1
|
Larivière C, Preuss R, Coutu MF, Sullivan MJ, Roy N, Henry SM. Disability reduction following a lumbar stabilization exercise program for low back pain: large vs. small improvement subgroup analyses of physical and psychological variables. BMC Musculoskelet Disord 2024; 25:358. [PMID: 38704535 PMCID: PMC11069239 DOI: 10.1186/s12891-024-07480-4] [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: 01/08/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Little is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment. METHODS Participants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were collected twice (baseline, end of treatment), while psychological measures (fear-avoidance beliefs, pain catastrophizing, psychological distress, illness perceptions, outcome expectations) were collected at four time points (baseline, mid-treatment, end of treatment, follow-up). The participants were divided into three subgroups (large, moderate and small clinical improvements) based on the change of perceived disability scores. ANOVA for repeated measure compared well-contrasted subgroups (large vs. small improvement) at different times to test for SUBGROUP × TIME interactions. RESULTS Statistically significant interactions were observed for several physical and psychological measures. In all these interactions, the large- and small-improvement subgroups were equivalent at baseline, but the large-improvement subgroup showed more improvements over time compared to the small-improvement subgroup. For psychological measures only (fear-avoidance beliefs, pain catastrophizing, illness perceptions), between-group differences reached moderate to strong effect sizes, at the end of treatment and follow-up. CONCLUSIONS The large-improvement subgroup showed more improvement than the small-improvement subgroup with regard to physical factors typically targeted by this specific exercise program as well as for psychological factors that are known to influence clinical outcomes.
Collapse
Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada.
| | - Richard Preuss
- School of Physical & Occupational Therapy, McGill University, 845 Sherbrooke Wst, Montreal, QC, H3G 1Y5, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Marie-France Coutu
- Charles-Le Moyne Hospital Research Centre, University of Sherbrooke, 150 Place Charles-Le Moyne, Office 200, Longueuil, QC, J4K 0A8, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Michael J Sullivan
- Department of Psychology, McGill University, 1205 Docteur Penfield, Montreal, QC, H3A 1B1, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Nicolas Roy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Sharon M Henry
- Department of Neurological Sciences, University of Vermont, Burlington, VT, 05401, USA
| |
Collapse
|
2
|
Lendraitienė E, Styraitė B, Šakalienė R, Misytė G, Bileviciute-Ljungar I. Effects of Pain Neuroscience Education and Physiotherapy on Chronic Low Back Pain, Fear of Movement and Functional Status: A Randomised Pilot Study. J Clin Med 2024; 13:2081. [PMID: 38610845 PMCID: PMC11012892 DOI: 10.3390/jcm13072081] [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: 01/23/2024] [Revised: 03/04/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Chronic non-specific low back pain is a non-harmous condition often found in the general population. It is one of the most significant disabilities and needs different treatment modalities. This study investigates the effects of pain neuroscience education and physiotherapy on pain intensity, fear of movement and functional status in a Lithuanian cohort with non-specific low back pain. Methods: The study was performed at the primary health care unit in Kaunas, Lithuania. The key inclusion criterion was persistent non-specific low back pain longer than three months and which affects daily life functions. Thirty participants (mean 33.47, SD 4.38 years age, 70% women) were randomised into two training groups with and without pain neuroscience education (for a total of 60 min of teaching). Physiotherapy was performed twice per week during 45 min/session for a period of 10 weeks with exercises which strengthen, stabilize, and stretch the spinal cord muscles. Outcomes included pain intensity, kinesiophobia and disability and these were measured by self-scored questionnaires (numeric rating scale, Tampa scale for kinesiophobia-11, Oswestry disability index and the Roland-Morris questionnaire, respectively). Results: The results indicate that both groups improved in the measured outcomes, with the only difference between them being a better improvement in kinesiophobia in the group receiving physiotherapy and pain neuroscience education. Conclusions: The results of this study confirm that a relatively short intervention of pain neuroscience education enhances the effects of physiotherapy and should be implemented in clinical practice.
Collapse
Affiliation(s)
- Eglė Lendraitienė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Barbora Styraitė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Rasa Šakalienė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Gabija Misytė
- Department of Rehabilitation, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (E.L.); (B.S.); (G.M.)
| | - Indre Bileviciute-Ljungar
- Department of Clinical Sciences, Karolinska Institutet at Danderyd University Hospital, 18288 Stockholm, Sweden
- Multidisciplinary Pain Clinic, Capio St. Göran Hospital, 11219 Stockholm, Sweden
| |
Collapse
|
3
|
Santos MS, Santos PDJ, Vasconcelos ABS, Gomes ACA, de Oliveira LM, Souza PRM, Heredia‐Elvar JR, Da Silva‐Grigoletto ME. Neuroendocrine effects of a single bout of functional and core stabilization training in women with chronic nonspecific low back pain: A crossover study. Physiol Rep 2022; 10:e15365. [PMID: 36065850 PMCID: PMC9446407 DOI: 10.14814/phy2.15365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023] Open
Abstract
Exercise-induced hypoalgesia (EIH) is characterized as the pain reduction after an exercise session and it seems to be related to the release of plasma β-endorphin. In this sense, the core stabilization training (CT) has been suggested for patients with chronic nonspecific low back pain (CNSLBP), but it is unclear whether it induces EIH. Patients with CNSLBP have neuromotor dysfunctions that can affect the performance of functional tasks, thus, performing functional training (FT) could improve motor control and promote EIH, since functional training uses multi-joint exercises that aim to improve the functionality of actions performed in daily life. EIH is usually assessed using quantitative sensory tests (QST) such as conditioned pain modulation, pressure pain threshold, and temporal summation. Thus, the sum of parameters from quantitative sensory tests and plasma β-endorphin would make it possible to understand what the neuroendocrine effects of FT and CT session are. Our study compared the acute effect of CT and FT on the EIH and plasma β-endorphin release, and correlated plasma β-endorphin with quantitative sensory testing in patients with CNSLBP. Eighteen women performed two training sessions (CT and FT) with an interval of 48 h between sessions. EIH was assessed by QST and plasma β-endorphin levels. Results showed that only FT significantly increased plasma β-endorphin (FT p < 0.01; CT p = 0.45), which correlated with pain pressure threshold (PPT) and conditioned pain modulation (CPM). However, QST values were not different in women with CNSLBP after CT or FT protocols. Plasma β-endorphin correlated with PPT and CPM, however, the same did not occur with a temporal summation.
