The Main Role of Diaphragm Muscle as a Mechanism of Hypopressive Abdominal Gymnastics to Improve Non-Specific Chronic Low Back Pain: A Randomized Controlled Trial

Background: Chronic low back pain (LBP) has been stated as one of the main health concerns in the XXI century due to its high incidence. Objective: The objective of this study was to determine the effects of an 8-week program of hypopressive abdominal gymnastics (HAG) on inspiratory muscle strength, diaphragm thickness, disability and pain in patients suffering from non-specific chronic LBP. Methods: A total of 40 patients with chronic LBP were randomly divided into two groups. The experimental group carried out an 8-week supervised program of HAG (two sessions/week), whereas the control group did not receive any treatment. Outcomes were measured before and after the intervention, comprising diaphragm thickness during relaxed respiratory activity, maximal inspiratory pressure (PImax), pain intensity (NRS), pressure pain threshold and responses to four questionnaires: Physical Activity Questionnaire (PAQ), Roland–Morris Disability Questionnaire (RMQ), Central Sensitization Inventory (CSI) and Tampa Scale of Kinesiophobia-11 Items (TSK-11). Results: Statistically significant differences (p < 0.05) were observed for greater thickness of the left and right hemi-diaphragms at inspiration, as well as higher PImax and decreased NRS, CSI and RMQ scores in the intervention group. After treatment, the increases in the thickness of the left and right hemi-diaphragms at inspiration and PImax, as well as the decrease in the NRS and RMQ scores, were only predicted by the proposed intervention (R2 = 0.118–0.552). Conclusions: An 8-week HAG intervention seemed to show beneficial effects and predicted an increase in diaphragm thickness and strength during inspiration, as well as a reduction in pain intensity, central sensitization and disability, in patients suffering from chronic non-specific LBP with respect to non-intervention.

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Effects of Ai Chi and Yamamoto new scalp acupuncture on chronic low back pain

Fisioterapia em Movimento ◽

10.1590/0103-5150.028.004.ao09 ◽

2015 ◽

Vol 28 (4) ◽

pp. 723-730 ◽

Cited By ~ 2

Author(s):

Bárbara Maria Camilotti ◽

Neiva Leite ◽

Daysi Alberti ◽

Inara Aparecida Francisco ◽

Vera Lúcia Israel

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Functional Capacity ◽

Chronic Low Back Pain ◽

Scalp Acupuncture ◽

Control Group ◽

Low Back ◽

Aquatic Therapy ◽

Therapy Program

Abstract Introduction : Low Back pain affects a large part of the population and represents a major socioeconomic problem. There are many resources for treatment of this symptom, among them: acupuncture and aquatic therapy. Objective : To compare the effects of an aquatic physical therapy program (AI CHI) and Yamamoto New Scalp Acupuncture (YNSA) in pain intensity and functionality in patients with chronic low back pain. Material and methods : a clinical trial with a randomized sample. Sixty six individuals with chronic low back pain, of both genders were selected, however 44 individuals completed the study. The individuals were divided into three groups AI CHI (n = 15), YNSA (n = 15) and Control (n = 14). Ten 10 interventions with a program of aquatic therapy method (Ai Chi) and Yamamoto New Scalp Acupuncture (YNSA), were made, twice a week. The control group received the intervention only after the end of the study. Pain intensity was assessed by a visual analogue scale (VAS) and the functional capacity by Owestry functionality Index. Results : There was significant reduction in pain and improvement in functional capacity (p < 0.05) in YNSA and AI CHI and when compared to the control group. Conclusion : It was concluded that the YNSA and AI CHI were effective in reducing pain and improving the functionality of the lumbar spine in patients with chronic low back pain.

