Abstract
Purpose:
To compare two different exercises programs in the treatment of chronic low back pain.
Methods:
This study was performed with 63 patients with chronic low back pain. The control group consisted of 32 patients. Classical Strength Exercises (CSE) consisting of stretching and strengthening exercises were applied to the control group. The experimental group consisted of 31 patients. Muscle Endurance Training (MET) consisting of warm-up, endurance exercises and cool down were applied on the experimental group. At the end of the treatment session, a hot-pack was applied to the patients in both of the groups. Postural education and back care advice were also given. Patients attended a therapy program 3 days a week for 6 weeks. The disability, pain and muscle endurance were assessed in the 1st, 3rd and 6th weeks.
Results:
The 6th week measurement of disability was lower in the MET group than that of the CSE group (p<0.05). There was no significant difference in the VAS score and abdominal muscle endurance. In the 3rd and 6th week, back muscle endurance time was significantly higher in the MET group than that of the control group (p<0.05).
Conclusion:
Recent studies show that muscle endurance has a great importance in the prevention of Lower Back Pain (LBP). Therefore in the treatment of Chronic Low Back Pain, muscle endurance exercises that increase the level of endurance should be added to the treatment program.
Amaç:
Kronik bel ağrısının tedavisinde iki farklı egzersiz yöntemini karşılaştırmak.
Yöntem:
Bu çalışma, kronik bel ağrısı olan 63 hasta üzerinde gerçekleştirildi. Kontrol grubunu oluşturan (klasik kuvvetlendirme egzersiz programına alınan) 32 hastaya germe ve kuvvetlendirme egzersizlerinden oluşan klasik kuvvetlendirme programı, deney grubunu oluşturan (kassal dayanıklılık egzersiz programına alınan) 31 hastaya ısınma, soğuma ve dayanıklılık egzersizlerinden oluşan kassal dayanıklılık eğitimi uygulandı. Her iki gruptaki hastalara, postüral düzgünlük ve günlük yaşam aktivitelerinde dikkat edilecek durumlarla ilgili eğitim verildi ve tedavi seanslarının sonunda sıcak uygulama yapıldı. Hastalar haftada 3 gün olmak üzere 6 hafta boyunca tedaviye alındı. Tedavi öncesi ile tedavinin 3. ve 6. haftalarında yetmezlik, ağrı ve dayanıklılık ölçümleri yapıldı.
Sonuç:
3. ve 6. hafta elde edilen dayanıklılık sonuçları, kassal dayanıklılık eğitim grubunda klasik kuvvetlendirme egzersiz grubuna oranla daha düşük bulundu (p< 0.05). Abdominal kas dayanıklılığında ve görsel analog skalası değerlerinde her iki grup arasında fark bulunmamıştır (p>0.05). 3. ve 6. haftada sırt kaslarının dayanıklılık süreleri kontrol grubuna oranla deney grubunda anlamlı olarak yüksek bulunmuştur (p<0.05).
Tartışma:
Güncel çalışmalar kassal dayanıklılığın, kronik bel ağrısının önlenmesinde önemli olduğunu göstermiştir. Bu nedenle kronik bel ağrısının tedavisinde kasın dayanıklılık seviyesini arttıran dayanıklılık egzersizleri tedavi programına eklenmelidir.
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References
Notarnicola A, Fischetti F, Maccagnano G, Comes R, Tafuri S, Moretti B. Daily pilates exercises or inactivity for patients with low back pain: a clinical prospective observational study. Eur J Phys Rehab Med. 2014;50(1):59–66.
Park SD, Yu SH. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain. J Exerc Rehabil. 2013;9(2):286–91.
Jellema P, van Tulder MW, van Poppel MN, Nachemson AL, Bouter LM. Lumbal supports for prevention and treatment of low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine. 2001;26:377–86.
Evans DD, Carter M, Panico R, Kimble L, Morlock JT, Spears MJ. Characteristics and predictors of short-term outcomes in individuals self-selecting yoga or physical therapy for treatment of chronic low back pain. PM&R. 2010;2(11):1006–15.
