Effect of Core Stabilizing Training on Young Individuals Presenting Different Stages of Degenerative Disc Disease-Preliminary Report.
28 Mar 2021-International Journal of Environmental Research and Public Health (Multidisciplinary Digital Publishing Institute)-Vol. 18, Iss: 7, pp 3499
TL;DR: In this paper, the authors assessed the efficacy of stabilizing training for the deep core muscles of the lumbar spine in subjects with degenerative disc disease and found that the stabilizing exercise sessions improved the clinical outcomes in each group.
Abstract: The aim of this study was to assess the efficacy of stabilizing training for the deep core muscles of the lumbar spine in subjects with degenerative disc disease This study was conducted on 38 participants The participants were divided into two groups: the extrusion group (EXT, n = 17) and the protrusion group (PRO, n = 21) All the subjects underwent a four-week-long core stability exercise-based treatment (five sessions/week) Clinical outcome measures were assessed pre-intervention (pre), post-intervention (post) and four weeks after the intervention (follow-up) The primary outcome measures were the spinal range of motion (ROM; Spinal Mouse® device) and the Oswestry Disability Index (ODI) In the PRO group, the ROM decreased from 8852° pre-intervention to 8333° post-intervention and to 8282° at follow-up (p = 001), while the ODI decreased from 1614 points pre-intervention to 657 points post-intervention, with 942 points at follow-up (p < 001) In the EXT group, the ROM decreased from 8100° pre-intervention to 7705° post-intervention, then increased to 7794° at follow-up (p = 003), while the ODI decreased from 2258 points pre-intervention to 1541 points post-intervention and to 1470 points at follow-up (p < 0001) Although the stabilizing exercise sessions improved the clinical outcomes in each group, we cannot make conclusions as to whether the type of intervertebral disc damage significantly affects the results of stabilizing exercise-based treatment
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TL;DR: In this paper, the authors compared the effect of two programs of suspension and core stability exercises on some electromyography (EMG) coordinates, pain and range of motion of patients with disk herniation.
Abstract: Information about comparing the effectiveness of exercise methods on management of disk herniation is limited. The aim of this study was to compare the effect of two programs of suspension and core stability exercises on some electromyography (EMG) coordinates, pain and range of motion of patients with disk herniation. Thirty-two men with disk herniation participated in this clinical trial study which was randomly divided into three groups of suspension exercises (n: 12, age: 34.25 ± 8.81, BMI: 24.01 ± 2.7), core stability exercises (n: 10, age: 35 ± 10.3, BMI: 25 ± 2.27) and control (n: 10, age: 34.4 ± 6.67, BMI: 23.76 ± 1.45). Electrical activity of rectus abdominis, internal and external oblique and erector spinae muscles was masured by superficial EMG, back pain by McGill Pain Questionnaire and range of motion by Modified Schober test, one day before and immediately after of intervention period. The experimental groups performed an 8-week training period while the control group was only followed up. Data were analyzed using paired sample t test and analysis of covariance test and statistical significance was set at 0.05. Suspension group showed significant improvement in EMG of rectus abdominis, internal and external oblique muscles (respectively, p = 0.030, p = 0.017, p = 0.022) and pain (p = 0.001) compared to core stability group; but there was no significant difference between two groups in EMG of erector spinae muscle and range of motion. Changes in both training groups were significant in all variables compared to control groups (p ˂ 0.05). Our findings showed that although both exercises were effective in patients with lumbar disk herniation, but the effectiveness of suspension exercises in increasing muscle activation and reducing pain was more pronounced than core stability exercises. Iranian Registry of Clinical Trials (IRCT): IRCT20191016045136N1.
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TL;DR: In this paper , the authors examined degeneration in the lumbar musculus multifidus (LMF) and lumbus erector spinae (LES) muscles in patients with chronic LBP with non-radiculopathy Lumbar disc herniation, patients with mechanical LBP, and healthy individuals.
