Finger-floor Distance Research Articles

Anthropometric Measurements, Metabolic Profile and Physical Fitness in a Sample of Spanish Women with Type 2 Diabetes.

Background: Exercise training has proven to be effective for treatment of metabolic diseases, such as type 2 diabetes mellitus. The aims of this study were to compare anthropometric measurements, metabolic profile and physical fitness between active and sedentary women with type 2 diabetes, and to analyse relationships between anthropometry and metabolic profile and components of physical fitness (balance, flexibility, strength and endurance). Methods: Cross-sectional research on 28 women with type 2 diabetes. Amount of daily physical activity, BMI, waist circumference, HbA1c, fibrinogen, hs-CRP, tiptoe dynamic balance, static balance, finger floor distance, abdominal, upper and lower limb strength and walking cardiovascular endurance were recorded. Results: Age: 58.5 ± 7.8. Overall, 16 subjects were physically active and 12 were sedentary. Active subjects had lower BMI (p = 0.033) and better cardiovascular endurance (p = 0.025). BMI and waist circumference were not influenced by any physical fitness component. HbA1c, fibrinogen and hs-CRP were related with worse dynamic balance (p = 0.036, 0.006 and 0.031, respectively). Conclusions: Active women had lower BMI and showed a better performance in cardiovascular endurance. Tiptoe dynamic balance impairments were related to worse glycaemic control, hypercoagulation and inflammatory state.

A comparison of the effects of static stretching and the fascial distortion model (FDM) on hamstring flexibility.

Hamstring flexibility plays a significant role in physiotherapy. Various stretching studies have been conducted to increase hamstring flexibility, but the effects of the Fascial Distortion Model (FDM) on hamstring flexibility have not yet been investigated. Moreover, no studies have compared the effects of FDM and static stretching. To investigate the effects of the FDM on hamstring flexibility compared with static stretching. Thirthy healthy adults were divided into two groups: static stretching and FDM groups. Static stretching was performed to hamstring in the supine position. The FDM was performed using trigger band techniques that followed the hamstring in a longitudinal direction. Hamstring flexibility was measured using the active knee extension angle (KEA), passive straight leg raising (SLR), sit-and-reach (SR), and finger-floor distance (FFD) tests. A paired t-test and an independent t-test were performed to compare the hamstring flexibility measurements. Both groups showed significant differences (p< 0.05) in KEA, SLR, SR, and FFD before and after. However, no significant difference (p> 0.05) was found between the two groups. There was no difference in the effects of FDM and static stretching on hamstring flexibility.

Myofascial Release of the Hamstrings Improves Physical Performance-A Study of Young Adults.

Physical performance is mainly assessed in terms of gait speed, chair rise capacity, and balance skills, and assessments are often carried out on the lower limbs. Such physical performance is largely influenced by the strength of the quadriceps and hamstrings muscles. Flexibility of the hamstrings is important because quadriceps muscle activity influences the hip flexion angle. Therefore, hamstring flexibility is essential to improve physical performance. In this study, Myofascial Release (MFR) was applied to the hamstrings to evaluate its effects. MFR on the hamstrings was performed on 17 young adults. Physical function and physical performance were measured before, immediately after, and 5 days after the MFR intervention: finger floor distance (FFD), range of motion (ROM) of the straight leg raising test (SLR), standing long jump (SLJ), squat jump (SJ), functional reach test (FRT), comfortable walking speeds (C-walking speed), and maximum walking speeds (M-walking speed). The results of the analysis show a significant increase in FFD (−2.6 ± 8.9 vs. 0.4 ± 9.4 vs. 2.4 ± 8.9, p < 0.01), SLJ (185.6 ± 44.5 vs. 185.0 ± 41.8 vs. 196.6 ± 40.1, p < 0.01), and M-walking speed (2.9 ± 0.6 vs. 3.0 ± 0.6 vs. 3.3 ± 0.6, p < 0.01). This study has shown that MFR for hamstrings not only improves flexibility but also increases M-walking speed and physical performance of the SLJ. As MFR is safe and does not involve joint movement, it may be useful for maintaining and improving performance and flexibility during inactivity and for stretching before exercise.

