scholarly journals Relationship between Low Back Pain and Lumbar Proprioception, Functional Stability, Static Endurance of Trunk Muscles and Balance in Adolescents

2019 ◽  
Vol 2 (13) ◽  
Author(s):  
Lina Varnienė ◽  
Tomas Aukštikalnis ◽  
Gabrielė Andrejevaitė ◽  
Romualdas Sinkevičius ◽  
Juozas Raistenskis ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Trunk Muscles ◽  
Control Group ◽  
Low Back ◽  
Functional Stability ◽  
Test Results ◽  
Balance Tests ◽  
Lumbar Proprioception ◽  
Balance Error

Research background. Core management is particularly important for uninterrupted and continuous movement. Proprioceptive information is important to maintain the position of the body and control the centre of gravity. Low back pain ultimately affects motor control and leads to proprioceptive changes in injured structures and also can cause balance disorders. Unfortunately, it is unclear until now how low back pain affects proprioception. The aim of this study was to evaluate the relationship between low back pain and lumbar proprioception, functional stability, static endurance of trunk muscles and balance in adolescents. Methods. 42 adolescents participated in the study: 18 control subjects and 24 subjects with low back pain. We used the following assessment methods: the visual pain intensity scale (VAS) for pain evaluation, “flamingo” test, single leg test and balance error score system for balance assessment, Matthiass functional stability test for functional stability, and Biodex 4 Pro isokinetic dynamometer using trunk extension-flexion modular component and four points kneeling methodology for the evaluation of static endurance of trunk muscles, and proprioception. Results. After the assessment of balance, functional stability and proprioception, the results of the control group were statistically signifcantly better (p < 0.05). There was a moderate correlation between low back pain and Biodex 30 degree target reposition sense (r = 0.55), four points kneeling target position sense (r = 0.66), between low back pain and balance tests – “flamingo” and single leg test (r = 0.68, r = 0.61), between pain and Mathiass test (r = 0.52), also between proprioception and balance tests’ results (r = 0.44, r = 0.44, r = 0.46), proprioception and Mathiass test (r = 0.52). There was a strong correlation between pain and balance error scoring test (r = 0.85), balance error scoring test and four points kneeling test results (r = 0.71). All these correlationswere statistically signifcant. Conclusions. After the assessment of balance, functional stability and proprioception, the results of the control group were statistically signifcantly better (p < α). There was a moderate correlation between pain and proprioception, balance tests, Mathiass test results, also between proprioception and balance tests, Mathiass test. There was a strong correlation between pain and balance error scoring test results, between proprioception and balance error scoring test results.Keywords: Low back pain, proprioception, balance, functional stability.

scholarly journals The trunk muscles behavior in women with low back pain in the test of flexion and extension of the trunk

2020 ◽  
pp. 1-6
Author(s):  
Guilherme Thomaz de Aquino Nava ◽  
Beatriz Mendes Tozim ◽  
Mary Hellen Morcelli ◽  
Marcelo Tavella Navega
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Trunk Muscles ◽  
Control Group ◽  
Low Back ◽  
Muscle Recruitment ◽  
Trunk Flexion ◽  
Intergroup Comparison ◽  
Flexion And Extension

INTRODUCTION: Chronic low back pain has a direct repercussion on the activities of daily living and the alteration of motor control is its main cause. This change leads to instability of the trunk stabilizer systems that control movements. Trunk flexion and extension movements associated with external disturbances may increase the potential for motor control error, resulting in injury and pain. OBJECTIVE: To evaluate and compare the recruitment of the trunk stabilizer muscles, with and without load, in the flexion and extension movements of the trunk. METHODS: Thirty - four sedentary women were evaluated, aged between 30 and 59 years, divided into: low back pain group (LBPG n = 19) and control group (CG n = 15). The protocol consisted of clinical evaluation, pain evaluation, strength test of extensor trunk muscles and trunk flexion and extension tests (TFET). Muscle electromyography in internal oblique (IO), lumbar multifidus (LM), rectus abdominis (RA), external oblique (EO) and lumbar iliacus (LI) were performed simultaneously. Multivariate analysis of variance was used with two-way repeated measurements. RESULTS: LBPG presented a trend of greater recruitment in all muscles and loads evaluated, with muscle activation up to 47% higher when compared to CG. In the intergroup comparison, the global muscles demonstrated a tendency for greater activation in LBPG, with values up to 53% higher when compared to CG, and predominantly high effect size d> 0.80. In the intragroup comparison, the IO, EO, LI and LM muscles of the LBPG presented ascending muscle recruitment with increased load the opposite was seen in the CG, which showed increased activation only in the LI and LM muscles. CONCLUSION: Women with low back pain need more muscle recruitment to remain stable and, in challenging situations, use inefficient strategies.

