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@#Introduction: Lumbar stabilization exercises may improve core stability and reduce low back pain among older persons. However, the evidence is scarce. The objective of this study was to update evidence on the effectiveness of lumbar stabilization exercises on pain, disability, and functional performance among older persons with low back pain. Methods: This systematic review retrieved articles from PubMed, MEDLINE (via EBSCO), PEDro, Google Scholar, and ScienceDirect published from 2005 to 2020. The selected articles were scored using the McMaster Critical Review Form for Quantitative Studies for quality assessment. The data was extracted based on the study design, sample size, inclusion criteria, intervention, outcome, and conclusion. Results: A total of 2349 articles were found but only two articles met the inclusion criteria with both showing excellent scores on the McMaster Critical Review Form for Quantitative Studies. The findings showed lumbar stabilization exercises alone or combined with other interventions were effective in reducing pain intensity, and improving disability, and gait functional performance among older persons with low back pain. Conclusion: The current study suggests lumbar stabilization exercise is effective for pain, disability, and functional performance among older persons. However, further investigation is needed to gain more conclusive evidence for clinical practice.
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Resumen: Introducción: El dolor lumbar es una de las principales causas de incapacidad laboral en México; dentro del tratamiento conservador, se incluye la realización de ejercicios para la disminución del dolor. Objetivo: Valorar los efectos en la disminución del dolor lumbar con un programa controlado de ejercicios diseñados para mejorar la flexibilidad y fuerza en el núcleo o centro del cuerpo (core). Material y métodos: Se incluyeron a 18 personas: 12 mujeres y seis hombres de entre 24 y 70 años con dolor lumbar, el cual estaba referido con una puntuación de 2 a 10 utilizando la escala visual análoga (EVA), con o sin dolor en la extremidad inferior. Se aconsejó a los participantes abstenerse de tomar medicamentos, alcohol y de realizar actividades físicas intensas durante el período de tratamiento. Los participantes realizaron 12 sesiones de 10 ejercicios en tres series de 10 repeticiones, tres veces por semana, evaluándose durante estas sesiones: peso, distancia dedos piso, fuerza de recto anterior, diámetro abdominal e índice de Oswestry inicial y final. Resultados: Los datos se analizaron con la prueba de Wilcoxon. Se evidenció disminución no sólo en el dolor (p < 0.01), sino una mejoría en el peso, la flexibilidad y la percepción de incapacidad por la escala de Oswestry (p < 0.01), mostrando que la serie de ejercicios propuestos es una alternativa para al manejo del dolor lumbar. Discusión: Se recomienda la presencia de un terapeuta que acompañe y corrija las posturas para que los ejercicios sean bien realizados, así como darle valor al grado de incapacidad que produce el dolor en el desempeño cotidiano de las personas que lo presentan.
Abstract: Introduction: Low back pain is one of the main causes of work disability in Mexico, conservative treatment includes performing exercises. Objective: To assess the effects of lower back pain with a controlled exercise program to improve flexibility and strength in the core or center of the body. Material and methods: We included 18 people, 12 women and six men between 24 and 70 years of age, with low back pain, with a score of 2 to 10 using the visual analogue scale (VAS), with or without referred pain in the lower limb. Participants were advised to refrain from taking medications, alcohol and intense physical activities during the treatment period. The participants carried out 12 sessions of 10 exercises in 3 sets of 10 repetitions, 3 times per week, evaluating: weight, distance toes, anterior rectum strength, abdominal diameter, initial and final Oswestry index. Results: The results were analyzed with the Wilcoxon test, showing a decrease not only in pain (p < 0.01), but an improvement in weight, flexibility and perception of disability due to the Oswestry scale (p < 0.01) showing that the series of exercises proposed is an alternative to the management of low back pain. Discussion: It is recommended the presence of a therapist who accompanies and corrects the postures so that the exercises are performed well, as well as giving value to the degree of disability caused by pain in the daily performance of the people who present it.
