1
|
Elabd AM, Elabd OM. Efficacy of kinesio tape added to lumbar stabilization exercises on adult patients with mechanical low back pain: A randomized, single-blind clinical trial. J Bodyw Mov Ther 2024; 39:218-224. [PMID: 38876629 DOI: 10.1016/j.jbmt.2024.02.022] [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: 02/18/2023] [Revised: 01/25/2024] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Lumbar stabilization exercises (LSEs) are beneficial for chronic mechanical low back pain (CMLBP). However, further research focusing on intervention combinations is recommended. This study examined the effect of kinesio tape (KT) with LSEs on CMLBP adult patients. METHODS A randomized blinded clinical trial was conducted. Fifty CMLBP patients of both genders were assigned into one of two groups and received 8 weeks of treatment: group A (control): LSEs only, and group B (experimental): KT with LSEs. The primary outcome was back disability, measured by the Oswestry disability index. Secondary outcomes included pain intensity, trunk extensor endurance, and sagittal spinal alignment, as indicated by the visual analog scale, Sorensen-test, and C7-S1 sagittal vertical axis, respectively. The reported data was analyzed by a two-way MANOVA using an intention-to-treat procedure. RESULTS Multivariate tests indicate statistically significant effects for group (F = 4.42, p = 0.005, partial η2 = 0.148), time (F = 219.55, p < 0.001, partial η2 = 0.904), and group-by-time interaction (F = 3.21, p = 0.01, partial η2 = 0.149). Univariate comparisons between groups revealed significant reductions in the experimental group regarding disability (p = 0.029, partial η2 = 0.049) and pain (p = 0.001, partial η2 = 0.102) without a significant difference in the Sorensen test (p = 0.281) or C7-S1 SVA (p = 0.491) results. All within-group comparisons were statistically significant (p < 0.001). CONCLUSION The combination of KT and LSEs is an effective CMLBP treatment option. Although patients in both groups displayed significant changes in all outcomes, the combined interventions induced more significant reductions in back disability and pain intensity.
Collapse
Affiliation(s)
- Aliaa M Elabd
- Basic Science Department, Faculty of Physical Therapy, Benha University, Egypt.
| | - Omar M Elabd
- Department of Orthopedics and Its Surgeries, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt; Department of Physical Therapy, Aqaba University of Technology, Aqaba, Jordan
| |
Collapse
|
2
|
Saito M, Kobayashi N, Honda H, Kamono E, Yukizawa Y, Choe H, Ike H, Kumagai K, Inaba Y. Physical Therapy May Not Be Successful for Patients With Cam-Type Femoroacetabular Impingement Syndrome and May Result in Insufficient Hip Range of Motion When Femoral Anteversion Is Less Than 16° and α-Angle Is Greater Than 65°. Arthroscopy 2024; 40:766-776.e1. [PMID: 37479152 DOI: 10.1016/j.arthro.2023.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/23/2023] [Accepted: 07/01/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE To identify factors associated with insufficient range of motion (ROM) improvement after the posterior pelvic tilt change in cam-type femoroacetabular impingement syndrome. METHODS Preoperative computed tomography images from 71 consecutive patients with femoroacetabular impingement syndrome treated with arthroscopic cam resection were evaluated. Using a dynamic computer simulation program, 3-dimensional models with a 10° posterior pelvic tilt from the supine functional pelvic plane (baseline) were created by computed tomography models. Patients were divided into 2 groups: those who experienced >10° (effective group) and ≤10° (ineffective group) improvements in internal rotation at 90° flexion after a 10° posterior pelvic tilt. Demographic characteristics; preoperative range of internal rotation at 90° flexion; and radiographic parameters, including Tönnis grade, lateral center-edge angle, acetabular roof obliquity angle, central acetabular anteversion, cranial acetabular anteversion, femoral anteversion, and α angle, were compared in the 2 groups. Univariate and multivariable logistic regression analyses were performed to evaluate factors associated with insufficient ROM improvement following a 10° posterior pelvic tilt. RESULTS The 71 patients included 58 men and 13 women, of mean age 41.4 ± 14.6 years. Posterior pelvic tilt was effective in 13 hips and ineffective in 58. Univariate analysis showed that preoperative range of internal rotation at 90°flexion, femoral anteversion, and α angle differed significantly in the 2 groups. Multivariable analysis showed that femoral anteversion <16° (odds ratio 7.4; 95% confidence interval 1.6-35; P = .012) and α angle >65° (odds ratio 6.7; 95% confidence interval 1.2-37; P = .027) were significant factors associated with insufficient ROM improvement after posterior pelvic tilt. CONCLUSIONS Physical therapy may not be successful for patients with cam-type femoroacetabular impingement syndrome and may result in insufficient hip ROM when femoral anteversion is less than 16° and α-angle is greater than 65°. CLINICAL RELEVANCE Patients with a prominent cam-type deformity and lower anterior femoral anteversion are at high risk of clinical failure following improvement in pelvic mobility by conservative treatment alone and are likely to benefit from surgery for cam deformity.
