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Gopal SR, Premkumar M, Kavitha S, Shipnu P. Benefits of core stability exercise and relaxation technique for primary dysmenorrhea in an unmarried girl: A case report. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:252. [PMID: 39309985 PMCID: PMC11414855 DOI: 10.4103/jehp.jehp_1629_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/05/2023] [Indexed: 09/25/2024]
Abstract
Primary dysmenorrhea denotes the onset of recurrent lower abdominal pain and uterine contractions throughout the bleeding phase of menstruation in the absence of any underlying pelvic pathology. Core stability exercise is considered a beneficial exercise program for managing several health problems. Various relaxation techniques can be used in womanhood with primary dysmenorrhea for relief of pain and improving their quality of life (QOL). The aim of this study was to learn and understand the benefits of core stabilization exercise along with relaxation techniques for primary dysmenorrhea in an unmarried girl. This single-case study was planned to analyze the effect of core stability exercise along with relaxation techniques in the management of primary dysmenorrhea symptoms. Relaxation exercises along with core stability exercises were given to subjectswith primary dysmenorrhea for 20 sessions of 30 minutes spanned for 5 weeks, four sessions a week. Along with the demographic profile, pre- and post -intervention value of pain in the visual analog scale (VAS) and Working Ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD) score was obtained, recorded, and analyzed. This single-case study results showed significant improvement in the outcome of pain in the VAS and WaLIDD score after the intervention of core stability exercise along with relaxation exercise for the primary dysmenorrhea patients. Pre- and post-intervention of core stability exercise along with Mitchell's relaxation exercises, measurements of VAS, and dysmenorrhea severity in WaLIDD scores revealed an effective reduction in pain and severity using core stability training and relaxation training in an unmarried girl diagnosed with primary dysmenorrhea.
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Affiliation(s)
- S Radhika Gopal
- Institute of Physiotherapy, Srinivas University, City Campus, Pandeshwar, Mangalore, Karnataka, India
| | - M Premkumar
- Institute of Physiotherapy, Srinivas University, City Campus, Pandeshwar, Mangalore, Karnataka, India
| | - S Kavitha
- Institute of Physiotherapy, Srinivas University, City Campus, Pandeshwar, Mangalore, Karnataka, India
- Department of Outpatient, Santosh of Physiotherapy, Madurai, Tamil Nadu, India
| | - P Shipnu
- Institute of Physiotherapy, Srinivas University, City Campus, Pandeshwar, Mangalore, Karnataka, India
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Elabd OM, Oakley PA, Elabd AM. Prediction of Back Disability Using Clinical, Functional, and Biomechanical Variables in Adults with Chronic Nonspecific Low Back Pain. J Clin Med 2024; 13:3980. [PMID: 38999544 PMCID: PMC11242843 DOI: 10.3390/jcm13133980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Researchers are focusing on understanding the etiology and predisposing factors of chronic nonspecific low back pain (CNSLBP), a costly prevalent and disabling disorder. Related clinical, functional, and biomechanical variables are often studied, but in isolation. We aimed to identify key factors for managing CNSLBP by examining the relationship between back disability and related clinical, functional, and biomechanical variables and developed prediction models to estimate disability using various variables. Methods: We performed a cross-sectional correlational study on 100 recruited patients with CNSLBP. Clinical variables of pain intensity (visual analog score), back extensor endurance (Sorenson test), functional variables of the back performance scale, 6 min walk test, and the biomechanical variable C7-S1 sagittal vertical axis were analyzed to predict disability (Oswestry disability index). Results: All variables independently, as well as in multi-correlation, were significantly correlated to disability (p < 0.05). The bivariate regression models were significant between back disability and pain intensity (Y = 11.24 + 2.189x), Sorensen results (Y = 105.48 - 0.911x), the back performance scale (Y = 6.65 + 2.486x), 6 min walk test (Y = 49.20 - 0.060x), and sagittal vertical axis (Y = 0.72 + 4.23x). The multi-regression model showed significant contributions from pain (p = 0.001) and Sorensen results (p = 0.028) in predicting back disability, whereas no significant effect was found for other variables. Conclusions: A multidisciplinary approach is essential not only for the management of but also for the assessment of chronic nonspecific low back pain, including its clinical, functional, and biomechanical characteristics. However, special emphasis should be placed on clinical characteristics, including the intensity of pain and back extensor endurance.
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Affiliation(s)
- Omar M. Elabd
- Department of Orthopedics and Its Surgeries, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa 35712, Egypt;
- Department of Physical Therapy, Aqaba University of Technology, Aqaba 771111, Jordan
| | - Paul A. Oakley
- Private Practice, Newmarket, ON L3Y 8Y8, Canada;
- Kinesiology and Health Science, York University, Toronto, ON M3J 1P3, Canada
| | - Aliaa M. Elabd
- Basic Science Department, Faculty of Physical Therapy, Benha University, Benha 13511, Egypt
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Alkhathami KM, Alqahtani B. Comparing the Scores of The Functional Movement Screen™ in Individuals with Low Back Pain versus Healthy Individuals: A Systematic Review and Meta-Analysis. Int J Sports Phys Ther 2024; 19:834-848. [PMID: 38966824 PMCID: PMC11221333 DOI: 10.26603/001c.120199] [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: 12/12/2023] [Accepted: 05/04/2024] [Indexed: 07/06/2024] Open
Abstract
Background The Functional Movement Screen™ (FMS™) is widely used to assess functional movement patterns and illuminate movement dysfunctions that may have a role in injury risk. However, the association between FMS™ scores and LBP remains uncertain. Objective The purpose of this systematic review and meta-analysis was to examine functional movement scores among patients with low back pain (LBP) and healthy subjects with no LBP and review the validity of the FMS™ tool for screening functional movement among LBP patients. Methods The systematic review and meta-analysis included papers assessing functional movement among adult patients with LBP using the FMS™ through a literature review of five databases. The search strategy focused used relevant keywords: Functional movement screen AND low back pain. The review included all papers assessing functional movement among LBP adult patients (>18 years old) using the FMS™ published between 2003 to 2023. The risk of bias in the involved studies was evaluated using the updated Cochrane ROB 2 tool. Statistical analysis was conducted using Review Manager software, version 5.4. The meta-analysis included the total FMS™ score and the scores of the seven FMS™ movement patterns. Results Seven studies were included in this systematic review were considered to have low to unclear risk of bias. The meta-analysis revealed that the LBP group had a significantly lower total FMS™ score than the control group by 1.81 points (95% CI (-3.02, -0.59), p= 0.004). Patients with LBP had a significantly lower score than the control group regarding FMS™ movement patterns, the deep squat (p <0.01), the hurdle step (p <0.01), the inline lunge (P value <0.01), the active straight leg raise (p <0.01), the trunk stability push-up (p=0.02), and the rotational stability screens (p <0.01). Conclusion Lower scores on the FMS™ are associated with impaired functional movement. Identifying the specific functional movement impairments linked to LBP can assist in the creation of personalized treatment plans and interventions. Further research is needed to assess the association of cofounders, such as age, gender, and body mass index, with the FMS™ score among LBP patients and controls. Level of evidence 1.
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Affiliation(s)
- Khalid M. Alkhathami
- Department of Health Rehabilitation, College of Applied Medical Sciences at Shaqra, Shaqra University, Shaqra, 11961, Saudi Arabia
| | - Bijad Alqahtani
- Department of Health Rehabilitation, College of Applied Medical Sciences at Shaqra, Shaqra University, Shaqra, 11961, Saudi Arabia
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Franco-López F, Durkalec-Michalski K, Díaz-Morón J, Higueras-Liébana E, Hernández-Belmonte A, Courel-Ibáñez J. Using Resistance-Band Tests to Evaluate Trunk Muscle Strength in Chronic Low Back Pain: A Test-Retest Reliability Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4131. [PMID: 39000910 PMCID: PMC11244540 DOI: 10.3390/s24134131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024]
Abstract
Exercise is a front-line intervention to increase functional capacity and reduce pain and disability in people with low strength levels or disorders. However, there is a lack of validated field-based tests to check the initial status and, more importantly, to control the process and make tailored adjustments in load, intensity, and recovery. We aimed to determine the test-retest reliability of a submaximal, resistance-band test to evaluate the strength of the trunk stability muscles using a portable force sensor in middle-aged adults (48 ± 13 years) with medically diagnosed chronic low back pain and healthy peers (n = 35). Participants completed two submaximal progressive tests of two resistance-band exercises (unilateral row and Pallof press), consisting of 5 s maintained contraction, progressively increasing the load. The test stopped when deviation from the initial position by compensation movements occurred. Trunk muscle strength (CORE muscles) was monitored in real time using a portable force sensor (strain gauge). Results revealed that both tests were highly reliable (intra-class correlation [ICC] > 0.901) and presented low errors and coefficients of variation (CV) in both groups. In particular, people with low back pain had errors of 14-19 N (CV = 9-12%) in the unilateral row test and 13-19 N (CV = 8-12%) in the Pallof press. No discomfort or pain was reported during or after the tests. These two easy-to-use and technology-based tests result in a reliable and objective screening tool to evaluate the strength and trunk stability in middle-aged adults with chronic low back pain, considering an error of measurement < 20 N. This contribution may have an impact on improving the individualization and control of rehabilitation or physical training in people with lumbar injuries or disorders.
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Affiliation(s)
- Francisco Franco-López
- Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, 30720 Murcia, Spain
| | | | | | - Enrique Higueras-Liébana
- Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, 30720 Murcia, Spain
| | | | - Javier Courel-Ibáñez
- Department of Physical Education and Sports, Faculty of Education and Sport Sciences, University of Granada, 52005 Melilla, Spain
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Dayican DK, Hosbay Z, Ozyurek B, Utku Umut G. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with cerebral palsy: a pilot cross-sectional study. Women Health 2024; 64:404-415. [PMID: 38706221 DOI: 10.1080/03630242.2024.2349559] [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: 07/21/2023] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
Pelvic floor symptoms may occur in women with low back pain due to dysfunction of the spinal stabilization muscles. Low back pain is the most common musculoskeletal problem experienced by the mothers of children with cerebral palsy (CP). Therefore, our aim in this study was to examine pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP. The study included 48 mothers of children with CP (n = 23) or without neurodevelopmental problems (n = 25). The mothers' pelvic floor symptoms and symptom-related quality of life were evaluated with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). PFDI-20 and PFIQ-7 scores did not differ between the two groups of mothers (p > .05). Additionally, moderately significant positive correlations were found between the age of the child with CP and duration of carrying and the PFDI-20 (r = 0.419, p = .047) and PFIQ-7 (r = 0.427, p = .042) scores. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP were similar to those in the mothers of children without neurodevelopmental problems. As the age of the child with CP and duration of carrying increase, the urinary symptoms and urinary and colorectoanal symptoms-related quality of life in their mothers may worsen.