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Humans , Male , Female , Low Back Pain/therapy , Exercise , Exercise Therapy , MexicoABSTRACT
Background: Neural mobilization (NM) constitutes the most effective, common method for assessing and treating several neuromuscular disorders. The study at hand aims to determine the effectiveness of the NM technique compared to lumbar stabilization exercise (LSE) and Radial Extracorporeal Shock Wave Therapy (rESWT) in the physical therapy management of chronic low back pain (CLBP) with radiculopathy. Methods: Two groups comprising 30 participants and randomly chosen formed the basis of this investigation: Group A (NM, LSE, and rESWT) and Group B (LSE and rESWT). The period of three to six weeks constituted the time it took to measure the results herein reached baseline. The results of the observations focused on pain assessed by numerical pain rating scale (NPRS), Lumbar flexion range of motion (Lumbar FROM) by Schober’s method, and disability level as measured by the Modified Oswestry Disability Questionnaire (MODQ). Results: In the control group, the mean scores of pain, lumbar FROM, and MODQ at baselines showed a high level of similarity (6.47, 2.87, and 43.71 respectively in the intervention group, and 6.20, 2.93 and 44.66. Both groups showed improvement in their pain scores at three weeks (P<0.05). However, only lumbar FROM and MODQ showed statistically significant improvement in favor of the intervention group at three weeks (P<0.05). By week 6, both groups achieved a statistically significant difference in the values of all variables. Conclusion: NM with LSE and rESWT is more effective than LSE and rESWT in the third week, and was similarly effective in the sixth week of the treatment. NM with LSE and rESWT may be an alternative treatment option in the treatment of CLBP.
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Background: Mechanical low back pain is one of the most common causes of discomfort amongst people all over. There are various exercises to reduce low back pain. Swiss ball exercises are one of the dynamic exercises which increase muscle strength, endurance, balance, and flexibility of the trunk while the individual leans on a swiss ball. Therefore the purpose of this study was to check the effects of lumbar stabilization exercises on a swiss ball in patients with mechanical low back pain. Methods: Forty participants out of which 30 were females and 10 were males who were suffering from mechanical low back pain between the age group of 20 to 60 years were included. They were divided into two groups, with each group having 20 subjects. One group was taught floor exercises, and the other was taught swiss ball exercises for two weeks thrice a week,i.e., six days. The pain and disability were checked with the Numeric Rating Scale, and Roland Morris Questionnaire scores respectively pre and post-intervention. Results: On comparison of the difference between both the groups the mean difference in the NRS and RMQ scores for floor group was one ± 1 and 0.75 ± 1.6(p<0.05). The mean difference in the NRS and RMQ scores for swiss ball group was 2.6 ± 0.5 and 3.7 ± 1.26(p<0.05). Conclusion: We can conclude that lumbar stabilization exercises on a swiss ball are effective in reducing mechanical low back pain compared to exercises done on the static surface.
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Background: Low back pain (LBP) is the fifth most common reason for physician visits, which affects nearly 60-80% of people throughout their lifetime. The lifetime prevalence of low back pain is reported to be as high as 84%. The most common type of low back pain is Mechanical low back pain. There are various risk factors for mechanical low back pain which are usually classified into physical, physiological and psychological factors. Heavy manual work and lifting weights constitute the physical work factors. Twisting, sitting for long hours, driving and whole body vibrations are also few physical causes. Low physical fitness and trunk muscle weakness are the physiological factors. The essential factors, which should always been taken into consideration in case of pain, are the psychosocial issues such as social influence, monotonous work, low job satisfaction, stress, anxiety, fear and depression. If left untreated or delay in the treatment may lead to degenerative changes. So, the aim of the study was to check the effectiveness of Lumbar Stabilization exercises with laser therapy In Patients with mechanical low back pain. Materials and methods: 60 patients were included in the study which was divided into two groups; Group A and Group B, 30 patients in each group. Subjects were randomly selected and assigned to each group. Pre-test measurements of the patient were done with the help of two measures - RolandMorris Low Back Pain and Disability Questionnaire for disability and Goniometer was used for range motion of lumbar spine movements for each group. The Subjects in Group-A were given Laser Sreenivasu Kotagiri, Neeti Mathur, Ashwin Kumar, Anup Kumar Song. Effectiveness of lumbar stabilization exercises with laser therapy in patients with mechanical low back pain. IAIM, 2019; 6(9): 117-126. Page 118 therapy for 10 minutes along with Kinesiotaping. The Subjects in Group-B were given Lumbar Stabilization exercises with laser therapy. Result analysis was done by Results: On comparing Group A and Group B for post-treatment RMQ score, results showed a significant difference (p=0.001). The overall study proved that Lumbar stabilization exercises along with laser therapy were more significant for Mechanical low back pain in improving Pain and decreasing the disability level. Conclusion: The analysis obtained indicated that Group B (Lumbar stabilization exercises along with laser therapy) showed more significant improvement when compared to Group A (Laser therapy along with Kinesiotaping).
