Finger-floor Distance Research Articles

Impact of Light-FRP (Functional restoration program) in a cohort of 47 patients with chronic low back pain

Methods.– Design: prospective before/after study. Population.– Sixty-four workers (37 males, mean age 42.4 8.8 years) with 187.9 148.7 days mean duration of sick leave during the preceding 24 months. Intervention.– Fifteen one-hour physiotherapy sessions, delivered in the community by private practice physiotherapists; 5 one-day session, in a rehabilitation center providing coordination by a physiatrist, contact with the occupational physician, advice by an occupational therapist and a psychologist, group interaction, on a 5-week period. Outcome measures.– Spine strength and flexibility, pain, psychological impact, quality of life, self assessment of ability to work. Results.– Among the patients, 87.5% have attended the scheduled physiotherapy sessions and 70.3% the multidisciplinary one day sessions. All parameters were significantly improved at the end of the program (P < 0.05). Finger-floor distance: 11.3 versus 17.6 cm; Sorensen test: 80.5 versus 60.6 sec; Ito test: 79.8 versus 53.4 sec. Pain: 42 versus 52 mm on the AVS. Quality of life DALLAS: 43.3 versus 59.2; work/leisure DALLAS: 42.6 versus 60,8; anxiety/depression DALLAS: 30,3 versus 41,3; social behavior DALLAS: 26,9 versus 32.2. HAD: 13.2 versus 15.7. FABQ: 35.1 versus 43.0. Physical SF36: 39.4 versus 34.7; mental SF36: 46.0 versus 41.4. The proportion of patients feeling able to work has significantly increased (28.3% versus 63.3%; P < 0.0001). Overall cost of the program for the social insurance system: 1532 s/patient. Discussion.– This program, mixing community based and rehabilitation center based services is both feasible, efficient on the short term, and cheaper than full time out-patient programs. Comparison to other programs could show that multidisciplinarity rather than intensity is the key component to success and can be achieved at an acceptable cost.

Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions

The home-based exercise therapy recommended to the patients with ankylosing spondylitis (AS) is a simply applicable and cheap method. The aim of this study was to investigate the effects of home-based exercise therapy on pain, mobility, function, disease activity, quality of life, and respiratory functions in patients with AS. Eighty patients diagnosed with AS according to the modified New York criteria were included in the study. Home-based exercise program including range of motion, stretching, strengthening, posture, and respiratory exercises was practically demonstrated by a physiotherapist. A training and exercise manual booklet was given to all patients. Patients following home-based exercise program five times a week at least 30min per session (exercise group) for 3months were compared with those exercising less than five times a week (control group). Visual analog scale pain (VASp) values at baseline were significantly higher in the exercise group. The exercise group showed improvements in VASp, tragus-wall distance, morning stiffness, finger-floor distance, modified Schober's test, chest expansion, the Bath Ankylosing Spondylitis Disease Activity Index, the Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL), forced expiratory volume in first second, and forced vital capacity at third month. There was significant difference in ASQoL scores between the two groups in favor of the exercise group at third month. Regular home-based exercise therapy should be a part of main therapy in patients with AS. Physicians should recommend that patients with AS do exercise at least five times a week at least 30min per session.

Evaluation of the effects of Global Postural Reeducation in patients with ankylosing spondylitis

The objective of this study is to assess the effects of Global Postural Reeducation (GPR) in patients with ankylosing spondylitis and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated for more than 4 months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire-Spondyloarthropathies-HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index-BASDAI). Statistical analysis was used with a significance level of P < 0.05. There was a statistically significant improvement for all the parameters analyzed between pre-and post-treatment in both groups. In the intergroup comparison, the GPR group showed a significantly greater improvement in morning stiffness (P = 0.013), spine mobility parameters, except finger-floor distance (P = 0.118), in chest expansion (P = 0.028), and in the physical aspect component of the SF-36 (P = 0.001). The results of this study showed that individual treatment with GPR (overall stretching) seems to have better clinical outcomes than group treatment with conventional segmental self-stretching and breathing exercises for patients with ankylosing spondylitis.