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Affiliation(s)
- Damla Korkmaz Dayican
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Tınaztepe University, İzmir, Turkey
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
| | - Zeynep Hosbay
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Burcin Ozyurek
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Pelvic Floor Center, Yeditepe University Hospital, İstanbul, Turkey
| | - Gulsena Utku Umut
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Department of Physiotherapy and Rehabilitation (English), Faculty of Health Sciences, Haliç University, İstanbul, Turkey
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Tsartsapakis I, Bagioka I, Fountoukidou F, Kellis E. A Comparison between Core Stability Exercises and Muscle Thickness Using Two Different Activation Maneuvers. J Funct Morphol Kinesiol 2024; 9:70. [PMID: 38651428 PMCID: PMC11036226 DOI: 10.3390/jfmk9020070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
Core stability training is crucial for competitive athletes, individuals who want to improve their health and physical performance, and those undergoing clinical rehabilitation. This study compared the ultrasound (US) muscle thickness of the abdominals and lumbar multifidus (LM) muscles between seven popular trunk stability exercises performed using hollowing and bracing maneuvers. Forty-four healthy young adults, aged between 21 and 32 years, performed a plank, bird dog, beast crawl, dead bug, Pilates tap, bridge, and side planks using the bracing and the hollowing maneuver. The thickness of the transversus abdominis (TrA), internal oblique (IO), and LM muscles was measured simultaneously using two ultrasound machines. Analysis of variance designs indicated that during hollowing, the bird dog and side plank exercises resulted in the greatest increase in the muscle's relative thickness overall. The relative thickness of all muscles was significantly greater (p < 0.001) during hollowing (22.7 ± 7.80 to 106 ± 24.5% of rest) compared to bracing (18.7 ± 7.40 to 87.1 ± 20.9% of rest). The TrA showed the greatest increase in thickness (p < 0.001) compared to the IO and LM. Additionally, the IO had a greater increase in thickness (p < 0.001) than the LM. In conclusion, our findings indicate that the bird dog and side plank exercises, when performed with hollowing, showed the most significant total muscle thickness increase. Notably, the hollowing maneuver enhances the thickness of the TrA, IO, and LM muscles more than the bracing maneuver. This contributes to the discussion on optimal strategies for dynamic core stabilization.
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Affiliation(s)
- Ioannis Tsartsapakis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, 62100 Serres, Greece
| | | | | | - Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, 62100 Serres, Greece
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Tuncer D, Gurses HN. The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial. Ear Hear 2024; 45:306-315. [PMID: 37784232 DOI: 10.1097/aud.0000000000001428] [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: 10/04/2023]
Abstract
OBJECTIVES To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss. DESIGN We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks. RESULTS In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except "eyes closed firm surface" of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, "overall" stability index in postural stability test, "overall," "left," and "backward left" of limits of stability test, all parameters of the mCTSIB, and BESS total. CONCLUSIONS Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.
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Affiliation(s)
- Deniz Tuncer
- Cardiopulmonary Physiotherapy Rehabilitation Department, Institute of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
| | - Hulya Nilgun Gurses
- Department of Cardiopulmonary Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
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Kim HG, Jung JH, Bae SU. Effects of the Three-Direction Movement Control Focus Complex Pain Program and Neurodynamic Focus Complex Pain Program on Pain, Mechanosensitivity, and Body Function in Taekwondo Athletes with Non-Specific Low Back Pain: A Preliminary Study. Healthcare (Basel) 2024; 12:422. [PMID: 38391798 PMCID: PMC10887569 DOI: 10.3390/healthcare12040422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
We aimed to determine the effects of three-direction movement control focus complex pain program (3D-MCE) and neurodynamic focus complex pain program (NDT) on pain, mechanosensitivity, and body function in Taekwondo athletes with non-specific low back pain. This study used a two-group pretest-posttest design and was conducted at a university physiotherapy lab and training center. It included 21 Taekwondo athletes with non-specific low back pain from a Taekwondo studio and a University in Busan. Participants were divided into a 3D-MCE group (n = 10) and an NDT group (n = 10). The numerical rating pain scale (NRPS), pain pressure threshold (PPT), movement analysis, and Oswestry Disability Index (ODI) were measured before and after the intervention. The intervention was performed for 45 min twice a week for 4 weeks. Each group performed movement control exercises and neurodynamic techniques. The NRPS, motion analysis, and ODI were significantly changed after the intervention in the 3-DMCE group. The NRPS, PPT, and ODI changed significantly after the intervention in the NDT group. Moreover, the PPT and motion analysis showed significant differences between the two groups. For Taekwondo athletes with non-specific low back pain, 3D-MCE improved the stability control ability of the lumbar spine. It was confirmed that neurodynamic techniques reduce muscle and nerve mechanosensitivity.
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Affiliation(s)
- Hong-Gil Kim
- Department of Physical Therapy, Graduate School, Dong-Eui University, Busan 47340, Republic of Korea
| | - Ju-Hyeon Jung
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dong-Eui University, Busan 47340, Republic of Korea
| | - Song-Ui Bae
- Department of Physical Therapy, Graduate School, Dong-Eui University, Busan 47340, Republic of Korea
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Almansoof HS, Nuhmani S, Muaidi Q. Role of kinetic chain in sports performance and injury risk: a narrative review. J Med Life 2023; 16:1591-1596. [PMID: 38406779 PMCID: PMC10893580 DOI: 10.25122/jml-2023-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/02/2023] [Indexed: 02/27/2024] Open
Abstract
The kinetic chain refers to the body's intricate coordination of various segments to perform a specific activity involving precise positioning, timing, and speed. This process is based on task-oriented and activity-specific pre-programmed muscle activation patterns enhanced by repeated practice. It demands muscular eccentric strength, joint flexibility, and musculotendinous elastic energy storage. The body core (lumbopelvic-hip complex) forms the kinetic chains' central point of activities in most sports because it facilitates load transfers to and from the limbs. The kinetic chain relationship with fascia, peripheral nerves, and tensegrity is fundamental to holistic human body movements. The kinetic chain function demands neuromuscular, sensorimotor, and neurocognitive control. Any blockage or defect in the kinetic chain can develop compensatory patterns, high demands on distal parts, and overuse and overload injuries. Taking a holistic approach and evaluating the integrity of the kinetic chain in athletes can significantly enhance efforts to improve sports performance and mitigate injury risk.
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Affiliation(s)
- Haifa Saleh Almansoof
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Qassim Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
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Fortin M, Rye M, Roussac A, Montpetit C, Burdick J, Naghdi N, Rosenstein B, Bertrand C, Macedo LG, Elliott JM, Dover G, DeMont R, Weber MH, Pepin V. The Effects of Combined Motor Control and Isolated Extensor Strengthening versus General Exercise on Paraspinal Muscle Morphology, Composition, and Function in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. J Clin Med 2023; 12:5920. [PMID: 37762861 PMCID: PMC10532355 DOI: 10.3390/jcm12185920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Low back pain (LBP), a globally widespread and persistent musculoskeletal disorder, benefits from exercise therapy. However, it remains unclear which type leads to greater changes in paraspinal muscle health. This study aimed to (1) compare the effects of a combined motor control and isolated lumbar extension exercise (MC+ILEX) versus a general exercise (GE) intervention on paraspinal muscle morphology, composition, and function, and (2) examine whether alterations in paraspinal muscle health were correlated with improvements in pain, function, and quality of life. Fifty participants with chronic LBP were randomly assigned to each group and underwent a 12-week supervised intervention program. Magnetic resonance imaging and ultrasound assessments were acquired at baseline, 6 and 12 weeks to examine the impact of each intervention on erector spinae (ES) and multifidus (MF) muscle size (cross-sectional area, CSA), composition, and function at L4-L5 and L5-S1. Self-reported questionnaires were also acquired to assess participant-oriented outcomes. Our findings indicated that the MC+ILEX group demonstrated greater improvements in MF and ES CSA, along with MF thickness at both levels (all p < 0.01). Both groups significantly improved in pain, function, and quality of life. This study provided preliminary results suggesting that an MC+ILEX intervention may improve paraspinal morphology while decreasing pain and disability.
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Affiliation(s)
- Maryse Fortin
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
- School of Health, Concordia University, Montreal, QC H4B 1R6, Canada
| | - Meaghan Rye
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Alexa Roussac
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Chanelle Montpetit
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Jessica Burdick
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Neda Naghdi
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Brent Rosenstein
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Cleo Bertrand
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Luciana G. Macedo
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 1C7, Canada;
| | - James M. Elliott
- Faculty of Medicine and Health, School of Health Sciences, The Kolling Institute, University of Sydney, Sydney, NSW 2050, Australia;
- Northern Sydney Local Health District, St. Leonards, NSW 2065, Australia
| | - Geoffrey Dover
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Richard DeMont
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
| | - Michael H. Weber
- Department of Orthopedic Surgery, McGill University Health Centre, Montreal, QC H3J 1A4, Canada;
| | - Véronique Pepin
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC H4B 1R6, Canada; (M.R.); (A.R.); (C.M.); (J.B.); (N.N.); (B.R.); (C.B.); (G.D.); (R.D.); (V.P.)
- School of Health, Concordia University, Montreal, QC H4B 1R6, Canada
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Zhang SK, Gu ML, Zhang T, Xu H, Mao SJ, Zhou WS. Effects of exercise therapy on disability, mobility, and quality of life in the elderly with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2023; 18:513. [PMID: 37468931 DOI: 10.1186/s13018-023-03988-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Exercise is an effective treatment in chronic low back pain (CLBP), but there are few studies on CLBP in the elderly, and the intervention effect is controversial. We aimed to compare the efficacy of different exercises therapy on CLBP, dysfunction, quality of life, and mobility in the elderly. METHODS We searched Web of Science, MEDLINE, Cochrane Library, Chinese National Knowledge Infrastructure, EMBASE, and PubMed from the database inception till December 31, 2022. The publication languages were Chinese and English. Randomized controlled trials (RCTs) of exercise intervention in the elderly (≥ 60 years) with CLBP were included. Two reviewers independently extracted the data and evaluated them using the Revised Cochrane Risk of Bias Tool for Randomized Trials 2 (RoB2). The pooled effect sizes on different aspects of outcome measures were calculated. RESULTS Sixteen articles (18 RCTs) were included, comprising a total of 989 participants. The quality of included studies was relatively high. Meta-analysis results indicated that exercise therapy could improve visual analog scale (VAS) (WMD = - 1.75, 95% CI - 2.59, - 0.92, p < 0.05), Oswestry disability index (ODI) (WMD = - 9.42, 95% CI - 15.04, - 3.79, p < 0,005), short-form 36-item health survey physical composite summary (SF-36PCS) (WMD = 7.07, 95% CI 1.01, 13.14, p < 0.05), short-form 36-item health survey mental composite summary (SF-36MCS) (WMD = 7.88, 95% CI 0.09, 15.67, p < 0.05), and timed up and go test (TUG) (WMD = - 0.92, 95% CI - 2.22, 0.38, p < 0.005). CONCLUSION Exercise therapy effectively improved VAS, ODI, and SF-36 indexes in the elderly. Based on the subgroup, when designing the exercise therapy regimen, aerobics, strength, and mind-body exercise (≥ 12 weeks, ≥ 3 times/week, ≥ 60 min) should be considered carefully, to ensure the safety and effectiveness for the rehabilitation of CLBP patients. More high-quality trials are needed in future to confirm the effect of exercise on SF-36 and TUG indexes.
