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ElAbd R, Dow T, Jabori S, Alhalabi B, Lin SJ, Dowlatshahi S. Pain and Functional Outcomes following Targeted Muscle Reinnervation: A Systematic Review. Plast Reconstr Surg 2024; 153:494-508. [PMID: 37104493 DOI: 10.1097/prs.0000000000010598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND It is estimated that by 2050, a total of 3.6 million patients will be living with an amputation in the United States. The objective of this systematic review is to evaluate the effect of targeted muscle reinnervation (TMR) on pain and physical functioning in amputees. METHODS A literature search was performed on PubMed, Embase, and MEDLINE up to November 28, 2021. Clinical studies assessing the outcomes of TMR (pain, prosthesis control, life quality, limb function, and disability) were included. RESULTS Thirty-nine articles were included. The total number of patients who underwent TMR was 449, and 716 were controls. Mean follow-up was 25 months. A total of 309 (66%) lower-limb and 159 (34%) upper-limb amputations took place in the TMR group, the most common being below-knee amputations (39%). The control group included a total of 557 (84%) lower-limb and 108 (16%) upper-limb amputations; the greatest proportion being below-knee amputations in this group as well (54%). Trauma was the most common indication for amputation. Phantom limb pain scores were lower by 10.2 points for intensity ( P = 0.01), 4.67 points for behavior ( P = 0.01), and 8.9 points for interference ( P = 0.09). Similarly, residual limb pain measures were lower for cases for intensity, behavior, and interference, but they failed to reach significance. Neuroma symptoms occurred less frequently, and functional and prosthesis control outcomes improved following TMR. CONCLUSION The literature evidence suggests that TMR is a promising therapy for improving pain, prosthesis use, and functional outcomes after limb amputation.
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Affiliation(s)
- Rawan ElAbd
- From the Division of Plastic and Reconstructive Surgery, McGill University Health Centre
- Division of Plastic and Reconstructive Surgery, Jaber AlAhmad AlSabah Hospital
| | - Todd Dow
- Division of Plastic and Reconstructive Surgery, Dalhousie University
| | - Sinan Jabori
- Division of Plastic and Reconstructive Surgery, University of Miami
| | - Becher Alhalabi
- From the Division of Plastic and Reconstructive Surgery, McGill University Health Centre
| | | | - Sammy Dowlatshahi
- Division of Plastic and Reconstructive Surgery
- Division of Hand Surgery, Department of Orthopedics, Beth Israel Deaconess Medical Center, Harvard Medical School
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Innocenti T, Schleimer T, Salvioli S, Giagio S, Ostelo R, Chiarotto A. In trials of physiotherapy for chronic low back pain, clinical relevance is rarely interpreted, with great heterogeneity in the frameworks and thresholds used: a meta-research study. J Physiother 2024; 70:51-64. [PMID: 38072712 DOI: 10.1016/j.jphys.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/11/2023] [Accepted: 11/23/2023] [Indexed: 01/07/2024] Open
Abstract
QUESTIONS How do authors of randomised controlled trials (RCTs) interpret the clinical relevance of the effects of physiotherapy interventions compared with no intervention on pain intensity, physical function and time to recovery in people with chronic low back pain (CLBP)? How can the clinical relevance be re-interpreted based on the available smallest worthwhile effect (SWE) threshold for this comparison? Are the studies in this field adequately powered? DESIGN Cross-sectional meta-research study. PARTICIPANTS People with CLBP. OUTCOME MEASURES Pain intensity, physical function and time to recovery. RESULTS This review included 23 RCTs with 1,645 participants. Twenty-two and 18 studies were included in the analysis of pain intensity and physical function, respectively. No studies investigated time to recovery. Sixteen studies reported varying thresholds to interpret clinical relevance for physical function and pain intensity. Discrepancies between interpretation using the minimal important difference and SWE values were observed in five studies. Study power ranged from 9% to 98%, with only four studies having a power > 80%. CONCLUSION Little attention is given to the interpretation of clinical relevance in RCTs comparing physiotherapy with no intervention in CLBP, with great heterogeneity in the frameworks and thresholds used. Future trials should inform patients and clinicians on whether the effect of an intervention is large enough to be worthwhile, using a reliable and comprehensive approach like available SWE estimates. REGISTRATION medRxiv https://doi.org/10.1101/2022.12.14.22283454.
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Affiliation(s)
- Tiziano Innocenti
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; GIMBE Foundation, Italy.