Abstract: BACKGROUND
Although several studies have been conducted to determine the cause of low back pain (LBP), a sufficient correlation has not been found between research findings and symptoms. Therefore there seems to be a need for studies to explain the relationship between pain and morphological changes in the paraspinal muscles of patients with LBP through comparisons with healthy control subjects.
OBJECTIVE
The aim of this study was to examine degeneration in the lumbar musculus multifidus (LMF) and lumbar musculus erector spinae (LES) muscles in patients with chronic LBP with non-radiculopathy lumbar disc herniation (LDH), patients with mechanical LBP, and healthy individuals.
METHODS
The study included 35 patients with mechanical LBP, 38 patients with non-radiculopathy LDH, and a control group of 36 healthy participants. In all patients and the control group, evaluations were made on axial magnetic resonance imaging slices at L3-S1 level of the LMF and LES cross-sectional areas (CSA), total CSA (TCSA = LMF+LES), fat infiltrations and asymmetries.
RESULTS
The mean CSA values of the right and left LMF and LES showed significant differences between the groups (p< 0.001, p= 0.002, p= 0.002, p= 0.010, respectively). Fat infiltrations showed a difference between the right-left LMF and left LES groups (p= 0.007, p< 0.001, p= 0.026, respectively). Asymmetry was not observed between the CSA and TCSA of the right and left sides.
CONCLUSION
A correlation was found between fat infiltration in the LMF and mechanical LBP and LDH. However, no significant correlation was determined between LBP and the CSA and TCSA of the LMF and LES. This was thought to be due to an incorrect result of CSA and TCSA in the evaluation of muscle mass. Therefore, for a more accurate evaluation of muscle mass, it can be considered necessary to measure muscle atrophy associated with fat infiltration or functional CSA.
References
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TL;DR: This specific exercise approach focuses on retraining a precise co-contraction pattern of the deep trunk muscles, the transversus abdominis and lumbar multifidus based on the knowledge of how muscles provide stability for the spine in normal situations.
642 citations
TL;DR: Clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition, as results are most applicable to acute orSubacuteLow-Back pain assessed in primary-care settings.
510 citations
TL;DR: The Spinal Mouse delivered consistently reliable values for standing curvatures and ranges of motion which compared well with those reported in the literature, suggesting that the device can be reliably implemented for in vivo studies of the sagittal profile and range of motion of the spine.
Abstract: There is an increasing awareness of the risks and dangers of exposure to radiation associated with repeated radiographic assessment of spinal curvature and spinal movements. As such, attempts are continuously being made to develop skin-surface devices for use in examining the progression and response to treatment of various spinal disorders. However, the reliability and validity of measurements recorded with such devices must be established before they can be recommended for use in the research or clinical environment. The aim of this study was to examine the reliability of measurements using a newly developed skin-surface device, the Spinal Mouse. Twenty healthy volunteers (mean age 41±12 years, nine males, 11 females) took part. On 2 separate days, spinal curvature was measured with the Spinal Mouse during standing, full flexion, and full extension (each three times by each of two examiners). Paired t-tests, intraclass correlation coefficients (ICC), and standard errors of measurement (SEM) with 95% confidence intervals were used to characterise between-day and interexaminer reliability for: standing sacral angle, lumbar lordosis, thoracic kyphosis, and ranges of motion (flexion, extension) of the thoracic spine, lumbar spine, hips, and trunk. The between-day reliability for segmental ranges of flexion was also determined for each motion segment from T1-2 to L5-S1. The majority of parameters measured for the ‘global regions’ (thoracic, lumbar, or hips) showed good between-day reliability. Depending on the parameter of interest, between-day ICCs ranged from 0.67 to 0.92 for examiner 1 (average 0.82) and 0.57 to 0.95 for examiner 2 (average 0.83); for 70% of the parameters measured, the ICCs were greater than 0.8 and generally highest for the lumbar spine and whole trunk measures. For lumbar spine range of flexion, the SEM was approximately 3°. The