DIFFERENCES IN THE EFFECTIVENESS OF STANDARD PHYSICAL THERAPY COMPARED TO MANUAL YUMEIHO THERAPY AND EXERCISE IN PATIENTS WITH CHRONIC NONSPECIFIC LOW BACK PAIN

Cilj ovog istraživanja je usporediti učinkovitost terapijskog programa koji kombinira manualnu terapiju tehnikom yumeiho i vježbe, sa standardnim protokolom fizikalne terapije u rehabilitaciji osoba s kroničnom križoboljom. Metode: U istraživanju je sudjelovalo 46 ispitanika, koji su metodom slučajnog odabira podijeljeni u dvije istobrojne skupine. Ispitanici u skupini 1 (n=23) provodili su manualnu terapiju tehnikom yumeiho i vježbanje, dok su ispitanici skupine 2 (n=23) provodili standardni tretman fizikalne terapije. Istraživanje se sastojalo od inicijalnog i finalnog testiranja boli u lumbalnom dijelu kralježnice pri kretanju, kvalitete života, funkcionalnosti pokreta u svakodnevici, razini depresije, pokretljivosti kralježnice i statičkoj ravnoteži. Između inicijalnog i finalnog testiranja proveden je terapijski postupak u trajanju od tri tjedna (ukupno 15 tretmana). Rezultati: U rehabilitacijskom protokolu koji je uključivao manualnu terapiju tehnikom yumeiho i vježbe zabilježena su statistički značajna poboljšanja između inicijalnog i finalnog stanja u svim praćenim dimenzijama, dok je u rehabilitacijskom protokolu koji je uključivao fizikalnu terapiju zabilježeno statistički značajno poboljšanje u smanjenju boli, pokretljivosti kralježnice i funkcionalnosti pokreta u svakodnevici. 2 x 2 miješanim modelom ANOVE zabilježena je značajna razlika u učincima između dva rehabilitacijska programa u osjećaju boli, pokretljivosti kralježnice, kvaliteti života u domeni psihičkog i fizičkog zdravlju i funkcionalnosti pokreta u svakodnevici. Veličina učinka je izračunata preko parcijalno kvadrirane ete. U svim je praćenim dimenzijama osim ravnoteže pronađena statistički značajna povezanost između primijenjenih metoda rehabilitacije i učinaka rehabilitacijskog procesa s naglaskom na značajno veća poboljšanja u ispitanika koji su bili podvrgnuti terapiji yumeiho. Značajne interakcije prate umjerene i velike veličine učinka (jer su u svim varijablama zabilježene vrijednosti veće od 0,14 za parcijalno kvadriranu etu. Zaključak: Rehabilitacijski protokol koji je uključivao manualnu terapiju pokazao se učinkovitim u liječenju kronične križobolje. Potrebna su daljnja istraživanja ovog područja za dobivanje jasnije slike, a prijedlozi autora idu u smjeru uspoređivanja korištenog rehabilitacijskog modela s ostalim metodama, dužeg praćenja u postrehabilitacijskom razdoblju te studija na većem broju ispitanika.The aim of this study was to compare the effi ciency of a therapeutic program that combines manual therapy based on Yumeiho technique and exercise with standard physical therapy protocol in the rehabilitation of people with chronic back pain. Methods: The study included 46 subjects randomly divided into two groups with the same number of subjects. Group 1 subjects (n=23) were conducting manual therapy based on Yumeiho technique combined with exercise, whereas group 2 subjects (n=23) underwent physiotherapy treatment.The research consisted of initial and fi nal testing of pain in lumbar spine during movement, quality of life, functionality of movement in everyday life, level of depression, mobility of the spine and static balance. Between the initial and fi nal testing, a 3-week therapy program was conducted with a total of 15 treatments. Results: The rehabilitation protocol that included manual therapy based on Yumeiho technique and exercise showed signifi cant improvements between the initial and fi nal state of all dimensions monitored, whereas the rehabilitation protocol using physical therapy reported signifi cant improvement in reducing pain, spine mobility and functionality of movement in everyday life. The 2x2 mixed ANOVA model yielded signifi cant difference between the two rehabilitation programs in the sense of pain, spine mobility, quality of life in the domain of mental and physical health, depression and movement functionality in everyday life. The effect size was calculated by the partially squaring eta. In all monitored dimensions except for balance, statistically signifi cant interactions were found between the rehabilitation methods applied and the effects of rehabilitation process, with signifi cantly higher improvements in the group undergoing therapy with Yumeiho technique. Signifi cant interactions followed moderate and large effect size because all the variables recorded higher values than 0.14 for the partially squaring eta. Conclusion: Rehabilitation protocol that included manual therapy proved to be effective in the treatment of chronic back pain. Additional research is needed to get better insight into comparison of this rehabilitation model with other methods, longer monitoring in the post-rehabilitation period, and a greater number of subjects