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OBJECTIVE: This study aimed to determine the efficacy of flexible pole training combined with lumbar stabilization in improving trunk muscle activities and to investigate the difference according to posture in young adults. METHODS: Twenty-five participants were enrolled in this study. The subjects were randomly allocated into either the flexible pole group or the rigid pole group. Participants performed lumbar stabilization exercises on quadruped and curl-up, with the flexible pole or rigid pole. Electromyography was used to assess the percent maximal voluntary isometric contracion (%MVIC) of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spine (ES) muscles. All participants completed one 30-minute session per day, 3 days per week, for 6 weeks. The evaluation was performed before and 6 weeks after the training, and follow-up. The data were analyzed using independent t-test and two-way repeated measure analysis of variance to determine the statistical significance. RESULTS: The flexible pole in curl-up showed significant differences in EO and IO muscle activities compared with the rigid pole. The flexible pole in quadruped showed significant differences in IO and ES muscle activities compared with the rigid pole. The RA, EO, IO, and ES muscle activities of both groups were significantly higher after 6 weeks training. CONCLUSION: The flexible pole in curl-up and quadruped showed an improvement in trunk muscle activation. The flexible pole combined with lumbar stabilization will be useful as an exercise tool to improve activity of trunk muscles.
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Adult , Humans , Young Adult , Electromyography , Exercise , Follow-Up Studies , Jupiter , Muscles , Posture , Rectus Abdominis , SpineABSTRACT
The purpose of this study is to evaluate the effect of lumbar stabilization exercise on lumbosacral region angle, lumbar strength, lower muscle strength, physical fitness, and low back pain of sedentary women. Twenty females who spend more than 6 hours a day as sedentary at working were recruited. The subjects were assigned to two different groups which are exercise group (n=10) and non-exercise group (n=10). Exercise program was consisted with Swiss ball and lumber stability exercise, and it was performed 60 min/day and 3 times/wk for 8 weeks. Two-way analysis of variance was conducted to analyze experimental data. As a result, there was no significant difference between groups in lumbar lordosis angle and lumbar sacral angle. However, Isometric lumbar extension strength, isokinetic knee flexion and extension peak torque in angular velocity were significantly different between groups, and the pain was reduced. To conclude, this study identified the effectiveness of lumbar stabilization exercise on lumbar muscular, strength, Sargent jump, sit and reach test and reduced pain.
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Animals , Female , Humans , Knee , Lordosis , Low Back Pain , Lumbosacral Region , Muscle Strength , Physical Fitness , Sedentary Behavior , TorqueABSTRACT
PURPOSE: The paper presents an intervention for clinical applications in the future by examining the effects of 3D stabilization exercise on patients with lumbar instability, which causes problems in the muscles and balance, and analyzing the effects of balanced lumbar muscles on the static balance. METHODS: After collecting samples randomly from thirty patients with lumbar instability, fifteen patients selected for 3D stabilization exercise were placed in the stability group and fifteen patients selected for Swiss ball exercise were placed in the ball exercise group. The intervention program was applied for thirty minutes a session, once a day, three days a week for four weeks. Before the intervention, the lumbar muscle activity and static balance were measured. After four weeks, they were re-measured in the same way and the data were analyzed. RESULTS: In relation to the within-group changes in muscle activity, all groups except for the LEO and REO groups showed significant differences. Regarding the between-group changes in muscle activity depending on the left and right difference, ES, RA, and TrA but not EO showed significant differences. In addition, there were significant differences in the between-group change in static balance. CONCLUSION: 3D stabilization exercise improves the muscle activity by promoting a balanced posture of lumbar muscles and changing senses, such as a proprioceptor but this had a positive influence on the static balance by controlling the balance of muscles.
