The Effect of Core Stabilization Exercises on Trunk-Pelvis Three-Dimensional Kinematics During Gait in Non-Specific Chronic Low Back Pain.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
01 Jul 2019
01 Jul 2019
Historique:
entrez:
18
6
2019
pubmed:
18
6
2019
medline:
21
8
2019
Statut:
ppublish
Résumé
Controlled clinical trial study. This study aimed to evaluate the effect of core stabilization exercise program (CSEP) on trunk-pelvis kinematics during gait in non-specific chronic low back pain (NCLBP). NCLBP is a major public burden with variety of dysfunction including gait variability. Thirty participants (15 NCLBP and 15 healthy) were included in this study via the convenience sampling method. NCLBP group were intervened via the 16 sessions CSEP 3 days for 6 weeks and trunk-pelvis kinematics (angular displacement, waveform pattern [CVp], and offset variability [CVo]) during gait, pain, disability were evaluated before and after the intervention. No significant differences in displacement and CVo in three planes were found between NCLBP and healthy groups. Independent t test was revealed that significant differences in CVp in the sagittal, frontal, and transverse planes were found between healthy and NCLBP in pre intervention. No significant changes in displacement and CVo were found as the result of intervention in NCLBP. Pain and disability decreased significantly after intervention. Paired t test revealed that the CSEP increased the frontal (P = 0.04) and transverse planes (P = 0.02) pattern variability significantly. However, there was a significant difference between groups in the sagittal plane CVp after intervention (sagittal plane CVp in healthy vs. NCLBP in post-CSE: mean difference = 14.1; P = 0.04). Considering the role of the deep trunk muscles in gait, and their common deconditioning in CLBP, a CSEP intervention may increase trunk-pelvis kinematic pattern variability. These results suggest CSEP may specifically increase transverse and frontal plane variability, indicating improved motor pattern replication through this movement planes. 2.
Sections du résumé
STUDY DESIGN
METHODS
Controlled clinical trial study.
OBJECTIVE
OBJECTIVE
This study aimed to evaluate the effect of core stabilization exercise program (CSEP) on trunk-pelvis kinematics during gait in non-specific chronic low back pain (NCLBP).
SUMMARY OF BACKGROUND DATA
BACKGROUND
NCLBP is a major public burden with variety of dysfunction including gait variability.
METHODS
METHODS
Thirty participants (15 NCLBP and 15 healthy) were included in this study via the convenience sampling method. NCLBP group were intervened via the 16 sessions CSEP 3 days for 6 weeks and trunk-pelvis kinematics (angular displacement, waveform pattern [CVp], and offset variability [CVo]) during gait, pain, disability were evaluated before and after the intervention.
RESULTS
RESULTS
No significant differences in displacement and CVo in three planes were found between NCLBP and healthy groups. Independent t test was revealed that significant differences in CVp in the sagittal, frontal, and transverse planes were found between healthy and NCLBP in pre intervention. No significant changes in displacement and CVo were found as the result of intervention in NCLBP. Pain and disability decreased significantly after intervention. Paired t test revealed that the CSEP increased the frontal (P = 0.04) and transverse planes (P = 0.02) pattern variability significantly. However, there was a significant difference between groups in the sagittal plane CVp after intervention (sagittal plane CVp in healthy vs. NCLBP in post-CSE: mean difference = 14.1; P = 0.04).
CONCLUSION
CONCLUSIONS
Considering the role of the deep trunk muscles in gait, and their common deconditioning in CLBP, a CSEP intervention may increase trunk-pelvis kinematic pattern variability. These results suggest CSEP may specifically increase transverse and frontal plane variability, indicating improved motor pattern replication through this movement planes.
LEVEL OF EVIDENCE
METHODS
2.
Identifiants
pubmed: 31205170
doi: 10.1097/BRS.0000000000002981
pii: 00007632-201907010-00008
doi:
Types de publication
Journal Article
Langues
eng
Pagination
927-936Commentaires et corrections
Type : ErratumIn
Références
Barondess J, Cullen M, de Lateur B, et al. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. 2001; Washington, DC: National Academy of Sciences, 1–512.
Airaksinen O, Brox J, Cedraschi C, et al. Chapter 4 European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006; 15:s192–s300.
