Effectiveness of core stability training and dynamic stretching in rehabilitation of chronic low back pain patient

Ebby Waqqash Mohamad Chan, Rahmat Adnan, Ridzuan Azmi

Abstract


To evaluate the effectiveness of core stability training and dynamic stretching on thoracolumbar range of motion (ROM), pain level and functional disability among chronic low back pain patients. Forty-three participants aged from 19-67 years old with the primary complaint of low back pain of more than 12 weeks’ duration were assigned to three groups: core stability (CS) (n=17), dynamic stretching (DS) (n=16) and control (n=12). All participants received regular thermotherapy and electrotherapy from the hospital rehabilitation unit. The CS group and DS groups were assigned with additional training, namely core stability training and dynamic stretching training programs for the respective groups. No additional training was given to the control group. The participants’ thoracolumbar range of motion (ROM), pain level and functional disability were tested over four different testing periods (pre, acute, ongoing, post). The current study shows both the CS group and DS group show significant improvement (p<0.05) in thoracolumbar ROM (CS group; ηp2 = 0.50, CS group; ηp2 = 0.66), pain level (CS group; ηp2 = 0.85, CS group; ηp2 = 0.81), and functional disability (CS group; ηp2 = 0.65, CS group; ηp2 = 0.82). In summary, both core stability exercise and dynamic stretching are effective in improving thoracolumbar ROM, pain-level, functional disability among chronic low back pain patients.


Keywords


Low back pain, core stability, stretching

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References


Alter, J. M. (2004). Science of Flexibility (3rd ed.): Human Kinetics.

Areeudomwong, P., Puntumetakul, R., Jirarattanaphochai, K., Wanpen, S., Kanpittaya, J., Chatchawan, U., & Yamauchi, J. (2012). Core stabilization exercise improves pain intensity, functional disability and trunk muscle activity of patients with clinical lumbar instability: A pilot randomized controlled study. Journal of Physical Therapy Science, 24(10), . doi: 10.1589/jpts.24.1007

Baard, L. M., Pietersen, J., & Rensburg, V. J. S. (2011). Interventions for chronic low back pain: whole body vibration and spinal stabilisation. South African Journal Of Sports Medicine, 23(2), 35-39.

Bronfort, G., Maiers, M. J., Evans, R. L., Schulz, C. A., Bracha, Y., Svendsen, K. H., Grimm, R. H., Owens, E. F., Garvey, T. A., & Transfeldt, E. E. (2011). Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial. The Spine Journal, 11(7), 585-598. doi: http://dx.doi.org/10.1016/j.spinee.2011.01.036

Brukner, P., & Khan, K. (2007). Clinical Sports Medicine (Third ed.). Sydney: McGraw-Hill.

Chen, H. -M., Wang, H. -H., Chen, C. -H., & Hu, H. -M. (2012). Effectiveness of a stretching exercise program on low back pain and exercise self-efficacy among nurses in Taiwan: A randomized clinical trial. Pain Management Nursing(0). doi: http://dx.doi.org/10.1016/j.pmn.2012.10.003

Chung, S., Lee, J., & Yoon, J. (2013). Effects of stabilization exercise using a ball on mutifidus cross-sectional area in patients with chronic low back pain. Journal of Sports Science and Medicine, 12, 1-9.

Cleland, J. A., Childs, J. D., Palmer, J. A., & Eberhart, S. (2006). Slump stretching in the management of non-radicular low back pain: A pilot clinical trial. Manual Therapy, 11(4), 279-286. doi: http://dx.doi.org/10.1016/j.math.2005.07.002

Devi, Z. K., Kumar, S. N., Babu, K. B., & Ayyappan, R. V. (2014). Effectiveness of muscle stretching in occupation related chronic mechanical low back pain in community nurses - A single blind study. International Journal of Physiotherapy and Research, 2(1), 403-410.

