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Nakai Y, Oe K, Matsuno R, Kiyama R, Kawada M, Takeshita Y, Miyazaki T, Araki S. Effect of Self-Myofascial Release of the Lower Back on Myofascial Gliding, Lumbar Flexibility, and Abdominal Trunk Muscle Strength: A Crossover Study. Sports (Basel) 2023; 11:147. [PMID: 37624127 PMCID: PMC10460077 DOI: 10.3390/sports11080147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Roller massage has been recognized as an effective intervention for managing various conditions. However, data on the effects of roller massage on the dynamic mechanisms of the myofascial and soft tissues of the lower back are limited. This study aimed to examine the effect of the self-myofascial release of the lower back on myofascial gliding, lumbar flexibility, and abdominal trunk muscle strength using a roller massager. This crossover study included 24 college athletes who underwent three interventions-roller massage, static stretching, and control (rest). Before and after the intervention, lumbar and fascial gliding were evaluated using ultrasonography. Long-seat anteflexion (lumbar flexibility) and abdominal trunk muscle strength were assessed. The movement velocities of the subcutaneous tissue and the multifidus muscle over time were calculated using echo video analysis software, and gliding was estimated using the cross-correlation coefficient between the velocities. Gliding, lumbar flexibility, and abdominal trunk muscle strength showed significant intervention-by-time interactions. Roller massage significantly improved gliding, lumbar flexibility, and abdominal trunk muscle strength. The self-myofascial release of the lower back using a roller massager improved the lumbar/fascia gliding, lumbar flexibility, and abdominal trunk muscle strength compared to static stretching.
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Affiliation(s)
- Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima City 899-4395, Japan
| | - Katsutoshi Oe
- Department of Mechanical and Electrical Engineering, Faculty of Engineering, Nippon Bunri University, 1727 Ichiki, Oita City 870-0397, Japan;
| | - Ryuko Matsuno
- Kirishima Orthopedics Clinic, 8-31 Kokubuchuoh, Kirishima City 899-4341, Japan;
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan; (R.K.); (M.K.); (Y.T.)
| | - Masayuki Kawada
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan; (R.K.); (M.K.); (Y.T.)
| | - Yasufumi Takeshita
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan; (R.K.); (M.K.); (Y.T.)
| | - Takasuke Miyazaki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City 890-8544, Japan;
| | - Sota Araki
- Course of Physical Therapist, Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi Aoba-ku, Sendai City 981-8522, Japan;
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Taşpınar G, Angın E, Oksüz S. The effects of Pilates on pain, functionality, quality of life, flexibility and endurance in lumbar disc herniation. J Comp Eff Res 2023; 12:e220144. [PMID: 36453667 PMCID: PMC10288967 DOI: 10.2217/cer-2022-0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022] Open
Abstract
Aim: To assess the effects of clinical Pilates exercises (CPE) on the level of pain, functional status, flexibility, static and dynamic endurance of the trunk muscles and quality of life (QoL) in patients with lumbar disc herniation. Materials & methods: Individuals were divided into two groups: the CPE (6 weeks, three-times a week) group (n = 27) and the control group (n = 27). The clinical outcome measures were the visual analog scale for the evaluation of the pain intensity, Oswestry disability index for functional disability, short form-36 for health related QoL, sit and reach and hand finger floor distance test for the flexibility, side-bridge and sit-ups test for the static and dynamic endurance. Results: At the end of the 6 weeks the amount of decrease in the level of pain and Oswestry disability index, amount of increase in sit-reach test and hand-finger-to-floor distance, duration of the lateral bridge and sits-ups test and most of the short form-36 sub parameters was significantly higher (p < 0.05) in the CPE group. Conclusion: CPE was an effective and safe method for symptomatic patients with lumbar disc herniation in reducing the pain level and functional disability and improving flexibility, static and dynamic endurance and partially their QoL. Clinical Trial Registration: NCT03198273 (ClinicalTrials.gov).