Muscle Strength During Active Straight Leg Raising Correlates with Walking Capacity in Patients with Lumbar Spinal Canal Stenosis with Neurogenic Intermittent Claudication

[Purpose] The purpose of this study was to investigate the factors related to walking capacity (WC) reflecting neurogenic intermittent claudication (IC). [Subjects and Methods] We selected 56 female patients (69.6 ± 8.0 years) with Lumber Spinal Canal Stenosis (LCS) with IC. We measured WC on a flat floor, and demonstrated that 3 factors predict the relationship with IC as follows: trunk forward bending in the standing position (finger-floor distance), muscle strength during active straight leg raising (ASLR) on the symptomatic side, and the degree of subjective pain soon after standing upright for 30 s. [Results] WC and muscle strength in ASLR were not affected by age. WC was correlated with ASLR strength. [Conclusion] These results suggest that the motion of ASLR leads to canal or foraminal stenosis, and that this test will be useful for patients with LCS.

鍼刺激(浅刺・呼気時・坐位)の立位体前屈に及ぼす影響

鍼刺激(浅刺・呼気時・坐位)の立位体前屈に及ぼす影響

Multicenter Randomized Controlled Trial to Evaluate the Effect of Home-Based Exercise on Patients With Chronic Low Back Pain

Prospective, randomized, controlled trial. To investigate the effectiveness of home-based exercise on pain, dysfunction, and quality of life (QOL) in Japanese individuals with chronic low back pain (CLBP). Exercise therapy is a widely used treatment for CLBP in many countries. The studies on its effectiveness have been performed only in Western industrialized countries. The existence of cross-cultural differences and heterogeneity of patients in each country may influence the outcome of interventions for CLBP. Data that would enable researchers to compare the effectiveness of interventions between widely different societies is lacking. A total of 201 patients with nonspecific CLBP were randomly assigned to either the control or exercise therapy group: 89 men and 112 women with a mean age of 42.2 years. The control group was treated with nonsteroidal anti-inflammatory drugs (NSAIDs), and the exercise group performed trunk muscle strengthening and stretching exercises. The primary outcome measures were pain intensity (visual analogue scale) and dysfunction level (Japan Low back pain Evaluation Questionnaire [JLEQ] and Roland-Morris Disability Questionnaire [RDQ]) over 12 months. The secondary outcome measure was FFD (Finger-floor distance). Statistical analysis was performed using Wilcoxon signed-ranks and Mann-Whitney U tests, and estimation of the median with 95% CI was calculated. In both groups, significant improvement was found at all points of follow-up assessment. However, JLEQ and RDQ were significantly more improved in the exercise group compared to the control group (P = 0.021 in JLEQ, P = 0.023 in RDQ). The 95% CI for the difference of medians of the change ratio between exercise and NSAID groups, [Exercise] - [NSAID], was -0.25 to -0.02 in JLEQ, -0.33 to 0.00 in RDQ, and -0.20 to 0.06 in visual analogue scale. The home-based exercise prescribed and monitored by board-certified orthopedic surgeons was more effective than NSAIDs for Japanese patients with CLBP.

Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects

High-velocity spinal manipulation is commonly adopted for treating chronic low-back pain (CLBP) and has been associated with changes in muscle activity, but the evidence is controversial. The aim of this study was to analyse the immediate effects of high-velocity spine manipulation on paraspinal activity during flexion–extension trunk movements. Forty nonspecific CLBP patients were randomised into two groups, manipulation ( n = 20) and control ( n = 20). While the manipulation group received high-velocity spine manipulation at the L4-L5 level, the control group remained lying in the same position. EMG-related variables, perceived pain intensity (100 mm VAS) and finger-floor distance were collected before and after spinal manipulation at the L4-L5 level. EMG surface signals from the right and left paraspinal muscles (L5-S1 level) were acquired during trunk flexion–extension cycles. EMG activity during the static relaxation phase was significantly reduced following intervention for the manipulation group but not for the control group. The extension-phase EMG activity was also reduced after manipulation, but the flexion-phase EMG levels remained unchanged. Accordingly, the percent changes in FRR and ERR were significantly larger for the manipulation group compared to the control. The results suggest that a high-velocity spinal manipulation is able to acutely reduce abnormal EMG activity during the full-flexion static phase and activation during the extension phase.