| | - Tim Schleimer
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
| | - Stefano Salvioli
- GIMBE Foundation, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Silvia Giagio
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Raymond Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Movement Sciences Research Institute, The Netherlands
| | - Alessandro Chiarotto
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Patti A, Thornton JS, Giustino V, Drid P, Paoli A, Schulz JM, Palma A, Bianco A. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis. Disabil Rehabil 2023:1-14. [PMID: 37632387 DOI: 10.1080/09638288.2023.2251404] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE Low back pain is the most frequently reported musculoskeletal disorder and represents one of the highest patient burdens in healthcare. This systematic review and meta-analysis aimed to investigate the effectiveness of Pilates exercise on pain intensity and functional disability caused by low back pain (LBP). MATERIALS AND METHODS A Systematic review with meta-analysis was conducted. Data sources: MEDLINE-NLM and MEDLINE-EBSCO. We also searched on Scopus Elsevier, Cochrane, DOAJ, SciELO, PEDro, and PLOS ONE databases. Eligibility criteria: randomized controlled trials (RCTs) evaluating LBP in which the primary treatment was based on Pilates exercise compared with no exercise, or non-specific exercise. RESULTS The search returned 1566 records of which 36 articles were included in the systematic review and 19 in the meta-analysis. Twenty-two studies compared the effects of Pilates exercise vs no exercise and 13 studies examined the effects of Pilates exercise vs non-specific exercise. Analysis showed that Pilates had a positive effect on the perception of LBP vs no exercise. A similar trend occurred with non-specific exercise. CONCLUSIONS Pilates exercise can decrease LBP compared to no exercise and non-specific exercise. General practitioners should consider Pilates exercise as an effective strategy to manage LBP and counteract the growing health. TRIAL REGISTRATION PROSPERO registration number: CRD42022308387.IMPLICATIONS FOR REHABILITATIONPilates is a good strategy for improving low back pain and is more effective than other exercise programs or no exercise.Pilates is a safe tool to apply to most of the population with low back pain.Pilates is a non-pharmacological strategy useful for counteracting low back pain.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Jenna M Schulz
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Canada
- Bone and Joint Institute, University of Western Ontario, London, Canada
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
- Regional Sports School of Italian National Olympic Committee (CONI) Sicilia, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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4
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Yang H, Wang X, Wang X, Yang J, Zhang W, Ding Y, Sang T, Chen W, Wang W. Effect of mindfulness-based mind-body therapies in patients with non-specific low back pain-A network meta-analysis of randomized controlled trials. Front Aging Neurosci 2023; 15:1148048. [PMID: 37455934 PMCID: PMC10340124 DOI: 10.3389/fnagi.2023.1148048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Background/objectives Although mindfulness-based mind-body therapy (MBMBT) is an effective non-surgical treatment for patients with non-specific low back pain (NLBP), the best MBMBT mode of treatment for NLBP patients has not been identified. Therefore, a network meta-analysis (NMA) was conducted to compare the effects of different MBMBTs in the treatment of NLBP patients. Methods PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for randomized controlled trials (RCTs) applying MBMBT for the treatment of NLBP patients, with all of the searches ranging from the time of database creation to January 2023. After 2 researchers independently screened the literature, extracted information, and evaluated the risks of biases in the included studies, the data were analyzed by using Stata 16.0 software. Results A total of 46 RCTs were included, including 3,886 NLBP patients and 9 MBMBT (Yoga, Ayurvedic Massage, Pilates, Craniosacral Therapy, Meditation, Meditation + Yoga, Qigong, Tai Chi, and Dance). The results of the NMA showed that Craniosacral Therapy [surface under the cumulative ranking (SUCRA): 99.2 and 99.5%] ranked the highest in terms of improving pain and disability, followed by Other Manipulations (SUCRA: 80.6 and 90.8%) and Pilates (SUCRA: 54.5 and 71.2%). In terms of improving physical health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Pilates (SUCRA: 72.3%) and Meditation (SUCRA: 55.9%). In terms of improving mental health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Meditation (SUCRA: 70.7%) and Pilates (SUCRA: 63.2%). However, in terms of improving pain, physical health, and mental health, Usual Care (SUCRA: 7.0, 14.2, and 11.8%, respectively) ranked lowest. Moreover, in terms of improving disability, Dance (SUCRA: 11.3%) ranked lowest. Conclusion This NMA shows that Craniosacral Therapy may be the most effective MBMBT in treating NLBP patients and deserves to be promoted for clinical use. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, PROSPERO [CRD42023389369].
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Affiliation(s)
- Huanying Yang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiangfu Wang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Xuetao Wang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jianxia Yang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Wanqian Zhang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Yanfang Ding
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Tingrui Sang
- Department of Traditional Chinese Orthopedics, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Weiguo Chen
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Wanhong Wang
- Department of Traditional Chinese Nursing, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
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Franks J, Thwaites C, Morris ME. Pilates to Improve Core Muscle Activation in Chronic Low Back Pain: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11101404. [PMID: 37239690 DOI: 10.3390/healthcare11101404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
Low back pain is prevalent in the community and associated with deficits in core muscle strength and activation. Pilates is argued to improve movement and reduce pain, yet there is a limited understanding of the specific effects of Pilates training on core muscle strength or activity. A systematic search of databases (CINAHL, Embase, Ovid MEDLINE) used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods to evaluate randomised controlled trials (RCTs) on the effects of Pilates to improve core muscle activation. Methodological quality was assessed using the Physiotherapy Evidence Database scale (PEDro). The certainty of findings was determined using the Grading of Recommendations Assessment, Development and Evaluation tool. Of the initial yield of 563 articles, eight RCTs met the inclusion criteria. A diverse range of Pilates interventions and outcome measures were utilised to assess effects on core muscle activation and strength. The main finding was that Pilates is not inferior to equivalently dosed exercises, and can be superior to non-equivalent or no exercise, for improving core muscle strength as indicated by muscle thickness. There was emerging evidence that Pilates positively impacts core muscle strength and can be an effective intervention for people living with chronic low back pain.