Collapse
Affiliation(s)
- Masayoshi Saito
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan; Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan; Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, Mito, Ibaraki, Japan
| | - Naomi Kobayashi
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan.
| | - Hideki Honda
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Emi Kamono
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Yohei Yukizawa
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Hyonmin Choe
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Hiroyuki Ike
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Ken Kumagai
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| |
Collapse
|
3
|
Artacho-Cordón F, Salinas-Asensio MDM, Galiano-Castillo N, Ocón-Hernández O, Peinado FM, Mundo-López A, Lozano-Lozano M, Álvarez-Salvago F, Arroyo-Morales M, Fernández-Lao C, Cantarero-Villanueva I. Effect of a Multimodal Supervised Therapeutic Exercise Program on Quality of Life, Pain, and Lumbopelvic Impairments in Women With Endometriosis Unresponsive to Conventional Therapy: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:1785-1795. [PMID: 37467936 DOI: 10.1016/j.apmr.2023.06.020] [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: 12/29/2022] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of "Physio-EndEA", a multimodal nine-week supervised exercise intervention, on quality of life, pain, and lumbopelvic impairments in women with endometriosis unresponsive to conventional therapy. DESIGN Parallel-group randomized controlled trial. Outcomes were measured at baseline, post-intervention, and at 1 year. SETTING Two Public University Hospitals. PARTICIPANTS This trial included 31 women with endometriosis (N=31) randomly allocated to "Physio-EndEA" group (n=16) or control group (n=15). Four participants dropped out of the study for causes unrelated to the intervention. INTERVENTIONS The "Physio-EndEA" program consisted of a 1-week lumbopelvic stabilization learning phase followed by an 8-week phase of stretching, aerobic, and resistance exercises focused on the lumbopelvic area. It was sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. Control group received the usual treatment stipulated by their gynecologist. MAIN OUTCOME MEASURES The primary outcome was quality of life. Secondary outcomes were pain intensity, pressure pain thresholds, pain-related catastrophic thoughts, abdominal and back strength, lumbopelvic stability, and muscle architecture. RESULTS Adherence rate was 90.6% and mean (±standard deviation) satisfaction was 9.44±0.73 out of 10. No remarkable health problems were reported during the trial. In comparison with controls, the quality of life was improved post-intervention and at 1 year in the Physio-EndEA group with large effect sizes (d>0.80). This group also evidenced: a reduced intensity of dyspareunia, catastrophic thoughts; an increase in pelvic, lumbar, and distal pressure pain thresholds; increases in abdominal and back strength and lumbopelvic stability; and increased thickness of transversus abdominis (right side) and width of lumbar multifidus (left side). CONCLUSION A 9-week program of multimodal supervised therapeutic exercise is a feasible and effective intervention to improve QoL in women with endometriosis. This program also offers benefits in terms of pain/sensitization and lumbopelvic impairments.
Collapse
Affiliation(s)
- Francisco Artacho-Cordón
- Department of Radiology and Physical Medicine, University of Granada, Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | | | - Noelia Galiano-Castillo
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Olga Ocón-Hernández
- Gynaecology and Obstetrics Unit, "San Cecilio" University Hospital, Granada, Spain
| | | | | | - Mario Lozano-Lozano
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Carolina Fernández-Lao
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Irene Cantarero-Villanueva
- Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; Department of Physiotherapy, University of Granada. Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| |
Collapse
|
4
|
Capel-Alcaraz AM, Castro-Sánchez AM, Matarán-Peñarrocha GA, Antequera-Soler E, Lara-Palomo IC. Effects of Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis. Clin J Sport Med 2023; 33:579-597. [PMID: 37432388 DOI: 10.1097/jsm.0000000000001175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The primary objective of this systematic review is to assess whether motor control exercises consisting of the methodology described by Richardson and Hodges improve the pain and disability of patients with nonspecific low back pain. DESIGN Systematic review and a meta-analysis. SETTING A literature review was conducted using PubMed, PEDro, Scielo, CINAHL, Web of Science, Dialnet, Scopus, and MEDLINE from inception to November 2021. PATIENTS Patients with chronic nonspecific low back pain. INTERVENTIONS Randomized controlled trials assessing motor control exercises versus inactive control, placebo or minimal intervention, and other exercises. MAIN OUTCOME MEASURES Pain intensity, disability, and physical activity were considered as primary outcomes. RESULTS Eighteen studies with 1356 patients were finally included in the systematic review, of which only 13 randomized clinical trials could be meta-analyzed. Statistically significant results were found in favor of the motor control group for the comparison with other exercises in disability at postintervention term (Mean Difference, 95% Confidence Interval [CI], -3.13 [-5.87 to -0.38], P = 0.03); for the comparison with inactive control, placebo, or minimal intervention in pain at postintervention term (MD, 95% CI, -18.10 [-30.79 to -5.41], P = 0.008); and for comparison with general exercises (MD, 95% CI, -12.70 [-20.80 to -4.60], P = 0.002). CONCLUSIONS Moderate-quality evidence regarding the effectiveness of motor control exercises to reduce pain intensity and disability exists, but the reduction should be interpreted with caution.
Collapse
Affiliation(s)
- Ana M Capel-Alcaraz
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain; and
| | | | | | - Eduardo Antequera-Soler
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain; and
| | - Inmaculada C Lara-Palomo
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain; and
| |
Collapse
|
5
|
Honda H, Kobayashi N, Kamono E, Yukizawa Y, Higashihira S, Takagawa S, Choe H, Ike H, Tezuka T, Inaba Y. Effect of 3-Dimensional Versus Single-Plane Changes in Pelvic Dynamics on Range of Motion in Hips With Femoroacetabular Impingement: A Computer Simulation Analysis. Orthop J Sports Med 2022; 10:23259671221123604. [PMID: 36186710 PMCID: PMC9523872 DOI: 10.1177/23259671221123604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background Femoroacetabular impingement (FAI) is primarily caused by bony impingement between the acetabulum and femoral neck during hip motion. Increasing posterior pelvic tilt improves hip range of motion in patients with FAI. Purpose To use computer simulation analysis to compare the effects of 3-dimensional (3D) changes in pelvic tilt (sagittal tilt [St], axial rotation, and coronal tilt) with changes in a single plane (St), with the aim of improving range of motion in patients with FAI. Study Design Controlled laboratory study. Methods We evaluated 43 patients with FAI treated by arthroscopic cam resection. A 3D simulation was used to construct the following pelvic models: a 5° and 10° increase posteriorly in St (St5° and St10°) and a combined 5° change in St, axial rotation, and coronal tilt (Complex5°) from the baseline of the anterior pelvic plane. Improvements in maximum internal rotation (MIR) at 45°, 70°, and 90° of hip flexion and improvements in maximum flexion with no internal rotation were compared among the St5°, St10°, and Complex5° models. The pelvic models of each single-plane change of 5° and 10° were evaluated in the same simulation. Results At 90° and 70°, there was a significant difference between the Complex5° and St10° models with respect to improvement in MIR (P = .004 at 90° of flexion; P = .017 at 70° of flexion). There was no significant difference in MIR at 45° of flexion (P = .71) or in maximum flexion (P = .42). Conclusion At 70° and 90° of hip flexion, a combined change in 3D pelvic alignment of 5° (ie, St, axial rotation, and coronal tilt) was more effective in improving hip MIR than a 10° change in St only. Clinical Relevance Effective physical therapy for FAI should address pelvic motion in all 3 planes rather than in a single plane.