Collapse
Affiliation(s)
- Marta Silva Santos
- Department of Physical Education, Functional Training GroupFederal University of SergipeSão CristóvãoBrazil
| | - Poliana de Jesus Santos
- Department of Physical Education, Functional Training GroupFederal University of SergipeSão CristóvãoBrazil
| | | | - Ana Carolina Amado Gomes
- Institute of Biological Sciences, Laboratory of Immunology and Genomics of ParasitesFederal University of Minas GeraisBelo HorizonteBrazil
| | - Luciana Maria de Oliveira
- Department of Morphology, Laboratory of Entomology and Tropical ParasitologyFederal University of SergipeSão CristóvãoBrazil
| | | | | | | |
Collapse
|
4
|
Larivière C, Rabhi K, Preuss R, Coutu MF, Roy N, Henry SM. Derivation of clinical prediction rules for identifying patients with non-acute low back pain who respond best to a lumbar stabilization exercise program at post-treatment and six-month follow-up. PLoS One 2022; 17:e0265970. [PMID: 35476707 PMCID: PMC9045609 DOI: 10.1371/journal.pone.0265970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Low back pain (LBP) remains one of the most common and incapacitating health conditions worldwide. Clinical guidelines recommend exercise programs after the acute phase, but clinical effects are modest when assessed at a population level. Research needs to determine who is likely to benefit from specific exercise interventions, based on clinical presentation. This study aimed to derive clinical prediction rules (CPRs) for treatment success, using a lumbar stabilization exercise program (LSEP), at the end of treatment and at six-month follow-up. The eight-week LSEP, including clinical sessions and home exercises, was completed by 110 participants with non-acute LBP, with 100 retained at the six-month follow-up. Physical (lumbar segmental instability, motor control impairments, posture and range of motion, trunk muscle endurance and physical performance tests) and psychological (related to fear-avoidance and home-exercise adherence) measures were collected at a baseline clinical exam. Multivariate logistic regression models were used to predict clinical success, as defined by ≥50% decrease in the Oswestry Disability Index. CPRs were derived for success at program completion (T8) and six-month follow-up (T34), negotiating between predictive ability and clinical usability. The chosen CPRs contained four (T8) and three (T34) clinical tests, all theoretically related to spinal instability, making these CPRs specific to the treatment provided (LSEP). The chosen CPRs provided a positive likelihood ratio of 17.9 (T8) and 8.2 (T34), when two or more tests were positive. When applying these CPRs, the probability of treatment success rose from 49% to 96% at T8 and from 53% to 92% at T34. These results support the further development of these CPRs by proceeding to the validation stage.
Collapse
Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- * E-mail:
| | - Khalil Rabhi
- Independent Statistician Consultant, Montréal, Québec, Canada
| | - Richard Preuss
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- School of Physical & Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Marie-France Coutu
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- Charles-Le Moyne Hospital Research Centre, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Nicolas Roy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
| | - Sharon M. Henry
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
| |
Collapse
|
5
|
Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord 2021; 22:998. [PMID: 34847915 PMCID: PMC8630919 DOI: 10.1186/s12891-021-04858-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
Background Therapeutic exercises are used in clinical practice for patients with low back pain (LBP). Core stabilization exercises can retrain the important function of local trunk muscles and increase the accuracy of the sensory integration process for stability of the spine in individuals with LBP. The aim of this study was to compare the effects of two different exercise regimes, Core stabilization exercises (CSE) and Strengthening exercise (STE), on proprioception, balance, muscle thickness and pain-related outcomes in patients with subacute non-specific low back pain (NSLBP). Methods Thirty-six subacute NSLBP patients, [mean age, 34.78 ± 9.07 years; BMI, 24.03 ± 3.20 Kg/m2; and duration of current pain, 8.22 ± 1.61 weeks], were included in this study. They were randomly allocated into either CSE (n = 18) or STE groups (n = 18). Exercise training was given for 30 min, three times per week, for up to 4 weeks. Proprioception, standing balance, muscle thickness of transversus abdominis (TrA) and lumbar multifidus (LM), and pain-related outcomes, comprising pain, functional disability and fear of movement, were assessed at baseline and after 4 weeks of intervention. Results The CSE group demonstrated significantly more improvement than the STE group after 4 weeks of intervention. Improvements were in: proprioception [mean difference (95% CI): − 0.295 (− 0.37 to − 0.2), effect size: 1.38, (p < 0.001)], balance: single leg standing with eyes open and eyes closed on both stable and unstable surfaces (p < 0.05), and percentage change of muscle thickness of TrA and LM (p < 0.01). Although both exercise groups gained relief from pain, the CSE group demonstrated greater reduction of functional disability [effect size: 0.61, (p < 0.05)] and fear of movement [effect size: 0.80, (p < 0.01)]. There were no significant adverse effects in either type of exercise program. Conclusion Despite both core stabilization and strengthening exercises reducing pain, core stabilization exercise is superior to strengthening exercise. It is effective in improving proprioception, balance, and percentage change of muscle thickness of TrA and LM, and reducing functional disability and fear of movement in patients with subacute NSLBP. Trial registration Thai Clinical Trial Registry (TCTR20180822001; August 21, 2018). Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04858-6.
Collapse
Affiliation(s)
- Su Su Hlaing
- Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, 123 Mittraphap Rd, Muang District, Khon Kaen, 40002, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, 123 Mittraphap Rd, Muang District, Khon Kaen, 40002, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, 123 Mittraphap Rd, Muang District, Khon Kaen, 40002, Thailand. .,School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, 123 Mittraphap Rd, Muang District, Khon Kaen, 40002, Thailand.
