Effect of Lumbar Stabilization and Dynamic Lumbar Strengthening Exercises in Patients With Chronic Low Back Pain
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Objective To compare the effects of lumbar stabilization exercises and lumbar dynamic strengthening exercises on the maximal isometric strength of the lumbar extensors, pain severity and functional disability in patients with chronic low back pain (LBP).Methods Patients suffering nonspecific LBP for more than 3 months were included prospectively and randomized into lumbar stabilization exercise group (n=11) or lumbar dynamic strengthening exercise group (n=10). Exercises were performed for 1 hour, twice weekly, for 8 weeks. The strength of the lumbar extensors was measured at various angles ranging from 0° to 72° at intervals of 12°, using a MedX. The visual analog scale (VAS) and the Oswestry Low Back Pain Disability Questionnaire (ODQ) were used to measure the severity of LBP and functional disability before and after the exercise.Results Compared with the baseline, lumbar extension strength at all angles improved significantly in both groups after 8 weeks. The improvements were significantly greater in the lumbar stabilization exercise group at 0° and 12° of lumbar flexion. VAS decreased significantly after treatment; however, the changes were not significantly different between the groups. ODQ scores improved significantly in the stabilization exercise group only. Conclusion Both lumbar stabilization and dynamic strengthening exercise strengthened the lumbar extensors and reduced LBP. However, the lumbar stabilization exercise was more effective in lumbar extensor strengthening and functional improvement in patients with nonspecific chronic LBP.
Abstract
Objective To compare the effects of lumbar stabilization exercises and lumbar dynamic strengthening exercises on the maximal isometric strength of the lumbar extensors, pain severity and functional disability in patients with chronic low back pain (LBP).Methods Patients suffering nonspecific LBP for more than 3 months were included prospectively and randomized into lumbar stabilization exercise group (n=11) or lumbar dynamic strengthening exercise group (n=10). Exercises were performed for 1 hour, twice weekly, for 8 weeks. The strength of the lumbar extensors was measured at various angles ranging from 0° to 72° at intervals of 12°, using a MedX. The visual analog scale (VAS) and the Oswestry Low Back Pain Disability Questionnaire (ODQ) were used to measure the severity of LBP and functional disability before and after the exercise.Results Compared with the baseline, lumbar extension strength at all angles improved significantly in both groups after 8 weeks. The improvements were significantly greater in the lumbar stabilization exercise group at 0° and 12° of lumbar flexion. VAS decreased significantly after treatment; however, the changes were not significantly different between the groups. ODQ scores improved significantly in the stabilization exercise group only. Conclusion Both lumbar stabilization and dynamic strengthening exercise strengthened the lumbar extensors and reduced LBP. However, the lumbar stabilization exercise was more effective in lumbar extensor strengthening and functional improvement in patients with nonspecific chronic LBP.
참고문헌 (26)
- Rozenberg S., "Chronic low back pain : definition and treatment", Rev Prat, 58, pp.265~272 (2008)
- Lawrence JP., "Back pain in athletes", J Am Acad Orthop Surg, 14, pp.726~735 (2006)
- Davies JE., "The value of exercises in the treatment of low back pain", Rheumatol Rehabil, 18, pp.243~247 (1979)
- Manniche C., "Intensive dynamic back exercises for chronic low back pain : a clinical trial", Pain, 47, pp.53~63 (1991)
- McKenzie RA., "Prophylaxis in recurrent low back pain", N Z Med J, 89, pp.22~23 (1979)
- Plum P., "Treatment of acute and chronic back pain with muscular exercises", Ugeskr Laeger, 147, pp.1604~1611 (1985)
- Martin PR., "Physiotherapy exercises for low back pain : process and clinical outcome", Int Rehabil Med, 8, pp.34~38 (1986)
- Mellin G., "Treatment of patients with chronic low back pain : comparison between rehabilitation centre and outpatient care", Scand J Rehabil Med, 16, pp.77~84 (1984)
- Carpenter DM., "Low back strengthening for the prevention and treatment of low back pain", Med Sci Sports Exerc, 31, pp.18~24 (1999)
- Dettori JR., "The effects of spinal flexion and extension exercises and their associated postures in patients with acute low back pain", Spine(Phila Pa 1976), 20, pp.2303~2312 (1995)
- O’Sullivan PB., "Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis", Spine(Phila Pa 1976), 22, pp.2959~2967 (1997)
- Standaert CJ., "Evidenceinformed management of chronic low back pain with lumbar stabilization exercises", Spine J, 8, pp.114~120 (2008)
- Panjabi MM., "The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement", J Spinal Disord, 5, pp.383~389 (1992)
- Urquhart DM., "Differential activity of regions of transverses abdominis during trunk rotation", Eur Spine J, 14, pp.393~400 (2005)
- Richardson CA., "Muscle control-pain control. What exercises would you prescribe?", Man Ther, 1, pp.2~10 (1995)
- Robinson ME., "Reliability of lumbar isometric torque in patients with chronic low back pain", Phys Ther, 72, pp.186~190 (1992)
- Jensen MP., "Interpretation of visual analog scale ratings and change scores : a reanalysis of two clinical trials of postoperative pain", J Pain, 4, pp.407~414 (2003)
- Richardson CA., "The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain", Spine(Phila Pa 1976), 27, pp.399~405 (2002)
- Fritz JM., "A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale", Phys Ther, 81, pp.776~788 (2001)
- Hodges PW., "Contraction of the abdominal muscles associated with movement of the lower limb", Phys Ther, 77, pp.132~142 (1997)
- Panjabi M., "Spinal stability and intersegmental muscle forces : a biomechanical model", Spine(Phila Pa 1976), 14, pp.194~200 (1989)
- Graves JE., "Effect of training frequency and specificity on isometric lumbar extension strength", Spine(Phila Pa 1976), 15, pp.504~509 (1990)
- Sanderson PL., "Compensation, work status, and disability in low back pain patients", Spine(Phila Pa 1976), 20, pp.554~556 (1995)
- Ferreira ML., "Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain : a randomized trial", Pain, 131, pp.31~37 (2007)
- Cairns MC., "Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain", Spine (Phila Pa 1976), 31, pp.E670~E681 (2006)
- Cynn HS., "Effects of lumbar stabilization using a pressure biofeedback unit on muscle activity and lateral pelvic tilt during hip abduction in sidelying", ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 87, pp.1454~1458 (2006), W B SAUNDERS CO-ELSEVIER INC