Collapse
Affiliation(s)
- Hideki Honda
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Naomi Kobayashi
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Emi Kamono
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Yohei Yukizawa
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Shota Higashihira
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shu Takagawa
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Hyonmin Choe
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hiroyuki Ike
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Taro Tezuka
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| |
Collapse
|
6
|
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: 33] [Impact Index Per Article: 16.5] [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.
Collapse
|
7
|
Ko MJ, Oh JS, An DH, Yoo WG, Noh KH, Kang MH. Effects of the abdominal drawing-in maneuver on hamstring rotational activity and pelvic stability in females. J Back Musculoskelet Rehabil 2022; 35:413-419. [PMID: 34250932 DOI: 10.3233/bmr-200358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The medial hamstring (MH) and lateral hamstring (LH) can be selectively trained through tibial internal and external rotation during prone knee flexion. However, no study has identified how a combined tibial rotation and lumbo-pelvic stability strategy influences MH and LH muscle activities. OBJECTIVE To investigate the combined effects of tibial rotation and the abdominal drawing-in maneuver (ADIM) on MH and LH muscle activities as well as pelvic rotation during prone knee flexion. METHODS Fifteen female volunteers performed prone knee flexion with tibial internal and external rotation, with and without the ADIM. Under each condition, MH and LH muscle activities were measured by surface electromyography (EMG), and the pelvic rotation angle by a smartphone inclinometer application. RESULTS The results showed increased MH (without the ADIM: p< 0.001, effect size (d) = 2.05; with the ADIM: p< 0.001, d= 1.71) and LH (without the ADIM: p< 0.001, d= 1.64; with the ADIM: p= 0.001, d= 1.58) muscle activities under internal and external tibial rotation, respectively. However, addition of the ADIM led to increased MH (internal tibial rotation: p= 0.001, d= 0.67; external tibial rotation: p= 0.019, d= 0.45) and LH (internal tibial rotation: p= 0.003, d= 0.79; external tibial rotation: p< 0.001, d= 1.05) muscle activities combined with reduced pelvic rotation (internal tibial rotation: p< 0.001, d= 3.45; external tibial rotation: p< 0.001, d= 3.01) during prone knee flexion. CONCLUSIONS These findings suggest that the ADIM could be useful for reducing compensatory pelvic rotation and enhancing selective muscle activation in the MH and LH, according to the direction of tibial rotation, during prone knee flexion.
Collapse
Affiliation(s)
- Min-Joo Ko
- Department of Rehabilitation Science, Graduate School, INJE University, Gimhae, Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, INJE University, Gimhae, Korea
| | - Duk-Hyun An
- Department of Physical Therapy, INJE University, Gimhae, Korea
| | - Won-Gyu Yoo
- Department of Physical Therapy, INJE University, Gimhae, Korea
| | | | - Min-Hyeok Kang
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea
| |
Collapse
|
8
|
del Mar Salinas-Asensio M, Ocón-Hernández O, Mundo-López A, Fernández-Lao C, Peinado FM, Padilla-Vinuesa C, Álvarez-Salvago F, Postigo-Martín P, Lozano-Lozano M, Lara-Ramos A, Arroyo-Morales M, Cantarero-Villanueva I, Artacho-Cordón F. 'Physio-EndEA' Study: A Randomized, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program to Improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031738. [PMID: 35162761 PMCID: PMC8834829 DOI: 10.3390/ijerph19031738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/18/2022] [Accepted: 01/30/2022] [Indexed: 11/16/2022]
Abstract
Aim: The ‘Physio-EndEA’ study aims to explore the potential benefits of a therapeutic exercise program (focused on lumbopelvic stabilization and tolerance to exertion) on the health-related quality of life (HRQoL) of symptomatic endometriosis women. Design: The present study will use a parallel-group randomized controlled trial design. Methods: A total of 22 symptomatic endometriosis women will be randomized 1:1 to the Physio-EndEA or usual care groups. The ‘Physio-EndEA’ program will consist of a one-week lumbopelvic stabilization learning phase followed by an eight-week phase of stretching, aerobic and resistance exercises focused on the lumbopelvic area that will be sequentially instructed and supervised by a trained physiotherapist (with volume and intensity progression) and adapted daily to the potential of each participant. The primary outcome measure is HRQoL. The secondary outcome measures included clinician-reported outcomes (pressure pain thresholds, muscle thickness and strength, flexibility, body balance and cardiorespiratory fitness) and patient-reported outcomes (pain intensity, physical fitness, chronic fatigue, sexual function, gastrointestinal function and sleep quality). Discussion: Findings of this study will help to identify cost-effective non-pharmacological options (such as this exercise-based intervention) that may contribute to the improvement of HRQoL in symptomatic endometriosis women.
