DOI QR코드

DOI QR Code

The Effect of Combined Functional Intervention Program on Changes in Pain and Contractile Properties in Prime-aged Females with Non-specific Chronic Low Back Pain

복합 기능 운동 중재 프로그램이 비특이적 만성요통 장년 여성의 통증 변화 및 수축 특성 변화에 미치는 효과

  • Hyungwoo Lee (Division of Sport Science, Incheon National University) ;
  • Seungwon Lee (Department of Human Movement Science, Incheon National University) ;
  • Kyoungkyu Jeon (Division of Sport Science, Incheon National University)
  • Received : 2023.03.25
  • Accepted : 2023.04.24
  • Published : 2023.06.30

Abstract

Objective: This study aimed to investigate the effect of a combined functional intervention program on the pain-related questionnaire, the erector spinae contractile properties, and trunk extensor strength of prime-aged females with non-specific chronic low back pain. Method: 16 (female: 16) prime-aged subjects (age: 60.88 ± 6.09 years, height: 158.16 ± 5.58 cm, weight: 59.05 ± 9.44 kg) participated in this study. Results: Except for Tampa Scale of Kinesiophobia all pain-related questionnaires revealed a significant decrease after the intervention program (p<.001). Tensiomyography of the erector spinae revealed a significant post-intervention program increase in the maximum radial displacement (p<.05) and velocity of contraction (p<.05), however, there wasn't a significant post-intervention program change in the contraction time. Additionally, Trunk extensor strength showed a significant increase post-intervention program (p<.001). Conclusion: Our results indicated that the combined functional intervention program positively changed pain-related questionnaires and reduced erector spinae muscle stiffness, increasing the velocity of erector spinae contraction. Additionally, improved the trunk extensor strength.

Keywords

Acknowledgement

This work was supported by Incheon National University Research Grant in 2022 (2022-0010).

