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Coleman M, Linières J, Thery C, Gautier A, Daste C, Rannou F, Nguyen C, Lefèvre-Colau MM, Rören A. Changes in isokinetic trunk muscle strength and endurance after two different restoration programs in people with chronic low back pain: A longitudinal retrospective study. Heliyon 2024; 10:e34914. [PMID: 39145024 PMCID: PMC11320202 DOI: 10.1016/j.heliyon.2024.e34914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 08/16/2024] Open
Abstract
Background Multidisciplinary functional restoration programs (FRPs) aim to improve pain and function in people with chronic low back pain (CLBP). The intensity and content of FRPs varies; the benefits of one program over another are unclear. Objective To assess changes in trunk muscle strength and endurance after an intensive (IFRP) (for people on sick leave for >6 months with high levels of fear-avoidance beliefs about physical activity and work) or semi-intensive (SIFRP) (for people working) FRP in people with CLBP. Methods Longitudinal retrospective study from March 2016 to December 2019. Setting: rehabilitation department of a tertiary care center. Trunk flexor and extensor muscle strength (60°.s-1) and endurance (120°.s-1) were measured with the Humac NORM isokinetic dynamometer at pre and post FRP. Change in isokinetic variables (peak torque, total work and flexor/extensor ratio) after each program was assessed with a paired t-test (p < 0.05). Pearson's rho and multiple linear regression assessed associations between changes in isokinetic and clinical variables and demographic characteristics. Results 125 individuals, 63.2 % female, age 43.5 (10.3) years, were included. Mean low back pain intensity was 49.8 (24.9) and 37.2 (25.8)/100 and mean activity limitation (QBPDS) was 38.8 (16.4) and 32.0 (14.6)/100 in the IFRP and SFRP groups, respectively. Trunk extensor peak torque, flexor total work, extensor total work and flexor/extensor peak ratio improved significantly in both FRPs, p < 0.001. The flexor/extensor total work ratio improved in the IFRP group only, p = 0.003. Trunk extensor endurance increased more in the IFRP than the SIFRP group, the absolute pre-post differences for extensor total work [95%CI] N.m were 611.7 [495.2; 728.3] in the IFRP group and 380.0 [300.8; 459.3] in the SIFRP group. No variables were correlated and none predicted improvement in extensor total work in either group. Conclusion This study highlights the short-term independence of clinical and trunk muscle strength and endurance changes.
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Affiliation(s)
- Marvin Coleman
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
- Université Paris Cité, Institut des Sciences du Sport-Santé de Paris (URP 3625), F-75015, Paris, France
| | - Jonathan Linières
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
| | - Camille Thery
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
| | - Adrien Gautier
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
| | - Camille Daste
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
- Université Paris Cité, INSERM, UMR 1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité, 75004, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006, Paris, France
- Fédération pour la Recherche sur le Handicap et l’Autonomie, 75013, Paris, France
| | - François Rannou
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006, Paris, France
- Fédération pour la Recherche sur le Handicap et l’Autonomie, 75013, Paris, France
- Université Paris Cité, INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs, Campus Saint-Germain-des-Prés, 75006, Paris, France
| | - Christelle Nguyen
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006, Paris, France
- Fédération pour la Recherche sur le Handicap et l’Autonomie, 75013, Paris, France
- Université Paris Cité, INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs, Campus Saint-Germain-des-Prés, 75006, Paris, France
| | - Marie-Martine Lefèvre-Colau
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
- Université Paris Cité, INSERM, UMR 1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité, 75004, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006, Paris, France
- Fédération pour la Recherche sur le Handicap et l’Autonomie, 75013, Paris, France
| | - Alexandra Rören
- AP-HP, Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014, Paris, France
- Université Paris Cité, INSERM, UMR 1153, Centre de Recherche en Épidémiologie et Statistique Sorbonne Paris Cité, 75004, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006, Paris, France
- Fédération pour la Recherche sur le Handicap et l’Autonomie, 75013, Paris, France
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Alfaya FF, Reddy RS, Alshahrani MS, Gautam AP, Mukherjee D, Al Salim ZA, Alqhtani RS, Ghulam HSH, Alyami AM, Al Adal S, Jabour AA. Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform. Life (Basel) 2023; 13:2104. [PMID: 37895485 PMCID: PMC10608059 DOI: 10.3390/life13102104] [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: 09/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023] Open
Abstract
Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.
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Affiliation(s)
- Fareed F Alfaya
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Zuhair A Al Salim
- Department of Sport Science and Physical Activity, College of Science, University of Hafr Al Batin, Hafr Al Batin 39524, Saudi Arabia
| | - Raee S Alqhtani
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Hussain Saleh H Ghulam
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Abdullah Mohammed Alyami
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Saeed Al Adal
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
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Hinnekens S, Bara J, Scheen P, Hidalgo B. Sex-related differences in motor control strategies during isometric contractions in the Sorensen test posture with different external loading. J Back Musculoskelet Rehabil 2022; 36:651-660. [PMID: 36530075 DOI: 10.3233/bmr-220058] [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: 12/15/2022]
Abstract
BACKGROUND There is a sex-related difference in strength and endurance in trunk muscles: males have more strength while females have more endurance. OBJECTIVE Investigate sex-related differences in motor control strategies in back muscles during isometric contractions (IC) in the Sorensen test posture. METHODS Thirty-six healthy and young volunteers performed different tasks: three maximal voluntary contraction (MVC) tests recorded with a bio-feedback force sensor, and followed by five loaded IC (LIC) tests using bodyweight and loads of 0 to 8 kg with a 2-kg step. Surface electromyography was used to measure the activity of bilateral lumbar paravertebral (LP) and quadratus lumborum (QL) muscles. RESULTS Sex-related and load-related differences in EMG amplitudes were highlighted during LIC tests. Females showed significantly (p-value = 0.02) greater EMG amplitude for the highest load (8 kg) than males. Besides, significant differences between low (2 and 4 kg) and high (6 and 8 kg) loads for both LP and QL muscles and for both sexes were observed. Finally, for MVC tests, males produced significantly (p-value = 1.02e-4) greater strength during MVC tests (4.25 ± 1.37 N/kg vs 2.60 ± 0.78 N/kg). CONCLUSION The results were clinically relevant to bring attention to load strategy during rehabilitation, particularly in females who seemed to recruit the QL muscle more.
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Affiliation(s)
- Simon Hinnekens
- Mechatronic, Electrical Energy & Dynamic Systems (MEED), Institute of Mechanics, Materials & Civil Engineering (iMMC), Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Julie Bara
- Faculté des Sciences de la Motricité, Université catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Pauline Scheen
- Faculté des Sciences de la Motricité, Université catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Benjamin Hidalgo
- Faculté des Sciences de la Motricité, Université catholique de Louvain, Louvain-La-Neuve, Belgium.,Neuromusculoskeletal Lab (NMSK), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium.,Haute Ecole Léonard de Vinci, Département de Kinésithérapie, Brussels, Belgium
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Lenoir dit Caron R, Rouzée M, Coquart J, Gilliaux M. Compliance with a personalised home exercise programme in chronic low back pain patients after a multidisciplinary programme: A pilot randomised controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1050157. [PMID: 36466941 PMCID: PMC9712950 DOI: 10.3389/fresc.2022.1050157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 12/21/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a very common problem throughout the world. One treatment possibility is the multidisciplinary programme (MP) in a rehabilitation centre, which provides intensive rehabilitation through physical exercise to quickly improve the patient conditions. Patients nevertheless do not always continue the exercises when they return home. This study thus evaluated compliance with a personalised home-based programme for CLBP patients post-MP. METHODS A randomised controlled single-blind trial was conducted. Thirty patients were randomised into two groups and participated in an MP for 4 weeks. They were then given an exercise booklet for home rehabilitation. In addition, each patient in the experimental group constructed a personalised exercise programme with a physiotherapist. The control group was only encouraged to continue the exercises at home. To assess therapeutic compliance, both groups were asked to document each completed exercise in a logbook. In addition, pain intensity, flexibility, muscle endurance, activity limitations, participation restrictions, and beliefs about physical activity were assessed at the beginning and end of the MP and again after 12 weeks at home. RESULTS Compliance was good for all activities in both groups, but there were no significant differences between groups. All participants improved on the criteria by the end of MP, and both groups maintained the improvements in most of the criteria at 3-month follow-up. CONCLUSION This study showed the effectiveness of an MP for CLBP in the short and medium term. However, future research should focus on longer-term compliance.
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Affiliation(s)
- R. Lenoir dit Caron
- Normandie University, CETAPS Laboratory, UR 3832, Mont Saint Aignan, France
- Clinical Research Department, La Musse Hospital (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France
| | - M. Rouzée
- Cabinet de Kinésithérapie, Ferrière-Haut-Clocher, France
| | - J. Coquart
- Unité de Recherche Pluridisciplinaire Sport Santé Société” is a departement, Univ. Lille, Univ. Artois, Univ. Littoral Côte D'Opale, ULR 7369 - URePSSS - Unité de Recherche Pluridisciplinaire Sport Santé Société, Liévin, France
| | - M. Gilliaux
- Normandie University, CETAPS Laboratory, UR 3832, Mont Saint Aignan, France
- Clinical Research Department, La Musse Hospital (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France
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Fältström A, Skillgate E, Tranaeus U, Weiss N, Källberg H, Lyberg V, Nomme M, Thome N, Omsland T, Pedersen E, Hägglund M, Waldén M, Asker M. Normative values and changes in range of motion, strength, and functional performance over 1 year in adolescent female football players: Data from 418 players in the Karolinska football Injury Cohort study. Phys Ther Sport 2022; 58:106-116. [DOI: 10.1016/j.ptsp.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/28/2022]
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Functional Performance, Leg Muscle Strength, and Core Muscle Endurance in Multiple Sclerosis Patients With Mild Disability: A Cross-Sectional Study. Motor Control 2022; 26:729-747. [PMID: 36068072 DOI: 10.1123/mc.2021-0129] [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: 11/22/2021] [Revised: 06/20/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to investigate the relationship of sit-to-stand and walking performance with leg muscle strength and core muscle endurance in people with multiple sclerosis (PwMS) with mild disabilities. In this study, 49 PwMS (Expanded Disability Status Scale score = 1.59 ± 0.79) and 26 healthy controls were enrolled. The functional performances, including sit-to-stand and walking performances, were evaluated with the five-repetition sit-to-stand test, timed up and go test, and 6-min walking test. The PwMS finished significantly slower five-repetition sit-to-stand, timed up and go, and 6-min walking test than the healthy controls. In addition, the significant contributors were the weakest trunk lateral flexor endurance for five-repetition sit-to-stand; the Expanded Disability Status Scale score, and the weakest hip adductor muscle for timed up and go; the weakest hip extensor muscles strength for 6-min walking test. The functional performances in PwMS, even with mild disabilities, were lower compared with healthy controls. Decreases in both leg muscle strength and core muscle endurance are associated with lower functional performance in PwMS.