Collapse
Affiliation(s)
- María del Mar Salinas-Asensio
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
| | - Olga Ocón-Hernández
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco M. Peinado
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
| | - Carmen Padilla-Vinuesa
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
| | | | - Paula Postigo-Martín
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Ana Lara-Ramos
- Gynaecology and Obstetrics Unit, ‘Virgen de las Nieves’ University Hospital, E-18012 Granada, Spain;
| | - Manuel Arroyo-Morales
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physiotherapy, University of Granada, E-18016 Granada, Spain; (C.F.-L.); (P.P.-M.); (M.L.-L.); (M.A.-M.); (I.C.-V.)
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
| | - Francisco Artacho-Cordón
- Biohealth Research Institute in Granada (ibs.GRANADA), E-18012 Granada, Spain; (O.O.-H.); (F.M.P.); (C.P.-V.)
- “Cuídate” Support Unit for Oncology Patients (UAPO), Sport and Health University Research Institute (iMUDS), E-18016 Granada, Spain
- Department of Radiology and Physical Medicine, University of Granada, E-18016 Granada, Spain
- CIBER Epidemiology and Public Health (CIBERESP), E-28029 Madrid, Spain
- Correspondence: (M.d.M.S.-A.); (F.A.-C.)
| |
Collapse
|
9
|
Higashihara A, Mendiguchia J, Ono T, Nagano Y, Sasaki S, Mineta S, Hirose N. Neuromuscular responses of the hamstring and lumbopelvic muscles during unanticipated trunk perturbations. J Sports Sci 2021; 40:431-441. [PMID: 34727847 DOI: 10.1080/02640414.2021.1996986] [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: 10/19/2022]
Abstract
Hamstring strain often occurs when an opponent unanticipatedly perturbs an athlete's movements. We examined the neuromuscular responses of hamstring and trunk muscles during unanticipated trunk perturbations in athletes with and without a history of hamstring strain injury. Male college athletes (11 with a history of a unilateral hamstring injury and 10 without prior injury) knelt while wearing a chest harness attached to a cable that was pulled backward. They were instructed to resist the force isometrically and maintain their position when the perturbations were applied. The pressure was released with or without a cue (CUE or NoCUE). We measured trunk acceleration, three-dimensional kinematic data, and surface electromyography (EMG) signals of the erector spinae, internal oblique, gluteus maximus, biceps femoris long head, and semitendinosus muscles. Maximum trunk acceleration and displacement were greater with NoCUE in both groups (p < 0.05). EMG amplitude did not differ after perturbation of any investigated muscle. The injured group demonstrated a delayed onset of the gluteus maximus and erector spinae muscles in NoCUE versus CUE stimuli (p < 0.05). Athletes with a history of hamstring strain injury exhibited a reduced neuromuscular coordination of the lumbopelvic muscles in response to unanticipated trunk movement.
Collapse
Affiliation(s)
| | - Jurdan Mendiguchia
- Department of Physical Therapy, Zentrum Rehabilitation and Performance Center, Pamplona, Spain
| | - Takashi Ono
- Faculty of Economics, Tokuyama University, Yamaguchi, Japan
| | - Yasuharu Nagano
- Department of Sports Wellness Sciences, Japan Women's College of Physical Education, Tokyo, Japan
| | - Shogo Sasaki
- Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Shinshiro Mineta
- School of Physical Education, Osaka University of Health and Sport Sciences, Osaka, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| |
Collapse
|
10
|
George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG60. [PMID: 34719942 PMCID: PMC10508241 DOI: 10.2519/jospt.2021.0304] [Citation(s) in RCA: 194] [Impact Index Per Article: 64.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Low back pain (LBP) remains a musculoskeletal condition with an adverse societal impact. Globally, LBP is highly prevalent and a leading cause of disability. This is an update to the 2012 Academy of Orthopaedic Physical Therapy (AOPT), formerly the Orthopaedic Section of the American Physical Therapy Association (APTA), clinical practice guideline (CPG) for LBP. The overall objective of this update was to provide recommendations on interventions delivered by physical therapists or studied in care settings that included physical therapy providers. It also focused on synthesizing new evidence, with the purpose of making recommendations for specific nonpharmacologic treatments. J Orthop Sports Phys Ther 2021;51(11):CPG1-CPG60. doi:10.2519/jospt.2021.0304.
Collapse
|
11
|
Kobayashi N, Higashihira S, Kitayama H, Kamono E, Yukizawa Y, Oishi T, Takagawa S, Honda H, Choe H, Inaba Y. Effect of Decreasing the Anterior Pelvic Tilt on Range of Motion in Femoroacetabular Impingement: A Computer-Simulation Study. Orthop J Sports Med 2021; 9:2325967121999464. [PMID: 33959669 PMCID: PMC8060763 DOI: 10.1177/2325967121999464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/09/2020] [Indexed: 11/07/2022] Open
Abstract
Background: The influence of pelvic tilt mobility, which can be reproduced in
computer-simulation models, is an important subject to be addressed in the
understanding of femoroacetabular impingement (FAI) pathophysiology. Purpose: To use computer-simulation models of FAI cases to evaluate the optimum
improvement in hip range of motion (ROM) achieved by decreasing the anterior
pelvic tilt and compare the results with the improvement in ROM achieved
after cam resection surgery. Study Design: Controlled laboratory study. Methods: The pre- and postoperative computed tomography (CT) images from 28 patients
with FAI treated with arthroscopic cam resection were evaluated. Using a
dynamic computer-simulation program, 3-dimensional models with a 5° and a
10° decrease in anterior pelvic tilt from the supine functional pelvic plane
(baseline) were created from the preoperative CT scans. Similar models were
constructed for hips before (at baseline) and after cam resection.