References

  1. Agten, A., Stevens, S., Verbrugghe, J., Timmermans, A. & Vandenabeele, F. (2020). Biopsy samples from the erector spinae of persons with nonspecific chronic low back pain display a decrease in glycolytic muscle fibers. The Spine Journal, 20(2), 199-206.
  2. Aoki, Y., Sugiura, S., Nakagawa, K., Nakajima, A., Takahashi, H., Ohtori, S., . . . Nishikawa, S. (2012). Evaluation of non-specific low back pain using a new detailed visual analogue scale for patients in motion, standing, and sitting: characterizing nonspecific low back pain in elderly patients. Pain Research and Treatment, 2012.
  3. Castaneda-Babarro, A., Arbillaga-Etxarri, A., Gutierrez-Santamaria, B. & Coca, A. (2020). Physical activity change during COVID-19 confinement. International Journal of Environmental Research and Public Health, 17(18), 6878.
  4. Chiarotto, A., Maxwell, L. J., Terwee, C. B., Wells, G. A., Tugwell, P. & Ostelo, R. W. (2016). Roland-Morris Disability Questionnaire and Oswestry Disability Index: which has better measurement properties for measuring physical functioning in nonspecific low back pain? Systematic review and meta-analysis. Physical Therapy, 96(10), 1620-1637. https://doi.org/10.2522/ptj.20150420
  5. Daneau, C., Tetreau, C., Deroche, T., Mainville, C., Cantin, V. & Descarreaux, M. (2021). Impact of load expectations on neuromuscular and postural strategies during a freestyle lifting task in individuals with and without chronic low back pain. PloS One, 16(2), e0246791.
  6. Ditroilo, M., Smith, I. J., Fairweather, M. M. & Hunter, A. M. (2013). Long-term stability of tensiomyography measured under different muscle conditions. Journal of Electromyography and Kinesiology, 23(3), 558-563. https://doi.org/10.1016/j.jelekin.2013.01.014
  7. Fairbank, J. C. & Pynsent, P. B. (2000). The Oswestry disability index. Spine, 25(22), 2940-2953. https://doi.org/10.1097/00007632-200011150-00017
  8. Frizziero, A., Pellizzon, G., Vittadini, F., Bigliardi, D. & Costantino, C. (2021). Efficacy of core stability in non-specific chronic low back pain. Journal of Functional Morphology and Kinesiology, 6(2), 37.
  9. Fujii, R., Imai, R., Shigetoh, H., Tanaka, S. & Morioka, S. (2022). Task-specific fear influences abnormal trunk motor coordination in workers with chronic low back pain: a relative phase angle analysis of object-lifting. BMC Musculoskeletal Disorders, 23(1), 1-12. https://doi.org/10.1186/s12891-021-04954-7
  10. Gomes-Neto, M., Lopes, J. M., Conceicao, C. S., Araujo, A., Brasileiro, A., Sousa, C., . . . Arcanjo, F. L. (2017). Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis. Physical Therapy in Sport, 23, 136-142. https://doi.org/10.1016/j.ptsp.2016.08.004
  11. Gordon, R. & Bloxham, S. (2016). A systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Paper presented at the Healthcare.
  12. Goubert, D., Van Oosterwijck, J., Meeus, M. & Danneels, L. (2016). Structural changes of lumbar muscles in nonspecific low back pain. Pain Physician, 19(7), E985-E999.
  13. Gregg, C. D., McIntosh, G., Hall, H., Watson, H., Williams, D. & Hoffman, C. W. (2015). The relationship between the Tampa Scale of Kinesiophobia and low back pain rehabilitation outcomes. The Spine Journal, 15(12), 2466-2471. https://doi.org/10.1016/j.spinee.2015.08.018
  14. Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., . . . Sieper, J. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356-2367. https://doi.org/10.1016/S0140-6736(18)30480-X
  15. Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A. & van Tulder, M. W. (2021). Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews, 9(9), CD009790.
  16. Hayden, J. A., Ellis, J., Ogilvie, R., Stewart, S. A., Bagg, M. K., Stanojevic, S., . . . Saragiotto, B. T. (2021). Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. Journal of Physiotherapy, 67(4), 252-262. https://doi.org/10.1016/j.jphys.2021.09.004
  17. Hazime, F. A., da Cunha, R. A., Soliaman, R. R., Romancini, A. C. B., de Castro Pochini, A., Ejnisman, B. & Baptista, A. F. (2017). Anodal transcranial direct current stimulation (tDCS) increases isometric strength of shoulder rotators muscles in handball players. International Journal of Sports Physical Therapy, 12(3), 402.
  18. Hong, S. & Shin, D. (2020). Relationship between pain intensity, disability, exercise time and computer usage time and depression in office workers with non-specific chronic low back pain. Medical Hypotheses, 137, 109562.
  19. Hvid, L. G., Strotmeyer, E. S., Skjodt, M., Magnussen, L. V., Andersen, M. & Caserotti, P. (2016). Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults-a randomized controlled trial. Experimental Gerontology, 80, 51-56. https://doi.org/10.1016/j.exger.2016.03.018
  20. Ibrahim, A. A., Akindele, M. O., Kaka, B. & Mukhtar, N. B. (2021). Development of the Hausa version of the Pain Catastrophizing Scale: translation, cross-cultural adaptation and psychometric evaluation in mixed urban and rural patients with chronic low back pain. Health and Quality of Life Outcomes, 19, 1-14. https://doi.org/10.1186/s12955-020-01607-6