The key to Injury Prevention would be Daily Stretching for Muscle Flexibility and Strength

Authors’ and collaborators have continued research concerning stretching, the flexibility of thoracic spine. In this study, author himself continued our stretching protocol for 4 months. The changes were i) the spreading degree of open legs, ii) bridge posture bending the whole body backward, iii) finger floor distance (FFD) with 3 to 18cm. The purpose was self-verification by habituation training, and clinical efficacy was found. For other effects, he has not been injured for the period as soccer player at all, and has felt comfortable operation subjectively. This process will be beneficial for managing various patients and athletes from now.

An exploratory study on the impact of static and dynamic sitting postures on lumbar and pelvic mobility during visual display terminal work.

[Purpose] Limited studies exist on the impact of sustained work at a visual display terminal (VDT) on the position and motion of the pelvis and lumbar spine. We evaluated the changes in movement of the lumbar column and pelvis during VDT work. [Participants and Methods] We evaluated the sitting posture of 20 healthy adults while they performed VDT work. The effects of the sitting posture on lumbo-pelvic position and motion were captured using a three-dimensional accelerometer. Between-posture effects of VDT work were evaluated using an analysis of variance (ANOVA). A two-way ANOVA was used to assess the root mean square (RMS) values of the 80-min VDT work period for each posture. A one-way ANOVA was used to evaluate pre- and post-work changes in RMS values during the finger floor distance test (FFD). [Results] People in the dynamic sitting balance chair (DSBC)-based posture demonstrated significantly higher pelvic RMS values than those in reclining and upright sitting postures. The DSBC-based posture was also associated with significantly higher pre- and post-work lumbar and pelvic RMS values during the FFD than in the reclining and upright sitting postures. [Conclusion] The dynamic balance chair may be an effective method of establishing a pattern of spinal exercise during prolonged sitting.

Cross-cultural Adaptation and Validation of the Hausa Version of the Oswestry Disability Index 2.1a for Patients With Low Back Pain.

Validation of a translated, culturally adapted questionnaire. To translate the Oswestry Disability Index (ODI) version 2.1a into Hausa Language and to validate its use in a cohort of patients with low back pain (LBP). The ODI is one of the most commonly used condition-specific questionnaires for assessing functional disability in patients with LBP, yet, no formal cross-culturally adapted and validated Hausa version exists. The Hausa version of the ODI 2.1a (ODI-H) was developed according to established guidelines. Validation was performed among 200 patients with LBP recruited from both rural and urban Nigeria. Reliability was assessed using internal consistency (Cronbach α), test-retest reliability by computing intraclass correlation coefficient, standard error of measurement, and minimal detectable change. Convergent validity was assessed by correlating the ODI-H with Visual Analogue Scale for pain, Fear-Avoidance Beliefs Questionnaire, and finger-floor distance test. Divergent validity was assessed by correlating the ODI-H with age, educational level, and occupational status. Exploratory factor analysis (EFA) and confirmatory factor analysis were also performed. Confirmatory factor analysis was performed with three models: 1) one-factor theory-driven model, 2) two-factor theory-driven model (dynamic and static factors), and 3) a model based on our EFA. The ODI-H had high internal consistency (Cronbach α = 0.87) and excellent test-retest reliability (intraclass correlation coefficient = 0.937) with standard error of measurement and minimal detectable change being 3.69 and 10.2 respectively. The construct validity (convergent and divergent validity) is supported as all (6:6, 100%) the a priori hypotheses were confirmed. The EFA yielded a two-factor model explaining 54.3% of the total variance but demonstrated poor fit. The one-factor and two-factor theory-driven model had acceptable fit but the one-factor theory-driven model was better. The ODI-H version 2.1a was transculturally equivalent, reliable, and valid tool for assessing functional disability among Hausa-speaking patients with LBP. The use of this tool can be recommended for future clinical and research purposes. 3.

Short-term effectiveness of the flexion-distraction technique in comparison with high-velocity vertebral manipulation in patients suffering from low-back pain

