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Ylinen J, Pasanen T, Heinonen A, Kivistö H, Kautiainen H, Multanen J. Trunk muscle activation of core stabilization exercises in subjects with and without chronic low back pain. J Back Musculoskelet Rehabil 2024; 37:897-908. [PMID: 38250755 DOI: 10.3233/bmr-230043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Weakness and atrophy in trunk muscles have been associated with chronic low back pain (CLBP). OBJECTIVE This study aimed to identify isometric exercises resulting the highest trunk muscle activity for individuals with and without CLBP. METHODS Fourteen males with CLBP and 15 healthy age-matched healthy subjects were recruited for this study. Muscle activity during maximal voluntary isometric contraction (MVIC) was measured for a comparative reference with surface electromyography (sEMG) from six trunk muscles. Thereafter maximum EMG amplitude values were measured during eleven trunk stability exercises. The maximal EMG activity in each exercise relative to the MVICs was analyzed using generalizing estimating equations (GEE) models with the unstructured correlation structure. RESULTS The GEE models showed statistically significant differences in muscle activity between exercises within both groups (p< 0.001), with no significant differences between groups (p> 0.05). The highest muscle activity was achieved with the hip flexion machine for multifidus, side pull with a resistance band for lumbar extensors, side and single-arm cable pull exercises for thoracic extensors, rotary plank and the hip flexion machine for abdominal. CONCLUSION This study found five isometric trunk exercises that exhibited highest muscle activity depending on muscle tested, with no significant difference between individuals with and without CLBP.
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Affiliation(s)
- Jari Ylinen
- Department of Physical Medicine and Rehabilitation, NOVA, Central Hospital of Central Finland, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tero Pasanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Heikki Kivistö
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Juhani Multanen
- Department of Physical Medicine and Rehabilitation, NOVA, Central Hospital of Central Finland, Jyväskylä, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Bates NA, Huffman A, Goodyear E, Nagai T, Rigamonti L, Breuer L, Holmes BD, Schilaty ND. Physical clinical care and artificial-intelligence-guided core resistance training improve endurance and patient-reported outcomes in subjects with lower back pain. Clin Biomech (Bristol, Avon) 2023; 103:105902. [PMID: 36805199 DOI: 10.1016/j.clinbiomech.2023.105902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/19/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Low back pain is an extremely prevalent issue with an extensive impact, ranging from decreased quality of life to lost years of productivity. Many interventions have been developed to alleviate chronic lower back pain, yet it remains a widespread problem. The objective of this study was to examine the role of artificial intelligence guided resistance training relative to clinical variables in subjects experiencing lower back pain. METHODS 69 out of 108 enrolled and 92 accrued subjects completed the 8-week intervention. Subjects were randomized into four groups (Control, Training, Clinical, or Combined). The Training cohort received supervised artificial-intelligence-guided core-focused resistance training while the Clinical group received clinical care. The Combined group received both clinical care and artificial-intelligence-guided training and the Control group received no treatment. Participants were evaluated using functional testing and patient-reported outcomes at baseline, 4 weeks, and 8 weeks. FINDINGS In the clinical tests, the Clinical and Combined cohorts showed increased total time for isometric extensor endurance and the Clinical cohort increased total distance traveled in the 6-min walk test at 8 weeks. The Training, Clinical, and Combined groups showed improvements in Patient-reported outcomes after 8 weeks. Most of the significant improvements were only seen at the 8-week evaluation for both the clinical evaluations and Patient-reported outcomes. The Control group did not show significant improvements in any outcome measures. INTERPRETATION The present data indicate that core-focused interventions, including artificial-intelligence-guided moderate-resistance exercise, can increase objective functional outcomes and patient satisfaction using Patient-reported outcomes in individuals with lower back pain.
