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The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections

Kyoung A Kim1, Myung Ha Lee2, Hyun Kyung Kim2, Seok Hee Jeong2
Korean Journal of Adult Nursing 2013;25(4):454-463.
Published online: August 18, 2013

1Lee Chun Tek Hospital, Suwon

2College of Nursing, Chonbuk National University, Jeonju, Korea

Corresponding author: Lee, Myung Ha College of Nursing, Chonbuk National University, 567 Baekje-daero, deokjin-gu, Jeonju 561-756, Korea Tel: +82-63-270-3104, Fax: +82-63-270-3127, E-mail: leemh@jbnu.ac.kr
• Received: February 8, 2013   • Accepted: August 17, 2013

© 2013 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study aimed to evaluate the effects of exercise program on chronic low back pain, daily living disability and depression in chronic low back pain patients treated with epidural injections.
  • Methods
    The design of this study was a nonequivalent control group pretest-posttest experiment. The sample was recruited among low back pain patients treated with epidural injections from an orthopedic specialty hospital. Participants were randomly assigned to a treatment group (n=25) or a comparison group (n=27). The treatment was a six week exercise program for low back pain. Data were collected from September to November 2011, and were analyzed using descriptive statistics, x2-test, one-tailed t-test for independent samples, and Mann-Whitney U test using the SPSS/WIN 12.0 program.
  • Results
    Patients in the treatment group reported statistically significantly lower levels of back pain on flexion and extension, less daily living disability, and less depression than those in the comparison group.
  • Conclusion
    The back pain relief exercise program could be an effective adjunct nursing intervention for low back pain patients treated with epidural injections.
  • Key Words: Exercise; Low back pain; Disability; Depression
Figure 1.
A twelve step exercise program.
kjan-25-454f1.jpg
Table 1.
Homogeneity of General Characteristics (N=52)
Characteristics Categories Exp. (n=25) Cont. (n=27) x2 or t p
n (%) or M±SD n (%) or M±SD
Gender Male 11 (44.0) 15 (55.6) 0.69 .405
Female 14 (56.0) 12 (44.4)
Age (year)   42.60±10.95 48.11±9.40 -1.95 .057
Education ≤Middle school 8 (32.0) 14 (51.9) 2.09 .171
≥High school 17 (68.0) 13 (48.1)
Spouse Yes 8 (32.0) 7 (25.9) 0.23 .629
No 17 (68.0) 20 (74.1)
Occupation Yes 18 (72.0) 17 (63.0) 0.48 .488
No 7 (28.0) 10 (37.0)
Standing at work (hour)   5.12±3.63 5.14±3.91 -0.02 .979
Sitting at work (hour)   4.72±3.15 4.22±2.93 0.58 .559
Hypertension Yes 5 (20.0) 6 (22.2) 0.03 .845
No 20 (22.2) 21 (77.8)
Diabetes mellitus Yes 2 (8.0) 4 (14.8) 0.59 .442†
No 23 (92.0) 23 (85.2)
Arthritis Yes 3 (12.0) 4 (14.8) 0.08 1.000†
No 22 (88.0) 23 (85.2)

Exp.=experimental group; Cont.=control group.

†Fisher's exact test.

Table 2.
Homogeneity of Dependent Variables (N=52)
Variables Exp. (n=25) Cont. (n=27) t or Z p
M±SD M±SD
Pain on extension 6.72±1.84 6.06±1.94 1.26 .106
Pain on flexion 6.74±1.66 6.14±1.93 1.20 .117
Daily living disability 30.84±4.36 30.37±4.27 0.39 .347
Depression 25.96±8.42 25.40±6.53 -0.30 .381†

Exp.=experimental group; Cont.=control group.

†Mann-Witney U test.

Table 3.
Comparison of Pain, Daily Life Disability, and Depression between Two Groups (N=52)
Variables Group Pre Post Difference t p
M±SD M±SD M±SD
Pain on extension Exp. (n=25) 6.72±1.84 1.86±1.04 -4.86±1.77 -2.32 .012
Cont. (n=27) 6.06±1.94 2.37±.944 -3.69±1.85
Pain on flexion Exp. (n=25) 6.74±1.66 1.74±1.10 -5.00±1.88 -2.37 .010
Cont. (n=27) 6.14±1.93 2.43±.937 -3.70±2.04
Daily life disability Exp. (n=25) 30.84±4.36 13.95±4.51 -16.88±6.01 -2.41 010
Cont. (n=27) 30.37±4.27 17.61±5.07 -12.75±6.30
Depression Exp. (n=25) 25.96±8.42 14.56±3.94 -11.40±6.22 -3.13 .002
Cont. (n=27) 25.40±6.53 18.37±4.26 -7.03±3.54

Exp.=experimental group; Cont.=control group.