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Affiliation(s)
- Shi-Kun Zhang
- Department of Police Physical Education, Jiangsu Police Institute, Nanjing, Jiangsu Province, China
| | - Mei-Ling Gu
- Nanjing Tian-zheng Primary School, Nanjing, China
| | - Ting Zhang
- Nanjing Tian-zheng Primary School, Nanjing, China
| | - Hong Xu
- Department of Sport & Health Science, College of Natural Science, Sangmyung University, Seoul, Korea
| | - Su-Jie Mao
- Graduate School of Nanjing University of Physical Education, Nanjing Sport Institute, Nanjing, China
| | - Wen-Sheng Zhou
- Department of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China.
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12
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Akuzawa H, Morito T, Oshikawa T, Kumai T, Kaneoka K. Functional relationship between the foot intrinsic and extrinsic muscles in walking. J Electromyogr Kinesiol 2023; 71:102781. [PMID: 37247509 DOI: 10.1016/j.jelekin.2023.102781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
The intrinsic and extrinsic muscles are considered to stabilize the foot and contribute to propulsion during walking. This study aimed to clarify the functional relationship between intrinsic and extrinsic muscles during walking. Thirteen healthy men participated in this study. The muscle activities of the intrinsic muscles (quadratus plantae and abductor hallucis), and the extrinsic muscles (flexor hallucis longus, flexor digitorum longus, and tibialis posterior) were measured using fine-wire and surface electromyography during walking. The muscle onset timing after foot contact was calculated and compared among muscles using the one-way ANOVA. The stance phase was divided into early and late braking, and early and late propulsion phases. Muscle activity among phases was compared using repeated-measures ANOVA. The onset time of the abductor hallucis was significantly earlier than those of the flexor digitorum longus and tibialis posterior. The quadratus plantae demonstrated significantly earlier onset than that of the tibialis posterior. In the late propulsion phase, the activity of extrinsic muscles decreased, whereas intrinsic muscles were continuously active. Early activation of the intrinsic muscles may stabilize the foot for efficient torque production by the extrinsic muscles. Furthermore, the intrinsic muscles may contribute to the final push-off after the deactivation of extrinsic muscles.
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Affiliation(s)
- Hiroshi Akuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan; Institute for Sport Sciences, Waseda University, Nishi-Tokyo, Japan.
| | - Tsuyoshi Morito
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Tomoki Oshikawa
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
| | - Koji Kaneoka
- Faculty of Sport Sciences, Waseda University, Nishi-Tokyo, Japan
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13
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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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14
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Perotti L, Stamm O, Mesletzky L, Vorwerg S, Fournelle M, Müller-Werdan U. Needs and Attitudes of Older Chronic Back Pain Patients towards a Wearable for Ultrasound Biofeedback during Stabilization Exercises: A Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4927. [PMID: 36981835 PMCID: PMC10049307 DOI: 10.3390/ijerph20064927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Chronic back pain has a high prevalence, especially in older adults, and seriously affects sufferers' quality of life. Segmental stabilization exercise (SSE) is often used during physiotherapy to enhance core stability. The execution of SSE requires the selective contraction of deep abdominal and back muscles. Motor learning can be supported using ultrasound imaging as visual biofeedback. ULTRAWEAR is a mobile ultrasound system that provides deep learning-based biofeedback on SSE execution, which is currently under development. We interviewed 15 older chronic back pain patients (CBPPs) to investigate their pain management behavior, experience with SSE, as well as their needs and requirements for ULTRAWEAR. We also gathered information about future-usage scenarios. CBPPs reported a high willingness to use the system as a feedback tool both in physiotherapeutic practices and at home. The automated detection and evaluation of muscle contraction states was highlighted as a major benefit of the system compared to the more subjective feedback provided by traditional methods such as palpation. The system to be developed was perceived as a helpful solution to support learning about SSE.
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Affiliation(s)
- Luis Perotti
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Oskar Stamm
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Lisa Mesletzky
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Susan Vorwerg
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
| | - Marc Fournelle
- Department of Ultrasound, Fraunhofer Institute for Biomedical Engineering, 66280 Sulzbach, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13347 Berlin, Germany
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Activation asymmetry of the lateral abdominal muscles in response to neurodevelopmental traction technique in children with pelvic asymmetry. BIOMEDICAL HUMAN KINETICS 2023. [DOI: 10.2478/bhk-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Study aim: The aim of the study was to evaluate asymmetry of activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique in children with pelvic asymmetry.
Material and methods: Measurements of LAM activation asymmetry were performed during traction with the force of 5% body weight in two experimental conditions: 1) in neutral position, 2) in 20° posterior trunk inclination. Twenty-three healthy children with pelvic asymmetry participated in the study. To evaluate LAM activation asymmetry ultrasound technology was employed (two Mindray DP660 devices (Mindray, Shenzhen, China)). Activation asymmetry indices for each individual LAM were calculated.
Results: The magnitude of LAM activation asymmetry indexes formed a gradient, with the most profound transversus abdominis (TrA) showing the greatest asymmetry, and the most superficial obliquus externus – the smallest. The inter-muscle differences were most pronounced between the TrA and the two more superficial oblique muscles. There were no correlation between the magnitude of pelvic asymmetry and LAM activation asymmetry.
Conclusions: During the neurodevelopmental traction technique there is a difference in individual LAM activation symmetry, with deeper muscles showing greater asymmetry. The activation asymmetry of the LAM does not seem to be associated with the pelvic asymmetry. Results are similar to those recorded in earlier studies in samples where no pelvic asymmetry were subjected to analysis.
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16
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Bauer J, Gruber M, Muehlbauer T. Correlations between core muscle strength endurance and upper-extremity performance in adolescent male sub-elite handball players. Front Sports Act Living 2022; 4:1050279. [DOI: 10.3389/fspor.2022.1050279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Handball is an Olympic contact sport with high physical, tactical, and technical demands by the players. Out of the different techniques, throwing is the most important one to be able to score. The objective of the study was to investigate the relationships between core muscle strength endurance (Bourban test: ventral, dorsal and lateral chain) and shoulder mobility/stability (Upper Quarter Y Balance test [YBT-UQ]) as well as throwing velocity in adolescent male sub-elite handball players (N = 32, age: 17.1 ± 0.7 years, height: 181.8 ± 6.3 cm, BMI: 24.6 ± 4.9 kg/m2). All participants were free of injuries at least two weeks prior to the study, experienced (training experience: 8.5 ± 3.3 years) handball players who were tested mid-season in the evening of one of their training sessions. Pearson correlations were calculated for core muscle strength endurance with (a) shoulder mobility/stability and (b) throwing velocity. The throwing arm reach displayed significant correlations (both p < 0.05) between the Bourban test (ventral chain) and the inferolateral reach direction (IL) of the YBT-UQ (r = 0.41) as well as the composite score (CS) (r = 0.34). For the dorsal chain, significant correlations (all p < 0.01) were found for the medial (MD) (r = 0.42) and IL (r = 0.61) reach direction as well as the CS (r = 0.51). For the right but not the left side of the lateral chain, significant correlations (both p < 0.05) were detected for the IL reach direction (r = 0.40) and the CS (r = 0.35). For the non-throwing arm reach, significant correlations were found between the ventral chain and the MD reach direction (r = 0.53, p < 0.01) as well as the CS (r = 0.31, p < 0.05). For the dorsal chain, significant correlations (all p < 0.01) were found for the MD (r = 0.47) and IL (r = 0.44) reach direction as well as the CS (r = 0.41). For the lateral chain, significant correlations were detected for the MD (left and right side: r = 0.49, p < 0.01) and IL (left and right side: r = 0.35, p < 0.05) reach direction as well as the CS (left and right side: r = 0.37, p < 0.05). The dorsal chain but not the ventral and lateral chain of the Bourban test showed a significant correlation with throwing velocity (r = 0.33, p < 0.05). Our results indicate that better core muscle strength endurance is associated with better shoulder mobility/stability as well as partially higher throwing velocity of adolescent male sub-elite handball players. Therefore, practitioners should integrate core muscle strength endurance exercises into the training routines to improve upper-extremity performance of this target group.
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The Role of Core Stability and Core Muscles in Ankylosing Spondylitis: A Review of Functional and Clinical Importance. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1123915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Purpose: Physiotherapy and exercise training are one of the cornerstones in the treatment of patients with ankylosing spondylitis (AS). However, although the effects of exercise programs and their superiority over each other have still not been determined, research on this subject is continuing in the literature day by day. Due to the pathophysiology of AS, the spine is one of the most affected areas of the musculoskeletal system. Therefore, stabilization of the lumbopelvic region and the spine, which is the reference point for the core muscles, is important for the treatment and management of this disease.
In this review, the involvement of core muscles and core stability in patients with AS and the literature on core training programs will be discussed.
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18
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Kim N, Yoon SH, Kim M, Lee SH, Kim DH, Kim KH. Effect of direct vibration on the activity of deep trunk muscles of patients with non-specific chronic low back pain. J Back Musculoskelet Rehabil 2022; 35:1109-1118. [PMID: 35213345 DOI: 10.3233/bmr-210211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Vibration training is an adjuvant to muscle-strengthening exercises. OBJECTIVE To investigate the short-term effects of direct vibration on the deep trunk muscles of patients with non-specific chronic low back pain (CLBP). METHODS Participants with non-specific CLBP were randomly placed into two groups: the vibration-plus stabilization exercise (VSE) group (n= 31) and the conventional stabilization exercise (CSE) group (n= 31). The groups underwent 12 sessions of an exercise program. The thickness and activity of the trunk muscles were measured using ultrasonography and surface electromyography. RESULTS Ultrasonography revealed that the ratio of muscle thickness to contraction and relaxation was statistically increased after exercise in the bilateral transversus abdominis (TrA) and lumbar multifidus (LM) muscles in the CSE group (p= 0.031), and in the bilateral TrA, LM, and internal oblique (IO) muscles in the VSE group (p< 0.001). The LM/lumbar erector spinae (LES) ratio in the CSE group (p= 0.037), and the IO/rectus abdominis (RA), TrA/RA, and LM/LES ratios in the VSE group (p= 0.019) were statistically increased. Multiple regression analysis showed that symptom improvement was related to increased activity of the deep trunk muscles in the VSE group (p< 0.001). CONCLUSION Direct vibration can increase the selective activity of contracting deep trunk muscles.
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Affiliation(s)
- Nackhwan Kim
- Department of Physical Medicine and Rehabilitation, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Korea
| | - Soo Hoon Yoon
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea
| | - Minhee Kim
- Department of Physical Medicine and Rehabilitation, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Korea
| | - Sang-Heon Lee
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea
| | - Dong Hee Kim
- Department of Physical Medicine and Rehabilitation, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Korea
| | - Ki Hoon Kim
- Department of Physical Medicine and Rehabilitation, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Korea
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19
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Moreno-Segura N, Martín-San Agustín R, García-Bafalluy S, Escriche-Escuder A. Effects of core training on trunk function, balance, and gait in stroke patients: A systematic review and meta-analysis of randomised controlled trials. Clin Rehabil 2022; 36:1635-1654. [PMID: 35892183 DOI: 10.1177/02692155221117220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) includes determining the effects of core training alone or combined with conventional therapy on trunk function, balance, and gait in stroke patients; analysing these effects considering the stroke stage and the core training type; establishing the methodological quality of the studies published to date; and knowing the best dosage and type of exercise these aspects. DATA SOURCE Cochrane Library, Medline, Web of Science, Scopus, and Science Direct were searched from inception to January 2022. REVIEW METHOD A review and meta-analysis of RCTs about core intervention effects on trunk function, balance, and gait in stroke patients was carried out following the Preferred Items for Reporting in Systematic Review and Meta-Analyses guidelines. The Cochrane Collaboration tool was used to assess the risk of bias and internal validity of the included studies. RESULTS Twenty-nine studies were included (1030 stroke patients). The mean age of the participants was 58.46 ± 9.89 years, and the average time since the stroke incident was 308.64 ± 175.52 days. The meta-analysis results showed significant improvements in core interventions for trunk function (P ≤ 0.008) and balance (P < 0.00001) but not for gait performance (P = 0.11 in chronic and P = 0.06 in pooled cases). In relation to the differential meta-analysis between training performed on stable and unstable surfaces, no significant differences were found in trunk function (P = 0.06) or balance measures (P = 0.05). CONCLUSION Core training improves trunk function and balance in acute and chronic patients, but no changes were found in gait performance.