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Affiliation(s)
- Gülşan Taşpınar
- Medicalport Tunççevik Hospital, Kurtuluş Street, No.70 Bellapais Road, Kyrenia, Cyprus
| | - Ender Angın
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, 99628, North Cyprus via Mersin 10, Famagusta, Turkey
| | - Sevim Oksüz
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, 99628, North Cyprus via Mersin 10, Famagusta, Turkey
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Su CH, Peng HY, Tien CW, Huang WC. Effects of a 12-Week Pilates Program on Functional Physical Fitness and Basal Metabolic Rate in Community-Dwelling Middle-Aged Women: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16157. [PMID: 36498231 PMCID: PMC9737173 DOI: 10.3390/ijerph192316157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Background: The aging society worldwide carries public and inevitable issues. Aging is accompanied by multiple diseases, and the health impacts challenge healthcare and social systems. In addition to medical treatment, exercise has been recognized as an effective strategy not only for disease prevention and alleviation, but also for multiple health benefits on health promotion. The purpose of this study was to investigate the effects of a suitable Pilates exercise intervention program on health maintenance and benefits in community-dwelling middle-aged women with a quasi-experimental design. Methods: We recruited healthy middle-aged community-dwelling women who had not regularly exercised in the previous three months. The participants were assigned to the experimental (n = 22) and control (n = 23) groups based on a quasi-experimental design. The experimental group participated in a mat-based Pilates exercise class twice a week (1 h/session) throughout the 12-week intervention, whereas there was no intervention for the control group. Body composition, basal metabolic rate, and functional physical fitness—comprising cardiovascular capacity, flexibility, muscular strength of upper limbs, muscular strength of lower limbs, core strength, agility, static balance, and dynamic balance—were assessed as primary outcomes in both groups before and after the intervention. Results: There were no significant differences in any of the dependent variables between the two groups before the exercise intervention. After the 12-week intervention, body composition, including body mass index, body fat (−1.5 to 3%), and basal metabolic rate (+10.6%), and functional fitness, including flexibility (+3.5%), core strength (+31.5%), lower-limb strength (+13.5%), agility (+7.3%), and balance (+4.2%), improved significantly in the experimental group relative to the control group (p < 0.05). Moreover, the improvement in physical fitness in lower-limb strength, agility, and balance for fall prevention also demonstrated higher clinical significance than the control. Conclusions: This 12-week mat-based Pilates exercise program significantly improved body composition, basal metabolic rate, and functional physical fitness in community-dwelling middle-aged women. The beneficial effects of Pilates exercise programs may thus promote improved health in the middle-aged female population, with practical implications for communities.
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Affiliation(s)
- Chien-Hsiao Su
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
- Department of Rehabilitation, Camillian St. Mary’s Hospital Luodong, Yilan 265502, Taiwan
| | - Hsuen-Ying Peng
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
| | - Cheng-Wen Tien
- Physical Education Office, General Education Center, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
| | - Wen-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
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Risk Factors for Progressive Spinal Sagittal Imbalance in the Short-Term Course after Total Hip Arthroplasty: A 3 Year Follow-Up Study of Female Patients. J Clin Med 2022; 11:jcm11175179. [PMID: 36079110 PMCID: PMC9457188 DOI: 10.3390/jcm11175179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/15/2022] [Accepted: 08/30/2022] [Indexed: 11/21/2022] Open
Abstract
Total hip arthroplasty (THA) for patients with hip osteoarthritis improves hip flexion contracture, subsequently improving spinal sagittal balance. However, in some cases, spinal sagittal imbalance develops in the course after THA, and its risk factors remain unknown. We aimed to investigate the risk factors of progressive spinal sagittal imbalance after THA. This retrospective cohort study of a prospectively maintained database included female patients aged ≥50 years who underwent THA. Before performing THA, we obtained each patient’s anthropometric and muscle strength measurements and whole-spine radiographs. Three years postoperatively, patients underwent whole-spine radiography to examine changes in the spinal sagittal balance. Patients were assigned into groups on the basis of their preoperative and 3 year postoperative sagittal vertical axis (SVA) values. Patients with 3 year postoperative SVA values ≥40 mm with an increase ≥30 mm were categorized into the imbalance group; the other patients were categorized into the non-imbalance group. Of 103 patients, 11 (10.7%) were in the imbalance group. In multiple logistic regression analysis, preoperative weak abdominal trunk muscle strength (ATMS) (p = 0.007) and small sacral slope (SS) (p = 0.005) were significant risk factors for progressive spinal sagittal imbalance. In conclusion, risk factors for progressive spinal sagittal imbalance after THA were weak preoperative ATMS and small SS.