Balthazard P, Goumoens P, Gilles R, Demeulenaere P, Ballabeni P, Deriaz O. Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2012;13:162–74.
Sung PS. Disability and back muscle fatigability changes following two therapeutic exercise interventions in participants with recurrent low back pain. Med Sci Monit. 2013;14:40–8.
Champagne A, Descarreaux M, Lafond D. Back and hip extensor muscles fatigue in healthy subjects: task-dependency effect of two variants of the Sorensen test. Eur Spine J. 2008;17(12):1721–6.
Schenkman ML, Jordan S, Akuthota V, Roman M, Kohrt WM, Hearty T, et al. Functional movement training for recurrent low back pain: lessons from a pilot randomized controlled trial. PM&R. 2009:1(2):137–46.
Heydari A, Nargol AVF, Jones APC, Humphrey AR, Greenough CG. EMG analysis of lumbar paraspinal muscles as a predictor of the risk of low-back pain. Eur Spine J. 2010;19:1145–52.
Hwang JA, Bae SH, Kim GD, Kim KY. The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients. J Phys Ther Sci. 2013;25(9):1189–92.
Hofmann J, Peters S, Geidl W, Hentschke C, Pfeifer K. Effects of behavioral exercise therapy on the effectiveness of a multidisciplinary rehabilitation for chronic non-specific low back pain: Study protocol for a randomised controlled trial. BMC Musculoskelet Disord. 2013;11(14):8–9.
Kim HJ, Kim YE, Bae SH, Kim KY. The effect of the neurac sling exercise on postural balance adjustment and muscular response patterns in chronic low back pain patients. J Phys Ther Sci. 2013;25(8):1015–9.
Park JH, Lee SH, Ko SD. The effects of the Nintendo Wii exercise program on chronic work-related low back pain in industrial workers. J Phys Ther Sci. 2013;25(8):985–8.
Pincus T, Santos R, Breen A, Burton AK, Underwood M. A review and proposal for a core set of factors for prospective cohorts in low back pain: a consensus statement. Arthritis Rheum. 2008;59(1):14–24.
Licciardone JC, Gatchel RJ, Kearns CM, Minotti DE. Depression, somatization, and somatic dysfunction in patients with nonspecific chronic low back pain: results from the Osteopathic Trial. J Am Osteopath Assoc. 2012;112(12):783–91.
F. Steiger F, Wirth B, de Bruin ED, Mannion AF. Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review. Eur Spine J. 2012;21(4):575–98.
Huang Q, Li D, Yokotsuka N, Zhang Y, Ubukata H, Huo M, et al. The intervention effects of different treatment for chronic low back pain as assessed by the cross-sectional area of the multifidus muscle. J Phys Ther Sci. 2013;25(7):811–3.
D’orazio B. In search of the perfect treatment. In: Darling D, Butterworth- Heinmann. Rehabilitation. USA, Andover medical publishers. 1993;32–71.
Larivière C, da Silva RA, Arsenault AB, Nadeau S, Plamondon A, Vadeboncoeur R. Specificity of a back muscle exercise machine in healthy and low back pain subjects. Med Sci Sports Exerc. 2010;42(3):592–9.
Sinaki M, Mokri B. Low back pain and disorders of the lumbar spine. In: Braddom RL, Buschbacher RM, Dumitru D, Johnson EW, Matthews D, Sinaki M, editors. Physical medicine and rehabilitation. 2nd ed. Philadelphia: WB Saunders Company Publishing. 1996;813–50.
Thomas K, Lee RYW. Fatigue of abdominal and paraspinal muscles during sustained loading of the trunk in the coronal plane. Arch Phys Med Rehabil. 2000;81(7):916–20.
Chok B, Lee R, Latimer J, Tan SB. Endurance training of trunk extensor muscles in people with subacute low back pain. Phys Ther. 1999;79(11):1032–42.
