Effect of combination of pressure biofeedback therapy and Flexi-bar in sitting on chronic non-specific low back pain / 中国康复理论与实践

ObjectiveTo explore the immediate and short-term effects of pressure biofeedback therapy combined with Flexi-bar exercise in the sitting position on chronic non-specific low back pain (CNSLBP). MethodsFrom June to September, 2022, 27 CNSLBP students in Xuzhou Medical University and other universities around were randomly divided into pressure biofeedback unit (PBU) group (n = 9), Flexi-bar group (n = 9) and combined group (n = 9). On the basis of routine rehabilitation guidance, the PBU group accepted pressure biofeedback therapy, the Flexi-bar group accepted active vibration therapy, and the combined group accepted pressure biofeedback therapy and active vibration therapy, for three weeks. They were measured core stability with Stabilizer, lumbar joint repositioning error (LJRE) with iHandy, and bilateral transverse abdominis thickness and multifidus muscle cross-sectional area with ultrasonography; and assessed with Visual Analogue Scale for pain (VAS), Oswestry Disability Index (ODI) before and after treatment; and the core stability were measured immediately after the first treatment. ResultsThe indexes of core stability improved after the first treatment (|t| > 3.000, P < 0.05) in all groups, and improved the most in the combined group (F > 10.909, P < 0.001). All the indexes improved after three weeks of treatment (|t| > 2.604, P < 0.05), except for LJRE in PBU group; and they were the best in the combined group (|F| > 4.061, P < 0.05), except LJRE was not significantly different from the Flexi-bar group (P > 0.05). ConclusionPressure biofeedback therapy combined with Flexi-bar exercise in the sitting position can more effectively improve core stability and core muscles, proprioception, and pain for patients with CNSLBP.

Correlation Of Core Muscle Strength and Lower Limb Muscle Strength With Lower Limb Functional Status In Healthy Middle Old Population

Background: Aging is a gradual, life-long process and highly variable, characterized by a progressive and cumulative generalized impairment of physiological functions which in turn reduces functional performance and disturbs ADL's & may lead to significant impact on core & lower limb muscles, which are important in functioning. Thus, the study aimed at assessing correlation amongst the core & lower limb muscles and functional status. Methods and procedures: 84 participants between 70-79 years of age (Male:Female = 1:1) were assessed for core strength, Lower limb strength and functional mobility using pressure biofeedback, five times sit to stand and timed up and go test respectively and data was tabulated & analyzed further in SPSS. Results: Spearman's correlation was used in this study which showed significant positive correlation between core strength and lower limb strength with lower limb functional status. (r(Core)=0.813, r(5SST) =0.893; p(Core)=0.00, p(5SST) =0.00) Discussion: Optimal core stability helps maintain the center of gravity within the altered base of support and this could be a reason for individuals with good core strength having better functional mobility. Also force of muscle contraction is directly proportional to velocity of movement which is seen reduced in lower limb musculature because of aging in this population. Conclusion: The present study concluded that strong correlation of core strength and lower limb strength with functional mobility exists among middle old elderly population.

Test-retest reliability of the intra abdominal pressure by using pressure biofeedback / 重庆医学

Objective To assess the test-retest reliability of pressure biofeedback in measuring intra abdominal pressure in the lumbar region for normal subjects .Methods We choosed 33 subjects (20 to 27 years old) and asked them to do four movements (movement A :prone position ;movement B :supine position with flexion hip and knee joint ;movement C :supine position with single flexion hip and knee joint ;movement D :prone position with flexion shoulder joint ;) by using pressure biofeedback twice totally ,and the last measurement should be done after 24 h .The indicator of test-retest reliability of joint position was intraclass correlation co-efficient (ICC) .Results The test-retest reliability of intra abdominal pressure was modest in the four movements in the lumbar re-gion ,and the values of ICC were from 0 .786 - 0 .848 .The test-retest reliability of intra abdominal pressure was good in Movement A [ICC(95% CI)= 0 .817(0 .630 - 0 .910)] ,Movement B [ICC(95% CI)= 0 .848 (0 .692 - 0 .925)] ,Movement D [ICC(95% CI)= 0 .841(0 .678 - 0 .921)] .And the test-retest reliability of intra abdominal pressure was good in Movement C [ICC (95% CI) =0 .786(0 .566 - 0 .894)] .Conclusion The test-retest reliability of intra abdominal pressure was modest and good in the lumbar re-gion ,and pressure biofeedback could be useful to assess intra abdominal pressure .

Application of Pressure Biofeedback in Rehabilitation of Chronic Low Back Pain (review) / 中国康复理论与实践

Chronic low back pain is a common type of pain which is related to the dysfunction of low back muscles. In recent years, the pressure biofeedback has been widely used for the assessment and treatment of chronic low back pain. This paper reviewed the reliability and validity of pressure biofeedback unit in the evaluation of lumbar and abdominal muscles activity, as well as its application on the rehabil-itation of chronic low back pain, which mainly related to the assessment and treatment of lumbar muscle activity and lumbar spine stability.