| | - Ei Ei Khine
- Department of Radiology, Yangon Orthopedic Hospital, Kyee Myin Daing Township, Yangon, 11101, Myanmar
| | - Rose Boucaut
- University of South Australia: Allied Health and Human Performance, Adelaide, SA, 5001, Australia
| |
Collapse
|
6
|
Heredia-Elvar JR, Juan-Recio C, Prat-Luri A, Barbado D, Vera-Garcia FJ. Observational Screening Guidelines and Smartphone Accelerometer Thresholds to Establish the Intensity of Some of the Most Popular Core Stability Exercises. Front Physiol 2021; 12:751569. [PMID: 34744790 PMCID: PMC8570278 DOI: 10.3389/fphys.2021.751569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/23/2021] [Indexed: 11/28/2022] Open
Abstract
The lack of training load control, mainly exercise intensity, is one of the main limitations of core stability (CS) programs, which makes the training individualization and the analysis of the dose-response relationship difficult. The objectives of this study were to assess the inter-and intra-rater agreement when using new observational screening guidelines to decide if a core stability exercise represents an adequate training intensity level for a given participant. Besides, the relationship between experts' ratings based on these criteria and pelvic accelerations recorded with a smartphone accelerometer was also analyzed. Ten healthy physically active participants with a smartphone accelerometer placed on their pelvis were video-taped while performing a progression of seven variations of the front bridge, back bridge, side bridge and bird-dog exercises. Two expert and four non-expert raters watched the videos and used the observational screening guidelines to decide for each exercise variation if it represented an adequate training intensity level or not. In order to analyze the inter-and intra-rater agreement, several Kappa (κ) statistics were used. Receiver operating characteristic (ROC) curves to explore if the accelerometry allowed to establish pelvic acceleration thresholds representing the minimum level of exercise intensity for CS training. Cut-off acceleration values were calculated balancing sensitivity (Se) and 1-specifity (1-Sp) indexes (i.e., Youden index) or minimizing 1-Sp. The intra-and inter-rater analysis showed a substantial-high level of agreement with a prevalence-adjusted bias-adjusted Kappa > 0.69. The ROC curves showed that the acceleration thresholds for the bridging exercises were very similar, with global cut-off values of 0.35 m/s2 (Se = 82%; 1-Sp = 15%) when using the Youden Index and of 0.50 m/s2 when minimizing 1-Sp (Se = 31%), whilst the bird-dog exercise showed lower cut-off values (Youden Index: 0.21 m/s2, Se = 90%, 1-Sp = 16%; minimizing 1-Sp: 0.32 m/s2, Se = 40%). Overall, this study provides observational screening guidelines and smartphone accelerometer thresholds to facilitate the decision-making process when setting the intensity of some of the most popular core stability exercises in young physically active individuals.
Collapse
Affiliation(s)
- Juan R Heredia-Elvar
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - Casto Juan-Recio
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - Amaya Prat-Luri
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - David Barbado
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
| | - Francisco J Vera-Garcia
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
| |
Collapse
|
7
|
Dynamic evaluation of the contractile function of lumbodorsal muscles during locust pose in yoga by real-time ultrasound. BMC Sports Sci Med Rehabil 2021; 13:87. [PMID: 34376224 PMCID: PMC8353835 DOI: 10.1186/s13102-021-00313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 07/15/2021] [Indexed: 11/10/2022]
Abstract
Background and Purpose Chronic low back pain (CLBP), which has a close relationship with lumbar muscle degeneration, can be effectively treated by exercise therapy, and yoga has been widely accepted by clinicians and patients with CLBP. The purpose of this study was to observe the changes in the thickness of lumbodorsal muscles that occur during locust pose in yoga and how these changes occur. From the changes in muscle thickness that occur in the locust pose, the contractile function of lumbodorsal muscles can be evaluated. Methods Fifty-two healthy volunteers (from May 2019 to August 2019, age from 28 to 68 years, 23 males and 29 females (age: 40 ± 8 years; weight: 68.3 ± 5.2 kg; height: 170.2 ± 13.1 cm) were recruited, and lumbodorsal muscle, including the multifidus, longissimus, iliocostalis, and quadratus lumborum, ultrasonic examinations were carried out in the relaxed and contracted states. The changes in the thickness of the lumbodorsal muscles in the relaxed and contracted states were dynamically observed by real-time ultrasound when subjects were performing the locust yoga pose. Then, the thicknesses of the muscles during the two states were measured to calculate the ratio of contraction of each muscle and determine the statistical significance of the change in thickness of each muscle. Results The mean thickness of the left multifidus in the relaxed state was 1.32 ± 0.27 cm (95 % CI: 1.24 ~ 1.39), that in the contracted state was 1.60 ± 0.30 cm (95 % CI: 1.52 ~ 1.69) (obviously different between the relaxed and contracted states, P < 0.001), and those in the corresponding right side were 1.37 ± 0.31 cm (95 % CI: 1.29 ~ 2.46) and 1.68 ± 0.38 cm (95 % CI: 1.58 ~ 1.79) (P < 0.001), respectively. The mean thickness of the left quadratus lumborum in the relaxed state was 1.38 ± 0.32 cm (95 % CI: 1.29 ~ 1.47), that in the contracted state was 1.62 ± 0.40 cm (95 % CI: 1.50 ~ 1.73) (P = 0.001), and those in the corresponding right side were 1.30 ± 0.32 cm (95 % CI: 1.21 ~ 1.39) and 1.55 ± 0.41 cm (95 % CI: 1.44 ~ 1.67) (P = 0.001), respectively. The mean thickness of the left longissimus in the relaxed was 2.33 ± 0.51 cm (95 % CI: 2.19 ~ 2.47), that in the contracted state was 3.20 ± 0.61 cm (95 % CI: 3.03 ~ 3.37) (P < 0.001), and those in the corresponding right side were 2.34 ± 0.49 cm (95 % CI 2.20 ~ 2.48) and 3.26 ± 0.68 cm (95 % CI 3.07 ~ 3.45) (P < 0.001), respectively. The mean thickness of the left iliocostalis in the relaxed state was 1.88 ± 0.41 cm (95 % CI: 1.76 ~ 1.99), that in the contracted state was 2.34 ± 0.49 cm (95 % CI: 2.00 ~ 2.47) (P < 0.001), and those in the corresponding right side were 1.98 ± 0.40 cm (95 % CI: 1.87 ~ 2.09) and 2.44 ± 0.56 cm (95 % CI: 2.29 ~ 2.60) (P < 0.001), respectively. The mean contracted state/resting state (C/R) of the longissimus was 1.39 ± 0.14 on the left and 1.40 ± 0.16 on the right. The multifidus and iliocostalis had the second highest C/R. The mean C/R of the multifidus was 1.23 ± 0.12 on the left and 1.24 ± 0.15 on the right, and the mean C/R of the iliocostalis was 1.25 ± 0.12 on the left and 1.24 ± 0.14 on the right. The quadratus lumborum had the lowest C/R, and the mean C/R of the quadratus lumborum was 1.17 ± 0.10 on the left and 1.19 ± 0.11 on the right. Conclusions Ultrasound can be used to dynamically assess the contractile function of the lumbar muscle in the locust pose of yoga, the C/R ratio can be used to indicate the ability of a muscle to contract, and dynamic ultrasound can guide lumbar exercise and feedback the exercise results. The establishment of this model allowed data regarding the contraction state of the lumbar muscle to be obtained in a normal population, and based on this, future studies can further explore and evaluate the contraction state of the lumbar muscle after yoga exercise in CLBP patients, the effect exercise on lumbar instability and on a patient population after lumbar operation.