ObjectivesTo determine the short-term effects of a modified Flexion-Distraction (FD) technique in comparison with a high-velocity low-back spinal manipulation (HVLA-SM) protocol on patients suffering from chronic low-back pain (CLBP). Design and methodsA randomized controlled trial. The sample was composed of 150 patients suffering from CLBP, who were randomly assigned to either a FD (n = 75) or a HVLA-SM (n = 75) group. The variables used to study pain were the scores of the Visual Analogue Scale (VAS) and the Pressure Pain Threshold (PPT) on trigger points (TrPs) of the quadratus lumborum. In addition, the Oswestry Disability Index (ODI) was used to measure disability, and Schober’s test and the Finger Floor Distance test (FFDT) to measure changes in low-back spine motion. An Analysis of Covariance (ANCOVA) was used to measure group effect, and Number Needed to Treat (NNT) for effect size. ResultsGreater improvements occurred in the FD group, with a statistically significant group effect (p < 0.001) for all outcome variables. The ETA2 value was larger than 0.100 in the Schober’s and FDD tests, larger than 0.200 in the case of ODI and PPT, and larger than 0.300 for VAS. OR = 0.07 [IC 95% = 0.03 to 0.18] and NNT = 2.08 [IC 95% = 1.64–2.84) yielded improved values for the FD group. ConclusionFor patients suffering from CLBP, greater improvements in pain and function were observed in the group receiving the modified FD treatment than in the HVLA-SM group.

Effects of increased functional residual capacity on finger-floor distance in healthy young adults.

[Purpose] To investigate the effect of increased functional residual capacity on the finger-floor distance and to assess spinal curvature in the sagittal plane using the Spinal Mouse in healthy young participants. [Participants and Methods] Thirty-nine healthy volunteers (age=21.2 ± 0.8 years) participated in this study. The finger-floor distance was used to measure trunk flexion and was recorded at the resting expiration level and at 2 different functional residual capacity levels: 1,000 and 2,000 ml air inhaled at the resting expiration level. Spinal curvature morphology was evaluated using the Spinal Mouse in the sagittal plane when flexion was completed under the 2 increased functional residual capacity and resting expiration level conditions during finger-floor distance measurement. Finger-floor distance and spinal curvature were assessed according to functional residual capacity using one-way repeated measures analysis of variance and post-hoc analysis. [Results] Significant effects and differences were found for the finger-floor distance under all conditions. No significant effect was found for spinal curvature. [Conclusion] An increase in functional residual capacity may decrease trunk flexion. This correlation might also be observed in patients with chronic obstructive pulmonary disease.

Humoral and Cellular Patterns of Early Endothelial Progenitor Cells in Relation to the Cardiovascular Risk in Axial Spondylarthritis.

BackgroundSpondylarthritis (SpA) significantly affects sacroiliac, intervertebral and peripheral joints. Patients with SpA suffer from increased cardiovascular risk (CVR). The endothelial progenitor cell (EPC) system critically perpetuates vascular repair. The aim of the study was to evaluate circulating EPCs in axial (ax)SpA with special attention on parameters of disease activity and CVR.MethodsDisease activity and functional impairment were quantified in 50 axSpA patients by using standardized parameters (Bath ankylosing spondylitis disease activity index (BASDAI), C-reactive protein (CRP), finger-floor distance (FFD) and Ott’ sign). Circulating EPCs and EPC regeneration were analyzed (fluorescence-activated cell sorting (FACS) and colony-forming unit (CFU) assay). Serum vasomodulatory mediators were quantified by enzyme-linked immunosorbent assay (ELISA).ResultsEPC colony numbers were lower in axSpA as compared to controls. Females displayed more colonies than males. In addition, fewer colonies were observed in smokers, in patients with a BASDAI of below 4 and in hypertension. Circulating CD133+/KDR+ cells did not differ between the groups. Follow-up analysis (33 months later) did not show any differences in gender, colony formation, CD133+/KDR+ cells or serum levels of vasomodulatory mediators if related to the categories of BASDAI, Ott’ sign or FFD.ConclusionsEPC colony formation is significantly affected in axSpA with particularly low levels in males. EPC-related parameters do not allow predicting disease activity-related or functional parameters nor are they useful for CVR assessment in SpA.

Myo-Tuning Approachが指床間距離に及ぼす影響

Myo-Tuning Approachが指床間距離に及ぼす影響

Trunk forward flexion mobility in reference to postural sway in women after delivery: A prospective longitudinal comparison between early pregnancy and 2- and 6-month postpartum follow-ups

