Effect of Remote Myofascial Release on Lumbar Elasticity and Pain in Patients With Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial

The effects of hamstring stretching exercises on pain intensity and function in low back pain patients: A systematic review with meta-analysis of randomized controlled trials

Objectives

This meta-analysis aims to synthesize the available data on the effectiveness of hamstring stretching exercises in relieving pain intensity and improving function for patients with low back pain.

Methods

Google Scholars, PubMed, Embase, Cochrane, MEDLINE, CNKI, Wanfang, and VIP were searched from inception to August 2023. We included randomized controlled trials that investigated the effectiveness of hamstring stretching exercises in patients with low back pain. The primary outcomes assessed were pain intensity, hamstring muscle flexibility, and function. Study selection, data extraction, and assessment of risk of bias were performed independently by two reviewers.

Results

Our searches retrieved 344 trials, of which 14 met the inclusion criteria for this review (n = 735 participants). The combined meta-analysis showed hamstring stretching resulted in lower pain scores (standardized mean difference = -0.72, 95% confidence interval: -1.35 to -0.09; I 2 = 89%, p = 0.03) in different categories of low back pain. Subgroup analysis showed that hamstring stretching led to a larger range of motion for cases of back pain with radiating pain (standardized mean difference = 2.39, 95% confidence interval: 1.76 to 3.02; I 2 = 0%, p < 0.001). The combined meta-analysis revealed that hamstring stretching resulted in lower Oswestry Disability Index scores in comparison to regular treatment, particularly in individuals suffering from low back pain across all subtypes (mean difference = -6.97, 95% confidence interval: -13.34 to -0.60; I 2 = 95%, p = 0.03).

Conclusions

This meta-analysis demonstrates the effectiveness of hamstring stretching exercises in reducing pain intensity in various categories of low back pain and improving the straight leg raise in patients experiencing back pain with radiating pain. Additionally, it highlights the improvement in function for patients with back pain across all subtypes.

Fascia Tissue Manipulations in Chronic Low Back Pain: A Pragmatic Comparative Randomized Clinical Trial of the 4xT Method® and Exercise Therapy

BACKGROUND

The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment effects of the use of the 4xT method.

METHODS

A randomized controlled trial was conducted to compare the effectiveness of the 4xT method and exercise therapy-only in patients with chronic nonspecific low back pain. Based on a priori sample size calculation, fifty-one individuals with chronic nonspecific low back pain were randomly assigned to either the 4xT or exercise group. Both groups underwent a six-week rehabilitation program with two treatments per week. The primary outcomes were trunk flexion and extension mobility, trunk flexion, and extension mobility-dependent pain, and quality of life evaluated during a 6-week therapy period and after a 6-week therapy-off period.

RESULTS

Interaction effects were noted in all outcomes. The 4xT group showed significant improvements over time for trunk flexion and extension mobility, trunk flexion and extension mobility-dependent pain, and quality of life (p < 0.05), with no significant relapse post-therapy (except for extension mobility). The exercise group exhibited significant within-time changes in the quality of life, as measured with the VAS (p < 0.05), but not for EQ-5D-3L.

CONCLUSIONS

The results of this study demonstrate that the 4xT method stands out as a promising and impactful treatment option for chronic nonspecific low back pain individuals, as it demonstrated significant reductions in mobility-dependent pain, increased trunk mobility, and improved quality of life compared to exercise-only treatments.

The effect of transcutaneous electrical nerve stimulation on pain and electrical stimulation muscle thickness in patients with non-specific chronic low back pain-based ultrasonographic evaluation

Aim: The existing mechanisms of transcutaneous electrical nerve stimulation (TENS) focuses more on the effect of neural tissue. This study investigated the effect of TENS on the thickness of the erector spinae muscles and reducing pain. Patients & methods: 56 individuals with low back pain participated in this single-blind, pre/post-test study. For 2 weeks, participants underwent ten sessions of TENS. The ultrasound evaluations examined the thickness of the erector spinae muscle, and the visual analog scale measured the severity of low back pain. Results: There was a decrease in pain score and muscle thickness after the interventions (p ≤ 0.004). There was also a strong correlation between reducing pain and decreasing muscle thickness (R = 0.709; p = 0.000). Conclusion: Following TENS in the lumbar, in addition to reducing pain, the thickness of the erector spinae muscles also decreased. Clinical Trial Registration: IRCT20200423047173N1 (ClinicalTrials.gov).