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Affiliation(s)
- Nathaniel A Bates
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Allison Huffman
- The Ohio State University School of Medicine, Columbus, OH, USA
| | - Evelyn Goodyear
- The Ohio State University School of Medicine, Columbus, OH, USA
| | - Takashi Nagai
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; United States Army Research Institute of Environmental Medicine, Natick, MA, United States of America
| | - Luca Rigamonti
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Policlinico San Pietro, Ponte San Pietro, Italy
| | - Logan Breuer
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Nathan D Schilaty
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA; Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA
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Lee GT, Himler P, Rhon DI, Young JL. Home Exercise Programs Are Infrequently Prescribed in Trials of Supervised Exercise for Individuals With Low Back Pain: A Scoping Review of 292 Randomized Controlled Trials. J Orthop Sports Phys Ther 2023; 53:120-142. [PMID: 36645192 DOI: 10.2519/jospt.2023.11448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES: To (1) determine how often home exercise programs (HEPs) are prescribed in supervised exercise trials for low back pain (LBP) and (2) describe characteristics of the HEP programs (design, purpose, dose, and adherence). DESIGN: Scoping review. LITERATURE SEARCH: PubMed, CINAHL, and Ovid MEDLINE were searched from January 1, 2010, to August 17, 2021. STUDY SELECTION CRITERIA: Randomized controlled trials that included adults with LBP who received exercise interventions. DATA SYNTHESIS: The presence or absence of a prescribed HEP and any details of the HEP including design, dose, and adherence were extracted and summarized. RESULTS: Of 2689 potentially relevant trials, 292 were eligible for inclusion. Ninety-four trials (32%) included a HEP. The most commonly prescribed home exercises were core stability, trunk strengthening, and motor control exercises. There was great variation in the frequency and duration with which HEPs were prescribed. Adherence to HEPs was measured in fewer than half of the trials, and the methods for measuring adherence were inconsistent. Adherence to HEPs ranged from 29% to 82% in the 21 trials that reported adherence. CONCLUSION: Home exercise programs are not regularly prescribed in supervised exercise trials for LBP. There was considerable variation in prescribing HEPs and monitoring exercise adherence in trials of exercise-based treatments for adults with LBP. There is no consistent method used to measure participants' adherence to HEPs, and adherence percentages vary widely. J Orthop Sports Phys Ther 2023;53(3):120-142. Epub: 16 January 2023. doi:10.2519/jospt.2023.11448.
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Dong K, Yu T, Chun B. Effects of Core Training on Sport-Specific Performance of Athletes: A Meta-Analysis of Randomized Controlled Trials. Behav Sci (Basel) 2023; 13:bs13020148. [PMID: 36829378 PMCID: PMC9952339 DOI: 10.3390/bs13020148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Improving athletes' performance is a major topic of interest in studies on competitive sports. Core training has been used as a training method in daily life and rehabilitation, and recently, in competitive sports, with positive results. Previous experimental studies showed that core training can improve the fitness level of athletes (e.g., balance, core stability, etc.), but offer no consistent conclusions on whether it can improve sport-specific performance. The purpose of this study was to investigate the effect of core training on the sport-specific performance of athletes through a meta-analysis. Relevant studies on randomized controlled trials were selected, and we calculated the effect size using standardized mean difference values and the random effects model. Results showed that core training had almost no effect on athletes' power and speed, while agility showed a medium effect size but no statistical significance. On the other hand, there was a large effect on general athletic performance, such as core endurance and balance. Consequently, core training had a great effect on the core endurance and balance of athletes, but little effect on sport-specific performance. This result implies that more elaborate core training programs should be designed to improve the sport-specific performance of athletes.
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Reyes-Ferrada W, Chirosa-Rios L, Martinez-Garcia D, Rodríguez-Perea A, Jerez-Mayorga D. Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2023; 36:1237-1250. [PMID: 37458013 DOI: 10.3233/bmr-220301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength. OBJECTIVE This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength. METHODS We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence. CONCLUSIONS Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.
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Affiliation(s)
- W Reyes-Ferrada
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - L Chirosa-Rios
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - D Martinez-Garcia
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - A Rodríguez-Perea
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - D Jerez-Mayorga
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
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Kantak SS, Johnson T, Zarzycki R. Linking Pain and Motor Control: Conceptualization of Movement Deficits in Patients With Painful Conditions. Phys Ther 2022; 102:6497839. [PMID: 35079833 DOI: 10.1093/ptj/pzab289] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 09/13/2021] [Accepted: 12/10/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED When people experience or expect pain, they move differently. Pain-altered movement strategies, collectively described here as pain-related movement dysfunction (PRMD), may persist well after pain resolves and, ultimately, may result in altered kinematics and kinetics, future reinjury, and disability. Although PRMD may manifest as abnormal movements that are often evident in clinical assessment, the underlying mechanisms are complex, engaging sensory-perceptual, cognitive, psychological, and motor processes. Motor control theories provide a conceptual framework to determine, assess, and target processes that contribute to normal and abnormal movement and thus are important for physical therapy and rehabilitation practice. Contemporary understanding of motor control has evolved from reflex-based understanding to a more complex task-dependent interaction between cognitive and motor systems, each with distinct neuroanatomic substrates. Though experts have recognized the importance of motor control in the management of painful conditions, there is no comprehensive framework that explicates the processes engaged in the control of goal-directed actions, particularly in the presence of pain. This Perspective outlines sensory-perceptual, cognitive, psychological, and motor processes in the contemporary model of motor control, describing the neural substrates underlying each process and highlighting how pain and anticipation of pain influence motor control processes and consequently contribute to PRMD. Finally, potential lines of future inquiry-grounded in the contemporary model of motor control-are outlined to advance understanding and improve the assessment and treatment of PRMD. IMPACT This Perspective proposes that approaching PRMD from a contemporary motor control perspective will uncover key mechanisms, identify treatment targets, inform assessments, and innovate treatments across sensory-perceptual, cognitive, and motor domains, all of which have the potential to improve movement and functional outcomes in patients with painful conditions.