Steele J, Bruce-Low S, Smith D, et al. Lumbar kinematic variability during gait in chronic low back pain and associations with pain, disability and isolated lumbar extension strength. Clin Biomech (Bristol, Avon) 2014; 29:1131–1138.
Steele J, Bruce-Low S, Smith D, et al. A randomized controlled trial of limited range of motion lumbar extension exercise in chronic low back pain. Spine (Phila Pa 1976) 2013; 38:1245–1252.
Vogt L, Pfeifer K, Portscher AM, et al. Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion. Spine (Phila Pa 1976) 2001; 26:1910–1919.
Lamoth CJ, Meijer OG, Daffertshofer A, et al. Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control. Eur Spine J 2006; 15:23–40.
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 2011; 45:342–347.
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 (Phila Pa 1976) 2002; 27:E92–E99.
Seay J, Van Emmerik R, Hamill J. Influence of low back pain status on Pelvis-Trunk coordination during walking and running. Spine (Phila Pa 1976) 2011; 36:16.
Seay J, Van Emmerik R, Hamill J. Low back pain status affects pelvis-trunk coordination and variability during walking and running. Clin Biomech (Bristol, Avon) 2011; 26:572–578.
Ebrahimi S, Kamali F, Razeghi M, et al. Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain. Hum Mov Sci 2017; 52:55–66.
Kim T, Chai E. Trunk and pelvic coordination at various walking speeds during an anterior load carriage task in subjects with and without chronic low back pain. J Phys Ther Sci 2015; 27:2353–2356.
van der Hulst M, Vollenbroek-Hutten MM, Rietman JS, et al. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: support of the “guarding†hypothesis? J Electromyogr kinesiol 2010; 20:31–38.
Thorstensson ALF, Carlson H, Zomlefer MR, et al. Lumbar back muscle activity in relation to trunk movements during locomotion in man. Acta Physiol Scand 1982; 116:13–20.
van Dieen JH, Selen LP, Cholewicki J. Trunk muscle activation in low-back pain patients, an analysis of the literature. J Electromyogr Kinesiol 2003; 13:333–351.
Wong AY, Parent EC, Prasad N, et al. Does experimental low back pain change posteroanterior lumbar spinal stiffness and trunk muscle activity? A randomized crossover study. Clin Biomech (Bristol, Avon) 2016; 34:45–52.
Selles RW, Wagenaar RC, Smit TH, et al. Disorders in trunk rotation during walking in patients with low back pain: a dynamical systems approach. Clin Biomech (Bristol, Avon) 2001; 16:175–181.
Park SD, Yu SH. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain. J Exerc Rehabil 2013; 9:286–291.
Hosseinifar M, Akbari M, Behtash H, et al. The effects of stabilization and McKenzie exercises on transverse abdominis and multifidus muscle thickness, pain, and disability: a randomized controlled trial in nonspecific chronic low back pain. J Phys Ther Sci 2013; 25:1541–1545.
Chung SH, You YY, Lee HJ, et al. Effects of stabilization exercise using flexi-bar on functional disability and transverse abdominis thickness in patients with chronic low back pain. J Phys Ther Sci 2018; 30:400–404.
Nabavi N, Mohseni Bandpei MA, Mosallanezhad Z, et al. The effect of 2 different exercise programs on pain intensity and muscle dimensions in patients with chronic low back pain: a randomized controlled trial. J Manipulative Physiol Ther 2018; 41:102–110.
Park KN, Kwon OY, Yi CH, et al. Effects of motor control exercise vs muscle stretching exercise on reducing compensatory lumbopelvic motions and low back pain: a randomized trial. J Manipulative Physiol Ther 2016; 39:576–585.
Shamsi M, Sarrafzadeh J, Jamshidi A, et al. Comparison of spinal stability following motor control and general exercises in nonspecific chronic low back pain patients. Clin Biomech (Bristol, Avon) 2017; 48:42–48.
Shamsi M, Sarrafzadeh J, Jamshidi A, et al. The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging. Physiother Theory Pract 2016; 32:277–283.
Steele J, Bruce-Low S, Smith D, et al. A randomized controlled trial of the effects of isolated lumbar extension exercise on lumbar kinematic pattern variability during gait in chronic low back pain. PM R 2013; 8:105–114.
