About
Scope & Aims
Editorial office
Editorial board
Reviewers
Ethical standards and procedures
Abstracting and indexing
Contact
Articles & Issues
Current issue
Articles in press
Archive
For Authors
General rules
Guide for authors
Templates
Publication charge
For Reviewers
Guide for reviewers
Our reviewers
ORIGINAL PAPER
Effect of proprioceptive training on lower back muscle performance in patients with chronic non-specific low back pain: a randomized controlled trial
1
Faculty of Physical Therapy, Cairo University, Giza, Egypt
Submission date: 2020-12-25
Acceptance date: 2021-03-01
Publication date: 2022-12-19
Physiother Quart. 2022;30(4):96-103
KEYWORDS
proprioceptive trainingback muscle performanceisokinetic dynamometerchronic non-specific low back pain
TOPICS
ABSTRACT
Introduction:
This study was conducted to investigate the impact of proprioceptive training in patients with chronic non-specific low back pain on lower back muscle performance.
Methods:
Overall, 43 participants of both genders (28 females and 15 males) with chronic non-specific low back pain aged 18–26 years were randomly assigned to 2 groups (A and B). Group A (n = 22) received proprioceptive training and conventional strengthening and stretching exercises 3 times per week for 8 weeks. Group B (n = 21) received conventional strengthening and stretching exercises 3 times per week for 8 weeks. To assess lower back muscle performance (peak torque) and the repositioning error of the lumbar spine, a Biodex System 3 Pro isokinetic dynamometer was used. A pressure pain algometer served to measure the pain level, and the functional level was evaluated with the Arabic version of Oswestry Disability Index. All subjects’ outcomes were assessed before and after treatment. For statistical analysis, mixed ANOVA was conducted to investigate the effect of treatment.
Results:
A statistically significant effect (p < 0.0001) of treatment and time was revealed in both groups for all measured variables. Between-group analysis implied a higher improvement in post-intervention results in group A (p < 0.05).
Conclusions:
This study indicated improvement in both groups, but adding proprioceptive training to conventional therapy resulted in more improvement in all measured variables.
This study was conducted to investigate the impact of proprioceptive training in patients with chronic non-specific low back pain on lower back muscle performance.
Methods:
Overall, 43 participants of both genders (28 females and 15 males) with chronic non-specific low back pain aged 18–26 years were randomly assigned to 2 groups (A and B). Group A (n = 22) received proprioceptive training and conventional strengthening and stretching exercises 3 times per week for 8 weeks. Group B (n = 21) received conventional strengthening and stretching exercises 3 times per week for 8 weeks. To assess lower back muscle performance (peak torque) and the repositioning error of the lumbar spine, a Biodex System 3 Pro isokinetic dynamometer was used. A pressure pain algometer served to measure the pain level, and the functional level was evaluated with the Arabic version of Oswestry Disability Index. All subjects’ outcomes were assessed before and after treatment. For statistical analysis, mixed ANOVA was conducted to investigate the effect of treatment.
Results:
A statistically significant effect (p < 0.0001) of treatment and time was revealed in both groups for all measured variables. Between-group analysis implied a higher improvement in post-intervention results in group A (p < 0.05).
Conclusions:
This study indicated improvement in both groups, but adding proprioceptive training to conventional therapy resulted in more improvement in all measured variables.
REFERENCES (45)
1.
Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769–781; doi: 10.1016/j.berh.2010.10.002.
2.
Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–2037; doi: 10.1002/art.34347.
3.
Key J. Back pain: a movement problem. A clinical approach incorporating relevant research and practice. Edinburgh: Churchill Livingstone; 2010.
4.
Wand BM, O’Connell NE. Chronic non-specific low back pain – sub-groups or a single mechanism? BMC Musculoskelet Disord. 2008;9(1):11; doi: 10.1186/1471-2474-9-11.
5.
Kavcic N, Grenier S, McGill SM. Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine. 2004;29(11):1254–1265; doi: 10.1097/00007632-200406010-00016.
6.
McGill SM, Grenier S, Kavcic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003;13(4):353–359; doi: 10.1016/s1050-6411(03)00043-9.
