1
|
Lehecka BJ, Burleson J, Diederich P, Salem M, Schoonover R, Tejano J. Hip and Trunk Variables in University Students with and without Recurrent Low Back Pain. Int J Sports Phys Ther 2024; 19:199-205. [PMID: 38313671 PMCID: PMC10837826 DOI: 10.26603/001c.91640] [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: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 02/06/2024] Open
Abstract
Background Low back pain (LBP) is a leading cause of disability. Recurrent low back pain (rLBP) is defined as two or more episodes of LBP in a 12-month period, each lasting more than 24 hours and separated by at least one pain-free month. Many studies have shown that hip and trunk variables have an influence on LBP. However, most of these are studies of participants with acute or chronic LBP rather than rLBP. Purpose To examine the difference between hip and trunk variables of university students with and without rLBP. Study Design Cross-Sectional. Methods Participants with and without rLBP between 18 and 35 years of age not currently undergoing clinical orthopedic care were recruited for this cross-sectional study. Bilateral hip range of motion (ROM) and trunk ROM were measured with a goniometer or measuring tape (hip motions in all planes along with trunk flexion, extension, and lateral flexion). Strength of the hip extensors, abductors, and external rotators was measured using a handheld dynamometer, and a single-leg bridge endurance test was performed to assess differences and correlations between outcomes. Results Twenty-six subjects aged 18 to 35 years with rLBP (n=10) and without rLBP (n=16) participated. Statistically significant differences between the two groups were found for right and left hip flexion (p = 0.029 and 0.039, respectively), right hip adduction (p = 0.043), and right hip extension (p = 0.021). No significant differences were found between groups for strength, endurance, or other ROM measures. Conclusion The findings of this study show statistically significant although clinically non-meaningful differences in hip flexion, extension, and adduction ROM in the rLBP group compared to the control group. This lack of clinically meaningful difference may be relevant to testing procedures and treatment of patients or athletes with rLBP. This study also suggests that hip strength and endurance may not play a major role in the development or treatment of rLBP. Level of Evidence: 3.
Collapse
|
2
|
Lee KH, Chon SC. Enhanced Pain Relief and Muscle Growth in Individuals with Low Back Instability: The Impact of Blood Flow Restriction Exercise during Sit to Stand Movements. Med Sci Monit 2024; 30:e942508. [PMID: 38268184 PMCID: PMC10826205 DOI: 10.12659/msm.942508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/10/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Blood flow restriction exercise (BFRE) improves muscle strength at a relatively low intensity by temporarily restricting blood flow. This study compared pain and quadriceps muscle mass (QMM) in 40 patients with lower back pain (LBP) undertaking sit-to-stand (STS) exercise with and without blood flow restriction. MATERIAL AND METHODS Forty adults were divided into 2 groups, and the experimental group (n=20) performed an STS exercise with BFRE, and the control group (n=20) performed an STS exercise without BFRE. Blood pressure, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), was measured using a portable blood pressure monitor. Saturation of percutaneous oxygen (SpO2) was measured using oxygen saturation. Pain was measured using the visual analog scale (VAS) and the Oswestry disability index (ODI). QMM was assessed using ultrasonography. RESULTS Data were analyzed using paired and independent t tests. SBP (P=.000), DBP (P=.004), and SpO2 (P=.001) were significantly different in the experimental group, both before and during the intervention. The VAS scores showed a statistically significant difference in the post-test (P=.003) and rate of change (P=.009) between the groups. The ODI scores showed statistically significant differences in the post-test (P=.000) and rate of change (P=.001) comparison between the groups. The rate of change in QMM, including the rectus femoris (P=.000), vastus intermedius (P=.004), vastus medialis (P=.001), and vastus lateralis (P=.014), increased significantly in the experimental group compared to that in the control group. CONCLUSIONS This study demonstrates that the additive effect of BFRE on pain relief and QMM increase, thus contributing to existing knowledge about therapeutic exercise for the effective management of LBP.