Improvements from baseline in maximum internal rotation at 45°, 70°, and 90°
of flexion were assessed for the 5° change in pelvic tilt, 10° change in
pelvic tilt, and cam resection models, and the results were compared for all
conditions. Results: The combination of a 10° change in pelvic tilt and cam resection showed the
largest ROM improvement from baseline (P < .001).
Improvement in internal rotation in the cam resection model was
significantly higher compared with the 5° pelvic tilt change model
(P < .001), while there was no significant
difference between the cam resection model and the 10° pelvic tilt change
model. Conclusion: Decreasing anterior pelvic tilt by 10° in the preoperative computer
simulation model resulted in an equivalent effect to cam resection, while a
5° change in pelvic tilt was inferior to cam resection in terms of ROM
improvement. Clinical Relevance: Enough of a decrease in anterior pelvic tilt may contribute to ROM
improvement that is as effective as that of cam resection surgery.
Collapse
Affiliation(s)
- Naomi Kobayashi
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Shota Higashihira
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Haruna Kitayama
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan.,Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Emi Kamono
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Yohei Yukizawa
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Takayuki Oishi
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Shu Takagawa
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Hideki Honda
- Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Hyonmin Choe
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan
| |
Collapse
|
12
|
Nanikawa W, Miyazaki J. Intra-rater reliability of measurement of abdominal perimuscular connective tissue thickness on ultrasound images. J Phys Ther Sci 2021; 33:32-36. [PMID: 33519071 PMCID: PMC7829557 DOI: 10.1589/jpts.33.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/07/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The thickness of the perimuscular connective tissue (PMCT) reflects muscular
atrophy and decreased flexibility that may cause low back pain. However, few studies have
used ultrasound imaging to measure PMCT thickness. We aimed to examine and confirm the
reliability of ultrasound in measuring the thickness of the PMCT of the abdominal wall
muscle. [Participants and Methods] The participants were 38 healthy adult males without
chronic back pain. The images were acquired in B mode with the participants in the supine
position and the PMCT thickness of the abdominal wall muscle was measured on the images.
The intraclass correlation coefficient (ICC) was used to confirm reliability. [Results]
The ICC for both within-day and between-day PMCT measurements by ultrasound were 0.7–0.9.
The 95% confidence interval ranged from 0.5–0.9. The standard error of measurement (SEM)
was 0.02–0.1 mm in the abdominal wall muscle and 0.5 mm in the interrecti distance (IRD).
The 95% confidence interval (95% CI) of the minimum detectable change (MDC95) was
0.1–0.3 mm in the abdominal wall muscle and 1.3–1.4 mm in the IRD. [Conclusion] We
conducted a study to confirm the reliability of ultrasound-based measurement of PMCT
thickness of the abdominal wall muscle, and the ICC results established reliability.
However, since the values measured were small (0.02–1.4 mm) and there is a limit to visual
observation, it was necessary to measure using computer software.
Collapse
Affiliation(s)
- Wataru Nanikawa
- Department of Physical Therapy, Faculty of Health Science, Aino University: 4-5-4 Higashioda, Ibaraki-shi, Osaka 567-0012, Japan.,Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Japan
| | - Junya Miyazaki
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, Japan
| |
Collapse
|
13
|
Efficacy of Integrating Cervical Posture Correction With Lumbar Stabilization Exercises for Mechanical Low Back Pain: A Randomized Blinded Clinical Trial. J Appl Biomech 2020; 37:43-51. [PMID: 33176277 DOI: 10.1123/jab.2020-0005] [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] [Received: 01/08/2020] [Revised: 08/15/2020] [Accepted: 08/27/2020] [Indexed: 11/18/2022]
Abstract
Although current lumbar stabilization exercises are beneficial for chronic mechanical low back pain, further research is recommended focusing on global spinal alignment normalization. This randomized, controlled, blinded trial was conducted to determine the effects of adding cervical posture correction to lumber stabilization on chronic mechanical low back pain. Fifty adult patients (24 males) with chronic mechanical low back pain and forward head posture received 12 weeks treatment of either both programs (group A) or lumbar stabilization (group B). The primary outcome was back pain. The secondary outcomes included the craniovertebral angle, Oswestry Disability Index, C7-S1 sagittal vertical axis, and sagittal intervertebral movements. The multivariate analysis of variance indicated a significant group-by-time interaction (P = .001, partial η2 = .609). Pain, disability, C7-S1 sagittal vertical axis, and l2-l3 intervertebral rotation were reduced in group A more than B (P = .008, .001, .025, and .001). Craniovertebral angle was increased in A when compared to B (P = .001). However, there were no significant group-by-time interactions for other intervertebral movements. Within-group comparisons were significant for all outcomes except for craniovertebral angle within patients in the control group. Adding cervical posture correction with lumber stabilization for management of chronic low back pain seemed to have better effects than the application of a stabilization program only.
