The Relationship Between Hip-Abductor Strength and the Magnitude of Pelvic Drop in Patients With Low Back Pain

Context:It has been theorized that a positive Trendelenburg test (TT) indicates weakness of the stance hip-abductor (HABD) musculature, results in contralateral pelvic drop, and represents impaired load transfer, which may contribute to low back pain. Few studies have tested whether weakness of the HABDs is directly related to the magnitude of pelvic drop (MPD).Objective:To examine the relationship between HABD strength and MPD during the static TT and during walking for patients with nonspecific low back pain (NSLBP) and healthy controls (CON). A secondary purpose was to examine this relationship in NSLBP after a 3-wk HABD-strengthening program.Design:Quasi-experimental.Setting:Clinical research laboratory.Participants:20 (10 NSLBP and 10 CON).Intervention:HABD strengthening.Main Outcome Measures:Normalized HABD strength, MPD during TT, and maximal pelvic frontal-plane excursion during walking.Results:At baseline, the NSLBP subjects were significantly weaker (31%; P = .03) than CON. No differences in maximal pelvic frontal-plane excursion (P = .72), right MPD (P = 1.00), or left MPD (P = .40) were measured between groups. During the static TT, nonsignificant correlations were found between left HABD strength and right MPD for NSLBP (r = −.32, P = .36) and CON (r = −.24, P = .48) and between right HABD strength and left MPD for NSLBP (r = −.24, P = .50) and CON (r = −.41, P = .22). Nonsignificant correlations were found between HABD strength and maximal pelvic frontal-plane excursion for NSLBP (r = −.04, P = .90) and CON (r = −.14, P = .68). After strengthening, NSLBP demonstrated significant increases in HABD strength (12%; P = .02), 48% reduction in pain, and no differences in MPD during static TT and maximal pelvic frontal-plane excursion compared with baseline.Conclusions:HABD strength was poorly correlated to MPD during the static TT and during walking in CON and NSLBP. The results suggest that HABD strength may not be the only contributing factor in controlling pelvic stability, and the static TT has limited use as a measure of HABD function.

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A comparative study of the therapeutic efficacy of vertical oscillatory pressure and transverse oscillatory pressure in the management of Chronic Low Back Pain

Revista Pesquisa em Fisioterapia ◽

10.17267/2238-2704rpf.v8i2.1916 ◽

2018 ◽

Vol 8 (2) ◽

pp. 216-222

Author(s):

Oluwadare Akanni Ogundipe ◽

Olufemi Opeyemi Ogundiran

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Low Back ◽

Significant Difference ◽

Before And After ◽

Treatment Data ◽

Quasi Experimental ◽

Oscillatory Pressure

BACKGROUND: The use of physical modalities in treatment of Chronic Low Back Pain (CLBP) is potentially beneficial, but the general evidence still leaves questions about its security application. OBJECTIVE: This study sought to investigate and compare the relative efficacy of Vertical Oscillatory Pressure (VOP) and Transverse Oscillatory Pressure (TOP) in the management chronic low back pain (CLBP) of mechanical origin. METHODS: A two-group, quasi-experimental design was utilized, involving a total of forty-two participants purposively recruited with due consideration of the specific inclusion and exclusion criteria. Five research questions were raised with corresponding hypotheses formulated for them, which were tested at 0.05 level of significance. The participants were randomly assigned to the VOP and TOP groups, and were subsequently managed thrice weekly for a duration of six weeks. The pain intensity rating, straight leg raising, and spinal range of motion were the outcome measures selected, which were assessed before and after treatment. Data were collected, organized, and analyzed using descriptive and T-Student test analytical statistics. RESULTS: The results of the study showed a significant difference in each of the outcome measures for both groups (p<0,05). CONCLUSION: This suggested that both VOP and VOP were relatively effective in managing CLBP.

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The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain

Chiropractic & Osteopathy ◽

10.1186/1746-1340-18-1 ◽

2010 ◽

Vol 18 (1) ◽

Cited By ~ 26

Author(s):

Amir M Arab ◽

Mohammad R Nourbakhsh

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Strength ◽

Iliotibial Band ◽

Low Back ◽

Abductor Muscle ◽

Hip Abductor ◽

The Relationship

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Compression shorts reduce prenatal pelvic and low back pain: a prospective quasi-experimental controlled study

PeerJ ◽

10.7717/peerj.7080 ◽

2019 ◽

Vol 7 ◽

pp. e7080

Author(s):