Proceedings of the 12th International Conference on Kinanthropology

Proceedings of the 12th Conference of Sport and Quality of Life 2019 gatheres submissions of participants of the conference. Every submission is the result of positive evaluation by reviewers from the corresponding field. Conference is divided into sections – Analysis of human movement; Sport training, nutrition and regeneration; Sport and social sciences; Active ageing and sarcopenia; Strength and conditioning training; section for PhD students

Effectiveness of manual yumeiho therapy and exercises on recovery in patients suffering from chronic nonspecific low back pain

Uvod: Kronična križobolja vodeći je uzrok globalne onesposobljenosti stanovništva u svijetu koja uzrokuje opadanje kvalitete života te stalni porast troškova zdravstvene skrbi. Postoje različite vrste manualnih terapija koje se koriste u rješavanju kronične križobolje, a recentnija istraživanja ukazuju da rehabilitacijski model u kojemu se primjenjuju manualna terapija i vježbe daje značajno bolje rezultate od njihove pojedinačne primjene. Pregledom dosadašnjih istraživanja nije pronađena nijedna studija utjecaja manualne terapije yumeiho tehnikom i vježbanja na kroničnu križobolju. Shodno tome cilj je ovoga istraživanja bio analizirati utjecaj rehabilitacijskog programa, koji uključuje manualnu terapiju yumeiho tehnikom i vježbe, na rješavanje kronične križobolje te usporedba toga programa s fizikalnom terapijom. Metode: U istraživanju je sudjelovalo 50 ispitanika u dobi od 40 do 60 godina (M=51,60; sd= ± 5,73) koji su metodom slučajnog odabira podijeljeni u dvije skupine s jednakim brojem ispitanika. Ispitanici u eksperimentalnoj skupini (n=25) provodili su manualnu terapiju yumeiho tehnikom uz vježbe jačanja i istezanja dubokih mišića zdjelice i lumbalno-glutealne regije. Ispitanici kontrolne skupine (n=25) provodili su tretman fizikalne terapije koji se sastojao od primjene elektroterapije i terapijskoga ultrazvuka uz osnovne vježbe jačanja trbušne muskulature i istezanja lumbalnoga dijela leđa. Mjerenje se sastojalo od inicijalnog i finalnog testiranja boli u lumbalnomu dijelu kralježnice pri kretanju (VAS skala boli), kvalitete života (Short Form 36), funkcionalnosti pokreta u svakodnevici (Oswestry Disability Indeks), razini depresije (Beck Depression Inventory), pokretljivosti kralježnice (PRETKLON U USKOM RAZNOŽENJU), statičkoj ravnoteži (MIRNO STAJANJE NA JEDNOJ NOZI) i neuropatske boli (Leeds assesment of neuropathic symptoms and signs). Između inicijalnoga i finalnoga testiranja proveden je terapijski postupak u trajanju od tri tjedna (ukupno 15 tretmana). Osim finalnoga mjerenja koje je provedeno neposredno poslije završetka terapije, ponovljeno mjerenje boli, kvalitete života i funkcionalnosti pokreta u svakodnevici provodilo se i mjesec, dva i tri nakon provedbe rehabilitacijskih programa. Rezultati: Nakon rehabilitacijskoga protokola, koji je uključivao manualnu terapiju yumeiho tehnikom i vježbe, zabilježena su statistički značajna poboljšanja (p<0,05) kod ispitanika između inicijalnoga i finalnoga stanja u svim praćenim varijablama osim u varijabli ravnoteže. Kod ispitanika koji su provodili fizikalnu terapiju zabilježeno je statistički značajno poboljšanje (p<0,05) u smanjenju boli, poboljšanju fizičkoga zdravlja, pokretljivosti kralježnice, depresije i funkcionalnosti pokreta u svakodnevici, dok nisu zabilježena poboljšanja psihičkoga zdravlja, neuropatske boli i ravnoteže. Glavni nalaz ovoga istraživanja ukazuje da su neposredno nakon provedbe rehabilitacijskoga protokola ostvarena značajna poboljšanja (p<0,05) u svim praćenim varijablama (VAS, ODI, SF-36, PRETKLON, BECK, LANSS) osim u varijabli ravnoteže, i to u korist skupine koja je provodila manualnu terapiju yumeiho tehnikom i vježbe. Potrebno je naglasiti da postignuti učinci neposredno nakon terapija imaju jednaku dinamiku opadanja. Nijedna terapija ne doprinosi dugom trajanju postignutih učinaka. Rezultati se jednako ponašaju između skupina. Zaključak: Rezultati upućuju da je rehabilitacijski protokol koji uključuje manualnu terapiju yumeiho tehnikom i vježbe učinkovitija metoda u odnosu na standardnu fizikalnu terapiju u liječenju pacijenata koji pate od