Comparison of Muscle Activation and Co-Contraction Patterns for Trunk Muscles During Four-Point Hand-Knee and Hand-Foot Kneeling Positions / 医用生物力学

Objective To analyze the similarities and differences between four-point hand-knee position and hand-foot kneeling positions in trunk muscle activation and co-contraction, explore the possibility of hand-foot kneeling position as core stabilization exercises, so as to provide suggestions for actual training.Methods Nineteen healthy volunteers randomly performed exercises of four-point hand-knee position (4 motions) and hand-foot kneeling position (3 motions), while surface electromyography (sEMG) signals were collected from bilateral rectus abdominis, external oblique, erector spine, and multifidus muscles. The average sEMG and muscle co-contraction index (CCI) based on the sEMG signals were analyzed and compared.Results Significant differences were found in the sEMG and CCI within and between the two positions. Under four-point hand-knee position with the right hand and left leg lifting, the activation of all muscles was higher than that in the starting position. In four-point hand-knee position with the left leg lifting, the activation of ipsilateral multifidus muscle was significantly higher than that in hand-foot kneeling position. The activation degree of external oblique muscle and rectus abdominis was higher in hand-foot kneeling position with right hand lifting. A total of 28 muscle matching methods were obtained by pair-to-pair matching of 8 muscles. The starting posture in four-point hand-knee position fluctuated the least, indicating that the spine was the most stable, while the index of other exercises fluctuated in a larger range.Conclusions The possibility of hand-foot kneeling position as core stabilization exercises was proved from two aspects, namely, muscle activation and CCI. The hand-foot kneeling position and four-point hand-knee position can be used for strengthening abdominal muscles and back muscles, respectively. The four-point hand-knee position with contralateral upper and lower limbs lift is a more advanced exercise for trunk muscles, but sports injuries should be avoided.

Clinical and physical efficiency of virtual reality games in soccer players with low back pain / Eficiencia de los juegos de realidad virtual en jugadores de futbol con dolor de espalda baja / Eficiência clínica e física de jogos de realidade virtual em jogadores de futebol com dor lombar

ABSTRACT Introduction: Virtual reality training (VRT) is an advanced technology that creates virtual games by a computer through specific software. It is a type of rehabilitation training commonly used in balance problems to treat musculoskeletal conditions. Objective: To determine and compare the effects of virtual reality games with those of core stabilization training on physical efficiency in soccer players with chronic low back pain. Methods: A randomized, double-blinded, controlled study was conducted on 60 LBP participants at a university hospital. The first group (n=20) received virtual reality (VR) training; the second group (n=20) received core stabilization (CS) training; and the third group (n=20) received conventional training exercises for four weeks. Scores of clinical and sports performance were measured at baseline, and after 4 weeks, 8 weeks and 6 months. Results: The baseline demographic and clinical characters did not show any significant differences (p>0.05) in the statistical analysis, which shows a homogenous population. Four weeks following the training, the VR training group showed more significant changes in clinical scores than the CS training and control groups (p≤0.001). The scores for sports performance also showed more significant improvement in the VR training group than in the other two groups (p≤0.001). The same improved clinical and sports performance changes were seen at 8 weeks and 6 months of follow-up in the VR training group, when compared to the other two groups (p≤0.001). Conclusion: This study suggests that training through virtual reality games results in long-term improvement in clinical and sports performance compared to other forms of training in soccer players with chronic low back pain.Level of evidence I b; Therapeutic studies - Investigation of treatment results.