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Tsolakis C, Cherouveim ED, Skouras AZ, Antonakis-Karamintzas D, Czvekus C, Halvatsiotis P, Savvidou O, Koulouvaris P. The Impact of Obesity on the Fitness Performance of School-Aged Children Living in Rural Areas-The West Attica Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811476. [PMID: 36141749 PMCID: PMC9517351 DOI: 10.3390/ijerph191811476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 05/17/2023]
Abstract
This study aimed to investigate the relationship of body mass index (BMI) with muscle and cardiorespiratory fitness in children living within rural areas (regional unit of West Attica) in Greece. Participants included 399 students (187 boys, 212 girls), ages 8-12 years old, and were evaluated in physical performance tests. The point prevalence of overweight and obesity was 21.39% and 26.20% in boys, and 19.90% and 23.79% in girls. Significant differences were observed in all physical performance tests (handgrip, long jump, shuttle run, trunk flexors, and extensors endurance) between normal weight and obese participants. BMI was positively correlated with handgrip (r = 0.442-0.462, p < 0.001). There was a negative association with long jump (r = -0.206, p < 0.001), 20 m shuttle run (r = -0.394, p < 0.001), trunk flexors (r = -0.403, p < 0.001) and trunk extensors endurance (r = -0.280, p < 0.001). The regression analysis showed that 20-30% of the overall variation for physical performance assessments could be accounted for by BMI, age, and sex. With the exception of the long jump and the endurance of the trunk extensors, BMI alone may explain more than 10% of the outcome of most tests. This study highlights the determinant of BMI on muscle and cardiorespiratory fitness. The management of obesity should begin early in childhood to prevent adult chronic cardiovascular and metabolic diseases.
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Affiliation(s)
- Charilaos Tsolakis
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
- Correspondence: ; Tel.: +30-693-275-5173
| | - Evgenia D. Cherouveim
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
- School of Physical Education & Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
| | - Apostolos Zacharias Skouras
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | | | - Cara Czvekus
- Health Science, James Madison University, Harrisonburg, VA 22807, USA
| | - Panagiotis Halvatsiotis
- 2nd Department of Internal Medicine Propaedeutic “Attikon” University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Olga Savvidou
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Panagiotis Koulouvaris
- 1st Department of Orthopedics Surgery, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
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Nishimura Y, Tsuboi H, Murata KY, Minoshima Y, Sato H, Umezu Y, Tajima F. Comparison of erector spinae fatigability between female patients with Parkinson's disease and healthy individuals: a cross sectional pilot study. BMC Neurol 2022; 22:189. [PMID: 35606705 PMCID: PMC9125835 DOI: 10.1186/s12883-022-02719-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postural abnormality is one of the main symptoms of Parkinson's disease (PD). The erector spinae muscles play an important role in maintaining an upright posture, but the fatigability of the erector spinae in patients with PD is unknown. The purpose of this study was to compare the trunk extension maximum voluntary contraction (MVC) and the fatigability of the erector spinae between female patients with PD and healthy volunteers. METHODS Th participants of this cross-sectional pilot study comprised 19 patients with PD and nine healthy volunteers matched for sex, age, and physical characteristics as a control group. The MVC of all participants was measured, and after sufficient rest, the Sørensen back endurance test was conducted to the point of exhaustion. The muscle activity of the erector spinae during the Sørensen back endurance test was measured using surface electromyography. The median frequency (MF) slope, which is an index of fatigability, was calculated from the recorded surface muscle activity by means of power spectrum analysis using a Fast Fourier transformation. RESULTS Nine of the 19 patients with PD were unable to perform the Sørensen back endurance test, and a lower proportion of the PD group were able to perform it compared with the control group. The MVC of those patients with PD who were able to perform the Sørensen back endurance test was lower than that of the control group, and the time for which the pose could be maintained was shorter. There was no significant difference between the MF slope on the left and right side in the PD group, and it was higher on both sides than in the control group. CONCLUSION This is the first study to demonstrate a reduction of maximum muscle strength and great fatigability of the erector spinae in patients with PD. This discovery strongly underlines the need for paraspinal muscle training from an early stage with the aim of preventing the progression of postural abnormality in patients with PD.
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Affiliation(s)
- Yukihide Nishimura
- Department of Rehabilitation Medicine, Iwate Medical University, Yahaba-cho Shiwa-gun, Iwate, 028-3695, Japan.
| | - Hiroyuki Tsuboi
- Rehabilitation Division, Iwate Medical University Hospital, Iwate, Japan
| | - Ken-Ya Murata
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Yuta Minoshima
- Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Hideyuki Sato
- Department of Rehabilitation, Konan Medical Center, Hyogo, Japan
| | - Yuichi Umezu
- Department of Rehabilitation, Kokura Rehabilitation Hospital, Fukuoka, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
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Langenfeld A, Wirth B, Scherer-Vrana A, Riner F, Gaehwiler K, Valdivieso P, Humphreys BK, Scholkmann F, Flueck M, Schweinhardt P. No alteration of back muscle oxygenation during isometric exercise in individuals with non-specific low back pain. Sci Rep 2022; 12:8306. [PMID: 35585081 PMCID: PMC9117220 DOI: 10.1038/s41598-022-11683-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was (I) To compare back muscle oxygenation and perfusion as well as Biering–Sorensen muscle endurance (BSME) test holding times between chronic non-specific low back pain (CNSLBP) patients and asymptomatic controls matched for age, body mass index (BMI), sex and physical activity, and (II) to investigate factors associated with BSME holding times. Muscle perfusion (tHb) and oxygenation (SmO2) were measured by near-infrared spectroscopy (NIRS) based oximetry in three back muscles during the BSME. Reliability of tHb and SmO2 was assessed in a separate sample. BSME holding time and SmO2 were compared between patients (n = 45) and controls (n = 45) and factors associated with BSME holding time were assessed using multiple linear regression. Reliability for SmO2 was excellent (ICC = 0.87–0.99). THb showed poor to moderate reliability and was not further used. Groups differed for BSME holding time (P = 0.03), pain intensity (P ≤ 0.0005) and subcutaneous tissue thickness (P = 0.01) but not for NIRS measures. Physical activity and BMI were associated with BSME holding times. Insufficient muscle oxygenation does not seem to be a major factor contributing to CNSLBP. Future investigation should evaluate other determinants of BSME holding times, such as motivation and recruitment of auxiliary muscles.
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Affiliation(s)
- Anke Langenfeld
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Brigitte Wirth
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.,Winterthur Institute of Health Economics, School of Management and Law, University of Applied Sciences, Gertrudstr. 15, 8400, Winterthur, Switzerland
| | - Andrea Scherer-Vrana
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Fabienne Riner
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Kyra Gaehwiler
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Paola Valdivieso
- Laboratory of Muscle Plasticity, Balgrist University Hospital and University of Zurich, Balgrist Campus, Lengghalde 5, 8008, Zurich, Switzerland
| | - B Kim Humphreys
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Felix Scholkmann
- Scholkmann Data Analysis Services, Scientific Consulting and Physical Engineering, Schuppisstr. 5, 8057, Zurich, Switzerland.,Department for Neonatology, University Hospital Zurich and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Martin Flueck
- Laboratory of Muscle Plasticity, Balgrist University Hospital and University of Zurich, Balgrist Campus, Lengghalde 5, 8008, Zurich, Switzerland.,Swiss Federal Institute of Sport Magglingen SFISM, Lärchenplatz building HLP 107, 2532, Magglingen, Switzerland
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Balgrist University Hospital and University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
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Tranaeus U, Weiss N, Lyberg V, Hagglund M, Waldén M, Johnson U, Asker M, Skillgate E. Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players: the Karolinska football Injury Cohort (KIC). BMJ Open 2022; 12:e055063. [PMID: 35022175 PMCID: PMC8756291 DOI: 10.1136/bmjopen-2021-055063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Football is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify risk factors for injury in adolescent female football players. METHODS AND ANALYSIS The Karolinska football Injury Cohort (KIC) is an ongoing longitudinal study that will include approximately 400 female football academy players 12-19 years old in Sweden. A detailed questionnaire regarding demographics, health status, lifestyle, stress, socioeconomic factors, psychosocial factors and various football-related factors are completed at baseline and after 1 year. Clinical tests measuring strength, mobility, neuromuscular control of the lower extremity, trunk and neck are carried out at baseline. Players are followed prospectively with weekly emails regarding exposure to football and other physical activity, health issues (such as stress, recovery, etc), pain, performance and injuries via the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O). Players who report a substantial injury in the OSTRC-O, that is, not being able to participate in football activities, or have reduced their training volume performance to a moderate or major degree, are contacted for full injury documentation. In addition to player data, academy coaches also complete a baseline questionnaire regarding coach experience and education. ETHICS AND DISSEMINATION The study was approved by the Regional Ethical Review Authority at Karolinska Institutet, Stockholm, Sweden (2016/1251-31/4). All participating players and their legal guardians give their written informed consent. The study will be reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology. The results will be published in peer-reviewed academic journals and disseminated to the Swedish football movement through stakeholders and media.
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Affiliation(s)
- Ulrika Tranaeus
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nathan Weiss
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Victor Lyberg
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Martin Hagglund
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Linköping University, Linkoping, Sweden
- Football Research Group, Linköping, Sweden
| | - Markus Waldén
- Sport Without Injury ProgrammE (SWIPE), Linköping University, Linkoping, Sweden
- Football Research Group, Linköping, Sweden
- Department of Orthopaedics, Hässleholm-Kristianstad Hospitals, Hässleholm, Sweden
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Martin Asker
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Eva Skillgate
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
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Thompson HR, Pavlovic A, D’Agostino E, Napier MD, Konty K, Day SE. The association between student body mass index and tests of flexibility assessed by the FITNESSGRAM®: New York City public school students, 2017-18. PLoS One 2022; 16:e0262083. [PMID: 34972179 PMCID: PMC8719681 DOI: 10.1371/journal.pone.0262083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
FITNESSGRAM® is the most widely used criterion-referenced tool to assess/report on student health-related fitness across the US. Potential weight-related biases with the two most common tests of musculoskeletal fitness–the trunk extension and Back-Saver Sit-and-Reach (sit-and-reach)—have been hypothesized, though have not been studied. To determine the association between musculoskeletal fitness test performance and weight status, we use data from 571,133 New York City public school 4th-12th grade students (85% non-White; 75% qualified for free or reduced-price meals) with valid/complete 2017–18 FITNESSGRAM® data. Adjusted logistic mixed effects models with a random effect for school examined the association between weight status and whether a student was in the Healthy Fitness Zone (HFZ; met sex- and age-specific criterion-referenced standards) for the trunk extension and sit-and-reach. Compared to students with normal weight, the odds of being in the HFZ for trunk extension were lower for students with underweight (OR = 0.77; 95% CI: 0.741, 0.795) and higher for students with overweight (OR = 1.10; 95% CI: 1.081, 1.122) and obesity (OR = 1.11; 95% CI: 1.090, 1.13). The odds of being in the HFZ for sit-and-reach were lower for students with underweight OR = 0.85; 95% CI: 0.826, 0.878), overweight (OR = 0.83; 95% CI: 0.819, 0.844) and obesity (OR = 0.65; 95% CI: 0.641, 0.661). Students with overweight and obesity perform better on the trunk extension, yet worse on the sit-and-reach, compared to students with normal weight. Teachers, administrators, and researchers should be aware of the relationship of BMI with student performance in these assessments.
