The Effectiveness Of Radial Extracorporeal Shock Wave Therapy In Patients With Chronic Low Back Pain: A Prospective, Randomized, Single-Blinded Pilot Study.

PURPOSE: This prospective, randomized and single-blinded study assesses the influence of radial extracorporeal shock wave therapy (rESWT) in patients with low back pain (LBP). METHODS: A total of 52 patients with LBP were enrolled in the study, out of which a homogeneous group of 40 patients with mean age of 53.45±4.9 years was included. Patients were randomized into group A (n=20) treated with rESWT (2000 pulses; 2.5 bars; 5 Hz, 7 mins) performed twice a week for five weeks (10 sessions) and stabilization training, as well as group B (n=20) treated with sham rESWT and stabilization training. To analyze the therapeutic progress, the following tests were performed (before and after therapy; 1 and 3 months follow-up) to assess pain and functional efficiency: (1) Visual Analog Scale (VAS), (2) Laitinen Pain Scale (LPS), and (3) Oswestry Disability Index (ODI). RESULTS: The control group had a statistically significant advantage over the rESWT group (4.4 vs. 3.1 points on the VAS; p=0.039). However, in long-term observations, group A gradually experienced more pain relief than group B (2.7 vs. 3.5 points, p>0.05, at one month and 2.0 vs. 4.4 points at three months after treatment; p<0.0001). Similar findings can be seen in the analysis of changes in pain sensations measured with the LPS. The functional state (ODI) was better in rESWT group, especially in follow-up observation (9.3 vs. 14.6 points, p=0.033, at one month and 9.3 vs. 17.8 points, p=0.004, at three months after treatment). CONCLUSION: The rESWT combined with stabilization training is particularly effective in the long-term and achieves a stable beneficial effect for patients with LBP. The use of rESWT has a significant long-term influence on the reduction of pain and the improvement of the general functional state in relation to the conventional motor improvement program.

The impact of core muscles training on the range of anterior pelvic tilt in subjects with increased stiffness of the hamstrings.

The aim of this study is to verify the hypotheses that muscular coordination training of the core region in subjects showing increased hamstring stiffness results in an increase in anterior pelvic tilt and that there is a correlation between hamstring stiffness and anterior pelvic tilt. The two-group, non-blinded experimental controlled trial with three repeated measurements of the dependent variables. The experimental group received muscular coordination training during a period of two weeks, control group - no training. Thirty generally healthy subjects (9 women) were randomly assigned to the two equal groups. Passive knee extension test (hamstring stiffness); the range of anterior pelvic tilt (as measured in neutral standing position and during forward bending of the trunk). A significant decrease in the level of hamstring stiffness was recorded in the experimental group accompanied by an increase in anterior pelvic tilt. No significant changes were observed in the control group. There was a significant, negative, and moderate correlation between hamstring stiffness and anterior pelvic tilt with forward bending of the trunk).