Jaclyn M. Szkwara ◽

Wayne Hing ◽

Rodney Pope ◽

Evelyne Rathbone

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Usual Care ◽

Outcome Measures ◽

Controlled Study ◽

Low Back ◽

Body Temperatures ◽

Change Scores ◽

Sf 36 ◽

Quasi Experimental

BackgroundCommon prenatal ailments negatively impact performance of activities of daily living and it has been proposed that the use of dynamic elastomeric fabric orthoses, more commonly referred to as compression garments, during pregnancy might aid in the reduction of pain from these ailments, allowing for improved functional capacity. However, the effectiveness of such garments in this context has not been established. This study aims to determine whether compression shorts are effective and thermally safe in the prevention and management of prenatal pelvic and low back pain (LBP).MethodA prospective quasi-experimental controlled study using parallel groups without random allocation was conducted, involving 55 childbearing women (gestational weeks 16–31) recruited from hospital and community-based maternity care providers. The compression shorts group (SG) wore SRC Pregnancy Shorts in addition to receiving usual care. The comparison group (CG) received usual care alone. Primary outcome measures—Numeric Pain Rating Scale (NPRS) and Roland Morris Disability Questionnaire (RMDQ) and secondary measures Pelvic Floor Impact Questionnaire - 7 (PFIQ-7) and SF-36 Short Form Health Survey—were assessed fortnightly over 6-weeks for both groups. The compression SG self-assessed daily their body temperatures to monitor thermal impact. Data analysis involved descriptive analyses of the primary and secondary outcome measures scores by group and time-point, and multivariable linear regressions to assess between-group differences in change scores at 6-weeks from baseline while controlling for baseline factors.ResultsAfter controlling for baseline scores, gestational weeks and parity, statistically significant differences in NPRS and RMDQ change scores between groups were in favour of the compression SG. At 6-weeks, mean (SD) NPRS change scores in the compression SG and CG were significantly different, at −0.38 (2.21) and 2.82 (2.68), respectively,p= 0.003. Mean (SD) RMDQ change scores in the compression SG and CG were also significantly different, at 0.46 (3.05) and 3.64 (3.32), respectively,p= 0.009. A total of 883 (99.7%) of the reported daily self-assessed body temperatures ranged between 35.4 and 38.0 °C when wearing the compression shorts. At 6-weeks, mean (SD) PFIQ-7 and SF-36 change scores in the compression SG and CG were not significantly different.ConclusionCompression shorts are effective and thermally safe for prenatal management of pelvic and LBP.RegistrationTrial registration was not required (Australian Government Department of Health Therapeutic Goods Administration (TGA), 2018).

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THE RELATIONSHIP BETWEEN CHRONIC LOW BACK PAIN AND PHYSICAL FACTORS IN COLLEGIATE POLE VAULTERS: A CROSS-SECTIONAL STUDY

International Journal of Sports Physical Therapy ◽

10.26603/ijspt20200537 ◽

2020 ◽

Vol 15 (4) ◽

pp. 537-547

Author(s):

Shota Enoki ◽

Rieko Kuramochi ◽

Yuki Murata ◽

Gaku Tokutake ◽

Takuya Shimizu

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Cross Sectional Study ◽

Physical Factors ◽

Low Back ◽

Sectional Study ◽

Cross Sectional ◽

The Relationship

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Aplicabilidade clínica das técnicas de liberação manual diafragmática: uma revisão sistemática

Caderno de Educação Física e Esporte ◽

10.36453/2318-5104.2020.v18.n3.p111 ◽

2020 ◽

Vol 18 (3) ◽

pp. 111-116

Author(s):

