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Effects of Trunk Stability Exercises and Thoracic Manipulation on Spine Flexibility in Chronic Low Back Pain Patients

척추 안정화 운동과 등뼈가동술이 만성 허리통증환자의 척추 유연성에 미치는 영향

  • Park, Sun-Ja (Department of Physical Therapy, Graduate School, Ulsan Science College) ;
  • Kim, Eun-Kyung (Department of Physical Therapy, Industry Academic Cooperation Foundation, Dankook University) ;
  • Kim, Young-Mi (Department of Physical Therapy, Andong Science College) ;
  • Kang, Dong-Yeon (Department of Special Education, Kaya University)
  • 박선자 (울산과학대학교 물리치료학과) ;
  • 김은경 (단국대학교 산학협력단) ;
  • 김영미 (안동과학대학교 물리치료과) ;
  • 강동연 (가야대학교 특수교육과)
  • Received : 2021.03.13
  • Accepted : 2021.05.10
  • Published : 2021.05.31

Abstract

PURPOSE: This study aimed to investigate the benefits of thoracic manipulation and the trunk stability exercises on spine trunk flexibility and the pain index of chronic low back pain patients. METHODS: The study included 44 patients suffering from chronic low back pain. The participants were divided into two groups: the first group was assigned for trunk stability exercises (TSE), and the second group was randomly assigned TSE and thoracic manipulation at the same time (TSE+TM). Both groups carried out each assigned treatment thrice a week for 8 weeks. The study outcome was based on assessment of spine trunk flexibility and the pain index. Spine trunk flexibility was measured by spine flexion and extension through a range of motion and thoracic cage circumference. The pain index was measured using a visual analog scale (VAS). RESULTS: Spine flexion and extension range of motion showed a significant difference within each group and between the groups before and after the treatment. The measurement of the thoracic cage circumference also showed a notable difference within each group and between the groups before and after the treatment. There was no change in the pain index. CONCLUSION: These results indicate that thoracic manipulation with the trunk stability exercises is an efficient treatment for improving the spine trunk flexibility and soothing pain for chronic low back pain patients.