scholarly journals EMG-pressure Response in the Transverse Abdominis and Multifidus Muscles among Individuals With and Without Chronic Low Back Pain

2020 ◽  
Author(s):  
Chu huai Wang ◽  
Xin Li ◽  
Wai Leung Ambrose Lo ◽  
Song wei Lu ◽  
Howe Liu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Activity ◽  
Low Cost ◽  
Random Order ◽  
Trunk Muscles ◽  
Control Group ◽  
Low Back ◽  
Maximal Voluntary Isometric Contraction ◽  
Pressure Biofeedback

Abstract Background: Pressure biofeedback unit (PBU) is a non-invasive, low-cost, and widely used device for monitoring, evaluating and training transverse abdominals (TA) and multifidus (MF) muscles of patients with low back pain (LBP). There has been little research on quantifying muscle activity under different pressures. The primary aim of this preliminary study was to explore the response between deep local trunk muscles (TA and MF) and different target pressures of PBU in seated positions. Methods: Twenty-two patients with chronic LBP (cLBP) and 24 age matched healthy individuals were recruited. Electromyography (EMG) signals were recorded from the TA and MF muscles while individuals contract the TA and MF muscles in seated position to achieve PBU pressure value of 50, 60 and 70mmHg in random order. The t-test was used to compare between-group and within-subjects’ effects to examine the effect of different pressure values. Spearman’s correlation analysis was performed in the cLBP group to determine potential correlations. Results: The %MVIC of the TA and MF in the cLBP group were statistically higher than the control group at each pressure value (P＜0.05). The slope of the cLBP subjects was significantly steeper than the healthy control subjects (TA: P=0.01, MF: P＜0.001). During maximal voluntary isometric contraction (MVIC) of TA and MF, compared with pain-free group, cLBP patients showed a significant decrease (P≤0.001). MF MVIC was significantly and moderately negatively correlated with visual analog scale (VAS) (r = -0.48, P=0.024) and Oswestry Disability Index (ODI) (r = -0.59, P=0.004). Conclusions: The study demonstrates the feasibility of using PBU to assess muscle contraction that corresponds with changes of muscle activity as measured by EMG. The use of EMG to quantify the extent of how much the PBU activates muscles may provide important information to clinicians and researchers for patients with LBP.

scholarly journals Comparison of Trunk Muscle Activities during Pressure Feedback Monitoring among Individuals With and Without Chronic Low Back Pain

2020 ◽  
Author(s):  
Chu Huai Wang ◽  
Xin Li ◽  
Wai Leung Ambrose Lo ◽  
Song Wei Lu ◽  
Howe Liu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Contraction ◽  
Rating Scale ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Emg Activity ◽  
Control Group ◽  
Low Back ◽  
Pressure Feedback

Abstract Background: Pressure biofeedback unit (PBU) is a widely used non-invasive device for the monitoring of transverse abdominals (TA) and multifidus (MF) muscles in patients with low back pain (LBP). There is little research that compared trunk muscle activities with pressure feedback during trunk muscle contraction in a seated position. The aim this study was to compare muscle activities between deep local trunk muscles (TA and MF) and different target pressures (50, 60 and 70mmHg) of PBU in individuals with and without cLBP. Methods: Twenty-two patients with chronic LBP (cLBP) and 24 age matched healthy individuals were recruited. Electromyography (EMG) signals were recorded from the TA and MF muscles while the TA and MF were contracted to achieve PBU pressure value of 50, 60 and 70mmHg in random order. The average EMG amplitude (AEMG) of 3 replicate trials was used in the analysis after normalization to %MVIC. %MVIC is defined as the mean of the three AEMG divided by the AEMG of MVIC. Two-way ANOVA was performed to assess the effects of groups (Healthy and cLBP) and the three different target pressures of PBU. Spearman’s correlation analysis was performed in the cLBP group to determine potential correlations between EMG activity, NPRS and ODI. Results: The %MVIC of the TA and MF in the cLBP group were statistically higher than the control group at each pressure value (P＜0.05). The slope of the %MVIC-pressure of the cLBP subjects was significantly steeper than the healthy subjects (TA: P=0.01, MF: P＜0.001). During maximal voluntary isometric contraction (MVIC) of TA and MF, compared with pain-free group, cLBP subjects showed a decrease in EMG amplitudes (P≤0.001). The MVIC of MF was negatively correlated with Numerical Pain Rating Scale (r = -0.48, P=0.024) and Oswestry Disability Index (r = -0.59, P=0.004). Conclusions: The study demonstrated the feasibility of using PBU to assess muscle contraction that corresponds with changes of muscle activity as measured by EMG. Clinicians may be able to confer PBU measurements with EMG recordings to estimate the level of muscle activities during MF and TA contraction exercise in patients with cLBP.