Dulce Marieli Danieli ◽

Fabíola De Almeida Gomes ◽

Bruna Eibel ◽

William Dhein

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Gastroesophageal Reflux ◽

Randomized Clinical Trials ◽

Experimental Studies ◽

Scar Tissue ◽

Low Back ◽

Musculoskeletal Manipulations ◽

Clinical Applicability ◽

Quasi Experimental

INTRODUÇÃO: O diafragma é o principal músculo respiratório e desempenha um papel importante na respiração e na regulação fisiológica. Uma terapia que visa melhorar essas condições referentes ao diafragma, é a técnica de liberação manual diafragmática. OBJETIVO: O objetivo deste estudo foi verificar a aplicabilidade clínica das técnicas manuais de liberação diafragmática e identificar as principais técnicas, populações investigadas, variáveis avaliadas e seus desfechos. MÉTODOS: Foram pesquisadas as seguintes bases de dados: PubMed, Scielo e Science Direct, com os descritores “Diaphragm [Mesh]” e “Musculoskeletal Manipulations [Mesh]” com seus correspondentes no mesmo idioma. Foram incluídos ensaios clínicos randomizados, não randomizados, estudos semi, quase-experimentais e estudos pilotos ou de caso, que abordaram técnicas de liberação manuais diafragmáticas.RESULTADOS: Há variadas técnicas de liberação diafragmática, sendo as mais mencionadas: normalização dos pilares do diafragma, alongamento e estiramento do diafragma, relaxamento dos pilares do diafragma. Além disso, as técnicas de liberação diafragmática vêm sendo associadas a protocolos de terapia manipulativa osteopática (TMO). As principais populações estudadas foram de pacientes saudáveis, com lombalgia, cervicalgia, osteoartrite, asmáticos, doença pulmonar obstrutiva crônica, constipados, cardiopatas e com refluxo gastroesofágico. Os principais desfechos avaliados são variáveis musculoesqueléticas (dor, flexibilidade, amplitude, espessura diafragmática), variáveis cardiorrespiratórias (pressão inspiratória/expiratória máxima (PImax e Pemax), mobilidade torácica, frequência cardíaca e respiratória), qualidade de vida e disfunções gastrointestinais/gastroesofágicas. CONCLUSÃO: A aplicabilidade clínica das técnicas de liberação diagramática está sendo investigada associado com outras técnicas osteopáticas, em protocolos de TMO em pacientes saudáveis, pneumopatas, cardiopatas, gestantes, em cicatriz pós-cirúrgica, constipados, com refluxo gastroesofágico, osteoartrite, cervicalgia e com lombalgia. Evidencia-se: diminuição ou eliminação das dores musculoesqueléticas, aumento da flexibilidade, ADM, Pimáx e Pemáx, aumento da mobilidade torácica, aumento da qualidade de vida, diminuição do inchaço e dor abdominal e sem efeito em cardiopatas.ABSTRACT. Clinical applicability of manual diaphragmatic release techniques: a systematic review.BACKGROUND: The diaphragm is the main respiratory muscle and plays an important role in breathing and physiological regulation. A therapy that aims to improve these conditions regarding the diaphragm, is the manual diaphragmatic release technique.OBJECTIVE: The aim of this study was to verify the clinical applicability of manual diaphragmatic release techniques and searching the main techniques, population, evaluated variables, and outcomes. METHODS: The following electronic databases were searched: PubMed, Scielo, and Science Direct, with the descriptors “Diaphragm [Mesh]” and “Musculoskeletal Manipulations [Mesh]” with their correspondents in the same language. There were included randomized clinical trial, non-randomized clinical trials, semi, and quasi-experimental studies, and pilot or case studies, which addressed manual diaphragmatic release techniques.RESULTS: There are various diaphragmatic release techniques, the most mentioned are: normalization of the diaphragm pillars, stretching of the diaphragm, relaxation of the diaphragm pillars, and protocols for osteopathic manipulative therapy (OMT) for the diaphragm. The main populations studied were healthy patients, with low back pain, asthmatics, chronic pulmonary obstructive disease, constipated, cardiac patients, and gastroesophageal reflux. The main outcomes assessed are musculoskeletal variables (pain, flexibility, range of motion, diaphragmatic thickness), cardiorespiratory variables (maximal inspiratory/expiratory pressure (MIP and MEP), chest mobility, heart, and respiratory rate), quality of life, and gastrointestinal/ gastroesophageal disorders.CONCLUSION: The clinical applicability of diagrammatic release techniques is being investigated in association with other osteopathic techniques, in protocols of OMT in healthy subjects, patients with lung diseases, heart disease, pregnant women, scar tissue, constipated, with gastroesophageal reflux, osteoarthritis, cervicalgia and with low back pain. There is evidence of reduction and elimination of musculoskeletal pain, increased MIP, increased chest mobility, an increase in health quality, a decrease of bloating and abdominal pain related to constipation, and a decrease of reflux symptoms.

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Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

SPORT AND SOCIETY ◽

10.36836/uaic/fefs/10.50 ◽

2019 ◽

pp. 3-13

Author(s):

Alexandru Cîtea ◽

George-Sebastian Iacob

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Postural Control ◽

Human Body ◽

Sagittal Plane ◽

The Body ◽

Lower Limbs ◽

Low Back ◽

Pilates Method ◽

The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

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Long-term improvements following a residential combined physical and psychological programme for chronic low back pain

BMJ Open Quality ◽

10.1136/bmjoq-2020-001068 ◽

2021 ◽

Vol 10 (2) ◽

pp. e001068

Author(s):

Shaun Wellburn ◽

Cormac G Ryan ◽

Andrew Coxon ◽

Alastair J Dickson ◽

D John Dickson ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Rating Scale ◽

Secondary Outcome ◽

Low Back ◽

Residential Setting ◽

Wide Range

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.

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