Collapse
|
8
|
Osuka S, Ishida T, Yamanaka M, Chiba T, Miura T, Koshino Y, Saito Y, Nakata A, Samukawa M, Kasahara S, Tohyama H. Abdominal draw-in maneuver changes neuromuscular responses to sudden release from trunk loading in patients with non-specific chronic low back pain. J Orthop Sci 2020; 25:781-786. [PMID: 31740080 DOI: 10.1016/j.jos.2019.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/29/2019] [Accepted: 10/15/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Abdominal draw-in maneuver (ADIM) has been recommended to achieve appropriate trunk muscle response for patients with non-specific chronic low back pain (CLBP). However, it has remained unclear whether the intervention with ADIM could change the trunk muscle response to sudden release from loading, which is considered to contribute mechanical circumstances to low back pain. The purpose of the present study was to investigate the effects of the intervention with ADIM on electromyography (EMG) activities of trunk muscles following sudden release from loading. METHODS Seventeen subjects with non-specific CLBP participated. Subjects resisted trunk flexion or extension loading in semi-seated position, and then the loading was suddenly released. EMG recordings of 6 trunk muscles were acquired using a wireless surface EMG system. Onset and offset times were calculated from the EMG data. The intervention with ADIM was provided for 4 weeks. The onset and offset times were compared between pre- and post-intervention with ADIM. RESULTS At the post-intervention, the onset of trunk flexors following release from trunk flexion loading became significantly earlier than pre-intervention (P = 0.028). The offset of flexors following release from trunk extension loading of post-intervention was significantly earlier than that of pre-intervention (P = 0.001). CONCLUSIONS We showed that the intervention with ADIM changed the EMG activity of trunk flexors in response to sudden release from loading. These results suggest a possibility that ADIM might be effective to improve the neuromuscular control of trunk flexors for the treatment of young patients with non-specific CLBP.
Collapse
Affiliation(s)
- Satoshi Osuka
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan; Division of Rehabilitation, Hokkaido University Hospital, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Masanori Yamanaka
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Takeshi Chiba
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan; Division of Rehabilitation, Hokkaido University Hospital, Sapporo, Japan
| | - Takuya Miura
- Department of Rehabilitation, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan
| | - Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan; Rehabilitation Center, NTT East Japan Sapporo Hospital, Sapporo, Japan
| | - Yuki Saito
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Akimi Nakata
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | | | | |
Collapse
|
9
|
Oh YJ, Park SH, Lee MM. Comparison of Effects of Abdominal Draw-In Lumbar Stabilization Exercises with and without Respiratory Resistance on Women with Low Back Pain: A Randomized Controlled Trial. Med Sci Monit 2020; 26:e921295. [PMID: 32182226 PMCID: PMC7100066 DOI: 10.12659/msm.921295] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study examined the effects of abdominal draw-in lumbar stabilization exercises (ADIM) with respiratory resistance on women ages 40-49 years with low back pain. MATERIAL AND METHODS Forty-four women ages 40-49 years were screened for participation and were randomly assigned to either a respiratory with resistance exercise group (n=22) or a control group (n=22). Abdominal draw-in lumbar stabilization exercises were administered to both groups, but only the respiratory with resistance exercise group received the respiratory resistance training. The exercise training lasted 50 min per session, 3 sessions per week for 4 weeks. The assessment methods used were the quadruple visual analogue scale (QVAS), Oswestry disability index-Korean version (ODI-K), diaphragm thickness and contraction rate, and lung capacity test. RESULTS Both groups showed significant differences in the QVAS, ODI-K, maximum voluntary ventilation (MVV), and diaphragm thickness and contraction rate before and after the intervention (p<0.05). In the respiratory resistance exercise group, the ODI-K, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), MVV, and diaphragm thickness and contraction rate showed significantly better improvement than the control group (p<0.05). CONCLUSIONS A lumbar stabilization exercise program consisting of ADIM and respiratory resistance resulted in decreased pain, reduced dysfunctions, and increased muscle thickness in contraction, contraction rate, and pulmonary function. Strong contraction of the diaphragm and deep abdominal muscles through breathing resistance increased the pressure in the abdominal cavity. Therefore, this may be an effective clinical exercise method for patients with lumbar instability.
Collapse
Affiliation(s)
- Youn-Jung Oh
- Department of Physical Therapy, Graduate School, Daejeon University, Daejeon, South Korea
| | - Sam-Ho Park
- Department of Physical Therapy, Graduate School, Daejeon University, Daejeon, South Korea
| | - Myung-Mo Lee
- Department of Physical Therapy, Daejeon University, Daejeon, South Korea
| |
Collapse
|
10
|
Larivière C, Preuss R, Ludvig D, Henry SM. Is postural control during unstable sitting a proxy measure for determinants associated with lumbar stability? J Biomech 2020; 102:109581. [DOI: 10.1016/j.jbiomech.2019.109581] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 01/29/2023]
|
11
|
Fontana Carvalho AP, Dufresne SS, Rogerio de Oliveira M, Couto Furlanetto K, Dubois M, Dallaire M, Ngomo S, da Silva RA. Effects of lumbar stabilization and muscular stretching on pain, disabilities, postural control and muscle activation in pregnant woman with low back pain. Eur J Phys Rehabil Med 2020; 56:297-306. [PMID: 32072792 DOI: 10.23736/s1973-9087.20.06086-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Low back pain is common during pregnancy. Lumbar stabilization and stretching exercises are recommended to treat low back pain in the general population. However, few studies have applied the effects of these two interventions in pregnant women with low back pain. AIM To compare the effects of lumbar stabilization and stretching exercises for the treatment of gestational low back pain. DESIGN A pilot randomized clinical trial. SETTING Laboratory of Functional Evaluation and Human Motor Performance and physical therapy clinics. POPULATION Initially, 30 pregnant women with low back pain were recruited, of which 24 met the following inclusion criteria: being between 19-29 weeks of gestation; being in prenatal clinical follow-up; having nonspecific mechanical low back pain started in pregnancy; not participating in specific low back pain treatment in the last 3 months. A total of 20 women completed the study (10 each group). METHODS The main outcome measures were clinical (pain by Visual Analogue Scale (VAS) and McGill Pain Questionnaire and disability by Roland Morris Questionnaire), and secondary outcome measures were: postural balance (force platform); muscle activation level of multifidus, iliocostalis lumborum, rectus abdominis and external abdominal oblique (electromyography). The women were randomized into two groups for 6 weeks of intervention twice a week for a 50-minute treatment: 1) lumbar stabilization exercise protocol and 2) stretching exercise protocol. RESULTS There was a significant reduction (P=0.03) in pain (1.68 in VAS and 4.81 for McGill questionnaire) for both interventions, but no change in disability score. In addition, both interventions were comparable for a significant improvement in postural stability (in mean d=0.77) for the velocity sway parameter, and significantly increased activation (P>0.05) of the external abdominal oblique muscle after intervention. CONCLUSIONS Both modalities (lumbar stabilization and stretching) were efficient for pain reduction, improving balance and increasing one trunk activity muscle after 6 weeks of intervention in pregnant women with low back pain. CLINICAL REHABILITATION IMPACT The present study has implications, especially for clinical decision-making with regard to therapy choice in pregnant women with LBP to reduce pain and improve trunk function as measured through balance performance.
