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

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

Effects of Pilates Stabilization Exercise combined with Pain Neurosicence Education on Pain, Disability Index, and Physichosocial Factor in Patients with Chronic Back Pain

통증신경과학 교육을 결합한 필라테스 안정화 운동이 만성요통 환자의 통증 정도, 장애지수, 심리적 요인에 미치는 영향

  • O-kook Kwon (Dept. of Physical Therapy, Pila In Fit Academy) ;
  • Ji-young Yoo (Dept. of Physical Therapy, Pila In Fit Academy) ;
  • Chan-ho Pack (Dept. of Physical Therapy, Bareun Sling Exercise Cernter) ;
  • Yeong-sik Yang (Dept. of Physical Therapy, Woo Ju Pain Clinic) ;
  • Dal-yeong Yu (Dept. of Physical Therapy, OPT Exercise Center)
  • Received : 2024.03.23
  • Accepted : 2024.04.25
  • Published : 2024.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study conducted a comparative evaluation of the effects of Pilates stabilization exercise combined with pain neuroscience education (PNE) in patients with chronic low back pain. The evaluation was based on their visual analogue scale (VAS) scores, Korean Oswestry disability index (KODI) scores, and fear avoidance belief questionnaire (FABQ) scores. Methods: A total of 36 participants were recruited and randomly assigned to either a Pilates stabilization exercise group (PSE, n=18) or Pilates stabilization exercise combined with pain neuroscience education group (PPNE, n=18). Both the PSE and PPNE groups participated in 50-minute sessions of Pilates stabilization exercise, three times per week for six weeks. The VAS, KODI, and FABQ scores of the participants were measured before and after the intervention. Results: There were significant improvements in the VAS of the PSE and PPNE group, with significant difference found between them. Both groups showed a significant decline in KODI scores following the exercise interventions, with significant difference observed between the two groups. FABQ scores were significantly decline in both groups, with significant difference found between them. Conclusion: In this study, Pilates stabilization exercise combined with pain neuroscience education was found to be more effective than Pilates stabilization exercise alone in reducing the VAS, KODI, and FABQ scores of patients with chronic low back pain. Thus, Pilates stabilization exercise combined with pain neuroscience education can be used in clinical practice to treat and prevent chronic lower back pain.

