Non-specific low back pain (NSLBP) is a common musculoskeletal condition causing functional disability and affecting the quality of life. Exercise therapy especially Dynamic Stabilisation Exercises ...(DSE) and Muscle Energy Techniques (MET) are frequently used in the treatment of NSLBP. However there are some inconsistencies with the use of DSE and the physiological mechanisms underlying the therapeutic effects of MET are currently unclear, and a review of literature on these interventions recommend further research. Therefore this study was designed to determine the effect of DSE and MET for the management of patients with NSLBP.
This study will involve 141 participants with chronic NSLBP. They will be randomised into three groups: two intervention groups i.e. DSE plus MET group, DSE alone and control (standard physiotherapy treatment). Outcomes that include trunk range of motion, Transverse Abdominus contraction rate, trunk muscles endurance, level of pain perception, quality of life, functional disability, activity limitation and participation restrictions will be assessed at baseline, 6th and 12th week of intervention, however, while follow-up assessment at 3-months after the intervention. Data will be analysed using descriptive statistics and inferential statistics of repeated ANOVA; P < 0.05.
The study outcome will determine the combined effect of DSE plus MET on trunk muscles functions, level of pain perception, quality of life, functional disability, activity limitations and participation restrictions in patients with chronic NSLBP.
www.ClinicalTrials.gov
: NCT03449810
Introduction: Cervical radiculopathy is the clinical condition when a nerve root in the cervical spine becomes inflamed or damaged due to compression because of various reasons resulting in a change ...in neurological function. Kinesio taping is a treatment method used by physical therapists to improve symptoms associated with musculoskeletal disorders. It can be stretched to 140% of its original length before being applied to the skin. It subsequently provides a constant pulling (shear) force to the skin, unlike traditional athletic tape. Aim: To study the effect kinesio taping on pain, neck disability and physical function of upper limb in cervical radiculopathy. Materials and Methods: This longitudinal study was carried out at SGT Hospital Gurugram, Hrayana, India, between February 2018 to August 2018. Fifty subjects, aged 18-50 years with positive response for the 4 test item cluster described by Wainner RS et al., were included in the study and were given manual therapy treatment, cervical stabilisation exercises and kinesio taping. There were three sessions per week for a total of four weeks. Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS) and Disability of the Arm, Shoulder and Hand (DASH) questionnaire were the outcome measures. The readings were noted at prelevel (0 week), mid-levels (at 2 weeks weeks) and at post-levels (at 4 weeks weeks). Comparison of different values was done using paired t-test. Level of significance was taken at p-value <0.05. Results: The mean age of patients was 48.1±11.9 years. The NDI scores at 0 weeks, at 2 weeks, at 4 weeks were 46.00±4.96, 30.48±4.56, 14.84±3.94, respectively. The DASH scores at 0 weeks, at 2 weeks, at 4 weeks were 59.52±7.55, 34.49±8.70, 0.74±0.69, respectively. The NPRS scores at 0 weeks, at 2 weeks, at 4 weeks were 8.72±0.7, 5.10±1.07, 0.74±0.69. All the variables showed significant improvement between different intervals. Conclusion: Kinesio taping method along with manual therapy treatment, cervical stabilisation exercises was effective in treating patients with cervical radiculopathy.
Non-specific neck pain (NsNP) constitutes a burden to the bearers and a management challenge to physiotherapists globally. Effectiveness of neck stabilisation and dynamic exercises in the management ...of NsNP has been documented, but it is not clear which exercise regimen is more effective in alleviating its associated pain, depression and anxiety. This study was carried out to compare the effectiveness of neck stabilisation and/or dynamic exercises on pain intensity, depression and anxiety among patients with NsNP.
Eighty-nine consenting individuals with NsNP participated in this single-blind, randomised controlled trial. They were recruited from the outpatient physiotherapy clinics of the National Orthopaedic Hospital in Dala, Kano State, Nigeria. Participants were randomly assigned into one of three intervention groups: neck stabilisation exercise group (NSEG; n=30), neck dynamic exercise group (NDEG; n=28) and neck stabilisation and dynamic exercise group (NSDEG; n=31). Treatment was administered thrice weekly for 8 consecutive weeks. Variables were assessed at baseline, at the end of the fourth and eighth weeks. Pain intensity was assessed through the use of a visual analogue scale, while depression and anxiety were evaluated using both the Beck Depression Inventory and Beck Anxiety Inventory. The data was analysed using descriptive statistics, multivariate analysis of variance (MANOVA) and post hoc tests with Bonferroni adjustment at the p=0.05 significant level.