kronične križobolje. S obzirom na globalni nedostatak istraživanja o učincima manualne terapije yumeiho tehnikom, rezultati ovoga istraživanja doprinose boljem razumijevanju tehnike koja, iako se koristi u praksi, nije dovoljno istražena. Ovo istraživanje pomaže boljemu razumijevanju učinkovitosti terapijskoga programa koji uključuje manualnu terapiju yumeiho tehnikom i vježbe u odnosu na standardnu fizikalnu terapiju bez yumeiho tehnike u tretmanu brojnih aspekata koje opisuju ukupno zdravlje osoba s križoboljom. Potrebna su daljnja istraživanja za dobivanje jasnije slike radi uspoređivanja korištenoga rehabilitacijskog modela s ostalim metodama te dužega praćenja u postrehabilitacijskomu periodu.Introduction: Chronic low back pain is the leading cause of global disability in the world which causes a decline in quality of life and increases the healthcare costs. There are different types of manual therapies used in the treatment of chronic low back pain, but recent research shows that a rehabilitation model, which combines manual therapy and exercise, allows considerably better results than their separate usage. The review of the previous research did not provide any study that analyses the impact of manual therapy using Yumeiho technique and exercising, related to chronic low back pain. Consequently, the aim of this study is to analyze the impact of a rehabilitation program which includes Yumeiho manual therapy and exercise, in order to solve chronic low back pain and compare it to standard physical therapy. Methods: The study included 50 participants, aged 40 to 60 (M=51.60; sd=±5.73), randomly divided into two groups of the same number of participants. The participants in the group 1 (n=25) were conducting manual therapy based on Yumeiho technique combined with exercise, while participants of the group 2 (n=25) were conducting a physical therapy treatment that consisted of electrotherapy and the therapeutic ultrasound, combined with exercises for strengthening abdominal muscles and stretching the lumbar part of the spine. The measurement procedure consisted the initial and final testing of low back pain during movement (VAS pain scale), quality of life (Short Form 36), functionality of movement in everyday life (Oswestry Disability Index), the level of depression (Beck Depression Inventory), spine mobility (BENT IN THE NARROW POSTURE), static balance (STILL STANDING ON ONE LEG) and neuropathic pain (Leeds assesment of neuropathic symptoms and signs). Between the initial and final testing, a three-week therapy program was done (15 treatments in total). Apart from final measurement, conducted as therapy ended, repeated measurement of pain, quality of life and functionality of the movement in everyday life was taken one, two and three months after the rehabilitation program had finished. Results: After the rehabilitation protocol, which included manual therapy based on Yumeiho technique and exercise, significant improvements (p<0,05) between the initial and final testing of all monitored variables (except for balance) were recorded. In participants who were conducted physical therapy, statistically significant improvements (p<0,05) were recorded in: decreasing pain, physical health improvement, spine mobility, decreasing depression and better functionality of movement in everyday life. Significant improvements were not recorded for mental health, neuropathic pain and balance. The main finding of this study indicates that, immediately after the implementation of the rehabilitation protocol, significant improvements (p<0,05) were recorded in all the variables (VAS, ODI, SF-36, BENT, BECK, LANSS) except for the balance, among the group who combined Yumeiho manual therapy and exercises. It should be emphasized that the achieved effects have the same dynamics of decline immediately after the therapies. No therapy contributes to the longer duration of the achieved effects. The results remain equally between groups. Conclusion: In conclusion, the results suggest that the rehabilitation protocol which combines manual therapy and exercises, is more efficient method for the treatment of patients suffering from chronic low back pain, compared to standard physical therapy. Taking into account a global lack of the research on the effects of manual therapy using Yumeiho technique, the results of this study contribute to a better understanding of technique, which, even though used in practice, has not been examined enough. Moreover, this study helps to understand better efficiency of the therapeutic program that includes manual therapy based on Yumeiho technique combined with exercise. Especially in relation to standard physical therapy without Yumeiho, within a treatment of numerous variables which describe the overall health of people who suffer of chronic low back pain. Further studies are necessary to acquire a clearer picture towards a comparison of the used rehabilitation model with other methods and longer monitoring in the post-rehabilitation period