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Affiliation(s)
- Shailesh S Kantak
- Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA.,Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
| | - Tessa Johnson
- Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
| | - Ryan Zarzycki
- Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
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Nambi G, Abdelbasset WK, Elsayed SH, Verma A, George JS, Saleh AK. CLINICAL AND PHYSICAL EFFICIENCY OF VIRTUAL REALITY GAMES IN SOCCER PLAYERS WITH LOW BACK PAIN. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127062021_0034] [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
ABSTRACT Introduction: Virtual reality training (VRT) is an advanced technology that creates virtual games by a computer through specific software. It is a type of rehabilitation training commonly used in balance problems to treat musculoskeletal conditions. Objective: To determine and compare the effects of virtual reality games with those of core stabilization training on physical efficiency in soccer players with chronic low back pain. Methods: A randomized, double-blinded, controlled study was conducted on 60 LBP participants at a university hospital. The first group (n=20) received virtual reality (VR) training; the second group (n=20) received core stabilization (CS) training; and the third group (n=20) received conventional training exercises for four weeks. Scores of clinical and sports performance were measured at baseline, and after 4 weeks, 8 weeks and 6 months. Results: The baseline demographic and clinical characters did not show any significant differences (p>0.05) in the statistical analysis, which shows a homogenous population. Four weeks following the training, the VR training group showed more significant changes in clinical scores than the CS training and control groups (p≤0.001). The scores for sports performance also showed more significant improvement in the VR training group than in the other two groups (p≤0.001). The same improved clinical and sports performance changes were seen at 8 weeks and 6 months of follow-up in the VR training group, when compared to the other two groups (p≤0.001). Conclusion: This study suggests that training through virtual reality games results in long-term improvement in clinical and sports performance compared to other forms of training in soccer players with chronic low back pain.Level of evidence I b; Therapeutic studies – Investigation of treatment results.
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Affiliation(s)
- Gopal Nambi
- Prince Sattam bin Abdulaziz University, Saudi Arabia
| | | | - Shereen H. Elsayed
- Princess Nourah bint Abdulrahman University, Saudi Arabia; Cairo University, Egypt
| | - Anju Verma
- Prince Sattam bin Abdulaziz University, Saudi Arabia
| | | | - Ayman K. Saleh
- Prince Sattam Bin Abdulaziz University, Saudi Arabia; Al-Azhar University, Egypt
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Observation on the Curative Effect of Massage Manipulation Combined with Core Strength Training in Patients with Chronic Nonspecific Low Back Pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:7534577. [PMID: 34721644 PMCID: PMC8556100 DOI: 10.1155/2021/7534577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022]
Abstract
In this prospective study, we used the random number table method to equally divide 141 patients with chronic nonspecific low back pain (CNLBP) who met the inclusion criteria into 3 groups. One group who received massage manipulation therapy was recorded as the manipulation group (n = 47), one other group who received core strength training therapy was recorded as the training group (n = 47), and the other group who received massage manipulation combined with core strength training was recorded as the combination group (n = 47). All the patients were treated for 1w as the course of treatment, with the treatment conducted for 5 d/w for 4 w and 12 w of follow-up. The efficacies of the 3 groups were evaluated after treatment, and the visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and waist dynamic and static muscle endurance before and after treatment of the 3 groups were compared, and the long-term efficacies of the 3 groups were evaluated combined with the VAS scores at 6 w and 12 w after treatment. Our result was that, after treatment, the total effective rate of the combination group (95.74%) is significantly better than that of the manipulation group (80.85%) and the training group (78.72%) (P < 0.05). After treatment, the VAS and ODI scores of the 3 groups significantly decreased, and the waist dynamic endurance and static muscle endurance significantly increased, and the condition of the combination group was significantly improved compared with that of the manipulation group and the training group (P < 0.05). At 6w and 12w after treatment, the VAS scores of the manipulation group and training group were increased compared with those at the end of treatment (P < 0.05), there was no significant change in the combination group (P < 0.05), and the VAS scores of the combination group at 6 w and 12 w after treatment were lower than those of the manipulation group and training group at the same time point (P < 0.05). This suggests that the synergistic effect of massage manipulation combined with core strength training in the treatment of CNLBP can effectively alleviate patients' pain and waist dysfunction, enhance dynamic and static muscle endurance, and have significant short-term and long-term effects, which are worthy of promotion.