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Associations between Abdominal Trunk Muscle Weakness and Future Osteoporotic Vertebral Fracture in Middle-Aged and Older Adult Women: A Three-Year Prospective Longitudinal Cohort Study. J Clin Med 2022; 11:jcm11164868. [PMID: 36013104 PMCID: PMC9410457 DOI: 10.3390/jcm11164868] [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: 07/17/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022] Open
Abstract
Potential risk factors associated with future osteoporotic vertebral fracture (OVF) were prospectively investigated in middle-aged and older adult women. We enrolled 197 female patients aged ≥50 years who were scheduled to undergo surgery for lower-extremity degenerative diseases. Patient anthropometric and muscle strength measurements, a bone mineral density measurement of the lumbar spine (L-BMD), and full-spine standing radiographs to examine the presence of old OVFs and spinopelvic sagittal parameters were obtained preoperatively. We evaluated 141 patients who underwent full-spine standing radiographs three years postoperatively to identify new OVFs. We excluded 54 patients who did not undergo a second radiographic examination and 2 with new traumatic OVFs. Univariate and multivariate analyses were performed to identify risk factors associated with new non-traumatic OVF occurrence. Ten (7.1%) patients developed new non-traumatic OVFs during the study period (fracture group). The fracture group had less abdominal trunk muscle strength, lower L-BMD, smaller sacral slopes, and larger pelvic tilt than the non-fracture group. The fracture group showed a higher prevalence of old OVFs preoperatively than the non-fracture group. Abdominal trunk muscle weakness, low L-BMD, and the presence of old OVFs were identified as significant risk factors for OVF occurrence. In middle-aged or older adult women, abdominal trunk muscle weakness, low L-BMD, and old OVFs were associated with future OVF.
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Lee J, Kim D, Shin Y, Yi C, Jeon H, You SJH, Park C. Comparison of core stabilization techniques on ultrasound imaging of the diaphragm, and core muscle thickness and external abdominal oblique muscle electromyography activity. J Back Musculoskelet Rehabil 2022; 35:839-847. [PMID: 34657872 DOI: 10.3233/bmr-210051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To restore core stability, abdominal drawing-in maneuver (ADIM), abdominal bracing (AB), and dynamic neuromuscular stabilization (DNS) have been employed but outcome measures varied and one intervention was not superior over another. OBJECTIVE The purpose of this study was to compare the differential effects of ADIM, AB, and DNS on diaphragm movement, abdominal muscle thickness difference, and external abdominal oblique (EO) electromyography (EMG) amplitude. METHODS Forty-one participants with core instability participated in this study. The subjects performed ADIM, AB, and DNS in random order. A Simi Aktisys and Pressure Biofeedback Unit (PBU) were utilized to measure core stability, an ultrasound was utilized to measure diaphragm movement and measure abdominal muscles thickness and EMG was utilized to measure EO amplitude. Analysis of variance (ANOVA) was conducted at P< 0.05. RESULTS Diaphragm descending movement and transverse abdominis (TrA) and internal abdominal oblique (IO) thickness differences were significantly increased in DNS compared to ADIM and AB (P< 0.05). EO amplitude was significantly increased in AB compared to ADIM, and DNS. CONCLUSIONS DNS was the best technique to provide balanced co-activation of the diaphragm and TrA with relatively less contraction of EO and subsequently producing motor control for efficient core stabilization.
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Affiliation(s)
- Jaejin Lee
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Dohyun Kim
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Yoonkyum Shin
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Chunghwi Yi
- Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Hyeseon Jeon
- Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Sung Joshua Hyun You
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Chanhee Park
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea.,Department of Physical Therapy, Yonsei University, Wonju, Korea
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Kurokawa Y, Kato S, Demura S, Shinmura K, Yokogawa N, Yonezawa N, Shimizu T, Kitagawa R, Miaki H, Tsuchiya H. Validation and comparison of trunk muscle activities in male participants during exercise using an innovative device and abdominal bracing maneuvers. J Back Musculoskelet Rehabil 2022; 35:589-596. [PMID: 34397401 DOI: 10.3233/bmr-210001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Abdominal bracing is effective in strengthening the trunk muscles; however, assessing performance can be challenging. We created a device for performing abdominal trunk muscle exercises. The effectiveness of this device has not yet been evaluated or comparedOBJECTIVE: We aimed to quantify muscle activity levels during exercise using our innovative device and to compare them with muscle activation during abdominal bracing maneuvers. METHODS This study included 10 men who performed abdominal bracing exercises and exercises using our device. We measured surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique, internal oblique (IO), and erector spinae (ES) muscles in each of the exercises. The EMG data were normalized to those recorded during maximal voluntary contraction (%EMGmax). RESULTS During the bracing exercise, the %EMGmax of IO was significantly higher than that of RA and ES (p< 0.05), whereas during the exercises using the device, the %EMGmax of IO was significantly higher than that of ES (p< 0.05). No significant difference was observed in the %EMGmax of any muscle between bracing exercises and the exercises using the device (p= 0.13-0.95). CONCLUSIONS The use of our innovative device results in comparable activation to that observed during abdominal bracing.