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Affiliation(s)
| | | | | | - Adrián Escriche-Escuder
- Faculty of Health Sciences, Universidad Internacional de Valencia - VIU, Valencia, Spain.,Department of Physiotherapy, University of Malaga, Malaga, Spain
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20
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Shanbehzadeh S, ShahAli S, Hides J, Ebrahimi-Takamjani I, Rasouli O. Effect of Motor Control Training on Trunk Muscle Morphometry, Pain, and Disability in People With Chronic Low Back Pain: A Systematic Review and Meta-Analysis. J Manipulative Physiol Ther 2022; 45:202-215. [PMID: 35879124 DOI: 10.1016/j.jmpt.2022.06.003] [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: 03/01/2022] [Revised: 05/12/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to study the effects of motor control training (MCT) on trunk muscle morphometry measured by ultrasound imaging and pain and disability in individuals with chronic low back pain. METHODS PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from study inception until January 2021. Randomized control trials evaluating both muscle morphometry and pain or disability in individuals with chronic low back pain were included. Study selection, data extraction, and quality assessment were performed by 2 reviewers independently. Modified Downs and Black tool and the Grading of Recommendations Assessment, Development and Evaluation approach were used to assess the risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random effects model with mean difference or standardized mean difference (SMD). RESULTS Of 3459 studies initially identified, 15 studies were included, and 13 studies were selected for meta-analysis. The results revealed no differences in the resting thickness of the transversus abdominis, internal and external oblique, and lumbar multifidus muscles in studies that compared MCT with other interventions. The transversus abdominis muscles contraction ratio was greater (SMD = 0.93; 95% confidence interval [CI], -0.0 to 1.85) and lower pain (weighted mean difference: -1.07 cm; 95% CI, -1.91 to -0.22 cm; P = .01) and disability (SMD = -0.86; 95% CI, -1.42 to -0. 29; P < .01) scores were found in the groups who underwent MCT compared with other interventions. CONCLUSION This systematic review and meta-analysis found that motor control exercise training increased the transverse abdominis contraction ratio (muscle activation) and improved the level of pain and disability compared to other interventions in people with chronic low back pain. However, motor control exercise training was not superior to other interventions in increasing the resting thickness of deep abdominal and lumbar multifidus muscles in intervention times less than 12 weeks.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran; Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam ShahAli
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Julie Hides
- School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, Queensland, Australia
| | - Ismail Ebrahimi-Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Omid Rasouli
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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21
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Lee J, Kim D, Shin Y, Yi C, Jeon H, You SJH, Park C. Comparison of core stabilization techniques on ultrasound imaging of the diaphragm, and core muscle thickness and external abdominal oblique muscle electromyography activity. J Back Musculoskelet Rehabil 2022; 35:839-847. [PMID: 34657872 DOI: 10.3233/bmr-210051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To restore core stability, abdominal drawing-in maneuver (ADIM), abdominal bracing (AB), and dynamic neuromuscular stabilization (DNS) have been employed but outcome measures varied and one intervention was not superior over another. OBJECTIVE The purpose of this study was to compare the differential effects of ADIM, AB, and DNS on diaphragm movement, abdominal muscle thickness difference, and external abdominal oblique (EO) electromyography (EMG) amplitude. METHODS Forty-one participants with core instability participated in this study. The subjects performed ADIM, AB, and DNS in random order. A Simi Aktisys and Pressure Biofeedback Unit (PBU) were utilized to measure core stability, an ultrasound was utilized to measure diaphragm movement and measure abdominal muscles thickness and EMG was utilized to measure EO amplitude. Analysis of variance (ANOVA) was conducted at P< 0.05. RESULTS Diaphragm descending movement and transverse abdominis (TrA) and internal abdominal oblique (IO) thickness differences were significantly increased in DNS compared to ADIM and AB (P< 0.05). EO amplitude was significantly increased in AB compared to ADIM, and DNS. CONCLUSIONS DNS was the best technique to provide balanced co-activation of the diaphragm and TrA with relatively less contraction of EO and subsequently producing motor control for efficient core stabilization.
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Affiliation(s)
- Jaejin Lee
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Dohyun Kim
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Yoonkyum Shin
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Chunghwi Yi
- Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Hyeseon Jeon
- Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Sung Joshua Hyun You
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Chanhee Park
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
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23
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Sitges C, Terrasa JL, García-Dopico N, Segur-Ferrer J, Velasco-Roldán O, Crespí-Palmer J, González-Roldán AM, Montoya P. An Educational and Exercise Mobile Phone–Based Intervention to Elicit Electrophysiological Changes and to Improve Psychological Functioning in Adults With Nonspecific Chronic Low Back Pain (BackFit App): Nonrandomized Clinical Trial. JMIR Mhealth Uhealth 2022; 10:e29171. [PMID: 35289758 PMCID: PMC8965676 DOI: 10.2196/29171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/28/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Concomitant psychological and cognitive impairments modulate nociceptive processing and contribute to chronic low back pain (CLBP) maintenance, poorly correlated with radiological findings. Clinical practice guidelines recommend self-management and multidisciplinary educational and exercise-based interventions. However, these recommendations are based on self-reported measurements, which lack evidence of related electrophysiological changes. Furthermore, current mobile health (mHealth) tools for self-management are of low quality and scarce evidence. Thus, it is necessary to increase knowledge on mHealth and electrophysiological changes elicited by current evidence-based interventions.
Objective
The aim of this study is to investigate changes elicited by a self-managed educational and exercise-based 4-week mHealth intervention (BackFit app) in electroencephalographic and electrocardiographic activity, pressure pain thresholds (PPTs), pain, disability, and psychological and cognitive functioning in CLBP versus the same intervention in a face-to-face modality.
Methods
A 2-arm parallel nonrandomized clinical trial was conducted at the University of the Balearic Islands (Palma, Spain). A total of 50 patients with nonspecific CLBP were assigned to a self-managed group (23/50, 46%; mean age 45.00, SD 9.13 years; 10/23, 43% men) or a face-to-face group (27/50, 54%; mean age 48.63, SD 7.54 years; 7/27, 26% men). The primary outcomes were electroencephalographic activity (at rest and during a modified version of the Eriksen flanker task) and heart rate variability (at rest), PPTs, and pressure pain intensity ratings. The secondary outcomes were pain, disability, psychological functioning (mood, anxiety, kinesiophobia, pain catastrophizing, and fear-avoidance beliefs), and cognitive performance (percentage of hits and reaction times).
Results
After the intervention, frequency analysis of electroencephalographic resting-state data showed increased beta-2 (16-23 Hz; 0.0020 vs 0.0024; P=.02) and beta-3 (23-30 Hz; 0.0013 vs 0.0018; P=.03) activity. In addition, source analyses revealed higher power density of beta (16-30 Hz) at the anterior cingulate cortex and alpha (8-12 Hz) at the postcentral gyrus and lower power density of delta (2-4 Hz) at the cuneus and precuneus. Both groups also improved depression (7.74 vs 5.15; P=.01), kinesiophobia (22.91 vs 20.87; P=.002), activity avoidance (14.49 vs 12.86; P<.001), helplessness (6.38 vs 4.74; P=.02), fear-avoidance beliefs (35 vs 29.11; P=.03), and avoidance of physical activity (12.07 vs 9.28; P=.01) scores, but there was an increase in the disability score (6.08 vs 7.5; P=.01). No significant differences between the groups or sessions were found in heart rate variability resting-state data, electroencephalographic data from the Eriksen flanker task, PPTs, subjective ratings, or cognitive performance.
Conclusions
Both intervention modalities increased mainly beta activity at rest and improved psychological functioning. Given the limitations of our study, conclusions must be drawn carefully and further research will be needed. Nevertheless, to the best of our knowledge, this is the first study reporting electroencephalographic changes in patients with CLBP after an mHealth intervention.
Trial Registration
ClinicalTrials.gov NCT04576611; https://clinicaltrials.gov/ct2/show/NCT04576611
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Affiliation(s)
- Carolina Sitges
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Juan L Terrasa
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Nuria García-Dopico
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Joan Segur-Ferrer
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Jaume Crespí-Palmer
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), University of the Balearic Islands (UIB), Palma, Spain
| | - Ana María González-Roldán
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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Jain PD, Nayak A, Karnad SD. Relationship between trunk muscle strength, reaching ability and balance in children with Down syndrome - A cross-sectional study. Brain Dev 2022; 44:95-104. [PMID: 34579982 DOI: 10.1016/j.braindev.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with Down Syndrome (DS) present with neuromuscular disturbances leading to delayed developmental milestones, poor quality of movement and poor balance. The aim of this study is to discuss the role of trunk muscle strength in the functional performance of children with DS. METHODOLOGY 28 children were recruited in the study, 14 with DS and 14 age and gender-matched controls. Trunk muscle strength, reaching ability and balance were assessed using a Handheld Dynamometer, Modified Functional Reach test and Pediatric Balance Scale, respectively. RESULTS Children with DS present with poorer trunk muscle strength, reaching ability and balance as compared to typically developing (TD) children. There was a positive correlation between trunk muscle strength and lateral reaching in children with DS. A strong to moderate correlation was observed between the trunk muscle strength and balance in children with DS. DISCUSSION Children with DS demonstrated a significantly weak trunk muscle groups. Lateral reaching distance is reduced due to the poor proximal control and they present with near-normal forward reach distance attributed to compensation using the lower trunk muscles. They exhibit poor balance in the components that require a small base of support. CONCLUSION Children with DS exhibit weak trunk muscles along with lesser reaching distance and poor balance. Also, trunk muscle strength influences lateral reaching ability. Trunk muscle strength, mainly trunk extensors impacted functional balance in sitting, standing and while performing transfers.