Velde G, Mierau D. The effect of exercise on percentile rank aerobic capacity, pain and self-rated disability in patients with chronic low back pain. Arch Phys Med Rehabil. 2000;81(11):1457–63.
Arokoski JP, Valta T, Airaksinen O, Kankaanpaa M. Back and abdominal muscle function during stabilization exercise. Arch Phys Med Rehabil. 2001;82(8):1089–98.
Yoon JS, Lee JH, JS.The effect of swiss ball stabilization exercise on pain and bone mineral density of patients with chronic low back pain. J Phys Ther Sci. 2013;25:953–6.
Chung S, Lee J, Yoon J. Effects of stabilization exercise using a ball on multifidus cross-sectional area in patients with chronic low back pain. J Sport Sci Med. 2013;12(3):533–41.
Hwang JA, Bae SH, Do Kim G, Kim KY. The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients. J Phys Ther Sci. 2013;25(9):1189–92.
Moon HJ, Choi KH, Kim DH, Kim HJ, Cho YK, Lee KH, et.al. Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain. Ann Rehabil Med. 2013;37(1):110–7.
Yakut E, Düger T, Oksüz C, Yörükan S, Ureten K, Turan D, et al. Validation of Turkish version of the Oswestry Disability Index for patient with low back pain. Spine. 2004;29(5):581–5.
Brooks C, Siegler JC, Cheema BS, Marshall PW. No relationship between body mass index and changes in pain and disability after exercise rehabilitation for patients with mild to moderate chronic low back pain. Spine. 2013;38(25):2190–5.
Taddio A, O’Brien L, Ipp M, Stephens D, Goldbach M, Koren G. Reliability and validity of observer ratings of pain using the visual analog scale (VAS) in infants undergoing immunization injections. Pain. 2009;147(1-3):141–6.
Ito T, Shirado O, Suziki H, Takahashi M, Kaneda K, Strax TE. Lumbar trunk muscle endurance testing: inexpensive alternative to machine for evaluation. Arch Phys Med Rehabil. 1996;77(1):75–9.
Keller A, Hellesnes J, Brox JI. Reliability of the isokinetic trunk extensor test, boering-sorensen test and Astrand Bicycle test. Spine. 2001;26(7):771–7.
McKeon MD, Albert WJ, Neary JP. Assessment of neuromuscular and haemodynamic activity in individuals with and without chronic low back pain. Dyn Med. 2006;5:6.
Mayer JM, Nuzzo JL, Chen R, Quillen WS, Verna JL, Miro R, et al. The impact of obesity on back and core muscular endurance in firefighters. J Obes. 2012;1–7. DOI:10.1155/2012/729283.
Barker KL, Dawes H, Hansford P, Shamley D. Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool. Arch Phys Med Rehabil. 2003;84(9):1319–23.
Sung PS. Multifidi muscles median frequency before and after spinal stabilization exercises. Arch Phys Med Rehabil. 2003;84(9):1313–8.
Oldervoll LK, Zwart JA, Suebuk S. Comparison of two physical exercises programs for the early intervention of pain in the neck, shoulders and lower back in female hospital staff. J Rehabil Med. 2001;33(4):156–61.
Moffroid MT, Haugh LD, Haig AJ, Henry SM, Pope MH. Endurance training of Trunk extensor muscles. Phys Ther.1993;73(1):3–10.
Smeets RJ, Wade D, Hidding A, Van Leeuwen PJ, Vlaeyen JW, Knottnerus JA. The association of physical deconditioning and chronic low back pain: a hypothesis-oriented systematic review. Disabil Rehabil. 2006; 28(11):673–93.
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Günay, S., Yildirim, Y. & Karadibak, D. The effect of the muscle endurance training on the chronic low back pain. Turk J Physiother Rehabil 25, 4 (2014). https://doi.org/10.7603/s40680-014-0004-y
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DOI: https://doi.org/10.7603/s40680-014-0004-y