The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
권호 표지

Effects of Thoracic and Hip Joint Mobility Exercise and Lumbar Stability Exercise on Pain and Balance in Women with Chronic Back Pain

등뼈와 엉덩관절 가동성운동을 겸한 허리 안정성 운동이 만성 허리통증 여성 환자들의 통증과 균형에 미치는 영향

  • Yun-kyung Choi (Dept. of Physical Therapy, Graduate School Korea National University of Transportation) ;
  • Yong-min Kim (Dept. of Physical Therapy, Korea National University of Transportation)
  • 최윤경 (한국교통대학교 일반대학원 물리치료학과) ;
  • 김영민 (한국교통대학교 일반과학대학 물리치료학과)
  • Received : 2023.04.04
  • Accepted : 2023.06.03
  • Published : 2023.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The purpose of this study was to evaluate the pain, static balance, and dynamic balance abilities of women with chronic low back pain by performing thoracic and hip joint mobility exercises and lumbar stability exercises. Methods: The subjects of this study were 20 adult women with low back pain who lived in C city for more than 12 weeks. The experimental group performed the thoracic and hip mobility exercises with lumbar stability exercises and the control group performed the lumbar stability exercise with general exercise program. Both groups participated in the exercise program three times a week for six weeks, from December 20, 2022 to March 7, 2023. The balance ability were measured using BT4, and pain was measured using visual analog scale (VAS). The collected data were analyzed by independent sample t-test and paired t-test using SPSS version 23.0 program. Results: After 6 weeks of intervention, there was a significant change in VAS between the experimental group and the control group, and there was no difference between the two groups (p>.05). In the case of balance ability, there was a no significant increase in the experimental group (p>.05). Conclusion: Thoracic and hip joint mobility exercises and lumbar stability exercises for adult female patients with chronic low back pain may be partially effective in static balance and dynamic balance.