RESUMEN Introducción: El entrenamiento de realidad virtual (VRT) es una tecnología avanzada, que crea juegos virtuales por computadora a través de un software específico. Es un tipo de entrenamiento de rehabilitación que se usa comúnmente en problemas de equilibrio para tratar afecciones musculoesqueléticas. Objetivo: Encontrar y comparar los efectos de los juegos de realidad virtual sobre el entrenamiento de estabilización central sobre la eficiencia física en jugadores de fútbol con dolor lumbar crónico. Métodos: Se realizó un estudio controlado, aleatorizado, doble ciego en 60 participantes con dolor lumbar en un hospital universitario. El primer grupo (n = 20) recibió entrenamiento de realidad virtual (VR), el segundo grupo (n = 20) recibió entrenamiento de estabilización central (CS) y el tercer grupo (n = 20) recibió ejercicios de entrenamiento convencionales durante cuatro semanas. Los puntajes de rendimiento clínico y deportivo se midieron al inicio del estudio, después de 4 semanas, 8 semanas y 6 meses. Resultados: Los caracteres demográficos y clínicos basales no mostraron ninguna diferencia significativa (p. 0,05) en el análisis estadístico lo que indica una población homogénea. Cuatro semanas después del entrenamiento, el grupo de entrenamiento de RV mostró cambios más significativos en las puntuaciones clínicas que los de entrenamiento de CS y los grupos de control (p≤0,001). Las puntuaciones de rendimiento deportivo también mostraron una mejora significativa en el grupo de entrenamiento de RV comparadas con los otros dos grupos (p≤0,001). Hubo los mismos cambios clínicos y de rendimiento deportivo a las 8 semanas y 6 meses de seguimiento en el grupo de entrenamiento de RV y en los otros dos grupos (p≤0,001). Conclusión: Nuestro estudio sugirió que el entrenamiento a través de juegos de realidad virtual mejoró el rendimiento clínico y deportivo más que otros entrenamientos en jugadores de fútbol con dolor lumbar crónico a largo plazo. Nivel de evidencia Ib; Estudios terapéuticos, investigación de los resultados del tratamiento.

RESUMO Introdução: O treinamento com realidade virtual (TRV) é uma tecnologia avançada que cria jogos virtuais para computador por meio de software específico. É um tipo de treinamento de reabilitação comumente usado em problemas de equilíbrio no tratamento de doenças musculoesqueléticas. Objetivo: Determinar e comparar os efeitos dos jogos de realidade virtual com o treinamento de estabilização central na eficiência física de jogadores de futebol com dor lombar crônica. Métodos: Estudo randomizado, duplo-cego e controlado realizado com 60 participantes com lombalgia em um hospital universitário. O primeiro grupo (n = 20) recebeu treinamento de realidade virtual (RV), o segundo grupo (n = 20) recebeu treinamento de estabilização central (EC) e o terceiro grupo (n = 20) recebeu exercícios de treinamento convencional por quatro semanas. Os escores de desempenho clínico e esportivo foram medidos no início do estudo e depois de 4 semanas, 8 semanas e 6 meses. Resultados: As características demográficas e clínicas basais não mostraram diferença significativa (p > 0,05) na análise estatística, o que indica população homogênea. Quatro semanas depois do treinamento, o grupo RV mostrou mudanças mais significativas nos escores clínicos do que os grupos EC e controle (p ≤ 0,001). Os escores de desempenho esportivo também mostraram melhora significativa no grupo RV do que nos outros dois grupos (p ≤ 0,001). As mesmas mudanças benéficas de desempenho clínico e esportivo foram observadas em 8 semanas e 6 meses de acompanhamento no grupo RV em comparação com os outros dois grupos (p ≤ 0,001). Conclusão: Este estudo sugere que o treinamento com jogos de realidade virtual resulta em melhora do desempenho clínico e esportivo a longo prazo do que outras formas de treinamento em jogadores de futebol com dor lombar crônica. Nível de evidência Ib; Estudos terapêuticos, Investigação dos resultados de tratamentos.

