Objective:To determine, for adults with chronic low back pain, which exercise interventions are the most effective at reducing pain compared to other treatments.Data sources:A search of MEDLINE, CINAHL, EMBASE, SPORTDiscus, PsycINFO and The Cochrane Library was conducted up to October 2014.Review methods:Databases were searched for published reports of randomised trials that investigated the treatment of chronic low back pain of non-specific origin with an exercise intervention. Two authors independently reviewed and selected relevant trials. Methodological quality was evaluated using the Downs and Black tool.Results:Forty-five trials met the inclusion criteria and thirty-nine were included in the meta-analysis. Combined meta-analysis revealed significantly lower chronic low back pain with intervention groups using exercise compared to a control group or other treatment group (Standard Mean Deviation (SMD) =-0.32, CI 95% -0.44 to -0.19, P<0.01). Separate exploratory subgroup analysis showed a significant ...

Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials

A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain

Objective Examine the effectiveness of specific modes of exercise training in non-specific chronic low back pain (NSCLBP). Design Network meta-analysis (NMA). Data sources MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL. Eligibility criteria Exercise training randomised controlled/clinical trials in adults with NSCLBP. Results Among 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): −1.86 (–2.54 to –1.19)), resistance (SUCRA=80%; −1.14 (–1.71 to –0.56)) and stabilisation/motor control (SUCRA=80%; −1.13 (–1.53 to –0.74)) for physical function and resistance (SUCRA=80%; −1.26 (–2.10 to –0.41)) and aerobic (SUCRA=80%; −1.18 (–2.20 to –0.15)) for mental health. True control was most likely (SUCRA≤10%) to be the worst treatment for all outcomes, followed by therapist hands-off control for pain (SUCRA=10%; 0.09 (–0.71 to 0.89)) and physical function (SUCRA=20%; −0.31 (–0.94 to 0.32)) and therapist hands-on control for mental health (SUCRA=20%; −0.31 (–1.31 to 0.70)). Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function (p>0.095; SUCRA Summary/conclusion There is low quality evidence that Pilates, stabilisation/motor control, resistance training and aerobic exercise training are the most effective treatments, pending outcome of interest, for adults with NSCLBP. Exercise training may also be more effective than therapist hands-on treatment. Heterogeneity among studies and the fact that there are few studies with low risk of bias are both limitations.

https://bjsm.bmj.com/content/bjsports/54/21/1279.full.pdf

Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis

Objective To investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. Design Systematic review and meta-analysis of randomised trials. Data sources Medline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017. Study selection criteria Randomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments. Results For pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) −0.94, 95% CI −1.69 to −0.19). Specific exercises were superior to generic exercises (SMD −0.65, 95% CI −0.99 to −0.32). Corticosteroid injections were superior to no treatment (SMD −0.65, 95% CI −1.04 to −0.26), and ultrasound guided injections were superior to non-guided injections (SMD −0.51, 95% CI −0.89 to −0.13). Nonsteroidal anti-inflammatory drugs (NSAIDS) had a small to moderate SMD of −0.29 (95% CI −0.53 to −0.05) compared with placebo. Manual therapy was superior to placebo (SMD −0.35, 95% CI −0.69 to −0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD −0.32, 95% CI −0.62 to −0.01). Laser was superior to sham laser (SMD −0.88, 95% CI −1.48 to −0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (−0.39, 95% CI −0.78 to –0.01) and tape was superior to sham (−0.64, 95% CI −1.16 to −0.12), with small to moderate SMDs. Conclusion Although there was only very low quality evidence, exercise should be considered for patients with shoulder impingement symptoms and tape, ECSWT, laser or manual therapy might be added. NSAIDS and corticosteroids are superior to placebo, but it is unclear how these treatments compare to exercise.

