Changes in Muscle Thickness After Exercise and Biofeedback in People With Low Back Pain

2014 ◽  
Vol 23 (4) ◽  
pp. 307-318 ◽  
Author(s):  
Shandi L. Partner ◽  
Mark Alan Sutherlin ◽  
Shellie Acocello ◽  
Susan A. Saliba ◽  
Eric M. Magrum ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Group Differences ◽  
Low Back ◽  
Lateral Abdominal Wall ◽  
Percent Change ◽  
Before And After

Context:Individuals with low back pain (LBP) have reduced function of the transversus abdominis (TrA) and lumbar multifidus (LM) muscles. Biofeedback during exercise may increase the ability to contract the TrA and LM muscles compared with exercise alone.Objective:To compare TrA preferential activation ratio (PAR) and the percent change in LM-muscle thickness in patients with LBP history before and after exercise with or without biofeedback.Design:Controlled laboratory study.Setting:University research laboratory.Patients:20 LBP individuals, 10 exercise alone and 10 exercise with biofeedback.Interventions:Patients were allotted to tabletop exercises in isolation or tabletop exercises with visual, auditory, and tactile biofeedback.Main Outcome Measures:TrA PAR and percent change in LM-muscle thickness.Results:There were no differences between groups at baseline (all P > .05). Nonparametric statistics showed decreased resting muscle thickness for total lateral abdominal-wall muscles (P = .007) but not TrA (P = .410) or LM (P = .173). Percent TrA thickness increased from table to standing positions before (P = .006) and after exercise (P = .009). TrA PAR increased after exercise (pre 0.01 ± 0.02, post 0.03 ± 0.04, P = .033) for all patients and for exercise with biofeedback (pre 0.02 ± 0.01, post 0.03 ± 0.01, P = .037) but not for exercise alone (pre 0.01 ± 0.02, post 0.02 ± 0.05, P = .241). No group differences were observed for TrA PAR before (exercise 0.01 ± 0.02, exercise with biofeedback 0.02 ± 0.01, P = .290) or after exercise (exercise 0.02 ± 0.05, exercise with biofeedback 0.03 ± 0.01, P = .174). There were no group differences in LM percent change before exercise (P = .999) or after exercise (P = .597). In addition, no changes were observed in LM percent change as a result of exercise among all participants (P = .391) or for each group (exercise P = .508, exercise with biofeedback P = .575).Conclusion:TrA PAR increased after a single session of exercises, whereas no thickness changes occurred in LM.

Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

2021 ◽  
Author(s):  
Ecenur Atli ◽  
Dilber Karagozoglu Coskunsu ◽  
Zeynep Turan ◽  
Ozden Ozyemisci Taskiran
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Control Group ◽  
Low Back

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p<0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p>0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p>0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.

The Effect of Traditional Bridging or Suspension-Exercise Bridging on Lateral Abdominal Thickness in Individuals With Low Back Pain

2012 ◽  
Vol 21 (2) ◽  
pp. 151-160 ◽  
Author(s):  
Rebecca J. Guthrie ◽  
Terry L. Grindstaff ◽  
Theodore Croy ◽  
Christopher D. Ingersoll ◽  
Susan A. Saliba
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Minimal Detectable Change ◽  
Abdominal Muscles ◽  
Low Back ◽  
Time Interaction ◽  
Contraction Ratio

Context:Individuals with low back pain (LBP) are thought to benefit from interventions that improve motor control of the lumbopelvic region. It is unknown if therapeutic exercise can acutely facilitate activation of lateral abdominal musculature.Objective:To investigate the ability of 2 types of bridging-exercise progressions to facilitate lateral abdominal muscles during an abdominal drawing-in maneuver (ADIM) in individuals with LBP.Design:Randomized control trial.Setting:University research laboratory.Participants:51 adults (mean ± SD age 23.1 ± 6.0 y, height 173.6 ± 10.5 cm, mass 74.7 ± 14.5 kg, and 64.7% female) with LBP. All participants met 3 of 4 criteria for stabilization-classification LBP or at least 6 best-fit criteria for stabilization classification.Interventions:Participants were randomly assigned to either traditional-bridge progression or suspension-exercise-bridge progression, each with 4 levels of progressive difficulty. They performed 5 repetitions at each level and were progressed based on specific criteria.Main Outcome Measures:Muscle thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) was measured during an ADIM using ultrasound imaging preintervention and postintervention. A contraction ratio (contracted thickness:resting thickness) of the EO, IO, and TrA was used to quantify changes in muscle thickness.Results:There was not a significant increase in EO (F1,47 = 0.44, P = .51) or IO (F1,47 = .30, P = .59) contraction ratios after the exercise progression. There was a significant (F1,47 = 4.05, P = .05) group-by-time interaction wherein the traditional-bridge progression (pre = 1.55 ± 0.22; post = 1.65 ± 0.21) resulted in greater (P = .03) TrA contraction ratio after exercise than the suspension-exercise-bridge progression (pre = 1.61 ± 0.31; post = 1.58 ± 0.28).Conclusion:A single exercise progression did not acutely improve muscle thickness of the EO and IO. The magnitude of change in TrA muscle thickness after the traditional-bridging progression was less than the minimal detectable change, thus not clinically significant.