Collapse
Affiliation(s)
- Adriana P Fontana Carvalho
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Pitagoras UNOPAR, Londrina, PR, Brazil.,Doctoral Program in Rehabilitation Sciences, UEL/UNOPAR, Londrina, PR, Brazil
| | - Sébastien S Dufresne
- Department of Health Sciences, BioNR Research Laboratory, Université du Québec à Chicoutimi, Chicoutimi QC, Canada
| | - Márcio Rogerio de Oliveira
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Pitagoras UNOPAR, Londrina, PR, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Pitagoras UNOPAR, Londrina, PR, Brazil.,Doctoral Program in Rehabilitation Sciences, UEL/UNOPAR, Londrina, PR, Brazil
| | - Maryane Dubois
- Department of Health Sciences, BioNR Research Laboratory, Université du Québec à Chicoutimi, Chicoutimi QC, Canada
| | - Mathieu Dallaire
- Department of Health Sciences, BioNR Research Laboratory, Université du Québec à Chicoutimi, Chicoutimi QC, Canada
| | - Suzy Ngomo
- Department of Health Sciences, BioNR Research Laboratory, Université du Québec à Chicoutimi, Chicoutimi QC, Canada
| | - Rubens A da Silva
- Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Pitagoras UNOPAR, Londrina, PR, Brazil - .,Doctoral Program in Rehabilitation Sciences, UEL/UNOPAR, Londrina, PR, Brazil.,Department of Health Sciences, BioNR Research Laboratory, Université du Québec à Chicoutimi, Chicoutimi QC, Canada.,Research Centre on Health, CIUSSS du Saguenay-Lac-Saint-Jean, Chicoutimi, QC, Canada
| |
Collapse
|
12
|
Vera-Garcia FJ, Irles-Vidal B, Prat-Luri A, García-Vaquero MP, Barbado D, Juan-Recio C. Progressions of core stabilization exercises based on postural control challenge assessment. Eur J Appl Physiol 2020; 120:567-577. [PMID: 32048007 DOI: 10.1007/s00421-020-04313-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/01/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The intensity progression of core stabilization exercises (CSEs) is usually based on personal criteria rather than on objective parameters. To develop exercise progressions for four of the most common CSEs based on the postural control challenge imposed on the participants, and to analyze the effect of participants' sex and postural control level on these progressions. METHODS Seventy-six males and females performed five variations of front bridge, back bridge, side bridge and bird-dog exercises on two force platforms. The mean velocity of the center of pressure displacement was calculated to assess exercise intensity through the measurement of the participants' body sway (PBS). RESULTS In general, long bridges produced higher PBS than short bridges, bridging with single leg support produced higher PBS than bridging with double leg support and bridging on a hemisphere ball produced higher PBS than bridging on the floor. The most difficult bridging variations were those performed on a hemisphere ball with single leg support. Regarding the bird-dog, two-point positions produced higher PBS than three-point positions and the positions performed on a hemisphere ball produced higher PBS than those performed on the floor. CONCLUSION The CSE progressions obtained by males and females were very similar. However, the participants with high trunk control showed less significant differences between exercise variations than the participants with low trunk control, which shows the need to individualize the progressions according to the participants' training level. Overall, this study provides useful information to guide the prescription of CSE progressions in young physically active individuals.
Collapse
Affiliation(s)
- Francisco J Vera-Garcia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - Belen Irles-Vidal
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - Amaya Prat-Luri
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - María Pilar García-Vaquero
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - David Barbado
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain.
| | - Casto Juan-Recio
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| |
Collapse
|
13
|
Wattananon P, Klomjai W, Sung W. One session of motor control exercise improves joint position sense assessed by an iPhone application: a randomized controlled trial. J Phys Ther Sci 2019; 31:583-589. [PMID: 31417226 PMCID: PMC6642896 DOI: 10.1589/jpts.31.583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/22/2019] [Indexed: 01/04/2023] Open
Abstract
[Purpose] To establish the test-retest reliability of an iPhone application and determine
the immediate effect of motor control exercise (MCE) on lumbar position sense.
[Participants and Methods] This study used a two-arm, randomized controlled trial design
with a blinded assessor. Sixty healthy participants were randomized into the exercise or
control group. The exercise group underwent 30-min MCE, whereas the control group rested
for 15 min. Lumbar motion measured by two iPhones with goniometer application was used to
determine the test-retest reliability. Absolute repositioning errors (pre- and post-test)
from the control and exercise groups were used to determine the immediate effect of MCE on
lumbar position sense. [Results] The test-retest reliability was 0.67–0.95. A significant
interaction effect was found for Angle*Time, main effect of Angle, and main effect of
Time. Post-hoc comparison showed a significant improvement in position sense at 45° and
60° in the exercise group. [Conclusion] The findings suggest that a mobile phone
application has the ability to detect changes in lumbar position sense between sessions
that exceed measurement error following MCE. One session of specific MCE can improve
lumbar position sense at high lumbar flexion.
