Journal List > Korean J Adult Nurs > v.25(4) > 1076207

Korean J Adult Nurs. 2013 Aug;25(4):454-463. Korean.
Published online August 31, 2013.
© 2013 Korean Society of Adult Nursing
The Effect of Exercise Program on Pain, Daily Living Disability, and Depression in Chronic Low Back Pain Patients Treated with Epidural Injections
Kyoung A Kim,1 Myung Ha Lee,2 Hyun Kyung Kim,2 and Seok Hee Jeong2
1Lee Chun Tek Hospital, Suwon, Korea.
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, Email:
Received February 08, 2013; Revised June 12, 2013; Accepted August 17, 2013.



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.


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, χ2-test, one-tailed t-test for independent samples, and Mann-Whitney U test using the SPSS/WIN 12.0 program.


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.


The back pain relief exercise program could be an effective adjunct nursing intervention for low back pain patients treated with epidural injections.

Keywords: Exercise; Low back pain; Disability; Depression


Figure 1
A twelve step exercise program.
Click for larger image


Table 1
Homogeneity of General Characteristics (N=52)
Click for larger image

Table 2
Homogeneity of Dependent Variables (N=52)
Click for larger image

Table 3
Comparison of Pain, Daily Life Disability, and Depression between Two Groups (N=52)
Click for larger image


This article is a condensed form of the first author's master's thesis from Chonbuk National University.

1. Aceves-González C, Prado-Leon LR. Low back pain and depression: A study in a population of Mexican workers. Work 2008;31(2):159–166.
2. Benzon HT. Epidural steroid injections for low back pain and lumbosacral radiculopathy. Pain 1986;3:277–295. [doi: 10.1016/0304-3959(86)90115-6]
3. Choi D, Choi K. 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 2010;2(1):1–7.
4. Choi SY. Relieving program on the back muscle strength, intensity of pain, disability level in elementary school women teacher. Korean Journal of Women Health Nursing 2001;7(2):169–187.
5. Crowley L. The effectiveness of home exercise programmes for patients with rheumatoid arthritis: A review of the literature. Physical Therapy Reviews 2009;14(3):149–159. [doi: 10.1179/174328809X435277]
6. Fairbank JK, Pynsent PB. The Oswestry Disability Index. Spine 2000;25:2940–2952.
7. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods 2009;41:1149–1160. [doi: 10.3758/brm.41.4.1149]
8. Gard G, Gille KA, Grahn B. Functional activities and psychosocial factors in the rehabilitation of patients with low back pain. Scandinavian Journal of Caring Sciences 2000;14(2):75–81.
9. Gaskell L, Enright S, Tyson S. The effects of a back rehabilitation programme for patients with chronic low back pain. Journal of Evaluation in Clinical Practice 2007;13(5):795–800. [doi: 10.1111/j.1365-2753.2006.00772.x]
10. Gatchel RJ, Bernstein D, Stowell AW, Pransky G. Psychosocial differences between high risk acute vs. chronic low back pain patients. Pain Practice 2008;8(2):91–97.
11. Hagen EM, Grasdal A, Eriksen HR. Does early intervention with a light mobilization program reduce longterm sick leave for low back pain: A 3 year follow up study. Spine 2003;28(20):2309–2315.
12. Holmes S. Pursuit of happiness. Nursing Mirror 1985;161(3):43–45.
13. Itz C, Geurts J, van Kleef M, Nelemans P. Clinical course of non-specific low back pain: A systematic review of prospective cohort studies set in primary care. European Journal Of Pain 2013;17(1):5–15. [doi: 10.1002/j.1532-2149.2012.00170.x]
14. Jeon CH, Kim DJ, Kim DJ, Lee HM, Park HJ. Cross-cultural adaptation of the Korean version of the Oswestry Disability Index (ODI). Korean Society of Spine Surgery 2005;12(2):146–152. [doi: 10.4184/jkss.2005.12.2.146]
15. Jette AM. Functional status index: Reliability of a chronic disease evaluation instrument. Archives Physical Medicine & Rehabilitation 1980;61(9):395–401.
16. Kim DY, Oh SG, Park JH. Caudal epidural steroid injections for the treatment of chronic lower back pain. Korean Journal of Family Medicine 2003;24:260–264.
17. Kim JC, Kim HB, Kim MJ, Lee SG. Evaluation of epidural injection with modified Dallas Pain Questionnaire in patients with low back pain. Journal of Korean Academy of Rehabilitation Medicine 2000;24(1):108–116.
18. Kwon BA. In: Effects of spinal stabilization exercise on cross-sectional areas and recovery of function in patients with chronic low back pain. Seoul: Hanyang University; 2009.
Unpublished doctoral dissertation.
19. Lee JK. In: A study on construction of exercise prediction model for the low back pain patients. Seoul: Yonsei University; 1997.
Unpublished doctoral dissertation.
20. McKenzie RA. Prophylaxis in recurrent low back pain. The New Zealand Medical Journal 1979;89(627):22–23.
21. Nam KH. In: The effect of back pain relief exercise on pain from daily activities, low back pain and depression of the patients with chronic back pain. Chuncheon: Kangwon University; 2004.
Unpublished master's thesis.
22. National Evidence-based Healthcare Collaborating Agency. The effect of injection treatment on pain in chronic low back pain. 2010 [Retrieved January 9, 2013].
23. Park HS, Son JT. A study on the relationship between optimism and depression in chronic low-back pain patients. Korean Academy of Psychiatric and Mental Health Nursing 2001;10(2):125–136.
24. Park JY. Nonsurgical management of chronic low back pain. Journal of the Korean Medical Association 2007;50(6):507–522. [doi: 10.5124/jkma.2007.50.6.507]
25. Risch SV, Norvell NK, Pollock ML, Risch ED, Langer H, Fulton M, et al. Lumbar strengthening in chronic low back pain patients. Physiologic and psychological benefits. Spine 1993;18(2):232–238.
26. Rittweger J, Just K, Kautzch K, Reeg P, Felsenberg D. Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: A randomized controlled trial. Spine 2002;27(17):1829–1834.
27. Scott J, Huskinsson EC. Vertical or horizontal visual analogue scales. Annals of the Rheumatic Diseases 1979;38(6):560. [doi: 10.1136/ard.38.6.560]
28. Williams PC. In: The lumbosacral spine: Emphasizing conservative management. New York, NY: McGraw-Hill Book Company; 1965.