Collapse
|
3
|
Miñambres-Martín D, Martín-Casas P, López-de-Uralde-Villanueva I, Fernández-de-las-Peñas C, Valera-Calero JA, Plaza-Manzano G. Physical Function in Amateur Athletes with Lumbar Disc Herniation and Chronic Low Back Pain: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063743. [PMID: 35329430 PMCID: PMC8953459 DOI: 10.3390/ijerph19063743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023]
Abstract
This study aimed to analyze if chronic low back pain (LBP) and lumbar disc herniation induce biomechanics, flexibility, body balance, physical activity, and muscular function alterations compared to a similar asymptomatic cohort. Fifty male volunteers (n = 25 with chronic LBP and lumbar disc herniation and n = 25 pain-free subjects) were enrolled. Range of motion (internal and external hip rotation, ankle dorsiflexion, and active straight leg raise, ASLR), trunk flexibility (finger−floor distance), body balance (Y-balance test) and muscle function (Biering−Sorensen test, prone and lateral bridges) outcomes were assessed. Comparative analyses between sides and group were conducted. Results: Patients showed greater weight and BMI compared with controls (p < 0.05). None of the outcomes bilaterally assessed showed side-to-side differences for pain-free participants (all, p > 0.05) or LBP patients (all, p > 0.05). Regarding the differences between groups, LBP patients showed limited internal hip rotation (p < 0.001), finger−floor distance (p < 0.001), body balance (p < 0.001), and muscle endurance (planks p < 0.001; Biering−Sorensen test p < 0.05). External hip rotation, ASLR, and ankle dorsiflexion range of movement were comparable in both groups (p > 0.05). The sample of pain-free amateur athletes showed greater range of movement for internal hip rotation, lower finger−floor distance, better body balance, and muscle function. However, the external hip rotation, ankle dorsiflexion, and ASLR tests showed no difference between cases and controls.
Collapse
Affiliation(s)
- Diego Miñambres-Martín
- Premium Madrid Global Health Care, 28016 Madrid, Spain;
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (P.M.-C.); (I.L.-d.-U.-V.); (G.P.-M.)
- Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (P.M.-C.); (I.L.-d.-U.-V.); (G.P.-M.)
- Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
- Correspondence:
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain; (P.M.-C.); (I.L.-d.-U.-V.); (G.P.-M.)
- Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| |
Collapse
|
4
|
Sellmann A, Wagner D, Holtz L, Eschweiler J, Diers C, Williams S, Disselhorst-Klug C. Detection of Typical Compensatory Movements during Autonomously Performed Exercises Preventing Low Back Pain (LBP). SENSORS (BASEL, SWITZERLAND) 2021; 22:111. [PMID: 35009660 PMCID: PMC8747326 DOI: 10.3390/s22010111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
With the growing number of people seeking medical advice due to low back pain (LBP), individualised physiotherapeutic rehabilitation is becoming increasingly relevant. Thirty volunteers were asked to perform three typical LBP rehabilitation exercises (Prone-Rocking, Bird-Dog and Rowing) in two categories: clinically prescribed exercise (CPE) and typical compensatory movement (TCM). Three inertial sensors were used to detect the movement of the back during exercise performance and thus generate a dataset that is used to develop an algorithm that detects typical compensatory movements in autonomously performed LBP exercises. The best feature combinations out of 50 derived features displaying the highest capacity to differentiate between CPE and TCM in each exercise were determined. For classifying exercise movements as CPE or TCM, a binary decision tree was trained with the best performing features. The results showed that the trained classifier is able to distinguish CPE from TCM in Bird-Dog, Prone-Rocking and Rowing with up to 97.7% (Head Sensor, one feature), 98.9% (Upper back Sensor, one feature) and 80.5% (Upper back Sensor, two features) using only one sensor. Thus, as a proof-of-concept, the introduced classification models can be used to detect typical compensatory movements in autonomously performed LBP exercises.
Collapse
Affiliation(s)
- Asaad Sellmann
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany; (D.W.); (L.H.); (S.W.); (C.D.-K.)
| | - Désirée Wagner
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany; (D.W.); (L.H.); (S.W.); (C.D.-K.)
| | - Lucas Holtz
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany; (D.W.); (L.H.); (S.W.); (C.D.-K.)
| | - Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Clinic, 52074 Aachen, Germany;
| | | | - Sybele Williams
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany; (D.W.); (L.H.); (S.W.); (C.D.-K.)
| | - Catherine Disselhorst-Klug
- Department of Rehabilitation and Prevention Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany; (D.W.); (L.H.); (S.W.); (C.D.-K.)