  • Aceves-González C., Prado-Leon L. R.. 2008;Low back pain and depression: A study in a population of Mexican workers. Work. 31(2):159-166.
  • Benzon H. T.. 1986;Epidural steroid injections for low back pain and lumbosacral radiculopathy. Pain. 3:277-295. http://dx.doi.org/10.1016/0304-3959(86)90115-6.
  • Choi D., Choi K.. 2010;The effect of lumbar exercise by gym-ball and elastic band on lumbar strength in chronic low back pain patients. The Korean Journal of Ideal Body & Meridian Pathways. 2(1):1-7.
  • Choi S. Y.. 2001;Relieving program on the back muscle strength, intensity of pain, disability level in elementary school women teacher. Korean Journal of Women Health Nursing. 7(2):169-187.
  • Crowley L.. 2009;The effectiveness of home exercise programmes for patients with rheumatoid arthritis: A review of the literature. Physical Therapy Reviews. 14(3):149-159. http://dx.doi.org/10.1179/174328809X435277.
  • Fairbank J. K., Pynsent P. B.. 2000;The Oswestry Disability Index. Spine. 25:2940-2952.
  • Faul F., Erdfelder E., Buchner A., Lang A.-G.. 2009;Statistical power analyses using G∗Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 41:1149-1160. http://dx.doi.org/10.3758/brm.41.4.1149.
  • Gard G., Gille K. A., Grahn B.. 2000;Functional activities and psychosocial factors in the rehabilitation of patients with low back pain. Scandinavian Journal of Caring Sciences. 14(2):75-81.
  • Gaskell L., Enright S., Tyson S.. 2007;The effects of a back rehabilitation programme for patients with chronic low back pain. Journal of Evaluation in Clinical Practice. 13(5):795-800. http://dx.doi.org/10.1111/j.1365-2753.2006.00772.x.
  • Gatchel R. J., Bernstein D., Stowell A. W., Pransky G.. 2008;Psychosocial differences between high risk acute vs. chronic low back pain patients. Pain Practice. 8(2):91-97.
  • Hagen E. M., Grasdal A., Eriksen H. R.. 2003;Does early intervention with a light mobilization program reduce longterm sick leave for low back pain: A 3 year follow up study. Spine. 28(20):2309-2315.
  • Holmes S.. 1985;Pursuit of happiness. Nursing Mirror. 161(3):43-45.
  • Itz C., Geurts J., van Kleef M., Nelemans P.. 2013;Clinical course of non-specific low back pain: A systematic review of prospective cohort studies set in primary care. European Journal Of Pain. 17(1):5-15. http://dx.doi.org/10.1002/j.1532-2149.2012.00170.x.
  • Jeon C. H., Kim D. J., Kim D. J., Lee H. M., Park H. J.. 2005;Cross-cultural adaptation of the Korean version of the Oswestry Disability Index (ODI). Korean Society of Spine Surgery. 12(2):146-152. http://dx.doi.org/10.4184/jkss.2005.12.2.146.
  • Jette A. M.. 1980;Functional status index: Reliability of a chronic disease evaluation instrument. Archives Physical Medicine & Rehabilitation. 61(9):395-401.
  • Kim D. Y., Oh S. G., Park J. H.. 2003;Caudal epidural steroid injections for the treatment of chronic lower back pain. Korean Journal of Family Medicine. 24:260-264.
  • Kim J. C., Kim H. B., Kim M. J., Lee S. G.. 2000;Evaluation of epidural injection with modified Dallas Pain Questionnaire in patients with low back pain. Journal of Korean Academy of Rehabilitation Medicine. 24(1):108-116.
  • Kwon B. A.. 2009;Effects of spinal stabilization exercise on cross-sectional areas and recovery of function in patients with chronic low back pain Unpublished doctoral dissertation, Hanyang University, Seoul..
  • Lee J. K.. 1997;A study on construction of exercise prediction model for the low back pain patients Unpublished doctoral dissertation, Yonsei University, Seoul..
  • McKenzie R. A.. 1979;Prophylaxis in recurrent low back pain. The New Zealand Medical Journal. 89(627):22-23.
  • Nam K. H.. 2004;The effect of back pain relief exercise on pain from daily activities, low back pain and depression of the patients with chronic back pain Unpublished master's thesis, Kangwon University, Chuncheon..
  • National Evidence-based Healthcare Collaborating Agency. 2010;The effect of injection treatment on pain in chronic low back pain Retrieved January 9, 2013, from.http://www.neca.re.kr/ktic/publication/disease_view.jsp?runMode=boardView&seq=18&t=20130110022819776&boardNo=GA&cpage=5&range=10&block=10&searchCol=&searchVal=&condition=&menuName=&named=.
  • Park H. S., Son J. T.. 2001;A study on the relationship between optimism and depression in chronic low-back pain patients. Korean Academy of Psychiatric and Mental Health Nursing. 10(2):125-136.
  • Park J. Y.. 2007;Nonsurgical management of chronic low back pain. Journal of the Korean Medical Association. 50(6):507-522. http://dx.doi.org/10.5124/jkma.2007.50.6.507.
  • Risch S. V., Norvell N. K., Pollock M. L., Risch E. D., Langer H., Fulton M., et al. 1993;Lumbar strengthening in chronic low back pain patients. Physiologic and psychological benefits. Spine. 18(2):232-238.
  • Rittweger J., Just K., Kautzch K., Reeg P., Felsenberg D.. 2002;Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: A randomized controlled trial. Spine. 27(17):1829-1834.
  • Scott J., Huskinsson E. C.. 1979;Vertical or horizontal visual analogue scales. Annals of the Rheumatic Diseases. 38(6):560http://dx.doi.org/10.1136/ard.38.6.560.
  • Williams P. C.. 1965. The lumbosacral spine: Emphasizing conservative management. New York, NY: McGraw-Hill Book Company.