Collapse
Affiliation(s)
- Peemongkon Wattananon
- Faculty of Physical Therapy, Mahidol University: 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand
| | - Wanalee Klomjai
- Faculty of Physical Therapy, Mahidol University: 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand
| | - Won Sung
- Good Shepherd Penn Partners, Penn Therapy and Fitness, USA
| |
Collapse
|
14
|
L’Heureux J, Coutu MF, Berbiche D, Larivière C. Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1617777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Judith L’Heureux
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Marie-France Coutu
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Charles-LeMoyne Hospital Research Centre, Longueuil, Canada
| | - Djamal Berbiche
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Christian Larivière
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Institut Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Canada
| |
Collapse
|
15
|
Pain and Pain-Related Disability Associated With Proprioceptive Impairment in Chronic Low Back Pain Patients: A Systematic Review. J Manipulative Physiol Ther 2019; 42:210-217. [DOI: 10.1016/j.jmpt.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/05/2018] [Accepted: 10/21/2018] [Indexed: 12/27/2022]
|
16
|
Larivière C, Henry SM, Gagnon DH, Preuss R, Dumas J. Ultrasound Measures of the Abdominal Wall in Patients with Low Back Pain Before and After an 8‐week Lumbar Stabilization Exercise Program, and Their Association With Clinical Outcomes. PM R 2019; 11:710-721. [DOI: 10.1002/pmrj.12000] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Christian Larivière
- Institut de recherche Robert‐Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest Montréal Québec H3A 3C2 Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM)Centre intégré universitaire de santé et de services sociaux du Centre‐Sud‐de‐l'Ile‐de‐Montréal (CCSMTL)MontréalQuébecCanada
| | - Sharon M. Henry
- Department of Rehabilitation TherapyThe University of Vermont Medical Center Burlington VT
| | - Dany H. Gagnon
- School of Rehabilitation, Faculty of MedicineUniversité de Montréal Montréal Québec Canada
| | - Richard Preuss
- School of Physical & Occupational TherapyMcGill University Montréal Québec Canada
| | - Jean‐Pierre Dumas
- School of Rehabilitation, Faculty of MedicineUniversité de Sherbrooke Sherbrooke Québec Canada
| |
Collapse
|
17
|
Nowotny AH, Calderon MG, de Souza PA, Aguiar AF, Léonard G, Alves BMO, Amorim CF, da Silva RA. Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial. BMJ Open Sport Exerc Med 2018; 4:e000452. [PMID: 30555717 PMCID: PMC6267311 DOI: 10.1136/bmjsem-2018-000452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/14/2018] [Accepted: 10/03/2018] [Indexed: 02/07/2023] Open
Abstract
Background Chronic low back pain (CLBP) is an important disorder in athletes that may negatively affect their performance in competitions. The literature usually recommends physiotherapy based on exercises for back pain management in athletes. Recent evidence suggests that interventions based on lumbar muscle stabilisation exercises (LMSE) and back endurance-resistance exercises (BERE) may improve back pain and function performance. However, it is still unclear which type of exercise is more effective for the treatment of CLBP in athletes. Objective To compare the efficacy of LMSE versus BERE in athletes with CLBP. Design The study is a 2-arm, prospectively registered, randomised controlled trial. Setting The physical therapy clinical and biomechanics laboratory of the UNOPAR University. Participants 32 male athletes with CLBP, age between 18 and 40 years old, recruited from the local community. Intervention An 8-week intervention programme will be carried out with LMSE s versus BERE. Measurements Trunk neuromuscular patterns during balance tasks (unipodal and over a ball) using electromyography and force platform parameters, pain, disability, fear and avoidance will be assessed by a blinded assessor at baseline and at follow-up after 8 weeks of intervention period. Limitations The absence of blinding intervention and the exclusion of female athletes, seated sports and swimmers will affect the internal and external validity of the study. Conclusions The results of this study will elucidate which of these two interventions promote better results in trunk neuromuscular pattern, back pain and function in male athletes with CLBP.
Collapse
Affiliation(s)
| | | | | | - Andreo Fernando Aguiar
- Doctoral and Masters Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Londrina-PR, Brazil
| | - Guillaume Léonard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Research Center on Aging, Institute of Geriatrics, Université de Sherbrooke, Québec, Canada
| | - Bruno Mazziotti Oliveira Alves
- Master and Doctoral Program in Physical Therapy, University of City of São Paulo, UNICID, São Paulo, Brazil.,Paris Saint-Germain Departament of Physical Therapy and Biomechanics, Paris Saint-Germain Football Club, Paris, France
| | - Cesar Ferreira Amorim
- Master and Doctoral Program in Physical Therapy, University of City of São Paulo, UNICID, São Paulo, Brazil.,Département des Sciences de la Santé, Programme de physiothérapie de l'université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada.,Physical Therapy and Neuroscience Departments, Wertheims' Colleges of Nursing and Health Sciences and Medicine, Florida International University (FIU), Miami, Florida, United States
| | - Rubens Alexandre da Silva
- Doctoral and Masters Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Londrina-PR, Brazil.,Département des Sciences de la Santé, Programme de physiothérapie de l'université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
| |
Collapse
|
18
|
Puntumetakul R, Chalermsan R, Hlaing SS, Tapanya W, Saiklang P, Boucaut R. The effect of core stabilization exercise on lumbar joint position sense in patients with subacute non-specific low back pain: a randomized controlled trial. J Phys Ther Sci 2018; 30:1390-1395. [PMID: 30464372 PMCID: PMC6220097 DOI: 10.1589/jpts.30.1390] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/27/2018] [Indexed: 01/04/2023] Open
Abstract
[Purpose] This study aimed to examine the effect of core stabilization exercise (CSE) on joint position sense, pain intensity, and functional disability in patients with subacute non-specific low back pain (NSLBP). [Participants and Methods] Thirty-eight participants with subacute nonspecific low back pain of 6-12 weeks duration, aged 18-60 years, were included in this study. Participants were randomly divided into two groups: a core stabilization exercise group (n=19) or a control group (n=19). Outcomes measures included lumbar joint repositioning error (LJRE), numeric pain rating scale (11-NRS), and the Roland-Morris disability questionnaires (RMDQ). Measures were taken at baseline, 4 weeks, 7 weeks of intervention, and at 4 weeks after the last intervention. [Results] All outcomes measures were significantly improved in the core stabilization exercise group, compared with the control group. [Conclusion] Core stabilization exercise can improve acuity of joint position sense, reduce pain, and functional disability compared with thermal therapy. The finding demonstrated that core stabilization exercises are more suitable for patients with subacute NSLBP than thermal therapy and this should be useful to clinicians.