7.
Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol. 2003;13(4):371–379; doi: 10.1016/s1050-6411(03)00044-0.
8.
Moseley GL, Hodges PW, Gandevia SC. Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements. Spine. 2002;27(2):E29–E36; doi: 10.1097/00007632-200201150-00013.
9.
Richardson C, Jull G, Hodges PW, Hides J. Therapeutic exercise for spinal segmental stabilization in low back pain: scientific basis and clinical approach. Edinburgh: Churchill Livingstone; 1999.
10.
Tanaka ML, Nussbaum MA, Ross SD. Evaluation of the threshold of stability for the human spine. J Biomech. 2009;42(8):1017–1022; doi: 10.1016/j.jbiomech.2009.02.008.
11.
Nashner LM. Sensory, neuromuscular, and biomechanical contributions to human balance. In: Duncan PW (ed.), Balance, Proceedings of the APTA Forum. Alexandria: American Physical Therapy Association; 1989; 5–12.
12.
Laskowski ER, Newcommer-Aney K, Smith J. Proprioception. Phys Med Rehabil Clin N Am. 2000;11(2):323–340; doi: 10.1016/S1047-9651(18)30132-3.
13.
Yun EH. Comparing the effects of lumbar stabilization exercise and McKenzie exercise on the range of motion and pain of the patient with low back pain. Unpublished master’s thesis. Seoul: Dankook University; 2003.
14.
Riemann BL, Lephart SM. The sensorimotor system, part II: The role of proprioception in motor control and functional joint stability. J Athl Train. 2002;37(1):80–84.
15.
Magill RA. Motor learning and control: concepts and applications, 7th ed. Boston: McGraw-Hill; 2004.
16.
Rolli Salathé C, Elfering A. A health- and resource-oriented perspective on NSLBP. ISRN Pain. 2013;2013:640690; doi: 10.1155/2013/640690.
17.
Solomonow M, Krogsgaard M. Sensorimotor control of knee stability, a review. Scand J Med Sci Sports. 2001;11(2):64–80; doi: 10.1034/j.1600-0838.2001.011002064.x.
18.
Riemann BL, Myers JB, Lephart SM. Sensorimotor system measurement techniques. J Athl Train. 2002;37(1):85–98.
19.
Kapreli E, Athanasopoulos S, Papathanasiou M, Van Hecke P, Kelekis D, Peeters R, et al. Lower limb sensorimotor network: issues of somatotopy and overlap. Cortex. 2007;43(2):219–232; doi: 10.1016/S0010-9452(08)70477-5.
20.
McCaskey MA, Schuster-Amft C, Wirth B, Suica Z, de Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review. BMC Musculoskelet Disord. 2014;15:382; doi: 10.1186/1471-2474-15-382.
21.
Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332; doi: 10.1136/bmj.c332.
22.
Aoki Y, Sugiura S, Nakagawa K, Nakajima A, Takahashi H, Ohtori S, et al. Evaluation of nonspecific low back pain using a new detailed visual analogue scale for patients in motion, standing, and sitting: characterizing nonspecific low back pain in elderly patients. Pain Res Treat. 2012;2012:680496; doi: 10.1155/2012/680496.
23.
Hussien HM, Abdel-Raoof NA, Kattabei OM, Ahmed HH. Effect of Mulligan concept lumbar SNAG on chronic nonspecific low back pain. J Chiropr Med. 2017;16(2):94–102; doi: 10.1016/j.jcm.2017.01.003.
24.
Georgy EE. Lumbar repositioning accuracy as a measure of proprioception in patients with back dysfunction and healthy controls. Asian Spine J. 2011;5(4):201–207; doi: 10.4184/asj.2011.5.4.201.
25.
Zawadzki J, Bober T, Siemieński A. Validity analysis of the Biodex System 3 dynamometer under static and isokinetic conditions. Acta Bioeng Biomech. 2010;12(4):25–32.
26.
Nordez A, Casari P, Cornu C. Accuracy of Biodex system 3 pro computerized dynamometer in passive mode. Med Eng Phys. 2008;30(7):880–887; doi: 10.1016/j.medengphy.2007.11.001.