Keywords

References

  1. Akuthota V, Nadler S. Core strengthening. Arch Rehabil Res Clin Transl. 2004;85:S82-92. https://doi.org/10.1053/j.apmr.2003.12.005
  2. Alqarni AM, Schneiders AG, Hendrick PA. Clinical tests to diagnose lumbar segmental instability: A systematic review. JOSPT Cases.2011;41(3):130-140. https://www.jospt.org/doi/10.2519/jospt.2011.3457
  3. Baek IH. The Effects of Indirect Thoracic Joint Mobilization on Thoracolumbar Proprioception, Active Range of Motion, Pain, and Disability in Patients with Chronic Low Back Pain. Konyang University. Doctoral Dissertation. 2015.
  4. Boonstra AM, Preuper HRS, Reneman MF, et al. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165-169. https://doi.org/10.1097/MRR.0b013e3282fc0f93
  5. Burns SA, Mintken PE, Austin GP. Clinical decision making in a patient with secondary hip-spine syndrome. Physiother Theory Pract. 2011;27(5):384-397. https://doi.org/10.3109/09593985.2010.509382
  6. Choi JS. The Effect of Thoracic Vertebrae Mobility through Sling on Static and Dynamic Balance in Patients with Chronic Low Back Pain. Graduate School of Dongshin University. Master Thesis. 2015.
  7. Chuter VH, de Jonge XAJ. Proximal and distal contributions to lower extremity injury: A review of the literature. Gait Posture. 2012;36(1):7-15. https://doi.org/10.1016/j.gaitpost.2012.02.001
  8. Desai I, Marshall PW. Acute effect of labile surfaces during core stability exercises in people with and without low back pain. J Electromyogr Kinesiol. 2010;20(6):1155-1162. https://doi.org/10.1016/j.jelekin.2010.08.003
  9. Donelson R. Is your client's back pain "Rapidly reversible"? improving low back care at its foundation: Prof Case Manag. 2008;13(2):87-96. https://doi.org/10.1097/01.PCAMA.0000314179.09285.5a
  10. Fon GT, Pitt MJ, Thies Jr AC. Thoracic kyphosis: Range in normal subjects. AJR Am J Roentgenol. 1980;134(5):979-983. https://doi.org/10.2214/ajr.134.5.979
  11. GO JH. Effect of Combined Intervention of Lumbar Stabilization and Lower Extremity Strength Exercise on Lumbar Pain-related and Physical Function Factors of Middle-aged Women with Chronic Back Pain. Konkuk University. Master Thesis 2021.
  12. Grimshaw PN, Burden AM. Case report: Reduction of low back pain in a professional golfer. Med Sci Sports Exerc. 2000;32(10):1667-1673. https://doi.org/10.1097/00005768-200010000-00001
  13. Hart JM, Fritz JM, Kerrigan DC, et al. Quadriceps inhibition after repetitive lumbar extension exercise in persons with a history of low back pain. J Athl Train. 2006;41(3):264. PMC1569566
  14. Han JH, Lee HJ. The Effect of ankle balance traning on unstable and stable surface on proprioception, balance and muscle strength in obese middle-aged woman. KSIM. 2018;6.3:59-71.
  15. Heneghan NR, Lokhaug SM, Tyros I, et al. Clinical reasoning framework for thoracic spine exercise prescription in sport: A systematic review and narrative synthesis. BMJ Open Sport Exerc Med. 2020;6(1):e000713. http://dx.doi.org/10.1136/bmjsem-2019-000713
  16. Hibbs AE, Thompson KG, French D, et al. Optimizing performance by improving core stability and core strength. Sports Med. 2008;.38(12):995-1008. https://doi.org/10.2165/00007256-200838120-00004
  17. Hides JA, Richardson CA, Jull GA. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine. 1996;21(23):2763-2769. https://doi.org/10.1097/00007632-199612010-00011
  18. Hoy D, March L, Brooks P, et al. The global burden of low back pain: Estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(6):968-974. https://dx.doi.org/10.1136/annrheumdis-2013-204428
  19. Hwang DG. Effects of Thoracic Mobility Exercise on the Range of Motion, Pain, Disability Index, and Quality of Life of Middle-Aged Women with Chronic Low Back Pain. Sahmyook University Graduate School. Master Thesis. 2022.
  20. Janda V. Muscle Function Testing. Elsevier. London. 13-43, 2013.
  21. Jang SH. An Exercise Program to Improve Hip Mobility has an Immediate Effect on the Pain of Amateur Golfers with Chronic Back Pain, Hip and Trunk Rotation Range of Motion Golf performance. Daejeon University. Master Thesis. 2018.
  22. Kim WD. Correlation among Hip Extension range of motion, Hip Extension asymmetry, Pain Intensity, Disability Index, Compensatory Lumbar Movement in Nonspecific Chronic Low Back Pain Patients. Kyungnam University. Master Thesis.
  23. Kisner C, Colby LA, Borstad J. Therapeutic Exercise. Foundations and Techniques. FA Davis. Philadelphia. 491-545, 2017. 
  24. Koes BW, Van TM, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430-1434. https://doi.org/10.1136/bmj.332.7555.1430
  25. Kwon SJ. The Effects of Spinal Mobility Exercise and Lumbar Stabilization Exercise on the range of motion and Balance of the Lumbar Segment in Chronic Back Pain Patients. Hallym University. Master Thesis. 2020.