BackgroundIt has been documented that pregnancy-related increased connective tissue laxity may persist postpartum; however, it is still unclear for how long. This longitudinal study aimed to compare total trunk forward flexion mobility in women between their first trimester of pregnancy and at 2- and 6-month postpartum follow-ups. We also searched for a correlation between women's trunk flexibility and their postural stability in the sagittal plane. MethodsSeventeen healthy women participated in the study. Data were collected at their 7–12 weeks gestation appointments and at 6–10 and 25–28 weeks postpartum. At each session, the women performed a finger floor distance test, and data were collected on their waist circumference and BMI. The women's center of foot pressure mean velocity in the anterior-posterior direction was computed from 30-s long quiet-standing trials on a stationary force plate. FindingsTotal trunk forward flexion mobility was significantly higher at 2 and 6 months postpartum compared to that in early pregnancy (P < 0.05). At 6 months postpartum, a moderate negative correlation between finger floor distance test values and their anterior-posterior center of foot pressure mean velocity was observed (r = −0.6, P < 0.05). InterpretationIncreased total trunk flexibility may be present in women 6 months postpartum. During that period, women with higher trunk flexibility may be more likely to present higher anterior-posterior postural sway velocity in quiet standing.

Pole Exercise Causes Body Changes in Physical Flexibility and Exercise Function

Background: Theoretical mode of spinal stability and core stability has been introduced previously, which has proceeded to rehabilitative approaches. We have focused on physical flexibility and exercise function, and firstly devised an original pole exercise in sitting position that can be done simply and cost-effectively.Subjects and Methods: The subjects 11 healthy young adults, 27.0 ± 5.6 years old. Methods included the intervention of pole exercise with Exercise of the thorax, lower thoracic vertebrae and pelvis, upper thoracic vertebrae and pelvis. Before and after the exercise, we investigated examinations. Tests of physical flexibility were Wing Test, Thomas Test, Shoulder Extension Test, straight leg raise (SLR), Body warp prone position, Heel Buttock Distance (HBD) and Finger Floor Distance (FFD). Tests of exercise functions were Back Muscle Strength (BMS), Weight Bearing Index (WBI), Functional Reach Test (FRT) and closed eye leg standing time.Results: The data of 7 flexibility tests and 4 exercise function tests revealed the significant differences between before and after the pole exercise (p<0.05). These tests would cover detail aspects of several human abilities in physiotherapy.Discussion and Conclusion: In current study, pole exercise seems to be clinically simple and easy method to perform. These results suggested that pole exercise including 6 movements would have clinical efficacy as to physical flexibility and exercise function in short period. Currently obtained data could become fundamental data for clinical application and research development in the future.

Efficacy of balneotherapy, peloidotherapy and group exercises in the management of Ankylosing Spondylitis

The objective of this study is to determine the efficacy of balneological treatment consisting of hydrotherapy and peloidotherapy and group exercise therapy in the management of ankylosing spondylitis (AS). 40 AS patients fromthe Department of Medical Ecology and Hydroclimatology Istanbul Faculty of Medicinewere randomized into two groups. In group1 patients prescribed 15 sessions of hot water pool hydrotherapy and peloidotherapy with local mud pack application for 3 weeks duration at the Balneological Treatment Outpatient Unit of the Department. At the last session, they had given home based exercise program instructions and brochure for ankylosing spondylitis. In Group 2 patients attended15 sessions of group exercise therapy supervised by a physiotherapist at Cerrahpasa Medical Faculty, Physical Medicine and Rehabilitation Exercise Unit, for 3 weeks duration. At the last session, they had given the same home-based exercise program and brochure for ankylosing spondylitis. The patients were examined before therapy, after completing the all treatment sessions and 3th and 6th months afterwards. Outcome measures were pain intensity (visual analog scale, VAS), patient's general evaluation (VAS), physician's general evaluation (VAS), Health Assessment Questionnaire (HAQ), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Lumbar Schober index (cm), finger-floor distance(cm), occiput-wall distance(cm) and chest expansion (cm). Statistically significant improvement on pain-VAS scores was seen in Group 1, in all assessments. In Group 2, statistically significant decrease in pain-VAS was only seen after the therapy. But decrease in pain at 3rd and 4th measurement weren't significant.In group comparisons, metrological indexes were found statistically significant in exercise group patients except chest expansion outcomes which were seen significant in both groups, in all short-term and long-term assessments. Besides improving pain ambulatory balneological treatment and exercise therapy seem to improve inspiratory function and mobility in AS patients. This type of treatment may be added in the overall treatment program as an effective nonpharmacological modality considering the beneficial effects on respiratory system and spine mobility as well as on pain and function in AS patients.

