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http://dx.doi.org/10.12674/ptk.2015.22.3.001

The Effect of Thoracic Joint Mobilization on Pain, Proprioception and Static Balance in Patients With Chronic Low Back Pain  

Yang, Jin-mo (Dept. of Physical Therapy, The Graduate School, Daejeon University)
Kim, Suhn-yeop (Dept. of Physical Therapy, College of Health & Medical Science, Daejeon University)
Publication Information
Physical Therapy Korea / v.22, no.3, 2015 , pp. 1-11 More about this Journal
Abstract
The purpose of this study was to investigate the effect of lumbar stabilization training and additional thoracic mobilization on pain, proprioception and static balance in patients with chronic low back pain. The subjects of this study were 48 chronic low back pain patients who were randomly allocated to an experimental group 1 ($n_1=16$, lumbar stabilization and thoracic mobilization, thoracic hypomobility), experimental group 2 ($n_2=16$, lumbar stabilization and thoracic mobilization, thoracic normal mobility), and a control group ($n_3=16$, lumbar stabilization, thoracic hypomobility) after a thoracic mobility test. Both experimental groups underwent lumbar stabilization training and additional thoracic mobilization. The control group underwent only lumbar stabilization training. The intervention was performed 3 times per week, 30 minutes each time, for a total of 6 weeks. Thoraco-lumbar joint reposition error was measured using an electrogoniometer and static balance ability was measured using the Tetrax posture analysis system. Subjects' pain level was measured using a 100 mm visual analogue scale. Statistical analyses were performed using a one-way analysis of variance and a paired t-test. Post-hoc testing was carried out with a Bonferroni test. The pain level was significantly lower in both experimental groups compared to the control group. Both experimental groups showed significant reductions in joint reposition error angle (flexion, extension, and side bending) compared to the control group. The static balance level was significantly lower in both experimental groups than in the control group. In summary, lumbar stabilization exercises and additional thoracic mobilization significantly improved the pain level, proprioception, and static balance in patients with chronic low back pain.
Keywords
Low back pain; Thoracic hypomobility; Thoracic mobilization;
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1 Alexander KM, LaPier TL. Differences in static balance and weight distribution between normal subjects and subjects with chronic unilateral low back pain. J Orthop Sports Phys Ther. 1998; 28(6):378-383.   DOI
2 Arokoski JP, Valta T, Airaksinen O, et al. Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil. 2001;82(8): 1089-1098.   DOI
3 Brumagne S, Cordo P, Lysens R, et al. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine (Phila Pa 1976). 2000;25(8): 989-994.   DOI
4 Cleland JA, Glynn P, Whitman JM, et al. Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: A randomized clinical trial. Phys Ther. 2007;87(4):431-440.   DOI
5 Descarreaux M, Blouin JS, Teasdale N. Repositioning accuracy and movement parameters in low back pain subjects and healthy control subjects. Eur Spine J. 2005;14(2):185-191.   DOI
6 Descarreaux M, Dugas C, Lalanne K, et al. Learning spinal manipulation: The importance of augmented feedback relating to various kinetic parameters. Spine J. 2006;6(2):138-145.   DOI
7 Edmond, Susan L. Joint Mobilization/Manipulation: Extremity and spinal techniques. 2nd ed. St Louis, Mosby, 2006:280-307.
8 Franca FR, Burke TN, Hanada ES, et al. Segmental stabilization and muscular strengthening in chronic low back pain: A comparative study. Clinics (Sao Paulo). 2010;65(10):1013-1017.   DOI
9 Gonnella C, Paris SV, Kutner M. Reliability in evaluating passive intervertebral motion. Phys Ther. 1982;62(4):436-444.   DOI
10 Gross AR, Hoving JL, Haines TA, et al. A cochrane review of manipulation and mobilization for mechanical neck disorders. Spine (Phila Pa 1976). 2004;29(14):1541-1548.   DOI
11 Haynes S, Williams K. Impact of seating posture on user comfort and typing performance for people with chronic low back pain. Int J Ind Ergon. 2008;38(1):35-46.   DOI
12 Hazard RG. Chronic low back pain and disability: The efficacy of functional restoration. Bull Hosp Jt Dis. 1996;55(4):213-216.
13 Hur JG, Song JC, Roh YM, et al. Effect on active exercise programs in employees with chronic low back pain. Korean J Occup Environ Med. 2005;17(1):44-57.
14 Kaltenborn FM, Evjenth O, Kaltenborn TB, et al. The Spine: Basic evaluation and mobilization techniques. 3rd ed. Oslo, Olaf Norli Bokhandel, 1993:11-87, 163-216.
15 Kim SY, Baek IH. Effect of transversus abdominal muscle stabilization exercise to spinal segment motion on trunk flexion-extension. Phys Ther Korea. 2003;10(1):63-76.
16 Ko TS, Jung HB, Kim JA. The effects of thoracic mobilization on pain, disability index and spinal mobility in chronic low back pain. J Special Edu Rehabil Sci. 2009;48(2):115-137.
17 Learman KE, Myers JB, Lephart SM, et al. Effects of spinal manipulation on trunk proprioception in subjects with chronic low back pain during symptom remission. J Manipulative Physiol Ther. 2009;32(2):118-126. http://dx.doi.org/10.1016/j.jmpt.2008.12.004   DOI
18 Levangie PK, Norkin CC. Joint Structure and Function: A comprehensive analysis. 5th ed. Philadelphia, PA, F.A. Davis Co., 2011:3-211.
19 Lundy-Ekman L. Neuroscience: Fundamentals for rehabilitation. 4th ed. St Louis, Saunders, 2013: 187-242.
20 Maduri A, Wilson S. Lumbar position sense with extreme lumbar angle. J Electromyogr Kinesiol. 2009;19(4):607-613. http://dx.doi.org/10.1016/j.jelekin.2008.03.004   DOI
21 Magee DJ. Orthopedic Physical Assessment. 6th ed. Philadelphia, Saunders, 2013:508-549.
22 Newcomer K, Laskowski ER, Yu B, et al. Repositioning error in low back pain: Comparing trunk repositioning error in subjects with chronic low back pain and control subjects. Spine (Phila Pa 1976). 2000;25(2):245-250.   DOI
23 O'Sullivan PB, Burnett A, Floyd AN, et al. Lumbar repositioning deficit in a specific low back pain population. Spine (Phila Pa 1976). 2003;28(10): 1074-1079.   DOI
24 Olson KA. Manual Physical Therapy of the Spine. 1st ed. St Louis, Saunders, 2008:14-97, 210-256.
25 Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-389.   DOI
26 Parkhurst TM, Burnett CN. Injury and proprioception in the lower back. J Orthop Sports Phys Ther. 1994;19(5):282-295.   DOI
27 Shumway-Cook A, Woollacott MH. Motor Control: Theory and practical applications. 3rd ed. Philadelpia, PA, Lippincott Williams & Wilkins, 2007:3-153.
28 Singer KP, Giles LG. Manual therapy considerations at the thoracolumbar junction: An anatomical and functional perspective. J Manipulative Physiol Ther. 1990;13(2):83-88.
29 Wagner DR, Tatsugawa K, Parker D, et al. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High Alt Med Biol. 2007;8(1):27-31.   DOI
30 Yi TL, Kang Y, Lee YS. Reliability of single leg balance test using posturography. The Korean J Sports Med. 2014;32(2):120-125.   DOI