  26. Luoto S, Aalto H, Taimela S, et al. One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up. Spine. 1998;23(19):2081-2089. https://doi.org/10.1097/00007632-199810010-00008
  27. Magee DJ, Manske RC. Orthopedic Physical Assessment-E-Book. Elsevier Health Sciences. Canada. 7th ed. 765-868, 2020.
  28. Mormile M. Reliability and Validity of the GWalk for Use in Postural Control. Georgia Southern University. Master Thesis. 2017.
  29. 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. https://doi.org/10.1097/00007632-200201150-00013
  30. Panjabimm. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5: 383-383. https://doi.org/10.1097/00002517-199212000-00001
  31. Park DH, Lee YH, Lee GS. Effects of thoracic mobilization exercise program on pain, heart rate variability and depression in patients with chronic low back pain. Journal of The Korean Society of Integrative Medicine. 2019;7(4):161-170. https://doi.org/10.15268/ksim.2019.7.4.161
  32. Park SW. Effects of Autologous Muscle Relaxation and Backbone Mobility Exercise on Pain Disability Index and Backbone Joint Mobility Range of Chronic Back Pain Patients. Master Thesis. 2020.
  33. Park TS, Kuo A, Smith MT. Chronic low back pain: A mini-review on pharmacological management and pathophysiological insights from clinical and pre-clinical data. Inflmmopharmacology. 2018;26(4):881-898. https://doi.org/10.1007/s00586-006-1072-1
  34. Piirainen JM, Avela J, Sippola N, et al. Age dependency of neuromuscular function and dynamic balance control. Eur J Sport Sci. 2010;10(1):69-79. https://doi.org/10.1080/17461390903100254
  35. Pinto RS, Gomes N, Radaelli R, et al. Effect of range of motion on muscle strength and thickness. The Journal of Strength & Conditioning Research. 2012;26(8):2140-2145. https://doi.org/10.1519/JSC.0b013e31823a3b15
  36. Pradhan BB. Evidence-informed management of chronic low back pain with watchful waiting. Spine. 2008;8(1):253-257. https://doi.org/10.1016/j.spinee.2007.10.028
  37. Reiman MP, Weisbach PC, Glynn PE. The hip's influence on low back pain a distal link to a proximal problem. J Sport Rehabil. 2009;18(1):24-32. https://doi.org/10.1123/jsr.18.1.24
  38. Richardson C, Jull G. Muscle control-pain control: What exercises would you prescribe? Man Ther. 1995;1(1):2-10. https://doi.org/10.1054/math.1995.0243
  39. Sadeghisani M, Manshadi FD, Kalantari KK, et al. Correlation between hip rotation range-of -motion impairment and low back pain. A Literature Review. Ortop Traumatol Rehabil. 2015;17(5):455-462. https://doi.org/10.5604/15093492.1186813
  40. Sahrmann S, Azevedo DC, Van Dillen L. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017;21(6):391-399. https://doi.org/10.1016/j.bjpt.2017.08.001
  41. Shamsi M, Mirzaei M, Shahsavari S, et al. Modeling the effect of static stretching and strengthening exercise in lengthened position on balance in low back pain subject with shortened hamstring; A randomized controlled clinical trial. BMC Musculoskelet Disord. 2020;21(1):1-9. https://doi.org/10.1186/s12891-020-03823-z
  42. Shum GL, Crosbie J, Lee RY. Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit. Spine. 2005;30(17):1998-2004. https://doi.org/10.1097/01.brs.0000176195.16128.27
  43. Singer K, Giles L. Manual therapy considerations at the thoracolumbar junction: An anatomical and functional perspective. J Manipulative Physiol Ther. 1990;13(2):83-88.
  44. Sung YB. Effects of Thoracic Mobilization and Manipulation on the Function and Psychology of Patients with Chronic Low Back Pain. Graduate School of Korea National Transportation University. Master's thesis. 2013.
  45. Tully EA, Wagh P, Galea MP. Lumbofemoral rhythm during hip flexion in young adults and children. Spine. 2002;27(20):E432-E440. https://doi.org/10.1097/00007632-200210150-00013
  46. Van Dillen LR, Bloom NJ, Gombatto SP, et al. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Phys Ther Sport. 2008;9(2):72-81. https://doi.org/10.1016/j.ptsp.2008.01.002
  47. Wagner H, Anders C, Puta C, et al. Musculoskeletal support of lumbar spine stability. Pathophysiology. 2005;12(4):257-265. https://doi.org/10.1016/j.pathophys.2005.09.007
  48. Ward SR, Kim CW, Eng CM, et al. Architectural analysis and intraoperative measurements demonstrate the unique design of the multifidus muscle for lumbar spine stability. J Bone Joint Surg Am. 2009;91(1):176. https://doi.org/10.2106/JBJS.G.01311
  49. YU MH. The Effects of Lumbar Stabilization Exercise on Pain, Joint Range of Motion, Muscular Thickness, and Lumbar Function Index of Chronic Back Pain Patients with Lumbar Instability and Lumbar Stabilization. Sahmyook University. Master Thesis. 2017.
  50. YU JH. The Effects of Hip Manual Therapy on Pain, Static, Dynamic Balance, and Psychological Factors of Chronic Low Back Pain Patients. Graduate School Hallym University. Master Thesis. 2014.