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Affiliation(s)
- Yuki Kurokawa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satoshi Kato
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Noritaka Yonezawa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Ryo Kitagawa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroichi Miaki
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Association of low back pain with muscle weakness, decreased mobility function, and malnutrition in older women: A cross-sectional study. PLoS One 2021; 16:e0245879. [PMID: 33493191 PMCID: PMC7833166 DOI: 10.1371/journal.pone.0245879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background Low back pain (LBP) and decreased mobility function are common problem among older people. Muscle weakness has been reported as a risk factor for these conditions, and exercise therapy can improve them. We created a novel exercise device that also measures abdominal trunk muscle strength. Malnutrition has also emerged as a major problem among older people. Muscle is a direct key linking decreased mobility function and malnutrition. This study aimed to examine the associations of LBP with not only decreased physical function and muscle weakness but also nutritional status of older people. Methods We examined the associations of LBP with muscle weakness, decreased mobility function (locomotive syndrome [LS]), and malnutrition among older women. The study included 101 female patients aged 60 years or older scheduled to undergo surgery for degenerative lower extremity diseases. Preoperatively, physical tests including abdominal trunk muscle strength assessment using the device and laboratory tests were conducted. Subjects with LBP (numerical rating scale ≥2; range, 0–4) during the preceding month were allocated to the LBP group (n = 36). Other subjects were allocated to the non-LBP group (n = 65). Results The LBP group had lower abdominal trunk and knee extensor muscle strength, lower serum albumin, and hemoglobin levels as blood biomarkers associated with malnutrition risk, and higher LS test scores than the non-LBP group. A multivariate analysis showed that abdominal trunk muscle weakness and advanced LS were associated with LBP. LBP intensity was negatively correlated with abdominal trunk and knee extensor muscle strength and positively correlated with the LS test score. The serum hemoglobin level was negatively correlated with the LS test score. Conclusion Abdominal trunk muscle weakness and decreased mobility function were associated with LBP among older women.
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Efficacy of abdominal trunk muscles-strengthening exercise using an innovative device in treating chronic low back pain: a controlled clinical trial. Sci Rep 2020; 10:21883. [PMID: 33318516 PMCID: PMC7736894 DOI: 10.1038/s41598-020-78908-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/01/2020] [Indexed: 12/29/2022] Open
Abstract
Exercise is the most common conservative intervention for chronic low back pain (CLBP). We have developed an innovative exercise device for the abdominal trunk muscles that also measures muscle strength in a sitting position. The device, which is easy for patients with CLBP to use, allows for lumbar stabilization exercise under pressure. This study aimed to examine the efficacy of abdominal trunk muscle strengthening using the device in improving CLBP. We conducted a two-group non-randomized controlled clinical trial. CLBP patients were allocated into two groups. The strengthening group underwent a 12-week exercise program that included abdominal trunk muscle strengthening using our device and stretching exercises, while the control group received a 12-week stretching exercise program. The outcome measures included the improvement of the abdominal trunk muscle strength measured by the device, pain intensity of CLBP, physical function, and quality of life (QOL). A total of 40 participants (20 in each group) were analyzed. The strengthening group showed better improvement in the abdominal trunk muscle strength, CLBP, physical function, and QOL than in the control group. In conclusion, the strengthening exercise using the device with easy stretching was effective in improving the strength of the abdominal trunk muscles, pain intensity of CLBP, physical function, and QOL.
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10
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Effect of the Abdominal Draw-In Maneuver and Bracing on Abdominal Muscle Thickness and the Associated Subjective Difficulty in Healthy Individuals. Healthcare (Basel) 2020; 8:healthcare8040496. [PMID: 33227933 PMCID: PMC7712241 DOI: 10.3390/healthcare8040496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 11/16/2022] Open
Abstract
We evaluated the trunk abdominal muscle thickness while performing different exercises to identify the most effective training and to investigate the subjective difficulty associated with exercising. Twenty-eight men (mean age: 21.6 ± 0.9 years) without orthopedic diseases were enrolled. Ultrasonic imaging was used to measure the thickness of the transversus abdominis (TA), internal oblique, and external oblique muscles while at rest and while performing the abdominal draw-in maneuver and abdominal bracing. Measurements were made in the supine and sitting positions, and the subjective difficulty in performing each exercise was examined using a 5-level evaluation scale. The TA and internal oblique muscle thicknesses were significantly greater during the abdominal draw-in maneuver (ADIM) than during bracing or resting, in the supine and sitting positions. The subjective difficulty of abdominal bracing (AB) was graded significantly higher than that of ADIM. Additionally, a correlation between subjective difficulty and muscle thickness was found for the TA and IO. Our results may contribute to the choice of more effective exercises for spinal stability.