Effects of Flexi-bar on Nonspecific Low Back Pain / 中国康复理论与实践

Objective:To investigate the effects of Flexi-bar on nonspecific low back pain. Methods:From June, 2020 to January, 2021, 30 patients with nonspecific low back pain were enrolled. Firstly, all the patients performed core stabilization exercise (supine bridge, curl-up and four-point support) using Flexi-bar or not, respectively. And the difference of electromyography (EMG) root mean square (RMS) value of transversus abdominis and multifidus was observed. Secondly, they were randomly divided into control group (n = 15) and experimental group (n = 15). The control group performed core stabilization exercise, and the experimental group received Flexi-bar training in addition, 30 minutes a time, three times a week, for six weeks. They were evaluated with Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), and measured the thickness of transversus abdominis and the area of multifidus before and after training. Results:Firstly, there was significant difference in RMS of transversus abdominis and multifidus between using Flexi-bar or not (|t| > 2.468, P < 0.05), except the RMS of transversus in supine bridge (|t| < 2.029, P > 0.05). Secondly, before training, there was no significant difference between the control group and the experimental group (|t| < 1.944, P > 0.05); after training, the scores of VAS and ODI significantly decreased (|t| > 6.808, P < 0.001), the thickness of transversus abdominis and the area of multifidus significantly increased (|t| > 5.937, P < 0.001), and all the indexes were better in the experimental group than in the control group (|t| > 2.411, P < 0.05)， except the thickness of transverse abdominis (t = -1.431, P > 0.05). Conclusion:Flexi-bar could facilitate to reduce pain and improve the function of patients with nonspecific low back pain.

Effect of Chiropractic on Nonspecific Low Back Pain / 中国康复理论与实践

Objective:To observe the clinical effect of chiropractic on nonspecific low back pain (NLBP). Methods:From July, 2016 to January, 2018, 90 patients with NLBP were randomly divided into control group (n = 45) and observation group (n = 45). Both groups accepted core stabilization exercises (CSE) and routine physical therapy, and the observation group received chiropractic additionally. They were treated for four weeks and followed up for six months. Before, and two and four weeks after treatment, and at six-month follow-up, they were evaluated with Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), abdominal and dorsal muscle endurance test (AMET) and waist active range of motion (AROM). Results:Two and four weeks after treatment, the result of VAS, ODI, AMET, and waist AROM improved significantly in both groups (P < 0.05), and they were better in the observation group than in the control group (t > 0.263, P < 0.001). At six-month follow-up, the scores of VAS and ODI improved significantly (P < 0.05), and were better in the observation group than in the control group (t > 5.911, P < 0.001). Conclusion:CSE and routine physical therapy combined with chiropractic could better reduce the pain, improve the dysfunction, and increase the spinal stability for patients with NLBP.

Effect of core stabilization exercises on knee osteoarthritis / 中国综合临床

Objective To investigate the effect of core stabilization exercises( CSE) on knee osteoarthritis. Methods Sixty cases patients with knee osteoarthritis were randomly divided into treatment group (n = 30)and control group(n = 30). Patients in control group were accepted conventional therapy including conventional physiotherapy,acupuncture,and massage,while in treatment group were accepted CSE besides conventional therapy. All patients were assessed with Lysholm Knee Scoring Scale(LKSS)and Visual Analogous Scale(VAS)before and after treatment. Results VAS in treatment group before and after treatment were(8. 31 ± 1. 16)and(3. 37 ± 0. 97),and the difference was statistically significant( t = 16. 30,P = 0. 00). VAS in control group before and after treatment VAS were(8. 26 ± 1. 22)and(5. 06 ± 0. 82),and the difference was statistically significant( t = 12. 19,P = 0. 000. VAS in two groups after treatment was statistically significant (t = - 6. 98,P = 0. 00). LKSS in treatment group before and after treatment were(32. 92 ± 4. 21),(60. 19 ± 4. 42),and the difference was statistically significant(t = - 30. 44,P = 0. 00). LKSS in control group before and after treatment was(34. 82 ± 5. 58),(53. 49 ± 3. 66),and the difference was statistically significance (t = - 14. 82,P = 0. 00). After the treatment,LKSS in the two groups was significant difference(t = 7. 16,P= 0. 00). Conclusion The core stability training can improve the patients with knee osteoarthritis of knee joint function,relieve pain.