Abstract The aim of this study was to analyze trunk muscle activity during bridge style stabilization exercises, when combined with single and double leg support strategies. Twenty-nine healthy ...volunteers performed bridge exercises in 3 different positions (back, front and side bridges), with and without an elevated leg, and a quadruped exercise with contralateral arm and leg raise (“bird-dog”). Surface EMG was bilaterally recorded from rectus abdominis (RA), external and internal oblique (EO, IO), and erector spinae (ES). Back, front and side bridges primarily activated the ES (approximately 17% MVC), RA (approximately 30% MVC) and muscles required to support the lateral moment (mostly obliques), respectively. Compared with conventional bridge exercises, single leg support produced higher levels of trunk activation, predominantly in the oblique muscles. The bird-dog exercise produced greatest activity in IO on the side of the elevated arm and in the contralateral ES. In conclusion, during a common bridge with double leg support, the antigravity muscles were the most active. When performed with an elevated leg, however, rotation torques increased the activation of the trunk rotators, especially IO. This information may be useful for clinicians and rehabilitation specialists in determining appropriate exercise progression for the trunk stabilizers.
•Electrical stimulation was tolerable in patients with chronic low back pain.•Stabilization exercises with NMES did not add clinical benefit for the CLBP.•Because of the small sample; clinicians ...should interpreting the results cautiously.
One proposed mechanism of chronic low back pain might be paraspinal muscle impairment. Commonly, this impairment is treated with stabilization exercises. However, the effect size of stabilization exercises has been previously reported to be small.
Randomized controlled trial.
To investigate the clinical benefit of using neuromuscular electrical stimulation as a supplement to stabilization exercises in patients with chronic low back pain.
Thirty participants with chronic low back pain were randomized into a stabilization exercise only group (n=15) or a stabilization exercise plus neuromuscular electrical stimulation group (n=15). The stabilization exercises included abdominal, side support, and quadruped exercises. The neuromuscular electrical stimulation was applied to the lumbar paraspinal muscles for 20min each session. Both groups received their respective interventions twice a week for 6 weeks. Participant eligibility for inclusion was age between 18 and 60 years, body mass index ≤34, chronic low back pain ≥3 months, Numeric Pain Rating Scale ≥3, Modified Oswestry Disability Questionnaire score ≥20 and ability to understand English. Outcome measurements were self-reported neuromuscular electrical stimulation tolerability scale, Modified Oswestry Disability Questionnaire, Numeric Pain Rating Scale, Fear-Avoidance Beliefs Questionnaire and paraspinal muscle strength.
The neuromuscular electrical stimulation was reported to be tolerable. There were no significant between-group differences on any of the outcome measures (p>0.05).
The application of neuromuscular electrical stimulation on the paraspinal muscles was reported to be tolerable. Supplementing stabilization exercises with neuromuscular electrical stimulation did not offer any additional clinical benefit for the chronic low back pain patients.
Abdominal curl-up exercise may excessively increased superficial neck flexor such as sternocleidomastoid (SCM) muscle. Also, the muscle activity of the abdominal muscles haven`t investigated during ...abdominal curl-up with craniocervical flexion (CCF). Therefore, the purpose of our study was to determine the effect of CCF on the muscle activity of the abdominal and SCM muscles during abdominal curl-up. Twelve healthy subjects (six men and six women) with no history of abdominal or lower back pain within 6 weeks were recruited. Surface electromyographic signals were collected on SCM, rectus abdominis (RA), internal oblique (IO), and external oblique (EO) muscles bilaterally during performing the traditional abdominal curl-up and the abdominal curl-up with CCF. Paired t-tests were used to compare the differences in the muscle activity of the bilateral SCM, RA, EO, and IO muscles between the traditional abdominal curl-up and the abdominal curl-up with CCF (p<.05). There was significantly lower electromyogram (EMG) activity of the both SCMs during the abdominal curl-up with CCF (Right SCM, 39.50±15.29%MVIC; Left SCM, 38.24±17.31%MVIC) than with the traditional abdominal curl-up (Right SCM, 54.85±20.05%MVIC; Left SCM, 53.18±26.72%MVIC) (p<.05). The activity of abdominal muscles were not significantly different between the traditional abdominal curl-up and the abdominal curl-up with CCF. The abdominal curl-up with CCF requires significantly less muscle activity of SCM. Consequently, the abdominal curl-up with CCF is recommended to prevent excessive activation of superficial cervical flexors during abdominal curl-up exercise.
