Title Page
Abstract
Contents
1. Introduction 12
1.1. Background and Necessity 12
1.2. Purpose 17
1.3. Hypotheses 17
2. Theoretical Background 18
2.1. Anatomical Structure of The Lumbar vertebrae 18
2.1.1. Features of lumbar vertebrae and disc 22
2.1.2. Anatomical structure of ligaments around the spine 25
2.1.3. Features of the spinal apophyseal joint 29
2.2. Features of lumbar vertebrae 31
2.3. Spinal mobilization 34
2.4. Stability and Instability of The Spine 37
2.5. Upper lumbar vertebrae auto-mobilization and thoracic vertebrae auto- mobilization of the K-E Concept 39
2.6. Mckenzie exercise 41
3. Methods 43
3.1. Subjects 43
3.2. Process of the Research 46
3.3. Intervention 48
3.3.1. Upper lumbar vertebrae auto-mobilization 48
3.3.2. thoracic vertebrae auto-mobilization 49
3.3.3. Mckenzie exercise 50
3.4. Clinical Measurements 51
3.4.1. Pain 51
3.4.2. Range of motion 52
3.4.3. Intervertebral motion test 54
3.4.4. Stability test 61
3.4.5. Lumbar Disability test 62
3.5. Statistical Analysis 63
4. Results 64
4.1. General Characteristics of Subjects 64
4.2. Comparison of the Pain between Three groups 65
4.3. Comparison of the Lumbar Flexion ROM between Three groups 67
4.4. Comparison of the Lumbar Extension ROM between Three groups 69
4.5. Comparison of the thoracic intervertebral motion between Three groups 71
4.6. Comparison of the Lumbar intervertebral motion between Three groups 75
4.7. Comparison of the lumbar Instability between Three groups 77
4.8. Comparison of the lumbar Stability between Three groups 79
4.9. Comparison of the Lumbar Disability Index between Three groups 81
5. Discussion 83
6. Conclusion 88
List of references 89
List of Abbreviations 101
Abstract of Korean 106
Appendix 108
Table 1. General Characteristics of Subjects 64
Table 2. Effect of UAM, TAM and MCK on Pain 65
Table 3. Effect of UAM, TAM and MCK on Lumbar Flexion ROM 67
Table 4. Effect of UAM, TAM and MCK on Lumbar Extension ROM 69
Table 5. Effect of UAM, TAM and MCK on thoracic intervertebral motion 71
Table 6. Effect of UAM, TAM and MCK on Lumbar intervertebral motion 75
Table 7. Effect of UAM, TAM and MCK on Lumbar vertebrae Instability 77
Table 8. Effect of UAM, TAM and MCK on Lumbar Stability 79
Table 9. Effect of UAM, TAM and MCK on Lumbar Disability 81
Figure 1. Structure of the spine 20
Figure 2. General structure of lumbar 20
Figure 3. Intervertebral disc of lumbar vertebrae 23
Figure 4. Ligament of lumbar vertebrae 28
Figure 5. Apophyseal joints of lumbar vertebrae 30
Figure 6. Function of lumbar vertebrae 33
Figure 7. K-E Concept wedge 40
Figure 8. Flow Diagram of the Entire Experimental Procedure 47
Figure 9. K-E concept Lumbar auto-mobilization 48
Figure 10. K-E concept Thoracic auto-mobilization 49
Figure 11. McKenzie exercise (Press-up exercise) 50
Figure 12. Visual Analogue Scale 51
Figure 13. modified Schober method 53
Figure 14. Lumbar, Thoracic passive physiologic intervertebral motion test - 1 55
Figure 15. Lumbar passive physiologic intervertebral motion test - 2 56
Figure 16. Thoracic passive physiologic intervertebral motion test - 2 56
Figure 17. Lumbar passive accessory intervertebral motion test - 1 57
Figure 18. Thoracic passive accessory intervertebral motion test - 1 57
Figure 19. Lumbar passive accessory intervertebral motion test - 2 58
Figure 20. Thoracic passive accessory intervertebral motion test - 2 58
Figure 21. passive lumbar extension test 59
Figure 22. prone instability test 60
Figure 23. Stabilizer Pressure Biofeedback Charranoofa Group Inc, USA (Stabilizer); Stability Test 61
Figure 24. Effect of UAM, TAM and MCK on Pain 66
Figure 25. Post-hoc of the effects of UAM, TAM and MCK on pain 66
Figure 26. Effect of UAM, TAM and MCK on Lumbar Flexion ROM 68
Figure 27. Post-hoc of the Effect of UAM, TAM and MCK on Lumbar Flexion ROM 68
Figure 28. Effect of UAM, TAM and MCK on Lumbar Extension ROM 70
Figure 29. Post-hoc of the Effect of UAM, TAM and MCK on Lumbar Extension ROM 70
Figure 30. Effect of UAM, TAM and MCK on thoracic intervertebral motion 73
Figure 31. Post-hoc of the Effect of UAM, TAM and MCK on thoracic intervertebral motion 73
Figure 32. Effect of UAM, TAM and MCK on Lumbar intervertebral motion 76
Figure 33. Post-hoc of the Effect of UAM, TAM and MCK on Lumbar intervertebral motion 76
Figure 34. Effect of UAM, TAM and MCK on Lumbar vertebrae Instability 78
Figure 35. Post-hoc of the Effect of UAM, TAM and MCK on Lumbar vertebrae Instability 78
Figure 36. Effect of UAM, TAM and MCK on Lumbar Stability 80
Figure 37. Post-hoc of the Effect of UAM, TAM and MCK on Lumbar Stability 80
Figure 38. Effect of UAM, TAM and MCK on Lumbar Disability 82
Figure 39. Post-hoc of the Effect of UAM, TAM and MCK on Lumbar Disability 82