ORIGINAL PAPER
Effects of proprioceptive neuromuscular facilitation techniques in treating chronic nonspecific low back pain patients
 
More details
Hide details
1
Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt
 
2
Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
 
3
Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
 
 
Submission date: 2020-02-19
 
 
Acceptance date: 2020-04-19
 
 
Publication date: 2021-06-21
 
 
Physiother Quart. 2021;29(2):32-37
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
As one of the highly prevalent musculoskeletal disorders, low back pain incurs high medical care costs. Proprioceptive neuromuscular facilitation has been used in treating chronic low back pain. This study aimed to investigate the effects of multiple proprioceptive neuromuscular facilitation techniques on endurance of the trunk musculature, spinal mobility, and impairment of function in cases of chronic low back pain.

Methods:
Patients in this study were randomly assigned into 3 groups. Group A received rhythmic stabilization training, group B received a combination of isotonic exercises, while group C received a combination of both rhythmic stabilization training and combination of isotonic exercises. Trunk endurance was evaluated with trunk flexion and trunk extension endurance tests, spinal mobility was assessed with a modified Schober test, and functional impairment was measured with Oswestry Disability Index.

Results:
ANOVA showed significant differences (p < 0.05) among the groups after treatment in the measured outcomes. Tukey’s honest significant difference post-hoc test revealed a highly statistically significant improvement in the measured outcomes of group C in comparison with the other groups in the post-intervention conditions.

Conclusions:
The application of the rhythmic stabilization training technique of proprioceptive neuromuscular facilitation followed by a combination of isotonic exercises was more effective than implementing either technique alone in the treatment of patients with chronic low back pain.

REFERENCES (32)
1.
Bin Homaid M, Abdelmoety D, Alshareef W, Alghamdi A, Alhozali F, Alfahmi N, et al. Prevalence and risk factors of low back pain among operation room staff at a tertiary care center, Makkah, Saudi Arabia: a cross-sectional study. Ann Occup Environ Med. 2016;28:1; doi: 10.1186/s40557-016-0089-0.
 
2.
Shafizadeh M. Movement coordination during sit-to-stand in low back pain people. Hum Mov. 2016;17(2):107–111; doi: 10.1515/humo-2016-0012.
 
3.
Grabois M. Management of chronic low back pain. Am J Phys Med Rehabil. 2005;84(3 Suppl.):S29–S41; doi: 10.1097/01.PHM.0000154908.76436.C2.
 
4.
Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379(9814):482–491; doi: 10.1016/S0140-6736(11)60610-7.
 
5.
Dąbek J, Piotrkowicz J, Korzeń D, Gąsior Z. Knowledge and use of ergonomic principles in physicians and nurses with low back pain. Health Prob Civil. 2019;13(3):217–224; doi: 10.5114/hpc.2019.81342.
 
6.
Kofotolis N, Sambanis M. The influence of exercise on musculoskeletal disorders of the lumbar spine. J Sports Med Phys Fitness. 2005;45(1):84–92.
 
7.
Endamlı DB, Bayramlar K, Turhan B. Investigation of fascial treatment effectiveness on pain, flexibility, functional level, and kinesiophobia in patients with chronic low back pain. Physiother Quart. 2019;27(3):1–5; doi: 10.5114/pq.2019.86461.
 
8.
May S, Johnson R. Stabilization exercises for low back pain: a systematic review. Physiotherapy. 2008;94(3):179–189; doi: 10.1016/j.physio.2007.08.010.
 
9.
Kofotolis N, Kellis E. Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain. Phys Ther. 2006;86(7):1001–1012; doi: 10.1093/ptj/86.7.1001.
 
10.
Kofotolis N, Vrabas IS, Kalogeropoulou E, Sambanis M, Papadopoulos C, Kalogeropoulos I. Proprioceptive neuromuscular facilitation versus isokinetic training for strength, endurance and jumping performance. J Hum Mov Studies. 2002;42(2):155–165.
 
11.
Kofotolis N, Vrabas IS, Vamvakoudis E, Papanikolaou A, Mandroukas K. Proprioceptive neuromuscular facilitation training induced alterations in muscle fibre type and cross sectional area. Br J Sports Med. 2005;39(3):e11; doi: 10.1136/bjsm.2004.010124.
 
12.
Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001;26(11):E243–E248; doi: 10.1097/00007632-200106010-00004.
 
13.
Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005;85(3):209–225; doi: 10.1093/ptj/85.3.209.
 
14.
Luomajoki H, Kool J, de Bruin ED, Airaksinen O. Improvement in low back movement control, decreased pain and disability, resulting from specific exercise intervention. Sports Med Arthrosc Rehabil Ther Technol. 2010;2:11; doi: 10.1186/1758-2555-2-11.
 
