DOI QR코드

DOI QR Code

Effects of Chiropractic Using Sacro Occipital Technique on Pain and Physical Function in Patients with Low Back Pain

천골후두골 테크닉을 이용한 카이로프랙틱이 만성 요통환자의 통증과 신체기능에 미치는 영향

  • Jeong, Ji-Moon (Graduate School of Alternative Medicine, Kyonggi University) ;
  • Kim, Jaehee (Graduate School of Alternative Medicine, Kyonggi University)
  • 정지문 (경기대학교 대학원 대체의학과) ;
  • 김재희 (경기대학교 대학원 대체의학과)
  • Received : 2013.08.08
  • Accepted : 2013.09.06
  • Published : 2013.09.30

Abstract

The aim of this study was to identify the effects of chiropractic treatment using Sacro Occipital Technique (SOT) on low back pain (LBP) and physical functions in patients with chronic LBP. Forty-five women with chronic LBP were randomly assigned to the Diversified Technique (DT), SOT or DT+SOT group and received chiropractic treatment two times a week for 8 weeks. LBP was measured using Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) at baseline and after 4 and 8 weeks of treatment. Physical functions were evaluated using lumbar strength, flexibility, and body symmetries. After 4 and 8 weeks, VAS, ODI, and RMDQ were significantly decreased in all 3 groups (all p<.001). Lumbar strength, flexibility, and shoulder and pelvic balances were significantly improved in all 3 groups (all p<.05). In conclusion, our results suggest that SOT and DT both may be effective for reducing LBP and improving physical functions.

본 연구의 목적은 천골후두골 테크닉을 이용한 카이로프랙틱이 만성 요통환자의 통증과 신체기능에 미치는 영향을 규명하는 것이다. 만성요통이 있는 여성 45명을 세 실험군에 15명씩 무선할당하여 디버시파이드 테크닉, 천골 후두골 테크닉 또는 두 테크닉을 혼합하여 주 2회, 8주간 시술하였다. 무처치 대조군은 요통이 없는 건강한 여성 12명으로 구성되었다. 시술 전, 4주후, 8주후에 요통은 시각적상사척도, Oswestry와 Roland-Morris 요통장애지수로 측정하였고, 신체기능은 요부 근력과 유연성 및 체형으로 평가하였다. 처치 4주와 8주 후 대조군에서는 유의한 변화가 나타나지 않은 반면, 세 실험군 모두에서 요통강도와 요통장애지수가 유의하게 감소하였으며(모두 p<.001), 요부근력과 유연성 및 어깨와 골반 균형도 향상되었다(모두 p<.05). 결론적으로 천골후두골 테크닉과 디버시파이드 테크닉을 이용한 카이로프랙틱 시술 모두 요통환자의 통증의 경감과 기능 향상에 효과적인 것으로 사료된다.

