Lumbar Stabilization, Strengthening and Stretching in Chronic Low Back Pain

University of Sao Paulo General Hospital

Status: Completed

Conditions: Chronic Low Back Pain

Treatments: Other: Stabilization , strengthening and stretching

Study type: Interventional

Funder types: Other

Identifiers

NCT01124201

1249/06

Details and patient eligibility

About

The purpose of this study was to compare the efficacy of three exercise programs in patients with chronic low back pain: Segmental stabilization, superficial strengthening and stretching. Groups were contrasted regarding pain, functional disability and TrA muscle activation capacity. The three groups of exercise improved pain and functional disabilities, and the Segmental stabilization group was better in the ability to recruit TrA muscle.

Full description

Objective: To contrast the efficacy of three exercise programs, segmental stabilization and strengthening of abdominal and trunk muscle and lumbar stretching on pain, functional impairment, and activation of the transversus abdominis muscle (TrA), in individuals with chronic low back pain.

Design: Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus) (n=15, mean age 42,02 ± 8,15), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) (n=15, mean age 41,71±6,41) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles) (n=15 mean age 41,53 ± 4,41). Groups were contrasted regarding pain (visual analogical scale and McGill pain questionnaire), functional disability (Oswestry disability questionnaire) and TrA muscle activation capacity (Pressure Biofeedback Unit = PBU). The program lasted 6 weeks, and sessions happened twice a week, with duration of 30 minutes each. Analysis of variance was used for inter and intragroup comparisons. Significance level was established at 5%.

Patients attended two weekly sessions during six weeks and were evaluated for pain (visual analogue scale and McGill Pain Questionnaire), functional disability (Oswestry disability index), and ability to contract the TrA (Pressure biofeedback unit) before and after the treatment. The treatment program consisted of 30 minutes sessions. The Anova one-way and Tukey´s Post Hoc were used to compare groups. The significance level adopted was 5%.

Enrollment: 45 patients

Sex: All

Ages: 23 to 53 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• low back pain for more than 3 months
• patients willing to participate and could participate in an exercise program safely and without cognitive impairments that would limit their participation.

Exclusion criteria

• past history of back surgery
• rheumatologic disorders
• spine infections
• spine exercise training in the 3 months before study onset.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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45 participants in 3 patient groups

Stabilization group

Experimental group

Description:

In the Segmental Stabilization group exercises focused on the transversus abdominis and lumbar multifidus muscles.

Treatment:

Other: Stabilization , strengthening and stretching

Strengthening group

Experimental group

Description:

In the Superficial Strengthening group, exercises focused on the rectus abdominis, abdominus obliquus internus, abdominus obliquus externus and erector spinae muscles.

Treatment:

Other: Stabilization , strengthening and stretching

Stretching group

Experimental group

Description:

Stretching group: erector spinae, posterior connective tissues and ischiotibials muscles

Treatment:

Other: Stabilization , strengthening and stretching