Effectiveness of manual yumeiho therapy and exercises on recovery in patients suffering from chronic nonspecific low back pain

Uvod: Kronična križobolja vodeći je uzrok globalne onesposobljenosti stanovništva u svijetu koja uzrokuje opadanje kvalitete života te stalni porast troškova zdravstvene skrbi. Postoje različite vrste manualnih terapija koje se koriste u rješavanju kronične križobolje, a recentnija istraživanja ukazuju da rehabilitacijski model u kojemu se primjenjuju manualna terapija i vježbe daje značajno bolje rezultate od njihove pojedinačne primjene. Pregledom dosadašnjih istraživanja nije pronađena nijedna studija utjecaja manualne terapije yumeiho tehnikom i vježbanja na kroničnu križobolju. Shodno tome cilj je ovoga istraživanja bio analizirati utjecaj rehabilitacijskog programa, koji uključuje manualnu terapiju yumeiho tehnikom i vježbe, na rješavanje kronične križobolje te usporedba toga programa s fizikalnom terapijom. Metode: U istraživanju je sudjelovalo 50 ispitanika u dobi od 40 do 60 godina (M=51,60; sd= ± 5,73) koji su metodom slučajnog odabira podijeljeni u dvije skupine s jednakim brojem ispitanika. Ispitanici u eksperimentalnoj skupini (n=25) provodili su manualnu terapiju yumeiho tehnikom uz vježbe jačanja i istezanja dubokih mišića zdjelice i lumbalno-glutealne regije. Ispitanici kontrolne skupine (n=25) provodili su tretman fizikalne terapije koji se sastojao od primjene elektroterapije i terapijskoga ultrazvuka uz osnovne vježbe jačanja trbušne muskulature i istezanja lumbalnoga dijela leđa. Mjerenje se sastojalo od inicijalnog i finalnog testiranja boli u lumbalnomu dijelu kralježnice pri kretanju (VAS skala boli), kvalitete života (Short Form 36), funkcionalnosti pokreta u svakodnevici (Oswestry Disability Indeks), razini depresije (Beck Depression Inventory), pokretljivosti kralježnice (PRETKLON U USKOM RAZNOŽENJU), statičkoj ravnoteži (MIRNO STAJANJE NA JEDNOJ NOZI) i neuropatske boli (Leeds assesment of neuropathic symptoms and signs). Između inicijalnoga i finalnoga testiranja proveden je terapijski postupak u trajanju od tri tjedna (ukupno 15 tretmana). Osim finalnoga mjerenja koje je provedeno neposredno poslije završetka terapije, ponovljeno mjerenje boli, kvalitete života i funkcionalnosti pokreta u svakodnevici provodilo se i mjesec, dva i tri nakon provedbe rehabilitacijskih programa. Rezultati: Nakon rehabilitacijskoga protokola, koji je uključivao manualnu terapiju yumeiho tehnikom i vježbe, zabilježena su statistički značajna poboljšanja (p<0,05) kod ispitanika između inicijalnoga i finalnoga stanja u svim praćenim varijablama osim u varijabli ravnoteže. Kod ispitanika koji su provodili fizikalnu terapiju zabilježeno je statistički značajno poboljšanje (p<0,05) u smanjenju boli, poboljšanju fizičkoga zdravlja, pokretljivosti kralježnice, depresije i funkcionalnosti pokreta u svakodnevici, dok nisu zabilježena poboljšanja psihičkoga zdravlja, neuropatske boli i ravnoteže. Glavni nalaz ovoga istraživanja ukazuje da su neposredno nakon provedbe rehabilitacijskoga protokola ostvarena značajna poboljšanja (p<0,05) u svim praćenim varijablama (VAS, ODI, SF-36, PRETKLON, BECK, LANSS) osim u varijabli ravnoteže, i to u korist skupine koja je provodila manualnu terapiju yumeiho tehnikom i vježbe. Potrebno je naglasiti da postignuti učinci neposredno nakon terapija imaju jednaku dinamiku opadanja. Nijedna terapija ne doprinosi dugom trajanju postignutih učinaka. Rezultati se jednako ponašaju između skupina. Zaključak: Rezultati upućuju da je rehabilitacijski protokol koji uključuje manualnu terapiju yumeiho tehnikom i vježbe učinkovitija metoda u odnosu na standardnu fizikalnu terapiju u liječenju pacijenata koji pate od kronične križobolje. S obzirom na globalni nedostatak istraživanja o učincima manualne terapije yumeiho tehnikom, rezultati ovoga istraživanja doprinose boljem razumijevanju tehnike koja, iako se koristi u praksi, nije dovoljno istražena. Ovo istraživanje pomaže boljemu razumijevanju učinkovitosti terapijskoga programa koji uključuje manualnu terapiju yumeiho tehnikom i vježbe u odnosu na