Collapse
|
14
|
Larouche MC, Camiré Bernier S, Racine R, Collin O, Desmons M, Mailloux C, Massé-Alarie H. Stretch-induced hypoalgesia: a pilot study. Scand J Pain 2020; 20:837-845. [PMID: 32881712 DOI: 10.1515/sjpain-2020-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/10/2020] [Indexed: 01/07/2023]
Abstract
Objectives Stretching is an intervention often used in various kinds of rehabilitation protocols and the effects on pain sensitivity has sparsely been investigated, especially when addressing potential effects on pain. The objective is to investigate the immediate effects of an axial and peripheral prolonged stretch on pressure pain sensitivity (PPT) and temporal summation (TS) on local and distal sites in healthy subjects. Methods Twenty-two healthy volunteers were recruited to participate in this pilot study. Two prolonged stretching protocols were performed: low back and wrist extensors stretches. PPT and pinprick TS were measured pre- and post-intervention at local and remote sites. Repeated measures analysis of variance (ANOVA) was used to examine the effects and significance of the interventions. Results The low back stretch induced an increase in PPT for both local and remote sites, and the wrist stretch produced a PPT increase only at the local site. TS did not change. Conclusions Low back stretching induced an increase in PPT at both local and remote sites whereas the wrist stretch only increased PPT locally, suggesting hypoalgesia at these sites. Further studies are needed to confirm the effect and mechanisms using randomised, controlled and parallel study design. Considering that pain sensitivity is different than clinical pain, results are difficult to extrapolate to clinical practice. Future studies testing clinical pain are needed to better understand the clinical implication of these results.
Collapse
Affiliation(s)
| | | | - Rosalie Racine
- McGill University, School of Occupational and Physical Therapy, Montreal, Canada
| | - Olivier Collin
- McGill University, School of Occupational and Physical Therapy, Montreal, Canada
| | - Mikaël Desmons
- Cirris research centre, Université Laval, Quebec City, Canada
| | | | - Hugo Massé-Alarie
- Cirris research centre, Université Laval, Quebec City, Canada.,Rehabilitation Unit, Université Laval, Quebec City, Canada
| |
Collapse
|
15
|
Ahn JO, Weon JH, Koh EK, Jung DY. Effectiveness of hamstring stretching using a pressure biofeedback unit for 4 weeks: A randomized controlled trial. Hong Kong Physiother J 2020; 40:99-107. [PMID: 33005074 PMCID: PMC7526059 DOI: 10.1142/s1013702520500092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 02/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background Stretching and length test of hamstring muscles have been performed commonly to manage lower back pain (LBP) in sports rehabilitation. Previous literatures addressed that stretching techniques and length test of hamstring muscles should be performed with the pelvic maintained in an anterior tilt position. However, there is no study to determine the effectiveness of pressure biofeedback unit (PBU) to maintain in anterior pelvic tilting (APT) on length test and stretching of hamstring muscles. Objective To determine the effectiveness of hamstring muscles stretching using a PBU. Methods Forty participants with shortness of hamstrings randomized into two groups. Participants performed the active knee extension (AKE) stretching without (control group) or with PBU (intervention group) for four weeks. AKE tests without and with PBU were administered three times before and after hamstrings stretching by each group. Results The AKE test without PBU showed a significant main effect of time ( p < 0 . 01 ) but not of group ( p = 0 . 55 ) on the AKE angle. The AKE test with PBU showed a significant increase in the AKE angle in the post-intervention compared to the pre-intervention assessments in both groups ( p < 0 . 01 ). The difference of AKE angle between the pre- and post-intervention results was significantly greater in the intervention group than in the control group ( p < 0 . 01 ). Conclusion We recommend the use of a PBU to maintain the pelvic anterior tilting position when performing the AKE test or AKE stretching.
Collapse
Affiliation(s)
- Jin-Oh Ahn
- Department of KEMA Therapy, Graduate School of Humanities Industry, Joongbu University, Geumsan, South Korea
| | - Jong-Hyuck Weon
- Department of Physical Therapy, College of Health & Welfare, Joongbu University, Geumsan, South Korea
| | - Eun-Kyung Koh
- Department of Physical Therapy, Masan University, Changwon, South Korea
| | - Do-Young Jung
- Department of Physical Therapy, College of College of Health & Welfare, Joongbu University, Geumsan, South Korea
| |
Collapse
|
16
|
Bagheri R, Hedayati R, Ehsani F, Hemati-Boruojeni N, Abri A, Taghizadeh Delkhosh C. Cognitive Behavioral Therapy With Stabilization Exercises Affects Transverse Abdominis Muscle Thickness in Patients With Chronic Low Back Pain: A Double-Blinded Randomized Trial Study. J Manipulative Physiol Ther 2020; 43:418-428. [PMID: 32928570 DOI: 10.1016/j.jmpt.2019.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/21/2019] [Accepted: 03/29/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Nonspecific chronic low back pain (NCLBP) is a major public health and global socioeconomic burden with a variety of symptoms, such as fear-avoidance behaviors. This study aimed to evaluate the effect of cognitive behavioral therapy (CBT) associated with stabilization exercise (SE) on thickness of transverse abdominis (TrA) muscle in patients with NCLBP. METHODS Forty patients with NCLBP were randomly assigned into experimental CBT associated with SE (n = 20) and control groups without SE (n = 20). Transverse abdominis muscle thickness was assessed during abdominal drawing in maneuver (ADIM) and active straight leg raise (ASLR) of the right lower limb using ultrasound imaging. Fear-avoidance belief and disability were evaluated using a fear-avoidance belief questionnaire (FABQ) and a Roland-Morris disability questionnaire (RMDQ) before and after intervention. RESULTS Mixed-model analysis of variance indicated that the effect of time was significant for the right and left TrA contraction thickness during ADIM and left TrA contraction thickness during ASLR (P < .05). However, the experimental group exhibited higher right and left TrA muscle thickness compared with the control group during ADIM (P = .001). Moreover, there were no significant differences between groups in the thickness of TrA muscle during ASLR (P > .05). The effect of time was significant for FABQ (P = .02) and RMDQ (P = .01); however, the effect of group was significant for the FABQ after intervention (P = .04). CONCLUSIONS Stabilization exercise associated with CBT is more effective than SE alone in improving fear avoidance belief and in increasing the thickness of the TrA muscle during ADIM task.