Transcutaneous electrical nerve stimulation in acute versus chronic low back pain

Objective: Low back pain (LBP) is a common disabling health problem. We aimed to compare the efficacy of using transcutaneous electric stimulation (TENS) in alleviating pain and restoring function in patients with acute versus chronic LBP. Subjects and Methods: The patients were divided into two groups acute and chronic, (n=50 in each). TENS was applied for a total of 10 sessions over a period of 2 weeks. Activity and resting visual analog scale (VAS) for low back pain, Roland Morris Disability Questionnaire (RDQ) and Oswestry Disability Index (ODI) and hand finger floor distance (HFFD) values were recorded at baseline and at one month after therapy. Results: Improvement in both groups after one month of use was observed in activity and resting VAS scores, as well as RDQ scores (p < 0.05, more in the chronic group). Improvement in ODI and HFFD was only noted in the chronic group (p < 0.05). Conclusion: TENS use is more beneficial in patients with chronic compared to acute LBP especially when it comes to physical function.

A Comparative study of efficacy of Thiocolchicoside with Diclofenac vs Eperisone with Diclofenac in patients with back pain

Background: A number of drugs are available for the treatment of Low back pain (LBP) as per the available literature. This study was undertaken to compare the efficacy of Thiocolchicoside– diclofenac and Eperisone – diclofenac in patients with low back pain. Materials and Methods: A prospective, open labeled, randomized, comparative clinical study was conducted in order to establish the efficacy of Thiocolchicoside – diclofenac and Eperisone – diclofenac in patients with back pain. Thirty patients of either sex with back pain were randomly allocated to two groups to receive either Thiocolchicoside (4 mg)+Diclofenac (50mg) twice a day (Group A) or Eperisone (150 mg) Sustained Release+Diclofenac (100mg) preparation once a day (Group B). Results: The finger to floor distance was improved significantly after treatment with both the drugs for 7 days. There was a statistically significant difference in improvement of finger to floor distance of both the drugs and was marked in Group B. About 80% of the patients were normal after 7 days of treatment in Group B. The VAS scores and Global assessment scale had also shown the lower scores for group B compared to group A. Conclusion: The Eperisone with diclofenac was found to be more effective in terms of Finger floor distance and improvement in Lasegue’s sign, VAS score and global assessment scale than Thiocolchicoside with Diclofenac.

The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study

BackgroundSpinal deformities affect the overall alignment of the spine and thus the vectors of loading on the lumbar region and intervertebral discs. Due to wedging of the disc or vertebrae of unbalanced spinal segments, alignment change may affect the range of motion (ROM) of individual spinal segments or the global spine. This is particularly important in adolescent idiopathic scoliosis (AIS) patients who may suffer from early degeneration, back stiffness and pain. Hence, this study aimed to determine the correlation between spine range of motion (ROM) and adolescent idiopathic scoliosis (AIS) curve magnitude.MethodsConsecutive recruitment of all AIS patients with Lenke 5 (thoracolumbar/lumbar) curves within one month was performed with ROM assessments in the coronal, sagittal and axial planes using the change in C7-S1 distance on standing upright, active flexion and extension positions, change in finger-floor distance on forward bending position and lateral bending, lateral bending angles, modified Schober’s test, and trunk rotation in seating position. Patients were further stratified into two groups based on their lumbar spine curve magnitude: Group A with curves of 10 to 39 degrees and Group B with 40 degrees or greater. Univariate and multivariate analyses were conducted, with lumbar curve magnitude severity being the dependent variable.ResultsIn total, 58 patients (n = 12 males, n = 46 females; mean age: 15.7 years) were recruited. The mean curve magnitudes were 25 ± 6.5 degrees in Group A and 48 ± 10.6 degrees in Group B. Mean axial rotation (Group A: 90 ± 21.7 degree; Group B: 76 ± 19.6 degrees; p = 0.038) and lateral bending ROM (Group A: 67 ± 13.4 degrees; Group B: 58 ± 14.3 degrees; p = 0.045) decreased in more severe curves. These two parameters continued to remain significant irrespective of the curve severity cut-off values.ConclusionsThis is the first study to determine associations between spinal ROM parameters with the lumbar curve magnitude in AIS patients. We found that the coronal curve severity is associated with reduced axial and coronal ROM. This is a platform for future studies assessing lumbar spine biomechanics in AIS and to determine the effects of altered spine motion in this context and its implication in patient management and outcomes.

Comparison of immediate effects between two medical stretching techniques on Hamstrings flexibility.