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Evaluation of functional disability and pain in patients with chronic low back pain submitted to physiotherapy

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2016.14.374 ◽

2020 ◽

pp. 1-6

Author(s):

Andrei Luiz Sales Teixeira ◽

Noberto Fernandes da Silva ◽

Edson Meneses da Silva Filho

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Functional Disability ◽

Therapy Group ◽

Public Health Problem ◽

Control Group ◽

Low Back ◽

Mobility Limitations

Introduction: Chronic low back pain (CLBP) is one of the causes that usually result in mobility limitations in the economically active population due to musculo-skeletal disorders. It has, as main symptoms, pain and disability and should be seen as a public health problem. Objective: This study aimed to evaluate the Functional Disability (FD) and pain intensity in patients with CLBP, underwent to manipulative therapy and conventional physiotherapy at Getulio Vargas Hospital. Method: This was a randomized trial study with a control group, with a sample, participants with CLBP, who were divided into two groups: those who underwent manipulative physiotherapy (group 1) and those who underwent conventional therapy (group 2), and the both groups were subjected to two treatments at different times. The program lasted five weeks, and 2 weeks for each intervention, performing two weekly sessions, which average duration was 30 minutes and one week interval between treatments. There were collected sociodemographic data, data related to FD using the Disability questionnaire Roland-Morris (RMDQ) and data related to pain intensity using the Visual Analogue Scale (VAS). Results: The study included 14 patients with mean age of 51 + 9 years. They showed significant improvement in RMDQ (p <0.001) and VAS (p <0.001), after being subjected to manipulative group, also showing a significant treatment effect over conventional treatment in both RMDQ (p = 0.004) and EVA (p = 0.006). Conclusion: Through this study, it can be shown that patients with CLBP showed significant improvements in functional capacity, by reducing the FD and reduction of painful symptoms, after being subjected to a five-week-program of manipulative physiotherapy.

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The Effects of Stabilization Exercise on the Thickness of Lateral Abdominal Muscles During Standing Tasks in Women With Chronic Low Back Pain: A Randomized Triple-Blinded Clinical Trial Study

Journal of Sport Rehabilitation ◽

10.1123/jsr.2019-0058 ◽

2020 ◽

Vol 29 (7) ◽

pp. 942-951 ◽

Cited By ~ 1

Author(s):

Fatemeh Ehsani ◽

Rozita Hedayati ◽

Rasool Bagheri ◽

Shapour Jaberzadeh

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Abdominal Muscle ◽

Control Group ◽

Abdominal Muscles ◽

Low Back ◽

Stabilization Exercise ◽

Postural Tasks

Context: Chronic low back pain (CLBP) often presents with a dysfunction in deep abdominal muscles activity during standing tasks. Although some studies indicated that deep abdominal muscle activity improved during some functional tasks following stabilization exercise (SE), there is no study to evaluate the effect of SE on lateral abdominal muscles thickness during standing postural tasks. Objective: The purpose of this study was (1) to evaluate the lateral abdominal muscles thickness in the participants with CLBP while standing on a balance board and (2) to compare the effects of SE and a general exercise (GE) program on the lateral muscles thickness changes. Methods: This was a between-groups, triple-blinded randomized controlled trial design. In total, 40 females with CLBP were randomly assigned into 2 groups: GE (control group) and supervised progressive SE (experimental group). Diagnostic ultrasound imaging was used before and after the intervention to measure lateral abdominal muscles thickness during standing on 2 different levels of platform in the Biodex Balance System. Visual analog scale and Roland–Morris Disability Questionnaire were used to evaluate changes in pain intensity and disability. Results: The results indicated significant increases in transverse abdominis muscle thickness during all standing tasks (P = .02) and significant decreases in pain intensity and disability following SE intervention (P < .001). However, the lateral abdominal muscle thicknesses were not changed after GE intervention while standing postural tasks (P > .05). The GE group revealed only significant decreases in pain intensity after intervention (P = .03). Conclusion: Supervised progressive SE improved the activity of deep abdominal muscles in standing postural tasks in the patients with CLBP.