Keywords

References

  1. Airaksinen O, Brox JI, Cedraschi C, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15 Suppl 2:S192-300. https://doi.org/10.1007/s00586-006-1072-1
  2. Delitto A, George SZ, Van Dillen L, et al. Low back pain. J Orthop Sports Phys Ther. 2012;42(4):A1-57.
  3. Edmondston SJ, Singer KP. Thoracic spine: anatomical and biomechanical considerations for manual therapy. Man Ther. 1997;2(3):132-43. https://doi.org/10.1054/math.1997.0293
  4. Levangie PK, Norkin CC. Joint Structure and Function; A Comprehensive Analysis. 3rd. Philadelphia: FA. Davis Company. 2000.
  5. Hodges PW, Pengel LH, Herbert RD, et al. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27(6):682-92. https://doi.org/10.1002/mus.10375
  6. 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):1074-9. https://doi.org/10.1097/01.BRS.0000061990.56113.6F
  7. Cleland JA, Childs JD, McRae M, et al. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man Ther. 2005;10(2):127-35. https://doi.org/10.1016/j.math.2004.08.005
  8. Singer KP, Giles LG. Manual therapy considerations at the thoracolumbar junction: an anatomical and functional perspective. J Manipulative Physiol Ther. 1990;13(2):83-8.
  9. 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):431-40. https://doi.org/10.2522/ptj.20060217
  10. Niemisto L, Lahtinen-Suopanki T, Rissanen P, et al. A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine. 2003;28(19):2185-91. https://doi.org/10.1097/01.BRS.0000085096.62603.61
  11. Rasmussen-Barr E, Nilsson-Wikmar L, Arvidsson I. Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man Ther. 2003;8(4):233-41. https://doi.org/10.1016/S1356-689X(03)00053-5
  12. Arokoski JP, Valta T, Kankaanpaa M, et al. Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients. Arch Phys Med Rehabil. 2004;85(5):823-32. https://doi.org/10.1016/j.apmr.2003.06.013
  13. Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine (Phila Pa 1976). 2001;26(11):E243-8. https://doi.org/10.1097/00007632-200106010-00004
  14. Goldby LJ, Moore AP, Doust J, et al. A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine. 2006;31(10):1083-93. https://doi.org/10.1097/01.brs.0000216464.37504.64
  15. Aure OF, Nilsen JH, Vasseljen O. Manual therapy and exercise therapy in patients with chronic low back pain: a randomized, controlled trial with 1-year follow-up. Spine. 2003;28(6):525-31. https://doi.org/10.1097/01.brs.0000049921.04200.a6
  16. Ko TS, Jung HB, Kim SY. The Effects of Thoracic Mobilization on Pain, Disability Index and Spinal Mobility in Chronic Low Back Pain Patients. Journal of Special Education & Rehabilitation Science. 2009;48(2):115-37.
  17. Seichert N, Senn E, Bellikon R. Sagittal shape and mobility of the spine validity and reliability of the new MediMouse/SpinalMouse. Eur Spine J. 2000;9(4):331.
  18. Mannion AF, Knecht K, Balaban G, et al. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature. Eur Spine J. 2004;13(2):122-36. https://doi.org/10.1007/s00586-003-0618-8
  19. Ki C. Effects of Forced Breathing Exercise on the Trunk Functions of Chronic Low Back Pain Patients. Master's Degree. Daegu University. 2013.
  20. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-7. https://doi.org/10.1111/j.1553-2712.2001.tb01132.x
  21. Kim JS, Bae SS, Ju MY. The Effect of Dynamic Lumbar Stabilization Exercise on Low Back Pain Patients. J Kor Phys Ther. 2001;13(3):495-508
  22. Cairns MC, Harrison K, Wright C. Pressure biofeedback: a useful tool in the quantification of abdominal muscular dysfunction?. Physiotherapy. 2000;86(3):127-38. https://doi.org/10.1016/S0031-9406(05)61155-8
  23. Fritz JM, Whitman JM, Childs JD. Lumbar spine segmental mobility assessment: an examination of validity for determining intervention strategies in patients with low back pain. Arch Phys Med Rehabil. 2005;86(9):1745-52. https://doi.org/10.1016/j.apmr.2005.03.028
  24. Queiroz BC, Cagliari MF, Amorim CF, et al. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil. 2010;91(1):86-92. https://doi.org/10.1016/j.apmr.2009.09.016
  25. Evjenth O, Hamberg J. Muscle Stretching in Manual Therapy: The spinal column and the temporo-mandibular joint. Alfta Rehab. 1984.
  26. Krauss J, Evjenth O, Creighton D. Translatoric spinal manipulation for physical therapists. Minneapolis: Orthopedic Physical Therapy Products. 2006:45-85.
  27. Olson KA. Manual Physical Therapy of the Spine-E-Book. Elsevier Health Sciences. 2015.
  28. Hoeksma HL, Dekker J, Ronday HK, et al. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial. Arthritis Rheum. 2004;51(5):722-9. https://doi.org/10.1002/art.20685
  29. Lederman E. Fundamentals of manual therapy: physiology, neurology and psychology. Churchill Livingstone. 1997.
  30. Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis. FA Davis. 2011.
  31. Hur JG. Effect on Thoracic Exercise Programs in Employees With Chronic Low Back Pain. Physical Therapy Korea. 2005;12(2):44-57.
  32. Kim SY, Baek IH. Effects of transversus abdominal muscle stabilization exercise to spinal segment motion on trunk flexion-extension. Physical Therapy Korea. 2003;10(1):63-76.
  33. Kaltenborn FM, Kaltenborg FM, Kaltenborn TB, et al. Manual Mobilization of the Joints: The Kaltenborn Method of Joint Examination and Treatment: Traction-Manipulation of the Extremities and Spine: Basic Thrust Techniques. Norli. 2008.
  34. Descarreaux M, Dugas C, Lalanne K, et al. Learning spinal manipulation: the importance of augmented feedback relating to various kinetic parameters. The Spine Journal. 2006;6(2):138-45. https://doi.org/10.1016/j.spinee.2005.07.001
  35. Yang JM, Kim SY. The Effect of Thoracic Joint Mobilization on Pain, Proprioception and Static Balance in Patients With Chronic Low Back Pain. Physical Therapy Korea. 2015;22(3):1-11. https://doi.org/10.12674/ptk.2015.22.3.001
  36. Bicalho E, Setti JAP, Macagnan J, et al. Immediate effects of a high-velocity spine manipulation in paraspinal muscles activity of nonspecific chronic low-back pain subjects. Man Ther. 2010;15(5):469-75. https://doi.org/10.1016/j.math.2010.03.012
  37. Skyba D, Radhakrishnan R, Rohlwing J, et al. Joint manipulation reduces hyperalgesia by activation of monoamine receptors but not opioid or GABA receptors in the spinal cord. Pain. 2003;106(1-2):159-68. https://doi.org/10.1016/S0304-3959(03)00320-8