15.
Macedo LG, Latimer J, Maher CG, Hodges PW, Nicholas M, Tonkin L, et al. Motor control or graded activity exercises for chronic low back pain? A randomised controlled trial. BMC Musculoskelet Disord. 2008;9:65; doi: 10.1186/1471-2474-9-65.
 
16.
Maher CG, Latimer J, Hodges PW, Refshauge KM, Moseley GL, Herbert RD, et al. The effect of motor control exercise versus placebo in patients with chronic low back pain [ACTRN012605000262606]. BMC Musculoskelet Disord. 2005;6:54; doi: 10.1186/1471-2474-6-54.
 
17.
Voss DE, Ionta MK, Meyers BJ. Proprioceptive neuromuscular facilitation: patterns and techniques, 3rd ed. New York: Harper & Row; 1985.
 
18.
Saliba VL, Johnson GS, Wardlaw C. Proprioceptive neuromuscular facilitation. In: Basmajian JV, Nyberg RE (eds.), Rational manual therapies. Baltimore: Williams & Wilkins; 1992; 243–284.
 
19.
Malliou P, Gioftsidou A, Beneka A, Godolias G. Measurements and evaluations in low back pain patients. Scand J Med Sci Sports. 2006;16(4):219–230; doi: 10.1111/j.1600-0838.2005.00504.x.
 
20.
Reiman MP, Krier AD, Nelson JA, Rogers MA, Stuke ZO, Smith BS. Comparison of different trunk endurance testing methods in college-aged individuals. Int J Sports Phys Ther. 2012;7(5):533–539.
 
21.
Demoulin C, Vanderthommen M, Duysens C, Crielaard J-M. Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint Bone Spine. 2006;73(1):43–50; doi: 10.1016/j.jbspin.2004.08.002.
 
22.
Bronner S. Functional rehabilitation of the spine: the lumbopelvis as a key point of control. In: Brownstien B, Bronner S (eds.), Functional movement in orthopaedic and sports physical therapy: evaluation, treatment, and outcomes. New York: Churchill Livingstone; 1997; 141–190.
 
23.
Algarni AS, Ghorbel S, Jones JG, Guermazi M. Validation of an Arabic version of the Oswestry index in Saudi Arabia. Ann Phys Rehabil Med. 2014;57(9–10):653–663; doi: 10.1016/j.rehab.2014.06.006.
 
24.
Guermazi M, Mezghani M, Ghroubi S, Elleuch M, Ould Sidi Med A, Poiraudeau S, et al. The Oswestry index for low back pain translated into Arabic and validated in an Arab population [in French]. Ann Readapt Med Phys. 2005:48(1):1–10; doi: 10.1016/j.annrmp.2004.06.055.
 
25.
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.
 
26.
Hosseinifar M, Akbari A, Ghiasi F, Shamsoaldini N, Shahraki R. The effects of proprioceptive neuromuscular facilitation exercises on pain, function, lumbar mobility, and lumbar lordosis in patients with non-specific chronic low back pain. Int J Pharm Res Allied Sci. 2016;5(4):250–261.
 
27.
Franklin CVJ, Kalirathinam D, Palekar T, Nathani N. Effectiveness of PNF training for chronic low back pain. J Nurs Health Sci. 2013;2(4):41–52; doi: 10.13140/2.1.1213.2486.
 
28.
Fleck SJ, Kraemer WJ. Resistance training: basic principles (part 1 of 4). Phys Sportsmed. 1988;16(3):160–171; doi: 10.1080/00913847.1988.11709461.
 
29.
Lusting SA, Ball TE, Looney M. A comparison of two proprioceptive neuromuscular facilitation techniques for improving range of motion and muscular strength. Isokinet Exerc Sci. 1992;2(4):154–159; doi: 10.3233/IES-1992-2402.
 
30.
Osternig LR, Robertson RN, Troxel RK, Hansen P. Differential responses to proprioceptive neuromuscular facilitation (PNF) stretch techniques. Med Sci Sports Exerc. 1990;22(1):106–111.
 
31.
Van Tulder M, Malmivaara A, Esmail R, Koes B. Exercise therapy for low back pain: a systematic review within the framework of the Cochrane Collaboration back review group. Spine. 2000;25(21):2784 –2796; doi: 10.1097/00007632-200011010-00011.
 
32.
Biering-Sørensen F. Physical measurements as risk indicators for low-back trouble over a one-year period. Spine. 1984;9(2):106–119; doi: 10.1097/00007632-198403000-00002.
 
eISSN:2544-4395
Journals System - logo
Scroll to top