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Affiliation(s)
- Hannah R. Thompson
- Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, California, United States of America
- * E-mail:
| | - Andjelka Pavlovic
- Division of Youth Education, The Cooper Institute®, Dallas, Texas, United States of America
| | - Emily D’Agostino
- Department of Population Health Sciences, Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Melanie D. Napier
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Kevin Konty
- Office of School Health, New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Sophia E. Day
- Office of School Health, New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
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Isometric Trunk Strength Assessment of Athletes: Effects of Sex, Sport, and Low Back Pain History. J Sport Rehabil 2021; 31:38-46. [PMID: 34552035 DOI: 10.1123/jsr.2021-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/08/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT The importance of isometric trunk strength (ITS) among sport science professionals is higher than its actual reported effect size on either performance or low back pain (LBP) occurrence. OBJECTIVE To provide normative values of ITS and strength ratios, and to evaluate the effect of sex, sports discipline, and LBP status. DESIGN Crossover study. SETTING University research laboratory. PARTICIPANTS Five hundred and sixty-seven elite athletes (186 females) with and without a history of LBP from different sports. MAIN OUTCOME MEASURE Participants underwent ITS testing for trunk flexors, extensors, and lateral flexors. Normalized maximal strength (in newton meter per kilogram) and strength ratios were calculated. Differences between sex, LBP, and sport disciplines were assessed with 3-way analysis of variance (sex × LBP status × 7 sport categories) and partial eta-squared (ηp2) effect size. The predictive validity of ITS for LBP was checked with receiver operating characteristics (area under the curve). RESULTS The authors found significant differences in extensor and flexor ITS in favor of male athletes (medium ηp2, P < .05), while sex differences in lateral flexion ITS had a low size effect (P < .05). A low size effect was also observed for the differences in strength ratios extensors/flexors (mean 1.47; 95% confidence interval, 1.45-1.50) and left flexors/right flexors (mean 0.99; 95% confidence interval, 0.98-1.01) among sexes. The sport discipline-related differences generally had a low size effect. No significant differences in ITS were found between LBP and LBP-free athletes. Only 50% to 58% of athletes (area under the curve, 0.501-0.582) were correctly classified as LBP or LBP-free using different ITS and strength ratio variables. CONCLUSIONS ITS and strength ratios have low predictive validity for LBP history but may discriminate between sex and sport disciplines. Our data are a useful reference point for meaningful individual results interpretation when athletes are evaluated during training or rehabilitation.
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Exercise interventions can improve muscle strength, endurance, and electrical activity of lumbar extensors in individuals with non-specific low back pain: a systematic review with meta-analysis. Sci Rep 2021; 11:16842. [PMID: 34413400 PMCID: PMC8376921 DOI: 10.1038/s41598-021-96403-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/05/2021] [Indexed: 12/13/2022] Open
Abstract
Exercise interventions have been recommended for people with non-specific low back pain. The literature is scarce regarding the effects of exercise on muscle strength, endurance, and electrical activity of lumbar extensor muscles. Electronic searches were carried out from May 2020 until August 2020 in the following databases: PUBMED, CENTRAL, EMBASE, PEDro, SPORTDiscus, Scielo, and LILACS. Only randomized controlled trials with passive and active control groups were included. The methodological quality of the included studies was performed using the Physiotherapy Evidence Database Scale. Eight studies, involving 508 participants, were included in metanalytical procedures. Exercise interventions demonstrated superior effects on muscle activity (Electromyography) when compared with active controls (p < 0.0001). Exercise interventions demonstrated superior effects on muscle endurance (Sorensen Test) when compared with passive (p = 0.0340) and active controls (p = 0.0276). Exercise interventions demonstrated superior effects on muscle strength (Machine) when compared with passive controls (p = 0.0092). Exercise interventions can improve muscle strength, endurance, and electrical activity in people with non-specific low back pain.
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Martínez-Romero MT, Ayala F, Aparicio-Sarmiento A, De Ste Croix M, Sainz De Baranda P. Reliability of five trunk flexion and extension endurance field-based tests in high school-aged adolescents: ISQUIOS programme. J Sports Sci 2021; 39:1860-1872. [PMID: 33775212 DOI: 10.1080/02640414.2021.1903706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to explore the inter-session reliability of the measures obtained from 2 trunk extension (Biering-Sorensen and Dynamic Extensor Endurance (DEE) tests) and 3 trunk flexion (Ito, Side Bridge and Bench Trunk Curl-Up (BTC) tests) endurance field-based tests in adolescents. A total of 208 (males, n = 100; females, n = 108) adolescents performed all the field-based tests on 2 separate testing sessions, 7-days apart. The inter-session reliability scores were explored through relative reliability, inter-session differences and precision of measurements. Most of the trunk endurance measures demonstrated acceptable relative reliability (the intraclass correlation coefficients (ICC) ranged from 0.75 to 0.94). However, significant inter-session differences were identified for measures from the DEE and BTC tests. Likewise, the precision of the measurement of each field-based test was poor (the the standard error of measurement expressed as a percentage of the mean score (CVTE) ranged from 11.3 to 24.4%) with the minimal detectable change (MDC95) revealing that changes higher than 42% for trunk extension endurance tests and 31.4% for trunk flexion endurance tests after an intervention are required to indicate a significant change above measurement error. Therefore, the findings from this study indicate that only the BTC test demonstrates acceptable inter-session reliability (ICC > 0.9, CVTE ~ 10%, MDC95 ~ 30%) to monitor the changes in trunk endurance scores that may be expected in adolescents after performing an intervention programme.
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Affiliation(s)
- María Teresa Martínez-Romero
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Francisco Ayala
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain.,Ramon y Cajal post doctoral fellow (RYC2019-028383-I/AEI/10.13039/501100011033)
| | - Alba Aparicio-Sarmiento
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Mark De Ste Croix
- Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain.,School of Sport and Exercise, Exercise and Sport Research Centre, University of Gloucestershire, Gloucester, UK
| | - Pilar Sainz De Baranda
- Department of Physical Activity and Sport, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain.,Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
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15
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Lancaster GD, Stilley JD, Franke WD. How Does Rescuer Fitness Affect the Quality of Prolonged Cardiopulmonary Resuscitation? PREHOSP EMERG CARE 2021; 26:195-203. [PMID: 33620281 DOI: 10.1080/10903127.2021.1894275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: High quality cardiopulmonary resuscitation (CPR) is crucial for patients experiencing cardiac arrest. CPR quality declines within the first few minutes of CPR performance. Being more fit is associated with higher CPR quality, yet the fitness parameters needed remain uncertain. It is also unknown how CPR quality is affected during a protocol of realistic CPR when rescuers switch compressors every two minutes, as recommended by the American Heart Association (AHA), and extended duration, as might be encountered with an out-of-hospital cardiac arrest. The purpose of the present study is to determine the extent to which different measures of physical fitness predict high quality CPR performance when rescuers follow current CPR guidelines. Methods: Subjects underwent a fitness assessment evaluating lower back muscular endurance, abdominal muscular endurance, upper body muscular strength, and upper body anaerobic power. At least 48 hours later, subjects returned to the laboratory for CPR testing. CPR quality was determined by compression rate (>100/minute), compression depth (>2 inches, or 50 mm), and adequate (full) chest recoil between compressions, based on American Heart Association guidelines. A CPR Quality Score, designed to represent cardiac output, was calculated as the product of compression rate and depth. Results: Thirty-three of 42 subjects were able to achieve a CPR Quality Score greater than 5000, the minimum needed to meet AHA recommendations. Higher anaerobic power and bench press scores were predictive of both high CPR Quality Scores (R2=0.47) and compression depth (R2=0.47). Sex (female) was predictive of better chest compression recoil percentages (R2=0.15). Conclusion: Most rescuers can maintain high quality CPR if given two minute breaks between cycles. Rescuers with high anaerobic fitness and muscular strength may be able to provide higher quality CPR.
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Spatial Distribution and Asymmetry of Surface Electromyography on Lumbar Muscles of Soldiers with Chronic Low Back Pain. Pain Res Manag 2020; 2020:6946294. [PMID: 33163126 PMCID: PMC7605927 DOI: 10.1155/2020/6946294] [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: 04/20/2020] [Revised: 07/07/2020] [Accepted: 10/14/2020] [Indexed: 11/17/2022]
Abstract
This study investigated spatial distribution and asymmetry of surface electromyography on lumbar muscles during a sustained contraction in soldiers with and without chronic low back pain. Twenty healthy soldiers and twenty chronic low back pain (CLBP) soldiers had performed the Sorensen test with a duration of 60 seconds. The corresponding muscle fatigue, spatial distribution, and the asymmetry of muscle activity over bilateral paraspinal lumbar regions were measured by the high-density surface electromyography (HDsEMG). The paired and independent samples t-tests were performed to compare the degree of muscle fatigue and asymmetry. The repeated-measures analyses of variance (ANOVA) were used to compare spatial distribution between groups and muscle fatigue. The baseline characteristics of soldiers between groups were comparable. CLBP soldiers had significantly less muscle fatigue on both sides of erector spinae compared to healthy ones. The spatial distribution was significantly associated with the group factor but independent of muscle fatigue. In addition, the asymmetry of erector spinae activity in the CLBP soldiers was significantly higher than the healthy one. In conclusion, uneven spatial distribution and asymmetry of lumbar muscle activity play significant roles in CLBP patients. The HDsEMG could be used as an objective method in distinguishing the function of the erector spinae between healthy individuals and CLBP patients during 1 min sustained contraction.
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Martínez-Romero MT, Ayala F, De Ste Croix M, Vera-Garcia FJ, Sainz de Baranda P, Santonja-Medina F, Sánchez-Meca J. A Meta-Analysis of the Reliability of Four Field-Based Trunk Extension Endurance Tests. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3088. [PMID: 32365490 PMCID: PMC7246735 DOI: 10.3390/ijerph17093088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/26/2020] [Indexed: 12/30/2022]
Abstract
This meta-analysis aimed to estimate the inter- and intra-tester reliability of endurance measures obtained through trunk extension field-based tests and to explore the influence of the moderators on the reliability estimates. The reliability induction rate of trunk extension endurance measures was also calculated. A systematic search was conducted using various databases, and subsequently 28 studies were selected that reported intraclass correlation coefficients for trunk extension endurance measures. Separate meta-analyses were conducted using a random-effects model. When possible, analyses of potential moderator variables were carried out. The inter-tester average reliability of the endurance measure obtained from the Biering-Sorensen test was intraclass correlation coefficient (ICC) = 0.94. The intra-session reliability estimates of the endurance measures recorded using the Biering-Sorensen test, the prone isometric chest raise test, and the prone double straight-leg test were ICC = 0.88, 0.90, and 0.86, respectively. The inter-session average reliability of the endurance measures from the Biering-Sorensen test, the prone isometric chest raise test, and the dynamic extensor endurance test were ICC = 0.88, 0.95, and 0.99, respectively. However, due to the limited evidence available, the reliability estimates of the measures obtained through the prone isometric chest raise, prone double straight-leg, and dynamic extensor endurance tests should be considered with a degree of caution. Position control instruments, tools, and familiarization session demonstrated a statistical association with the inter-session reliability of the Biering-Sorensen test. The reliability induction rate was 72.8%. Only the trunk extension endurance measure obtained through the Biering-Sorensen test presented sufficient scientific evidence in terms of reliability to justify its use for research and practical purposes.