Ages of participants in NSEG (46.8±12.4 years), NDEG (48.6±11.6 years) and NSDEG (45.1±13.4 years) were comparable. The comparison for NSEG, NSDEG and NDEG within groups revealed that there was significant difference in pain intensity, depression and anxiety scores from baseline, in the fourth and eighth weeks of the study - (F=62.40, p=0.001, F=13.91, p=0.001 and F=20.93, p=0.001); (F=11.92, p=0.001, F=8.75, p=0.004 and F=9.70, p=0.001) and (F=36.63, p=0.001, F=11.99, p=0.001 and F=6.59, p=0.001), respectively. A group comparison of the pain intensity, depression and anxiety scores of participants in the NSEG, NSDEG and NDEG at the baseline of the study revealed that there were no significant differences in the pain intensity and depression and anxiety scores among the three groups: p=0.159, 0.58 and 0.179, respectively. At week 4 of the study, however, a significant difference in pain intensity and anxiety scores across the three groups was recorded - p=0.018, p=0.011, respectively, but no significant difference was noted in depression scores (p=0.93). At week 8 of the study, it was determined that there were significant differences in pain intensity and depression scores p=0.001 and p=0.041, but no significant dissimilarities in the anxiety scores. Post hoc revealed that only pain was significant and lay with NSEG.
The study concluded that the stabilisation, dynamic and stabilisation, plus dynamic exercises were effective in relieving pain and reducing depression and anxiety in patients with NsNP. However, stabilisation showed a more marked effect than the combination exercises of stabilisation plus dynamic exercises, and dynamic exercises in reducing pain intensity in patients with NsNP.
It is recommended that stabilisation exercises be chosen over stabilisation plus dynamic exercises, or dynamic exercise, while treating patients with NsNP. However, both are effective.
Exercise rehabilitation is one of the few evidence-based treatments for chronic non-specific low back pain (cLBP), but individual success is notoriously variable and may depend on the patient’s ...adherence to the prescribed exercise regime. This prospective study examined factors associated with adherence and the relationship between adherence and outcome after a programme of physiotherapeutic spine stabilisation exercises. A total of 32/37 patients with cLBP completed the study (mean age, 44.0 (SD = 12.3) years; 11/32 (34%) male). Adherence to the 9-week programme was documented as: percent attendance at therapy, percent adherence to daily home exercises (patient diary) and percent commitment to rehabilitation (Sports Injury Rehabilitation Adherence Scale (SIRAS)). The average of these three measures formed a multidimensional adherence index (MAI). Psychological disturbance, fear-avoidance beliefs, catastrophising, exercise self-efficacy and health locus of control were measured by questionnaire; disability in everyday activities was scored with the Roland–Morris disability scale and back pain intensity with a 0–10 graphic rating scale. Overall, adherence to therapy was very good (average MAI score, 85%; median (IQR), 89 (15)%). The only psychological/beliefs variable showing a unique significant association with MAI was exercise self-efficacy (Rho = 0.36,
P
= 0.045). Pain intensity and self-rated disability decreased significantly after therapy (each
P
< 0.01). Adherence to home exercises showed a moderate, positive correlation with the reduction in average pain (Rho = 0.54,
P
= 0.003) and disability (Rho = 0.38,
P
= 0.036); higher MAI scores were associated with greater reductions in average pain (Rho = 0.48,
P
= 0.008) and a (n.s.) tendency for greater reductions in disability (Rho = 0.32,
P
= 0.07) Neither attendance at therapy nor SIRAS were significantly related to any of the outcomes. The benefits of rehabilitation depended to a large extent on the patient’s exercise behaviour outside of the formal physiotherapy sessions. Hence, more effort should be invested in finding ways to improve patients’ motivation to take responsibility for the success of their own therapy, perhaps by increasing exercise self-efficacy. Whether the “adherence–outcome” interaction was mediated by improvements in function related to the specific exercises, or by a more “global” effect of the programme, remains to be examined.
El dolor crónico de espalda baja es una de las principales causas de discapacidad. La intervención más eficaz es el ejercicio, con un beneficio superior en términos de dolor y funcionalidad.
Conocer ...el grado de adherencia a los programas de ejercicio terapéutico es indispensable para evaluar la eficacia como servicios de salud, planificar estrategias, optimizar recursos, y favorecer la plena recuperación de los pacientes en un menor tiempo.
Se realizó un estudio prospectivo, observacional con seguimiento a 6 meses de 31 pacientes con dolor crónico de espalda baja, incluidos en el programa de estabilidad lumbar. Se aplicaron escalas de valoración para dolor, funcionalidad, ansiedad, depresión y miedo a la actividad física. Se registró la adherencia mediante un diario de terapia. Se realizaron pruebas paramétricas para correlaciones de interés, así como para determinar los cambios presentados en el tiempo de seguimiento.
El porcentaje de adherencia fue de 82-84% en cada trimestre. La adherencia no mostró correlaciones con variables sociodemográficas, depresión, ansiedad ni miedo. Los pacientes categorizados como adherentes mostraron una mejoría más rápida y evidente en cuanto al dolor y funcionalidad (p>0.05).