Effectiveness of Physical Therapy and Epidural Steroid Injections in Lumbar Spinal Stenosis

Randomized single-blind controlled trial. We aimed to compare the effects of epidural steroid injections and physical therapy program on pain and function in patients with lumbar spinal stenosis (LSS). LSS is one of the most common degenerative spinal disorders among elderly population. Initial treatment of this disabling painful condition is usually conservative including analgesics, nonsteroidal anti-inflammatory drugs, exercise, physical therapy, or epidural steroid injections. Owing to lack of sufficient data concerning the effectiveness of conservative treatment in LSS, we aimed to compare the effectiveness of epidural steroid injections and physical therapy program in a randomized controlled manner. A total of 29 patients diagnosed as LSS were randomized into 3 groups. Group 1 (n = 10) received an inpatient physical therapy program for 2 weeks, group 2 (n = 10) received epidural steroid injections, and group 3 (n = 9) served as the controls. All study patients additionally received diclofenac and a home-based exercise program. The patients were evaluated at baseline, 2 weeks, 1 month, 3 months, and 6 months after treatment by finger floor distance, treadmill walk test, sit-to-stand test, weight carrying test, Roland Morris Disability Index, and Nottingham Health Profile. Both epidural steroid and physical therapy groups have demonstrated significant improvement in pain and functional parameters and no significant difference was noted between the 2 treatment groups. Significant improvements were also noted in the control group. Pain and functional assessment scores (RMDI, NHP physical activity subscore) were significantly more improved in group 2 compared with controls at the second week. Epidural steroid injections and physical therapy both seem to be effective in LSS patients up to 6 months of follow-up.

Immediate Effects of the Suboccipital Muscle Inhibition Technique in Subjects With Short Hamstring Syndrome

Objective The purpose of this study is to identify the effects of the suboccipital muscle inhibition technique in patients with short hamstring syndrome by means of tests designed to evaluate the elasticity of the hamstring muscles and pressure algometry of myofascial trigger points. Methods Randomized clinical trial (pre and postintervention). The study population comprised young adult students following their studies at the Physiotherapy School at the University of Extremadura (Spain) and footballers from an Extremadura Football Club with short hamstring syndrome. The sample (70 subjects = 47 male and 23 female) was randomly divided into a control group (n = 34) and an intervention group (n = 36). Mean sample age was 23.40 ± 3.82 years. The control group was subjected to a placebo technique, whereas the intervention group was subjected to the suboccipital muscle inhibition technique. Pre and postintervention evaluation was used for the assessment of hamstring elasticity, and pressure algometry was also used (myofascial trigger points). Statistical analyses were performed using the SPSS 14.5 package (SPSS Inc, Chicago, Ill), comparing the sample between groups (Kolmorogov-Smirnov test, Student t test, 2-way analysis of variance [ANOVA], the χ 2 test). Results The distribution of the quantitative variables was normal, and the mean time doing physical activity per week was 2.82 ± 4.03 hours. Two-way ANOVA afforded statistically significant results for the finger-floor test, straight leg raise test-left, straight leg raise test-right, left popliteal angle test ( P values < .001), and right popliteal angle test ( P = .005). For pressure algometry, only the right semimembranosus muscle afforded statistically significant differences ( P = .021). Conclusions According to the finger-floor distance test, the straight leg raise test, and the popliteal angle test, the suboccipital muscle inhibition technique modified the elasticity of the hamstring muscles for this group of subjects. The suboccipital muscle inhibition technique modifies the pressure algometry of the semimembranosus muscle but does not modify that of the semitendinosus muscle or biceps femoris.

Acute low back pain: clinical course and prognostic factors

Purpose. The aim of this study was to assess the clinical course of patients with acute low back pain (LBP) throughout 12 weeks and to identify the prognostic factors for non-recovery in the short term.Method. A total of 91 patients with acute LBP (<3 weeks) were included in this study. Baseline assessments including demographic variables, clinical characteristics of pain, lost work time and results of clinical examination were noted. Pain intensity, disability, general health perception and depression were assessed according to visual analogue scale, Roland Morris Disability Questionnaire (RMDQ), Nottingham Health Profile (NHP) and Beck Depression Inventory, respectively. Patients were assessed for pain intensity and disability at baseline, and at 1, 2, 4, 8 and 12 weeks of follow-up. Recovery was considered if patients scored <4 on the RMDQ and pain had resolved. At the 2nd week of follow-up, patients were divided into two groups according to recovery (Group 1) or non-recovery (Group 2) to identify the prognostic factors, which were analysed by multiple logistic regression.Results. At 2 weeks, 52 (57.1%) of the patients had recovered and only eight (8.7%) developed chronic LBP. Mean pain intensity and mean disability scores dropped 96.7 and 96.4%, respectively, of initial levels during the 12 weeks. Sixty per cent of 63 employed patients reported lost time from work. A comparison between groups revealed that finger-floor distance, RMDQ and NHP (pain, physical mobility, emotional reactions, sleep, energy level, and distress subgroups) were statistically significantly lower in Group 1, and NHP-pain was strongly associated with non-recovery in the short term.Conclusions. Acute LBP patients with disability generally recover in the first weeks. General health perception (NHP) – pain subgroup score was identified in particular as the best prognostic factor for non-recovery in the short term. Hence, pain should be given particular consideration in baseline assessments of acute LBP patients.

