당성

박지훈,이상민,박태규,최용수 대한척추외과학회 2021 대한척추외과학회지 Vol.28 No.4

Study Design: Feasibility study. Objectives: This study was conducted to investigate the morphological changes in post-exercise ultrasound imaging of the lumbar multifidus muscle to evaluate the effects of spinal exercise. Summary of Literature Review: There is a paucity of reports assessing appropriate spinal exercise programs in elderly patients with sarcopenia. Materials and Methods: This study was conducted on 23 volunteers with no history of spinal disease. The volume and thickness of the lumbar multifidus muscle as a trunk stabilizer were measured by dynamic ultrasound imaging, at rest and after exercise of the muscle to evaluate the strength of the extensor muscle. The criteria for diagnosing sarcopenia were analyzed, including gait speed, hand grip strength, muscle mass, and thickness change between at-rest and post-exercise states. Results: At rest, the mean volume and thickness of the lumbar multifidus muscle were 357.17±59.25 mm² and 2.54±0.32 cm, respectively. After exercise, the mean volume and thickness of the lumbar multifidus muscle changed to 407.35±70.10 mm² and 2.78±0.36 cm, respectively. There was a significant increase in lumbar multifidus volume (14.00%, p=0.01) and thickness (9.42%, p=0.01) after exercise. The mean gait speed was 10.2±0.15 m/s and the mean hand grip strength was 19.30±2.08 kg. There was a positive correlation between changes in lumbar multifidus volume and hand grip strength (r=0.56, p=0.01). Conclusions: These results suggest that dynamic ultrasound imaging of the lumbar multifidus could be helpful in evaluating the effect of spinal exercise. 연구 계획: 타당성 연구목적: 본 연구는 요추 다열근의 운동 전후 초음파 영상의 형태학적 변화를 조사하여 척추 운동 치료 효과를 평가하고자 하였다. 선행 연구문헌의 요약: 근감소증이 있는 환자에서 척추 운동 치료를 평가하는 연구는 많지 않은 실정이다. 대상 및 방법: 척추 질환의 병력이 없는 23명의 지원자를 연구 대상으로 하였다. 동적 초음파 영상을 이용하여 운동 치료 전과 운동 치료 후 요추 다열근의 면적과 두께를 측정하였고, 근감소증의 진단 기준인 보행 속도, 악력을 측정하여 운동 전후 근육 면적과 두께 변화와의 상관 관계를 비교분석하였다. 결과: 운동 치료 전 요추 다열근의 평균 면적과 두께는 각각 357.17±59.25 mm2, 2.54±0.32 cm였고, 운동 치료 후 평균 면적과 두께는 407.35 ±70.10 mm2, 2.78±0.36 cm로, 운동 치료 후 요추 다열근의 유의한 면적 증가(14.00%, p=0.01)와 두께 증가(9.42%, p=0.01)가 있었다. 평균 보행 속도는 1.02±0.15 m/sec, 평균 악력은 19.30±2.08 kg이었다. 운동 치료 후 요추부 다열근의 면적 변화와 악력에는 양의 상관 관계가 있었다. (r=0.56, p=0.01) 결론: 요추 다열근의 동적 초음파 영상은 척추 운동 치료의 효과를 평가하는데 유용한 방법이 될 수 있으리라 사료된다.

Comparison of Multifidus Muscle Activity and Pelvic Tilting Angle During Typing in Nonspecific Lower Back Pain Subjects with and without Visual Biofeedback

( In-cheol Jeon ) 대한물리치료학회 2021 대한물리치료학회지 Vol.33 No.1

Purpose: Biofeedback using various ways has helped correct the sitting posture. This study compared the multifidus muscle activity, pelvic and 2nd sacrum tilting angle during typing in nonspecific lower back pain (NCLBP) subjects with and without visual biofeedback. Methods: Thirty subjects with NCLBP were enrolled in this study. An electromyography device was used to measure the multifidus muscle activity. An electromagnetic tracking motion device was used to measure the pelvic and 2nd sacrum tilting angle. The multifidus muscle activity, pelvic, and 2nd sacrum tilting angle were measured before and after typing for 30 minutes in the sitting position. An independent t-test was used to compare the changing values for 30 minutes between the group with and without visual biofeedback. Results: The changing values of the multifidus muscle activity, pelvic, and 2nd sacrum tilting angle were significantly smaller in the group with visual biofeedback than the group without visual biofeedback (p<0.05). Conclusions: In subjects with NCLBP, the visual biofeedback can be recommended to maintain the multifidus muscle activity, pelvic, and 2nd sacrum tilting angle during typing for 30 minutes.

요통환자의 허리운동 방법이 요추다열근 면적에 미치는 영향

김정훈(Kim Jung-hoon),이완희(Lee Wan-hee),이재구(Lee Jae-koo) 한국체육과학회 2008 한국체육과학회지 Vol.17 No.2

This study was to examine and compare the influence on multifidus muscle volume in the low back pain patients by lumbar stabilization exercise and segmental stabilization exercise. Randomized study design of two groups was used : 15 in the lumbar stabilization exercise and 15 in the segmental stabilization exercise . The exercise was performed for 30 minutes per day and three times a week during 6 weeks period. The CT scans was used to measure multifidus muscle volume between lumbar vertebra 4 and 5. The results were as follows: First, there were significantly increased in the multifidus muscle voulme from pre to post-exercise(left:45.07㎟, right:49.67㎟)in the lumbar stabilization exercise (p<.05). Second, there were significantly increased in the multifidus muscle volume from pre to postexercise(left:68.97㎟, right:75.62㎟)in the segmental stabilization exercise(p<.05). There was statistical significant difference between the segmental stabilization exercise was more effective on the multifidus muscle volume. The results showed that the segmental stabilization exercise be more effective finally multifidus muscle volume of low back pain patients than that of the lumbar stabilization exercise.

만성 요통 환자의 상지 기능적 동작시 초음파에 나타나는 다열근의 변화

장원석 ( Won Seok Jang ) 대한물리의학회 2009 대한물리의학회지 Vol.4 No.1

Purpose The purpose of this study is change of lumbar multifidus muslce recorded simultaneously by ultrasound imaging during upper extremity functional movement in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women, Methods 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing, Multifidus size were measured from L4 vertebral segement, The ultrasound imaging apparatus(Sonoace 6000, Medison, Korea) was epuipped with a 5-MHz convex array transducer. The upper extremity lifting movement used to activate the multifiedus was then measured. Results Results of the analysis showed that at the L4 vertebral leves, healthy asymptomatic subjects had significantly larger multifidus muscle compared with chronic LBP subjects, Conclusion This study will be used as treatment method of patient with chronic LBP, The multifidus muscle in chronic LBP patients clinical significance, Most of chronic LBP patients have multifidus contraction pattern, Especially multifidus contraction in L4 vertebral segement, So chronic LBP patients necessary mltifidus muscle release treatment.