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http://dx.doi.org/10.13066/kspm.2018.13.4.113

The Effects of Sling and Resistance Exercises on Muscle Activity and Pelvic Rotation Angle During Active Straight Leg Raises and Pain in Patients with Chronic Low Back Pain  

Kim, Dae-Hyun (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
Kim, Tae-Ho (Department of Physical Therapy, Daegu University)
Publication Information
Journal of the Korean Society of Physical Medicine / v.13, no.4, 2018 , pp. 113-121 More about this Journal
Abstract
PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.
Keywords
ASLR; EMG; Pelvic rotation angle; Resistance exercises; Sling exercises;
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1 Hungerford B, Gilleard W, Lee D. Altered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers. Clin Biomech (Bristol, Avon). 2004;19(5):456-64.   DOI
2 Johnson EN, Thomas JS. Effect of Hamstring Flexibility on Hip and Lumbar Spine Joint Excursions During Forward Reaching Tasks in Individuals With and Without Low Back Pain. Arch Phys Med Rehabil. 2010;91(7):1140-2.   DOI
3 Kang HK, Jung JH, Yu JH. Comparison of Trunk Muscle Activity During Bridging Exercises Using a Sling in Patients with Low Back Pain. J Sports Sci Med. 2012;11(3):510-5.
4 Kendall F, McCreary E, Provance P. Muscle testing and function 4th edition. Baltimore. Williams and Wilkins. 1993.
5 Kim GY, Kin SH. Effects of Push-ups Plus Sling Exercise on Muscle Activation and Cross-sectional Area of the Multifidus Muscle in Patients with Low Back Pain. J Phys Ther Sci. 2013;25(12):1575-8.   DOI
6 Kim TH. Factors influencing pelvic and trunk motions during one-leg standing. Dissertation of Doctor degree, Yonsei University. 2010.
7 Kirkesola G. Neurac-a new treatment method for long-term musculoskeletal pain. the journal Fysioterapeuten. 2009;76(12):16-25.
8 Kong KW. Effects of Bridging Exercise using Vibration Stimulation and ADIMs on the Lengthening and Thickness of Transversus abdominis in Healthy Adults. J Kor Phys Ther. 2016;28(6):393-7.   DOI
9 Lamoth CJ, Meijer OG, Wuisman PI, et al. Pelvis-Thorax Coordination in the Transverse Plane During Walking in Persons With Nonspecific Low Back Pain. Spine. 2002;7(4):92-9.
10 Lee SB, Cho WJ. The effect of sling exercise on sagittal lumbosacral angle and intervertebral disc area of chronic low back pain patients. J Exerc Rehabil. 2016;12(5):471-5.   DOI
11 Vleeming A, Mooney V, Stoeckart R. Movement Stability and Lumbopelvic Pain (2nd ed). Churchill Livingstone. 2007.
12 Wiltse L, Rothman S. Spondylolisthesis: Classification, diagnosis and natural history. Semin Spine Surg. 1989;1(1):78-94.
13 Winter DA. Biomechanics and motor control of human movement. Hoboken, john Wiley & Sons, Inc. 2009.
14 Yu CW, Kim SY. Comparison of Lumbopelvic Rotation Angle during Active Straight Leg Raise in Patients with Chronic Low Back Pain with and without Lumbar Segmental Instability. J Korean Soc Phys Med. 2015;10(4):39-48.   DOI
15 Meeus M, Roussel NA, Truijen S, et al. Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: An experimental study. J Rehabil Med. 2010;42(9): 884-90.   DOI
16 Lehman GJ, McGill SM. Quantification of the differences in electromyographic activity magnitude between the upper and lower portions of the rectus abdominis muscle during selected trunk exercises. Phys Ther. 2001;81(5):1096-101.
17 Liebenson C, Karpowicz M, Brown HM, et al. The active straight leg raise test and lumbar spine stability. PM R. 2009;1(6):530-5.   DOI
18 Liebenson C. Rehabilitation of the spine: a practitioner's manual. 2nd Ed. Baltimore. Lippincott Williams & Wilkins. 2006.
19 Lopez-Minarro PA, Muyor JM, Belmonte F, et al. Acute effects of hamstring stretching on sagittal spinal curvatures and pelvic tilt. J Hum Kinet. 2012;31(1):69-78.