Collapse
Affiliation(s)
- Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rozita Hedayati
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nasim Hemati-Boruojeni
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Afsane Abri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | | |
Collapse
|
17
|
Wattananon P, Prasertkul W, Sakulsriprasert P, Laskin JJ. Effect of increased relative stiffness of the lumbar spine on hamstring muscle stretching in individuals with a history of low back pain suspected to have a clinical lumbar instability: A randomized crossover design. Clin Biomech (Bristol, Avon) 2020; 75:104996. [PMID: 32339943 DOI: 10.1016/j.clinbiomech.2020.104996] [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: 02/05/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Theoretically, lumbopelvic stabilization techniques during hamstring muscle stretching could increase lumbar stiffness relative to hamstring muscle in individuals with a history of low back pain and suspected clinical lumbar instability. However, evidence to support this theory is limited. This study aimed to 1) determine changes in lumbopelvic, lumbar, and hip motions, and hamstring muscle length after stretching exercises with lumbopelvic stiffening or relaxing techniques, and 2) compare those changes between techniques. METHODS This study used a randomized crossover design. Thirty-two participants with a history of low back pain and bilateral hamstring muscle tightness were recruited. The order of the first technique was randomly assigned. After a 2-day washout, participants were crossed over to the second technique. Motion data during active forward trunk bending and bilateral hamstring muscle length during passive knee extension were collected pre- and post-intervention. FINDINGS Significant increases (P < 0.05) were found in bilateral hamstring muscle length for both techniques. However, stiffening technique demonstrated a significant decrease in lumbar motion (P < 0.05) and increase in hip motion (P < 0.05), while relaxing technique demonstrated trends showing increases in lumbar and hip motions (P = 0.134 and 0.115, respectively). The findings showed significantly greater improvement (P < 0.05) in lumbar and hip motions with stiffening technique. INTERPRETATION The findings suggest increased relative stiffness of the lumbar spine during hamstring muscle stretching can specifically lengthen bilateral hamstring muscle and decrease excessive lumbar motion. This stiffening technique may prevent excessive movement of the lumbar spine, thereby reducing the risk of recurrent low back pain.
Collapse
Affiliation(s)
- Peemongkon Wattananon
- Motor Control and Neural Plasticity Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
| | - Wallika Prasertkul
- Physical Therapy Clinic, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand..
| | - Prasert Sakulsriprasert
- Biomechanics and Sport Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
| | - James J Laskin
- School of Physical Therapy and Rehabilitation Science, University of Montana, 135 Skaggs Building, Missoula, MT 59812, USA.
| |
Collapse
|
18
|
Bagheri R, Ebrahimi Takamjani I, Pourahmadi MR, Jannati E, Fazeli SH, Hedayati R, Akbari M. Trunk-Pelvis Kinematics Variability During Gait and Its Association With Trunk Muscle Endurance in Patients With Chronic Low Back Pain. J Appl Biomech 2020; 36:76-84. [PMID: 32176861 DOI: 10.1123/jab.2019-0322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/01/2019] [Accepted: 01/03/2020] [Indexed: 11/18/2022]
Abstract
The first purpose was to investigate the trunk muscle endurance, the second aim was to evaluate the trunk-pelvis kinematics during gait, and the third was to evaluate the relationship between trunk-pelvis kinematics and the trunk muscle endurance. Thirty participants (15 nonspecific chronic low back pain [NCLBP] and 15 healthy) were included. The authors first assessed trunk muscle endurance on endurance testing protocols. The authors next measured the trunk-pelvis kinematics during gait using a 3-dimensional motion capture system. Angular displacement, waveform pattern (CVp), and offset variability (CVo) were also examined. Statistical analysis revealed a significant difference in (1) the trunk muscle endurance and (2) sagittal, frontal, and transverse planes CVp between groups (P < .05). A significant moderate correlation was found between supine double straight-leg raise and frontal CVp (r = .521, P = .03) and transverse planes CVp (r = .442, P = .05). However, a significant moderate correlation was observed between prone double straight-leg raise and sagittal plane CVp (r = .528, P = .03) and transverse plane CVp (r = .678, P = .001). The relationship between (1) lower trunk extensor endurance with transverse and sagittal planes CVp and (2) lower abdominal muscle endurance with transverse and frontal planes CVp suggests that gait variability in these planes may result because of trunk muscle deconditioning accompanying NCLBP.
Collapse
|
19
|
Prather H, van Dillen L. Links between the Hip and the Lumbar Spine (Hip Spine Syndrome) as they Relate to Clinical Decision Making for Patients with Lumbopelvic Pain. PM R 2019; 11 Suppl 1:S64-S72. [PMID: 31074168 DOI: 10.1002/pmrj.12187] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This narrative review focuses on the links between the hip and lumbar spine in the context of lumbopelvic pain. The literature regarding this topic is variable, found in many disciplines of care using different terminology. Collectively these inconsistencies add to the complexity of understanding the current evidence as it pertains to clinical practice. We have chosen to review studies that describe and assess overlapping pain distributions between the lumbar spine and hip, hip osteoarthritis and lumbopelvic pain, improvements in low back pain following hip arthroplasty, association of hip range of motion and lumbopelvic pain, and lumbopelvic motion and hip motion as they relate to low back pain and gender. The links between the hip and lumbar spine may provide the clinician important information to make decisions and recommendations for people presenting with the clinical symptom complex including lumbopelvic pain.