Muscle assessment in healthy teenagers: Comparison with teenagers with low back pain

ObjectivesTo describe muscle parameters in healthy teenagers and compare them to teenagers with chronic low back pain. MethodsA comparative study of 276 control teenagers and 51 teenagers with chronic low back pain (CLBP), benefiting from a specific treatment, 14.5 years average age. The control group is made up of teenagers without back pain and teenagers who reported some back pain when we asked them, but without specific treatment. The results to four static tests assessing trunk flexors, trunk extensors, hip extensors and quadriceps endurance are statistically compared. In the control group, associations between different clinical measures and possible back pain are looked for. ResultsThe two groups are homogeneous, concerning age, weight, standing height, sitting height and BMI (p>0,05). Low back pain is more common in girls, either in the control group (n=48; 69% of girls) or in the group with CLBP (n=51; 78%). CLBP is associated with a poor endurance strength of the trunk extensors (median: 2min 31s in the control group to 1min 45s in the CLBP), with hip extensors weakness (median: 2min 20s in the control group to 1min 24s in the CLBP), and with quadriceps weakness (median: 2min 39s in the control group to 1min 20s in the CLBP), (p=0.000). No significant difference was found between trunk flexors endurance in the two groups (median: 2min 11s in the control group to 2min 13s in the CLBP). In the control group, 48 teenagers reported back pain “often”, “very often” or “all the time”; no links were found between pain and muscle flexibility, measured with finger-floor distance, heel-cheek distance, and popliteal angle. Only the sitting height was found statistically higher (p=0.003) in the control teenagers who reported back pain (87cm) related to the ones who have no pain (85cm). Sport influences global strength in lower limbs and changes the ratio of quadriceps to hip extensors, in favour of quadriceps. Neither pain nor the ratio of trunk flexors to trunk extensors are modified by sport. There is a linear relation between Shirado's and Sorensen's logarithmic values: it is consequently possible to predict the Shirado value when we have the Sorensen one. Trunk extensors, hip extensors and quadriceps endurance is lower in the CLBP group, 14.5 years of age.

Modified measurement of finger-floor distance-Self-assessment bending scale-

Finger-floor distance (FFD), which represents trunk flexibility, is a reliable assessment of lumbar impairment. Although this measurement is easy to test, it is difficult to adopt in a large, epidemiological study because it requires examiners. As an alternative, we developed a simple self-assessment bending scale (SABS). The purpose of the present study was to investigate the validity and reliability of the SABS. The SABS has 7-point grading scheme: (1) Fingertips can not reach beyond the knees; (2) Fingertips can reach beyond the knees but the wrists can not; (3) Wrists can reach beyond the knees, but fingertips can not reach the ankles; (4) Fingertips can reach the ankles, but not the floor; (5) Fingertips can touch the floor; (6) All of the fingers can reach the floor; and (7) Palms can reach the floor. We measured the FFD and SABS in 55 healthy volunteers. SABS assessments were made and documented independently by the subject and examiner. The SABS highly correlated with the FFD (r =0.95). Kappa statistics for the SABS grades given independently by the subjects and the examiner were high at 0.98. These findings suggest that the SABS may be used as an alternative to FFD measurements in epidemiological studies.