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Affiliation(s)
- Jennifer Franks
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
| | - Claire Thwaites
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, VIC 3150, Australia
| | - Meg E Morris
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Rehabilitation Centre, Healthscope, Glen Waverley, VIC 3150, Australia
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Wong CM, Rugg B, Geere JA. The effects of Pilates exercise in comparison to other forms of exercise on pain and disability in individuals with chronic non-specific low back pain: A systematic review with meta-analysis. Musculoskeletal Care 2023; 21:78-96. [PMID: 36912214 DOI: 10.1002/msc.1667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the effects of Pilates exercise (PE) with other forms of exercise on pain and disability in individuals with chronic non-specific low back pain (CNSLBP) and to inform clinical practice and future research. STUDY DESIGN Systematic review with meta-analysis conducted and reported in line the Preferred Reporting Items for Systematic review and Meta-analysis. LITERATURE SEARCH Six electronic databases were searched from inception to April 2021. STUDY SELECTION CRITERIA Randomised controlled trials (RCTs) comparing the effect of PE with other forms of exercise for adults with CNSLBP on pain and disability. DATA SYNTHESIS Two reviewers assessed the risk of bias of the trials, guided by the Cochrane RoB2 tool. Available data were extracted for meta-analysis with subgroup analysis. Pilates exercise was compared to general exercise (GE), direction-specific exercise (DSE) and spinal stabilisation exercise (SSE). Certainty of evidence was interpreted following the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Eleven RCTs were included. A low certainty of evidence supported PE was more effective than GE in pain reduction [Effect size (ES) 0.44]. Moreover, very low levels of certainty were revealed for effectiveness of PE compared with DSE for pain reduction (ES 0.65) and equivalence of PE and SSE for pain and disability. CONCLUSIONS This review found no strong evidence for using one type of exercise intervention over another when managing patients with CNSLBP. Existing evidence does not allow this review to draw definitive recommendations. In the absence of a superior exercise form clinicians should work collaboratively with the patient, using the individual's goals and preferences to guide exercise selection. Further appropriately designed research is warranted to explore this topic further.
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Affiliation(s)
- Chi Ming Wong
- School of Health Sciences, University of East Anglia, Norwich, UK.,Locomotor Services, Homerton Healthcare NHS Foundation Trust, London, UK
| | - Bradley Rugg
- School of Health Sciences, University of East Anglia, Norwich, UK.,The Clementine Churchill Hospital, Harrow, UK
| | - Jo-Anne Geere
- School of Health Sciences, University of East Anglia, Norwich, UK
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Yu Z, Yin Y, Wang J, Zhang X, Cai H, Peng F. Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2850. [PMID: 36833545 PMCID: PMC9956295 DOI: 10.3390/ijerph20042850] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a common health problem. Pilates is a unique exercise therapy. This meta-analysis aims to evaluate the efficacy of Pilates on pain, functional disorders, and quality of life in patients with chronic low back pain (CLBP). METHODS PubMed, Web of Science, CNKI, VIP, Wanfang Data, CBM, EBSCO, and Embase were searched. Randomized controlled trials of Pilates in the treatment of CLBP were collected based on the inclusion and exclusion criteria. The meta-analysis was performed using RevMan 5.4 and Stata 12.2. RESULTS 19 randomized controlled trials with a total of 1108 patients were included. Compared with the controls, the results showed the following values: Pain Scale [standard mean difference; SMD = -1.31, 95%CI (-1.80, -0.83), p < 0.00001], Oswestry Disability Index (ODI) [mean difference; MD = -4.35, 95%CI (-5.77, -2.94), p < 0.00001], Roland-Morris Disability Questionnaire (RMDQ) [MD = -2.26, 95%CI (-4.45, -0.08), p = 0.04], 36-item Short-Form (SF-36) (Physical Function (PF) [MD = 5.09, 95%CI (0.20, 9.99), p = 0.04], Role Physical (RP) [MD = 5.02, 95%CI (-1.03, 11.06), p = 0.10], Bodily Pain (BP) [MD = 8.79, 95%CI (-1.57, 19.16), p = 0.10], General Health (GH) [MD = 8.45, 95%CI (-5.61, 22.51), p = 0.24], Vitality (VT) [MD = 8.20, 95%CI(-2.30, 18.71), p = 0.13], Social Functioning (SF) [MD = -1.11, 95%CI (-7.70, 5.48), p = 0.74], Role Emotional (RE) [MD = 0.86, 95%CI (-5.53, 7.25), p = 0.79], Mental Health (MH) [MD = 11.04, 95%CI (-12.51, 34.59), p = 0.36]), Quebec Back in Disability Scale (QBPDS) [MD = -5.51, 95%CI (-23.84, 12.81), p = 0.56], and the sit-and-reach test [MD = 1.81, 95%CI (-0.25, 3.88), p = 0.09]. CONCLUSIONS This meta-analysis reveals that Pilates may have positive efficacy for pain relief and the improvement of functional disorders in CLBP patients, but the improvement in quality of life seems to be less obvious. REGISTRATION PROSPERO CRD42022348173.
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Affiliation(s)
- Zhengze Yu
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Yikun Yin
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Jialin Wang
- College of Physical Education and Health, Geely University of China, Chengdu 641432, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Xingxing Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Hejia Cai
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
| | - Fenglin Peng
- College of Physical Education and Health, Guangxi Normal University, Guilin 541006, China
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Lunkes LC, Dias Neto MA, Barra LF, de Castro LR, Ferreira AS, Meziat-Filho N. Education to keep the abdomen relaxed versus contracted during pilates in patients with chronic low back pain: study protocol for a randomised controlled trial. BMC Musculoskelet Disord 2023; 24:49. [PMID: 36670384 PMCID: PMC9854226 DOI: 10.1186/s12891-023-06160-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Low back pain is a very common symptom frequently characterized as a biopsychosocial problem. This study aims to investigate the effectiveness of education to keep the abdomen relaxed versus contracted during Pilates exercises in patients with primary chronic low back pain. METHODS Two-group randomised controlled trial with allocation of parallel groups and intention-to-treat-analysis. This study will be conducted in Lavras, MG, Brazil. A total of 152 participants will be randomised into two groups that will be treated with Pilates exercises for 12 weeks (twice a week for 60 minutes). Recruitment began in May 2022. The control group will receive guidance on the specific activation of the center of strength (the powerhouse), while the experimental group will receive guidance to perform the exercises in a relaxed and smooth way. Primary outcomes will be pain intensity (Numeric Pain Rating Scale) and disability (Rolland-Morris Questionnaire) 12 weeks post randomisation. Secondary outcomes will be global improvement (Perception of Global Effect Scale) and specific functionality (Patient-specific Functional Scale). The outcomes will be analyzed using repeated-measure linear mixed models. The assessors were not considered blinded because the participants were not blinded, and outcomes were self-reported. DISCUSSION The findings of this study will help in clinical decision-making concerning the need to demand abdominal contraction during the exercises, understanding if it's a fundamental component for the effectiveness of the Pilates method for this population. TRIAL REGISTRATION This trial was prospectively registered in the Clinical Trials (NCT05336500) in April 2022.