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Affiliation(s)
- Preyal D Jain
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Akshatha Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Shreekanth D Karnad
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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D’souza CJ, Santhakumar H, Bhandary B, Rokaya A. Immediate effect of stabilization exercises versus conventional exercises of the trunk on dynamic balance among trained soccer players. Hong Kong Physiother J 2021; 42:23-30. [PMID: 35782693 PMCID: PMC9244602 DOI: 10.1142/s1013702522500032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Trunk stability is key in controlling body balance and movements. Trunk Stabilization Exercises (TSE) and Conventional Trunk Exercises (CTE) are performed to improve dynamic balance. The authors have previously reported that dynamic balance was improved by a 12-week and 6-week TSE program. However, there is a dearth of research on its immediate effect on dynamic balance in trained soccer players. Objective: To compare the immediate effect of TSE with that of CTE on dynamic balance in trained soccer players. Methods: Forty-eight male soccer players (24.60 ± 1.38 years) participated in this crossover study, wherein each participant took part in three exercise sessions: TSE, CTE, and No Exercise control (NE), each consisting of three steps: pre-test, intervention and post-test, with an interval of one week between each exercise condition. To assess dynamic balance, the Y Balance Test-Lower Quarter (YBT-LQ) score in the anterior, posteromedial, and posterolateral directions was measured before and 5 minutes after each intervention. Results: The YBT-LQ composite score was significantly improved after TSE (0.51) as compared to CTE (0.22) and NE (0.04) (p<0.05). Furthermore, in TSE and CTE conditions, YBT-LQ scores of the posterolateral and posteromedial directions significantly improved at the post-test (p<0.05). Conclusion: Both TSE and CTE are effective in immediately improving dynamic balance; however, TSE showed greater improvement as compared to the latter. Immediate improvements in the posteromedial and posterolateral directions of the YBT-LQ were demonstrated after performing the TSE and CTE.
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Affiliation(s)
| | | | - Bhaskara Bhandary
- Department of Orthopaedics, AJ Institute of Medical Sciences, Mangalore, India
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26
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Bini RR, Bini AF. Comparison of linea alba length and core-muscles engagement during core and lower back orientated exercises. J Bodyw Mov Ther 2021; 28:131-137. [PMID: 34776131 DOI: 10.1016/j.jbmt.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/10/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND A comparison of Linea Alba (LA) length and engagement of the Transverse Abdominis (TrA), External Oblique (EO) and Internal Oblique (IO) between core-orientated and lower back orientated exercises (e.g. glute bridge and hip extension) is lacking. Therefore, the aim of this study was to compare the length of the LA and the engagement of TrA, EO and IO when performing the prone plank, bird dog, dead bug, lateral plank, glute bridge and hip extension. METHODS Thirteen apparently healthy participants volunteered to this study. Ultrasound scanning of the anterior and antero-lateral abdominal walls at baseline and whilst performing prone plank, bird dog, dead bug, lateral plank, glute bridge and hip extension exercises was performed. LA length and thickness of the TrA, EO and IO were measured from ultrasound images. RESULTS LA length (p = 0.77) and TrA thickness (p = 0.23) were not different between exercises. EO thickness was larger for the lateral plank compared to the bird dog (p = 0.01, d = 1.73), glute bridge (p < 0.01, d = 2.64), and hip extension (p < 0.01, d = 1.89). The dead bug was also larger in comparison to the glute bridge (p < 0.01, d = 2.05) and to the hip extension (p = 0.01, d = 1.45). For the IO thickness, the lateral plank was larger than the bird dog (p = 0.03, d = 1.21) and the dead bug (p = 0.04, d = 1.12). CONCLUSION No difference was observed between exercises for the length of the LA or for the thickness of the TrA, which suggests that this muscle is similarly engaged in the assessed exercises, leading to a consistent stretch for the LA.
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Affiliation(s)
- Rodrigo Rico Bini
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
| | - Alice Flores Bini
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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27
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Gait Asymmetry Comparison between Subjects with and without Nonspecific Chronic Low Back Pain. Symmetry (Basel) 2021. [DOI: 10.3390/sym13112129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Individuals with chronic low back pain (LBP) report impaired somatosensory function and balance. However, there is a lack of investigation on limb motion similarities between subjects with and without LBP during gait. The aim of this study was to compare gait parameters as well as combined limb motions using the kinematic similarity index (KSI) between subjects with and without LBP. Twenty-two subjects with LBP and 19 age- and body mass index-matched control subjects participated in this study. The combined limb motions in the gait cycle of subjects with LBP were compared with those of a prototype derived from healthy subjects. The calculations resulted in response vectors that were analyzed in comparison to control-derived prototype response vectors for the normalized index at 5% increments in the gait cycle. The results of our study indicated that the KSI of the control group demonstrated higher similarities in the swing (t = 4.23, p = 0.001) and stance (t = 6.26, p = 0.001) phases compared to the LBP group. The index for the whole gait cycle was significantly different between the groups (t = 6.52, p = 0.001), especially in the midstance and swing phases. The LBP group could have adjusted the gait patterns during these specific phases. The KSI is useful for clinical outcome measures to differentiate kinematic changes and to demonstrate quantified similarities in the gait cycle between subjects with and without LBP. It is warranted to validate the KSI for the analysis of physiological gait asymmetry using a larger sample in future studies.
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28
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Cashin AG, Rizzo RRN, Wand BM, O'Connell NE, Lee H, Bagg MK, O'Hagan E, Maher CG, Furlan AD, van Tulder MW, McAuley JH. Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane Reviews. Hippokratia 2021. [DOI: 10.1002/14651858.cd014691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Aidan G Cashin
- Prince of Wales Clinical School, Faculty of Medicine; The University of New South Wales; Sydney Australia
- Centre for Pain IMPACT; Neuroscience Research Australia; Sydney Australia
| | - Rodrigo RN Rizzo
- Centre for Pain IMPACT; Neuroscience Research Australia; Sydney Australia
- School of Health Sciences, Faculty of Medicine and Health; The University of New South Wales; Sydney Australia
| | - Benedict M Wand
- School of Physiotherapy; The University of Notre Dame Australia; Fremantle Australia
| | - Neil E O'Connell
- Department of Health Sciences, Centre for Health and Wellbeing Across the Lifecourse; Brunel University London; Uxbridge UK
| | - Hopin Lee
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS); University of Oxford; Oxford UK
- School of Medicine and Public Health; The University of Newcastle; Newcastle Australia
| | - Matthew K Bagg
- Centre for Pain IMPACT; Neuroscience Research Australia; Sydney Australia
| | - Edel O'Hagan
- Prince of Wales Clinical School, Faculty of Medicine; The University of New South Wales; Sydney Australia
- Centre for Pain IMPACT; Neuroscience Research Australia; Sydney Australia
| | - Christopher G Maher
- Sydney School of Public Health; The University of Sydney; Sydney Australia
- Institute for Musculoskeletal Health; The University of Sydney and Sydney Local Health District; Sydney Australia
| | | | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences; VU University Amsterdam; Amsterdam Netherlands
| | - James H McAuley
- Centre for Pain IMPACT; Neuroscience Research Australia; Sydney Australia
- School of Health Sciences, Faculty of Medicine and Health; The University of New South Wales; Sydney Australia
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Puntumetakul R, Saiklang P, Tapanya W, Chatprem T, Kanpittaya J, Arayawichanon P, Boucaut R. The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157811. [PMID: 34360103 PMCID: PMC8345381 DOI: 10.3390/ijerph18157811] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/19/2022]
Abstract
Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.
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Affiliation(s)
- Rungthip Puntumetakul
- Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand;
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Correspondence: ; Tel.: +66-834196186
| | - Pongsatorn Saiklang
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok 26120, Thailand;
| | - Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand;
| | - Thiwaphon Chatprem
- Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Jaturat Kanpittaya
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Preeda Arayawichanon
- Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Rose Boucaut
- iCAHE (International Centre for Allied Health Evidence), School of Health Sciences (Physiotherapy), University of South Australia, Adelaide, SA 5001, Australia;
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Mitchell B, Deckers K, De Smedt K, Russo M, Georgius P, Green M, Gulve A, van Buyten JP, Smet I, Mehta V, Baranidharan G, Rathmell J, Gilligan C, Goss B, Eldabe S. Durability of the Therapeutic Effect of Restorative Neurostimulation for Refractory Chronic Low Back Pain. Neuromodulation 2021; 24:1024-1032. [PMID: 34242440 PMCID: PMC8456956 DOI: 10.1111/ner.13477] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/27/2021] [Accepted: 05/18/2021] [Indexed: 01/23/2023]
Abstract
Objectives The purpose of the ongoing follow‐up of ReActiv8‐A clinical trial is to document the longitudinal benefits of episodic stimulation of the dorsal ramus medial branch and consequent contraction of the lumbar multifidus in patients with refractory mechanical chronic low back pain (CLBP). We report the four‐year outcomes of this trial. Materials and Methods ReActiv8‐A is a prospective, single‐arm trial performed at nine sites in the United Kingdom, Belgium, and Australia. Eligible patients had disabling CLBP (low back pain Numeric Rating Scale [NRS] ≥6; Oswestry Disability Index [ODI] ≥25), no indications for spine surgery or spinal cord stimulation, and failed conventional management including at least physical therapy and medications for low back pain. Fourteen days postimplantation, stimulation parameters were programmed to elicit strong, smooth contractions of the multifidus, and participants were given instructions to activate the device for 30‐min stimulation‐sessions twice daily. Annual follow‐up through four years included collection of NRS, ODI, and European Quality of Life Score on Five Dimensions (EQ‐5D). Background on mechanisms, trial design, and one‐year outcomes were previously described. Results At baseline (N = 53) (mean ± SD) age was 44 ± 10 years; duration of back pain was 14 ± 11 years, NRS was 6.8 ± 0.8, ODI 44.9 ± 10.1, and EQ‐5D 0.434 ± 0.185. Mean improvements from baseline were statistically significant (p < 0.001) and clinically meaningful for all follow‐ups. Patients completing year 4 follow‐up, reported mean (±standard error of the mean) NRS: 3.2 ± 0.4, ODI: 23.0 ± 3.2, and EQ‐5D: 0.721 ± 0.035. Moreover, 73% of participants had a clinically meaningful improvement of ≥2 points on NRS, 76% of ≥10 points on ODI, and 62.5% had a clinically meaningful improvement in both NRS and ODI and 97% were (very) satisfied with treatment. Conclusions In participants with disabling intractable CLBP who receive long‐term restorative neurostimulation, treatment satisfaction remains high and improvements in pain, disability, and quality‐of‐life are clinically meaningful and durable through four years.
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Affiliation(s)
- Bruce Mitchell
- Monash Clinical Research Pty Ltd, Clayton, VIC, Australia
| | | | | | - Marc Russo
- Hunter Pain Clinic, Broadmeadow, NSW, Australia
| | - Peter Georgius
- Sunshine Coast Clinical Research, Noosa Heads, QLD, Australia
| | - Matthew Green
- Pain Medicine of South Australia, Welland, SA, Australia
| | - Ashish Gulve
- The James Cook University Hospital, Middlesbrough, UK
| | | | - Iris Smet
- Algemeen Ziekenhuis Nikolaas, Sint-Niklaas, Belgium
| | | | | | - James Rathmell
- Brigham and Women's Healthcare, Harvard Medical School, Boston, MA, USA
| | - Chris Gilligan
- Brigham and Women's Healthcare, Harvard Medical School, Boston, MA, USA
| | - Ben Goss
- Mainstay Medical BV, Amsterdam, The Netherlands
| | - Sam Eldabe
- The James Cook University Hospital, Middlesbrough, UK
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Abstract
Spinal injury and back pain are a common problem facing patients seeking medical care including athletes, which can lead to significant disability, medical costs, and impaired performance for these patients. Rehabilitation including core muscle stabilization, Kinesio taping, and flexibility have been shown to help with treatment and prevention. Critical factors such as equipment, technique, and rule changes can also be an important part of spine injury prevention.