Background: Pelvic floor muscle (PFM) dysfunction and pain are common complications seen in pelvic cancers including the gynecological and genitourinary systems before and after treatments such as ...chemotherapy, radiotherapy, and surgeries and may contribute to significant morbidity as the survival rates increase in these patients.
Objective: The objective of the clinical trial was to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) and stabilization exercises on pelvic pain in pelvic cancer survivors following multimodal treatment.
Materials and Methods: Thirty-one patients including both male and female adults treated for pelvic cancers were recruited in the study. Outcome measures in terms of pain were assessed at baseline and at the end of the study by the visual analog scale and genitourinary pain index (GUPI) scale, abdominal muscle strength by pressure biofeedback unit for transverse abdominal (TrA) muscle, and quality of life (QOL) by functional assessment of cancer therapy general questionnaire. Pelvic stabilization exercises and TENS were administered once daily approximately 30 min during the acute hospitalization.
Results: Pelvic stabilization exercises and TENS demonstrated to be effective in ameliorating pelvic pain (P < 0.001) and improving in the GUPI scores of pain, incontinence, increasing strength of TrA musculature (P < 0.001), and improving overall QOL (P < 0.005).
Conclusion: The trial suggests that a combination of pelvic stabilization exercises and conventional TENS may be used as a strategic tool to reduce pain and improve PFM strength after multimodal treatments in pelvic cancer survivors in the clinical setup of an Indian Scenario.
Objective: The aim of this study was to compare the effects of balance exercises and combined exercises (neuromuscular and stabilization exercises) on pain, function, and range of motion of female ...athletes with chronic ankle instability. Methods: Participants were 30 female athletes with chronic ankle instability selected using a convenience sampling technique and randomly assigned into three groups balance exercises (n=10), combined exercises (n=10) and control (n=10). The amount of pain was measured by the Visual Analog Scale (VAS). Functional characteristics were tested by side hop test, 8 hop test, single-leg triple hop test, and single-leg hop test. A goniometer was used to measure ankle dorsiflexion and plantar flexion range of motion. Both exercise groups performed their exercises for 6 weeks (3 sessions per week each for 60 minutes). After the intervention, they went under post-test assessment and their results were then compared. The Levene's test was used to test the homogeneity of variances in the pre-test phase, while Analysis of Covariance (ANCOVA) was used to examine the between-group changes, Tukey's post hoc test for determining the location of the difference between groups, and t-test for assessing the differences within groups. Results: Balance and combined exercises had a significant effect on the subjects 'pain (P=0.03 and 0.01), functional characteristics (P≤0.01) and ankle dorsiflexion (P=0.01) and plantar flexion (P=0.01 and 0.02) range of motion. Comparing two exercise programs, it was found that the effect of combined exercises on pain, function and dorsiflexion range of motion of subjects was higher. Conclusion: It is recommended that for correct and timely rehabilitation of the athletes with ankle injury, balance exercises along with combined exercises should be used to reduce their pain, and improve function and range of motion.
BACKGROUNDThis study "Effectiveness of Mckenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: an experimental study" was conducted ...to study and find the effectiveness of Mckenzie approach and segmental spinal stabilization exercises on reduction of pain, correction of rounded shoulder, and disability. Pain, disability, and rounded shoulders are the major limiting factors as it affects the quality of life and reduces efficiency and social participation. MATERIALS AND METHODSThe study was conducted among 120 individuals with cervical postural syndrome, and fulfilling the inclusion and exclusion criteria was included. The outcome measures were Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Vernier caliper to evaluate pain, functional disability, and rounded shoulder, respectively. Subjects were randomly divided into two groups, Group A and Group B, by using SPSS software. Interventional training was given for 6 weeks to the patients. Group A subjects were given spinal stabilization exercises. Group B subjects were given Mckenzie approach. The statistical analysis was performed using SPSS; pre-test and post-test were used to calculate the results, followed by data presentation and analysis. RESULTThe result showed that at the end of the 6 weeks on comparison between pre- and post-intervention of Group A and Group B, both the techniques were effective, but group B was significantly effective than Group A. CONCLUSIONIt was noted that McKenzie approach and segmental spinal stabilization exercises were effective on neck pain in individuals with cervical postural syndrome, but on comparing both techniques, Mckenzie protocol is more beneficial than segmental spinal stabilization exercises. The study accepts the alternate hypothesis that there is significant effect of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome.