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Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702520500109 ◽

2020 ◽

Vol 40 (02) ◽

pp. 109-119

Author(s):

Wahyuddin Wahyuddin ◽

Mantana Vongsirinavarat ◽

Keerin Mekhora ◽

Sunee Bovonsunthonchai ◽

Rachaneewan Adisaipoapun

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Facet Joint ◽

Low Back ◽

Stabilization Exercise ◽

Muscle Energy Technique ◽

Left And Right ◽

Muscle Energy

Background: Facet joint is a potential structure to be the source of chronic low back pain (LBP) affecting lumbar motion, pain, and disability. Other than the recommended treatment of lumbar stabilization exercise (LSE), several manual procedures including muscle energy technique (MET) are commonly used in physical therapy clinic. However, little evidences of the effects of MET have been reported. Objective: This study aimed to compare the immediate effects of MET and LSE in patients with chronic LBP with suspected facet joint origin. Methods: Twenty-one patients with low back pain were recruited and randomly assigned to receive treatment either MET or LSE. The outcomes were kinematic changes, pain intensity, and disability level. Lumbar active range of motion (ROM) of flexion, extension, left and right lateral flexion, and left and right rotation were evaluated using the three-dimension motion analysis system at baseline and immediately after treatment. Pain intensity was evaluated using visual analogue scale (VAS) at baseline, immediately after, and two days after treatment. Thai version of the modified Oswestry disability questionnaire (ODQ) was utilized at baseline and two days after treatment. The mixed model analysis of variance was used to analyze all outcomes. Results: The results showed that all outcomes were not different between groups after treatments. Although there were statistically significant improvements after the treatments when collapsing the groups, the minimal clinically important change was found only for pain but not for lumbar movements and disabilities scores. Conclusion: The effect of MET and LSE alone in single session might not be intensive enough to improve movements and decrease disability in patients with chronic LBP with suspected facet joint origin.

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Cupping as An Effective Complementary Therapy to Reduce Chronic Low Back Pain in Medical Rehabilitation Subdivision Perkebunan Hospital Jember

International Journal Of Scientific Advances ◽

10.51542/ijscia.v2i6.12 ◽

2021 ◽

Vol 2 (6) ◽

Author(s):

Debie Saktyana Iriawandani ◽

Hanik Badriyah Hidayati ◽

Wahyudi Widada ◽

Zuhrotul Eka Yulis ◽

Azham Purwandhono

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Intervention Group ◽

Cupping Therapy ◽

Medical Rehabilitation ◽

Control Group ◽

P Value ◽

Low Back

Pain, especially chronic pain lasts prolonged weariness, usually persistent and recurring. Thus, pain is often found in patients with Chronic Low Back Pain (CLBP). One alternative treatment to reduce chronic low back pain is cupping therapy. The main principle of cupping therapy is using of negative pressure to attract toxin substances, free radicals in the blood, inflammation cells, metabolic waste or Causative Pathological Substances (CPS), scarification in the form of skin removal and removing CPS. The aim of this study was to analyze the effect of cupping therapy on pain intensity of CLBP patients in Medical Rehabilitation Sub Division Perkebunan Hospital Jember. The design in this study was quasi experiment nonequivalent control group. The population was all CLBP patients who underwent physiotherapy in the physiotherapy room at Perkebunan Hospital Jember. The sample consisted of 34 respondents (17 respondents in the intervention group and 17 respondents in the control group) using purposive sampling. A cupping therapy was done once in the intervention group. Statistical test results using Wilcoxon obtained p value 0.000 with a value of α <0.05, so it can be concluded that there is an effect of cupping therapy on pain intensity of CLBP patients in Medical Rehabilitation Sub Division Perkebunan Hospital Jember. Cupping Therapy can be used as a complementary or alternative therapy to reduce pain of CLBP patients at Perkebunan Hospital Jember.