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Effects of the Multidimensional Treatment on Pain, Disability, and Sitting Posture in Patients with Low Back Pain: A Randomized Controlled Trial. Pain Res Manag 2021; 2021:5581491. [PMID: 34306274 PMCID: PMC8263210 DOI: 10.1155/2021/5581491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/21/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to investigate the effects of multidimensional approach model on the pain, disability, and sitting posture in patients with nonspecific low back pain (LBP). Sixty LBP patients were recruited and were randomly divided into two groups: multidimensional treatment (MT) group (n = 30) and unimodal treatment (UT) group (n = 30). All participants underwent 48 sessions of treatment (40 min/session, two sessions per day, 2 days per week) for 12 weeks. The MT group conducted a core stability exercise twice a day and additionally provided training on pain principles and management methods. The UT group only performed a core stability exercise twice a day. The visual analog scale (VAS) and Oswestry Disability index (ODI) were used to measure pain intensity and disability. Thoracolumbar kyphosis and lumbar lordosis in the sitting position were measured using a motion capture system. After training, the pain and disability in the MT group improved significantly greater than the UT group (p < 0.05). In the MT group, the pain relief effect persisted 3 months after the end of training. Thoracolumbar kyphosis and lumbar lordosis in the MT group were significantly improved compared to the UT group (p < 0.05). Thus, MT combined with core stability exercise may be used to improve the pain, disability, and sitting posture in patients with LBP.
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Fortin M, Rye M, Roussac A, Naghdi N, Macedo LG, Dover G, Elliott JM, DeMont R, Weber MH, Pepin V. The effects of combined motor control and isolated extensor strengthening versus general exercise on paraspinal muscle morphology and function in patients with chronic low back pain: a randomised controlled trial protocol. BMC Musculoskelet Disord 2021; 22:472. [PMID: 34022854 PMCID: PMC8141240 DOI: 10.1186/s12891-021-04346-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Exercise is a common approach for the management of patients with chronic non-specific low back pain (LBP). However, there is no clear mechanistic evidence or consensus on what type of exercise is more effective than others. While considerable evidence suggests a link between lumbar muscle health (e.g., atrophy and fatty infiltration) with functional deficits, it is unknown whether exercises targeting the lumbar spine can lead to noticeable improvements in muscle health and functional outcomes. The primary aim of this study is to compare the effect of combined motor control and isolated strengthening lumbar exercises (MC + ILEX) versus a general exercise group (GE) on multifidus muscle morphology (size and composition). Secondary aims include assessing the effect of the interventions on overall paraspinal muscle health, pain and disability, as well as psychological factors as possible effect modifiers. METHODS A total of 50 participants with chronic non-specific LBP and moderate to severe disability, aged between 18 and 60, will be recruited from the local orthopaedic clinics and university community. Participants will be randomised (1:1) to either the MC + ILEX or GE group. Participants will undergo 24 individually supervised exercise sessions over a 12-week period. The primary outcome will be multifidus morphology (atrophy) and composition (fatty infiltration). Secondary outcomes will be muscle function (e.g., % thickness change during contraction), morphology, lumbar extension strength, pain intensity and disability. Potential treatment effect modifiers including maladaptive cognitions (fear of movement, catastrophizing), anxiety, depression, physical activity, and sleep quality will also be assessed. All measurements will be obtained at baseline, 6-week and 12-week; self-reported outcomes will also be collected at 24-week. Between-subjects repeated measure analysis of variance will be used to examine the changes in paraspinal muscle morphology over the different time points. Linear mixed models will be used to assess whether baseline scores can modify the response to the exercise therapy treatment. DISCUSSION The results of this study will help clarify which of these two common interventions promote better results in terms of overall paraspinal muscle heath, back pain, disability and psychological factors in adults with chronic LBP. TRIAL REGISTRATION NTCT04257253 , registered prospectively on February 5, 2020.
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Affiliation(s)
- Maryse Fortin
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada.
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada.
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Montreal, Quebec, Canada.
| | - Meaghan Rye
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada
| | - Alexa Roussac
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada
| | - Neda Naghdi
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada
| | - Luciana Gazzi Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Geoffrey Dover
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Montreal, Quebec, Canada
| | - James M Elliott
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Northern Sydney Local Health District, The Kolling Institute and Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Richard DeMont
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Michael H Weber
- Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Véronique Pepin
- Department Health Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, SP-165.29, Montreal, Quebec, H4B 1R6, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
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Panhan AC, Gonçalves M, Eltz GD, Villalba MM, Cardozo AC, Bérzin F. Co-contraction of the core muscles during Pilates exercise on the Wunda Chair. J Back Musculoskelet Rehabil 2021; 33:719-725. [PMID: 31771036 DOI: 10.3233/bmr-181267] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The co-contraction of the core muscles has been reported as the key mechanism towards spinal stability. Classic Pilates exercises aimed at these muscles are known to improve the stability and strength of the trunk without damaging the deep structures of the spine. OBJECTIVE To evaluate the co-contraction of the mobilizing (rectus abdominis; longissimus) and stabilizing (multifidus; internal oblique) trunk muscles during Pilates exercises - going up front, mountain climber, and swan. METHODS Sixteen women, all Pilates practitioners, participated in the study. The stabilizing and mobilizing muscles of the trunk (right side) were submitted to electromyography to calculate the percentage of co-contraction during the exercises. One-way repeated measures analysis of variance (ANOVA) was used to verify the difference in %COCON between stabilizers and mobilizers among the three exercises. The post-hoc Bonferroni test (P< 0.01) was applied when necessary. The paired t-test (P< 0.01) was used to verify the difference in %COCON between stabilizers and mobilizers separately for each exercise. RESULTS The co-contraction values of the stabilizers were higher than those of the mobilizers for all exercises. The going up front (stabilizers) and the swan (mobilizers) exercises showed the highest %COCON values. CONCLUSIONS The Pilates method is effective for either rehabilitating pathologies or training the trunk muscles in healthy individuals and athletes.
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Affiliation(s)
- Ana Carolina Panhan
- Department of Morphology, Anatomy Division, Piracicaba Dental School, UNICAMP, Piracicaba, São Paulo, Brazil
| | - Mauro Gonçalves
- Department of Physical Education, São Paulo State University, UNESP, Rio Claro, São Paulo, Brazil
| | - Giovana Duarte Eltz
- Department of Physical Education, São Paulo State University, UNESP, Rio Claro, São Paulo, Brazil
| | - Marina Mello Villalba
- Department of Physical Education, São Paulo State University, UNESP, Rio Claro, São Paulo, Brazil
| | | | - Fausto Bérzin
- Department of Morphology, Anatomy Division, Piracicaba Dental School, UNICAMP, Piracicaba, São Paulo, Brazil
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ÖZKUL Ç, GÜÇLÜ GÜNDÜZ A, ESMER M, YILDIRIM MŞ, ELDEMİR K, İRKEÇ C. Mutual relationship between upper extremity function and core muscle endurance in patients with multiple sclerosis. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.809605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Jebavy R, Baláš J, Vomackova H, Szarzec J, Stastny P. The Effect of Traditional and Stabilization-Oriented Exercises on Deep Stabilization System Function in Elite Futsal Players. Sports (Basel) 2020; 8:sports8120153. [PMID: 33260580 PMCID: PMC7761023 DOI: 10.3390/sports8120153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 11/21/2022] Open
Abstract
Background: This study aimed to compare the effect of traditional and stability-oriented strength exercises on trunk stability and deep stabilization system (DSS) activation in elite futsal players. Methods: Twenty elite futsal players (21–34 years, 180 ± 13 cm, 79 ± 15 kg) were randomly divided into a group that performed stability-oriented exercises and a group that performed traditional strength exercises. Both interventions lasted for 10 weeks and included 25 strength training sessions. Main outcome measures: The DSS pretest and posttest included the diaphragm test, trunk flexion test, back extension test, hip flexion test, intraabdominal pressure test, and a side plank test on a 1–5 point scale. Results: Both groups had similar initial test results, where the stability-oriented exercise group had significantly improved intraabdominal pressure test (p = 0.004, by lower quartile rate), trunk flexion (p = 0.036, by 0.5 grade in median), and side plank (p = 0.002, by 1 grade in median) in posttest results. Traditional exercise did not change the results of any of the included DSS function tests. Conclusions: Stabilization-oriented exercises effectively activate the functions of the DSS and should be prioritized over traditional strength exercises in injury prevention training programs. The use of stabilization-oriented exercises might prevent injury and overloading in elite futsal players.
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Affiliation(s)
- Radim Jebavy
- Department of Track and Field, Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic;
| | - Jiří Baláš
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic;
| | - Helena Vomackova
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic;
| | - Jakub Szarzec
- Faculty of Nursing and Professional Health Studies, Health University in Bratislava, 83101 Bratislava, Slovakia;
| | - Petr Stastny
- Department of Sport Games, Faculty of Physical Education and Sport, Charles University, 16252 Prague, Czech Republic
- Correspondence: ; Tel.: +420-777198764
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Ribas J, Gomes MA, Montes AM, Ribas C, Duarte JA. Resolution of chronic lower back pain symptoms through high-intensity therapeutic exercise and motor imagery program: a case-report. Physiother Theory Pract 2020; 38:1545-1552. [PMID: 33225789 DOI: 10.1080/09593985.2020.1839985] [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: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE Nonspecific chronic lower back pain (CLBP) is a difficult to manage clinical condition that is more prevalent in adulthood but also affects adolescents, compromising their well-being and activities of daily living. This case report aimed to describe the clinical evolution of a female adolescent with nonspecific and severe CLBP treated successfully through a combination of high-intensity exercise and motor imagery training. Case Description: A 13-year-old girl with CLBP with radicular pain to the lower limbs, spasms, and movement limitations, for whom pharmacological treatment (i.e. analgesic and muscle relaxant agents) and hydrotherapy, hot wet therapy, and muscle relaxation were unsuccessful. After a careful physiotherapy evaluation, the patient underwent a 36-session intervention, performed 3 times/week for 12 weeks, which was composed of high-intensity therapeutic exercise, adjusted for the patient condition, along with motor imagery training. The patient was reevaluated after the intervention and again 3 years later by the same physiotherapist. Outcomes: The intervention led to a favorable clinical outcome, with pain relief, improved posture, and decreased disability. The patient's clinical condition remained stable at the time of the last follow-up evaluation. Conclusion: These results show that the adjusted combined program led to favorable clinical improvement in the condition, with sustained long-term effects after the intervention.
