urban taxi drivers differ from other professional drivers with respect to their risk 
 profiles for work - related low back disorders1 .
biomechanical studies show that the driving activities within 
 automobiles can impose postural strains on lumbar spines1 .
reported that back pain is an important health 
 problem for taxi drivers , as well as an urgent occupational safety and health management 
 issue2 .
back pain is significantly 
 related to the suitability of the driver s seat pan , job stress , and time2 .
the current study developed unilateral 
 exercises for urban drivers and investigated the effect of these exercises on low back pain 
 ( lbp ) .
a 40-year - old male , who complained of lbp on the left side at l35 levels , participated in 
 the study .
the objective and methods of the study were explained to the subject prior to his 
 participation .
informed consent was also obtained according to the ethical principles of the 
 declaration of helsinki .
he had been driving a 
 taxi for 4  h / day in an urban area .
an examination revealed that his pelvis was tilted 
 posteriorly . when he performed a forward flexion in the standing position with his knees 
 fully extended , he experienced pain and stiffness in his left lower back .
the visual analog 
 scale ( vas ) score of his back pain was 7 .
an examiner measured the pelvic inclination with a 
 palpation meter ( palm ; performance attainment associates , st .
the rotation 
 of the innominate bones in the sagittal plane was also measured with the caliper tips of the 
 palm in contact with the ipsilateral anterior superior iliac spine and posterior superior 
 iliac spine3 . in the initial assessment , 

the anterior pelvic tilt angles were 2 and 8 on the right and left sides ( normal range , 11 
  4 ) , respectively .
a dual inclinometer ( acumar , lafayette instrument co. , lafayette , usa ) 
 was used to measure the trunk angles .
the initial lumbar flexion angle was 60 , and the 
 initial extension angle was 45. an examination revealed that his lumbar was rotated to the 
 left side .
this study conducted two 10-day sessions and measured the lbp , pelvic tilt angle , 
 and trunk angle after each session .
session 1 involved lumbar extension and flexion 
 exercises , as well as lumbar stability exercises using a ball .
session 2 comprised 
 unilateral resistance exercises , which include pushing and holding for 10  s with the left 
 foot on a 45-degree inclined springboard while sitting on a chair with the knee flexed .
the 
 unilateral stretching exercise for the quadratus lumborum ( ql ) muscles was performed by 
 crossing the right leg over the left leg and slowly lowering both legs to the right ; this 
 position was held for 30  s with the arms extended out to the sides of the body .
after the first session , the anterior pelvic tilt angles were 4 and 8 on the right and 
 left sides , respectively .
the lumbar flexion angle was 68 , and the extension angle was 45. 
 lumbar rotation movement was observed during lumbar flexion .
after the second session , the anterior pelvic tilt angles were 9 and 
 10 on the right and left sides , respectively .
the lumbar flexion angle was 68 , and 
 extension angle was 50. lumbar rotation movement was not observed during flexion .
lumbar extension and flexion and lumbar stability exercises that are generally recommended 
 for people suffering from lumbago are also helpful for normal pelvic alignment , as well as 
 in reducing lbp among urban drivers .
however , the effects of these exercises are limited . 
 with the driver s seat on the left side in korean cars ,
the accelerator is located near the right foot , and 
 the brake pedal is located between the right and left feet .
urban drivers spend a 
 considerable amount of time on operating the brake pedal while driving around the busy roads 
 of cities1 , 2 . extending and pushing on the right leg to operate the brake pedal 
 between the right and left feet increase the length of the right leg ; this operation may 
 have caused the right lateral tilt in the right side of the pelvis and one - sided backward 
 tilt of the right pelvis4 , 5 .
therefore , resistance exercises with the left foot pushing 
 a decline board , which was performed by the subject in the current study , were considered to 
 reduce greatly the differences in the angles of the right and left sides of the pelvis as 
 well as the pain therein . moreover , while the right foot moves repeatedly back and forth 
 between the accelerator and the brake pedal , the muscles around the left side of the pelvis 
 stiffen4 . in particular , the ql muscles 
 of the waist move in a compensatory manner to maintain the pelvic posture in the sitting 
 position5 . the unilateral stretching 
 exercise for the ql muscles performed in the current study
is considered to reduce lumbago 
 by improving the right lateral tilt in the right side of the pelvis and reducing the tension 
 of the ql muscles . in conclusion , analyzing car features and performing individual 
 approaches are necessary in providing treatment for urban drivers with lbp .
 [ purpose ] this study aimed to develop unilateral exercises for urban drivers and 
 investigate the effect of these exercises on low back pain ( lbp ) . 
 [ subject and methods ] a 
 40-year - old male driver , who complained of lbp on the left side at l35 levels , 
 participated in this study . a two - session program was conducted , and lbp , pelvic tilt 
 angle , and trunk range of motion were measured after each session . [ results ] after the 
 unilateral exercises , the anterior pelvic tilt angle was improved and the visual analog 
 scale score of back pain decreased . 
 [ conclusion ] analyzing car features and performing 
 individual approaches are necessary in providing treatment for urban drivers with lbp . 
INTRODUCTION
SUBJECT AND METHODS
RESULTS
DISCUSSION