scholarly journals Comparison of Whole-Body Electromyostimulation versus Recognized Back-Strengthening Exercise Training on Chronic Nonspecific Low Back Pain: A Randomized Controlled Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Anja Weissenfels ◽  
Nicolas Wirtz ◽  
Ulrike Dörmann ◽  
Heinz Kleinöder ◽  
Lars Donath ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Training ◽  
Pain Intensity ◽  
Trunk Muscles ◽  
Whole Body ◽  
Control Group ◽  
Low Back ◽  
Randomized Controlled ◽  
Strengthening Exercise

Background. Low back pain (LBP) affects almost everyone at least once in their lifetime. Various meta-analyses show promising effects on pain reduction for conventional exercise. However, the lack of time and, especially for pain patients, a fear of movement (“kinesiophobia”) as well as functional limitations often oppose participation in such activities. In contrast, the advantage of novel training technologies like whole-body electromyostimulation (WB-EMS) lies particularly in a joint-friendly, time-effective, and highly customized training protocol and might be an alternative option for LBP patients. A meta-analysis of individual patient data and a comparison of WB-EMS against a passive control group confirmed the proof principle. Thus, the aim of this randomized controlled trial is to compare WB-EMS with a recognized back-strengthening exercise protocol to determine the corresponding effects on chronic, nonspecific LBP in people suffering from this. Methods and Findings. This randomized, controlled multicenter study is focused on novel and time-effective training technologies and LBP. In this contribution, the focus is primarily on the comparison of WB-EMS against a comparable conventional exercise training (CT). One hundred ten nonspecific chronic LBP patients, 40–70 years old, were randomly allocated to the intervention arms (WB-EMS: 55 vs. CT: 55). Both groups completed a 12-week program (WB-EMS: 1 × 20 min/week vs. CT: 1 × 45 min/week) specifically dedicated to LBP. The selection of the content of the active control group was based on the principles of WB-EMS training, which uses electrical stimulation to train mainly strength and stabilization in a very short time. Exercises were similar in all groups, with the focus on strengthening and stabilizing the trunk. Outcome measures were assessed by a four-week pain diary (before and during the last four weeks of intervention) as well as an isometric maximum strength measurement of the trunk muscles at baseline and after 12 weeks of intervention. Primary study endpoint was average pain intensity at the lumbar spine. Secondary study endpoints were maximum isometric strength of the back and the abdominals. The mean pain intensity of LBP decreased significantly in both groups (WB-EMS: −22.3 ± 20.9% vs. CT: −30.2 ± 43.9%; p<0.001), however, without significant intergroup difference (p=0.160). A similar result was observed for “maximum isometric strength of trunk muscles.” The increase in back strength (WB-EMS: 15.6 ± 24.9% vs. CT: 23.0 ± 30.9%) was highly significant in both groups (p=0.001), and similar changes were observed for the trunk flexors (WB-EMS: 17.6 ± 24.8% vs. CT: 18.1 ± 24.8%). Also, at the secondary endpoint, no significant difference in pairwise comparison was observed in both cases (extension: p=0.297; flexion: p=0.707). Conclusion. In summary, both, WB-EMS and conventional back-strengthening protocol are comparably effective in reducing nonspecific chronic LBP in this dedicated cohort. The result is particularly positive in terms of time effectiveness and offers an adequate alternative for people with limited time resources or other barriers to conventional training methods.

scholarly journals Effect of RUSI-based core stability exercise on chronic non-specific low back pain patients: study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e047317
Author(s):  
Shanshan Lin ◽  
Bo Zhu ◽  
Yiyi Zheng ◽  
Shufeng Liu ◽  
Chuhuai Wang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Income ◽  
Repeated Measures ◽  
Mixed Model ◽  
Developed Countries ◽  
Core Stability ◽  
Trunk Muscles ◽  
Control Group ◽  
Low Back