27.
Graven-Nielsen T, Vaegter HB, Finocchietti S, Handberg G, Arendt-Nielsen L. Assessment of musculoskeletal pain sensitivity and temporal summation by cuff pressure algometry: a reliability study. Pain. 2015;156(11):2193–2202; doi: 10.1097/j.pain.0000000000000294.
28.
Fritz JM, Irrgang JJ. A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale. Phys Ther. 2001;81(2):776–788; doi: 10.1093/ptj/81.2.776.
29.
Strimpakos N. The assessment of the cervical spine. Part 2: Strength and endurance/fatigue. J Bodyw Mov Ther. 2011;15(4):417–430; doi: 10.1016/j.jbmt.2010.10.001.
30.
Wikstrom EA, Powers ME, Tillman MD. Dynamic stabilization time after isokinetic and functional fatigue. J Athl Train. 2004;39(3):247–253.
31.
Descarreaux M, Blouin J-S, Teasdale N. Repositioning accuracy and movement parameters in low back pain subjects and healthy control subjects. Eur Spine J. 2005;14(2):185–191; doi: 10.1007/s00586-004-0833-y.
32.
Newcomer K, Laskowski ER, Yu B, Larson DR, An KN. Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects. Spine. 2000;25(2):245–250; doi: 10.1097/00007632-200001150-00017.
33.
O’Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10):1074–1079; doi: 10.1097/01.BRS.0000061990.56113.6F.
34.
Farasyn A, Meeusen R. The influence of non-specific low back pain on pressure pain thresholds and disability. Eur J Pain. 2005;9(4):375–381; doi: 10.1016/j.ejpain.2004.09.005.
35.
Fischer AA. Algometry in diagnosis of musculoskeletal pain and evaluation of treatment outcome: an update. J Musculoskelet Pain. 1998;6(1):5–32; doi: 10.1300/J094v06n01_02.
36.
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):1189–1192; doi: 10.1589/jpts.25.1189.
37.
Kachanathu SJ, Alenazi AM, Seif HE, Hafez AR, Alroumim MA. Comparison between Kinesio taping and a traditional physical therapy program in treatment of nonspecific low back pain. J Phys Ther Sci. 2014;26(8):1185–1188; doi: 10.1589/jpts.26.1185.
38.
Kisner C, Colby LA. Therapeutic exercise: foundations and techniques. Philadelphia: F.A. Davis Company; 2012.
39.
Bruhn S, Kullmann N, Gollhofer A. The effects of a sensorimotor training and a strength training on postural stabilisation, maximum isometric contraction and jump performance. Int J Sports Med. 2004;25(1):56–60; doi: 10.1055/s-2003-45228.
40.
Zech A, Hübscher M, Vogt L, Banzer W, Hänsel F, Pfeifer K. Balance training for neuromuscular control and performance enhancement: a systematic review. J Athl Train. 2010;45(4):392–403; doi: 10.4085/1062-6050-45.4.392.
41.
Hadadnezhad M, Yarahmadi Y, Abbasi A. The effects of sensorimotor training on proprioception and anticipatory postural adjustment of some trunk muscle of subject with non-specific chronic low back pain [in Persian]. J Anesth Pain. 2019;10(1):72–84.
42.
Gatti R, Faccendini S, Tettamanti A, Barbero M, Balestri A, Calori G. Efficacy of trunk balance exercises for individuals with chronic low back pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2011;41(8):542–552; doi: 10.2519/jospt.2011.3413.
43.
Marshall PW, Murphy BA. Muscle activation changes after exercise rehabilitation for chronic low back pain. Arch Phys Med Rehabil. 2008;89(7):1305–1313; doi: 10.1016/j.apmr.2007.11.051.
44.
Johannsen F, Remvig L, Kryger P, Beck P, Warming S, Lybeck K, et al. Exercises for chronic low back pain: a clinical trial. J Orthop Sports Phys Ther. 1995;22(2):52–59; doi: 10.2519/jospt.1995.22.2.52.
45.
Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res. 2007;25(3):404–412; doi: 10.1002/jor.20220.
| eISSN: | 2544-4395 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