Dorso-Lumbar Pain in a Woman Diagnosed With Ankylosing Spondylitis

A 41-year-old woman with a history of smoking 5 cigarettes a day was diagnosed at 27 years of age with ankylosing spondylitis with a positive HLA-B27, according to the modified New York criteria. She was initially treated with analgesics and sulphasalazine, receiving up to 1000 mg/day, not tolerating a higher dose due to gastrointestinal complications, achieving good control of her disease. In March 2004, the patient presented intense dorsolumbar pain that increased with rest and improved with movement. The pain partially improved with the use of paracetamol and muscle relaxants. She did not present fever nor constitutional symptoms and had no history of trauma. The physical examination evidenced pain of the spinous processes of the dorsolumbar spine, a modified Schober test of 1.3 cm, a finger-floor distance of 5 cm, BASFI (Bath Ankylosing Spondylitis Functional Index) of 51, and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) of 48. The laboratory testing showed: hemoglobin, 11.6 g/dL (12-15); mean corpuscular volume, 83.20 fl (78-100); erythrocyte sedimentation rate, 25 (020); and CRP, 5.4 mg/L (0-5). The blood chemistry, blood proteins, and urine tests were normal. PPD was positive (11 mm), with a normal chest x-ray. Blood cultures, serology for Brucella and acid-alcohol resistant bacilli in urine were negative. The patient had a lumbar spine x-ray that showed a wedgelike appearance of D-12 which had not been observed on previous x-rays as well as osteopenia and squaring of the vertebral bodies. The study was completed with a STIR magnetic resonance (MR) of the spine (Figure 1) which showed a hyperintense image in T2 with fat suppression, compatible with a grade C1 Anderson lesion (edema of the vertebral body) at the level of D7 and D8; a Dorso-Lumbar Pain in a Woman Diagnosed With Ankylosing Spondylitis

大学ボクシング選手の腰痛と身体特性の検討

The purpose of this study is to evaluate physical characteristics of boxing players with/without low back pain (LBP). Materials and methods : 18 college boxing players were divided into two groups ; The first group consisted of eight subjects with LBP (LBP group), the other one consisted of ten subjects without LBP (no LBP group). The evaluation items were as follows : muscular strength of trunk extension/ flexion/ rotation, cross-sectional areas of the muscles of the lumber region, X ray photograph of lumber spine, MRI, general joint laxity test, muscle tightness test, muscle hardness, tenderness and moiré topography. Results : 9 out of 18 subjects showed lumber region abnormalities in their X ray photograph and MRI. The following evaluation items of LBP group read significant differences compared to those of no LBP group ; The trunk rotator peak torque was weaker at the angular velocity of 120 deg/sec, the laterality of SLR was significantly larger, while the finger floor distance value indicated significantly lower. Discussion : In LBP group, it is suggested that the decline of trunk flexion muscle strength possibly preceded the fall of trunk extension muscle strength which, however, was not observed.

Plantar Infrared Thermography Measurements and Low Back Pain Intensity

To study the skin temperature disorders in low back pain (LBP) patients compared with reference persons without LBP and to evaluate the relationship between pain intensity and other clinical signs and temperature abnormalities. Sixty-five patients with unilateral chronic LBP with or without referred nonradicular leg pain (29 men and 36 women; age range, 30-51 years) and 20 reference persons without LBP (7 men and 13 women; age range, 30-49 years) participated in this study. The pain level was recorded by the use of a visual analog scale (0-100). Questionnaires and a series of spinal mobility tests (the modified Schober, straight leg-raising test, finger-floor distance, side bending) were used. Thermographic images of the low back area and legs (anterior, lateral, and posterior surfaces and the plantar surfaces of feet) were taken with an infrared video camera. The temperature changes in the plantar surface correlated with LBP intensity. The pain levels differed in the groups with the different types of temperature changes. There were significant lower extremity regional skin temperature alterations (at least 1 regional interside difference more than 0.3 degrees C) in most cases both in LBP patients and in reference persons, but plantar interside temperature difference was significantly higher in LBP patients. Temperature changes of the plantar surface seem to be connected with LBP intensity. Temperature measurements may be useful as an adjunctive physiological test in the evaluation and documentation of autonomic dysfunction in LBP patients.

Spinal Range of Motion, Muscle Endurance, and Back Pain and Function at Least 20 Years After Fusion or Brace Treatment for Adolescent Idiopathic Scoliosis

A consecutive series of patients with adolescent idiopathic scoliosis (AIS), treated between 1968 and 1977 before 21 years of age with either distraction and fusion using Harrington rods (ST, n = 156; 145 females and 11 males) or with brace (BT, n = 127; 122 females and 5 males), were followed at least 20 years after completion of the treatment. To determine the long-term outcome in terms of spinal mobility and muscle strength and its possible correlations to present back pain and function in patients surgically or brace treated for AIS. Few reports on long-term outcome on these variables have previously been presented for this group of patients. A total of 135 (87%) of ST and 102 (80%) of BT patients underwent a complete examination by two unbiased observers incl. evaluation of lumbar muscle endurance and spinal mobility, curve size (Cobb method), validated questionnaires in terms of general and disease-specific quality of life aspects, as well as present back function and pain. An age- and sex-matched control group of 100 persons was randomly selected and subjected to the same examinations. For both ST and BT groups, lumbar spinal motion as well as muscle endurance were significantly decreased compared with controls. For ST patients, better lumbar extensor and flexor muscle endurance or lumbar spinal mobility correlated with a better physical function. The length of fusion into the lumbar spine correlated inversely with lumbar range of motion, but the finger-floor distance was not affected. BT patients with reduced lumbar spinal mobility experienced lumbar back pain more often than controls. For both brace treated and surgically treated AIS patients, spinal mobility and muscle endurance were reduced more than 20 years after completed treatment. The physical function was not severely restricted.