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The Effect of Classical Massage with Different Oils on Nonspecific Chronic Low Back Pain and Function

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v1i20.796 ◽

2019 ◽

Vol 1 (20) ◽

Author(s):

Kristina Venckūnienė ◽

Vaida Pokvytytė ◽

Vida Ostasevičienė ◽

Gerda Kazlauskaitė ◽

Jūratė Požėrienė ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Range Of Motion ◽

Chronic Low Back Pain ◽

Functional Disability ◽

Modern Society ◽

Control Group ◽

Low Back ◽

Natural Components

Research background. Chronic nonspecifc low back pain is one of the most widespread health problems in modern society. Massage together with oils is commonly used for low back pain. However, no studies are available on the eﬀect of classical massage with diﬀerent oils on functional state and pain in patients with chronic low back pain. The aim of this research was to determine the eﬀects of classical massage with diﬀerent oils on patients with chronic nonspecifc low back pain. Methods. This study included 14 women. They were randomly assigned into two groups. The experimental group received classical massage using oil of natural components and the control group received massage with Vaseline oil. All participants received seven massage sessions, one session lasted 20 min. Pain intensity (VAS scale), functional disability level (Oswestry Low Back Disability Questionnaire) and measurement of spine ﬂexion range of motion (Modifed Shober test) were evaluated before and after intervention. Results. Both groups showed signifcant improvements in pain intensity (p < 0.05). Massage with oil of natural components was more eﬀective then massage with Vaseline oil in reducing pain (p < 0.05). Functional disability decreased in both groups (p < 0.05), but no signifcant diﬀerence was found between groups. The range of motion changes were not signifcant after intervention in two groups. Conclusions. Classical massage with oil of natural components and classical massage with Vaseline oil were found to be eﬀective in relieving pain and decreasing functional disability in patients with chronic low back pain. Massage with oil of natural components was more eﬀective than massage with Vaseline oil in reducing pain.Keywords: chronic nonspecifc low back pain, classical massage, oil.

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Efficacy of Lidocaine and Ketamine Combination on Reduction of Pain Intensity, Improvement of Functional State and Central Desensitization of Chronic Low Back Pain

BioScientia Medicina ◽

10.32539/bsm.v4i4.167 ◽

2020 ◽

Vol 4 (4) ◽

pp. 45-54

Author(s):

Henry Sugiharto ◽

Hasnawi Haddani ◽

Yuki Fitria ◽

Rizal Zainal

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Functional State ◽

Chronic Low Back Pain ◽

Central Sensitization ◽

P Value ◽

Peripheral Sensitization ◽

Low Back ◽

Post Intervention

Abstract Background: Chronic low back pain (LBP) prevalence is approximately 20% of world population. Central and peripheral sensitization are considered as the main mechanism of pain chronification. This study hypothesize that lidocaine and ketamine combination reduces pain intensity, improves functional state and central desensitization of chronic low back pain. It is by modulating central sensitization in sub-anesthetic dose, prolonging inactivation of Na-channel, blocking NMDA-receptor and preventing secondary hyperalgesia. Aim of study: To evaluate the efficacy of lidocaine and ketamine combination on the intensity of pain, functional state and central desensitization of chronic low back pain. Methods:. This double blind randomized control trial study was carried out in Mohammad Hoesin General Hospital, Palembang, Indonesia from May 2018 to January 2019. A total of 20 patients with low back pain that last for more than 3 months, aged >18 years old, of either sex who were willing to be enrolled in this study, were randomly allocated into one of the two groups of 10 each. The treatment group (n=10) received standardized therapy (analgesic and physiotherapy) + intravenous ketamine 0.5 mg/kg + lidocaine 2 mg/kg and the control group (n=10) received standardized therapy + 100 ml Nacl 0.9%. Pain intensity, functional state, and central desensitization were measured before the treatment, day 7 after treatment, and a month after treatment using Numeric Pain Rating Scale (NPRS), Functional Pain Scale (FPS), and Central Sensitization Inventory (CSI). Results: The administration of ketamine 0.5 mg/kg + lidocaine 2 mg/kg resulted in NPRS and CSI changes was effective since the 7th day post intervention (p-value=0.021 and p-value=0.001) while on FPS changes, it was effective since the 30th day post intervention (p-value=0.000) Conclusion: From the result, it could be concluded that the administration of ketamine and lidocaine is effective on decreasing pain intensity and central desensitization in chronic LBP.