Keywords

References

  1. G. B. Andersson. "Epidemiological features of chronic low-back pain", Lancet, Vol.354(9178), pp.581-5, 1999. DOI: http://dx.doi.org/10.1016/S0140-6736(99)01312-4
  2. B. F. Walker, R. Muller, W. D. Grant. "Low back pain in Australian adults: prevalence and associated disability", JMPT, Vol.27(4), pp.238-44, 2004.
  3. J. K. Freburger, G. M. Holmes, R. P. Agans, A. M. Jackman, J. D. Darter, A. S. Wallace, L. D. Castel, W. D. Kalsbeek, T. S. Carey. "The rising prevalence of chronic low back pain", Arch Intern Med, Vol.169(3), pp.251-8, 2009. DOI: http://dx.doi.org/10.1001/archinternmed.2008.543
  4. H. J. Jeong. "The effect of bareunmom physical exercise therapy on low back pain patients", Chosun University, 2009.
  5. H. Brisby. "Pathology and possible mechanisms of nervous system response to disc degeneration", J Bone Joint Surg Am, Vol.88(l2), pp.68-71, 2006. DOI: http://dx.doi.org/10.2106/JBJS.E.01282
  6. K. J. McQuade, J. A. Turner, D. M. Buchner. "Physical fitness and chronic low back pain. An analysis of the relationships among fitness, functional limitations, and depression", Clin Orthop Relat Res, Vol.233, pp.198-204, 1988.
  7. R. Chou, L. H. Huffman. "Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline", Ann. Intern. Med, Vol.147(7), pp.492-504, 2007. DOI: http://dx.doi.org/10.7326/0003-4819-147-7-200710020 -00008
  8. A. D. Furlan, L. Brosseau, M. Imamura, E. Irvin. "Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group", Spine, Vol.27, pp.1896-1910, 2002. DOI: http://dx.doi.org/10.1097/00007632-200209010-00017
  9. A. K. Kanodia, A. T. Legedza, R. B. Davis, D. M. Eisenberg, R. S. Phillips. "Perceived benefit of Complementary and Alternative Medicine (CAM) for back pain: a national survey", JABFM, Vol.23(3), pp.354-362, 2010. DOI: http://dx.doi.org/10.3122/jabfm.2010.03.080252
  10. D. H. Jeong, S. K. Kim, J. H. Seo. "Effects of combined exercise and creatine intake to muscular function and pain in back pain patients", The Korean Journal of Exercise Nutrition, Vol.13(3), pp.193-201, 2009.
  11. J. A. Hayden, M. W. Tulder, G. Tomlinson. "Systematic review: strategies for using exercise therapy to improve outcome in chronic low back pain", Ann Intern Med, Vol.142, pp.776-85, 2005. DOI: http://dx.doi.org/10.7326/0003-4819-142-9-200505030 -00014
  12. P. M. Barnes, B. Bloom, R. L. Nahin. "Complementary and alternative medicine use among adults and children: United States, 2007", National Health Statistics Reports, Vol.12, pp.1-23, 2008.
  13. T. W. Meade, S. Dyer, W. Browne, J. Townsend, A. O. Frank. "Low back pain of mechanical origin: randomized comparison of chiropractic and hospital outpatient treatment", BMJ, Vol.300, pp.1431-1437, 1990. DOI: http://dx.doi.org/10.1136/bmj.300.6741.1723
  14. A. Wilkey, M. Gregory, D. Byfield, P. W. McCarthy. "A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic", JACM, Vol.14(5), pp.465-473, 2008. DOI: http://dx.doi.org/10.1089/acm.2007.0796
  15. D. D. Palmer, B. J. Palmer. "The science of chiropractic: principles and adjustment. 1st ed. Davenport: Palmer School of Chiropractic", 1906.
  16. M. Christensen, D. R. Morgan. "Job analysis of chiropractic: a project report, survey analysis and summary of the practice of chiropractic within the United States", Greeley (Colo)7 National Board of Chiropractic Examiners. pp.78, 1993.
  17. D. W. Evans. "Mechanisms And Effects of Spinal High-velocity, Low-amplitude Thrust Manipulation: Previous Theories", JMPT, Vol.25(4), pp.251-262, 2002.
  18. H. Getzoff. "Disc technique: An adjusting procedure for any lumbar discogenic syndrome", JCM, Vol.2(4), pp.142-4, 2003. DOI: http://dx.doi.org/10.1016%2FS0899-3467(07)60078-0 https://doi.org/10.1016%2FS0899-3467(07)60078-0
  19. M. F. Flanagan. "Relationship between CSF and Fluid dynamics in the neural canal", JMPT, Vol.11(6), pp.489-492, 1988.
  20. C. L. Blum. "Role of chiropractic and sacro-occipital technique in asthma treatment", JCM. 1(1), 16-22, 2002. DOI: http://dx.doi.org/10.1016/S0899-3467(07)60023-8
  21. J. I. Hochman. "The effect of sacro occipital technique categoryⅡ blocking on spinal ranges of motion: A case series", JMPT, Vol.28(9), pp.719-723, 2005.
  22. J. M. Wang, D. J. Kim. "Assessment of the Spinal Pain Using Visual Analogue Scale (VAS)", Journal of Korean Society of Spine Surgery, Vol.2(2), pp.177-84, 1995.
  23. J. C. Fairbank, P. B. Pynsent. "The Oswestry Disability Index", Spine, Vol.25(22), pp.2940-2952, 2000. DOI: http://dx.doi.org/10.1097/00007632-200011150-00017