Carpes F, Reinehr F, Mota C. Effects of a program for trunk strength and stability on pain, low back and pelvis kinematics, and body balance: a pilot study. J Bodyw Mov Ther 2008; 12:22–30.
Winter DA, MacKinnon CD, Ruder GK, et al. Chapter 32. An integrated EMG/biomechanical model of upper body balance and posture during human gait. Prog Brain Res 1993; 97:359–367.
Vogt L, Banzer W. Measurement of lumbar spine kinematics in incline treadmill walking. Gait Posture 1999; 9:18–23.
O’Dwyer N, Smith R, Halaki M, et al. Independent assessment of pattern and offset variability of time series waveforms. Gait Posture 2009; 29:285–289.
Bagheri R, Ebrahimi Takamjani I, Dadgoo M, et al. Gender-related differences in reliability of thorax, lumbar, and pelvis kinematics during gait in patients with non-specific chronic low back pain. Ann Rehabil Med 2018; 42:239–249.
Harsted S, Mieritz RM, Bronfort G, et al. Reliability and measurement error of frontal and horizontal 3D spinal motion parameters in 219 patients with chronic low back pain. Chiropr Man Therap 2016; 24:13.
Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther 2005; 85:209–225.
Fairbank JC, Pynsent PB. The Oswestry disability index. Spine (Phila Pa 1976) 2000; 25:2940–2953.
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 (Phila Pa 1976) 2006; 31:E454–E459.
Elsevier Health Sciences, Drake R, Vogl AW, Mitchell AW. Gray's Anatomy for Students. 2009.
Hidalgo B, Gilliaux M, Poncin W, et al. Reliability and validity of a kinematic spine model during active trunk movement in healthy subjects and patients with chronic non-specific low back pain. J Rehabil Med 2012; 44:756–763.
Crosbie J, Vachalathitib R, Smith R. Patterns of spinal motion during walking. Gait Posture 1997; 5:6–12.
Leardini A, Biagi F, Belvedere C, et al. Quantitative comparison of current models for trunk motion in human movement analysis. Clin Biomech (Bristol, Avon) 2009; 24:542–550.
Leardini A, Biagi F, Merlo A, et al. Multi-segment trunk kinematics during locomotion and elementary exercises. Clin Biomech (Bristol, Avon) 2011; 26:562–571.
Bagheri R, Takamjani IE, Dadgoo M, et al. A protocol for clinical trial study of the effect of core stabilization exercises on spine kinematics during gait with and without load in patients with non-specific chronic low back pain. Chiropr Man Therap 2017; 25:31.
Steele J, Bruce-Low S, Smith D, et al. A randomized controlled trial of the effects of isolated lumbar extension exercise on lumbar kinematic pattern variability during gait in chronic low back pain. PM R 2016; 8:105–114.
Lamoth CJ, Daffertshofer A, Meijer OG, et al. Effects of experimentally induced pain and fear of pain on trunk coordination and back muscle activity during walking. Clin Biomech (Bristol, Avon) 2004; 19:551–563.
Dwyer O, Smith N, Halaki R, et al. Independent assessment of pattern and offset variability of time series waveforms. Gait Posture 2016; 29:285–289.
Newcomer KL, Jacobson TD, Gabriel DA, et al. Muscle activation patterns in subjects with and without low back pain. Arch Phys Med Rehabil 2002; 83:816–821.
Danneels L, Cagnie B, D’Hooge R, et al. The effect of experimental low back pain on lumbar muscle activity in people with a history of clinical low back pain: a muscle functional MRI study. J Neurophysiol 2015; 115:851–857.
Hanada EY, Johnson M, Hubley-Kozey C. A comparison of trunk muscle activation amplitudes during gait in older adults with and without chronic low back pain. PM R 2011; 3:920–928.
Hodges PW. Core stability exercise in chronic low back pain. Orthop Clin North Am 2003; 34:245–254.
Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999; 4:74–86.
Panjabi M. The stabilizing system of the spine: Part 1. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992; 5:383–389. discussion, 339.
Fernandes R, Armada-da-Silva P, Pool-Goudaazward A, et al. Three dimensional multi-segmental trunk kinematics and kinetics during gait: test-retest reliability and minimal detectable change. Gait Posture 2016; 46:18–25.