| |
Collapse
|
5
|
Cejudo A. Lower Extremity Flexibility Profile in Basketball Players: Gender Differences and Injury Risk Identification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211956. [PMID: 34831712 PMCID: PMC8617794 DOI: 10.3390/ijerph182211956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022]
Abstract
Analysis of the flexibility profile of basketball players (BPs) can reveal differences in range of motion (ROM) by gender and also identify those players who are at higher risk for sports injuries. A descriptive observational study was conducted to determine the lower extremity flexibility profile of sixty-four basketball players and gender differences to identify players at higher risk of injury due to limited and asymmetric ROM in one or more movements. Participants: Sixty-four (33 male and 31 female) competitive athletes from the national leagues of the Spanish basketball league system participated in the present study (power of sample size ≥0.99). The eight passive ROM tests of the hip, knee and ankle were assessed using the ROM-SPORT battery. Each player completed a questionnaire on age, basic anthropometric data, dominant extremities, and training and sport-related variables. The lower extremity flexibility profile was established at 15° and 10° hip extension (HE), 39° and 38° ankle dorsiflexion with knee extended (ADF-KE), 40° and 39° ankle dorsiflexion with knee flexed (ADF-KF), 43° and 43° hip abduction (HAB), 75° and 61° hip abduction with the hip flexed (HAB-HF), 78° and 83° hip flexion with the knee extended (HF-KE), 134° and 120° knee flexion (KF), and 145° and 144° hip flexion (HF) by male and female basketball players, respectively. Sex differences in HE, HAB-HF, and KF were observed in BPs (p ≤ 0.01; Hedges’ g ≥ 1.04). Players reported limited ROM in ADF-KF, HE, HAB-HF, HF-KE, and KF; and asymmetric ROM mainly in HE, ADF-KE, KF, ADF-KF, and HF-KE. In conclusion, this study provides gender-specific lower extremity flexibility profile scores in BPs that can help athletic trainers and athletic and conditioning trainers to identify those players who are at higher risk of injury due to abnormal ROM scores.
Collapse
Affiliation(s)
- Antonio Cejudo
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100 Murcia, Spain
| |
Collapse
|
6
|
Hatefi M, Babakhani F, Ashrafizadeh M. The effect of static stretching exercises on hip range of motion, pain, and disability in patients with non-specific low back pain. J Exp Orthop 2021; 8:55. [PMID: 34318348 PMCID: PMC8316530 DOI: 10.1186/s40634-021-00371-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/16/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose The benefits of providing static stretching exercise targeting the hips in patients with non-specific Low Back Pain (NSLBP) are not well established. The objective of the study was to verify the effects of static stretching on function, pain and range of motion on patients with non-specific Low Back Pain (NSLBP). Methods Thirty females with NSLBP were randomly assigned to two control (n = 15) and experimental (n = 15) groups. The experimental group received 3 stretch practice sessions per week for a period of 8 weeks. The Oswestry low back pain Disability Questionnaire (ODI), visual analog scale (VAS), and passive hip range of motion (PROM) were employed before and after the intervention. Results The results of mixed model analysis of variance indicate that the group × time interactions was not significant (p > 0.05) for all measurement outcomes. However, there was a main effect for Time (ODI: p = 0.002, VAS: p = 0.001, PROM-R: p = 0.016, PROM-L: p = 0.001). Such that the ODI, VAS, PROM-R, and PROM-L were showed significant differences before and after the intervention in the experimental group. Conclusions The results demonstrated a significant difference in PROM, pain, and disability after 8 weeks of stretching exercises in participants with NSLBP and limited hip extension. Therefore, it would be reasonable to infer that NSLBP might be partly related to hip flexors tightness.
Collapse
Affiliation(s)
- Mohamadreza Hatefi
- Department of Biomechanics and Sport Injuries, Faculty of Physical Education, Kharazmi University, Tehran, Iran.
| | - Farideh Babakhani
- Department of Sports Injury and Corrective Exercise, Faculty of Physical Education, Allameh Tabataba'i University, Tehran, Iran
| | - Mohadeseh Ashrafizadeh
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran
| |
Collapse
|
7
|
Intra- and inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing. PLoS One 2020; 15:e0243646. [PMID: 33301541 PMCID: PMC7728246 DOI: 10.1371/journal.pone.0243646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/25/2020] [Indexed: 12/30/2022] Open
Abstract
Background In clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM). Methods Two raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements. Findings Intra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886–0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71–0.87) and the IMC methods (ICCs 0.61–0.993) and (almost) perfect in the TM methods (ICCs 0.923–0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9–3.3° for the DI methods and 0.5–1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5–1.3cm for the TM methods and 0.6–2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41–0.81). Interpretation Measurement repetitions of either one or multiple trained raters can be considered reliable in all three devices.
Collapse
|