  24. C. H. Jeon, D. J. Kim, S. K. Kim, D. J. Kim, H. M. Lee, H. J. Park. "Validation in the cross-cultural adaptation of the Korean version of the Oswestry Disability Index", J Korean Med Sci, Vol.21(6), pp.1092-7, 2006. DOI: http://dx.doi.org/10.3346/jkms.2006.21.6.1092
  25. M. O. Roland, R. W. Morris. "A study of the natural history of back pain. Part 1: Development of a reliable and sensitive measure of disability in low back pain", Spine, Vol.8, pp.141-144, 1983. DOI: http://dx.doi.org/10.1097/00007632-198303000-00005
  26. G. Bronfort, M. J. Maiers, R. L. Evans, C. A. Schulz, Y. Bracha, K. H. Svendsen, R. H. Grimm, E. F. Owens, T. A. Garvey, E. E. Transfeldt. "Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial", The spine, Vol.11, pp.585-598, 2011. DOI: http://dx.doi.org/10.1016/j.spinee.2011.01.036
  27. Haas, M., Groupp, E., Kraemer, D. F. "Dose-response for chiropractic care of chronic low back pain", The spine, Vol.4, pp.574-583, 2004. DOI: http://dx.doi.org/10.1016/j.spinee.2004.02.008
  28. M. R. Gudavalli, J. A. Cambron, M. McGregor, J. Jedlicka, M. Keenum, A. J. Ghanayem, A. G. Patwardhan. "A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain", Eur Spine J, Vol.15, pp.1070-1082, 2006. DOI: http://dx.doi.org/10.1007/s00586-005-0021-8
  29. M. A. Hondras, C. R. Long, Y. Cao, R. M. Rowell, W. C. Meeker. "A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 year and older with subacute or chronic low back pain", JMPT, Vol.32(5), pp.330-343, 2009.
  30. Y. H. Kim, H. Khil. "Effects of chiropractic treatment and low back pain exercise on lumbar lordotic angle, MVAS and lumbar strength in low back pain patients", Exercise Science, Vol.19(3), pp.257-266, 2010. https://doi.org/10.15857/ksep.2010.19.3.257
  31. S. B. Kim, J. H. Khil. "Effects of chiropractic treatment and low back rehabilitation exercise on sEMG, foot pressure and MVAS in low back pain patients", Health & Sports; Official Journal of KACEP, Vol.11(1), pp.53-64, 2009.
  32. T. K. Koo, J. H. Cohen, Y. P. Zheng. "Immediate effect of nimmo receptor tonus technique on muscle elasticity, pain perception, and disability in subjects with chronic low back pain", JMPT, Vol.35(1), pp.45-53, 2012.
  33. T. K. O. Nakagawa, H. R. M. Norose, M. Eder, H. Tilscher. "Chiropractic Therapy- Diagnosis and Treatment", Kagaku Shimbun-sha, pp.10-12.1997.
  34. D. Driscoll, G. Dicicco. "The effects of metronome breathing on the variability of autonomic activity measurement", JMPT, Vol.23(9), pp.610-4, 2000.
  35. B. D. Wyke. "Articular neurology and manipulative therapy. In: Glasgow E. Aspects of manipulative therapy", New York: Churchill Livingstone, pp.72-7, 1985.
  36. J. G. Pickar. "Neurophysiological effects of spinal manipulation", Spine, Vol.2(5), pp.357-71, 2002. DOI: http://dx.doi.org/10.1016/S1529-9430(02)00400-X
  37. J. R. Lee. "The effects of chiropractic and exercise treatment on chronic low back pain athletes' spinal problem, functional improvement, and inflammatory causative cytokinin level", National Sport University, Graduate School, 2009.
  38. G. D. Park. "The Effect of Gonstead Technique and Sling-Exercise-Therapy on Lumbar Back Strength and Flexibility for Patients by Chronic Low Back Pain", Journal of Sport and Leisure Studies, Vol.27, pp.189-201, 2006.
  39. J. M. Jeong. "Comparison of body flexibility by chiropractic spinal adjusting therapy", Dong Bang Graduate University, 2009.
  40. Y. H. Kim, J. H. Khil. "Effects of Chiropractic Treatment and Low Back Exercise on Flexibility, Cervical Lordosis Angle, and Pelvic Deviation in Low Back Pain Patients", Exercise Science, Vol, 12(3), pp.97-106, 2010.
  41. K. Lewit. "X-Ray of trunk rotation", JMPT, Vol.20(7), pp.454-458, 1997.
  42. G. A. Knutson. "Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part1. anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance", Chiropractic & Osteopathy, Vol.13(1), 11, 2005. DOI: http://dx.doi.org/10.1186/1746-1340-13-12
  43. G. A. Knutson. "Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part2. the functional or unloaded leg-length asymmetry", Chiropractic & Osteopathy, Vol.13(1), 12, 2005. DOI: http://dx.doi.org/10.1186/1746-1340-13-12
  44. N. Heese. "Major Bertrand De Jarnette: Six decades of sacro occipital research, 1924-1984", Chiropractic History, Vol.11(1), pp.13-15, 1991.
  45. C. Leboeuf. "The reliability of specific sacro-occipital technique diagnostic tests", JMPT, Vol.14(9), pp.512-517, 1991.