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Affiliation(s)
- María Teresa Martínez-Romero
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, 30720 San Javier (Murcia), Spain
| | - Francisco Ayala
- Department of Sport Science, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche (Alicante), Spain
| | - Mark De Ste Croix
- School of Sport and Exercise, Exercise and Sport Research Centre, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - Francisco J. Vera-Garcia
- Department of Sport Science, Sports Research Centre, Miguel Hernández University of Elche, 03202 Elche (Alicante), Spain
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, 30720 San Javier (Murcia), Spain
| | - Fernando Santonja-Medina
- Department of Surgery, Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Traumatology and Orthopedic Surgery Service, Virgen de la Arrixaca University Clinical Hospital, 30120 Murcia, Spain
| | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain
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Abstract
Supplemental digital content is available in the text. Objective This study investigates the feasibility, reliability, and correlations of recommended functional tests in lung transplant recipients shortly after surgery. Design This is an observational study. Methods Fifty patients (28 females) performed well-standardized maximum isometric back extension in a sitting position, handgrip strength, and Biering-Sørensen endurance tests shortly before discharge from the acute hospital, shortly thereafter, and 2 mos later after subacute rehabilitation. Results Back extension testing was well feasible, but only two thirds of the patients could perform the Biering-Sørensen test at baseline and they experienced a greater number of minor but no major adverse events. Absolute reliability measures and the intraclass correlation coefficients were excellent for the strength (0.97–0.98 [0.95–0.99]) and good for the endurance tests (0.69 [0.26–0.87]). Handgrip revealed high correlation with back strength (≥0.75) but not with Biering-Sørensen scores. Conclusions Well-controlled maximum back strength testing is feasible and reliable, and the scores are highly correlated with grip strength in lung transplant recipients shortly before hospital discharge. The Biering-Sørensen test should be limited to patients without dominant weakness and/or fear. Future research should investigate whether grip instead of back extension strength can safely be used for proper exercise prescription.
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Roghani T, Khalkhali Zavieh M, Talebian S, Akbarzadeh Baghban A, Katzman W. Back Muscle Function in Older Women With Age-Related Hyperkyphosis: A Comparative Study. J Manipulative Physiol Ther 2019; 42:284-294. [PMID: 31257003 DOI: 10.1016/j.jmpt.2018.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 11/08/2018] [Accepted: 11/15/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to compare static maximal back extensor muscle force, endurance, and characteristics of flexion relaxation phenomenon (FRP) in older women with and without age-related hyperkyphosis. METHODS Maximum back extensor force and endurance measured in a sitting position with a designed load cell setup; appearance, onset, and offset angles of FRP; and extension relaxation ratio (ERR) during a dynamic flexion-extension task were compared between 24 older women with hyperkyphosis (thoracic kyphosis angle ≥50°), mean age 65 ± 4.4 years, and 24 older women without hyperkyphosis (thoracic kyphosis angle ≪50°), mean age 63 ± 4.3 years. Variables of force, endurance, angles of FRP, and ERR were analyzed using an independent sample t test. A χ2 test was used to identify differences between groups in FRP appearance. RESULTS Static back extensor force and endurance were significantly lower among those with versus those without hyperkyphosis (P ≪ .001). Although the 2 groups did not differ in FRP appearance and ERR in the superficial erector spinal muscles (P ≫ .05), FRP in the hyperkyphosis group started sooner and ended later than in the group without hyperkyphosis (P ≪ .05). CONCLUSION Our study indicates that women with age-related hyperkyphosis had decreased static maximal force and endurance of the back extensor muscles and prolonged myoelectrical silence of the superficial erector spinal muscles. Reduced endurance of the superficial erector spinal muscles may trigger early onset of FRP and prolonged relaxation of these muscles.
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Affiliation(s)
- Tayebeh Roghani
- Musculoskeletal Research Center, Rehabilitation Research Institute and Department of Physical Therapy, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Khalkhali Zavieh
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences and Health Services, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Wendy Katzman
- Department of Physical Therapy and Rehabilitation Sciences, University of California, San Francisco, California
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González-Gálvez N, Poyatos MC, Marcos-Pardo PJ, Feito Y, Vale RGDS. PILATES TRAINING INDUCES CHANGES IN THE TRUNK MUSCULATURE OF ADOLESCENTS. REV BRAS MED ESPORTE 2019. [DOI: 10.1590/1517-869220192503163535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction The Pilates Method may be an appropriate form of exercise for improving trunk muscle strength, which can be a predictor of pain and musculoskeletal problems. Objective The objective of this study was to assess the effects of the Pilates Method on muscle strength and endurance of the extensor and flexor muscles of the trunk in a group of adolescents. Methods The sample consisted of 101 high-school students divided into two groups: an experimental group (EG=81) and a control group (CG=20). The intervention was carried out twice a week for six weeks. Each session lasted 55 minutes, and was divided into three parts: warm-up, main part, and cool down. Muscle strength was assessed by the Sörensen Test and the Bench Trunk-curl Test. The paired sample T-test, the T- test for independent samples, and Pearson’s correlation coefficient were applied. The size of the effect (d) was determined. Results The EG showed significant improvements in both tests (+34.77 points; +18.55 points, respectively). No changes were observed in the CG. The effect size was high (d>1.15) for both tests, which means that the results were improved in a large proportion of the participants. The control group showed a decline in strength of the trunk musculature. In the experimental group, both boys and girls showed significant improvements in both tests. This strength increase was enhanced for a large proportion of boys and girls (d>1.15). The effect size was high (d>1.15) for both tests and for both sexes. Conclusion Six-weeks after implementing the Pilates Method in Physical Education lessons, the muscle strength of the flexor and extensor muscles of the trunk in adolescents was improved. Level of Evidence II; Therapeutic studies-Investigation of treatment results.
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Affiliation(s)
| | | | | | - Yuri Feito
- Kennesaw State University, United States
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Schulz C, Evans R, Maiers M, Schulz K, Leininger B, Bronfort G. Spinal manipulative therapy and exercise for older adults with chronic low back pain: a randomized clinical trial. Chiropr Man Therap 2019; 27:21. [PMID: 31114673 PMCID: PMC6518769 DOI: 10.1186/s12998-019-0243-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background Low back pain (LBP) is a common disabling condition in older adults which often limits physical function and diminishes quality of life. Two clinical trials in older adults have shown spinal manipulative therapy (SMT) results in similar or small improvements relative to medical care; however, the effectiveness of adding SMT or rehabilitative exercise to home exercise is unclear. Methods We conducted a randomized clinical trial assessing the comparative effectiveness of adding SMT or supervised rehabilitative exercise to home exercise in adults 65 or older with sub-acute or chronic LBP. Treatments were provided over 12-weeks and self-report outcomes were collected at 4, 12, 26, and 52 weeks. The primary outcome was pain severity. Secondary outcomes included back disability, health status, medication use, satisfaction with care, and global improvement. Linear mixed models were used to analyze outcomes. The primary analysis included longitudinal outcomes in the short (week 4-12) and long-term (week 4-52). An omnibus test assessing differences across all groups over the year was used to control for multiplicity. Secondary analyses included outcomes at each time point and responder analyses. This study was funded by the US Department of Health and Human Services, Health Resources and Services Administration. Results 241 participants were randomized and 230 (95%) provided complete primary outcome data. The primary analysis showed group differences in pain over the one-year were small and not statistically significant. Pain severity was reduced by 30 to 40% after treatment in all 3 groups with the largest difference (eight percentage points) favoring SMT and home exercise over home exercise alone. Group differences at other time points ranged from 0 to 6 percentage points with no consistent pattern favoring one treatment. One-year post-treatment pain reductions diminished in all three groups. Secondary self-report outcomes followed a similar pattern with no important group differences, except satisfaction with care, where the two combination groups were consistently superior to home exercise alone. Conclusions Adding spinal manipulation or supervised rehabilitative exercise to home exercise alone does not appear to improve pain or disability in the short- or long-term for older adults with chronic low back pain, but did enhance satisfaction with care. Trial registration NCT00269321.
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Affiliation(s)
- Craig Schulz
- University of Minnesota, Mayo Building C504, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Roni Evans
- University of Minnesota, Mayo Building C504, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Michele Maiers
- Northwestern Health Sciences University, 2501 W. 84th Street, Bloomington, MN 55431 USA
| | - Karen Schulz
- Hennepin Healthcare Research Institute, 914 South 8th Street S3.116, Minneapolis, MN 55404 USA
| | - Brent Leininger
- University of Minnesota, Mayo Building C504, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Gert Bronfort
- University of Minnesota, Mayo Building C504, 420 Delaware Street SE, Minneapolis, MN 55455 USA
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22
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Grande-Alonso M, Suso-Martí L, Cuenca-Martínez F, Pardo-Montero J, Gil-Martínez A, La Touche R. Physiotherapy Based on a Biobehavioral Approach with or Without Orthopedic Manual Physical Therapy in the Treatment of Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial. PAIN MEDICINE 2019; 20:2571-2587. [DOI: 10.1093/pm/pnz093] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Objective
To compare the effectiveness of a biobehavioral approach with and without orthopedic manual physical therapy on the intensity and frequency of pain in patients diagnosed with nonspecific chronic low back pain.
Methods
A single-blind randomized controlled trial. Fifty patients were randomly allocated into two groups: one group received biobehavioral therapy with orthopedic manual physical therapy, and the other group received only biobehavioral therapy. Both groups completed a total of eight sessions, with a frequency of two sessions per week. The somatosensory, physical, and psychological variables were recorded at baseline and during the first and third month after initiation of treatment.
Results
In both groups, the treatment was effective, presenting significant differences for all the variables in the time factor. There were no significant differences between groups in intensity or frequency of pain, with a large effect size (>0.80), but there were intragroup differences for both intervention groups at one- and three-month follow-up. There were also no significant differences between groups in the secondary variables during the same follow-up period.
Conclusions
The results of this study suggest that orthopedic manual physical therapy does not increase the effects of a treatment based on biobehavioral therapy in the short or medium term, but these results should be interpreted with caution.