scholarly journals Cocontraction of Ankle Dorsiflexors and Transversus Abdominis Function in Patients With Low Back Pain

2012 ◽  
Vol 47 (4) ◽  
pp. 379-389 ◽  
Author(s):  
Seung-Chul Chon ◽  
Joshua H. You ◽  
Susan A. Saliba
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Onset Time ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Low Back ◽  
Control Groups ◽  
Thickness Change ◽  
And Control ◽  
Ankle Dorsiflexors

Context: The abdominal draw-in maneuver (ADIM) with cocontraction has been shown to be a more effective method of activating the transversus abdominis (TrA) in healthy adults than the ADIM alone. Whether such an augmented core stabilization exercise is effective in managing low back pain (LBP) remains uncertain. Objective: To determine the effect of 2 weeks of ADIM and cocontraction training on abdominal muscle thickness and activation timing and to monitor pain and function in patients with LBP. Design: Case-control study. Setting: Local orthopaedic clinic and research laboratory. Patients or Other Participants: Twenty patients with mechanical LBP (age = 27.20 ± 6.46 years, height = 166.25 ± 8.70 cm, mass = 58.10 ± 11.81 kg) and 20 healthy, age-matched people (age = 24.25 ± 1.59 years, height = 168.00 ± 8.89 cm, mass = 60.65 ± 11.99 kg) volunteered for the study. Intervention(s): Both the LBP and control groups received ten 30-minute sessions of ADIM and cocontraction training of the tibialis anterior (TA) and rectus femoris (RF) muscles over a 2-week period. Main Outcome Measure(s): A separate, mixed-model analysis of variance was computed for the thicknesses of the TrA, internal oblique (IO), and external oblique muscles. The differences in mean and peak electromyographic (EMG) amplitudes, onset time, and latency were compared between the groups. The visual analog pain scale, Pain Disability Index, and LBP rating scale were used to assess pain in the LBP group before and after the intervention. Results: We found an interaction between the LBP and control groups and a main effect from pretest to posttest for only TrA muscle thickness change (F1,38 = 6.57, P = .01). Reductions in all pain measures were observed after training (P &lt; .05). Group differences in peak and mean EMG amplitudes and onset time values for TrA/IO and TA were achieved (P &lt; .05). The RF peak (t38 = −3.12, P = .003) and mean (t38 = −4.12, P = .001) EMG amplitudes were different, but no group difference was observed in RF onset time (t38 = 1.63, P = .11) or the cocontracted TrA/IO peak (t38 = −1.90, P = .07) and mean (t38 = −1.81, P = .08). The test-retest reliability for the muscle thickness measure revealed excellent correlations (intraclass correlation coefficient range, 0.95–0.99). Conclusions: We are the first to demonstrate that a cocontraction of the ankle dorsiflexors with ADIM training might result in a thickness change in the TrA muscle and associated pain management in patients with chronic LBP.

Comparison of Selective Local and Global Muscle Thicknesses in Females with and without Chronic Low Back Pain

2018 ◽  
Vol 20 (3) ◽  
pp. 197-204 ◽  
Author(s):  
Mahnaz Aboufazeli ◽  
Mohammad Akbari ◽  
Ali Ashraf Jamshidi ◽  
Mohammad Saleh Jafarpisheh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Healthy Subjects ◽  
Muscle Thickness ◽  
Gluteus Medius ◽  
Transversus Abdominis ◽  
Low Back ◽  
Lumbar Multifidus ◽  
Sample Test

Background. Chronic low back pain (LBP) leads to long-term physical and psychological problems and may result in acute deterioration of the pain. It is hypothesized that size changes in selected limb and pelvis muscles during contracting movements are different between healthy individuals and LBP patients. Materials and methods. A case-control study including two groups of 30 female participants with and without LBP symptoms was designed. Participants were 20-45 years old (36.7±6.7, healthy subjects; 34.6±6.2 LBP subjects). Ultrasonography was used to estimate the thicknesses of the quadratus lumborum (QL), gluteus medius (GMed), transversus abdominis (TrA) and lumbar multifidus (MF). Thickness changes of the muscles in a submaximal contracting position compared to the rest position were measured. Statistical analysis included an independent t-test to determine the significance of differences, and the Kolmogrov-Smirnov two-sample test to evaluate the normality and reliability. Results. All muscles increased their thickness during contractions. The average increase in LBP subjects was lower than in the healthy subjects. The smaller increase in the muscle thickness of GMed in the LBP group may suggest a weakness because of imbalance in the GMed muscle of LBP patients. Conclusions. 1. Ultrasonography of local and global muscles is an appropriate device for clinical diagnosis of LBP. 2. Strengthening TrA, MF, and GMed muscles for pain prevention is effective in the prevention and treatment of LBP.