https://bjsm.bmj.com/content/bjsports/51/18/1340.full.pdf

Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs

Ylang-ylang (Cananga odorata Hook F & Thomson) is one of the plants that are exploited at a large scale for its essential oil which is an important raw material for the fragrance industry The essential oils extracted via steam distillation from the plant have been used mainly in cosmetic industry but also in food industry Traditionally, C odorata is used to treat malaria, stomach ailments, asthma, gout, and rheumatism The essential oils or ylang-ylang oil is used in aromatherapy and is believed to be effective in treating depression, high blood pressure, and anxiety Many phytochemical studies have identified the constituents present in the essential oils of C odorata A wide range of chemical compounds including monoterpene, sesquiterpenes, and phenylpropanoids have been isolated from this plant Recent studies have shown a wide variety of bioactivities exhibited by the essential oils and the extracts of C odorata including antimicrobial, antibiofilm, anti-inflammatory, antivector, insect-repellent, antidiabetic, antifertility and antimelanogenesis activities Thus, the present review summarizes the information concerning the traditional uses, phytochemistry, and biological activities of C odorata This review is aimed at demonstrating that C odorata not only is an important raw material for perfume industry but also considered as a prospective useful plant to agriculture and medicine

/pdf/traditional-uses-phytochemistry-and-bioactivities-of-cananga-ys9vyakhkb.pdf

Traditional Uses, Phytochemistry, and Bioactivities of Cananga odorata (Ylang-Ylang)

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment.

/pdf/a-12-week-rehabilitation-program-improves-body-composition-5et2uk7j02.pdf

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom

Although the Ylang-Ylang aroma (YYA) has used as a general method for enhancing sedative effect, there was a little report on the efficacy of YYA on heart function using the electrocardiogram (EKG). Therefore, identifying of the effects of YYA on blood pressure (BP) and heart rate (HR) is important in order to demonstrate the effectiveness of YYA. The aim of this study was to investigate the effects of YYA on BP and HR in healthy men. Twenty-nine men took part in this study. The subjects were randomly divided into 2 groups: Ylang-Ylang group (YYG, n= 15) and control group (CG, n= 14). Physiological parameters recorded were BP by using a sphygmomanometer and HR by using an EKG. The present results demonstrated that inhalation of YYA significantly decreased the systolic and diastolic blood pressure. Inhalation of YYA also significantly decreased the HRs in 10 leads, except in lead I and aVR. This indicates that the HRs recorded in lead I and aVR were less sensitive or obtuse compared to those in the 10 other leads. Therefore, such a result reveals that it is necessary to be aware of the terms regarding the position. In the present results, YYA caused a reduction of HR and BP, and a relief of the arousal level in healthy men. The present results show a sedative effect of YYA, and this study provides some evidences for the usage of YYA in medicinal agent.

https://www.e-jer.org/upload/jer-9-2-7-250_255.pdf

Effects of Ylang-Ylang aroma on blood pressure and heart rate in healthy men

BACKGROUND: Effectiveness of inversion traction has been revealed in patients with chronic low back pain (CLBP), however, it is still unknown as to which angles of inversion traction positively affect patients with CLBP. OBJECTIVE: To investigate the angle-effects of inversion traction on pain sensation, lumbar flexibility, and trunk muscles (flexors and extensors) strength in patients with CLBP after an 8 week treatment program. METHODS: Forty-seven women suffering nonspecific CLBP for 23.00 ± 5.45 weeks were included prospectively and randomized into 3 groups: supine group (SG; n = 15), inversion �30 ◦ group (I30G; n = 18), and inversion �60 ◦ group (I60G; n = 14), respectively. Each group completed a 3-minute × 3-set inversion traction protocol at 0 ◦ ,i nverted�30 ◦ ,o r inverted�60 ◦ , respectively for 4 days a week during 8 weeks. The outcome measures included rating of pain using the visual analogue scale (VAS), flexibility of lumbosacral joint, and the isokinetic strength of the trunk flexors and extensors at 60 ◦ /s. RESULTS: Pain was significantly improved after 8 weeks. The reductions observed in VAS scores were lower in the I60G compared with the changes in I30G and SG. Significant interaction effects were observed in trunk flexion and extension particularly in the I60G condition. There was also a significant increase in the extensor peak torque of the I60G. CONCLUSIONS: Inversion traction at angle of �60 ◦ reduced back pain or discomfort and improved lumbar flexibility and isokinetic trunk extensor strength in patients with CLBP following an 8 week program. Therefore, this treatment modality may be suitable for patient groups of similar CLBP phenomenology.