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Affiliation(s)
- Mónica Grande-Alonso
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
| | - Joaquín Pardo-Montero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, España
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
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23
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Roghani T, Zavieh MK, Rahimi A, Talebian S, Manshadi FD, Baghban AA, King N, Katzman W. The reliability and validity of a designed setup for the assessment of static back extensor force and endurance in older women with and without hyperkyphosis. Physiother Theory Pract 2018; 34:882-893. [PMID: 29368984 PMCID: PMC6320670 DOI: 10.1080/09593985.2018.1430878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the intra-rater reliability and validity of a designed load cell setup for the measurement of back extensor muscle force and endurance. PARTICIPANTS The study sample included 19 older women with hyperkyphosis, mean age 67.0 ± 5.0 years, and 14 older women without hyperkyphosis, mean age 63.0 ± 6.0 years. METHODS Maximum back extensor force and endurance were measured in a sitting position with a designed load cell setup. Tests were performed by the same examiner on two separate days within a 72-hour interval. The intra-rater reliability of the measurements was analyzed using intraclass correlation coefficient (ICC), standard errors of measurement (SEM), and minimal detectable change (MDC). The validity of the setup was determined using Pearson correlation analysis and independent t-test. RESULTS Using our designed load cell, the values of ICC indicated very high reliability of force measurement (hyperkyphosis group: 0.96, normal group: 0.97) and high reliability of endurance measurement (hyperkyphosis group: 0.82, normal group: 0.89). For all tests, the values of SEM and MDC were low in both groups. A significant correlation between two documented forces (load cell force and target force) and significant differences in the muscle force and endurance among the two groups were found. CONCLUSION The measurements of static back muscle force and endurance are reliable and valid with our designed setup in older women with and without hyperkyphosis.
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Affiliation(s)
- Taybeh Roghani
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Khalkhali Zavieh
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Dehghan Manshadi
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nicole King
- Department of Physical Therapy and Rehabilitation Sciences, University of California, San Francisco, United Sates
| | - Wendy Katzman
- Department of Physical Therapy and Rehabilitation Sciences, University of California, San Francisco, United Sates
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24
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Clayton JD, Kirkwood RN, Gregory DE. The influence of hip mobility and quadriceps fatigue on sagittal spinal posture and muscle activation in rugby scrum performance. Eur J Sport Sci 2018; 19:603-611. [PMID: 30362885 DOI: 10.1080/17461391.2018.1537379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Rugby Union scrumming puts the spine under a high degree of loading. The aim of the current study was to determine how sagittal hip range of motion and quadriceps fatigue influence force output, spinal posture, and activation of the trunk and quadriceps muscles in rugby scrumming. Measures of sagittal hip flexion/extension range of motion were collected from 16 male varsity and club first XV level participants. Sagittal spine motion (electromagnetic motion capture), trunk and quadriceps activation (electromyography), and applied horizontal compressive force (force plate) were measured during individual machine scrumming. Participants performed a 5-trial scrum block involving 5 s of contact with 1-2 min recovery between each trial. They then performed a fatiguing protocol (wall sit to failure) and immediately returned to the scrum machine to perform another five trials. Though there was no significant influence of fatigue on the horizontal compressive force applied during contact (P = .83), there was a 52% increase in cervical flexion (P < .001), as well as decreased (18-23% lower) abdominal and erector spinae muscle activation (P < .05). Furthermore, quadriceps activation decreased (12-25% lower) over the course of the initial scrum block but increased (13-15% higher) in the post fatigue block (P < .05). Although athletes were able to maintain force output following the fatiguing wall sit task, there is the potential that they may be at an increased risk of spinal injury due to the combination of increased flexion and high-applied compressive force; a combination which has been shown to increase the likelihood of intervertebral disc herniation.
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Affiliation(s)
- Joshua D Clayton
- a Department of Kinesiology and Physical Education , Wilfrid Laurier University , Waterloo , Ontario , Canada
| | - Renata N Kirkwood
- a Department of Kinesiology and Physical Education , Wilfrid Laurier University , Waterloo , Ontario , Canada
| | - Diane E Gregory
- a Department of Kinesiology and Physical Education , Wilfrid Laurier University , Waterloo , Ontario , Canada.,b Department of Health Sciences , Wilfrid Laurier University , 75 University Ave West, Waterloo , Ontario , Canada
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Pourahmadi MR, Bagheri R, Jannati E, Ebrahimi Takamjani I, Sarrafzadeh J, Mohsenifar H. Effect of Elastic Therapeutic Taping on Abdominal Muscle Endurance in Patients With Chronic Nonspecific Low Back Pain: A Randomized, Controlled, Single-Blind, Crossover Trial. J Manipulative Physiol Ther 2018; 41:609-620. [PMID: 30098819 DOI: 10.1016/j.jmpt.2017.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the immediate effect of elastic therapeutic taping and sham taping of the abdominal musculature on maximum hold time of endurance tests in patients with chronic nonspecific low back pain (CNLBP). METHODS Twenty-six people with CNLBP and 26 asymptomatic individuals were included in this study. The CNLBP participants were allocated to an elastic therapeutic tape group or a sham tape group. Standard adhesive elastic therapeutic tape was utilized for facilitatory application in the elastic therapeutic tape group. The elastic therapeutic tape group received real elastic therapeutic taping on the transversus abdominis and internal obliques, and the sham tape group received sham elastic therapeutic taping application. For the sham group, the elastic therapeutic tape was positioned horizontally above the navel and applied without tension. After a wash-out period, each CNLBP participant was switched to the other group. Outcome measures included maximum hold time of supine isometric chest raise, supine double straight-leg raise, and abdominal drawing in maneuver. RESULTS The CNLBP participants had lower maximum hold time compared to the asymptomatic individuals (P ≤ .01). Following taping, both groups showed an increase in the maximum hold time (mean difference = 4.43 - 50.69 seconds; P ≤ .02). Although there was no difference between the results of both groups (P ≥ .12), effect sizes were large for the elastic therapeutic tape group (Cohen's d = -1.93 to -1.00). CONCLUSIONS The results suggest that the maximum hold time of endurance tests was decreased in CNLBP patients compared to healthy participants. The application of both elastic therapeutic tape and sham tape to the transversus abdominis and internal obliques produced short-term improvement in abdominal endurance. There was no statistically significant difference between the results of elastic therapeutic tape and sham tape.
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Affiliation(s)
- Mohammad R Pourahmadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Department of Physiotherapy, Semnan University of Medical Sciences, Semnan, Iran.
| | - Elham Jannati
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ismail Ebrahimi Takamjani
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Sarrafzadeh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Holakoo Mohsenifar
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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26
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Schlaeger S, Inhuber S, Rohrmeier A, Dieckmeyer M, Freitag F, Klupp E, Weidlich D, Feuerriegel G, Kreuzpointner F, Schwirtz A, Rummeny EJ, Zimmer C, Kirschke JS, Karampinos DC, Baum T. Association of paraspinal muscle water-fat MRI-based measurements with isometric strength measurements. Eur Radiol 2018; 29:599-608. [PMID: 30014202 DOI: 10.1007/s00330-018-5631-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Chemical shift encoding-based water-fat MRI derived proton density fat fraction (PDFF) of the paraspinal muscles has been emerging as a surrogate marker in subjects with sarcopenia, lower back pain, injuries and neuromuscular disorders. The present study investigates the performance of paraspinal muscle PDFF and cross-sectional area (CSA) in predicting isometric muscle strength. METHODS Twenty-six healthy subjects (57.7% women; age: 30 ± 6 years) underwent 3T axial MRI of the lumbar spine using a six-echo 3D spoiled gradient echo sequence for chemical shift encoding-based water-fat separation. Erector spinae and psoas muscles were segmented bilaterally from L2 level to L5 level to determine CSA and PDFF. Muscle flexion and extension maximum isometric torque values [Nm] at the back were measured with an isokinetic dynamometer. RESULTS Significant correlations between CSA and muscle strength measurements were observed for erector spinae muscle CSA (r = 0.40; p = 0.044) and psoas muscle CSA (r = 0.61; p = 0.001) with relative flexion strength. Erector spinae muscle PDFF correlated significantly with relative muscle strength (extension: r = -0.51; p = 0.008; flexion: r = -0.54; p = 0.005). Erector spinae muscle PDFF, but not CSA, remained a statistically significant (p < 0.05) predictor of relative extensor strength in multivariate regression models (R2adj = 0.34; p = 0.002). CONCLUSIONS PDFF measurements improved the prediction of paraspinal muscle strength beyond CSA. Therefore, chemical shift encoding-based water-fat MRI may be used to detect subtle changes in the paraspinal muscle composition. KEY POINTS • We investigated the association of paraspinal muscle fat fraction based on chemical shift encoding-based water-fat MRI with isometric strength measurements in healthy subjects. • Erector spinae muscle PDFF correlated significantly with relative muscle strength. • PDFF measurements improved prediction of paraspinal muscle strength beyond CSA.
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Affiliation(s)
- Sarah Schlaeger
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany. .,Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
| | - Stephanie Inhuber
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Alexander Rohrmeier
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Friedemann Freitag
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Elisabeth Klupp
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Georg Feuerriegel
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Kreuzpointner
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Ansgar Schwirtz
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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Hazar Kanik Z, Pala OO, Gunaydin G, Sozlu U, Alkan ZB, Basar S, Citaker S. Relationship between scapular muscle and core endurance in healthy subjects. J Back Musculoskelet Rehabil 2018; 30:811-817. [PMID: 28282793 DOI: 10.3233/bmr-150497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Scapular muscle endurance and core endurance reportedly influence shoulder injury risk. The exact relationship between scapular muscle endurance and core endurance, and how they impact one another in the healthy subjects remain unclear. OBJECTIVE To investigate the relationship between scapular muscle endurance and core endurance in healthy subjects. METHODS Fifty healthy volunteers (23 males, 27 females; mean age 20.42 ± 1.04 years) were participated in this study. Endurance of the serratus anterior and trapezius muscles was assessed using the scapular muscle endurance test. Sorensen test (endurance of trunk extensor muscles), trunk flexor endurance test, and side bridge test (endurance of lateral core muscles) were conducted to assess the core endurance. Pearson's product moment correlations examined relationships between scapular muscle endurance and each of the core endurance tests scores. RESULTS Scapular muscle endurance test scores showed a positive correlation with the side bridge test scores (r = 0.414; p = 0.003). No significant correlation was found between scapular muscle endurance test scores and the other core endurance tests scores (p > 0.05). CONCLUSIONS There appears to be a link between the scapular muscle endurance and lateral core muscles in healthy subjects; however, more research is needed to provide a definitive answer on the nature of this relationship. Further studies involving patients with shoulder pathology are warranted.
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28
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Sever O, Zorba E. Comparison of effect of static and dynamic core exercises on speed and agility performance in soccer players. ISOKINET EXERC SCI 2018. [DOI: 10.3233/ies-171120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ozan Sever
- Faculty of Sport Sciences, Ataturk University, Erzurum, Turkey
| | - Erdal Zorba
- Faculty of Sport Sciences, Gazi University, Ankara, Turkey
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29
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ShahAli S, Arab AM, Ebrahimi E, ShahAli S, Rahmani N, Negahban H, Kazemnejad A, Bahmani A. Ultrasound measurement of abdominal muscles during clinical isometric endurance tests in women with and without low back pain. Physiother Theory Pract 2018; 35:130-138. [DOI: 10.1080/09593985.2018.1441345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Shabnam ShahAli
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Massoud Arab
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Esmaeil Ebrahimi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva ShahAli
- Medical Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Rahmani
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Andia Bahmani
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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30
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Honarmand K, Minaskanian R, Maboudi SE, Oskouei AE. Electrophysiological assessment of piano players' back extensor muscles on a regular piano bench and chair with back rest. J Phys Ther Sci 2018; 30:67-72. [PMID: 29410569 PMCID: PMC5788778 DOI: 10.1589/jpts.30.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/13/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Sitting position is the dominant position for a professional pianist. There are
many static and dynamic forces which affect musculoskeletal system during sitting. In
prolonged sitting, these forces are harmful. The aim of this study was to compare
pianists’ back extensor muscles activity during playing piano while sitting on a regular
piano bench and a chair with back rest. [Subjects and Methods] Ten professional piano
players (mean age 25.4 ± 5.28, 60% male, 40% female) performed similar tasks for 5 hours
in two sessions: one session sitting on a regular piano bench and the other sitting on a
chair with back rest. In each session, muscular activity was assessed in 3 ways: 1)
recording surface electromyography of the back-extensor muscles at the beginning and end
of each session, 2) isometric back extension test, and 3) musculoskeletal discomfort
questionnaire. [Results] There were significantly lesser muscular activity, more ability
to perform isometric back extension and better personal comfort while sitting on a chair
with back rest. [Conclusion] Decreased muscular activity and perhaps fatigue during
prolonged piano playing on a chair with back rest may reduce acquired musculoskeletal
disorders amongst professional pianists.