Effects of Taijiquan on the Physical Fitness of Elderly Chinese People

We evaluated the efficacy of an 1-hour Taijiquan daily exercise for maintaining and improving the physical fitness of elderly Chinese people in an urban area of China. They had practiced Taijiquan in the park every morning for many years. Thirty subjects (male: n=10, average age 74.4 ± 3.2 years; female: n=20, average age 73.4 ± 4.4 years) participated in the study. Measures of physical fitness were taken immediately before and after the Taijiquan exercise. In both male and female groups, the results for tests consisting of standing on one leg with eyes open, grip strength, functional reach, 10-m walking speed, finger-floor distance, and standing on one leg while swinging the other leg were significantly improved. Results for standing on one leg with eyes closed, did not show a significant change. These results suggest that a 1-hour Taijiquan session can improve physical fitness in terms of static and dynamic balance, muscular strength, coordination, walking ability and flexibility in elderly individuals who have practiced Taijiquan over a long period of time. Thus, Taijiquan could help elderly individuals to maintain and improve their health and their ability to perform daily activities.

A Novel Back School Using a Multidisciplinary Team Approach Featuring Quantitative Functional Evaluation and Therapeutic Exercises for Patients With Chronic Low Back Pain

A prospective cohort study. To introduce a novel back school for the treatment of patients with chronic low back pain (CLBP), and to report its clinical results. Although back school is one of the treatment methods for patients with CLBP, its efficacy and appropriate style remain controversial. No studies have been published regarding the combined program of back school with a multidisciplinary team approach. A total of 182 patients with CLBP (74 men and 108 women; average age, 43.8 years) participated in this study. All patients were enrolled in the back school using a multidisciplinary team approach featuring quantitative functional evaluation and therapeutic exercises. The following outcome measures were evaluated at the baseline, and 6 and 12 months after the enrollment: the level of pain evaluated with a Visual Analog Scale (VAS), flexibility of trunk and hamstrings (finger-floor distance, straight leg raising), trunk muscle strength and endurance, frequency of therapeutic exercises, and self-reported patient satisfaction. An averaged VAS score was 6.2 before enrollment in the program and 2.8 at follow-up. The pain improved in 141 patients (80.8%), did not change in 27 (15.4%), and was aggravated in 7 (3.8%). There was statistically significant improvement of finger-floor distance, trunk muscle strength, and endurance in the patients whose pain was relieved after enrollment in the program (P < 0.05). The compliance with the exercise program was significantly correlated with the clinical results (P < 0.05). We developed a novel back school using a multidisciplinary team approach, featuring quantitative functional evaluation and therapeutic exercises. The current study demonstrated that our program could provide a satisfactory result for the treatment of patients with CLBP. The quantitative functional evaluation was a worthwhile outcome measure when evaluating the efficacy of the treatment program. Teaching body mechanics and performing the therapeutic exercises through the multidisciplinary team approach are essential to managing CLBP in a general setting.

Effects of home-based daily exercise therapy on joint mobility, daily activity, pain, and depression in patients with ankylosing spondylitis

We investigated the effects of home-based daily exercise on joint mobility, functional capacity, pain, and depression in patients with ankylosing spondylitis (AS). The patients were randomly assigned to a wait-list control group or to an exercise-therapy group. The exercise-therapy group performed a 20-min exercise program once per day for 8 consecutive weeks. After 8 weeks, compared with the control group, the exercise group showed improvements in joint mobility (cervical flexion, extension, shoulder flexion, abduction, hip abduction, and knee flexion), finger-floor distance, and functional capacity. Pain and depression scores were significantly lower after the exercise program in the exercise group than in the control group. These findings indicate that exercise therapy increases joint mobility and functional capacity, and decreases pain and depression in patients with AS. Home-based exercise, which is easily accessible to patients, might be an effective intervention for AS.

他動的股関節内旋外旋運動が指床間距離に及ぼす影響

他動的股関節内旋外旋運動が指床間距離に及ぼす影響