standardnu fizikalnu terapiju bez yumeiho tehnike u tretmanu brojnih aspekata koje opisuju ukupno zdravlje osoba s križoboljom. Potrebna su daljnja istraživanja za dobivanje jasnije slike radi uspoređivanja korištenoga rehabilitacijskog modela s ostalim metodama te dužega praćenja u postrehabilitacijskomu periodu.Introduction: Chronic low back pain is the leading cause of global disability in the world which causes a decline in quality of life and increases the healthcare costs. There are different types of manual therapies used in the treatment of chronic low back pain, but recent research shows that a rehabilitation model, which combines manual therapy and exercise, allows considerably better results than their separate usage. The review of the previous research did not provide any study that analyses the impact of manual therapy using Yumeiho technique and exercising, related to chronic low back pain. Consequently, the aim of this study is to analyze the impact of a rehabilitation program which includes Yumeiho manual therapy and exercise, in order to solve chronic low back pain and compare it to standard physical therapy. Methods: The study included 50 participants, aged 40 to 60 (M=51.60; sd=±5.73), randomly divided into two groups of the same number of participants. The participants in the group 1 (n=25) were conducting manual therapy based on Yumeiho technique combined with exercise, while participants of the group 2 (n=25) were conducting a physical therapy treatment that consisted of electrotherapy and the therapeutic ultrasound, combined with exercises for strengthening abdominal muscles and stretching the lumbar part of the spine. The measurement procedure consisted the initial and final testing of low back pain during movement (VAS pain scale), quality of life (Short Form 36), functionality of movement in everyday life (Oswestry Disability Index), the level of depression (Beck Depression Inventory), spine mobility (BENT IN THE NARROW POSTURE), static balance (STILL STANDING ON ONE LEG) and neuropathic pain (Leeds assesment of neuropathic symptoms and signs). Between the initial and final testing, a three-week therapy program was done (15 treatments in total). Apart from final measurement, conducted as therapy ended, repeated measurement of pain, quality of life and functionality of the movement in everyday life was taken one, two and three months after the rehabilitation program had finished. Results: After the rehabilitation protocol, which included manual therapy based on Yumeiho technique and exercise, significant improvements (p<0,05) between the initial and final testing of all monitored variables (except for balance) were recorded. In participants who were conducted physical therapy, statistically significant improvements (p<0,05) were recorded in: decreasing pain, physical health improvement, spine mobility, decreasing depression and better functionality of movement in everyday life. Significant improvements were not recorded for mental health, neuropathic pain and balance. The main finding of this study indicates that, immediately after the implementation of the rehabilitation protocol, significant improvements (p<0,05) were recorded in all the variables (VAS, ODI, SF-36, BENT, BECK, LANSS) except for the balance, among the group who combined Yumeiho manual therapy and exercises. It should be emphasized that the achieved effects have the same dynamics of decline immediately after the therapies. No therapy contributes to the longer duration of the achieved effects. The results remain equally between groups. Conclusion: In conclusion, the results suggest that the rehabilitation protocol which combines manual therapy and exercises, is more efficient method for the treatment of patients suffering from chronic low back pain, compared to standard physical therapy. Taking into account a global lack of the research on the effects of manual therapy using Yumeiho technique, the results of this study contribute to a better understanding of technique, which, even though used in practice, has not been examined enough. Moreover, this study helps to understand better efficiency of the therapeutic program that includes manual therapy based on Yumeiho technique combined with exercise. Especially in relation to standard physical therapy without Yumeiho, within a treatment of numerous variables which describe the overall health of people who suffer of chronic low back pain. Further studies are necessary to acquire a clearer picture towards a comparison of the used rehabilitation model with other methods and longer monitoring in the post-rehabilitation period