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Affiliation(s)
- Kavan Honarmand
- Department of Physiotherapy, Tabriz University of Medical Sciences, Iran
| | | | | | - Ali E Oskouei
- Department of Physiotherapy, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences: Tavanir Boulevard, Tabriz, Postal Code: 5157635411, Iran
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Soltani P, Figueiredo P, Fernandes RJ, Vilas-Boas JP. Muscle activation behavior in a swimming exergame: Differences by experience and gaming velocity. Physiol Behav 2017; 181:23-28. [PMID: 28882467 DOI: 10.1016/j.physbeh.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 08/23/2017] [Accepted: 09/02/2017] [Indexed: 10/18/2022]
Abstract
The effects of playing intensity and prior exergame and sport experience on the activation patterns of upper limb muscles during a swimming exergame were investigated. Surface electromyography of Biceps Brachii, Triceps Brachii, Latissimus Dorsi, Upper Trapezius, and Erector Spinae of twenty participants was recorded, and the game play was divided into normal and fast. Mean muscle activation, normalized to maximum voluntary isometric contraction (MVIC), ranged from 4.9 to 95.2%MVIC and differed between normal and fast swimming for all techniques (p<0.05), except for Latissimus Dorsi during backstroke. After normalizing the %MVIC to playing velocity, selective behaviors were observed between muscles which were sufficient for pragmatic game play. Moreover, prior exergame and real sport experience did not have any effect on the muscle activation changes between normal and fast swimming. These behaviors are likely to happen when players understand the game mechanics, even after a short exposure. Such evaluation might help in adjusting the physical demands of sport exergames, for safe and meaningful experiences.
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Affiliation(s)
- Pooya Soltani
- Center of Research, Education, Innovation and Intervention in Sport (CIFI(2)D), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; Department of Physical Education and Sport Sciences, School of Education and Psychology, Shiraz University, Pardis-e-Eram, Eram Square, 71946-84759 Shiraz, Iran; Porto Biomechanics Laboratory (LABIOMEP), Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Pedro Figueiredo
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Ricardo J Fernandes
- Center of Research, Education, Innovation and Intervention in Sport (CIFI(2)D), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
| | - João Paulo Vilas-Boas
- Center of Research, Education, Innovation and Intervention in Sport (CIFI(2)D), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
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Low Back Pain With Impact at 17 Years of Age Is Predicted by Early Adolescent Risk Factors From Multiple Domains: Analysis of the Western Australian Pregnancy Cohort (Raine) Study. J Orthop Sports Phys Ther 2017; 47:752-762. [PMID: 28915771 DOI: 10.2519/jospt.2017.7464] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Prospective cohort study of the Western Australian Pregnancy Cohort (Raine) Study. Background Low back pain (LBP) commonly develops in adolescence and is a significant risk factor for adult LBP. A broad range of factors have been associated with the development of adolescent LBP, but prior literature has limitations related to characterization of LBP and the scope of risk factors considered. Objective This study aimed to identify potential factors contributing to the development of LBP, with and without impact, at 17 years of age, utilizing a broad range of exposures at 14 years of age. Methods Data from 1088 participants (52.1% female) with "no LBP," "LBP with minimal impact," and "LBP with impact" at 17 years of age and a range of measures from multiple domains, including spinal pain, physical, psychological, social, and lifestyle, at 14 years of age were collected for the study. Multivariable multinomial logistic regression was used to estimate the association of potential mechanistic factors at 14 years of age with LBP at 17 years of age. Results Female sex and back pain at 14 years of age were strongly associated with LBP at 17 years of age. Potential mechanistic factors for LBP outcomes at 17 years of age included exposures from the pain (neck/shoulder pain) and physical domains (standing posture subgroup membership, back muscle endurance, throwing distance), psychological domain (somatic complaints, aggressive behavior), social domain (socioeconomic area), and lifestyle domain (exercise out of school). Conclusion The findings support the multidimensional nature of adolescent LBP and highlight the challenge this presents for epidemiological research, clinical practice, and prevention initiatives in the general population. Level of Evidence Prognosis, level 1b. J Orthop Sports Phys Ther 2017;47(10):752-762. doi:10.2519/jospt.2017.7464.
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Balaguier R, Madeleine P, Rose-Dulcina K, Vuillerme N. Effects of a Worksite Supervised Adapted Physical Activity Program on Trunk Muscle Endurance, Flexibility, and Pain Sensitivity Among Vineyard Workers. J Agromedicine 2017; 22:200-214. [PMID: 28402188 DOI: 10.1080/1059924x.2017.1317683] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES In viticulture, the prevalence of low back pain is particularly high among vineyard workers exposed to sustained and awkward postures. One promising setting for low back pain prevention resides in the implementation of workplace physical activity. METHODS This nonrandomized pilot study aims at evaluating the effects of a worksite supervised adapted physical activity program among 17 vineyard workers volunteered to enter either an intervention group (n = 10) or a control group (n = 7).The intervention group followed a physical activity program for 8 weeks involving (1) 15 minutes of warm-up every working day and (2) two weekly 1-hour adapted physical activity sessions targeting trunk muscle endurance and flexibility. The control group was advised to continue normal physical activity. Evaluations were carried out at weeks 0, 4, 8, and 12. Physical capacity was assessed using flexibility tests for the trunk, along with trunk muscle flexor and extensor endurance tests. Finally, pain sensitivity was evaluated by assessing pressure pain thresholds over 14 anatomical locations in the low back region. RESULTS For the intervention group, the endurance of the trunk extensor and flexor significantly increased from baseline to week 8 as well as the pressure pain thresholds. No change was observed for the control group over the same period. CONCLUSIONS These encouraging results in combination with the high adherence rate set interesting foundations for the promotion of worksite supervised adapted physical activity and, most likely, offer a new promising approach to prevent low back pain among vineyard workers.
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Affiliation(s)
- Romain Balaguier
- a Autonomy, Gerontology, E-health, Imaging and Society (AGEIS), Faculty of Medicine , Grenoble Alpes University , Grenoble , France.,b Physical Activity and Human Performance Group, Centre for Sensory Motor Interaction (SMI), Department of Health Science and Technology , Aalborg University , Aalborg , Denmark
| | - Pascal Madeleine
- b Physical Activity and Human Performance Group, Centre for Sensory Motor Interaction (SMI), Department of Health Science and Technology , Aalborg University , Aalborg , Denmark
| | - Kévin Rose-Dulcina
- a Autonomy, Gerontology, E-health, Imaging and Society (AGEIS), Faculty of Medicine , Grenoble Alpes University , Grenoble , France
| | - Nicolas Vuillerme
- a Autonomy, Gerontology, E-health, Imaging and Society (AGEIS), Faculty of Medicine , Grenoble Alpes University , Grenoble , France.,b Physical Activity and Human Performance Group, Centre for Sensory Motor Interaction (SMI), Department of Health Science and Technology , Aalborg University , Aalborg , Denmark.,c Institut Universitaire de France , Paris , France
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Hildebrandt C, Müller L, Heisse C, Raschner C. Trunk Strength Characteristics of Elite Alpine Skiers - a Comparison with Physically Active Controls. J Hum Kinet 2017; 57:51-59. [PMID: 28713458 PMCID: PMC5504578 DOI: 10.1515/hukin-2017-0046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Core muscle imbalances and weak trunk strength are relevant for injury prevention and performance. Information regarding core strength requirements and ideal flexion/extension ratios in alpine skiing is limited. We aimed to compare trunk strength capacities in elite alpine skiers with those of a matched control group. The concentric maximal trunk flexion and extension of 109 elite skiers and 47 active controls were measured at 150°/s in a ballistic mode using the CON-TREX® TP 1000 test system. The relative flexion peak torque was higher in male ski racers (p = 0.003; 2.44 ± 0.30 Nm/kg) than in the controls (2.32 ± 0.42 Nm/kg). The relative peak torque for extension was 4.53 ± 0.65 Nm/kg in ski racers and 4.11 ± 0.52 Nm/kg in the controls (p = 0.001). Female athletes were significantly stronger in both, relative flexion force (p = 0.006; skiers 2.05 ± 0.22 Nm/kg; controls 1.74 ± 0.28 Nm/kg) and relative extension force (p = 0.001; skiers 3.55 ± 0.53 Nm/kg; controls 3.14 ± 0.48 Nm/kg). No significant differences were found in the ratios of flexion to extension forces in females and males. Ski racers are engaged in extensive strength training for both leg and trunk muscles, which explains the higher peak values. Both groups indicated a low ratio from 0.54-0.59, which represents high trunk extensor muscles strength relative to flexor muscles.
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Affiliation(s)
| | - Lisa Müller
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Christian Heisse
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Christian Raschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial. J Back Musculoskelet Rehabil 2017; 30:247-253. [PMID: 27636836 DOI: 10.3233/bmr-160741] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low Back Pain (LBP) is considered as one of the most frequent disorders, which about 80% of adults experience in their lives. Lumbar disc herniation (LDH) is a cause for acute LBP. Among conservative treatments, traction is frequently used by clinicians to manage LBP resulting from LDH. However, there is still a lack of consensus about its efficacy. OBJECTIVE The purpose of this study was to evaluate the effects of segmental traction therapy on lumbar discs herniation, pain, lumbar range of motion (ROM), and back extensor muscles endurance in patients with acute LBP induced by LDH. METHODS Fifteen patients with acute LBP diagnosed by LDH participated in the present study. Participants undertook 15 sessions of segmental traction therapy along with conventional physiotherapy, 5 times a week for 3 weeks. Lumbar herniated mass size was measured before and after the treatment protocol using magnetic resonance imaging. Furthermore, pain, lumbar ROM and back muscle endurance were evaluated before and after the procedure using clinical outcome measures. RESULTS Following the treatment protocol, herniated mass size and patients' pain were reduced significantly. In addition, lumbar flexion ROM showed a significant improvement. However, no significant change was observed for back extensor muscle endurance after the treatment procedure. CONCLUSION The result of the present study showed segmental traction therapy might play an important role in the treatment of acute LBP stimulated by LDH.
