Investigation of the effects of different treatment approaches on lumbar stabilizer muscles and diaphragm motility in individuals with chronic low back pain.

IF 1.1 4区 医学 Q3 REHABILITATION Turkish Journal of Physical Medicine and Rehabilitation Pub Date : 2024-08-26 eCollection Date: 2024-09-01 DOI:10.5606/tftrd.2024.13257
Kansu Kanlı, Pembe Hare Yigitoglu, Ahmet Özgül
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Abstract

Objectives: This study aimed to examine effects of core stabilization and aerobic exercises on lumbar stabilizer muscles and diaphragm motility in individuals with chronic low back pain (CLBP).

Patients and methods: Fifty-one patients (19 males, 32 females; mean age: 32.7±8.8 years; range, 20 to 60 years) with CLBP were included in this randomized controlled trial between March 2021 and May 2022. The patients were divided into three groups: the core group, the aerobic group, and the control group. Conventional treatments (hotpack, transcutaneous electrical nerve stimulation, ultrasound, and McKenzie exercises) were applied to all three patient groups. The core group received core stabilization exercises, and the aerobic group received aerobic exercises. The control group received only conventional treatments. Exercises were continued for six weeks. All patients were assessed through the Beck Depression Inventory (BDI), Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), and Nottingham Health Profile (NHP). Trunk flexor and extensor strength, as well as trunk flexor and back extensor endurance, was examined. Structural features of the multifidus (MF), transversus abdominis (TrA), external oblique (EO), internal oblique (IO), and diaphragm muscles, as well as diaphragm motility, were evaluated with ultrasound imaging. All measurements were repeated before and after six weeks of treatment.

Results: In all groups, post-treatment values of VAS rest/activity, trunk flexor endurance, back extensor endurance, trunk flexor/extensor muscle strength, BDI, RMDQ and, NHP scores improved significantly compared to pre-treatment (p=0.001). Resting and contraction thicknesses of TrA, MF, EO, and IO muscles increased significantly in both the core (p=0.001/0.001, p=0.001/0.002, p=0.001/0.001, and p=0.001/0.001, respectively) and aerobic groups (p=0.001/0.013, p=0.002/0.020, p=0.001/0.004, and p=0.001/0.010, respectively), while the control group did not show any significant difference (p=0.229/0.064, p=0.052/0.102, p=0.069/0.449, and p=0.094/0.146, respectively). After treatment, all groups showed significant increments in end-expiratory thickness (p=0.001), end-inspiratory thickness (p=0.001), motility of diaphragm during normal breathing (control, p=0.003; core, p=0.001; aerobic, p=0.001), and deep breathing (control, p=0.007; core, p=0.001; aerobic, p=0.001).

Conclusion: While aerobic and core stabilization exercises provided significant improvements in individuals with CLBP, the core stabilization group showed the best improvement in all parameters. Accordingly, the necessity of aerobic and core stabilization exercises in treatment programs comes to the fore in individuals with CLBP.

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研究不同治疗方法对慢性腰痛患者腰部稳定肌和膈肌运动的影响。
研究目的本研究旨在探讨核心稳定运动和有氧运动对慢性腰背痛(CLBP)患者腰部稳定肌和膈肌运动的影响:在 2021 年 3 月至 2022 年 5 月期间,51 名慢性腰背痛患者(19 名男性,32 名女性;平均年龄:32.7±8.8 岁;范围:20 至 60 岁)被纳入这项随机对照试验。患者被分为三组:核心组、有氧组和对照组。三组患者均接受常规治疗(热敷、经皮神经电刺激、超声波和麦肯锡运动)。核心组接受核心稳定运动,有氧组接受有氧运动。对照组只接受常规治疗。运动持续六周。通过贝克抑郁量表(BDI)、视觉模拟量表(VAS)、罗兰-莫里斯残疾问卷(RMDQ)和诺丁汉健康档案(NHP)对所有患者进行评估。对躯干屈肌和伸肌力量以及躯干屈肌和背部伸肌耐力进行了检查。通过超声波成像评估了多裂肌 (MF)、腹横肌 (TRA)、腹外斜肌 (EO)、腹内斜肌 (IO) 和膈肌的结构特征以及膈肌运动情况。在治疗前和治疗六周后重复进行所有测量:结果:与治疗前相比,各组治疗后的 VAS 休息/活动、躯干屈肌耐力、背部伸肌耐力、躯干屈肌/伸肌肌力、BDI、RMDQ 和 NHP 评分均有显著改善(P=0.001)。核心组(p=0.001/0.001、p=0.001/0.002、p=0.001/0.001 和 p=0.001/0.001)和有氧组(p=0.001/0.013、p=0.002/0.020、p=0.001/0.004 和 p=0.001/0.010),而对照组则无显著差异(分别为 p=0.229/0.064、p=0.052/0.102、p=0.069/0.449 和 p=0.094/0.146)。治疗后,所有组的呼气末厚度(p=0.001)、吸气末厚度(p=0.001)、正常呼吸时横膈膜的运动(对照组,p=0.003;核心组,p=0.001;有氧组,p=0.001)和深呼吸(对照组,p=0.007;核心组,p=0.001;有氧组,p=0.001)均有明显增加:结论:有氧运动和核心稳定运动能显著改善慢性阻塞性肺病患者的状况,而核心稳定运动组在所有参数方面的改善效果最好。因此,有氧运动和核心稳定运动在慢性阻塞性脑脊髓膜炎患者治疗计划中的必要性凸显出来。
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来源期刊
Turkish Journal of Physical Medicine and Rehabilitation
Turkish Journal of Physical Medicine and Rehabilitation Health Professions-Physical Therapy, Sports Therapy and Rehabilitation
CiteScore
2.20
自引率
0.00%
发文量
0
期刊介绍: The Turkish Journal of Physical Medicine and Rehabilitation (Formerly published as Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi) is the official journal of the Turkish Society of Physical Medicine and Rehabilitation. The journal is an international open-access, double-blind peer-reviewed periodical journal bringing the latest developments in all aspects of physical medicine and rehabilitation, and related fields. The journal publishes original articles, review articles, editorials, case reports (limited), letters to the editors. The target readership includes academic members, specialists, residents working in the fields of Physical Medicine and Rehabilitation. The language of the journal is English and it is published quarterly (in March, June, September, and December).
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