ICCs were also good for the interexaminer comparisons, ranging from 0.62 to 0.93 on day 1 (average 0.81) and 0.70 to 0.94 on day 2 (average 0.86), although small systematic differences were sometimes observed in their mean values. The latter were still evident even if both examiners used the same skin markings. For segmental ranges of flexion, the ICCs varied between vertebral levels but overall were lower than for the global measures (average for all levels in all analyses, ICC 0.6). For each examiner, the average between-day SEM over all vertebral levels was approximately 2°. For ‘global’ regions of the spine, the Spinal Mouse delivered consistently reliable values for standing curvatures and ranges of motion which compared well with those reported in the literature. This suggests that the device can be reliably implemented for in vivo studies of the sagittal profile and range of motion of the spine. As might be expected for the smaller angles being measured, the segmental ranges of flexion showed lower reliability. Their usefulness with regard to the interpretation of individual results and the detection of ‘real change’ on an individual basis thus remains questionable. Nonetheless, the group mean values showed few between-day differences, suggesting that the device may still be of use in providing clinically interesting data on segmental motion when examining groups of individuals with a given spinal pathology or undergoing some type of intervention.
321 citations
TL;DR: All the three scales had excellent test–retest reliability, however, the VAS was the most reliable, with the smallest errors in the measurement of OA knee pain.
Abstract: Objective Several scales are commonly used for assessing pain intensity. Among them, the numerical rating scale (NRS), visual analog scale (VAS), and verbal rating scale (VRS) are often used in clinical practice. However, no study has performed psychometric analyses of their reliability and validity in the measurement of osteoarthritic (OA) pain. Therefore, the present study examined the test-retest reliability, validity, and minimum detectable change (MDC) of the VAS, NRS, and VRS for the measurement of OA knee pain. In addition, the correlations of VAS, NRS, and VRS with demographic variables were evaluated. Methods The study included 121 subjects (65 women, 56 men; aged 40-80 years) with OA of the knee. Test-retest reliability of the VAS, NRS, and VRS was assessed during two consecutive visits in a 24 h interval. The validity was tested using Pearson's correlation coefficients between the baseline scores of VAS, NRS, and VRS and the demographic variables (age, body mass index [BMI], sex, and OA grade). The standard error of measurement (SEM) and the MDC were calculated to assess statistically meaningful changes. Results The intraclass correlation coefficients of the VAS, NRS, and VRS were 0.97, 0.95, and 0.93, respectively. VAS, NRS, and VRS were significantly related to demographic variables (age, BMI, sex, and OA grade). The SEM of VAS, NRS, and VRS was 0.03, 0.48, and 0.21, respectively. The MDC of VAS, NRS, and VRS was 0.08, 1.33, and 0.58, respectively. Conclusion All the three scales had excellent test-retest reliability. However, the VAS was the most reliable, with the smallest errors in the measurement of OA knee pain.
300 citations
TL;DR: An overview of the current concepts of vertebral instability is provided, focusing on degenerative lumbar intervertebral instability, and the different imaging modalities most indicated in diagnosing vertebra instability are reviewed.
Abstract: Intervertebral instability of the lumbar spine is thought to be a possible pathomechanical mechanism underlying low back pain and sciatica and is often an important factor in determining surgical indication for spinal fusion and decompression. Instability of the lumbar spine, however, remains a controversial and poorly understood topic. At present, much controversy exists regarding the proper definition of the condition, the best diagnostic methods, and the most efficacious treatment approaches. Clinical presentation is not specific, and the relationship between radiologic evidence of instability and its symptoms is controversial. Because of its simplicity, low expense, and pervasive availability, functional flexion-extension radiography is the most thoroughly studied and the most widely used method in the imaging diagnosis of lumbar intervertebral instability. In this article, we provide an overview of the current concepts of vertebral instability, focusing on degenerative lumbar intervertebral instabili...
256 citations