Introduction
Various studies have shown that spine stabilisation exercise therapy elicits improvements in symptoms/disability in patients with chronic non-specific low back pain (cLBP). However, few ...have corroborated the intended mechanism of action by examining whether clinical improvements (1) are greater in patients with functional deficits of the targeted muscles and (2) correlate with post-treatment improvements in abdominal muscle function.
Methods
Pre and directly after 9 weeks’ therapy, 32 cLBP patients (44.0 ± 12.3 years) rated their LBP intensity (0–10) and disability (0–24, Roland–Morris; RM) and completed psychological questionnaires. At the same timepoints, the voluntary activation of transversus abdominis (TrA), obliquus internus and obliquus externus during “abdominal-hollowing” and the anticipatory (“feedforward”) activation of these muscles during rapid arm movements were measured using M-mode ultrasound with tissue Doppler imaging.
Results
Pre-therapy to post-therapy, RM decreased from 8.9 ± 4.7 to 6.7 ± 4.3, and average pain, from 4.7 ± 1.7 to 3.5 ± 2.3 (each
P
< 0.01). The ability to voluntarily activate TrA increased by 4.5% (
P
= 0.045) whilst the anticipatory activation of the lateral abdominal muscles showed no significant change (
P
> 0.05). There was no significant correlation between the change in RM scores after therapy and either baseline values for voluntary (
r
= 0.24,
P
= 0.20) or anticipatory activation (
r
= 0.04,
P
= 0.84), or their changes after therapy (voluntary,
r
= 0.08,
P
= 0.66; anticipatory,
r
= 0.16,
P
= 0.40). In multiple regression, only a reduction in catastrophising (
P
= 0.0003) and in fingertip–floor distance (
P
= 0.0006) made unique contributions to explaining the variance in the reduction in RM scores.
Conclusion
Neither baseline lateral abdominal muscle function nor its improvement after a programme of stabilisation exercises was a statistical predictor of a good clinical outcome. It is hence difficult to attribute the therapeutic result to any specific effects of the exercises on these trunk muscles. The association between changes in catastrophising and outcome serves to encourage further investigation on larger groups of patients to clarify whether stabilisation exercises have some sort of “central” effect, unrelated to abdominal muscle function per se.
Objective Patients with low back pain have stability defects and trigger points that cause low back pain. The aim of this study was to compare the effect of six-weeks stabilization exercises with and ...without dry needles on pain and performance in patients with chronic nonspecific low back pain. Methods ISixty-six patients with chronic non-specific low back pain (age 31. 6±2. 3 years, and weight 79. 6±7. 5 kg) were selected and were randomly divided into 2 equal experimental (stabilization exercises with and without dry needles) groups and one control group. At first, patients' pain and function were measured by visual analog scale (VAS) and Qswestry disability questionnaire. Then, the experimental groups underwent an intervention under supervision of the experienced trainer. But the patients in the control group did not exercise and did not receive any interventions. In the posttest stage, pain and performance were evaluated again in the three groups. The SPSS version 20 was used to analyze the data at a significance level of P <0.05. Results IThe results of the study showed a significant improvement in pain and performance of patients in experimental groups following stabilization exercises alone and with dry needling compared to the control group. Conclusion It can be concluded that core stabilization exercises with dry needles have a significant effect on reducing pain in patients with chronic low back pain and also have a significant effect on improving performance. The effect of stabilization exercises with dry needling is superior than stabilization exercises alone; thus, it is recommended that stabilization exercises with dry needling be considered in the treatment plan of patients with chronic low back pain.
Introduction and hypothesis
The objective was to investigate the effects of spinal stabilization exercises (SSEs) focusing on the pelvic floor with regard to urinary symptoms, pelvic floor muscle ...strength (PFMS), core stability, quality of life (QoL), and perception of subjective improvement (PSI) in women with overactive bladder (OAB).
Methods
Patients were randomly divided into SSE (
n
=23) and control (
n
=24) groups. The SSE group received SSEs focusing on the pelvic floor for 3 days a week for 8 weeks and recommendation. The control group received only recommendation. Before (BT) and after treatment (AT), urinary symptoms were evaluated with Overactive Bladder Questionnaire-Version 8 (OAB-V8) and bladder diary. PFMS, core stability, and QoL were assessed using the Modified Oxford Scale (MOS), Sharman test, and King’s Health Questionnaire (KHQ) respectively. AT, PSI with a Likert-type scale, and compliance with recommendations using a visual analog scale were assessed.
Results
The OAB-V8 and the KHQ scores, the number of voids per day and voids per night decreased and the MOS and the Sharman scores increased in the SSE group (
p
<0.05). In the control group, the OAB-V8 and incontinence effect, social limitations, emotional state, and sleep sub-dimension scores related to KHQ decreased (
p
<0.05). The OAB-V8, role and physical limitations, emotional state, and sleep sub-dimension scores decreased more, and the MOS, the Sharman, the PSI, and the compliance with recommendations scores increased more in the SSE group than in the control group (
p
<0.05).
Conclusions
The SSEs focusing on the pelvic floor improved urinary symptoms, PFMS, core stability, QoL, and PSI. This exercise approach may be beneficial in the management of OAB.
The purpose of this study is to evaluate the effect of a six-week combined manual therapy (MT) and stabilizing exercises (SEs), with a one-month follow-up on neck pain and improving function and ...posture in patients with forward head and rounded shoulder postures (FHRSP).
