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      The effect of sling exercise on sagittal lumbosacral angle and intervertebral disc area of chronic low back pain patients

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          Abstract

          The purpose of this study was to observe the change of lumbosacral angle and intervertebral disc (IVD) area. The study was conducted on chronic low back pain (CLBP) female patients for 12 weeks by operating sling exercise and general physical therapy. The 57 CLBP were divided into 2 groups which, sling exercise group (SEG, n=34) and general physical therapy group (PTG, n=23). The experiment was conducted three times a week for 12 weeks. The lumbosacral angle, which means the angle between the L1–L2 lumbar was measured by plain radiography. The IVD area, which means the IVD height and volume was measured by magnetic resonance imaging. The pain was measured by visual analogue scale (VAS). As a result, after 12-week exercise, VAS had decreased in all groups. The angle of L3–4 and L4–5 and the height of IVD had increased in SEG. Also, IVD height and volume has more improved in SEG compare the PTG. Therefore, the sling exercise is proper treatment for CLBP patients’ recovery because It improve the lumbosacral angle and IVD area.

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          Sagittal alignment of the spine and pelvis during growth.

          Prospective study of the sagittal plane alignment of the spine and pelvis in the normal pediatric population. To document the sagittal alignment of the spine and pelvis and its change during growth in the normal pediatric population. Pelvic morphology as well as sagittal alignment of the spine and pelvis in the pediatric population are poorly defined in the literature. Five parameters were evaluated on lateral standing radiographs of 180 normal study participants 4 to 18 years of age: thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence. Statistical analysis was performed using two-tailed Student t tests and Pearson's coefficients (level of significance = 0.01). The mean thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence values were 43.0 degrees, 48.5 degrees, 41.2 degrees, 7.2 degrees and 48.4 degrees, respectively. There was no significant difference between males and females. Thoracic kyphosis, lumbar lordosis, pelvic tilt, and pelvic incidence were found to be weakly correlated with age, while sacral slope remained stable with growth. Pelvic morphology, as measured by the pelvic incidence angle, tends to increase during childhood and adolescence before stabilizing into adulthood, most likely to maintain an adequate sagittal balance in view of the physiologic and morphologic changes occurring during growth. Pelvic tilt and lumbar lordosis, two position-dependent parameters, also react by increasing with age, most likely to avoid inadequate anterior displacement of the body center of gravity. Sacral slope is achieved with the standing posture and is not further significantly influenced by age. These results are important to establish baseline values for these measurements in the pediatric population, in view of the reported association between pelvic morphology and the development of various spinal disorders such as spondylolisthesis and scoliosis.
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            Core strengthening.

            Core strengthening has become a major trend in rehabilitation. The term has been used to connote lumbar stabilization, motor control training, and other regimens. Core strengthening is, in essence, a description of the muscular control required around the lumbar spine to maintain functional stability. Despite its widespread use, core strengthening has had meager research. Core strengthening has been promoted as a preventive regimen, as a form of rehabilitation, and as a performance-enhancing program for various lumbar spine and musculoskeletal injuries. The intent of this review is to describe the available literature on core strengthening using a theoretical framework. To understand the concept of core strengthening.
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              The lumbar multifidus: does the evidence support clinical beliefs?

              The contribution of the trunk muscles to spinal stability is well established. There is convincing evidence for the role of multifidus in spinal stability. Recently, emphasis has shifted to the deep fibres of this muscle (DM) and five key clinical beliefs have arisen: (i) that DM stabilizes the lumbar spine whereas the superficial fibres of lumbar multifidus (SM) and the erector spinae (ES) extend and/or rotate the lumbar spine, (ii) that DM has a greater percentage of type I (slow twitch) muscle fibres than SM and ES, (iii) that DM is tonically active during movements of the trunk and gait, whereas SM and ES are phasically active, (iv) that DM and the transversus abdominis (TrA) co-contract during function, and (v) that changes in the lumbar paraspinal muscles associated with LBP affect DM more than SM or ES. This paper reviews the biomechanical, electromyographic, histochemical and morphological data that underpin these beliefs. Although there is support for the importance of the lumbar multifidus and the specific contribution of this muscle to intervertebral control, several of the clinical beliefs have little or no support and require further evaluation. These findings have implications for clinical practice.
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                Author and article information

                Journal
                J Exerc Rehabil
                J Exerc Rehabil
                Journal of Exercise Rehabilitation
                Korean Society of Exercise Rehabilitation
                2288-176X
                2288-1778
                October 2016
                31 October 2016
                : 12
                : 5
                : 471-475
                Affiliations
                [1 ]Department of Physical Education, Gyeongin National University of Education, Incheon, Korea
                [2 ]Department of Physical Education, College of Education, Dankook University, Yongin, Korea
                Author notes
                [* ]Corresponding author: Won-Je Cho, http://orcid.org/0000-0001-5256-8341, Department of Physical Education, College of Education, Dankook University, 152, Jukjeon-ro, Suji-gu, Yongin 16890, Korea, Tel: +82-31-8005-3867, Fax: +82-31-8021-7232, E-mail: dkwonje24@ 123456naver.com
                Article
                jer-12-5-471
                10.12965/jer.1632676.338
                5091064
                27807527
                c8e1287a-0069-497e-bc99-7e053b74f983
                Copyright © 2016 Korean Society of Exercise Rehabilitation

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 June 2016
                : 02 October 2016
                Categories
                Original Article

                lumbosacral angle,intervertebral disc area,visual analogue scale,chronic low back pain,sling exercise

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