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

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.

scholarly journals Effect of a full pilates group exercise program on transversus abdominis thickness, daily function and pain in women with chronic low back pain

Kinesiology ◽  
2021 ◽  
Vol 53 (2) ◽  
pp. 318-325
Author(s):  
Noelia Goldberg ◽  
Asaf Weisman ◽  
Snježana Schuster ◽  
Gali Dar ◽  
Youssef Masharawi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Transversus Abdominis ◽  
Group Differences ◽  
Control Group ◽  
Anatomical Location ◽  
Low Back ◽  
Healthy Group ◽  
Healthy Women ◽  
Pilates Method

The Pilates method is often used in the treatment of nonspecific low back pain (NSCLBP). The effect of Pilates group exercising (mat and apparatus combined) on women with NSCLBP is unknown. Studies on the Pilates method often use ultrasound (US) to measure transversus abdominis (TrA) thickness in one anatomical location. We recruited 40 women, 22 with NSCLBP and 18 healthy women (active control group), to join five weeks of biweekly Pilates group exercising (apparatus and mat). Measurements included TrA thickness (left and right) at rest, during active draw-in maneuver (ADIM), and its TrA% change in three anatomical areas; Roland-Morris disability questionnaire (RMDQ); and pain level (VAS). Before the study, no asymmetry in TrA thickness was noted as well as no between-group differences in TrA-thickness in three anatomic areas (in rest and ADIM). Following the intervention, TrA thickness increased during rest in the healthy group in two areas. No differences were noted between the two groups in ADIM in the anatomical locations. No between-group differences were found before the intervention in the TrA% change. Following the intervention, an increase in the TrA-% change was noticed in the NSCLBP group. A decrease in the healthy group was observed in area C. No effects were noted on the RMDQ and VAS. Five weeks of Pilates group exercising increased TrA thickness in healthy women and its percentage changed in women with NSCLBP. Measuring TrA thickness with US should be performed in three different anatomical locations on both sides. This measuring procedure has good inter- and intra-rater reliability and the potential to reveal physiological effects.

Laboratory Gait Analysis in Patients with Low Back Pain before and after a Pilates Intervention

2009 ◽  
Vol 18 (2) ◽  
pp. 269-282 ◽  
Author(s):  
Juliana Limba da Fonseca ◽  
Marcio Magini ◽  
Thais Helena de Freitas
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Lower Limb ◽  
Controlled Trial ◽  
Reaction Force ◽  
Control Group ◽  
Low Back ◽  
Before And After ◽  
Pilates Method

Objective:To evaluate the influence of pain on vertical ground-reaction force (VGRF) in patients with low back problems and the effect of the Pilates method on the gait of these patients.Design:A single-blind randomized controlled trial.Participants:28 individuals assigned to a control group (n = 11) and a low-back group (n = 17), the latter of which was subdivided into a Pilates group (n = 8) and a no-Pilates group (n = 9).Intervention:The Pilates group undertook 15 sessions of Pilates.Main Outcome Measures:The VGRF parameters were recorded during preferred and faster walking speeds. The data were collected before and after the intervention.Results:The weight-acceptance rate and push-off rate were significantly less in the right lower limb of low-back group than of the control group at preferred speed. Improvements were seen in the Pilates group postintervention, with increased middle-support force for the left lower limb at faster walking speed and decreased pain; this did not occur in the no-Pilates group.Conclusions:These results suggest that patients with low back pain use strategies to attenuate the amount of force imposed on their body. The Pilates method can improve weight discharge in gait and reduce pain compared with no intervention.

Effect of 2 Lumbar Spine Postures on Transversus Abdominis Muscle Thickness During a Voluntary Contraction in People With and Without Low Back Pain

2011 ◽  
Vol 34 (3) ◽  
pp. 164-172 ◽  
Author(s):  
Rafael Z. Pinto ◽  
Paulo H. Ferreira ◽  
Marcia R. Franco ◽  
Manuela L. Ferreira ◽  
Mariana C. Ferreira ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Muscle Thickness ◽  
Voluntary Contraction ◽  
Transversus Abdominis ◽  
Low Back ◽  
Transversus Abdominis Muscle

COMPARISON OF LATERAL ABDOMINAL MUSCLE THICKNESS IN YOUNG MALE SOCCER PLAYERS WITH AND WITHOUT LOW BACK PAIN

2019 ◽  
Vol 14 (2) ◽  
pp. 273-281 ◽  
Author(s):  
Pardis Noormohammadpour ◽  
Shadi Mirzaei ◽  
Navid Moghadam ◽  
Mohammad Ali Mansournia ◽  
Ramin Kordi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Young Male ◽  
Muscle Thickness ◽  
Abdominal Muscle ◽  
Soccer Players ◽  
Low Back

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

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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