Effect of Exercise on Inter-Recti Distance and Associated Low Back Pain Among Post-Partum Females; A Randomized Controlled Trial

Objective: This study aimed to emphasize facilitation training and strengthening of abdominal and core muscles in improving the inter-recti distance (IRD) and associated low back pain (LBP) among young postpartum females. Materials and methods: A single-blinded randomized controlled trial, among forty young postpartum females, was conducted at a community health center. The females were divided into two equal groups through the envelope method where Group A received abdominal crunch training protocol whereas group B received double straight leg raise (DSLR) exercise protocol for 6 weeks and pre and post IRD and Oswestry disability index (ODI) scores were recorded. Results: Group A showed improvement in IRD with a mean difference of 1.95±0.4 whereas in group B it was found to be 2.85±0.35 when assessed through finger palpation method. The mean difference of IRD, when measured through digital nylon caliper method in abdominal crunch and DSLR exercise group was 4.06±0.74 and 1.2±0.49 respectively. Moreover, ODI scores of group A were 2.70±1.05 whereas, group B scores were found to be 1.1±0.06 showing that LBP reduced in participants who performed abdominal crunch exercise. Conclusion: This study reveals that 6 weeks of exercise protocol was observed to be effective in the management of DRA. Thus, abdominal crunch exercise seemed to produce promising results in a reduction of IRD and associated LBP.

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Efficacy of the Addition of Modified Pilates Exercises to a Minimal Intervention in Patients With Chronic Low Back Pain: A Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20120190 ◽

2013 ◽

Vol 93 (3) ◽

pp. 310-320 ◽

Cited By ~ 46

Author(s):

Gisela C. Miyamoto ◽

Leonardo Oliveira Pena Costa ◽

Thalissa Galvanin ◽

Cristina Maria Nunes Cabral

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Mean Difference ◽

Low Back ◽

Minimal Intervention ◽

Time Points ◽

Randomized Controlled

Background The Pilates method has been used to improve function and reduce pain in patients with chronic nonspecific low back pain, although there is little scientific evidence that describes its efficacy. Objective The purpose of this study was to investigate the effectiveness of the addition of modified Pilates exercises to minimal intervention in patients with chronic low back pain. Design A randomized controlled trial was conducted. Setting The study was done in an outpatient physical therapy department in Brazil. Patients Eighty-six patients with chronic nonspecific low back pain participated in the study. Intervention All participants received an education booklet containing information about low back pain and were randomly allocated to receive 12 sessions, over 6 weeks, of exercises based upon Pilates principles (n=43) or of education alone (n=43). Measurements Primary outcomes were pain intensity and disability measured at 6 weeks and 6 months. Secondary outcomes were patient-specific functional disability, global impression of recovery, and kinesiophobia measured at 6 weeks and 6 months. All outcomes were measured by a blinded assessor in all time points. Results There was no loss to follow-up at any of the time points. Improvements were observed in pain (mean difference=2.2 points, 95% confidence interval [CI]=1.1 to 3.2), disability (mean difference=2.7 points, 95% CI=1.0 to 4.4), and global impression of recovery (mean difference=−1.5 points, 95% CI=−2.6 to −0.4) in favor of the Pilates group after intervention, but these differences were no longer statistically significant at 6 months. Limitations Treatment provider and participants could not be blinded to the interventions. Conclusions The addition of modified Pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic nonspecific low back pain; however, these effects were not sustained over time.

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Effectiveness of Mat Pilates or Equipment-Based Pilates Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20130277 ◽

2014 ◽

Vol 94 (5) ◽

pp. 623-631 ◽

Cited By ~ 42

Author(s):

Maurício Antônio da Luz ◽

Leonardo Oliveira Pena Costa ◽

Fernanda Ferreira Fuhro ◽

Ana Carolina Taccolini Manzoni ◽

Naiane Teixeira Bastos Oliveira ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Controlled Trial ◽

Mean Difference ◽

Low Back ◽

Randomized Controlled ◽

Specific Disability ◽

Blinded Assessor

Background The Pilates method has been widely used to treat patients with chronic low back pain. Pilates exercises can be performed in 2 ways: by using specific equipment or without it (also known as mat Pilates). There are no studies, however, that have compared the effectiveness of mat Pilates with that of equipment-based Pilates. Objective The aim of this study was to compare the effectiveness of mat Pilates and equipment-based Pilates in patients with chronic nonspecific low back pain. Design A 2-arm randomized controlled trial with a blinded assessor was conducted. Setting The study was conducted at a private physical therapy clinic in Brazil. Patients Eighty-six patients with chronic nonspecific low back pain participated. Intervention The patients were randomly allocated to 1 of 2 groups: a mat Pilates group (n=43) and an equipment-based Pilates group (n=43). The participants in both groups attended 12 Pilates sessions over a period of 6 weeks. Measurements The primary outcomes were pain intensity and disability. The secondary outcomes were global perceived effect, patient's specific disability, and kinesiophobia. A blinded assessor evaluated the outcomes at baseline and 6 weeks and 6 months after randomization. Results After 6 months, there was a statistically significant difference for disability (mean difference=3.0 points, 95% confidence interval [CI]=0.6 to 5.4), specific disability (mean difference=−1.1 points, 95% CI=−2.0 to −0.1), and kinesiophobia (mean difference=4.9 points, 95% CI=1.6 to 8.2) in favor of equipment-based Pilates. No differences were found for the remaining outcomes. Conclusions Equipment-based Pilates was superior to mat Pilates in the 6-month follow-up for the outcomes of disability and kinesiophobia. These benefits were not observed for pain intensity and global perceived effect in patients with chronic nonspecific low back pain.

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