The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Efficacy of Lumbar Segmental Stabilization Exercises and Breathing Exercises on Segmental Stabilization in Lumbar Instability Patients

  • Yang, Sung Rae (Department of Rehabilitation Science, Graduate school, Daegu University) ;
  • Kim, Young Mi (Department of Rehabilitation Science, Graduate school, Daegu University) ;
  • Park, Sun Ja (Department of Rehabilitation Science, Graduate school, Daegu University) ;
  • Kim, Cheol Yong (Department of Physical Therapy, Ulsan College)
  • Received : 2017.09.07
  • Accepted : 2017.10.18
  • Published : 2017.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to determine the effectiveness of breathing exercises and lumbar segmental exercises on the segmental stability of patients with chronic back pain. Methods: Fifty-nine patients, who suffered from chronic low back pain, were enrolled in this examination. They were divided randomly into three groups: experiment group 1 underwent breathing and segmental stabilization exercises (n=20), experiment group 2 experienced segmental stabilization exercises (n=20), and the control group was given the modality treatment (n=19). The measurements were assessed through an Oswestry disability questionnaire (ODQ), as well as a lumbar segmental instability test (LSIT). Results: The ODQ results for experimental groups 1 and 2 were similar (p<0.05), both before and after six weeks of exercise, but different among the three groups (p>0.05). The differences in segmental instability of each of the three groups were similar (p<0.05), and also similar among the three groups (p<0.05). Conclusion: These findings suggest that lumbar segmental stabilization exercises are efficient in increasing the segmental stability and alleviating pain in patients with chronic back pain. Additional studies on this subject will be needed to improve the clinical applications in the future.