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Integrated meditation and exercise therapy: A randomized controlled trial of a combined non-pharmacological intervention reduces disability and pain in patients with chronic low back pain

10.1101/652735 ◽

2019 ◽

Author(s):

Anna M. Polaski ◽

Amy L. Phelps ◽

Thomas J. Smith ◽

Eric R. Helm ◽

Natalia E. Morone ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Chronic Low Back Pain ◽

Moderate Intensity ◽

Pharmacological Intervention ◽

Control Group ◽

Low Back ◽

Post Intervention ◽

Walking Exercise

ABSTRACTIntegrative and complementary non-pharmacological treatments have proven efficacious in treating both the physiological and psychological symptoms of chronic pain conditions but the potential of many combined therapies is unknown. This study examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise in chronic low back pain (cLBP) patients. We hypothesized that meditation before exercise would reduce disability and pain by increasing mindfulness prior to physical activity. Thirty-eight adults completed either meditation and exercise treatment (MedExT) (n=18) or an audiobook control condition (n=20). Over a 4-week period, participants in the MedExT group performed 12-17 minutes of guided meditation followed by 30 minutes of moderate intensity walking exercise 5 days per week. Measures of disability, pain, mindfulness and anxiety were taken at baseline and post-intervention. Ratings of pain were also assessed by participant self-report, before and after each intervention session. Following MedExT, participants showed significant improvement in our primary outcome of disability compared to the control group (p<0.05). From pre to post-intervention, MedExT also increased mindfulness (p<0.05), but had no significant effect on quantitative sensory testing on the low back. Mean ratings of low back pain intensity and unpleasantness significantly improved with MedExT from before the study to during participation, respectively (intensity p<0.05; unpleasantness p<0.05). Overall, four weeks of MedExT produced substantive changes in disability, mindfulness and measures of pain intensity and unpleasantness.

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The genetic influence of the brain-derived neurotrophic factor Val66Met polymorphism in chronic low back pain

Advances in Rheumatology ◽

10.1186/s42358-021-00183-7 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Angela Shiratsu Yamada ◽

Flavia Tasmim Techera Antunes ◽

Camila Ferraz ◽

Alessandra Hubner de Souza ◽

Daniel Simon

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Neurotrophic Factor ◽

Central Sensitization ◽

Low Back ◽

Bdnf Gene ◽

Val66met Polymorphism ◽

Bdnf Val66met Polymorphism ◽

The Brain

Abstract Background The Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene is a potential biomarker of vulnerability to pain. Thus, the present study aimed to investigate the association of this polymorphism with clinical and biopsychosocial factors in patients with chronic low back pain (CLBP). Methods A total of 107 individuals with CLBP answered questionnaires that were validated and adapted for the Brazilian population, including the Brief Inventory of Pain, the Central Sensitization Inventory, the Roland Morris Disability Questionnaire, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, the Survey of Pain Attitude-Brief, and the Hospital Anxiety and Depression Scale. All of the subjects were genotyped for the BDNF Val66Met polymorphism. Results The sample showed moderate scores of disability, central sensitization, and kinesiophobia, in addition to mild anxiety, hopelessness, and ruminant thoughts. No significant association was observed between the Val66Met polymorphism and the variables analyzed. Besides, there was no relationship between the BDNF Val66Met polymorphism with CSI, catastrophization, or disabilities that were generated by CLBP. Conclusion The results showed that the Val66Met polymorphism of the BDNF gene was not associated with clinical and biopsychosocial characteristics of CLBP in the sample studied.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136816 ◽

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.

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