Three Case Studies of the Immediate Effect of Direct Stretching of the Tensor Fascia Latae and Gluteus Medius Strengthening Exercises on Non-specific Low-back Pain of Different Stages

Abstract Introduction Globally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated to increase spinal loading and reduce spinal stability. Differences in gluteus medius function have been reported in those with LBP compared to those without, although this has only been reported in individual studies. The aim of this systematic review was to determine if adults with a history, or current LBP, demonstrate differences in measures of gluteus medius function when compared to adults without LBP. Methods MEDLINE, EMBASE, AMED, PsycINFO, PubMED, Pro Quest Database, CINAHL and SPORTDiscus were searched from inception until December 2018 for published journal articles and conference abstracts. No language restrictions were applied. Only case-control studies with participants 18 years and over were included. Participants could have had any type and duration of LBP. Studies could have assessed gluteus medius function with any quantifiable clinical assessment or measurement tool, with the participant non-weight bearing or weight bearing, and during static or dynamic activity. Quality appraisal and data extraction were independently performed by two authors. Results The 24 included articles involved 1088 participants with LBP and 998 without LBP. The gluteus medius muscle in participants with LBP tended to demonstrate reduced strength and more trigger points compared to the gluteus medius muscle of those without LBP. The level of activity, fatigability, time to activate, time to peak activation, cross sectional area, and muscle thickness showed unclear results. Meta-analysis was not performed due to the heterogeneity of included studies. Conclusion Clinically, the findings from this systematic review should be considered when assessing and managing patients with LBP. Future studies that clearly define the type and duration of LBP, and prospectively assess gluteus medius muscle function in those with and without LBP are needed. Trial registration PROSPERO (CRD42017076773).

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Effects of lumbar extensor muscle strengthening and neuromuscular control retraining on disability in patients with chronic low back pain: a protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2018-028259 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028259

Author(s):

Joshua Brodie Farragher ◽

Adrian Pranata ◽

Gavin Williams ◽

Doa El-Ansary ◽

Selina M Parry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Randomised Controlled Trial ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Low Back ◽

Exercise Interventions ◽

Intervention Protocol ◽

Strengthening Exercises ◽

Randomised Controlled

IntroductionChronic low back pain (CLBP) is the leading cause of disability worldwide. However, there is no consensus in the literature regarding optimal management. Exercise intervention is the most widely used treatment as it likely influences contributing factors such as physical and psychological. Literature evaluating the effects of exercise on CLBP is often generalised, non-specific and employs inconsistent outcome measures. Moreover, the mechanisms behind exercise-related improvements are poorly understood. Recently, research has emerged identifying associations between neuromuscular-biomechanical impairments and CLBP-related disability. This information can be used as the basis for more specific and, potentially more efficacious exercise interventions for CLBP patients.Methods and analysisNinety-four participants (including both males and females) with CLBP aged 18–65 who present for treatment to a Melbourne-based private physiotherapy practice will be recruited and randomised into one of two treatment groups. Following baseline assessment, participants will be randomly allocated to receive either: (i) strengthening exercises in combination with lumbar force accuracy training exercises or (ii) strengthening exercises alone. Participants will attend exercise sessions twice a week for 12 weeks, with assessments conducted at baseline, midway (ie, 6 weeks into the trial) and at trial completion. All exercise interventions will be supervised by a qualified physiotherapist trained in the intervention protocol. The primary outcome will be functional disability measured using the Oswestry Disability Index. Other psychosocial and mechanistic parameters will also be measured.Ethics and disseminationThis study was given approval by the University of Melbourne Behavioural and Social Sciences Human Ethics Sub-Committee on 8 August 2017, reference number 1 749 845. Results of the randomised controlled trial will be published in peer-reviewed journals.Trial registration numberACTRN12618000894291.

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FRI0461-HPR Trunk stabilizing exercise and strengthening exercises in patients with non-specific chronic low back pain: A pilot blinded randomized trial

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-eular.2918 ◽

2013 ◽

Vol 71 (Suppl 3) ◽

pp. 745.3-746 ◽

Cited By ~ 1

Author(s):

C.M. Carmo ◽

M.F.A. Jacob ◽

K.S. Takara ◽

F.G. Santos ◽

F.A. Caromano ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Randomized Trial ◽

Chronic Low Back Pain ◽

Low Back ◽

Strengthening Exercises

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

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.1473 ◽

2018 ◽

Vol 20 (3) ◽

pp. 197-204 ◽

Cited By ~ 10

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.

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