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Affiliation(s)
- Luciana Crepaldi Lunkes
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brazil. .,Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG, 37203-593, Brazil.
| | - Milton Apolinário Dias Neto
- grid.441664.50000 0004 0508 9542Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG 37203-593 Brazil
| | - Lavínia Fernandes Barra
- grid.441664.50000 0004 0508 9542Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG 37203-593 Brazil
| | - Lívia Resende de Castro
- grid.441664.50000 0004 0508 9542Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG 37203-593 Brazil
| | - Arthur Sá Ferreira
- grid.441993.20000 0004 0466 2861Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ Brazil
| | - Ney Meziat-Filho
- grid.441993.20000 0004 0466 2861Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ Brazil
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9
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Abdi A, Bagheri SR, Shekarbeigi Z, Usefvand S, Alimohammadi E. The effect of repeated flexion-based exercises versus extension-based exercises on the clinical outcomes of patients with lumbar disk herniation surgery: a randomized clinical trial. Neurol Res 2023; 45:28-40. [PMID: 36039973 DOI: 10.1080/01616412.2022.2116686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Valuable impact of postoperative exercises on the clinical outcomes of patients with lumbar discectomy has been demonstrated. However, there is a lack of consensus on the best kind of postoperative exercises. This study aimed to evaluate the impact of the early postoperative flexion-based and extension-based exercises on the clinical outcomes of patients with lumbar discectomy. METHODS In this single-blind randomized clinical trial (RCT), 90 subjects with lumbar discectomy were randomly assigned to three groups. The flexion-based and extension-based exercises were planned for the first and the second groups, respectively. The third group was considered as the control group. Subjects in the experimental groups started their exercise program at the end of the 6th postoperative week and continued exercises for 8 weeks. We used Visual analogue scale (VAS), Oswestry Disability Index (ODI), modified Biering-Sorensen test (mBST), and Trunk Flexion Endurance Test (TFET) to evaluate back pain, disability, back and abdominal muscle endurance, respectively. The outcomes were investigated before starting the exercises program as well as at the end of the study. Moreover, return to work was evaluated at the end of the study. Data were analyzed using descriptive and inferential statistics by SPSS-24 software. RESULTS Our results showed that the VAS pain diminished in all the groups. However, this reduction was most in the McKenzie group (P < 0.001). Moreover, extension-based exercises reduced ODI more than other groups (P < 0.001). We found that extension-based and flexion-based exercises had more efficacy in increasing the back and trunk flexion endurance, respectively (P < 0.001). There was not a significant difference between the three groups in the term of returning to work (P = 0.06). CONCLUSIONS Both flexion-based and extension-based exercises could reduce postoperative back pain and disability. However, the impact of the extension-based program was more dominant. Moreover, these exercises could increase back and abdominal muscle endurance. Therefore, prescribing such low-cost home-based exercises could be very helpful for patients with lumbar discectomy.
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Affiliation(s)
- Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Zahra Shekarbeigi
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soheila Usefvand
- Master of Science of Sports Biomechanics, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
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10
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Shi J, Hu ZY, Wen YR, Wang YF, Lin YY, Zhao HZ, Lin YT, Wang YL. Optimal modes of mind-body exercise for treating chronic non-specific low back pain: Systematic review and network meta-analysis. Front Neurosci 2022; 16:1046518. [PMID: 36466167 PMCID: PMC9713308 DOI: 10.3389/fnins.2022.1046518] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/31/2022] [Indexed: 01/01/2024] Open
Abstract
Background There were limited studies that directly compare the outcomes of various mind-body exercise (MBE) therapies on chronic non-specific low back pain (CNLBP). Objectives To compare the efficacy of the four most popular MBE modes [Pilates, Yoga, Tai Chi (TC), and Qigong] in clinically CNLBP patients, we conducted a systematic review and network meta-analysis (NMA). Methods We searched databases for eligible randomized controlled trials (RCTs) (from origin to July 2022). RCTs were eligible if they included adults with CNLBP, and implemented one or more MBE intervention arms using Pilates, yoga, TC, and qigong. In addition, pain intensity and physical function were evaluated using validated questionnaires. Results NMA was carried out on 36 eligible RCTs involving 3,050 participants. The effect of exercise therapy on pain was in the following rankings: Pilates [Surface under cumulative ranking (SUCRA) = 86.6%], TC (SUCRA = 77.2%), yoga (SUCRA = 67.6%), and qigong (SUCRA = 64.6%). The effect of exercise therapy on function: Pilates (SUCRA = 98.4%), qigong (SUCRA = 61.6%,), TC (SUCRA = 59.5%) and yoga (SUCRA = 59.0%). Conclusion Our NMA shows that Pilates might be the best MBE therapy for CNLBP in pain intensity and physical function. TC is second only to Pilates in improving pain in patients with CNLBP and has the value of promotion. In the future, we need more high-quality, long-term follow-up RCTs to confirm our findings. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=306905, identifier: CRD42022306905.
