Effects of complex rehabilitation training on low back strength in chronic low back pain

Understanding social determinants of health and physical therapy outcomes in patients with low back pain: A scoping review

BACKGROUND

Low back pain (LBP) is the number one cause of disability worldwide; however, it is not clear how social determinants of health (SDOH) impact care management and outcomes related to physical therapy (PT) services for patients with LBP.

OBJECTIVE

The purposes of this scoping review are to examine and assimilate the literature on how SDOH and PT care relate to non-specific LBP outcomes and identify gaps in the literature to target for future research.

METHODS

Data were extracted from eight electronic databases from January 2011 to February 2022. Reviewers independently screened all studies using the PRISMA extension for scoping review guidelines. Data related to study design, type of PT, type of non-specific LBP, patient demographics, PT intervention, SDOH, and PT outcomes were extracted from the articles.

RESULTS

A total of 30,523 studies were screened, with 1961 articles undergoing full text review. Ultimately, 76 articles were identified for inclusion. Sex and age were the most frequent SDOH examined (88% and 78% respectively) followed by education level (18%). Approximately half of the studies that examined age, sex, and education level identified no effect on outcomes. The number of studies examining other factors was small and the types of outcomes evaluated were variable, which limited the ability to pool results.

CONCLUSIONS

Sex and age were the most frequent SDOH examined followed by education level. Other factors were evaluated less frequently, making it difficult to draw conclusions. Study design and heterogeneity of determinants and outcomes were barriers to examining the potential impact on patients with LBP.

Muscle contraction exercise for low back pain

Background

Low-back pain (LBP) continues to be one of the main problems for which sufferers seek treatment in primary care. It can be treated with different physiotherapy mechanisms.

Objective

The purpose of the study is to compare the effect of isotonic and isometric exercise on the reported pain of patients with low back pain.

Methods

Thirty participants, 16 males and 14 females aged between 22 and 50 years suffering from nonspecific low back pain were included. The sample was divided randomly into two groups, group A isometric exercises and group B isotonic exercises, both groups received conservative therapy of TENS and infrared (IR) therapy. The following outcome measures were used: Visual analogue scale, modified Oswestry disability index (MODI) and Endurance Test Measurement were administered pre-treatment and at the end of four weeks of treatment.

Results

Both groups were comparable in terms of demographic data, except for weight. Inter group analysis was done using the Mann-Whitney test. When comparing pre- and post-treatments using VAS scores, there were no significant differences between group A and group B (pre-test: P = 0 . 285 ; Post-test: P = 0 . 838 ). Mann-Whitney test was used to calculate the P-value test between pre-treatment and post- treatment for MODI and there was no significant difference between group A and group B, where the pre-test P-value was 0.061, and post-treatment was 0.077. Comparing between groups, pre- and post-abdominal endurance scores were done using the Mann-Whitney test. The pre-treatment scores revealed P value of 0.345, and the post-treatment scores revealed P value of 0.305. Therefore, there is no statistically significant difference between group A and group B in endurance scores.

Conclusion

There was no difference between the use isotonic and isometric exercises on LBP patients.

The effects of gluteal squeezes compared to bilateral bridges on gluteal strength, power, endurance, and girth

BACKGROUND

Hip extension weakness is correlated with low back, hip, and knee pathology. Isometric gluteal squeezes have been shown to elicit high electromyographic gluteal activity. However, there is little research regarding the specific effects of isometric gluteal squeezes on hip strength and functional outcomes. The purpose of this study was to identify the effects of gluteal squeezes on hip extension strength, vertical jump, broad jump, single-leg bridge endurance, and gluteal girth compared to bilateral gluteal bridging.

METHODS

A total of 32 healthy university students (mean age 23.28 ± 2.15 years) were randomly assigned to perform either gluteal squeezes or bilateral bridges daily. Subjects were tested at baseline and after 8 weeks of training. Subjects' hip extension strength, vertical jump, broad jump, single-leg bridge endurance, and gluteal girth were tested.

RESULTS

No statistically significant differences were found between the bridge and squeeze groups after 8 weeks of training. Both groups significantly improved hip extension strength bilaterally (p = 0.000-0.011). The squeeze group significantly increased gluteal girth at the level of the greater trochanter (p = 0.007), but no significant girth increase was seen in the bridge group (p = 0.742). Although increases were seen in both groups for the endurance and jump tasks, no statistically significant changes occurred for those outcomes. All outcome measurements demonstrated high reliability (ICC = 0.93-0.99).

CONCLUSION

Gluteal squeezes were as effective as bilateral bridges for increasing hip extension strength. Gluteal squeezes also significantly increased girth at the level of the greater trochanter. These results provide clinical and aesthetic reasons to perform gluteal squeezes.