Sixty women with neck pain and FHRSP were randomized into three groups: Group 1 performed SE and received MT (n = 20), Group 2 performed SE (n = 20) and Group 3 performed home exercises (n = 20) for six weeks. The follow-up time was one month after the post test. The pain, function, and head and shoulder angles were measured before and after the six-week interventions, and during a one-month follow-up.
There were significant within-group improvements in pain, function, and head and shoulder posture in groups 1 and 2. There were significant between-group differences in groups 1 and 2 in head posture, pain, and function favoring group 1 with effect size 0.432(p = 0.041), 0.533 (P = 0.038), and 0.565(P = 0.018) respectively. There were significant between-group differences in both intervention groups versus the control group favoring the intervention groups.
These findings suggest that both interventions were significantly effective in reducing neck pain and improving function and posture in patients. However, the improvement in function and pain were more effective in Group 1 as compared to Group 2, suggesting that MT can be used as a supplementary method to the stabilizing intervention in the treatment of neck pain. More researches are needed to confirm the result of this study.
UMIN000030141 modified on 2018.03.08. This study is a randomized control trial registered at UMIN-CTR website, the trial was retrospectively registered and the unique trial number is UMIN000030141 .
Abstract Aim We performed a systematic review with a meta-analysis to examine the efficacy of stabilization exercises versus general exercises or manual therapy in patients with low back pain. Design ...We searched MEDLINE, Cochrane Controlled Trials, Scielo, and CINAHL (from the earliest date available to November 2014) for randomized controlled trials that examined the efficacy of stabilization exercises compared to general exercises or manual therapy on pain, disability, and function in patients with low back pain. Weighted mean differences (WMD) and 95% confidence intervals were calculated. Results Eleven studies met the inclusion criteria (413 stabilization exercises patients, 297 general exercises patients, and 185 manual therapy patients). Stabilization exercises may provide greater benefit than general exercise for pain reduction and improvement in disability. Stabilization exercise improved pain with a WMD of −1.03 (95% CI: −1.29 to −0.27) and improved disability with a WMD of −5.41 (95% CI: −8.34 to −2.49). There were no significant differences in pain and disability scores among participants in the stabilization exercise group compared to those in the manual therapy group. Conclusions Stabilization exercises were as efficacious as manual therapy in decreasing pain and disability and should be encouraged as part of musculoskeletal rehabilitation for low back pain.
Almost half of stroke patients report impaired function of the upper limb and hand. Stability of the trunk is required for the proper movement of the body, including the legs and arms. The aim of the ...study was to analyze the effect of trunk stabilization exercises on coordinated movement of the affected upper limb in patients after stroke, using an Armoe®Spring device and the “wall” and “abacus” functional tests. Materials and methods: This is a randomized, double-blinded study. The research was carried out in the Rehabilitation Clinic on a group of 60 stroke patients who were randomly assigned to groups differing in the rehabilitation program. The study group had physiotherapy based on the NDT Bobath concept and the control group used classic exercises. The importance of the trunk for upper limb coordination was assessed on the Armeo®Spring device using three evaluation programs, “perpendicular fishing”; “horizontal fishing”; “reaction time”, and two proprietary tests, “wall” and “abacus”. Results: The post-treatment analysis showed significantly better results in the study group for the abacus (p < 0.001), wall (p = 0.003) tests, and a significantly higher percentage of task completion in the vertical fishing (p = 0.036) and reaction time (p = 0.009) tests. Conclusions: Physiotherapy including exercises to stabilize the trunk had a significant effect on increasing the functional efficiency of the affected upper limb and on improving the handgrip strength. The Armeo®Spring device is a good device for the functional assessment of the upper limb before and after therapy.
Purpose
The main aim of the trial was to assess the combined impact of graded Thera-Band strengthening exercises and scapular stabilization exercises on shoulder pain, physical function, and quality ...of life (QoL) in post-mastectomy adhesive capsulitis (AC).
Methods
Seventy females with unilateral post-mastectomy AC partook in the trial. Participants were subdivided equally into two groups at random. Both groups obtained the traditional physical therapy program; in addition, the intervention group received graded Thera-Band exercises for shoulder muscles and scapular stabilization exercises 5 days a week for 8 weeks. Range of motion (ROM) and muscle power of shoulder were assessed by digital goniometer and handheld dynamometer, respectively. Disability of the Arm, Shoulder, and Hand questionnaire (DASH) was utilized for assessment of shoulder function and visual analogue scale (VAS) for pain measurement while short-form (SF-36) for QoL assessment. All evaluation data was recorded prior to the trial and at the eighth week of interventions for both groups.
Results
All participants achieved improvements in shoulder ROM, muscle power, pain, and all aspects of QoL; however, higher statistical improvements were reported in all measurements with respect to strengthening exercises group (
p
< 0.001).
Conclusion
The addition of graded Thera-Band strengthening exercises and scapular stabilization exercises in post-mastectomy AC rehabilitation program has significant benefits in shoulder function and patients’ QoL.
Trial registration: This study is retrospectively registered at ClinicalTrials.gov NCT05311839.
Randomized controlled trial.
Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor ...control exercises.
To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise.
Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms.
Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region.
Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P=.505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001).
An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance. Registered at ClinicalTrials.gov (NCT01061632).
Therapy, level 2b-.
To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP).
A total of ...forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment.
It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05).
The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly.
NCT03898089.
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