Keywords

References

  1. Asenlof P, Soderlund A. A further investigation of theimportance of pain cognition and behaviour in pain rehabilitation: longitudinaldata suggest disability and fear of movement are most important. Clin Rehabil. 2010;24(5):422-430. https://doi.org/10.1177/0269215509353264. 
  2. Akuthota V, Nadler SF. Core strengthening. Arc of Phys Med Rehabil. 2004;85(S1):86-92. https://doi.org/10.1053/j.apmr.2003.12.005. 
  3. Barr KP, Griggs M, Cadby T. Lumbar stabilization: Coreconcepts and current literature, Part 1. Am J Phys Med Rehabil. 2005;84(6):473-480. https://doi.org/10.1097/01.phm.0000163709.70471.42. 
  4. Bodes Pardo G, Lluch Girbes E, Roussel NA,et al. Neurophysiology education and therapeutic exercise for patients with chronic low back Pain: A single-blindrandomized controlled Trial. Arch Phys Med Rehabil. 2018;99(2):338-347. https://doi.org/10.1016/j.apmr.2017.10.016. Epub 2017 Nov 11. 
  5. Fletcher C, Bradnam L, Barr C. The relationship between knowledge of pain neurophysiology and fear avoidance inpeople with chronic pain: A point in time, observational study. Physiother. Theory Pract. 2016;32(4):271-276 https://doi.org/10.3109/09593985.2015.1138010. 
  6. Hodges PW. Core stability exercise in chronic low back pain. Orthop Clin North Am. 2003;34(2):245-254. https://doi.org/10.1016/s0030-5898(03)00003-8. 
  7. Hjermstad MJ,Fayers PM, Haugen DF, et al. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: A systematic literature review. J Pain Symptom Manage. 2011;41(6):1073-1093 https://doi.org/10.1016/j.jpainsymman. 
  8. Javdaneh N, Saeterbakken AH, Shams A, et al. Pain neuroscience education combined with therapeutic exercises provides added benefit in the treatment of chronic neck pain. Int J Environ Res Public Health. 2021;18(16):8848. https://doi.org/10.3390/ijerph18168848 . 
  9. Joseph HP, William JM. Your Health & Return to Life Through Contrology. Allan Menezes and The Pilates Institute of Australasia. 2002.
  10. Kim DY, Lee SH, Lee HY, et al. Validation of the Korean version of the Oswestry disability index. Spine. 2005;30(5):123-127. https://doi.org/10.1097/01.brs.0000157172.00635.3a.PMID:15738775. 
  11. Lee, CW, Kim SG, Hyun J, et al. Influence of pilates mat and apparatus exercises on pain and balance of businesswomen with chronic low back pain. J Phys Ther Sci. 2014;26(4):475-477. https://doi.10.1589/jpts.26.475. 
  12. Lin HT, Hung WC, Hung JL, et al. Effects of pilates on patients with chronic non-specific low back pain: A systematic review. J Phys Ther 2016;28(10):2961-2969. https://doi.org/10.1589/jpts.28.2961. 
  13. Louw A, Diener I, Butler DS, et al. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011;92(12):2041-2056. https://doi.org/10.1016/j.apmr.2011.07.198. 
  14. Louw A, Farrell K, Choffin B, et al. Immediate effect of pain neuroscience education for recentons et low back pain: An exploratory single arm trial. J Man Manip Ther, 2019;27(5):267-276. 
  15. Malfliet A, Kregel J, Coppieters I, et al. Effect of pain neuroscience education combined with cognition-targeted motor control training on chronic spinal pain: A randomized clinical trial. JAMANeurol. 2018;75(7):808-817. https://doi.org/10.1001/jamaneurol.2018.0492. 
  16. McCracken LM, Turk DC. Behavioral and cognitive-behavioral treatment for chronic pain: outcome, predictors of outcome, and treatment process. Spine. 2002;27(22):2564-2573. https://doi.org/10.1097/00007632-200211150-00033. 
  17. Melzack R. Pain and the neuromatrix in the brain. J Dent Educ. 2001;65(12):1378-1382. https://doi.org/10.1002/j.0022-0337.2001.65.12.tb03497. 
  18. Mousavi SJ, Parnianpour M, Mehdian H, et al. The Oswestry disability index, the Roland-Morris disability questionnaire, and the Quebec back pain disability scale: Translation and validation studies of the Iranian versions. Spine. 2006;31(14):454-459. https://doi.org/10.1097/01.brs.0000222141.61424.f7 
  19. Nijs J, Meeus M, Cagnie B, et al. A modern neuroscience approach to chronic spinal pain: Combining pain neuroscience education with cognition-targeted motor control training. Phys Ther. 2014;94:730-738. https://doi.org/10.2522/ptj.20130258.Epub2014 Jan30. 
  20. Oktaviani I. Pilates workouts can reduce pain in pregnant women. Complement Ther Clin Prac. 2018;31:349-351. https://doi.org/10.1016/j.ctcp.2017.11.007. 
  21. Radebold A, Cholewicki J, Polzhofer GK, et al. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976). 2001;26(7):724-730. https://doi.org/10.1097/00007632-200104010-00004. 
  22. Rabiei P, Sheikhi B, Letafatkar A. comparing pain neuroscience education followed by motor control exercises with group-based exercises for chronic low back pain: A randomized controlled trial. pain pract. 2021;21(3):333-342. https://doi.org/10.1111/papr.12963.Epub 2020Nov 21. 
  23. Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: arandomized controlled trial. J Ortho Sports Phys Ther. 2006;36(7):472-484. https://www.jospt.org/doi/10.2519/jospt.2006. 
  24. Saracoglu I, Arik MI, Afsar E, et al. The effectiveness of pain neuroscience education combined with manual therapy and home exercise for chronic low back pain: A single-blind randomized controlled trial. Physiother Theory Pract. 2022;38(7):868-878. https://doi.org/10.1080/09593985.2020.1809046.Epub 2020 Aug 19. 
  25. Sterling M, Jull G, Vicenzino B, et al. Sensory hypersensitivity occurs soon after whiplash injury and is associated with poor recovery. Pain. 2003;104(3):509-517. https://doi.org/10.1016/S0304-3959(03)00078-2. 
  26. Watson JA, Ryan CG, Cooper L, et al. Pain Neuroscience education for adults with chronic musculoskeletal pain: A mixed-methods systematic review and meta-analysis. J Pain. 2019;20(10):1140. https://doi.org/10.1016/j.jpain.2019.02.011.Epub 2019 Mar 1. 
  27. Waddell G,Newton M, Henderson I, et al. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52(2):157-68. https://doi.org/10.1016/0304-3959(93)90127-B.