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Affiliation(s)
- Jian Shi
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zheng-Yu Hu
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu-Rong Wen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Ya-Fei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yang-Yang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao-Zhi Zhao
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - You-Tian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Yu-Ling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Baig AAM, Ansari B. Bilateral Asymmetrical Limb Proprioceptive Neuromuscular Facilitation Effects on Pain, Multifidus Activity, Range of Motion, and Disability in Low Back Pain: A Randomized Controlled Trial. J Manipulative Physiol Ther 2022; 45:604-613. [PMID: 37294220 DOI: 10.1016/j.jmpt.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP). METHODS A randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137). RESULTS Pain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P < .001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P > .05). CONCLUSION Bilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises.
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Affiliation(s)
- Aftab Ahmed Mirza Baig
- Department of Physiotherapy, Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Sindh, Pakistan.
| | - Basit Ansari
- Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Sindh, Pakistan
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12
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Best Exercise Options for Reducing Pain and Disability in Adults With Chronic Low Back Pain: Pilates, Strength, Core-Based, and Mind-Body. A Network Meta-analysis. J Orthop Sports Phys Ther 2022; 52:505-521. [PMID: 35722759 DOI: 10.2519/jospt.2022.10671] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine which type of exercise is best for reducing pain and disability in adults with chronic low back pain (LBP). DESIGN Systematic review with a network meta-analysis (NMA) of randomized controlled trials (RCTs). LITERATURE SEARCH Six electronic databases were systematically searched from inception to July 2021. STUDY SELECTION CRITERIA RCTs testing the effects of exercise on reducing self-perceived pain or disability in adults (aged 18-65 years) with chronic LBP. DATA SYNTHESIS We followed the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, incorporating NMAs of health care interventions) statement when reporting our NMA. A frequentist NMA was conducted. The probability of each intervention being the most effective was conducted according to surface under the cumulative ranking curve (SUCRA) values. RESULTS We included 118 trials (9710 participants). There were 28 head-to-head comparisons, 7 indirect comparisons for pain, and 8 indirect comparisons for disability. Compared with control, all types of physical exercises were effective for improving pain and disability, except for stretching exercises (for reducing pain) and the McKenzie method (for reducing disability). The most effective interventions for reducing pain were Pilates, mind-body, and core-based exercises. The most effective interventions for reducing disability were Pilates, strength, and core-based exercises. On SUCRA analysis, Pilates had the highest likelihood for reducing pain (93%) and disability (98%). CONCLUSION Although most exercise interventions had benefits for managing pain and disability in chronic LBP, the most beneficial programs were those that included (1) at least 1 to 2 sessions per week of Pilates or strength exercises; (2) sessions of less than 60 minutes of core-based, strength, or mind-body exercises; and (3) training programs from 3 to 9 weeks of Pilates and core-based exercises. J Orthop Sports Phys Ther 2022;52(8):505-521. Epub: 19 June 2022. doi:10.2519/jospt.2022.10671.
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13
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Huang TZ, Kim SY. Immediate effect of trunk flexion and extension isometric exercise using an external compression device on electromyography of the hip extensor and trunk range of motion of healthy subjects. BMC Sports Sci Med Rehabil 2022; 14:116. [PMID: 35729636 PMCID: PMC9215025 DOI: 10.1186/s13102-022-00506-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/14/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sacroiliac joints (SIJs) transmitted trunk load to lower extremities through the lumbopelvis. External compression devices across the SIJs could provide stability to the SIJs. A previous study established that using a device known as Active Therapeutic Movement version 2 (ATM®2) has been developed to improve pain and joint range of motion (ROM) in patients with LBP. However, no study has examined the physiological change in the muscle through ATM®2-based exercise thus far. This study aimed to determine the immediate effects of ATM®2 exercise on the contraction timing, back extension endurance, muscle fatigue, and trunk ROM of lumbar and lower limb muscles in healthy subjects. METHODS Thirty-six healthy subjects (mean age = 23.16 ± 2.3) volunteered to participate in this study. Subjects were instructed to perform ROM test using sit and reach test, back extensor endurance test using Biering-Sorensen test, erector spinae (ES), lumbar multifidus (LM) fatigue and onset time of Gluteus maximus (GM) in prone hip extension using electromyography before and after trunk flexion and extension isometric exercises. RESULTS The ROM in trunk flexion showed a significant increase of 7.9% after exercise compared to that before exercise (p < 0.05). Relative GM contraction onset timing significantly decreased after exercise (p < 0.05). The result of the Sorensen test after exercise showed a trend of increase in duration time. Muscle fatigue in the LM, however, showed a significant increase (p < 0.05), whereas muscle fatigue in the ES was reduced without statistical significance. CONCLUSIONS The results base on this study showed that exercise-based on ATM®2 is an effective exercise protocol with an effect on the biomechanics of healthy subjects. Clinical trial registration numbers KCT0006728. Clinical trial registration date: 09/11/2021.