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Affiliation(s)
- Jorge Ribas
- Department of Morphological Sciences, School of Health, Polytechnic Institute of Porto, Porto, Portugal.,Porto Physio Center, Private Practice, Porto, Portugal
| | - Maria Armanda Gomes
- Department of Anesthesiology, Centro Hospitalar De S. João, Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - António Mesquita Montes
- Department of Physiotherapy, Santa Maria Health School, Porto, Portugal.,Department of Physiotherapy and Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino De Almeida, Porto, Portugal
| | - Cláudia Ribas
- Porto Physio Center, Private Practice, Porto, Portugal
| | - José Alberto Duarte
- Sport Biology Department and Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
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A Randomized Controlled Trial Investigating the Effects of Equine Simulator Riding on Low Back Pain, Morphological Changes, and Trunk Musculature in Elderly Women. ACTA ACUST UNITED AC 2020; 56:medicina56110610. [PMID: 33202928 PMCID: PMC7696898 DOI: 10.3390/medicina56110610] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/20/2023]
Abstract
Background and objectives: Studies on the effects of an equine riding simulator (ERS) program on back pain, spinal alignment, and isokinetic moments in subjects with chronic low back pain (CLBP) remain limited. The purpose of this study was to analyze changes in elderly women with CLBP who participate in an ERS program. Materials and Methods: The 80 participants were all women aged 61–84 years who were randomly assigned to either the control group (CON) or ERS group (ERSG). ERS exercise was performed for a duration of 12 weeks (three times each week). The degree of pain was measured using the Oswestry Disability Index and the visual analog scale. Body composition and spinal alignment were measured using bioelectrical impedance and raster stereography. The isokinetic moments of trunk extensor and flexor were measured before and after the training period. Results: The ERSG showed a significant decrease in back pain compared to the CON. There was a significant decrease in levels of fat in the ERSG, although no differences were shown in terms of muscle mass. However, there was an increased basal metabolic rate (BMR) in the ERSG. Spinal alignment in the ERSG significantly improved. The peak torques of the trunk extensor in the ERSG were also significantly increased. Conclusion: It can be inferred that the ERS exercise can decrease fat and improve the trunk extensor strength through increased BMR, leading to better spinal alignment and reducing back pain in elderly women with CLBP.
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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.
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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
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Ganesh GS, Kaur P, Meena S. Systematic reviews evaluating the effectiveness of motor control exercises in patients with non-specific low back pain do not consider its principles - A review. J Bodyw Mov Ther 2020; 26:374-393. [PMID: 33992272 DOI: 10.1016/j.jbmt.2020.08.010] [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: 12/23/2019] [Revised: 07/11/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Motor control exercise (MCEs), spinal stabilization or core stability exercises were developed with the aim of restoring the coordination, control, and capacity of the trunk muscles and systematic reviews (SR) evaluating their effectiveness has shown conflicting results. This we hypothesized was due to the non-consideration of principles of neuroplasticity. The objective of this review was to review the operating definitions used in these reviews for these exercises and evaluate if these reviews have considered and satisfied the principles of these exercises in persons with NSLBP, both acute and chronic. METHODS The available evidence to address the research question was sought in the reviews published in English between January 2006 and April 2019 using the population, intervention, comparison, and outcome format. Data were extracted against the following factors: satisfy the principles of specific inclusion criteria; interventions; experience-dependent plasticity; and measure any one of the concepts of motor control. The quality of the evidence obtained was graded using the National Institute for Health and Care Excellence protocol and the quality of SRs evaluated using the R-AMSTAR. RESULTS Eleven reviews on core stability/spinal stabilization exercises and four reviews on MCE were considered in this review. The results showed that most of the studies considered by the reviews did not adhere to the principles of these exercises. CONCLUSION There is wide heterogeneity in the understanding, administration, and progression of exercises. The exercises were implemented without considering the potential for neuroplasticity of the nervous system and the principles of motor learning.
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Affiliation(s)
- G Shankar Ganesh
- Composite Regional Centre for Skill Development, Rehabilitation and Empowerment of Persons with Disabilities, Lucknow, Uttar Pradesh, India.
| | | | - Sadhana Meena
- Department of Physiotherapy, Sports Injury Centre, Safdarjung Hospital, New Delhi, India.
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Effects of 3D Moving Platform Exercise on Physiological Parameters and Pain in Patients with Chronic Low Back Pain. ACTA ACUST UNITED AC 2020; 56:medicina56070351. [PMID: 32679755 PMCID: PMC7404725 DOI: 10.3390/medicina56070351] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 01/07/2023]
Abstract
Background and objectives: Patient-handling activities predispose women to chronic low back pain (CLBP), but sufficient evidence is not available on whether a 3D moving platform, made for core stability exercise, affects pain, trunk flexibility, and static/dynamic muscle contractions in CLBP patients. Materials and Methods: The participants were twenty-nine women who were randomly divided into a control group (CON) and a 3D exercise group (3DEG), which took part in 3D moving exercise three times a week for 8 weeks. Both groups measured a visual analog scale (VAS) about their CLBP. Body composition, forward and backward trunk flexibilities, static muscle contraction property in rectus abdominis, and erector spinae were measured by tensiomyography, which found contraction time (Tc) and maximal displacement (Dm). Dynamic muscle contraction property in the abdomen and back were measured with an isokinetic device, which could measure peak torque (Pt) and work per repetition (Wr), before and after the trial. Results: The 3DEG had a significantly decreased fat mass and waist/hip ratio, as well as improved static muscle contractions of the erector spinae. The Wr of trunk extensor of 3D exercise group were also significantly increased. In the VAS, although the scores showed a significant change in some variables, while others did not. The Δ% in feeling pain at rest or at night, during exercise, walking, sitting in a hard chair, sitting in a soft chair, and lying down in 3DEG were significantly changed after 8 weeks. This indicates that the platform exercise provided a greater reduction of pain for activities that are done on a daily basis. Conclusions: This study confirms that the 3D moving platform exercise can provide the similar effect of the core stability exercise used in previous studies. Moreover, this study suggests that 3D moving platform exercise is a suitable means to reduce fatness, to increase trunk extensor, and to increase trunk backward flexibility, which led to reduced back pain in the women with CLBP.
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Kelli A, Kellis E, Galanis N, Dafkou K, Sahinis C, Ellinoudis A. Transversus Abdominis Thickness at Rest and Exercise in Individuals with Poststroke Hemiparesis. Sports (Basel) 2020; 8:sports8060086. [PMID: 32545550 PMCID: PMC7353629 DOI: 10.3390/sports8060086] [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: 05/17/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 11/16/2022] Open
Abstract
The activity of the transverse abdominal (TrA) muscle affects the stabilization of the trunk. It is known that after a stroke, people experience problems in performing daily activities. The purpose of this study was to examine whether there are differences in the transversus abdominal thickness between the two sides of the body in individuals with hemiparesis and controls. Eight patients with hemiparesis and nine controls matched for age and body mass index were examined by musculoskeletal ultrasound in four conditions: a) At rest, b) abdominal hollowing maneuver from the supine position, c) bridge, and d) abdominal hollowing maneuver from the bridge position. In each of the above conditions, the symmetry index was calculated as the absolute value of the difference in thickness between the two sides. Analysis of variance showed a lower TrA thickness at rest and exercise in patients compared to the control group (p < 0.05). Further, patients showed a lower contraction thickness ratio during exercise compared to controls (p < 0.05). The absolute symmetry of the TrA thickness was 12.59 ± 6.43% to 19.31 ± 10.43% in patients and it was significantly greater than the control group (3.01 ± 2.47% to 4.47 ± 2.87%). According to the above results, it seems that transverse abdominal activation exercises are particularly useful for improving the stability of patients with hemiparesis, as long as they are located and adapted to the deficit of each patient.
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Affiliation(s)
- Anna Kelli
- Private Physiotherapy Clinic, Kavala 65403, Greece;
| | - Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece; (K.D.); (C.S.); (A.E.)
- Correspondence: ; Tel.: +30-231-099-1053
| | - Nikiforos Galanis
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece;
| | - Konstantinos Dafkou
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece; (K.D.); (C.S.); (A.E.)
| | - Chrysostomos Sahinis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece; (K.D.); (C.S.); (A.E.)
| | - Athanasios Ellinoudis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece; (K.D.); (C.S.); (A.E.)
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Matarán-Peñarrocha GA, Lara Palomo IC, Antequera Soler E, Gil-Martínez E, Fernández-Sánchez M, Aguilar-Ferrándiz ME, Castro-Sánchez AM. Comparison of efficacy of a supervised versus non-supervised physical therapy exercise program on the pain, functionality and quality of life of patients with non-specific chronic low-back pain: a randomized controlled trial. Clin Rehabil 2020; 34:948-959. [PMID: 32517498 DOI: 10.1177/0269215520927076] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To compare the effectiveness of supervised physical therapy program versus non-supervised on pain, functionality, fear of movement and quality of life in patients with non-specific chronic low back pain. DESIGN A randomized double-blind clinical trial. SETTING Clinical outpatient unit; home. SUBJECTS A total of 64 participants with non-specific chronic low back pain were randomized into either supervised exercise group (n = 32) or non-supervised home exercise group (n = 32). INTERVENTIONS The supervised group was treated with therapy exercises (strengthen lumbopelvic musculature), while the non-supervised received an informative session of the exercises, which were performed un-supervised at home. Both groups received three weekly sessions for eight weeks. MAIN MEASURES Pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline, two, and six months of follow-up. RESULTS Although analysis of variance (ANOVA) test showed statistically significant differences between groups for pain (P = 0.028; supervised: 2.5 ± 2.1; non-supervised: 3.5 ± 1.5) and disability for Roland-Morris Disability Questionnaire (P = 0.004; supervised: 3.1 ± 2.2; non-supervised: 5.1 ± 3.0) and for Oswestry Disability Index (P = 0.034; supervised: 14.5 ± 7.1; non-supervised: 19.2 ± 10.0) at 8 weeks immediately posttreatment, there were no differences between the groups in patient-rated pain, functionality, fear of movement and quality of life at six months of follow-up. CONCLUSION Patients with chronic low back pain who received supervised exercise showed more improvement in both the short and long term in all patient-rated outcomes over the non-supervised group, but the differences were small and not clinically significant.
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Affiliation(s)
| | | | | | - Esther Gil-Martínez
- Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain
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Andrýsková A, Lee JH. The Guidelines for Application of Kinesiology Tape for Prevention and Treatment of Sports Injuries. Healthcare (Basel) 2020; 8:healthcare8020144. [PMID: 32466467 PMCID: PMC7349891 DOI: 10.3390/healthcare8020144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 12/05/2022] Open
Abstract
The number of kinesiology tape’s users is increasing year by year. However, the insufficiency of fundamental knowledge about the appropriate usage of kinesiology tapes can generate undesired side-effects caused by incorrect application of kinesiology tapes and/or denouncement of kinesiology tapes as an ineffective practice. Therefore, it is necessary to arrange a set of general guidelines of kinesiology taping that must be followed. If not, the treatment may have to be ceased due to the side-effects such as skin’s troubles. Another problem, which impeaches effectivity of treatment by kinesiology tapes, is focusing solely on the present area of pain or discomfort. However, such solution is only short-termed and the likelihood of reappearance of the pain is remarkably high. Therefore, it is essential to find and eliminate the origin of the problem. If these fundamentals conditions of tape’s application are satisfied, the treatment by kinesiology tapes may bring us far more better results.