Al término del seguimiento todos los pacientes presentaron mejoría significativa en cuanto a dolor y funcionalidad. Los pacientes con depresión mostraron puntajes más altos en las escalas de dolor, funcionalidad al inicio y término del estudio. Sin embargo, ni la depresión, la ansiedad, ni el miedo a ejecutar actividad fueron factores pronóstico de no adherencia terapéutica.
Chronic low back pain is a major cause of disability. The most effective intervention is exercise, with higher benefits in terms of pain and function.
Knowing the level of adherence to therapeutic exercise is essential to assess the effectiveness of health services, for planning strategies, optimising resources, and promoting the full recovery of patients in less time.
A prospective, observational study with 6 months follow-up was performed on 31 patients with chronic low back pain who underwent a lumbar stability program. Rating scales for pain, function, anxiety, depression and fear of avoidance were applied. Adherence was recorded using daily therapy diary. Parametric tests were performed to determine correlations of interest, and to evaluate the changes presented over time.
The percentage of adherence was 82-84% during the 3 trimesters. There were no correlations between adherence and socio-demographic variables, depression, anxiety, or fear of avoidance. Patients categorised as adherent showed faster and more significant improvements in pain and function (p > 0.05).
At the end of the study all patients had a significant improvement in pain and function. Depressed patients showed higher scores on scales of pain and disability at the beginning and end of the study. However, neither depression, anxiety, nor fear of running activity were predictors of non-adherence to the therapy.
Introduction: The aim of this study was to assess core stabilization exercise effects in reducing functional disability in patients with chronic low back pain (CLBP).Methods: This study included ...total of 90 patients aged 40 to 60 years. After a ten-day rehabilitation program the patients from an examination group (n = 30) performed home exercise program five times a week, patients from a first control group (n = 30) three times a week, while patients from a second control group (n = 30) did not perform the exercises at all. The patients performed core stabilization exercises of moderate intensity once a day in 30 minutes sessions. The patient's functional disability was estimated using the Oswestry Disability Index (ODI).Results: After two months of rehabilitation there was a statistically significant increase in functional ability in patients who performed the core stabilization exercises five times a week(p = 0.0001) and in patients who performed the core stabilization exercises three times per week (p = 0.0001). A statistically significant difference in functional ability was not recorded in patients who did not perform the exercises. The analysis of the average values of the ODI differences at the beginning and after two months of rehabilitation showed a statistically significant difference between the group who did not perform the exercises and the group who performed the core stabilization exercises three times a week (p = 0.0001), and between the group who did not perform the exercises and the group who performed the core stabilization exercises five times a week (p = 0.0001).Conclusions: The implementation of the core stabilization exercises leads to a reduction of functional disability in patients with CLBP.
Abstract Spinal stabilisation exercises are commonly used in the management of low back pain (LBP). There is limited evidence relating to patients' experiences of their involvement in such ...programmes. The aim of this study was to explore the experiences of a sample of individuals with chronic LBP who participated in a randomised controlled trial (RCT) investigating the most efficacious dosage and frequency of spinal stabilisation exercises. The qualitative study involved nine participants who took part in focus group discussions. The data were analysed using thematic content analysis and provided insights into the experiences of the participants. Four themes emerged: Physical dimensions of the LBP experience, emotional and psychological dimensions of the LBP experience and perceived effects of the programme and lastly, the impact of the treatment programme on participants' knowledge, understanding and adherence. In conclusion participants' experiences were not limited to the positive effects of stabilisation exercises on pain, functional disability and quality of life, but also reflected increases in confidence, the formulation of self help strategies and the ability to exert better control over their LBP. The findings highlight the importance of well planned associated educational support packages in the treatment of LBP paving the way for future qualitative research.
PURPOSE This study aimed to investigate the effects of trunk stabilization exercise (TSE) with abdominal expansion maneuver (AEM) that lasted for 8 weeks on postural stability and functional movement ...in college athletes. METHODS Twenty college athletes participated in the program (AEM=9, Control=11) and were subjected to 8-week TSE. The AEM group performed exercise by applying AEM techniques during TSE, and control group performed TSE without breathing-related instructions. Both groups measured postural stability with lower-quarter Y-balance test (LQYBT) and functional movement with functional movement screen (FMS) before and after applying TSE to verify the interaction before and after this study with the two groups. Two-way repeated analysis of variance was performed to evaluate the differences between groups and time for an absolute value of LQYBT and FMS, followed by Bonferroni’s multiple comparison tests for post-hoc analysis. RESULTS As a result of the left and right LQYBT, there was a significant difference between the time x group (p=.041, p=.033), and post-hoc analysis indicated that there was a significant difference between the AEM and control groups (p=.000, p=,000). Furthermore, the FMS total score indicated that there was a significant difference between the time × group (p=.039), and the post-hoc analysis showed the AEM group had significant results (p=.001), while there were no significant results in the control group (p=.255). CONCLUSIONS Application of AEM during TSE seems to be effective with regard to postural stability and functional movement in college athletes.
PDF
