Altered Ultrasonographic Activity of Abdominal Muscles during Breathing in Males with and without Nonspecific Chronic Low Back Pain

Purpose This study aimed to investigate the altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecifc chronic low back pain (NSCLBP). Design Cross-sectional study. Methods Twenty males with NSCLBP and 20 males without NSCLBP were recruited. Muscle thickness change was measured by ultrasonography during breathing in the end-inspiration and end-expiration phases for the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles. The data were normalized to the end-inspiration thickness. An independent t test was run to analyze the data at a confdence level of 95% (p<0.05). Results The participants with NSCLBP had thicker IO muscles in the end-inspiration (p =0.030) and end-expiration (p=0.017) phases as well as greater RA (p=0.006) and smaller EO (p=0.003) normalized thickness changes during breathing. Conclusion The normalized thickness changes during breathing difered between the participants with and without NSCLBP. Reduced EO and increased RA activity may predispose the spine to further injuries. Therefore, normalizing the breathing pattern should be considered in the management of people with NSCLBP. Keywords Low back pain · Abdominal muscles · Ultrasonography · Respiratio

Electromyography Activity of the Abdominal Muscles Relative to the Active Pelvic Floor Muscle Contraction in Low Back Pain and Healthy Individuals

Introduction: The purpose of present study was to compare electromyography activity of the abdominal muscles in response to the active pelvic floor muscle contraction in individuals with and without low back pain (LBP). Methods: A total of 30 female subjects (LBP=15) and (healthy=15) participated in the study. All subjects performed the active PFM contraction for three times. The correct pelvic floor muscle contraction was controlled by an ultrasound. Simultaneously, the electromyography signals of the right transverse abdominis, internal oblique and external oblique muscles were measured. Variables of electromyography amplitude were analyzed using an independent sample T-Test. Results: There was a high intra-tester reliability for electromyography measurement of abdominal muscle in LBP (ICC&gt;90) and healthy individuals (77&lt;ICC&lt;96). Transverse abdominis, internal oblique and external oblique muscle electromyography activity were increased during the pelvic floor muscle contractions in both women group with and without low back pain. The results of independent sample T-Test displayed no statistically significant difference in muscle co-activation pattern of the abdominal and pelvic floor muscles between the healthy group and LBP group (P&gt;0.05). The mean values for muscle electromyography amplitude in transverse abdominis, internal oblique and external oblique muscle were 0.37(0.41), 0.18(0.14) and 0.16 (0.10), respectively, for healthy individuals and 0.25 (0.17), 0.13 (0.19) and 0.18 (0.17) for individuals with LBP. Conclusion: There is a recognizable co-activation between abdominal and pelvic floor muscles in healthy and low back pain women.Keywords: Pelvic Floor Muscles, Abdominal Muscles, Low Back Pain, Electromyograph

Reliability of 3-Dimensional scapular kinematics measures of acromion marker cluster in patients with shoulder impingement syndrome during humeral elevation and lowering

Introduction: The purpose of this study was to investigate the Reliability of 3-D scapular kinematics measures of Motion analyzer and Acromion cluster in patients with Shoulder impingement syndrome during humeral elevation and lowering.Material & Methods: 20 Patients (Males=13, Females=7) with Shoulder Impingement Syndrome (mean age: 46.15 years) who participated in the study. They elevated and lowered humerous in frontal, sagittal and scapular movement plane during 8 seconds, using the VICON motion analyzer and Acromion marker cluster. The Scapular 3-D kinematics was measured, using VICON motion analyzer and Acromion marker cluster. Interclass correlation coefficient and Standard error of measurement were used.Results: Participants showed average of age 46.53±13.314 as well as average of BMI 28.14±3.93, and all quantitative and qualitative variables had the normal distribution. Trial-to-trial ICCs for the 3-D scapular kinematics variables for both elevation and lowering condition in the sagittal, frontal and scapular planes ranged from 0.58 to 0.99, which indicated fair to excellent reliability, and the SEM for both elevation conditions ranged from 1.7˚ to 15.4˚.Discussion: The reliability of the three-dimensional scapular attitudes for elevation and lowering phases were very good. The estimation of three-dimensional scapular attitudes using the method of calculation relative to the trunk is reproducible in the three movement planes during elevation and lowering phases and can be used to document the scapular behavior

The Effects of Consecutive Supervised Functional Lumbar Stabilizing Exercises on the Postural Balance and Functional Disability in Low Back Pain

Objectives: The aim of this study was to examine the effects of consecutively supervised core stability training on postural control and functional disability in female patients with non-specific chronic low back pain. Methods: Twenty nine female participants with non-specific chronic low back pain participated in the study. They were randomly divided into two groups: experimental group (10 days consecutively core stability exercises under physical therapist&rsquo;s supervision) and control group (without intervention). Before and after the intervention, stability situations, pain intensity and functional disability were assessed with Biodex, visual Analogue Scale, Oswestry and Quebec questionnaire scales respectively. Data were analyzed by using statistical methods, independent T test and ANCOVA. Results: The study results indicated no statistically significant differences in all variables except age between two groups before intervention. Analysis by ANCOVA showed a significant difference in disability, pain intensity, Overall Stability Index with Double Leg Eyes Closed, Anterior-Posterior Stability Index with Double Leg Eyes Closed and Medio-Lateral Stability Index with Double Leg Eyes Closed scores between two groups after intervention. However, other variable differences were not significant while these changes were greater in the intervention group. Discussion: The present study indicates that consecutively supervised core stability training is an effective approach in pain relief and improving postural control in female patients with non-specific chronic low back pain

Original Articles: Clinical Sciences - CLINICAL TRUNK MUSCLE ENDURANCE TESTS IN SUBJECTS WITH AND WITHOUT LOW BACK PAIN

Study design: A cross-sectional non-experimental study. Objectives: To collectively detect the reliability and feasibility of the five types of clinical tests that have been used to measure endurance of the trunk muscles in subjects with and without low back pain (LBP) and identify the sensitivity of each test to predict the probability of the occurrence of LBP. Background: Testing spinal muscle endurance seems to be very important in prediction, prevention and rehabilitation of LBP. Several types of methods of static endurance testing such as: Sorensen test, prone isometric chest raise test, prone double straight-leg raise test, supine isometric chest raise test and supine double straight-leg raise test regarding their utilization have been reported in the literature. However, identification of the tests that have more dominant sensitivity on assessment of LBP has not yet been determined. Information regarding the sensitivity of each test is needed for effective prevention and appropriate treatment strategies. Methods: A total of 200 subjects participated in this study. Subjects were categorized into four groups: asymptomatic males (N= 50, mean age= 38+12 years), asymptomatic females (N= 50, mean age= 43+11 years), males with LBP (N= 50, mean age= 39+12 years), and females with LBP (N= 50, mean age= 43+12 years). Five clinical tests were measured in each group and the relative association of each test on LBP was assessed. Results: Among all the performed tests, the prone double straight-leg raise test had the highest association with LBP. Other tests such as the prone isometric chest raise test, Supine isometric chest raise test and Supine double straight-leg raise test had low association with LBP in comparison with the prone double straight-leg raise test. Conclusion: It seems that the prone double straight-leg raise test has more association with LBP than other tests and could be used as a useful method for testing spinal muscle endurance, prediction of the probability of the occurrence of LBP, and prevention and rehabilitation of LBP