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References

    Citations

    Citations to this article as recorded by  
    • The Effects of Comprehensive Education Program on Anxiety, Uncertainty and Athletic Performance of Patients undergo Spinal Nerve Block
      Seon Hee Kim, Eun Sook Lee
      Korean Journal of Adult Nursing.2017; 29(2): 143.     CrossRef
    • Effects of the Back Pain Management Program on Patients with Chronic Low Back Pain
      In Ho Shin, Kyung-Sook Cho
      Journal of muscle and joint health.2014; 21(2): 114.     CrossRef

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    The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections
    Korean J Adult Nurs. 2013;25(4):454-463.   Published online August 31, 2013
    DOI: https://doi.org/10.7475/kjan.2013.25.4.454
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    The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections
    Korean J Adult Nurs. 2013;25(4):454-463.   Published online August 31, 2013
    DOI: https://doi.org/10.7475/kjan.2013.25.4.454
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    The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections
    Image
    Figure 1. A twelve step exercise program.

    Figure 1.

    The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections

    Homogeneity of General Characteristics (N=52)

    Characteristics Categories Exp. (n=25) Cont. (n=27) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Gender Male 11 (44.0) 15 (55.6) 0.69 .405
    Female 14 (56.0) 12 (44.4)
    Age (year)   42.60±10.95 48.11±9.40 -1.95 .057
    Education ≤Middle school 8 (32.0) 14 (51.9) 2.09 .171
    ≥High school 17 (68.0) 13 (48.1)
    Spouse Yes 8 (32.0) 7 (25.9) 0.23 .629
    No 17 (68.0) 20 (74.1)
    Occupation Yes 18 (72.0) 17 (63.0) 0.48 .488
    No 7 (28.0) 10 (37.0)
    Standing at work (hour)   5.12±3.63 5.14±3.91 -0.02 .979
    Sitting at work (hour)   4.72±3.15 4.22±2.93 0.58 .559
    Hypertension Yes 5 (20.0) 6 (22.2) 0.03 .845
    No 20 (22.2) 21 (77.8)
    Diabetes mellitus Yes 2 (8.0) 4 (14.8) 0.59 .442†
    No 23 (92.0) 23 (85.2)
    Arthritis Yes 3 (12.0) 4 (14.8) 0.08 1.000†
    No 22 (88.0) 23 (85.2)

    Exp.=experimental group; Cont.=control group.

    †Fisher's exact test.

    Homogeneity of Dependent Variables (N=52)

    Variables Exp. (n=25) Cont. (n=27) t or Z p
    M±SD M±SD
    Pain on extension 6.72±1.84 6.06±1.94 1.26 .106
    Pain on flexion 6.74±1.66 6.14±1.93 1.20 .117
    Daily living disability 30.84±4.36 30.37±4.27 0.39 .347
    Depression 25.96±8.42 25.40±6.53 -0.30 .381†

    Exp.=experimental group; Cont.=control group.

    †Mann-Witney U test.

    Comparison of Pain, Daily Life Disability, and Depression between Two Groups (N=52)

    Variables Group Pre Post Difference t p
    M±SD M±SD M±SD
    Pain on extension Exp. (n=25) 6.72±1.84 1.86±1.04 -4.86±1.77 -2.32 .012
    Cont. (n=27) 6.06±1.94 2.37±.944 -3.69±1.85
    Pain on flexion Exp. (n=25) 6.74±1.66 1.74±1.10 -5.00±1.88 -2.37 .010
    Cont. (n=27) 6.14±1.93 2.43±.937 -3.70±2.04
    Daily life disability Exp. (n=25) 30.84±4.36 13.95±4.51 -16.88±6.01 -2.41 010
    Cont. (n=27) 30.37±4.27 17.61±5.07 -12.75±6.30
    Depression Exp. (n=25) 25.96±8.42 14.56±3.94 -11.40±6.22 -3.13 .002
    Cont. (n=27) 25.40±6.53 18.37±4.26 -7.03±3.54

    Exp.=experimental group; Cont.=control group.
    Table 1. Homogeneity of General Characteristics (N=52)

    Exp.=experimental group; Cont.=control group.

    Fisher's exact test.

    Table 2. Homogeneity of Dependent Variables (N=52)

    Exp.=experimental group; Cont.=control group.

    Mann-Witney U test.

    Table 3. Comparison of Pain, Daily Life Disability, and Depression between Two Groups (N=52)

    Exp.=experimental group; Cont.=control group.

    Table 1.

    Table 2.

    Table 3.

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