Effectiveness of manual yumeiho therapy and exercises on recovery in patients suffering from chronic nonspecific low back pain

Uvod: Kronična križobolja vodeći je uzrok globalne onesposobljenosti stanovništva u svijetu koja uzrokuje opadanje kvalitete života te stalni porast troškova zdravstvene skrbi. Postoje različite vrste manualnih terapija koje se koriste u rješavanju kronične križobolje, a recentnija istraživanja ukazuju da rehabilitacijski model u kojemu se primjenjuju manualna terapija i vježbe daje značajno bolje rezultate od njihove pojedinačne primjene. Pregledom dosadašnjih istraživanja nije pronađena nijedna studija utjecaja manualne terapije yumeiho tehnikom i vježbanja na kroničnu križobolju. Shodno tome cilj je ovoga istraživanja bio analizirati utjecaj rehabilitacijskog programa, koji uključuje manualnu terapiju yumeiho tehnikom i vježbe, na rješavanje kronične križobolje te usporedba toga programa s fizikalnom terapijom. Metode: U istraživanju je sudjelovalo 50 ispitanika u dobi od 40 do 60 godina (M=51,60; sd= ± 5,73) koji su metodom slučajnog odabira podijeljeni u dvije skupine s jednakim brojem ispitanika. Ispitanici u eksperimentalnoj skupini (n=25) provodili su manualnu terapiju yumeiho tehnikom uz vježbe jačanja i istezanja dubokih mišića zdjelice i lumbalno-glutealne regije. Ispitanici kontrolne skupine (n=25) provodili su tretman fizikalne terapije koji se sastojao od primjene elektroterapije i terapijskoga ultrazvuka uz osnovne vježbe jačanja trbušne muskulature i istezanja lumbalnoga dijela leđa. Mjerenje se sastojalo od inicijalnog i finalnog testiranja boli u lumbalnomu dijelu kralježnice pri kretanju (VAS skala boli), kvalitete života (Short Form 36), funkcionalnosti pokreta u svakodnevici (Oswestry Disability Indeks), razini depresije (Beck Depression Inventory), pokretljivosti kralježnice (PRETKLON U USKOM RAZNOŽENJU), statičkoj ravnoteži (MIRNO STAJANJE NA JEDNOJ NOZI) i neuropatske boli (Leeds assesment of neuropathic symptoms and signs). Između inicijalnoga i finalnoga testiranja proveden je terapijski postupak u trajanju od tri tjedna (ukupno 15 tretmana). Osim finalnoga mjerenja koje je provedeno neposredno poslije završetka terapije, ponovljeno mjerenje boli, kvalitete života i funkcionalnosti pokreta u svakodnevici provodilo se i mjesec, dva i tri nakon provedbe rehabilitacijskih programa. Rezultati: Nakon rehabilitacijskoga protokola, koji je uključivao manualnu terapiju yumeiho tehnikom i vježbe, zabilježena su statistički značajna poboljšanja (p<0,05) kod ispitanika između inicijalnoga i finalnoga stanja u svim praćenim varijablama osim u varijabli ravnoteže. Kod ispitanika koji su provodili fizikalnu terapiju zabilježeno je statistički značajno poboljšanje (p<0,05) u smanjenju boli, poboljšanju fizičkoga zdravlja, pokretljivosti kralježnice, depresije i funkcionalnosti pokreta u svakodnevici, dok nisu zabilježena poboljšanja psihičkoga zdravlja, neuropatske boli i ravnoteže. Glavni nalaz ovoga istraživanja ukazuje da su neposredno nakon provedbe rehabilitacijskoga protokola ostvarena značajna poboljšanja (p<0,05) u svim praćenim varijablama (VAS, ODI, SF-36, PRETKLON, BECK, LANSS) osim u varijabli ravnoteže, i to u korist skupine koja je provodila manualnu terapiju yumeiho tehnikom i vježbe. Potrebno je naglasiti da postignuti učinci neposredno nakon terapija imaju jednaku dinamiku opadanja. Nijedna terapija ne doprinosi dugom trajanju postignutih učinaka. Rezultati se jednako ponašaju između skupina. Zaključak: Rezultati upućuju da je rehabilitacijski protokol koji uključuje manualnu terapiju yumeiho tehnikom i vježbe učinkovitija metoda u odnosu na standardnu fizikalnu terapiju u liječenju pacijenata koji pate od kronične križobolje. S obzirom na globalni nedostatak istraživanja o učincima manualne terapije yumeiho tehnikom, rezultati ovoga istraživanja doprinose boljem razumijevanju tehnike koja, iako se koristi u praksi, nije dovoljno istražena. Ovo istraživanje pomaže boljemu razumijevanju učinkovitosti terapijskoga programa koji uključuje manualnu terapiju yumeiho tehnikom i vježbe u odnosu na standardnu fizikalnu terapiju bez yumeiho tehnike u tretmanu brojnih aspekata koje opisuju ukupno zdravlje osoba s križoboljom. Potrebna su daljnja istraživanja za dobivanje jasnije slike radi uspoređivanja korištenoga rehabilitacijskog modela s ostalim metodama te dužega praćenja u postrehabilitacijskomu periodu.Introduction: Chronic low back pain is the leading cause of global disability in