Collapse
Affiliation(s)
- Heidi Prather
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery and Neurology, Washington University School of Medicine, St. Louis, MO
| | - Linda van Dillen
- Program in Physical Therapy, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| |
Collapse
|
20
|
The Effect of Core Stabilization Exercises on Trunk-Pelvis Three-Dimensional Kinematics During Gait in Non-Specific Chronic Low Back Pain. Spine (Phila Pa 1976) 2019; 44:927-936. [PMID: 31205170 DOI: 10.1097/brs.0000000000002981] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Controlled clinical trial study. OBJECTIVE This study aimed to evaluate the effect of core stabilization exercise program (CSEP) on trunk-pelvis kinematics during gait in non-specific chronic low back pain (NCLBP). SUMMARY OF BACKGROUND DATA NCLBP is a major public burden with variety of dysfunction including gait variability. METHODS Thirty participants (15 NCLBP and 15 healthy) were included in this study via the convenience sampling method. NCLBP group were intervened via the 16 sessions CSEP 3 days for 6 weeks and trunk-pelvis kinematics (angular displacement, waveform pattern [CVp], and offset variability [CVo]) during gait, pain, disability were evaluated before and after the intervention. RESULTS No significant differences in displacement and CVo in three planes were found between NCLBP and healthy groups. Independent t test was revealed that significant differences in CVp in the sagittal, frontal, and transverse planes were found between healthy and NCLBP in pre intervention. No significant changes in displacement and CVo were found as the result of intervention in NCLBP. Pain and disability decreased significantly after intervention. Paired t test revealed that the CSEP increased the frontal (P = 0.04) and transverse planes (P = 0.02) pattern variability significantly. However, there was a significant difference between groups in the sagittal plane CVp after intervention (sagittal plane CVp in healthy vs. NCLBP in post-CSE: mean difference = 14.1; P = 0.04). CONCLUSION Considering the role of the deep trunk muscles in gait, and their common deconditioning in CLBP, a CSEP intervention may increase trunk-pelvis kinematic pattern variability. These results suggest CSEP may specifically increase transverse and frontal plane variability, indicating improved motor pattern replication through this movement planes. LEVEL OF EVIDENCE 2.
Collapse
|
21
|
Yemm T. Alternative Approach to Psoas Release in Posterior Pelvic Pain. PM R 2019; 11 Suppl 1:S118-S119. [PMID: 31006982 DOI: 10.1002/pmrj.12169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 04/11/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Ted Yemm
- Peak Sports and Spine, St Louis, MO
| |
Collapse
|
22
|
Yoon JO, Kang MH, Kim JS, Oh JS. Effect of modified bridge exercise on trunk muscle activity in healthy adults: a cross sectional study. Braz J Phys Ther 2017; 22:161-167. [PMID: 28943402 PMCID: PMC5883971 DOI: 10.1016/j.bjpt.2017.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/08/2017] [Accepted: 07/07/2017] [Indexed: 11/30/2022] Open
Abstract
Bridge exercise with unstable surface increases trunk muscle activities. Bridge exercise with hip abduction increases trunk muscles activities. Modified bridge exercises are useful for co-activation of trunk muscles.
Design This is a cross-sectional study. Setting University research laboratory. Participants Fifteen healthy adults (mean age: 27.47 years) volunteered for this study. Intervention The individuals performed standard bridge exercise and modified bridge exercises with right leg-lift (single-leg-lift bridge exercise, single-leg-lift bridge exercise on an unstable surface, and single-leg-lift hip abduction bridge exercise). Main outcome measures During the bridge exercises, electromyography of the rectus abdominis, internal oblique, erector spinae, and multifidus muscles was recorded using a wireless surface electromyography system. Two-way repeated-measures analysis of variance (exercise by side) with post hoc pairwise comparisons using Bonferroni correction was used to compare the electromyography data collected from each muscle. Results Bilateral internal oblique muscle activities showed significantly greater during single-leg-lift bridge exercise (95% confidence interval: right internal oblique = −8.99 to −1.08, left internal oblique = −6.84 to −0.10), single-leg-lift bridge exercise on an unstable surface (95% confidence interval: right internal oblique = −7.32 to −1.78, left internal oblique = −5.34 to −0.99), and single-leg-lift hip abduction bridge exercise (95% confidence interval: right internal oblique = −17.13 to −0.89, left internal oblique = −8.56 to −0.60) compared with standard bridge exercise. Bilateral rectus abdominis showed greater electromyography activity during single-leg-lift bridge exercise on an unstable surface (95% confidence interval: right rectus abdominis = −9.33 to −1.13, left rectus abdominis = −4.80 to −0.64) and single-leg-lift hip abduction bridge exercise (95% confidence interval: right rectus abdominis = −14.12 to −1.84, left rectus abdominis = −6.68 to −0.16) compared with standard bridge exercise. In addition, the right rectus abdominis muscle activity was greater during single-leg-lift hip abduction bridge exercise compared with single-leg-lift bridge exercise on an unstable surface (95% confidence interval = −7.51 to −0.89). For erector spinae, muscle activity was greater in right side compared with left side during all exercises (95% confidence interval: standard bridge exercise = 0.19–4.53, single-leg-lift bridge exercise = 0.24–10.49, single-leg-lift bridge exercise on an unstable surface = 0.74–8.55, single-leg-lift hip abduction bridge exercise = 0.47–11.43). There was no significant interaction and main effect for multifidus. Conclusions Adding hip abduction and unstable conditions to bridge exercises may be useful strategy to facilitate the co-activation of trunk muscles.
Collapse
Affiliation(s)
- Jeong-Oh Yoon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, South Korea.
| | - Min-Hyeok Kang
- Department of Physical Therapy, International University of Korea, Jinju, South Korea
| | - Jun-Seok Kim
- Department of Rehabilitation Science, Graduate School, Inje University, Gimhae, South Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, South Korea
| |
Collapse
|