  21. Illes, S. T. (2015). Low back pain: when and what to do. Orvosi Hetilap, 156(33), 1315-1320.
  22. Jacobs, J. M., Hammerman-Rozenberg, R. & Stessman, J. (2005). Longevity and chronic back pain in older people. Journal of the American Geriatrics Society, 53(9), 1636-1637. https://doi.org/10.1111/j.1532-5415.2005.53487_5.x
  23. Jarvik, J. G., Comstock, B. A., Heagerty, P. J., Turner, J. A., Sullivan, S. D., Shi, X., . . . James, K. (2014). Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data. BMC Musculoskeletal Disorders, 15(1), 1-11. https://doi.org/10.1186/1471-2474-15-1
  24. Jeon, C. H., Kim, D. J., Kim, D. J., Lee, H. M. & Park, H. J. (2005). Cross-cultural adaptation of the Korean version of the oswestry disability index (ODI). Journal of Korean Society of Spine Surgery, 12(2), 146-152. https://doi.org/10.4184/jkss.2005.12.2.146
  25. Kim, D. Y., Lee, S. H., Lee, H. Y., Lee, H. J., Chang, S. B., Chung, S. K. & Kim, H. J. (2005). Validation of the Korean version of the oswestry disability index. Spine, 30(5), E123-E127. https://doi.org/10.1097/01.brs.0000157172.00635.3a
  26. Kim, W. D. & Shin, D. C. (2020). Correlations between hip extension range of motion, hip extension asymmetry, and compensatory lumbar movement in patients with non-specific chronic low back pain. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e925080-925081.
  27. Kim, J. H. & Park, H. Y. (2022). Effects of combined hip exercise and passive stretching on muscle stiffness, pain perception and painrelated disability, and physical function in older adults with low back pain. Physical Activity and Nutrition, 26(3), 016-024. https://doi.org/10.20463/pan.2022.0014
  28. Kliger, M., Stahl, S., Haddad, M., Suzan, E., Adler, R. & Eisenberg, E. (2015). Measuring the intensity of chronic pain: are the visual analogue scale and the verbal rating scale interchangeable? Pain Practice, 15(6), 538-547. https://doi.org/10.1111/papr.12216
  29. Koppenhaver, S., Gaffney, E., Oates, A., Eberle, L., Young, B., Hebert, J., . . . Shinohara, M. (2020). Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings. Musculoskeletal Science and Practice, 45, 102078.
  30. Langen, G., Sandau, I., Ueberschar, O., Nosaka, K. & Behringer, M. (2022). Methodical approaches to determine the rate of radial muscle displacement using tensiomyography: A scoping review and new reporting guideline. Journal of Electromyography and Kinesiology, 102702.
  31. Lee, H., Kim, C., An, S. & Jeon, K. (2022). Effects of Core Stabilization Exercise Programs on Changes in Erector Spinae Contractile Properties and Isokinetic Muscle Function of Adult Females with a Sedentary Lifestyle. Applied Sciences, 12(5), 2501.
  32. Macgregor, L. J., Hunter, A. M., Orizio, C., Fairweather, M. M. & Ditroilo, M. (2018). Assessment of skeletal muscle contractile properties by radial displacement: the case for tensiomyography. Sports Medicine, 48, 1607-1620. https://doi.org/10.1007/s40279-018-0912-6
  33. Maher, C., Underwood, M. & Buchbinder, R. (2017). Nonspecific low back pain. The Lancet, 389(10070), 736-747. https://doi.org/10.1016/S0140-6736(16)30970-9
  34. Mannion, A., Kaser, L., Weber, E., Rhyner, A., Dvorak, J. & Muntener, M. (2000). Influence of age and duration of symptoms on fibre type distribution and size of the back muscles in chronic low back pain patients. European Spine Journal, 9(4), 273-281. https://doi.org/10.1007/s005860000189
  35. Martin-Rodriguez, S., Loturco, I., Hunter, A. M., Rodriguez-Ruiz, D. & Munguia-Izquierdo, D. (2017). Reliability and measurement error of tensiomyography to assess mechanical muscle function: A systematic review. The Journal of Strength & Conditioning Research, 31(12), 3524-3536. https://doi.org/10.1519/JSC.0000000000002250
  36. Masaki, M., Aoyama, T., Murakami, T., Yanase, K., Ji, X., Tateuchi, H. & Ichihashi, N. (2017). Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clinical Biomechanics, 49, 128-133. https://doi.org/10.1016/j.clinbiomech.2017.09.008
  37. Meucci, R. D., Fassa, A. G. & Faria, N. M. X. (2015). Prevalence of chronic low back pain: systematic review. Revista de Saude Publica, 49(73), 1-10.
  38. Niederer, D. & Mueller, J. (2020). Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression. Plos One, 15(1), e0227423.
  39. Nishigami, T., Mibu, A., Tanaka, K., Yamashita, Y., Shimizu, M. E., Wand, B. M., . . . Moseley, G. L. (2018). Validation of the Japanese version of the Fremantle Back Awareness Questionnaire in patients with low back pain. Pain Practice, 18(2), 170-179. https://doi.org/10.1111/papr.12586
  40. Norris, C. & Matthews, M. (2008). The role of an integrated back stability program in patients with chronic low back pain. Complementary Therapies in Clinical Practice, 14(4), 255-263. https://doi.org/10.1016/j.ctcp.2008.06.001