This study aims to explore the effects of gaze stabilization exercises (GSEs) on gait, plantar pressure, and balance function in post-stroke patients (≤6 months). Forty post-stroke patients were ...randomly divided into an experimental group (n = 20) and a control group (n = 20). The experimental group performed GSEs combined with physical therapy, while the control group only performed physical therapy, once a day, 5 days a week, for 4 weeks. The Berg Balance Scale (BBS) was used to test the balance function and the risk of falling, which was the primary outcome. The Timed Up and Go test (TUGT) evaluated the walking ability and the fall risk. The envelope ellipse area and the plantar pressure proportion of the affected side were used to measure the patient’s supporting capacity and stability in static standing. The anterior−posterior center of pressure displacement velocity was used to test the weight-shifting capacity. Compared to the control group, the swing phase of the affected side, swing phase’s absolute symmetric index, envelope ellipse area when eyes closed, and TUGT of the experimental group had significantly decreased after GSEs (p < 0.05); the BBS scores, TUGT, the anterior−posterior COP displacement velocity, and the plantar pressure proportion of the affected side had significantly increased after 4 weeks of training (p < 0.05). In conclusion, GSEs combined with physical therapy can improve the gait and balance function of people following stroke. Furthermore, it can enhance the weight-shifting and one-leg standing capacity of the affected side, thus reducing the risk of falling.
A randomized controlled trial, prestest-posttest design, with a 3-, 6-, and 12-month follow-up.
To investigate the efficacy of a therapeutic exercise approach in a population with chronic low back ...pain (LBP).
Therapeutic approaches developed from the Pilates method are becoming increasingly popular; however, there have been no reports on their efficacy.
Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were randomly assigned to 1 of 2 groups. The specific-exercise-training group participated in a 4-week program consisting of training on specialized (Pilates) exercise equipment, while the control group received the usual care, defined as consultation with a physician and other specialists and healthcare professionals, as necessary. Treatment sessions were designed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region. Functional disability outcomes were measured with The Roland Morris Disability Questionnaire (RMQ/RMDQ-HK) and average pain intensity using a 101-point numerical rating scale.
There was a significantly lower level of functional disability (P = .023) and average pain intensity (P = .002) in the specific-exercise-training group than in the control group following the treatment intervention period. The posttest adjusted mean in functional disability level in the specific-exercise-training group was 2.0 (95% CI, 1.3 to 2.7) RMQ/RMDQ-HK points compared to a posttest adjusted mean in the control group of 3.2 (95% CI, 2.5 to 4.0) RMQ/RMDQ-HK points. The posttest adjusted mean in pain intensity in the specific-exercise-training group was 18.3 (95% CI, 11.8 to 24.8), as compared to 33.9 (95% CI, 26.9 to 41.0) in the control group. Improved disability scores in the specific-exercise-training group were maintained for up to 12 months following treatment intervention.
The individuals in the specific-exercise-training group reported a significant decrease in LBP and disability, which was maintained over a 12-month follow-up period. Treatment with a modified Pilates-based approach was more efficacious than usual care in a population with chronic, unresolved LBP.
Pilates programs are widely used as a form of regular exercise in a broad range of populations investigating their effectiveness for chronic low back pain (CLBP) treatment.
The aim of this study was ...to compare the effects of a Pilates program and a trunk strengthening exercise program on functional disability and health-related quality of life (HRQOL) in women with nonspecific CLBP.
A total of 101 volunteer women with CLBP provided data with a 3-month follow-up. They were randomized to either a Pilates (n= 37), trunk strengthening exercise (n= 36) or a control group (n= 28), exercising for a period of 8 weeks, three times a week. Data were collected on HRQOL using the Short-Form 36 Health Survey (SF-36v2), and functional disability using the Roland Morris Disability Questionnaire prior to program initiation, mid-intervention, immediately after program termination, and three months post-intervention.
The Pilates participants reported greater improvements on self-reported functional disability and HRQOL compared with participants in the trunk strengthening exercise and control groups (p < 0.05). The effects were retained for a period of three months after program termination for the Pilates group and to a lesser extent for the trunk strengthening exercise group.
An 8-week Pilates program improved HRQOL and reduced functional disability more than either a trunk strengthening exercise program or controls among women with CLBP.
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