Effects of pelvic tilt control using visual biofeedback on gluteus maximus, multifidus, and hamstring activities during three different bridge exercises

BACKGROUND

The effects of pelvic tilt control using visual biofeedback on gluteus maximus (GM), multifidus (MF), and hamstring (HAM) muscle activities during bridge exercises involving anterior pelvic tilt (APT), neutral pelvic tilt (NPT), and posterior pelvic tilt (PPT) were investigated.

METHODS

Twenty-five healthy participants were included (mean age, 24.6 ± 1.9 years). Visual biofeedback was used for the participants to self-control pelvic tilt during the bridge exercises. Pelvic tilt controls were performed in a random order (APT vs. NPT vs. PPT) following 30 minutes education program. GM, MF, and HAM muscle activities were measured by surface electromyography. One-way repeated analysis of variance and Bonferroni post hoc test were used.

RESULT

GM and MF muscle activities significantly differed among the different pelvic tilting controls (APT vs. NPT vs. PPT) (p < .017). GM muscle activity during the exercise involving PPT was significantly higher than that involving APT and NPT (p < .017). In contrast, MF muscle activity during the exercise involving PPT was significantly lower than that involving APT (p < .017). In addition, the GM/Right MF, GM/Left MF, and GM/HAM muscle activity ratios during the exercise involving PPT were significantly greater than those involving APT and NPT (p < .017).

CONCLUSIONS

The bridge exercise involving PPT using visual biofeedback can be recommended as a home exercise to selectively improve the muscle activity of the GM and the muscle activity ratio of the GM/HAM and GM/MF. This information may be valuable for clinicians seeking exercise programs to target specific muscles effectively.

Efficacy and safety of thread embedding acupuncture combined with acupuncture for chronic low back pain: A randomized, controlled, assessor-blinded, multicenter clinical trial

BACKGROUND

Low back pain is a very common disease. Many patients with chronic low back pain (CLBP) have been treated by complementary and alternative medicine such as acupuncture (AT) treatment. A type of AT, thread embedding acupuncture (TEA), consists of a thread that can continually stimulate at the AT points and has mechanical and chemical effects. Although TEA was widely used in clinical practice, there was little evidence of its efficacy and safety for CLBP.

METHODS

This clinical trial was randomized, controlled, assessor-blinded, two-armed, parallel, and conducted in multiple centers. Four Korean medical institutions recruited 38 outpatients with CLBP. The participants were randomly allocated to a treatment group (TEA combined with AT) or a control group (only AT) in a 1:1 ratio. All participants received conventional AT twice a week for 8 weeks (16 sessions) at 15 AT points (GV3 and bilateral BL23, BL24, BL25, BL26, BL40, BL60, and EX-B5) and the treatment group participants additionally received TEA once a week for 8 weeks (8 sessions) on 10 AT points in the multifidus, spinal erector, and lumbar quadrate muscles. The primary outcome measure of this study was the change of visual analog scale (VAS) from baseline (0 week) to the end of intervention (8 weeks). Secondary outcome measures included clinically relevant improvement (minimal clinically important difference) and 3% to 50% decrease on VAS, disability level (Korean version of Roland and Morris disability questionnaire), quality of life (Korean version of European quality of life 5dimension), global assessment (patient global impression of change), economic analysis, credibility test, and safety assessment.

RESULTS

The treatment group showed a significant reduction in VAS scores when compared with the control group (-33.7 ± 25.1 vs -15.6 ± 17.0, P = .013). As for the secondary outcome measures, the treatment group showed significant difference in 50% decrease on VAS and patient global impression of change. There was no serious adverse event associated with TEA and AT.

CONCLUSION

This clinical trial documents the efficacy and safety of TEA combined with AT for the management of CLBP.