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Affiliation(s)
- Adéla Andrýsková
- Integrated Physical Medicine Institute, Dong-Eui University, Busan 47340, Korea;
| | - Jung-Hoon Lee
- Integrated Physical Medicine Institute, Dong-Eui University, Busan 47340, Korea;
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dong-Eui University, Busan 47340, Korea
- Correspondence: ; Tel.: +82-51-890-4222
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Senbursa G, Pekyavas NO, Baltaci G. Comparison of Physiotherapy Approaches in Low Back Pain: A Randomized Controlled Trial. Korean J Fam Med 2020; 42:96-106. [PMID: 32438535 PMCID: PMC8010438 DOI: 10.4082/kjfm.20.0025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/06/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the effectiveness of rehabilitation approaches in individuals with low back pain (LBP) on pain, spinal mobility, disability, and muscular strength. METHODS Ninety volunteers were included and divided into four groups depending on the rehabilitation approach: group 1, soft tissue mobilization techniques and stabilization exercises (n=24; 11 females [F], 13 males [M]); group 2, Kinesio Taping and stabilization exercises (n=24; 12F, 12M); group 3, stabilization exercises (n=22; 11F, 11M); and group 4, reflex therapy and stabilization exercises (n=20; 10F, 10M). Visual Analog Scale for pain intensity, an isokinetic evaluation for strength at 60°/s and a side-plank position test for trunk stabilization were measured before and assessed at the beginning, after a 4-week treatment and during 4 weeks of follow-up. The functional status was evaluated with the Oswestry Disability Index. RESULTS Individuals in all groups showed similar decrease in pain after the treatment and at 1-month follow-up, but there were no significant differences in pain levels between the groups (P<0.05). CONCLUSION All therapeutic approaches were found to be effective in diminishing pain and thus helpful in increasing strength and stabilization in patients with LBP.
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Affiliation(s)
- Gamze Senbursa
- Anima Rapha Center of Manual Therapy and Reflexology, Ankara, Turkey
| | - Nihan Ozunlu Pekyavas
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Baskent University, Ankara, Turkey
| | - Gul Baltaci
- Department of Physiotherapy and Rehabilitation, Private Guven Hospital, Ankara, Turkey
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Effect of whole body vibration on the electromyographic activity of core stabilizer muscles: WBV ON CORE STABILIZER MUSCLES. J Bodyw Mov Ther 2020; 25:1-5. [PMID: 33714478 DOI: 10.1016/j.jbmt.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 02/21/2020] [Accepted: 05/02/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To analyze the effects of whole body vibration on electromyographic activity of the core muscles. METHODS This is an observational cross-sectional study composed of 30 males who practice physical activity. The amplitude of the electromyographic activation (Root Mean Square - RMS) of the rectus abdominis, external oblique, longissimus thoracis, multifidus muscles were evaluated during supine bridge, side plank and frontal plank exercises, performed with and without vibration (frequency: 50 Hz and amplitude: 4 mm). A significance level of 5% was assigned for all analyzes. RESULTS Whole body vibration did not alter the amplitude of electromyographic activity for any of the evaluated muscle groups, showing no difference between the conditions with and without vibration during the performance of the proposed exercises. CONCLUSION Under the conditions analyzed in this study, the vibrating platform does not change the activation amplitude of core muscles, suggesting that the use of whole body vibration is not necessary as an additional method to increase muscle activity during stabilization exercises in healthy men.
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Agten A, Stevens S, Verbrugghe J, Timmermans A, Vandenabeele F. Biopsy samples from the erector spinae of persons with nonspecific chronic low back pain display a decrease in glycolytic muscle fibers. Spine J 2020; 20:199-206. [PMID: 31563580 DOI: 10.1016/j.spinee.2019.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Low back pain (LBP) in Western Europe was classified as having the highest disability and overall burden among 291 studied conditions. For an extensive period of time, evidence related to morphological changes (eg, atrophy and fat infiltration) of the paraspinal muscles in persons with LBP has accumulated. Despite this evidence, there is limited knowledge on muscle fiber type composition of these muscles, and their relation to LBP. PURPOSE The aim of the study is to investigate differences in muscle fiber type composition between persons with nonspecific chronic low back pain (NSCLBP) and healthy controls for the lumbar erector spinae (ES) and multifidus (MF) muscle. STUDY DESIGN AND SETTING A cross-sectional study took place in the REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium. PATIENT SAMPLE Twenty persons with NSCLBP (age: 44.5±7.42) and 18 healthy controls (age: 39.89±7.90) participated in this study. OUTCOME MEASURES The primary outcome measure was paraspinal muscle fiber type composition. Secondary outcomes consisted of physiologic measures (maximal aerobic capacity and back muscle strength) and functional measures (activity level). METHODS Biopsy samples were taken from the lumbar ES and MF muscle at the L4 spinal level. These samples were stained using immunofluorescent antibodies against myosin heavy chains. In each sample, number and size (CSA) of type I, I/IIa, IIa, IIa/x, and IIx muscle fibers were quantified. From these data the relative cross-sectional fiber areas (RCSA) were calculated. To analyze differences in fiber type composition between healthy persons and persons with NSCLBP, a repeated measurements analysis of variance was used. Secondary outcome measures were analyzed using a Student's t test, and Wilcoxon test. This study was supported by the research fund of Hasselt University without potential conflict of interest. RESULTS There were no significant differences between both groups regarding anthropometric data. There were no significant between group differences for CSA in the ES. Persons with NSCLBP displayed a nonsignificant (p=.0978) increase in the number of type I muscle fibers, and a significant decrease (p=.0019) in the number of type IIx muscle fibers in the ES muscle. Persons with NSCLBP also displayed a trend toward a higher (p=.0596) RCSA for type I fibers and a significantly lower RCSA for type IIx fibers (p=.0411). There were no significant between group differences within the MF. Regarding the secondary outcome measures, there was a significant between group difference in activity level (p=.0004) and isokinetic back muscle strength (p=.0342). CONCLUSIONS This is the first study to examine muscle fiber type characteristics in both the ES and MF muscle of persons with NSCLBP. Based on muscle fiber characteristics, the paraspinal muscles of persons with NSCLBP seems to display a larger oxidative potential based on an increase of the number type I fibers at the expense of type IIx glycolytic fibers.
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Affiliation(s)
- Anouk Agten
- Hasselt University, Rehabilitation Research Center, Faculty of Rehabilitation Sciences and Physiotherapy, Agoralaan building A, 3590 Diepenbeek, Belgium.
| | - Sjoerd Stevens
- Hasselt University, Rehabilitation Research Center, Faculty of Rehabilitation Sciences and Physiotherapy, Agoralaan building A, 3590 Diepenbeek, Belgium
| | - Jonas Verbrugghe
- Hasselt University, Rehabilitation Research Center, Faculty of Rehabilitation Sciences and Physiotherapy, Agoralaan building A, 3590 Diepenbeek, Belgium
| | - Annick Timmermans
- Hasselt University, Rehabilitation Research Center, Faculty of Rehabilitation Sciences and Physiotherapy, Agoralaan building A, 3590 Diepenbeek, Belgium
| | - Frank Vandenabeele
- Hasselt University, Rehabilitation Research Center, Faculty of Rehabilitation Sciences and Physiotherapy, Agoralaan building A, 3590 Diepenbeek, Belgium
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Landing Kinematics, Sports Performance, and Isokinetic Strength in Adolescent Male Volleyball Athletes: Influence of Core Training. J Sport Rehabil 2020; 29:65-72. [PMID: 30526235 DOI: 10.1123/jsr.2018-0015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 10/15/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Core control and strength are important for reducing the risk of lower-extremity injury. Current evidence on the effect of core training in male adolescent athletes is limited, and other investigations into the effects of core training often emphasized core strength only. OBJECTIVE To examine whether core training emphasizing both control and strength of the trunk and hip would improve joint kinematics during landing, sports performance, and lower-extremity muscle strength in adolescent male volleyball athletes. DESIGN Single group pretest and posttest design. SETTING University laboratory. PARTICIPANTS Sixteen male participants (age: 13.4 [1] y, height: 167.8 [8.6] cm, mass: 58.6 [13.9] kg, and volleyball experience: 3.8 [1.5] y) from a Division I volleyball team at a junior high school. MAIN OUTCOME MEASUREMENTS Kinematics of the trunk and lower-extremity during box landing and spike jump landing tasks, volleyball-related sports performance, and isokinetic strength of hip and knee muscles were assessed before and after a 6-week core training program. RESULTS After training, the participants demonstrated decreased trunk flexion angle (P = .01, Cohen's d = 0.78) during the box landing task and reduced the maximum knee internal rotation angle (P = .04, Cohen's d = 0.56) during the spike jump landing task. The average isokinetic strength of hip flexors and external rotators, and knee flexors and extensors also significantly increased (P = .001, Cohen's d = 0.98; P = .04, Cohen's d = 0.57; P = .02, Cohen's d = 0.66; P = .003, Cohen's d = 0.87, respectively); however, sports performance did not show significant changes. CONCLUSIONS A more erect landing posture following training suggests that the core training program may be beneficial for improving core stability. The long-term effect of core training for knee injury prevention needs further investigation.
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Ozsoy G, Ilcin N, Ozsoy I, Gurpinar B, Buyukturan O, Buyukturan B, Kararti C, Sas S. The Effects Of Myofascial Release Technique Combined With Core Stabilization Exercise In Elderly With Non-Specific Low Back Pain: A Randomized Controlled, Single-Blind Study. Clin Interv Aging 2019; 14:1729-1740. [PMID: 31631992 PMCID: PMC6790630 DOI: 10.2147/cia.s223905] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/18/2019] [Indexed: 01/10/2023] Open
Abstract
Purpose To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP). Patients and methods A total of forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment. Results It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05). Conclusion The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly. ClinicalTrials.gov Identifier NCT03898089.
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Affiliation(s)
- Gulsah Ozsoy
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Nursen Ilcin
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ismail Ozsoy
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Barış Gurpinar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Oznur Buyukturan
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Buket Buyukturan
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Caner Kararti
- School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - Senem Sas
- Department of Physical Medicine and Rehabilitation, Kırsehir Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
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Borujeni BG, Yalfani A. Effect of respiratory muscle training session on ankle muscle activity in athletes with chronic low back pain performing overhead squats: a randomized controlled trial. INT J EVID-BASED HEA 2019; 18:256-264. [PMID: 31567604 DOI: 10.1097/xeb.0000000000000204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM The current study was conducted to evaluate the effect of a respiratory muscle training session on ankle muscle activity in athletes with chronic low back pain performing overhead squats. METHODS The current double-blind, randomized, controlled trial was conducted on 24 patients randomly selected as the training group and 23 patients as the control group. The training group received the respiratory muscle training protocol. The electromyography activity of the tibialis anterior, peroneus longus, gastrocnemius medialis and gastrocnemius lateralis muscles of the dominant leg was recorded in the participants. RESULTS The findings showed that a session of respiratory muscle training reduced the activities of some ankle joint muscles when performing overhead squats, including tibialis anterior in the static and dynamic overhead squat tests and peroneus longus in the ascending phase. In the dynamic test, the angle to reach peak activity changed in tibialis anterior in the descending phase and also in tibialis anterior and peroneus longus in the ascending phase. CONCLUSION Effects of respiratory muscle training prevented excessive ankle joint muscle activity through stimulating local muscles while performing overhead squats, which had indicated an improved postural control and multisectional proprioception to maintain postural stability and stimulated the local muscles of the core area.
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Affiliation(s)
- Behnam Gholami Borujeni
- Department of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
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