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Kato S, Demura S, Kurokawa Y, Takahashi N, Shinmura K, Yokogawa N, Yonezawa N, Shimizu T, Kitagawa R, Tsuchiya H. Efficacy and Safety of Abdominal Trunk Muscle Strengthening Using an Innovative Device in Elderly Patients With Chronic Low Back Pain: A Pilot Study. Ann Rehabil Med 2020; 44:246-255. [PMID: 32475095 PMCID: PMC7349035 DOI: 10.5535/arm.19100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/11/2019] [Indexed: 11/05/2022] Open
Abstract
Objective To examine the efficacy and safety of an innovative, device-driven abdominal trunk muscle strengthening program, with the ability to measure muscle strength, to treat chronic low back pain (LBP) in elderly participants. Methods Seven women with non-specific chronic LBP, lasting at least 3 months, were enrolled and treated with the prescribed exercise regimen. Patients participated in a 12-week device-driven exercise program which included abdominal trunk muscle strengthening and 4 types of stretches for the trunk and lower extremities. Primary outcomes were adverse events associated with the exercise program, improvement in abdominal trunk muscle strength, as measured by the device, and improvement in the numerical rating scale (NRS) scores of LBP with the exercise. Secondary outcomes were improvement in the Roland-Morris Disability Questionnaire (RDQ) score and the results of the locomotive syndrome risk test, including the stand-up and two-step tests. Results There were no reports of increased back pain or new-onset abdominal pain or discomfort during or after the device-driven exercise program. The mean abdominal trunk muscle strength, NRS, RDQ scores, and the stand-up and two-step test scores were significantly improved at the end of the trial compared to baseline. Conclusion No participants experienced adverse events during the 12-week strengthening program, which involved the use of our device and stretching, indicating the program was safe. Further, the program significantly improved various measures of LBP and physical function in elderly participants.
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Affiliation(s)
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yuki Kurokawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Naoki Takahashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Noritaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Ryo Kitagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Kato S, Demura S, Kurokawa Y, Shinmura K, Yokogawa N, Yonezawa N, Shimizu T, Oku N, Kitagawa R, Matsubara H, Kabata T, Tsuchiya H. Correlation between osteoporotic vertebral fracture and abdominal trunk muscle strength in middle-aged and older women. Arch Osteoporos 2019; 14:106. [PMID: 31673807 DOI: 10.1007/s11657-019-0654-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/09/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED We investigated the correlation between abdominal trunk muscle strength and spinal deformities in middle-aged and older women. The results indicated that abdominal trunk muscle weakness, older age, and low lumbar bone mineral density were significant risk factors associated with the presence of OVFs in the lower thoracic and lumbar spine. PURPOSE We developed an innovative exercise device for the abdominal trunk muscles that also measures muscle strength. We investigated the correlation between the strength and thoracolumbar spinal deformity in middle-aged and older women. METHODS This study included 206 consecutive female patients who were 50 years or older and scheduled to undergo surgery for degenerative diseases of the lower extremities. Patients with a history of symptomatic osteoporotic vertebral fractures (OVFs) requiring treatments were excluded. Before surgery, patients underwent physical measurements including abdominal trunk muscle strength using our device, full-spine standing radiography, and bone mineral density measurement of the lumbar spine (L-BMD). According to radiographic findings of the radiogram, patients were divided into four groups: control group (n = 134), listhesis group (n = 29), scoliosis group (n = 19), and fracture group (n = 24). The Tukey-Kramer honestly significant difference test was used to compare all measurements among the four groups. To identify factors associated with the presence of OVFs, a multivariate logistic regression analysis was performed. RESULTS The average abdominal trunk muscle strength in the fracture group was significantly lower than that of the control group. The multivariate analysis revealed that abdominal trunk muscle weakness, older age, and a low L-BMD were associated with OVF findings. CONCLUSIONS Abdominal trunk muscle weakness in middle-aged and older women was associated with OVF. The strength measurement can be a risk assessment of OVF.