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Humans , Muscles , PostureABSTRACT
INTRODUÇÃO: Eletrotermofototerapia e cinesioterapia são opções para o tratamento de lombalgias. Exercícios voltados para a musculatura paravertebral visam ao aumento de força e arco de movimento (ADM). A eletroestimulação neuromuscular (EENM) incrementa a função muscular. OBJETIVOS: Apurar a influência da EENM associada a um programa de core training (CT) sobre a lombalgia inespecífica crônica, com as variáveis de dor e ADM da coluna vertebral. MATERIAIS E MÉTODOS: Foi realizado ensaio clínico controlado randomizado duplo cego, com 27 pacientes atendidos na Clínica-Escola FIT-UGF, com diagnóstico médico relacionado a lombalgias. Foram formados dois grupos aleatoriamente: controle ativo (CORE; n = 13) e experimental (CORE + EENM; n = 14). O questionário de McGill e a fotogrametria foram aplicados antes da primeira e após a última sessão de tratamentos para medir dor e ADM, respectivamente. RESULTADOS: Os grupos eram homogêneos quanto à dor inicial (p = 0,99); a dor final do grupo CORE + EENM foi significativamente menor que a do grupo CORE (p = 0,03); a dor final do grupo CORE não apresentou diferença significativa em relação à inicial (p = 0,93); a dor final do grupo CORE + EENM foi significativamente menor que a inicial (p = 0,00). O ADM não apresentou diferença significativa intragrupos e intergrupos (p = 0,10). CONCLUSÃO: A aplicação de EENM em região lombar após CT foi eficaz, causando diminuição significativa da lombalgia inespecífica. Entretanto, não ocorreu diferença significativa do ADM entre os grupos.
INTRODUCTION: Electrothermophototherapy and kinesiotherapy are options to treat LBP. Exercise techniques turned to paravertebral muscles aims at power and range of motion (ROM) enhancement. Neuromuscular electrical stimulation (NMES) shows property to increase muscle function. OBJECTIVE: To test the influence of NMES in association to a core training (CT) program, about non-specific LBP treatment, at pain and ROM variables. MATERIALS AND METHODS: A randomized controlled double-blind trial was performed with 27 patients of FIT-UGF School Clinic with LBP related diagnoses. Two groups was randomly set: active control (CORE; n = 13) and experimental (CORE + NMES; n = 14). McGill pain questionnaire and photogrammetry was performed before first and after the last session, for pain and ROM measurement, respectively. RESULTS: The groups were similar about initial pain (p = 0.99); final pain of CORE + NMES was significantly lower than CORE (p = 0.03); final pain of CORE did not show significant difference related to the initial pain (p = 0.93); final pain of CORE + NMES group was significantly lower than initial pain (p = 0.00). The ROM did not vary significantly intra-group and inter-groups in any group (p = 0.10). CONCLUSION: The application of NMES in low back region after CT was effective, causing a significantly reduction in non-specific LBP. However, there was no significant difference in ROM between the groups.
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Electric Stimulation , Low Back PainABSTRACT
OBJECTIVE: To compare an isotonic lumbar extension exercise program utilizing lumbar extension exercise machines with modified combination program of isotonic lumbar extension exercises, including dynamic stabilization exercise, to improve and maintain trunk stability in the patient with microscopic lumbar discectomy. METHOD: We studied 41 male workers who underwent microscopic lumbar discectomy. Group 1 (n=24) was treated with the isotonic lumbar extension exercise program. Group 2 (n=17) was treated with the modified combination program of dynamic lumbar stabilization exercise and isotonic lumbar extension exercise. The categories that were evaluated and measured were trunk stability, isometric peak torque of lumbar extensor, weight distribution rate of both leg and trunk muscle balance, and Oswestry low back pain (LBP) disability index. RESULTS: After 3 months, group 1 revealed higher isometric peak torque, weight distribution rate of both leg and trunk muscle balance compared with that of group 2. At the end of 6 months, group 2 revealed higher isometric peak torque compared with that of group 1. CONCLUSION: We suggested that combined exercise program, that included the dynamic lumbar stabilization exercise and the isotonic lumbar extension exercise, was a valuable treatment for postoperative lumbar rehabilitation.