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Affiliation(s)
- Tian-Zong Huang
- Department of Physical Therapy, Graduate School, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea
| | - Suhn-Yeop Kim
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
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Li D, Chen C. Research on exercise fatigue estimation method of Pilates rehabilitation based on ECG and sEMG feature fusion. BMC Med Inform Decis Mak 2022; 22:67. [PMID: 35303877 PMCID: PMC8932330 DOI: 10.1186/s12911-022-01808-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose Surface electromyography (sEMG) is vulnerable to environmental interference, low recognition rate and poor stability. Electrocardiogram (ECG) signals with rich information were introduced into sEMG to improve the recognition rate of fatigue assessment in the process of rehabilitation. Methods Twenty subjects performed 150 min of Pilates rehabilitation exercise. Twenty subjects performed 150 min of Pilates rehabilitation exercise. ECG and sEMG signals were collected at the same time. Aftering necessary preprocessing, the classification model of improved particle swarm optimization support vector machine base on sEMG and ECG data fusion was established to identify three different fatigue states (Relaxed, Transition, Tired). The model effects of different classification algorithms (BPNN, KNN, LDA) and different fused data types were compared. Results IPSO-SVM had obvious advantages in the classification effect of sEMG and ECG signals, the average recognition rate was 87.83%. The recognition rates of sEMG and ECG fusion feature classification models were 94.25%, 92.25%, 94.25%. The recognition accuracy and model performance was significantly improved. Conclusion The sEMG and ECG signal after feature fusion form a complementary mechanism. At the same time, IPOS-SVM can accurately detect the fatigue state in the process of Pilates rehabilitation. On the same model, the recognition effect of fusion of sEMG and ECG(Relaxed: 98.75%, Transition:92.25%, Tired:94.25%) is better than that of only using sEMG signal or ECGsignal. This study establishes technical support for establishing relevant man–machine devices and improving the safety of Pilates rehabilitation.
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Affiliation(s)
- Dujuan Li
- North Sichuan Medical College, Nanchong, 631000, China
| | - Caixia Chen
- China West Normal University, Nanchong, 631000, China.
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Abstract
BACKGROUND Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. OBJECTIVES The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic non-specific low back pain compared to no treatment, usual care, placebo and other conservative treatments. SEARCH METHODS We searched CENTRAL (which includes the Cochrane Back and Neck trials register), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, SPORTDiscus, and trials registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform), and conducted citation searching of relevant systematic reviews to identify additional studies. The review includes data for trials identified in searches up to 27 April 2018. All eligible trials have been identified through searches to 7 December 2020, but have not yet been extracted; these trials will be integrated in the next update. SELECTION CRITERIA We included randomised controlled trials that assessed exercise treatment compared to no treatment, usual care, placebo or other conservative treatment on the outcomes of pain or functional limitations for a population of adult participants with chronic non-specific low back pain of more than 12 weeks' duration. DATA COLLECTION AND ANALYSIS Two authors screened and assessed studies independently, with consensus. We extracted outcome data using electronic databases; pain and functional limitations outcomes were re-scaled to 0 to 100 points for meta-analyses where 0 is no pain or functional limitations. We assessed risk of bias using the Cochrane risk of bias (RoB) tool and used GRADE to evaluate the overall certainty of the evidence. When required, we contacted study authors to obtain missing data. To interpret meta-analysis results, we considered a 15-point difference in pain and a 10-point difference in functional limitations outcomes to be clinically important for the primary comparison of exercise versus no treatment, usual care or placebo. MAIN RESULTS We included 249 trials of exercise treatment, including studies conducted in Europe (122 studies), Asia (38 studies), North America (33 studies), and the Middle East (24 studies). Sixty-one per cent of studies (151 trials) examined the effectiveness of two or more different types of exercise treatment, and 57% (142 trials) compared exercise treatment to a non-exercise comparison treatment. Study participants had a mean age of 43.7 years and, on average, 59% of study populations were female. Most of the trials were judged to be at risk of bias, including 79% at risk of performance bias due to difficulty blinding exercise treatments. We found moderate-certainty evidence that exercise treatment is more effective for treatment of chronic low back pain compared to no treatment, usual care or placebo comparisons for pain outcomes at earliest follow-up (MD -15.2, 95% CI -18.3 to -12.2), a clinically important difference. Certainty of evidence was downgraded mainly due to heterogeneity. For the same comparison, there was moderate-certainty evidence for functional limitations outcomes (MD -6.8 (95% CI -8.3 to -5.3); this finding did not meet our prespecified threshold for minimal clinically important difference. Certainty of evidence was downgraded mainly due to some evidence of publication bias. Compared to all other investigated conservative treatments, exercise treatment was found to have improved pain (MD -9.1, 95% CI -12.6 to -5.6) and functional limitations outcomes (MD -4.1, 95% CI -6.0 to -2.2). These effects did not meet our prespecified threshold for clinically important difference. Subgroup analysis of pain outcomes suggested that exercise treatment is probably more effective than education alone (MD -12.2, 95% CI -19.4 to -5.0) or non-exercise physical therapy (MD -10.4, 95% CI -15.2 to -5.6), but with no differences observed for manual therapy (MD 1.0, 95% CI -3.1 to 5.1). In studies that reported adverse effects (86 studies), one or more adverse effects were reported in 37 of 112 exercise groups (33%) and 12 of 42 comparison groups (29%). Twelve included studies reported measuring adverse effects in a systematic way, with a median of 0.14 (IQR 0.01 to 0.57) per participant in the exercise groups (mostly minor harms, e.g. muscle soreness), and 0.12 (IQR 0.02 to 0.32) in comparison groups. AUTHORS' CONCLUSIONS We found moderate-certainty evidence that exercise is probably effective for treatment of chronic low back pain compared to no treatment, usual care or placebo for pain. The observed treatment effect for the exercise compared to no treatment, usual care or placebo comparisons is small for functional limitations, not meeting our threshold for minimal clinically important difference. We also found exercise to have improved pain (low-certainty evidence) and functional limitations outcomes (moderate-certainty evidence) compared to other conservative treatments; however, these effects were small and not clinically important when considering all comparisons together. Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments.