IntroductionLow back pain (LBP) is one of the most highly prevalent pain both in developed countries and low-income and middle-income countries. Despite increasing healthcare resources and numerous treatment methods for LBP, the efficacy of these therapeutic strategies is still uncertain. Recently, core stability exercise (CSE) is popularly applied as a preventive or rehabilitative method in the treatment of LBP. However, the adequate activation of the local muscle systems of CSE needs further optimisation and quantification. This trial aims to investigate the feasibility and efficacy of CSE monitored by real-time ultrasound image (RUSI) on LBP individuals.Methods and analysisForty subjects with chronic non-specific LBP (CNLBP), aged from 20 to 50 years, will be randomly allocated into two groups using sealed, consecutively numbered opaque envelopes: (1) study group (SG): CSE monitored by RUSI and (2) control group (CG): identical CSE without monitoring. Interventions will last 30 mins, two times a week for 8 weeks. The primary outcomes include pain intensity, disability and quality of life, and the secondary outcomes will be the postural control static stability, onset timing of trunk muscles activation, ultrasound images of muscle thickness and surface electromyography (sEMG) signal of muscle activities. Outcome measures will be collected at baseline, 4 and 8 weeks during training, and at 6 months follow-up. Data will be collected and analysed by an assessor blinded to group allocation. Effect sizes and mixed-model repeated measures analysis of variance (2 groups×4 time points) will be calculated.Ethics and disseminationThis protocol and informed consent has been approved by the Institutional Research Ethics Committee of the First Affiliated Hospital, Sun Yat-sen University (Approval number: [2020] 254-1). The findings of this study will be disseminated to participants through social networks and will be submitted to peer-reviewed journals and scientific conferences.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000034498).

Urinary Excretion of Hydroxyproline after Fractures

1970 ◽  
Vol 16 (10) ◽  
pp. 853-855
Author(s):  
Mala Herzberg ◽  
Z Oberman ◽  
O Khermosh ◽  
S L Weissman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Urinary Excretion ◽  
Collagen Metabolism ◽  
Bone Collagen ◽  
Control Group ◽  
Low Back ◽  
Multiple Fractures ◽  
Daily Excretion ◽  
The Mean

Abstract Urinary excretion of hydroxyproline was measured in 12 cases of multiple fractures as an index of bone collagen metabolism. Measurements were made for 10 consecutive days after injury; 10 patients with low back pain served as the control group. With three exceptions, the mean daily excretion of hydroxyproline and the day-to-day variations were within the same range in the group with multiple fractures as in the control group.

scholarly journals Custom-Made Foot Orthoses as Non-Specific Chronic Low Back Pain and Pronated Foot Treatment

2021 ◽  
Vol 18 (13) ◽  
pp. 6816
Author(s):  
Aurora Castro-Méndez ◽  
Inmaculada Concepción Palomo-Toucedo ◽  
Manuel Pabón-Carrasco ◽  
Javier Ramos-Ortega ◽  
Juan Antonio Díaz-Mancha ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Control Group ◽  
Foot Orthoses ◽  
Low Back ◽  
Custom Made ◽  
Foot Posture ◽  
Foot Pronation ◽  
Pain Symptoms

Excessive foot pronation has been reported as being related to chronic low back pain symptoms and risk factors in sports-specific pathologies. Compensating custom-made foot orthotics treatment has not been entirely explored as an effective therapy for chronic low back pain (CLBP). This study aims to observe the effects of custom-made foot orthoses, in subjects with foot pronation suffering from CLBP. A total of 101 patients with nonspecific CLBP and a pronated foot posture index (FPI) were studied. They were randomized in two groups: an experimental one (n = 53) used custom-made foot orthotics, and the control group (n = 48) were treated with non-biomechanical effect orthoses. The CLBP was measured using the Oswestry Disability Index (ODI) Questionnaire and a visual analogue scale (VAS), both for lower back pain. The symptoms were evaluated twice, at first when the subject was included in the study, and later, after 4 weeks of treatment. The analysis of outcomes showed a significant decrease in CLBP in the custom-made foot orthoses participants group (p < 0.001 ODI; p < 0.001 VAS). These findings suggest that controlling excessive foot pronation by using custom-made foot orthoses may significantly contribute to improving CLBP.