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Abstract
BACKGROUND Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. OBJECTIVES The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic non-specific low back pain compared to no treatment, usual care, placebo and other conservative treatments. SEARCH METHODS We searched CENTRAL (which includes the Cochrane Back and Neck trials register), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, SPORTDiscus, and trials registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform), and conducted citation searching of relevant systematic reviews to identify additional studies. The review includes data for trials identified in searches up to 27 April 2018. All eligible trials have been identified through searches to 7 December 2020, but have not yet been extracted; these trials will be integrated in the next update. SELECTION CRITERIA We included randomised controlled trials that assessed exercise treatment compared to no treatment, usual care, placebo or other conservative treatment on the outcomes of pain or functional limitations for a population of adult participants with chronic non-specific low back pain of more than 12 weeks' duration. DATA COLLECTION AND ANALYSIS Two authors screened and assessed studies independently, with consensus. We extracted outcome data using electronic databases; pain and functional limitations outcomes were re-scaled to 0 to 100 points for meta-analyses where 0 is no pain or functional limitations. We assessed risk of bias using the Cochrane risk of bias (RoB) tool and used GRADE to evaluate the overall certainty of the evidence. When required, we contacted study authors to obtain missing data. To interpret meta-analysis results, we considered a 15-point difference in pain and a 10-point difference in functional limitations outcomes to be clinically important for the primary comparison of exercise versus no treatment, usual care or placebo. MAIN RESULTS We included 249 trials of exercise treatment, including studies conducted in Europe (122 studies), Asia (38 studies), North America (33 studies), and the Middle East (24 studies). Sixty-one per cent of studies (151 trials) examined the effectiveness of two or more different types of exercise treatment, and 57% (142 trials) compared exercise treatment to a non-exercise comparison treatment. Study participants had a mean age of 43.7 years and, on average, 59% of study populations were female. Most of the trials were judged to be at risk of bias, including 79% at risk of performance bias due to difficulty blinding exercise treatments. We found moderate-certainty evidence that exercise treatment is more effective for treatment of chronic low back pain compared to no treatment, usual care or placebo comparisons for pain outcomes at earliest follow-up (MD -15.2, 95% CI -18.3 to -12.2), a clinically important difference. Certainty of evidence was downgraded mainly due to heterogeneity. For the same comparison, there was moderate-certainty evidence for functional limitations outcomes (MD -6.8 (95% CI -8.3 to -5.3); this finding did not meet our prespecified threshold for minimal clinically important difference. Certainty of evidence was downgraded mainly due to some evidence of publication bias. Compared to all other investigated conservative treatments, exercise treatment was found to have improved pain (MD -9.1, 95% CI -12.6 to -5.6) and functional limitations outcomes (MD -4.1, 95% CI -6.0 to -2.2). These effects did not meet our prespecified threshold for clinically important difference. Subgroup analysis of pain outcomes suggested that exercise treatment is probably more effective than education alone (MD -12.2, 95% CI -19.4 to -5.0) or non-exercise physical therapy (MD -10.4, 95% CI -15.2 to -5.6), but with no differences observed for manual therapy (MD 1.0, 95% CI -3.1 to 5.1). In studies that reported adverse effects (86 studies), one or more adverse effects were reported in 37 of 112 exercise groups (33%) and 12 of 42 comparison groups (29%). Twelve included studies reported measuring adverse effects in a systematic way, with a median of 0.14 (IQR 0.01 to 0.57) per participant in the exercise groups (mostly minor harms, e.g. muscle soreness), and 0.12 (IQR 0.02 to 0.32) in comparison groups. AUTHORS' CONCLUSIONS We found moderate-certainty evidence that exercise is probably effective for treatment of chronic low back pain compared to no treatment, usual care or placebo for pain. The observed treatment effect for the exercise compared to no treatment, usual care or placebo comparisons is small for functional limitations, not meeting our threshold for minimal clinically important difference. We also found exercise to have improved pain (low-certainty evidence) and functional limitations outcomes (moderate-certainty evidence) compared to other conservative treatments; however, these effects were small and not clinically important when considering all comparisons together. Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments.