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Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jenna Ellis
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Antti Malmivaara
- Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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16
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Hernando-Jorge A, Pérez-Del-Pozo D, Sánchez-Martín D, Beltran-Alacreu H. [Therapeutic exercise as treatment for spinal chronic pain: systematic review of randomized clinical trials]. Rehabilitacion (Madr) 2021; 55:49-66. [PMID: 32888707 DOI: 10.1016/j.rh.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the present review was to analyze and compare the effectiveness of different types of therapeutic exercise in people with chronic spinal pain. METHODS Data search was conducted using the electronic database MEDLINE. Randomized clinical trials, conducted in patients between 18 and 65 years old with chronic pain in the spine region, were included. RESULTS Two independent reviewers performed the analysis of methodological quality using the PEDro scale, with 13 studies finally selected. The different types of therapeutic exercise had significant effects on pain reduction, decrease of disability and improvement of the quality of life of the patients. CONCLUSIONS The results show that there is no modality of therapeutic exercise superior to others. The combination of different therapeutic exercise modalities could be a complete tool for the management of chronic pain in the spine.
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Affiliation(s)
- A Hernando-Jorge
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Pérez-Del-Pozo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Sánchez-Martín
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - H Beltran-Alacreu
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España; CranioSPain Research Group. Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, España.
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Niewiadomy P, Szuścik-Niewiadomy K, Kuszewski MT, Kochan M, Pawlukiewicz M, Rychlik M, Piątkowska K. Assessment of the influence of global and local exercises on core stabilization mechanisms: randomized controlled trial. J Sports Med Phys Fitness 2020; 61:44-52. [PMID: 32720779 DOI: 10.23736/s0022-4707.20.11086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Over the last few years, various concepts of applying core stabilization mechanisms in the formation of human motor function have come to existence. The objective of the research was to assess the influence of two types of core stability training on deep abdominal muscle thickness and on global trunk mobility. METHODS The study involved 108 individuals divided into 3 groups: LT (local training), performing the stability training based on locally isolated work of the transversus abdominis muscle; GT (global training), performing the training based on global movement patterns; and CG (control group), who did not undergo the training. The workout programs comprised 4 weeks of the exercise, 4 times a week. The measurement of the observed muscle thickness was carried out by means of ultrasound imaging. Trunk mobility was evaluated based on the toe-touch test, as well as the measurement of lateral flexion ranges. All the measurements were performed before the workout programs, right after finishing and 2 weeks after the end of the training cycle. RESULTS Both training concepts have an impact on deep abdominal muscle thickness; however, in the LT group, significant improvement was noted with regard to the transversus abdominis, whereas in the GT group the improvement concerned the external oblique muscle. Both training methods also improved trunk mobility in the sagittal and frontal plane. CONCLUSIONS The results we have obtained imply that both concepts of core stability training affect the human body at a structural as well as functional level. The application of the described training methods may not only provide measurable benefits in the field of clinical physiotherapy, for instance in the treatment of spine-related back pain, but also in motor training designed to improve athletes' performance and to minimize the risk of injury.
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Affiliation(s)
- Paweł Niewiadomy
- Department of Balneoclimatology and Biological Regeneration, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Katarzyna Szuścik-Niewiadomy
- Department of Adapted Physical Activity and Sport, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Michał T Kuszewski
- Institute of Physiotherapy and Health Sciences, the Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Michał Kochan
- Institute of Physiotherapy and Health Sciences, the Jerzy Kukuczka Academy of Physical Education, Katowice, Poland -
| | - Mateusz Pawlukiewicz
- Institute of Physiotherapy and Health Sciences, the Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Mateusz Rychlik
- School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Klaudia Piątkowska
- School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
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Dorado C, López-Gordillo A, Serrano-Sánchez JA, Calbet JAL, Sanchis-Moysi J. Hypertrophy of Lumbopelvic Muscles in Inactive Women: A 36-Week Pilates Study. Sports Health 2020; 12:547-551. [PMID: 32396038 DOI: 10.1177/1941738120918381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The use of Pilates in various fields of sport sciences and rehabilitation is increasing; however, little is known about the muscle adaptations induced by this training method. HYPOTHESIS A standardized Pilates training program for beginners (9 months; 2 sessions of 55 minutes per week) will increase the muscle volume and reduce potential side-to-side asymmetries of the quadratus lumborum, iliopsoas, piriformis, and gluteus muscles (gluteus maximus, medius, and minimus). STUDY DESIGN Controlled laboratory study. LEVEL OF EVIDENCE Level 3. METHOD A total of 12 inactive, healthy women (35.7 ± 5.4 years) without previous experience in Pilates were randomly selected to participate in a supervised Pilates program (36 weeks, twice weekly). Muscle volume (cm3) was determined using magnetic resonance imaging at the beginning and end of the intervention program. Side-to-side asymmetry was calculated as [(left - right volume) × 100/right volume]. RESULTS Small, nonsignificant (P > 0.05) differences in the volume of the quadratus lumborum, iliopsoas, piriformis, and gluteus muscles were observed between pre- and post-Pilates program timepoints. Before and after Pilates, side-to-side asymmetry was less than 6% and nonsignificant in all muscles analyzed. CONCLUSION Modern Pilates performed twice weekly for 9 months did not elicit substantial changes in the volume and degree of asymmetry of the selected lumbopelvic muscles in inactive women. CLINICAL RELEVANCE The benefits of Pilates in rehabilitation or training are likely elicited by neuromuscular rather than morphological adaptations. Pilates has no significant impact on muscle volume and does not alter side-to-side ratios in muscle volume (degree of asymmetry) of the lumbopelvic muscles.