the world which causes a decline in quality of life and increases the healthcare costs. There are different types of manual therapies used in the treatment of chronic low back pain, but recent research shows that a rehabilitation model, which combines manual therapy and exercise, allows considerably better results than their separate usage. The review of the previous research did not provide any study that analyses the impact of manual therapy using Yumeiho technique and exercising, related to chronic low back pain. Consequently, the aim of this study is to analyze the impact of a rehabilitation program which includes Yumeiho manual therapy and exercise, in order to solve chronic low back pain and compare it to standard physical therapy. Methods: The study included 50 participants, aged 40 to 60 (M=51.60; sd=±5.73), randomly divided into two groups of the same number of participants. The participants in the group 1 (n=25) were conducting manual therapy based on Yumeiho technique combined with exercise, while participants of the group 2 (n=25) were conducting a physical therapy treatment that consisted of electrotherapy and the therapeutic ultrasound, combined with exercises for strengthening abdominal muscles and stretching the lumbar part of the spine. The measurement procedure consisted the initial and final testing of low back pain during movement (VAS pain scale), quality of life (Short Form 36), functionality of movement in everyday life (Oswestry Disability Index), the level of depression (Beck Depression Inventory), spine mobility (BENT IN THE NARROW POSTURE), static balance (STILL STANDING ON ONE LEG) and neuropathic pain (Leeds assesment of neuropathic symptoms and signs). Between the initial and final testing, a three-week therapy program was done (15 treatments in total). Apart from final measurement, conducted as therapy ended, repeated measurement of pain, quality of life and functionality of the movement in everyday life was taken one, two and three months after the rehabilitation program had finished. Results: After the rehabilitation protocol, which included manual therapy based on Yumeiho technique and exercise, significant improvements (p<0,05) between the initial and final testing of all monitored variables (except for balance) were recorded. In participants who were conducted physical therapy, statistically significant improvements (p<0,05) were recorded in: decreasing pain, physical health improvement, spine mobility, decreasing depression and better functionality of movement in everyday life. Significant improvements were not recorded for mental health, neuropathic pain and balance. The main finding of this study indicates that, immediately after the implementation of the rehabilitation protocol, significant improvements (p<0,05) were recorded in all the variables (VAS, ODI, SF-36, BENT, BECK, LANSS) except for the balance, among the group who combined Yumeiho manual therapy and exercises. It should be emphasized that the achieved effects have the same dynamics of decline immediately after the therapies. No therapy contributes to the longer duration of the achieved effects. The results remain equally between groups. Conclusion: In conclusion, the results suggest that the rehabilitation protocol which combines manual therapy and exercises, is more efficient method for the treatment of patients suffering from chronic low back pain, compared to standard physical therapy. Taking into account a global lack of the research on the effects of manual therapy using Yumeiho technique, the results of this study contribute to a better understanding of technique, which, even though used in practice, has not been examined enough. Moreover, this study helps to understand better efficiency of the therapeutic program that includes manual therapy based on Yumeiho technique combined with exercise. Especially in relation to standard physical therapy without Yumeiho, within a treatment of numerous variables which describe the overall health of people who suffer of chronic low back pain. Further studies are necessary to acquire a clearer picture towards a comparison of the used rehabilitation model with other methods and longer monitoring in the post-rehabilitation period

DIFFERENCES IN THE EFFECTIVENESS OF STANDARD PHYSICAL THERAPY COMPARED TO MANUAL YUMEIHO THERAPY AND EXERCISE IN PATIENTS WITH CHRONIC NONSPECIFIC LOW BACK PAIN