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Affiliation(s)
- Noureddin Karimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Parvin Akbarov
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Department of Physiotherapy, Tusi Memorial Clinic, Baku, Azerbaijan
| | - Leila Rahnama
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Relationships among Disability, Quality of Life, and Physical Fitness in Lumbar Spinal Stenosis: An Investigation of Elderly Korean Women. Asian Spine J 2017; 11:256-263. [PMID: 28443170 PMCID: PMC5401840 DOI: 10.4184/asj.2017.11.2.256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/29/2016] [Accepted: 08/05/2016] [Indexed: 01/03/2023] Open
Abstract
STUDY DESIGN A cross-sectional, case-control study. PURPOSE To investigate associations between physical fitness measures and disabilities related to back pain and quality of life (QOL) by the presence of symptomatic lumbar spinal stenosis (LSS) in elderly Korean women. OVERVIEW OF LITERATURE LSS leads to decreased functioning and reduced QOL. However, correlations among physical fitness, disability, and QOL have not been investigated in elderly women with LSS. METHODS Participants included women aged 65 years and older (n=192), divided into a study group (n=38) and a control group (n=154) based on the presence/absence of LSS. All participants underwent physical function and fitness tests. Oswestry disability index (ODI) scores and EuroQol five-dimensional questionnaire (EQ-5D-5L) scores were used to assess disability and health-related QOL. RESULTS The results for the handgrip strength, sit-and-reach, functional reach, and timed up and go (TUG) tests were significantly higher in the control group than the LSS group. ODI scores were significantly higher and EQ-5D-5L scores significantly lower in the LSS group. TUG and functional reach test scores were significantly correlated with ODI scores, and handgrip strength was strongly interrelated with ODI and EQ-5D-5L scores in the LSS group. No other physical fitness measures showed statistically significant relationships with ODI or EQ-5D-5L scores. CONCLUSIONS In elderly Korean women with LSS, back pain-related disability and QOL are significantly associated with some physical fitness parameters such as handgrip strength. Handgrip strength reflects general muscle strength, which is significantly interrelated with the level of disability and QOL. Our results suggest that enhancing generalized muscle strength helps to reduce disability due to back pain and improve QOL in patients with LSS.
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Yoosefinejad AK, Motealleh A, Khademi S, Hosseini SF. Lower Endurance and Strength of Core Muscles in Patients with Multiple Sclerosis. Int J MS Care 2017; 19:100-104. [PMID: 32607068 DOI: 10.7224/1537-2073.2015-064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system associated with a variety of symptoms and functional deficits. Balance impairment is a common concern in patients with MS. Core muscle stabilization is considered a main component of balance. The strength and endurance of core muscles have not been compared between patients with MS and healthy people. The objective of this study was to compare core muscle strength and endurance between ambulatory patients with MS and a healthy group. Methods Thirty-three patients with MS with Expanded Disability Status Scale scores ranging from 1.0 to 4.5 and 33 matched healthy people participated in this cross-sectional group comparison study. The primary outcome measure was endurance of core muscles assessed by functional endurance tests, and the secondary outcome was isometric strength of core muscles assessed using a dynamometer. Results Patients with MS had lower performance on endurance tests (P < .001) and strength tests (P < .05) compared with the control group. Conclusions These results show decreased core muscle strength and endurance in ambulatory individuals with MS compared with a matched control group. Future studies are required to assess how core muscle impairment affects balance and how it would be affected by rehabilitation and exercise programs.
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Park JH, Seo KS, Lee SU. Effect of Superimposed Electromyostimulation on Back Extensor Strengthening: A Pilot Study. J Strength Cond Res 2016; 30:2470-5. [PMID: 26840436 DOI: 10.1519/jsc.0000000000001360] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Park, JH, Seo, KS, and Lee, S-U. Effect of superimposed electromyostimulation on back extensor strengthening: a pilot study. J Strength Cond Res 30(9): 2470-2475, 2016-Electromyostimulation (EMS) superimposed on voluntary contraction (VC) can increase muscle strength. However, no study has examined the effect of superimposing EMS on back extensor strengthening. The purpose of this study was to determine the effect of superimposed EMS on back extensor strengthening in healthy adults. Twenty healthy men, 20-29 years of age, without low-back pain were recruited. In the EMS group, electrodes were attached to bilateral L2 and L4 paraspinal muscles. Stimulation intensity was set for maximally tolerable intensity. With VC, EMS was superimposed for 10 seconds followed by a 20-second rest period. The same protocol was used in the sham stimulation (SS) group, except that the stimulation intensity was set at the lowest intensity (5 mA). All subjects performed back extension exercise using a Swiss ball, with 10 repetitions per set, 2 sets each day, 5 times a week for 2 weeks. The primary outcome measure was the change in isokinetic strength of the back extensor using an isokinetic dynamometer. Additionally, endurance was measured using the Sorensen test. After 2 weeks of back extension exercise, the peak torque and endurance increased significantly in both groups (p ≤ 0.05). Effect size between the EMS group and the SS group was medium in strength and endurance. However, there was no statistically significant difference between 2 groups. In conclusion, 2 weeks of back extensor strengthening exercise was effective for strength and endurance. Superimposing EMS on back extensor strengthening exercise could provide an additional effect on increasing strength.
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Affiliation(s)
- Jae Hyeon Park
- 1Department of Rehabilitation Medicine, College of Medicine, Seoul National University, Seoul, South Korea; 2Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea; and 3Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
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Associations between Trunk Extension Endurance and Isolated Lumbar Extension Strength in Both Asymptomatic Participants and Those with Chronic Low Back Pain. Healthcare (Basel) 2016; 4:healthcare4030070. [PMID: 27657149 PMCID: PMC5041071 DOI: 10.3390/healthcare4030070] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/12/2016] [Accepted: 09/08/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Strength and endurance tests are important for both clinical practice and research due to the key role they play in musculoskeletal function. In particular, deconditioning of the lumbar extensor musculature has been associated with low back pain (LBP). Due to the relationship between strength and absolute endurance, it is possible that trunk extension (TEX) endurance tests could provide a proxy measure of isolated lumbar extension (ILEX) strength and thus represent a simple, practical alternative to ILEX measurements. Though, the comparability of TEX endurance and ILEX strength is presently unclear and so the aim of the present study was to examine this relationship. METHODS Thirty eight healthy participants and nineteen participants with non-specific chronic LBP and no previous lumbar surgery participated in this cross-sectional study design. TEX endurance was measured using the Biering-Sorensen test. A maximal ILEX strength test was performed on the MedX lumbar-extension machine. RESULTS A Pearson's correlation revealed no relationship between TEX endurance and ILEX strength in the combined group (r = 0.035, p = 0.793), the chronic LBP group (r = 0.120, p = 0.623) or the asymptomatic group (r = -0.060, p = 0.720). CONCLUSIONS The results suggest that TEX is not a good indicator of ILEX and cannot be used to infer results regarding ILEX strength. However, a combination of TEX and ILEX interpreted together likely offers the greatest and most comprehensive information regarding lumbo-pelvic function during extension.
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The Effect of Sitting on Stability Balls on Nonspecific Lower Back Pain, Disability, and Core Endurance: A Randomized Controlled Crossover Study. Spine (Phila Pa 1976) 2016; 41:E1074-E1080. [PMID: 27010995 DOI: 10.1097/brs.0000000000001576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Experimental randomized crossover. OBJECTIVE The aim of the study was to determine whether sitting on a ball for 90 min/d instead of a chair has an effect on low back pain (LBP), low back disability, and/or core muscle endurance. SUMMARY OF BACKGROUND DATA LBP may result from prolonged sitting. It has been proposed that replacing chairs with stability balls can diminish LBP in those who sit for prolonged periods. Research on the topic is sparse and inconclusive. METHODS A total of 90 subjects (university students, staff, and faculty, ages 18-65, who sit ≥4 hr/d) were randomly assigned to the intervention or control group for the first part of the study. Baseline data were collected: Oswestry Disability Index, a numerical pain rating scale for LBP, and four core muscle endurance tests. For 8 weeks, the control group sat on their usual chair. The intervention group sat on stability balls 5 d/wk, increasing up to 90 min/d. Baseline measurements were repeated postintervention. After a washout period, subjects switched groups, and the procedures were repeated-70 completed participation in control group and 76 in intervention group. RESULTS There were no statistically significant differences for pain or disability in either group (P > 0.05). Changes in isometric trunk flexion (P = 0.001), nondominant side plank (P = 0.008), and Sorensen (P = 0.006) endurance scores were significant within the intervention group but not the control group. Between-group comparisons revealed a significant difference for isometric trunk flexion (P = 0.005) and Sorensen endurance times (P = 0.010). Analysis also showed that ball-sitting did not prevent an increase in LBP over the 8-week period. CONCLUSION Ball-sitting had no significant effects on LBP or associated disability, but did improve core endurance in the sagittal plane. Although ball-sitting may be useful as an adjunct treatment for LBP when core muscles are involved, clinicians should rely on other, evidence-based treatments for LBP.
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Back muscle fatigue of younger and older adults with and without chronic low back pain using two protocols: A case-control study. J Electromyogr Kinesiol 2015; 25:928-36. [DOI: 10.1016/j.jelekin.2015.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/24/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022] Open
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Sions JM, Velasco TO, Teyhen DS, Hicks GE. Reliability of ultrasound imaging for the assessment of lumbar multifidi thickness in older adults with chronic low back pain. J Geriatr Phys Ther 2015; 38:33-9. [PMID: 24743751 DOI: 10.1519/jpt.0000000000000021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Ultrasound imaging (USI) has been shown to be a reliable measure for direct assessment of the lumbar multifidi among younger adults. However, given age- and chronic low back pain (CLBP)-related spinal changes, similar studies are needed before clinical use of USI among older adults with CLBP. The goals of this study were to evaluate intra- and interexaminer reliability for USI assessment of multifidi thickness at rest and during a contraction and to determine standard error of measurement values (SEMs) and minimal detectable change values (MDCs) among older adults with CLBP. METHODS Thirty-one adults, aged 60 to 85 years, with CLBP were recruited. Two examiners performed USI assessments of multifidus thickness at rest and during a contralateral lower extremity lift. Intraclass correlation coefficients (ICCs) were used to estimate inter- and intraexaminer reliability. Additionally, SEMs and MDCs were calculated. RESULTS All USI measurement techniques demonstrated excellent within-day, interexaminer procedural reliability (ICCs: 0.82-0.85) and good-to-excellent between-day, interexaminer procedural reliability (ICCs: 0.72-0.79). The SEMs ranged from 0.36 to 0.46 cm; MDCs ranged from 1.01 to 1.26 cm. Regardless of the measurement technique, examiner 1, the more experienced examiner, demonstrated lower SEMs and MDCs than examiner 2. DISCUSSION Lower ICCs, greater SEMs, and greater MDCs for USI multifidus thickness assessment in older adults with CLBP, when compared with previously published, procedural reliability results for younger adults with and without low back pain, may indicate that imaging is more challenging in this patient population. Factors, such as examiner training and participant anthropometrics, may impact reliability. CONCLUSIONS Good-to-excellent intra- and interexaminer USI procedural reliability may provide clinicians a direct assessment technique for clinical evaluation of the lumbar multifidi in older adults with CLBP. SEMs and MDCs may allow for accurate interpretation of USI assessments in this population.