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Affiliation(s)
- Cecilia Dorado
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Ana López-Gordillo
- Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - José A Serrano-Sánchez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
| | - José A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Joaquín Sanchis-Moysi
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Canary Islands, Spain.,Department of Physical Education Department, University of Las Palmas de Gran Canaria, Canary Islands, Spain
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Owen PJ, Miller CT, Mundell NL, Verswijveren SJJM, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med 2019; 54:1279-1287. [PMID: 31666220 PMCID: PMC7588406 DOI: 10.1136/bjsports-2019-100886] [Citation(s) in RCA: 215] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 12/29/2022]
Abstract
Objective Examine the effectiveness of specific modes of exercise training in non-specific chronic low back pain (NSCLBP). Design Network meta-analysis (NMA). Data sources MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL. Eligibility criteria Exercise training randomised controlled/clinical trials in adults with NSCLBP. Results Among 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): −1.86 (–2.54 to –1.19)), resistance (SUCRA=80%; −1.14 (–1.71 to –0.56)) and stabilisation/motor control (SUCRA=80%; −1.13 (–1.53 to –0.74)) for physical function and resistance (SUCRA=80%; −1.26 (–2.10 to –0.41)) and aerobic (SUCRA=80%; −1.18 (–2.20 to –0.15)) for mental health. True control was most likely (SUCRA≤10%) to be the worst treatment for all outcomes, followed by therapist hands-off control for pain (SUCRA=10%; 0.09 (–0.71 to 0.89)) and physical function (SUCRA=20%; −0.31 (–0.94 to 0.32)) and therapist hands-on control for mental health (SUCRA=20%; −0.31 (–1.31 to 0.70)). Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function (p>0.095; SUCRA<40%). NMA was not possible for trunk muscle endurance or analgesic medication. The quality of the synthesised evidence was low according to Grading of Recommendations Assessment, Development and Evaluation criteria. Summary/conclusion There is low quality evidence that Pilates, stabilisation/motor control, resistance training and aerobic exercise training are the most effective treatments, pending outcome of interest, for adults with NSCLBP. Exercise training may also be more effective than therapist hands-on treatment. Heterogeneity among studies and the fact that there are few studies with low risk of bias are both limitations.
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Affiliation(s)
- Patrick J Owen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Clint T Miller
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Niamh L Mundell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Simone J J M Verswijveren
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Scott D Tagliaferri
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Helena Brisby
- Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Steven J Bowe
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Daniel L Belavy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Lim EJ, Park JE. The effects of Pilates and yoga participant's on engagement in functional movement and individual health level. J Exerc Rehabil 2019; 15:553-559. [PMID: 31523676 PMCID: PMC6732550 DOI: 10.12965/jer.1938280.140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/20/2019] [Indexed: 11/22/2022] Open
Abstract
This study was conducted to investigate the effect of Pilates and yoga participating in their functional movement and individual health level. Ninety volunteers were randomly divided into three groups and evenly recruited female and male participants in each group through a reliable organization. Their age group was between the 30s and 40s. They were informed the research process and assigned to the consent form. Pilates group (n=30), yoga group (n=30), and control group (n=30) were assigned to fulfill short form of Rand 36-item health survey (SF-36) survey form based on self-administration method and were scored functional movement screen (FMS) test before the intervention. Pilates and yoga group were carried out certain exercise program 1-hr duration 3 times per week for 8 weeks. And control group did not perform any exercise during experimental period. After completion of the 8-week Pilates and yoga program, they recorded SF-36 and were scored FMS score for posttest in same way. When we compared the differences between pre- and posttreatment scores, we found that there was statistically significant difference among three groups on FMS (F [2,89]=15.56, P<0.001) and there was significant change in favor of Pilates group groups (F [2,89]=52.36, P<0.001) on SF-36. To conclude, Pilates group was more effective for improving functional movement and individual health level to assess quality of life than yoga group and control group.
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Affiliation(s)
| | - Jeong Eon Park
- Department of Early Childhood Education, Pukyong National University, Busan, Korea
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21
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Takinacı ZD, Karagülle M, İşsever H, Karagülle MZ. Clinical efficacy of spa therapy (balneotherapy) for chronic low back pain: A randomized single-blind trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100928] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mazloum V, Akodu A. WITHDRAWN: Comparative effects of dry needling and intramuscular electrical stimulation with and without kinesiology taping in patients with NON-SPECIFIC chronic low back pain. J Bodyw Mov Ther 2019. [DOI: 10.1016/j.jbmt.2019.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Eliks M, Zgorzalewicz-Stachowiak M, Zeńczak-Praga K. Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art. Postgrad Med J 2019; 95:41-45. [PMID: 30636192 PMCID: PMC6581086 DOI: 10.1136/postgradmedj-2018-135920] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 12/19/2022]
Abstract
According to the current recommendations on the management of chronic non-specific low back pain (CNLBP), the intervention in this group of patients should include a programme of exercises. Pilates is a system of exercises widely used in patients with low back pain. The practices based on this method have promoted the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. During each exercise, specific principles of this method should be followed to restore or sustain the motor control of the lumbar spine and proper body posture. The aim of this study is to present the current state of knowledge concerning the application of Pilates method in the management of CNLBP as well as to define factors (eg, duration, frequency, exercises performed on a mat or specific equipment) influencing the effectiveness of Pilates in these individuals.
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Affiliation(s)
- Małgorzata Eliks
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
| | - Małgorzata Zgorzalewicz-Stachowiak
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
| | - Krystyna Zeńczak-Praga
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
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