Keywords

References

  1. Wallden M. The neutral spine principle. J Bodyw Mov Ther. 2009;13(4):350-61. https://doi.org/10.1016/j.jbmt.2009.07.006
  2. Demoulin C, Distree V, Tomasella M et al. Lumbar functional instability: a critical appraisal of the literature. Ann Readapt Med Phys. 2007;50(8):677-84, 669-76. https://doi.org/10.1016/j.annrmp.2007.05.007
  3. Cook C, Brismee JM, Sizer PS Jr. Subjective and objective descriptors of clinical lumbar spine instability: a delphi study. Man Ther. 2006;11(1):11-21. https://doi.org/10.1016/j.math.2005.01.002
  4. Kim SJ, Ko MJ, Lee YS et al. Unusual clinical presentations of cervical or lumbar dorsal ramus syndrome. Korean J Spine. 2014;11(2):57-61. https://doi.org/10.14245/kjs.2014.11.2.57
  5. O'Sullivan PB, Phyty GD, Twomey LT et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22(24):2959-67. https://doi.org/10.1097/00007632-199712150-00020
  6. Jung DE, Kim K, Lee SK. Comparison of muscle activities using a pressure biofeedback unit during abdominal muscle training performed by normal adults in the standing and supine positions. J Phys Ther Sci. 2014;26(2):191-3. https://doi.org/10.1589/jpts.26.191
  7. Stevens VK, Bouche KG, Mahieu NN et al. Trunk muscle activity in healthy subjects during bridging stabilization exercises. BMC Musculoskelet Disord. 2006;7:75. https://doi.org/10.1186/1471-2474-7-75
  8. Marshall PW, Murphy BA. Core stability exercises on and off a Swiss ball. Arch Phys Med Rehabil. 2005;86(2):242-9. https://doi.org/10.1016/j.apmr.2004.05.004
  9. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S86-92.
  10. Panjabi MM. The stabilizing system of the spine. Part i. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-9. https://doi.org/10.1097/00002517-199212000-00001
  11. Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine. 1989;14(4):431-7. https://doi.org/10.1097/00007632-198904000-00018
  12. Nouwen A, Van Akkerveeken PF, Versloot JM. Patterns of muscular activity during movement in patients with chronic low-back pain. Spine. 1987;12(8):777-82. https://doi.org/10.1097/00007632-198710000-00012
  13. Kim K, Park RJ, Bae SS. Effect of diaphragmatic breathing exercise on activation of trunk muscle of patients with low back pain. J Kor Soc Phys Ther . 2005;17(3):311-27.
  14. Vera-Garcia FJ, Elvira JL, Brown SH et al. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. 2007;17(5):556-67. https://doi.org/10.1016/j.jelekin.2006.07.004
  15. Mehling WE, Hamel KA, Acree M et al. Randomized, controlled trial of breath therapy for patients with chronic low-back pain. Altern Ther Health Med. 2005;11(4):44-52.
  16. Kolar P, Neuwirth J, Sanda J et al. Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using mri synchronized with spirometry. Physiol Res. 2009;58(3):383-92.
  17. Perri MA, Halford E. Pain and faulty breathing: a pilot study. J Bodyw Mov Ther. 2004;8(4):297-306. https://doi.org/10.1016/S1360-8592(03)00085-8
  18. Smith MD, Russell A, Hodges PW. Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Aust J Physiother. 2006;52(1):11-6. https://doi.org/10.1016/S0004-9514(06)70057-5
  19. Mechling H. Physical activity, sport and successful aging. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2005;48(8):899-905. https://doi.org/10.1007/s00103-005-1105-7
  20. Fairbank JC, Couper J, Davies JB et al. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-3.
  21. Fairbank J. Revised Oswestry disability questionnaire. Spine. 2000;25(19):2552. https://doi.org/10.1097/00007632-200010010-00025
  22. Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000;25(22):2940-52. https://doi.org/10.1097/00007632-200011150-00017
  23. Jeon CH, Kim DJ, Kim SK et al. Validation in the cross-cultural adaptation of the korean version of the Oswestry disability index. J Korean Med Sci. 2006;21(6):1092-7. https://doi.org/10.3346/jkms.2006.21.6.1092
  24. Tidstrand J, Horneij E. Inter-rater reliability of three standardized functional tests in patients with low back pain. BMC Musculoskelet Disord. 2009;10:58. https://doi.org/10.1186/1471-2474-10-58
  25. Jones AY, Dean E, Chow CC. Comparison of the oxygen cost of breathing exercises and spontaneous breathing in patients with stable chronic obstructive pulmonary disease. Phys Ther. 2003;83(5):424-31.
  26. Cairns MC, Harrison K, Wright C. Pressure biofeedback: a useful tool in the quantification of abdominal muscular dysfunction? Physiotherapy. 2000;86(3):127-38. https://doi.org/10.1016/S0031-9406(05)61155-8
  27. Arokoski JP, Valta T, Airaksinen O et al. Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil. 2001;82(8):1089-98. https://doi.org/10.1053/apmr.2001.23819
  28. O'Sullivan PB. Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Man Ther. 2000;5(1):2-12. https://doi.org/10.1054/math.1999.0213
  29. Fritz JM, Whitman JM, Childs JD. Lumbar spine segmental mobility assessment: an examination of validity for determining intervention strategies in patients with low back pain. Arch Phys Med Rehabil. 2005;86(9):1745-52. https://doi.org/10.1016/j.apmr.2005.03.028
  30. McGill SM. Low back exercises: evidence for improving exercise regimens. Phys Ther. 1998;78(7):754-65. https://doi.org/10.1093/ptj/78.7.754
  31. Kliziene I, Sipaviciene S, Klizas S et al. Effects of core stability exercises on multifidus muscles in healthy women and women with chronic lowback pain. J Back Musculoskelet Rehabil. 2015;28(4):841-7. https://doi.org/10.3233/BMR-150596
  32. Javadian Y, Behtash H, Akbari M et al. The effects of stabilizing exercises on pain and disability of patients with lumbar segmental instability. J Back Musculoskelet Rehabil. 2012;25(3):149-55. https://doi.org/10.3233/BMR-2012-0321
  33. Ferreira PH, Ferreira ML, Maher CG et al. Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. Br J Sports Med. 2010;44(16):1166-72. https://doi.org/10.1136/bjsm.2009.061515
  34. Lee SJ, Kim YM. The effects of gluteal muscle exercises combined lumbar stabilization on lumbar stability in chronic low back pain patients with lumbar instability. J Kor Soc Phys Med. 2013;8(1):29-39. https://doi.org/10.13066/kspm.2013.8.1.029
  35. O'Sullivan PB, Beales DJ. Changes in pelvic floor and diaphragm kinematics and respiratory patterns in subjects with sacroiliac joint pain following a motor learning intervention: a case series. Manual therapy. 2007;12(3):209-18. https://doi.org/10.1016/j.math.2006.06.006
  36. Gandevia SC, Butler JE, Hodges PW et al. Balancing acts: respiratory sensations, motor control and human posture. Clin Exp Pharmacol Physiol. 2002;29(1-2):118-21. https://doi.org/10.1046/j.1440-1681.2002.03611.x
  37. Urquhart DM, Barker PJ, Hodges PW et al. Regional morphology of the transversus abdominis and obliquus internus and externus abdominis muscles. Clin Biomech. 2005;20(3):233-41. https://doi.org/10.1016/j.clinbiomech.2004.11.007
  38. Ebenbichler GR, Oddsson LI, Kollmitzer J et al. Sensory-motor control of the lower back: Implications for rehabilitation. Med Sci Sports Exerc. 2001;33(11):1889-98. https://doi.org/10.1097/00005768-200111000-00014

Cited by

  1. Effectiveness of Iliopsoas Self-Stretching on Hip Extension Angle, Gluteus Maximus Activity, and Pelvic Compensations during Prone Hip Extension in Subjects with Iliopsoas Shortness vol.30, pp.1, 2017, https://doi.org/10.18857/jkpt.2018.30.1.23
  2. Effect of Plank Exercise Combined with Breathing and Arm Exercises on Abdominal Muscle Thickness vol.31, pp.4, 2019, https://doi.org/10.18857/jkpt.2019.31.4.193
  3. 능동이완기법이 만성 허리통증 환자의 통증, 요통장애지수 및 골반비대칭에 미치는 영향 vol.15, pp.1, 2020, https://doi.org/10.13066/kspm.2020.15.1.133
  4. Effect of early stabilization exercise focused on the scapulothoracic joint on the recovery of surgical patients due to rotator cuff tear vol.32, pp.1, 2020, https://doi.org/10.18857/jkpt.2020.32.1.14
  5. Effects of Lumbar Stabilization Exercise on the Strength, Range of Motion and Pain vol.11, pp.4, 2017, https://doi.org/10.20540/jiaptr.2020.11.4.2229
  6. 보존적 물리치료를 동반한 근막이완술이 급성기 교통사고 환자의 허리통증, 관절운동범위, 신체기능에 미치는 영향 vol.16, pp.1, 2017, https://doi.org/10.13066/kspm.2021.16.1.93