Cilj ovog istraživanja je usporediti učinkovitost terapijskog programa koji kombinira manualnu terapiju tehnikom yumeiho i vježbe, sa standardnim protokolom fizikalne terapije u rehabilitaciji osoba s kroničnom križoboljom. Metode: U istraživanju je sudjelovalo 46 ispitanika, koji su metodom slučajnog odabira podijeljeni u dvije istobrojne skupine. Ispitanici u skupini 1 (n=23) provodili su manualnu terapiju tehnikom yumeiho i vježbanje, dok su ispitanici skupine 2 (n=23) provodili standardni tretman fizikalne terapije. Istraživanje se sastojalo od inicijalnog i finalnog testiranja boli u lumbalnom dijelu kralježnice pri kretanju, kvalitete života, funkcionalnosti pokreta u svakodnevici, razini depresije, pokretljivosti kralježnice i statičkoj ravnoteži. Između inicijalnog i finalnog testiranja proveden je terapijski postupak u trajanju od tri tjedna (ukupno 15 tretmana). Rezultati: U rehabilitacijskom protokolu koji je uključivao manualnu terapiju tehnikom yumeiho i vježbe zabilježena su statistički značajna poboljšanja između inicijalnog i finalnog stanja u svim praćenim dimenzijama, dok je u rehabilitacijskom protokolu koji je uključivao fizikalnu terapiju zabilježeno statistički značajno poboljšanje u smanjenju boli, pokretljivosti kralježnice i funkcionalnosti pokreta u svakodnevici. 2 x 2 miješanim modelom ANOVE zabilježena je značajna razlika u učincima između dva rehabilitacijska programa u osjećaju boli, pokretljivosti kralježnice, kvaliteti života u domeni psihičkog i fizičkog zdravlju i funkcionalnosti pokreta u svakodnevici. Veličina učinka je izračunata preko parcijalno kvadrirane ete. U svim je praćenim dimenzijama osim ravnoteže pronađena statistički značajna povezanost između primijenjenih metoda rehabilitacije i učinaka rehabilitacijskog procesa s naglaskom na značajno veća poboljšanja u ispitanika koji su bili podvrgnuti terapiji yumeiho. Značajne interakcije prate umjerene i velike veličine učinka (jer su u svim varijablama zabilježene vrijednosti veće od 0,14 za parcijalno kvadriranu etu. Zaključak: Rehabilitacijski protokol koji je uključivao manualnu terapiju pokazao se učinkovitim u liječenju kronične križobolje. Potrebna su daljnja istraživanja ovog područja za dobivanje jasnije slike, a prijedlozi autora idu u smjeru uspoređivanja korištenog rehabilitacijskog modela s ostalim metodama, dužeg praćenja u postrehabilitacijskom razdoblju te studija na većem broju ispitanika.The aim of this study was to compare the effi ciency of a therapeutic program that combines manual therapy based on Yumeiho technique and exercise with standard physical therapy protocol in the rehabilitation of people with chronic back pain. Methods: The study included 46 subjects randomly divided into two groups with the same number of subjects. Group 1 subjects (n=23) were conducting manual therapy based on Yumeiho technique combined with exercise, whereas group 2 subjects (n=23) underwent physiotherapy treatment.The research consisted of initial and fi nal testing of pain in lumbar spine during movement, quality of life, functionality of movement in everyday life, level of depression, mobility of the spine and static balance. Between the initial and fi nal testing, a 3-week therapy program was conducted with a total of 15 treatments. Results: The rehabilitation protocol that included manual therapy based on Yumeiho technique and exercise showed signifi cant improvements between the initial and fi nal state of all dimensions monitored, whereas the rehabilitation protocol using physical therapy reported signifi cant improvement in reducing pain, spine mobility and functionality of movement in everyday life. The 2x2 mixed ANOVA model yielded signifi cant difference between the two rehabilitation programs in the sense of pain, spine mobility, quality of life in the domain of mental and physical health, depression and movement functionality in everyday life. The effect size was calculated by the partially squaring eta. In all monitored dimensions except for balance, statistically signifi cant interactions were found between the rehabilitation methods applied and the effects of rehabilitation process, with signifi cantly higher improvements in the group undergoing therapy with Yumeiho technique. Signifi cant interactions followed moderate and large effect size because all the variables recorded higher values than 0.14 for the partially squaring eta. Conclusion: Rehabilitation protocol that included manual therapy proved to be effective in the treatment of chronic back pain. Additional research is needed to get better insight into comparison of this rehabilitation model with other methods, longer monitoring in the post-rehabilitation period, and a greater number of subjects