scholarly journals Quality of sleep in pregnant woman with low back pain

2015 ◽  
Vol 28 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Vanessa Patrícia Soares de Sousa ◽  
Silvia Oliveira Ribeiro ◽  
Carla Monique Ribeiro de Aquino ◽  
Elizabel de Souza Ramalho Viana
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sleep Quality ◽  
Pearson Correlation ◽  
Control Group ◽  
Low Back ◽  
Quality Of Sleep ◽  
Pressure Algometer ◽  
The Relationship

Introduction Pregnancy is characterized by several changes in her body. These changes contribute to the emergence of low back pain, which may influence the quality of sleep during pregnancy. Objective To compare the quality of sleep among pregnant women with and without low back pain during pregnancy, examining the relationship between two variables. Materials methods Thirty volunteers aged between 19 and 36 years, divided into control group (CG – n = 16) and Study Group (SG – n = 14), residents in the cities of Natal, were evaluated in the second trimester of pregnancy. To sleep evaluation were used to index the Pittsburgh Sleep Quality and the Epworth Sleepiness Scale. Low back pain was evaluated using the pressure algometer, Visual Analogue Scale (VAS) and Oswestry Disability Index. Statistical analysis used the Shapiro Wilk test, Student’s T test for independent samples and Pearson correlation test. Results The mean gestational and chronological ages were 28.2 ± 3.4 years and 19.9 ± 3.7 weeks, respectively. Sleep quality was lower in SG (8.21 ± 4.8) when compared to CG (5.94 ± 1.7) and was statistically significant (P = 0.021). Analyzing the relationship between sleep quality and pain intensity, it was observed that the variables have a positive correlation between them (r = 0.372, P = 0.043). Conclusion Our findings indicate that sleep quality is decreased in women with low back pain compared to those without pain.

scholarly journals Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20190006
Author(s):  
Maha Emad Ibrahim ◽  
Magdy Ahmed Awadalla ◽  
Aziza Sayed Omar ◽  
Mohammad al-Shatouri
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Control Group ◽  
Low Back ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Short Term ◽  
F Wave ◽  
Epidural Steroid ◽  
Caudal Epidural

Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml−1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

scholarly journals Effects of Exercises On Pregnancy Related Low Back Pain: A Quasi Experimental Study

2018 ◽  
Vol 08 (03) ◽  
pp. 163-167
Author(s):  
Abida Arif ◽  
Ghousia Shahid ◽  
Muhammad Arif Siddique ◽  
Khalid Aziz ◽  
Muhammad Faisal Fahim
Keyword(s):  
Experimental Study ◽  
Low Back Pain ◽  
Back Pain ◽  
Exercise Therapy ◽  
Post Treatment ◽  
Control Group ◽  
Low Back ◽  
Moderate Pain ◽  
Quasi Experimental ◽  
Experimental Group

Objective: To evaluate the effect of therapeutic exercises on pregnancy related low back pain in a tertiary care hospital of Karachi. Material & Methods: This was a quasi-experimental study with non-probability convenience sampling technique. Study was carried out at Liaquat National Hospital Karachi. Patients were divided into two groups (Experimental and Control). Inclusion criteria were age <30 years, 2nd and 3rd trimester, stable medical status and those who gave the informed consent. Exclusion were pregnancy induced hypertension (>140/90mmHg), Cardiac disease, diabetes mellitus, persistent vaginal bleeding, history of miscarriages, decreased foetal movement. Data was collected through assessment Modified Oswestry Low back pain disability questionnaire. SPSS version 23.0 was used to analyze the data. Results: A total of 30 samples were selected for the study. There were 15 respondents in experimental while 15 in control group. Disability levels were found to be significantly decreased after post treatment in experimental group with P-value= 0.002. It was seen that number of patients was increased from 1(6.7%) to 6(40%) in minimal disability group whereas crippled back pain group in pre-treatment group was totally shifted towards minimal or moderate pain 3(20.0%) and no case was seen in post-treatment. Conclusion: Low back pain in pregnancy can disturb daily life routine but exercise therapy and proper counselling will lead stress free life to female in gestation. After post treatment in experimental group showed decrease in pain as compare to control group who were not provided any exercise therapy. Working women in experimental group also showed decrease by crippled back pain to moderate pain after exercise. So in the end researcher suggest that physiotherapy exercises play a vital role in reducing Low Back Pelvic Pain (LBPP) during pregnancy.

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