Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control

BackgroundThe evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.ObjectiveThe purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.DesignThis was a randomized, placebo-controlled trial.SettingThe study was conducted in an outpatient physical therapy department in Australia.PatientsThe participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.InterventionTwelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.MeasurementsPrimary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.ResultsThe exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=−0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.LimitationClinicians could not be blinded to the intervention they provided.ConclusionsMotor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.

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An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720820966082 ◽

2020 ◽

pp. 001872082096608

Author(s):

Pongsatorn Saiklang ◽

Rungthip Puntumetakul ◽

James Selfe ◽

Gillian Yeowell

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Muscle Fatigue ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Trunk Muscle ◽

Low Back ◽

Prolonged Sitting ◽

Lumbar Extension

Objective The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. Background Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. Method Thirty participants with CLBP were randomly allocated: (a) control—sitting without exercise, and (b) intervention—supported dynamic lumbar extension with the ADIM technique. Results Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. Conclusion The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. Application Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.

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A randomized clinical trial comparing the McKenzie method and motor control exercises in people with chronic low back pain and a directional preference: 1-year follow-up

Physiotherapy ◽

10.1016/j.physio.2018.12.004 ◽

2019 ◽

Vol 105 (4) ◽

pp. 442-445

Author(s):

Mark H. Halliday ◽

Evangelos Pappas ◽

Mark J. Hancock ◽

Helen A. Clare ◽

Rafael Z. Pinto ◽

...

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Motor Control ◽

Back Pain ◽

Randomized Clinical Trial ◽

Chronic Low Back Pain ◽

Low Back ◽

Directional Preference ◽

Mckenzie Method

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Age- and sex-specific effects in paravertebral surface electromyographic back extensor muscle fatigue in chronic low back pain

GeroScience ◽

10.1007/s11357-019-00134-7 ◽

2019 ◽

Vol 42 (1) ◽

pp. 251-269 ◽

Cited By ~ 1

Author(s):

Gerold Ebenbichler ◽

Richard Habenicht ◽

Sara Ziegelbecker ◽

Josef Kollmitzer ◽

Patrick Mair ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Fatigue ◽

Chronic Low Back Pain ◽

Median Frequency ◽

Low Back ◽

Back Muscle ◽

The Impact ◽

Back Extensor ◽

Age And Sex

AbstractThe impact of aging on the back muscles is not well understood, yet may hold clues to both normal aging and chronic low back pain (cLBP). This study sought to investigate whether the median frequency (MF) surface electromyographic (SEMG) back muscle fatigue method—a proxy for glycolytic muscle metabolism—would be able to detect age- and sex-specific differences in neuromuscular and muscle metabolic functions in individuals with cLBP in a reliable way, and whether it would be as sensitive as when used on healthy individuals. With participants seated on a dynamometer (20° trunk anteflexion), paraspinal SEMG activity was recorded bilaterally from the multifidus (L5), longissimus (L2), and iliolumbalis (L1) muscles during isometric, sustained back extensions loaded at 80% of maximum from 117 younger (58 females) and 112 older (56 female) cLBP individuals. Tests were repeated after 1–2 days and 6 weeks. Median frequency, the SEMG variable indicating neuromuscular fatigue, was analyzed. Maximum back extensor strength was comparable between younger and older participants. Significantly less MF-SEMG back muscle fatigue was observed in older as compared to younger, and in older female as compared to older male cLBP individuals. Relative reliability was excellent, but absolute reliability appeared large for this SEMG-fatigue measure. Findings suggest that cLBP likely does not mask the age-specific diagnostic potential of the MF-SEMG back extensor fatigue method. Thus, this method possesses a great potential to be further developed into a valuable biomarker capable of detecting back muscle function at risk of sarcopenia at very early stages.

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