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Affiliation(s)
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Yuki Kurokawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noritaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Norihiro Oku
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Ryo Kitagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Hidenori Matsubara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Tamon Kabata
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
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Kato S, Murakami H, Demura S, Yoshioka K, Shinmura K, Yokogawa N, Igarashi T, Yonezawa N, Shimizu T, Tsuchiya H. Abdominal trunk muscle weakness and its association with chronic low back pain and risk of falling in older women. BMC Musculoskelet Disord 2019; 20:273. [PMID: 31159812 PMCID: PMC6547466 DOI: 10.1186/s12891-019-2655-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have indicated that trunk muscle strength decreases with chronic low back pain, and is associated with poor balance, poor functional performance, and falls in older adults. Strengthening exercises for chronic low back pain are considered the most effective intervention to improve functional outcomes. We developed an innovative exercise device for abdominal trunk muscles that also measures muscle strength. The correlation between muscle weakness, as measured by our device, the presence of chronic low back pain, and decreased physical ability associated with a risk of falling were evaluated in older women. Methods Thirty-eight elderly women, who could walk without support during daily activities and attended our outpatient clinic for treatment of chronic low back pain, knee or hip arthritis, or osteoporosis, were included in this study. Anthropometric measurements were performed. Grip power and one-leg standing time with eyes open were measured, and abdominal trunk muscle strength was measured using our device. History of falling in the previous 12 months was noted. Subjects with chronic low back pain (visual analog scale score ≥ 20 mm) for over 3 months were assigned to the low back pain group (n = 21). The remaining subjects formed the non-low back pain group (n = 17). Results Abdominal muscle strength of subjects in the low back pain group, and with history of falling, was significantly lower compared with that of subjects in the non-low back pain group, and in subjects without a history of falling, respectively. There was a moderate positive correlation between abdominal trunk muscle strength and one-leg standing time with eyes open. Conclusion We measured abdominal muscle strength in older women with chronic low back pain using our device, and it was significantly lower than that of those without chronic low back pain. Muscle weakness was associated with a history and risk of falling.
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Affiliation(s)
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Katsuhito Yoshioka
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Takashi Igarashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noritaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
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Lisón JF, Ortega-Santana B, Antón-Nogués Á, González-Requena P, Vera-Hervás C, Doménech-Fernández J, Sánchez-Zuriaga D, Salvador-Coloma P. Effects and underlying mechanisms of unstable shoes on chronic low back pain: a randomized controlled trial. Clin Rehabil 2018; 32:654-662. [PMID: 29333872 DOI: 10.1177/0269215517753972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effects that wearing unstable shoes has on disability, trunk muscle activity, and lumbar spine range of motion (ROM) in patients with chronic lower back pain (CLBP). DESIGN Randomized controlled trial. SETTING Orthopedic Surgery Service. PARTICIPANTS We randomized 40 adults with nonspecific CLBP either to an unstable shoes group ( n = 20) or to the control group ( n = 20). INTERVENTION The participants in the unstable shoes group were advised to wear these shoes for a minimum of six hours a day for four weeks. Control group participants were asked to continue wearing their regular shoes. OUTCOME MEASURES Our primary outcome was measurement of back-related dysfunction, assessed using the Roland-Morris Disability Questionnaire. Secondary outcomes included changes in electromyographic (EMG) activity of erector spinae (ES), rectus abdominis (RA), internus obliquus (IO), and externus obliquus (EO) muscles, and changes in lumbar spine ROM. RESULTS Between-group analysis highlighted a significant decrease in disability in the unstable shoes group compared to the control (-5, 95% confidence interval (CI) = -8.4 to -1.6). Our results revealed a significant increase in the percentage of RA, ES, IO, and EO EMG activity and in lumbar spine ROM in the unstable shoes group compared to the control group. Moreover, our results showed a significant negative correlation between disability and the percentage of ES, RA, and IO muscle activity at the end of the intervention. CONCLUSION This study shows that the use of unstable shoes contributes to improvements in disability, which are likely related to increased trunk muscle activity and lumbar spine ROM.
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Affiliation(s)
- Juan Francisco Lisón
- 1 Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Borja Ortega-Santana
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Álvaro Antón-Nogués
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Palmy González-Requena
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Cristina Vera-Hervás
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | | | - Daniel Sánchez-Zuriaga
- 4 Department of Human Anatomy and Embryology, Faculty of Medicine and Odontology, Universitat de València, Valencia, Spain
| | - Pablo Salvador-Coloma
- 2 Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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