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Affiliation(s)
- J Megan Sions
- 1Department of Physical Therapy, University of Delaware, Newark, Delaware. 2Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Materiel Command, Ft Detrick, Maryland
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Pagé I, Abboud J, O Shaughnessy J, Laurencelle L, Descarreaux M. Chronic low back pain clinical outcomes present higher associations with the STarT Back Screening Tool than with physiologic measures: a 12-month cohort study. BMC Musculoskelet Disord 2015; 16:201. [PMID: 26286385 PMCID: PMC4541753 DOI: 10.1186/s12891-015-0669-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stratification strategies based on identifying patient's prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research. The STarT Back Screening Tool (SBST) although promising, has not been studied in patients with chronic low back pain (cLBP). Considering how challenging it is to translate research into practice, the value of integrating a new tool should be thoroughly assessed. The purpose was therefore to assess associations between the short- and long-terms clinical status and two types of variables, physiologic measures and the SBST, in participants with cLBP. The ability of both types of variables to discriminate between participants with and without higher levels of disability, pain, fear of movement and patient's global impression of change was also investigated. METHODS Fifty-three volunteers with cLBP participated in an initial evaluation and follow-ups at 2-, 4-, 6- and 12-month. Physiologic measures (maximal voluntary contraction, maximal endurance and muscle activity evaluated during prone and lateral isometric tasks) and the SBST were assessed at baseline. Disability (Oswestry Disability Index, ODI), pain intensity (101-point Numerical Rating Scale, NRS), fear of movement (Tampa Scale for Kinesiophobia, TSK) and patient's global impression of change (7-point scale, PGIC) were evaluated at baseline and at each follow-up. Aside the use of correlation analyses to assess potential associations; ROC curves were performed to evaluate the discriminative ability of physiologic measures and the SBST. RESULTS The SBST allowed for the identification of participants presenting higher levels of disability (ODI ≥24 %), pain (NRS ≥37 %) or fear of movement (TSK ≥41/68) over a 12-month period (AUC = 0.71 to 0.84, ps < 0.05). The SBST score was also correlated with disability at each follow-up (τ = 0.22 to 0.33, ps < 0.05) and with pain intensity and fear of movement at follow-ups. Among physiologic measures, only maximal voluntary contraction was correlated to disability, pain intensity or fear of movement during the follow-up (|τ| = 0.26 to 0.32, ps < 0.05) and none was able to identify participants presenting higher levels of outcomes (AUC ps > 0.05). CONCLUSION Physiologic measures obtained during prone and lateral tests have limited associations with the clinical status over a 12-month period in patients with nonspecific chronic low back pain. On the other hand, the STarT Back Screening Tool is useful for the identification of patients who will present higher levels of disability, pain intensity and fear of movement over a year. TRIAL REGISTRATION Clinicaltrials.gov NCT02226692.
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Affiliation(s)
- Isabelle Pagé
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, Québec, Canada.
| | - Jacques Abboud
- Département d'anatomie, UQTR, Trois-Rivières, Québec, Canada.
| | - Julie O Shaughnessy
- Département de chiropratique, UQTR, Trois-Rivières, Québec, Canada. Julie.O'
| | - Louis Laurencelle
- Département des sciences de l'activité physique, UQTR, Trois-Rivières, Québec, Canada.
| | - Martin Descarreaux
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, 3351 Boul. Des Forges, Trois-Rivières, G9A 5H7, Québec, Canada.
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Straker LM, Hall GL, Mountain J, Howie EK, White E, McArdle N, Eastwood PR. Rationale, design and methods for the 22 year follow-up of the Western Australian Pregnancy Cohort (Raine) Study. BMC Public Health 2015; 15:663. [PMID: 26169918 PMCID: PMC4501054 DOI: 10.1186/s12889-015-1944-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young adulthood is a critical life period for health and health behaviours. Related measurements collected before and after birth, and during childhood and adolescence can provide a life-course analysis of important factors that contribute to health and behaviour in young adulthood. The Western Australian Pregnancy Cohort (Raine) Study has collected a large number of such measurements during the fetal, perinatal, infancy, childhood and adolescence periods and plans to relate them to common health issues and behaviours in young adults, including spinal pain, asthma, sleep disorders, physical activity and sedentary behaviour and, work absenteeism and presenteeism. The aim of this paper is to describe the rationale, design and methods of the 22 year follow-up of the Raine Study cohort. METHODS/DESIGN The Raine Study is a prospective cohort study. Participants still active in the cohort (n = 2,086) were contacted around the time of their 22nd birthday and invited to participate in the 22 year follow-up. Each was asked to complete a questionnaire, attend a research facility for physical assessment and an overnight sleep study, wear activity monitors for a week, and to maintain a sleep and activity diary over this week. The questionnaire was broad and included questions related to sociodemographics, medical history, quality of life, psychological factors, lifestyle factors, spinal pain, respiratory, sleep, activity and work factors. Physical assessments included anthropometry, blood pressure, back muscle endurance, tissue sensitivity, lung function, airway reactivity, allergic status, 3D facial photographs, cognitive function, and overnight polysomnography. DISCUSSION Describing the prevalence of these health issues and behaviours in young adulthood will enable better recognition of the issues and planning of health care resources. Providing a detailed description of the phenotype of these issues will provide valuable information to help educate health professionals of the needs of young adults. Understanding the life-course risk factors of health issues and behaviours in young adulthood will have important health planning implications, supporting the development of targeted interventions to improve current health status and reduce the onset and development of further ill-health across adulthood.
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Affiliation(s)
- Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Graham L Hall
- Telethon Kids Institute, University of Western Australia, Crawley, Australia.
| | - Jenny Mountain
- The University of Western Australia, Perth, WA, Australia.
| | | | | | - Nigel McArdle
- The University of Western Australia, Perth, WA, Australia.
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ShahAli S, Arab AM, Talebian S, Ebrahimi E, Bahmani A, Karimi N, Nabavi H. Reliability of ultrasound thickness measurement of the abdominal muscles during clinical isometric endurance tests. J Bodyw Mov Ther 2015; 19:396-403. [DOI: 10.1016/j.jbmt.2014.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 05/23/2014] [Accepted: 05/24/2014] [Indexed: 10/25/2022]
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The Relationship Between the Side-Lying Endurance Test and Ultrasound Thickness Measurement for Abdominal Muscles. ACTA ACUST UNITED AC 2015. [DOI: 10.5812/jjhr.6(2)2015.29206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mohseni Bandpei MA, Rahmani N, Majdoleslam B, Abdollahi I, Ali SS, Ahmad A. Reliability of Surface Electromyography in the Assessment of Paraspinal Muscle Fatigue: An Updated Systematic Review. J Manipulative Physiol Ther 2014; 37:510-21. [DOI: 10.1016/j.jmpt.2014.05.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 04/28/2014] [Accepted: 05/01/2014] [Indexed: 12/18/2022]
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Plowman SA. Top 10 research questions related to musculoskeletal physical fitness testing in children and adolescents. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2014; 85:174-187. [PMID: 25098013 DOI: 10.1080/02701367.2014.899857] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this article is to bring attention to the 10 most pressing questions relevant to musculoskeletal physical fitness testing in children and adolescents. The goal is to stimulate research to answer these questions. The most pressing needs include establishing definitive links between valid, reliable, and feasible field test measures of muscular strength, endurance, power, and flexibility and health risk factors/markers in children and adolescents; determining the effects of exercise training on these relationships; and documenting the tracking of these relationships. The role of flexibility in health-related physical fitness (HRPF) needs to be carefully and specifically examined. Although body weight/composition is a separate component of health-related fitness, it is also a factor that can influence the performance of musculoskeletal test items. The role of body weight, body fat, and central adiposity and the possibility of adjustment of tests results are important research questions. Several questions relate to which field tests are best for use in schools. Finally, actual health-related criterion-referenced cutoff values need to be developed. In conclusion, more quality research is needed to firmly establish the musculoskeletal area for HRPF in youth.
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Santana LMD, Nascimento PRCD, Lima TDS, Lopes ACT, Araujo AC, Azevedo FMD, Negrão Filho RDF. Electromyographic analysis of the vertebral extensor muscles during the Biering-Sorensen Test. MOTRIZ: REVISTA DE EDUCACAO FISICA 2014. [DOI: 10.1590/s1980-65742014000100017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of the study was to analyze the electromyographic signal of the multifidus, longissimus thoracis and the lumbar iliocostalis muscles during the Biering-Sorensen test in subjects without lower back pain. Twenty volunteers performed the test on three separate occasions. An analysis of variance detected a difference between the three test times (p = 0.0026). For the frequency domain, it was observed that there were differences between the multifidus and the lumbar erectors muscles; longissimus and iliocostalis muscles. However, in the time domain analysis, no difference was observed. As the values of the slope coefficients of median frequencies were higher for the multifidus muscle, compared to the longissimus and lumbar iliocostalis muscles, this may indicate a higher tendency toward muscle fatigue. Therefore, considering the applied methodology, the study of electromyographic signals in the frequency domain should be considered as an instrument to assess fatigue of the spinal extensor muscles in clinical situations.
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Beneck GJ, Popovich JM, Selkowitz DM, Azen S, Kulig K. Intensive, progressive exercise improves quality of life following lumbar microdiskectomy: a randomized controlled trial. Clin Rehabil 2014; 28:892-901. [DOI: 10.1177/0269215514525059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: The purpose of the study was to examine changes in quality of life measures in patients who have undergone an intensive exercise program following a single level microdiskectomy. Design: Randomized controlled trial with blinded examiners. Setting: The study was conducted in outpatient physical therapy clinics. Subjects: Ninety-eight participants (53 male, 45 female) who had undergone a single-level lumbar microdiskectomy allocated to receive exercise and education or education only. Interventions: A 12-week periodized exercise program of lumbar extensor strength and endurance training, and mat and upright therapeutic exercises was administered. Outcome measures: Quality of life was tested with the Short Form 36 (SF-36). Measurements were taken 4–6 weeks postsurgery and following completion of the 12-week intervention program. Since some participants selected physical therapy apart from the study, analyses were performed for both an as-randomized (two-group) design and an as-treated (three-group) design. Results: In the two-group analyses, exercise and education resulted in a greater increase in SF-36 scales, role physical (17.8 vs. 12.1) and bodily pain (13.4 vs. 8.4), and the physical component summary (13.2 vs. 8.9). In the three-group analyses, post-hoc comparisons showed exercise and education resulted in a greater increase in the SF-36 scales, physical function (10.4 vs. 5.6) and bodily pain (13.7 vs. 8.2), and the physical component summary (13.7 vs. 8.9) when compared with usual physical therapy. Conclusions: An intensive, progressive exercise program combined with education increases quality of life in patients who have recently undergone lumbar microdiskectomy.
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Affiliation(s)
- George J Beneck
- Department of Physical Therapy California State University Long Beach, Long Beach, CA, USA
| | - John M Popovich
- Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA
| | - David M Selkowitz
- Department of Physical Therapy Education, Western University of Health Sciences, Pomona, CA, USA
| | - Stan Azen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kornelia Kulig
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
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