Collapse
Affiliation(s)
- Rungthip Puntumetakul
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University: 123 Mittraphap Rd, Muang District, Khon Kaen 40002, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand
| | - Rungthip Chalermsan
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University: 123 Mittraphap Rd, Muang District, Khon Kaen 40002, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand
| | - Su Su Hlaing
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand.,Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Weerasak Tapanya
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand.,Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Pongsatorn Saiklang
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Thailand.,Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Australia
| |
Collapse
|
19
|
Does the Use of Electrotherapies Increase the Effectiveness of Neck Stabilization Exercises for Improving Pain, Disability, Mood, and Quality of Life in Chronic Neck Pain?: A Randomized, Controlled, Single-Blind Study. Spine (Phila Pa 1976) 2018; 43:E1174-E1183. [PMID: 29652778 DOI: 10.1097/brs.0000000000002663] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN This study was a prospective, randomized, controlled study. OBJECTIVE The aim of this study was to determine whether transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) increase the effectiveness of neck stabilization exercises (NSEs) on pain, disability, mood and quality of life for chronic neck pain (CNP). SUMMARY OF BACKGROUND DATA Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Electrotherapies, such as IFC and TENS, have been applied solo or combined with exercise for management of neck pain; however, the efficacy of these combinations is unclear. METHODS A total of 81 patients with CNP were included in this study. Patients were randomly assigned into three groups regarding age and gender. First group had NSE, second group had TENS and NSE, and third group had IFC and NSE. Pain levels [visual analogue scale (VAS)], limits of cervical range of motion (ROM), quality of life (short form-36), mood (Beck depression inventory), levels of disability (Neck Pain and Disability Index), and the need for analgesics of all patients were evaluated before treatment, at 6th and 12th week follow-up. Physical therapy modalities were applied for 15 sessions in all groups. All participants had group exercise accompanied by a physiotherapist for 3 weeks and an additional 3 weeks of home exercise program. RESULTS According to the intragroup assessment, the study achieved its purpose of pain reduction, ROM increase, improvement of disability, quality of life, mood and reduction in drug use in all three treatment groups (P < 0.05). However, clinical outcomes at 6th and 12 th week had no significant difference among the three groups (P > 0.05). CONCLUSION TENS and IFC therapies are effective in the treatment of CNP patients. However, they have no additional benefit or superiority over NSE. LEVEL OF EVIDENCE 2.
Collapse
|
20
|
Trunk postural adjustments: Medium-term reliability and correlation with changes of clinical outcomes following an 8-week lumbar stabilization exercise program. J Electromyogr Kinesiol 2018; 41:66-76. [DOI: 10.1016/j.jelekin.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/09/2018] [Accepted: 04/20/2018] [Indexed: 12/25/2022] Open
|
21
|
Shahvarpour A, Gagnon D, Preuss R, Henry SM, Larivière C. Trunk postural balance and low back pain: Reliability and relationship with clinical changes following a lumbar stabilization exercise program. Gait Posture 2018; 61:375-381. [PMID: 29448220 DOI: 10.1016/j.gaitpost.2018.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/05/2018] [Accepted: 02/06/2018] [Indexed: 02/02/2023]
Abstract
Lumbar stabilization programs reduce pain and disability, but the mechanisms of action underlying this treatment are unknown. Trunk postural control during unstable sitting represents a surrogate measure of motor control mechanisms involved to maintain the dynamic stability of the spine. This exploratory study aimed to determine the reliability of trunk postural control measures over an 8-week interval, their sensitivity to low back pain status and treatment and their relationship with clinical outcomes. Trunk postural control measures were determined in patients with low back pain before and after an 8-week lumbar stabilization exercise program. Healthy controls were assessed over the same interval, but without any treatment, to determine the reliability of the measures and act as a control group at baseline. The kinematics of a wobble chair during unstable sitting was summarized using different linear and nonlinear measures quantifying the quantity and quality of movement, respectively. The reliability of the measures was moderate to excellent. The results showed significant reduction in pain and disability following the intervention. While no impairment at baseline scores was found, some linear and nonlinear measures changed over the intervention period among the patient group. However, for nonlinear measures only, significant correlations were detected with the change scores of pain and disability. The change of measures over the intervention period was likely due to learning rather than the intervention as similar alteration was detected in the healthy subjects. The results suggest that only the quality (not the quantity) of movement may have relationship with pain and disability.
Collapse
Affiliation(s)
- Ali Shahvarpour
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, Quebec , H3T 1J4 Canada; Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul, de Maisonneuve O. Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Dany Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, Quebec , H3T 1J4 Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Richard Preuss
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Sharon M Henry
- Department of Rehabilitation and Movement Science, The University of Vermont, 305 Rowell Building, Burlington, VT, United States.
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul, de Maisonneuve O. Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| |
Collapse
|
22
|
Larivière C, Gagnon DH, Henry SM, Preuss R, Dumas JP. The Effects of an 8-Week Stabilization Exercise Program on Lumbar Multifidus Muscle Thickness and Activation as Measured With Ultrasound Imaging in Patients With Low Back Pain: An Exploratory Study. PM R 2017; 10:483-493. [DOI: 10.1016/j.pmrj.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 08/25/2017] [Accepted: 10/21/2017] [Indexed: 11/24/2022]
|
23
|
Shahvarpour A, Henry SM, Preuss R, Mecheri H, Larivière C. The effect of an 8-week stabilization exercise program on the lumbopelvic rhythm and flexion-relaxation phenomenon. Clin Biomech (Bristol, Avon) 2017; 48:1-8. [PMID: 28668552 DOI: 10.1016/j.clinbiomech.2017.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lumbar stabilization exercise programs should normalize the aberrant movements patterns often observed in patients with low back pain. This study aimed to determine the effect of an 8-week lumbar stabilization program on EMG/kinematics measures of the aberrant movement patterns in such patients. A secondary goal was to assess the 8-week test-retest reliability of these measures. METHODS The patients followed an 8-week lumbar stabilization program while no intervention was carried out on the controls. Before and after this period, kinematics of the spine along with the EMG of paraspinal muscles were recorded during trunk maximal flexion-extension. ANOVAs tested the effect of the intervention in the patients, relative to the controls. Within the patients, correlation of the EMG/kinematics measures with the change in disability and pain following the intervention was investigated. FINDINGS A significant reduction in pain (Hedges's g effect size=2.31) and improvement in function (g=1.74) was reported in the patients. While EMG/kinematics measures disclosed impairments in the patients at baseline compared to the controls, no change was observed over the intervention. Nevertheless, the change of lumbar range of motion was positively correlated (r=0.42; P=0.015) with the change in disability. INTERPRETATION Although pain and disability decreased following the intervention, the EMG/kinematics measures did not change concomitantly suggesting that the patients learned to stiffen the lumbar spine during the treatment, and this technique was applied even if pain and disability unequivocally decreased after the treatment, which would not necessarily be beneficial to the patient.