Concurrent validity of the pressure biofeedback unit and surface electromyography in measuring transversus abdominis muscle activity in patients with chronic nonspecific low back pain / Validade concorrente da unidade de biofeedback pressórico e eletromiografia de superfície na mensuração da atividade muscular do transverso abdominal em pacientes com dor lombar crônica inespecífica

BACKGROUND: The Pressure biofeedback unit (PBU) is an assessment tool used in clinical practice and research aimed to indirectly analyze the transversus abdominis (TrA) muscle activity. The concurrent validity of the PBU in a clinically relevant sample is still unclear. OBJECTIVE: The purpose of this study was to evaluate the concurrent validity and diagnostic accuracy of the PBU in measuring TrA muscle activity in patients with chronic nonspecific low back pain. METHOD: This study was performed using a validation, cross-sectional design. Fifty patients with chronic nonspecific low back pain were recruited for this study. To test the concurrent validity both PBU measures (index test) and superficial electromyographic measures (reference-standard test) were compared and collected by a physical therapist in a series of voluntary contraction maneuvers of TrA muscle. RESULTS: Participants were on average 22 years old, weighed 63.7 kilos, 1.70 meters height and mean low back pain duration was 1.9 years. It was observed a weak and non-significant Phi coefficient (r=0.2, p<0.20). With regards to diagnostic accuracy tests, our results suggest a low sensitivity (60%) and specificity (60%) of the PBU. The positive predictive value was high (0.8) and negative predictive value was low (0.2). Conclusions: Concurrent validity of the PBU in measuring TrA muscle activity in patients with chronic nonspecific low back pain is poor given the low correlation and diagnostic accuracy with superficial EMG.

CONTEXTUALIZAÇÃO: A Unidade de Biofeedback Pressórico (UBP) é uma ferramenta de avaliação usada na prática clínica e pesquisa científica para analisar indiretamente a atividade muscular do transverso abdominal (TrA). A validade concorrente da UBP em uma amostra clinicamente relevante ainda não está esclarecida. OBJETIVO: Avaliar a validade concorrente e acurácia diagnóstica da UBP em mensurar a atividade muscular do TrA em pacientes com dor lombar crônica inespecífica. MÉTODO: Este estudo foi realizado usando um delineamento de validação. Cinquenta pacientes com dor lombar crônica inespecífica foram recrutados. Para testar a validade concorrente, ambas as medidas pressóricas (teste índice) e eletromiográficas superficiais (teste padrão de referência) foram comparadas e coletadas por um fisioterapeuta a partir de uma manobra de contração voluntária do músculo TrA. RESULTADOS: Os participantes tinham em média 22 anos, 63,7 kg, 1,70 m de altura, e a duração média de dor lombar era de 1,9 ano. Observou-se um coeficiente Phi fraco e não significativo (r=0,2; p<0,20). Com relação aos testes de acurácia diagnóstica, os resultados sugerem uma baixa sensibilidade (60%) e especificidade (60%) da UBP. O valor preditivo positivo foi elevado (0,8), e o valor preditivo negativo foi baixo (0,2). Conclusões: A validade concorrente da UBP em mensurar a atividade muscular do TrA em pacientes com dor lombar crônica inespecífica é pobre, considerando a baixa correlação e acurácia diagnóstica com a EMG de superfície.

Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study

OBJECTIVE: To contrast the efficacy of two exercise programs, segmental stabilization and strengthening of abdominal and trunk muscles, on pain, functional disability, and activation of the transversus abdominis muscle (TrA), in individuals with chronic low back pain. DESIGN: Our sample consisted of 30 individuals, randomly assigned to one of two treatment groups: segmental stabilization, where exercises focused on the TrA and lumbar multifidus muscles, and superficial strengthening, where exercises focused on the rectus abdominis, abdominus obliquus internus, abdominus obliquus externus, and erector spinae. Groups were examined to discovere whether the exercises created contrasts regarding pain (visual analogical scale and McGill pain questionnaire), functional disability (Oswestry disability questionnaire), and TrA muscle activation capacity (Pressure Biofeedback Unit = PBU). The program lasted 6 weeks, and 30-minute sessions occurred twice a week. Analysis of variance was used for inter- and intra-group comparisons. The significance level was established at 5 percent. RESULTS: As compared to baseline, both treatments were effective in relieving pain and improving disability (p<0.001). Those in the segmental stabilization group had significant gains for all variables when compared to the ST group (p<0.001), including TrA activation, where relative gains were 48.3 percent and -5.1 percent, respectively. CONCLUSION: Both techniques lessened pain and reduced disability. Segmental stabilization is superior to superficial strengthening for all variables. Superficial strengthening does not improve TrA activation capacity.