20 Luoma K, Vehmas T, Kerttula L, et al. Chronic low back pain in relation to Modic changes, bony endplate lesions, and disc degenerationin a prospective MRI study. Eur Spine J. 2016;25(9):2873-81.   DOI
21 Mens JM, Vleeming A, Snijders CJ, et al. Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy. Spine (Phila Pa 1976). 2001;26(10):1167-71.   DOI
22 Neuman DA. Kinesiology of the musculoskeletal system. Foundations for physical rehabilitation. USA. Mosby. 2002.
23 Ng JK, Richardson CA, Parnianpour M, et al. EMG activity of trunk muscles and torque output during isometric axial rotation exertion: a comparison between back pain patients and matched controls. J Orthop Res. 2002;20(1):112-21.   DOI
24 Dankaerts W, O'sullivan PB, Burnett AF, et al. Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients. J Electromyogr Kinesiol. 2004;14(3):333-42.   DOI
25 Ainscough-Potts AM, Morrissey MC, Critchley D. The response of the transverse abdominis and internal oblique muscle to different postures. Man Ther. 2006;11(1): 54-60.   DOI
26 Akuthota V, Ferreiro A, Moore T, et al. Core Stability Exercise Principles. Curr Sports Med Rep. 2008;7(1):39-44.   DOI
27 Bak JW, Shim SY, Cho MK, et al. The effect of plank exercises with hip abduction using sling on trunk muscle activation in healthy adults. J Kor Phys Ther. 2017;29(3):128-34.   DOI
28 Cholewicki J, Simons AP, Radebold A. Effects of external trunk loads on lumbar spine stability. J Biomech. 2000;33(11):1377-85.   DOI
29 Cram JR, Kasman GS, Holtz J. Introduction to Surface Electromyography. Gaithersburg. Aspen Publishers. 1998.
30 Hakkinen K, Kallinen M, Izquierdo M, et al. Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people. J Appl Physiol. 1998;84(4):1341-9.   DOI
31 Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10(5):361-74.   DOI
32 Hicks GE, Fritz JM, Delitto A, et al. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005;86(9):1753-62.   DOI
33 Hoffman SL, Johnson MB, Zou D, et al. Effect of classificationspecific treatment on lumbopelvic motion during hip rotation in people with low back pain. Man Ther. 2011;16(4):344-50.   DOI
34 Persson AL, Hansson GA, Kalliomaki A, et al. Pressure pain thresholds and electromyographically defined muscular fatigue induced by a muscular endurance test in normal women. Clin J Pain. 2000;16(2):155-63.   DOI
35 Saeterbakken A, Andersen V, Brudeseth A, et al. The Effect of Performing Bi- and Unilateral Row Exercises on Core Muscle Activation. Int J Sport Med. 2015; 36(11):900-5.   DOI
36 Richardson C, Hodges P, Hides J. Therapeutic exercise for lumbopelvic stabilization. A motor control approach for the treatment and prevention of low back pain (2nd ed). Churchill Livingstone. 2005.
37 Roh HS, Cho WJ, Ryu WJ, et al. The change of pain and lumbosacral sagittal alignment after sling exercise therapy for patients with chronic low back pain. J Phys Ther Sci. 2016;28(10):2989-92.
38 Roussel NA, Nijs J, Truijen S, et al. Low back pain: Clinimetric properties of the trendelenburg test, active straight leg raise test, and breathing pattern during active straight leg raising. J Manipulative Physiol Ther. 2007;30(4):270-8.   DOI
39 Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis. Mosby. 2002.
40 Unsgaard-Tondel M, Fladmark AM, Oyvind SO Vasseljen. Motor Control Exercises, Sling Exercises, and General Exercises for Patients With Chronic Low Back Pain: A Randomized Controlled Trial With 1-Year Follow-up. Physical Therapy. 2010;90(10):1426-40.   DOI
41 van den Hoorn W, Bruijn SM, Meijer OG, et al. Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain. J Biomech. 2012;45(2):342-7.   DOI
42 Van Dillen LR, Sahrmann SA, Norton BJ, et al. The effect of modifying patient-preferred spinal movement and alignment during symptom testing in patients with low back pain: A preliminary report. Arch Phys Med Rehabil. 2003;84(3):313-22.   DOI