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Affiliation(s)
- Jill A Hayden
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jenna Ellis
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Rachel Ogilvie
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Antti Malmivaara
- Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maurits W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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Nambi G, Abdelbasset WK, Alrawaili SM, Alsubaie SF, Abodonya AM, Saleh AK. Virtual reality or isokinetic training; its effect on pain, kinesiophobia and serum stress hormones in chronic low back pain: A randomized controlled trial. Technol Health Care 2021; 29:155-166. [PMID: 32831210 DOI: 10.3233/thc-202301] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Evidence on the latest technologies in rehabilitation for reducing pain and altering serum stress hormones in low back pain (LBP) was lacking. OBJECTIVE To find the clinical and hormonal effects of virtual reality training (VRT) and isokinetic training (IKT) in chronic LBP patients. METHODS Through the simple random sampling method, 60 university football players with chronic LBP were allocated into three groups: NVRT= 20, NIKT= 20 and NCONTROL= 20. The three groups underwent different exercises for 4 weeks. Clinical (pain intensity and kinesiophobia) and hormonal (glucose, insulin, HOMA-IR, growth hormone, prolactin, ACTH and cortisol) values were measured at baseline, after 4 weeks and 6 months. RESULTS Four weeks following training, the VRT and IKT groups showed significant changes in pain intensity and kinesiophobia in comparison to the control group (p< 0.05). Hormonal measures also showed significant improvement in the VRT group in comparison to the other two groups (p< 0.05). CONCLUSION Training through virtual reality and isokinetic exercise is an effective approach in terms of pain and kinesiophobia. In terms of hormonal analysis, virtual reality shows slightly more improvements than isokinetic training in subjects with chronic LBP.
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Affiliation(s)
- Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.,Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Saud M Alrawaili
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Saud F Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ahmed M Abodonya
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.,Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ayman K Saleh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.,Department of Orthopedic, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
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Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105400. [PMID: 34070164 PMCID: PMC8158512 DOI: 10.3390/ijerph18105400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 11/22/2022]
Abstract
While competitive training is usually associated with the prevalence of back pain and injuries in athletes, little attention is being paid to the positive effects of sport-specific exercises on core musculature in the prevention of back problems. This scoping review aims (i) to map the literature that addresses the effects on reduction of back problems following athlete training with differing demands on the core musculature and (ii) to identify gaps in the existing literature and propose future research on this topic. The main literature search was conducted on the MEDLINE, PubMed, Web of Science, Scopus, and Cochrane Library databases and was completed on Elsevier, SpringerLink, and Google Scholar. A total of 21 research articles met the inclusion criteria. The findings of 17 studies identified that core strengthening and core stabilization exercises, alone or in combination with athlete training, contribute to the reduction of back pain in athletes, whereas only four studies revealed no significant association of core muscle strength and/or endurance with back problems. Nevertheless, more research is warranted to elucidate the pros and cons of purely sport-specific training with differing demands on the core musculature on back health in athletes. This could help us to design prevention strategies specifically tailored to individual athletes.
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Comparative Effects of Isokinetic Training and Virtual Reality Training on Sports Performances in University Football Players with Chronic Low Back Pain-Randomized Controlled Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2981273. [PMID: 32617104 PMCID: PMC7315304 DOI: 10.1155/2020/2981273] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/15/2020] [Accepted: 05/30/2020] [Indexed: 12/19/2022]
Abstract
Objective The objective of this study is to find and compare the effects of isokinetic training and virtual reality training on sports performances in university football players with chronic low back pain. Design This is a randomized, double-blinded controlled study. Methods The study was conducted on 45LBP participants at university hospital. First group (n = 15) received isokinetic training, second group (n = 15) received virtual reality training, and the control group (n = 15) received conventional training exercises for four weeks. Clinical (pain intensity and player wellness) and sports performance (40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores were measured at baseline, after 4 weeks, 8 weeks, and 6 months. Results Four weeks following training VRT group shows more significant changes in pain intensity and player wellness scores than IKT and control groups (p ≤ 0.001). Sports performance variables (such as 40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores also show significant improvement in VRT group than the other two groups (p ≤ 0.001). Conclusion Overall, our study suggests that strength training through virtual reality training protocol improves pain and sports performances than isokinetic training and other conventional trainings in university football players with chronic low back pain.
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