[Purpose] The aim of this study was to compare immediate effects between new medical stretching (NMS) and conventional medical stretching (CMS) techniques on Hamstrings flexibility. [Subjects and Methods] Thirteen healthy adult males, with finger floor distance (FFD) less than zero centimeter, without known musculoskeletal and neurological impairment in spine or lower extremities, were included. The subjects were randomly allocated to two groups. The subjects were instructed to perform NMS and CMS (hold for 30 seconds once, twice for each side of lower extremity) for both sides (total two minutes, only one session for one day). The interval between the two techniques was one week. FFD was measured with digital standing trunk flexion meter at the pre-intervention and post-intervention of both techniques. [Results] The mean values of FFD improved at the post-interventions of both techniques. The tests of within subject effects indicated that the main effect of treatment was not significant but the main effect of time was significant and the interaction of treatment and time was also significant. [Conclusion] The results of this study indicated that both medical stretching techniques were effective on Hamstrings flexibility immediately after the intervention and NMS technique was more effective on improving flexibility.

Comparison of physical activities of female football players in junior high school and high school.

[Purpose] This study aimed to compare physical activities between junior high school and high school female football players in order to explain the factors that predispose to a higher incidence of sports injuries in high school female football players. [Subjects and Methods] Twenty-nine female football players participated. Finger floor distance, the center of pressure during single limb stance with eyes open and closed, the 40-m linear sprint time, hip abduction and extension muscle strength and isokinetic knee flexion and extension peak torque were measured. The modified Star Excursion Balance Test, the three-steps bounding test and three-steps hopping tests, agility test 1 (Step 50), agility test 2 (Forward run), curl-up test for 30 seconds and the Yo-Yo intermittent recovery test were performed. [Results] The high school group was only significantly faster than the junior high school group in the 40-m linear sprint time and in the agility tests. The distance of the bounding test in the high school group was longer than that in the junior high school group. [Conclusion] Agility and speed increase with growth; however, muscle strength and balance do not develop alongside. This unbalanced development may cause a higher incidence of sports injuries in high school football players.

Application of extracorporeal shockwaves in the treatment of scoliosis: a case report.

[Purpose] In a pilot investigation, extracorporeal shockwave therapy was applied to patients with idiopathic scoliosis. This case report aimed to describe the effects of repeated extracorporeal shockwave therapy on the clinical signs of a patient with scoliosis due to a functional tethered cord syndrome. [Subject and Methods] In June 2016, a 13-year-old girl presented with a left thoracic curvature. Radiograph showed a left thoracic curve of 24°. An angle of trunk rotation of 21° was measured using a scoliometer. Extracorporeal shockwave therapy was proposed to support conservative treatment. Five sessions of extracorporeal shockwave therapy were applied. Finger-floor distance and the angle of trunk rotation before and after each application of extracorporeal shockwave therapy were measured. [Results] The average finger-floor distances before and after extracorporeal shockwave therapy were 22.6 cm and 15.6 cm, respectively. The average angles of trunk rotation before and after the therapy were 13° and 10.2°, respectively. [Conclusion] The short-term effect of extracorporeal shockwave therapy was revealed in this study. The neural structures that inhibited free mobility of the spine were mobilized. Furthermore, deformity was reduced by applying extracorporeal shockwave therapy.

Short-term effect of back school based on cognitive behavioral therapy involving multidisciplinary collaboration.

ObjectivesThe purpose of this study was to develop a comprehensive back school program that included elements of CBT (Cognitive Behavioral Therapy), implement this through multidisciplinary collaboration, and ascertain its effectiveness as a pilot study. DesignThis school was implemented in the form of five 90-minute group sessions held every other week.MethodsParticipants comprised 7 chronic low back pain patients with poor improvement in the usual treatment. Practitioners were orthopaedic surgeon, physical therapist, and a clinical psychologist. This school contents were patient education, self-monitoring, back exercise, relaxation, stress management, cognitive restructuring, activity pacing, and exposure. ResultsFrom the Wilcoxon signed-rank test, each score of four scales or items (sense of control, PCS (pain catastrophizing), PASS-20 (escape/avoidance), FFD (finger-floor distance)) after this program significantly improved. Results of calculating the effect size, sense of control (d=0.55) is 'moderate', the PCS (d=1.12) and the PASS-20 (d=1.64) were 'large'.ConclusionsThis back school may be useful for physical function and psychological variables which much related to pain management and daily disabilities in patients with poor respond to standard orthopaedic treatment.