Collapse
Affiliation(s)
- Ali Shahvarpour
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul. Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada; Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, Quebec H3A 3C2, Canada.
| | - Sharon M Henry
- Department of Rehabilitation and Movement Science, The University of Vermont, 305 Rowell Building, Burlington, VT 05405-0068, United States.
| | - Richard Preuss
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Hakim Mecheri
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, Quebec H3A 3C2, Canada.
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, Quebec H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| |
Collapse
|
24
|
Lee JB, Brown SHM. Time course of the acute effects of core stabilisation exercise on seated postural control. Sports Biomech 2017; 17:494-501. [PMID: 28929936 DOI: 10.1080/14763141.2017.1364416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Core stabilisation exercises are often promoted for purposes ranging from general fitness to high-performance athletics, and the prevention and rehabilitation of back troubles. These exercises, when performed properly, may have the potential to enhance torso postural awareness and control, yet the potential for achieving immediate gains has not been completely studied. Fourteen healthy young participants performed a single bout of non-fatiguing core stabilisation exercise that consisted of repeated sets of 2 isometric exercises, the side bridge and the four-point contralateral arm-and-leg extension. Seated postural control, using an unstable balance platform on top of a force plate, was assessed before and after exercise, including multiple time points within a 20-minute follow-up period. Nine standard postural control variables were calculated at each time point, including sway displacement and velocity ranges, root mean squares and cumulative path length. Statistical analysis showed that none of the postural control variables were significantly different at any time point following completion of core stabilisation exercise. Thus, we conclude that a single bout of acute core stabilisation exercise is insufficient to immediately improve seated trunk postural control in young healthy individuals.
Collapse
Affiliation(s)
- Jordan B Lee
- a Department of Kinesiology , University of Guelph-Humber , Toronto , Canada.,b Department of Human Health and Nutritional Sciences , University of Guelph , Guelph , Canada
| | - Stephen H M Brown
- b Department of Human Health and Nutritional Sciences , University of Guelph , Guelph , Canada
| |
Collapse
|
25
|
Lee JH. Effects of the centrifugal contraction exercise of the rectus abdominis accompanied with the isometric exercise of the transversus abdominis on pain and balance of lower back pain patients. J Phys Ther Sci 2017; 29:1405-1408. [PMID: 28878472 PMCID: PMC5574325 DOI: 10.1589/jpts.29.1405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/24/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The current study attempted to examine the effects of centrifugal contraction exercise of the rectus abdominis during the isometric contraction of the transversus abdominis on pain and balance of patients with chronic back pain. [Subjects and Methods] The subjects included thirty patients who were diagnosed with back pain due to causes other than neurological by a specialist after conducting a medical precision diagnosis. The experiment was performed after evenly dividing the subjects into two groups, namely, control and experimental, using a random method. This study measured pain by using the visual analog scale. To determine the patients' balancing ability using the Multifunktionale trainsgerate balance measurer. [Results] All groups showed a statistically significant within-group difference in visual analog scale and balance change. However, no significant between-group difference was observed in the comparison of therapy effects. [Conclusion] Strengthening the rectus abdominis can be an important factor for increasing the stability and reducing the pain of the lumbar area among patients with back pain.
Collapse
Affiliation(s)
- Jung-Ho Lee
- Department of Physical Therapy, Kyungdong University, Republic of Korea
| |
Collapse
|
26
|
Boucher JA, Roy N, Preuss R, Larivière C. The effect of two lumbar belt designs on trunk repositioning sense in people with and without low back pain. Ann Phys Rehabil Med 2017; 60:306-311. [DOI: 10.1016/j.rehab.2017.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/20/2017] [Accepted: 03/05/2017] [Indexed: 01/03/2023]
|
27
|
da Silva RA, Vieira ER, Fernandes KBP, Andraus RA, Oliveira MR, Sturion LA, Calderon MG. People with chronic low back pain have poorer balance than controls in challenging tasks. Disabil Rehabil 2017; 40:1294-1300. [PMID: 28282992 DOI: 10.1080/09638288.2017.1294627] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To compare the balance of individuals with and without chronic low back pain during five tasks. METHOD The participants were 20 volunteers, 10 with and 10 without nonspecific chronic low back pain, mean age 34 years, 50% females. The participants completed the following balance tasks on a force platform in random order: (1) two-legged stance with eyes open, (2) two-legged stance with eyes closed, (3) semi-tandem with eyes open, (4) semi-tandem with eyes closed and (5) one-legged stance with eyes open. The participants completed three 60-s trials of tasks 1-4, and three 30-s trials of task 5 with 30-s rests between trials. The center of pressure area, velocity and frequency in the antero-posterior and medio-lateral directions were computed during each task, and compared between groups and tasks. RESULTS Participants with chronic low back pain presented significantly larger center of pressure area and higher velocity than the healthy controls (p < 0.001). There were significant differences among tasks for all center of pressure variables (p < 0.001). Semi-tandem (tasks 3 and 4) and one-leg stance (task 5) were more sensitive to identify balance impairments in the chronic low back pain group than two-legged stance tasks 1 and 2 (effect size >1.37 vs. effect size <0.64). There were no significant interactions between groups and tasks. CONCLUSIONS Individuals with chronic low back pain presented poorer postural control using center of pressure measurements than the healthy controls, mainly during more challenging balance tasks such as semi-tandem and one-legged stance conditions. Implications for Rehabilitation People with chronic low back had poorer balance than those without it. Balance tasks need to be sensitive to capture impairments. Balance assessments during semi-tandem and one-legged stance were the most sensitive tasks to determine postural control deficit in people with chronic low back. Balance assessment should be included during rehabilitation programs for individuals with chronic low back pain for better clinical decision making related to balance re-training as necessary.
Collapse
Affiliation(s)
- Rubens A da Silva
- a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil.,b Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR , Londrina-PR , Brazil
| | - Edgar R Vieira
- c Physical Therapy & Neuroscience Departments, Wertheims' Colleges of Nursing and Health Sciences & Medicine , Florida International University (FIU) , Miami , FL , USA
| | - Karen B P Fernandes
- a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil.,b Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR , Londrina-PR , Brazil
| | - Rodrigo A Andraus
- a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil.,b Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR , Londrina-PR , Brazil
| | - Marcio R Oliveira
- a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil.,b Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR , Londrina-PR , Brazil
| | - Leandro A Sturion
- a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil.,b Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR , Londrina-PR , Brazil
| | - Mariane G Calderon
- a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil
| |
Collapse
|