  41. O'Sullivan, P., Caneiro, J. P., O'Keeffe, M. & O'Sullivan, K. (2016). Unraveling the complexity of low back pain. Journal of Orthopaedic & Sports Physical Therapy, 46(11), 932-937. https://doi.org/10.2519/jospt.2016.0609
  42. O'Sullivan, P. (2005). Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Manual Therapy, 10(4), 242-255. https://doi.org/10.1016/j.math.2005.07.001
  43. Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J., Tagliaferri, S. D., Brisby, H., . . . Belavy, D. L. (2020). Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine, 54(21), 1279-1287. https://doi.org/10.1136/bjsports-2019-100886
  44. Paravlic, A. H., Pisot, R. & Simunic, B. (2020). Muscle-specific changes of lower extremities in the early period after total knee arthroplasty: Insight from tensiomyography. Journal of Musculoskeletal & Neuronal Interactions, 20(3), 390.
  45. Park, S. (2020). Theory and usage of tensiomyography and the analysis method for the patient with low back pain. Journal of Exercise Rehabilitation, 16(4), 325.
  46. Plotkin, D. L., Roberts, M. D., Haun, C. T. & Schoenfeld, B. J. (2021). Muscle fiber type transitions with exercise training: Shifting perspectives. Sports, 9(9), 127.
  47. Prat-Luri, A., de Los Rios-Calonge, J., Moreno-Navarro, P., Manresa-Rocamora, A., Vera-Garcia, F. J. & Barbado, D. (2023). Effect of trunk-focused exercises on pain, disability, quality of life and trunk physical fitness in low back pain and how potential effect modifiers modulate their effects: a systematic review with meta-analyses. Journal of Orthopaedic & Sports Physical Therapy, 53(2), 64-93. https://doi.org/10.2519/jospt.2023.11091
  48. Qaseem, A., Wilt, T. J., McLean, R. M. & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514-530. https://doi.org/10.7326/M16-2367
  49. Rey, E., Lago-Penas, C. & Lago-Ballesteros, J. (2012). Tensiomyography of selected lower-limb muscles in professional soccer players. Journal of Electromyography and Kinesiology, 22(6), 866-872. https://doi.org/10.1016/j.jelekin.2012.06.003
  50. Saeterbakken, A. H., Chaudhari, A., van den Tillaar, R. & Andersen, V. (2019). The effects of performing integrated compared to isolated core exercises. Plos One, 14(2), e0212216.
  51. Shafshak, T. S. & Elnemr, R. (2021). The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain. JCR: Journal of Clinical Rheumatology, 27(7), 282-285.
  52. Sipaviciene, S. & Kliziene, I. (2020). Effect of different exercise programs on non-specific chronic low back pain and disability in people who perform sedentary work. Clinical Biomechanics, 73, 17-27.
  53. Smith, B. E., Littlewood, C. & May, S. (2014). An update of stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskeletal Disorders, 15(1), 1-21. https://doi.org/10.1186/1471-2474-15-1
  54. Subramanian, M. & Venkatesan, P. (2022). The predictors for altered central pain modulation in individuals with non-specific chronic low back pain: A systematic review. Pain Practice, 22(2), 276-284.
  55. Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y. & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173.
  56. Swinkels-Meewisse, E., Swinkels, R., Verbeek, A., Vlaeyen, J. & Oostendorp, R. (2003). Psychometric properties of the Tampa Scale for kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain. Manual Therapy, 8(1), 29-36. https://doi.org/10.1054/math.2002.0484
  57. Tsauo, J. Y., Chen, W. H., Liang, H. W. & Jang, Y. (2009). The effectiveness of a functional training programme for patients with chronic low back pain-a pilot study. Disability and Rehabilitation, 31(13), 1100-1106. https://doi.org/10.1080/09638280802511047
  58. Tsuji, T., Matsudaira, K., Sato, H. & Vietri, J. (2016). The impact of depression among chronic low back pain patients in Japan. BMC Musculoskeletal Disorders, 17(1), 1-9. https://doi.org/10.1186/s12891-015-0856-z
  59. Vadala, G., Russo, F., De Salvatore, S., Cortina, G., Albo, E., Papalia, R. & Denaro, V. (2020). Physical activity for the treatment of chronic low back pain in elderly patients: a systematic review. Journal of Clinical Medicine, 9(4), 1023.
  60. Walton, D. M., Wideman, T. H. & Sullivan, M. J. (2013). A Rasch analysis of the pain catastrophizing scale supports its use as an interval-level measure. The Clinical Journal of Pain, 29(6), 499-506. https://doi.org/10.1097/AJP.0b013e318269569c
  61. Wand, B. M., Catley, M. J., Rabey, M. I., O'Sullivan, P. B., O'Connell, N. E. & Smith, A. J. (2016). Disrupted self-perception in people with chronic low back pain. Further evaluation of the Fremantle Back Awareness Questionnaire. The Journal of Pain, 17(9), 1001-1012.
  62. Wun, A., Kollias, P., Jeong, H., Rizzo, R. R., Cashin, A. G., Bagg, M. K., . . . Jones, M. D. (2021). Why is exercise prescribed for people with chronic low back pain? A review of the mechanisms of benefit proposed by clinical trialists. Musculoskeletal Science and Practice, 51, 102307.