The effect of inversion traction on pain sensation, lumbar flexibility and trunk muscles strength in patients with chronic low back pain

BACKGROUND: Although horse simulator riding is very beneficial for patients with several diseases, there are few studies relating to treating patients with chronic low back pain (CLBP) specifically in terms of physiological and psychological outcome measures. It also has not been medically verified yet on the aspects of psychological responses and physiological changes. As well as there are not known how it can decrease the pain, how it can increase the physical conditioning, and how much good time rides a horse simulator. OBJECTIVE: To investigate the time-effects of an 8 week horse simulator exercise on body composition, visual analogue scale (VAS), and isokinetic torques of the trunk and hip joints in patients with CLBP. METHODS: Forty one young men presenting with CLBP were divided into 4 groups: LBP control group (LCG), LBP horse simulator 10 min riding group (LHS10G), LBP horse simulator 20 min riding group (LHS20G), and LBP horse simulator 30 min riding group (LHS30G), respectively. Three horse simulator exercise groups completed a rehabilitation exercise protocol for 5 days per week during 8 weeks. VAS was used to measure the severity of CLBP and functional disability for checking psychological responses. Body composition measured by bioelectrical analyzer and isokinetic torques were used to consider the physiological pre-post changes. RESULTS: Compared with the baseline, the body composition indices did not change significantly. However, muscle mass and fat mass showed increasing and decreasing tendencies in the LHS30G. The VAS indices showed significant decrease in back pain including other 12 items. A significant decrease was observed for all items except for drug relief. Especially, most of items in the LHS20G were lower than those of the other groups in the post hoc comparison. The horse simulator exercise enhanced the isokinetic strength of trunk and hip muscles. Due to the increased strength, trunk flexor/extensor ratio, hip flexor/extensor ratio, and hip abductor/adductor were close to reference values. The deficit in the ratio scores: hip flexor and extensor and hip abductor and adductor evened out after an experiment. Especially, these improvements were associated particularly with LHS20G. CONCLUSIONS: The horse simulator exercise positively affected psychophysiological responses in patients with CLBP. However, with respect to pain, the 20 min horseback riding group was associated with the best results.

Time-effects of horse simulator exercise on psychophysiological responses in men with chronic low back pain

Performing warm-ups increases muscle temperature and blood flow, which contributes to improved exercise performance and reduced risk of injuries to muscles and tendons. Stretching increases the range of motion of the joints and is effective for the maintenance and enhancement of exercise performance and flexibility, as well as for injury prevention. However, stretching as a warm-up activity may temporarily decrease muscle strength, muscle power, and exercise performance. This study aimed to clarify the effect of stretching during warm-ups on muscle strength, muscle power, and muscle endurance in a nonathletic population. The subjects of this study consisted of 13 physically active male collegiate students with no medical conditions. A self-assessment questionnaire regarding how well the subjects felt about their physical abilities was administered to measure psychological readiness before and after the warm-up. Subjects performed a non–warm-up, warm-up, or warm-up regimen with stretching prior to the assessment of the isokinetic moments of knee joints. After the measurements, the respective variables were analyzed using nonparametric tests. First, no statistically significant intergroup differences were found in the flexor and extensor peak torques of the knee joints at 60°/sec, which were assessed to measure muscle strength. Second, no statistically significant intergroup differences were found in the flexor and extensor peak torques of the knee joints at 180°/sec, which were assessed to measure muscle power. Third, the total work of the knee joints at 240°/sec, intended to measure muscle endurance, was highest in the aerobic-stretch-warm-ups (ASW) group, but no statistically significant differences were found among the groups. Finally, the psychological readiness for physical activity according to the type of warm-up was significantly higher in ASW. Simple stretching during warm-ups appears to have no effect on variables of exercise physiology in nonathletes who participate in routine recreational sport activities. However, they seem to have a meaningful effect on exercise performance by affording psychological stability, preparation, and confidence in exercise performance.

/pdf/the-effect-of-warm-ups-with-stretching-on-the-isokinetic-42cj86tvkh.pdf

Jun-Youl Cha

Papers

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom

Effects of Ylang-Ylang aroma on blood pressure and heart rate in healthy men

The effect of inversion traction on pain sensation, lumbar flexibility and trunk muscles strength in patients with chronic low back pain

Time-effects of horse simulator exercise on psychophysiological responses in men with chronic low back pain

The effect of warm-ups with stretching on the isokinetic moments of collegiate men