Estes, T. M. (2008). The effects of static and dynamic stretching protocols on a 30-second anaerobic bicycle test. (M.S. 1461271), California University of Pennsylvania, United States -- Pennsylvania. Retrieved from http://search.proquest.com/docview/276099542?accountid=42518 ProQuest Dissertations & Theses (PQDT); ProQuest Dissertations & Theses (PQDT) database.

Fairbank, T. C. J., & Pynsent, B. P. (2000). The oswestry disability index. The Journal of Spine, 25(22), 2940–2953.

Ferreira, M. L., Ferreira, P. H., Latimer, J., Herbert, R. D., Hodges, P. W., Jennings, M. D., Maher, C. G., & Refshauge, K. M. (2007). Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain, 131(1–2), 31-37. doi: http://dx.doi.org/10.1016/j.pain.2006.12.008

França, F. R., Burke, T. N., Caffaro, R. R., Ramos, L. A., & Marques, A. P. (2012). Effects of muscular stretching and segmental stabilization on functional disability and pain in patients with chronic low back pain: A Randomized, controlled trial. Journal of Manipulative and Physiological Therapeutics, 35(4), 279-285. doi: http://dx.doi.org/10.1016/j.jmpt.2012.04.012

Gogia, P. P., Braatz, H. J., Rose, J. S., & Norton, J. B. (1986). Reliability and validity of goniometric measurements at the knee. Journal of the American Physical Therapy Association and Royal Dutch Society for Physical Therapy, 192-195.

Gooch, C. L., Pracht, E., & Borenstein, A. R. (2017). The burden of neurological disease in the United States: a summary report and call to action. Annals of neurology, 81(4), 479-484.

Henry, K. (2010). The effects of three different stretching interventions on running economy in trained female athletes. (Ph.D. 3414422), Texas Woman's University, United States -- Texas. Retrieved from http://search.proquest.com/docview/608981518?accountid=42518 ProQuest Dissertations & Theses (PQDT); ProQuest Dissertations & Theses (PQDT) database.

Herr, K. A., Spratt, K., & Richardson, G. (2004). Pain intensity assessment in older adults: use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults. Clinical Journal of Pain, 20(4), 207-219.

Houglum, A. P. (2005). Therapeutic exercise for musculoskeletal injuries (Second ed.): Human Kinetics.

Jaggers, J. R. (2006). The acute effects of dynamic and ballistic stretching on vertical jump height, force, and power. (M.S. 1437350), University of Louisville, United States -- Kentucky. Retrieved from http://search.proquest.com/docview/305318527?accountid=42518 ProQuest Dissertations & Theses (PQDT); ProQuest Dissertations & Theses (PQDT) database.

Karnath, B. (2003). Clinical signs of low back pain. Hospital Physician, 39-44.

Kujala, U. M., Salminen, J. J., Taimela, S., Oksanen, A., & Jaakkola, L. (1992). Subject characteristics and low back pain in young athletes and nonathletes. Medicine and Science in Sports and Exercise, 24(6), 627-632.

Lawand, P., Júnior, I. L., Jones, A., Sardim, C., Ribeiro, L. H., & Natour, J. (2015). Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain: A randomized controlled trial. Joint Bone Spine, 82(4), 272-277.

Lederman, E. (2010). The myth of core stability. Journal of Bodywork & Movement Therapies, 14, 84-98.

Longo, A. (2009). Active isolated stretching: An investigation of the mechanical mechanisms. (M.Sc. MR51908), Brock University (Canada), Canada. Retrieved from http://search.proquest.com/docview/305177548?accountid=42518 ProQuest Dissertations & Theses (PQDT); ProQuest Dissertations & Theses (PQDT) database.

Mohseni-Bandpei, M. A., Rahmani, N., Behtash, H., & Karimloo, M. (2011). The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain. Journal of Bodywork and Movement Therapies, 15(1), 75-81. doi: http://dx.doi.org/10.1016/j.jbmt.2009.12.001

Nelson, G. A., & Kokkonen, J. (2007). Stretching Anatomy. United States of America: Human Kinetics.

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. doi: http://dx.doi.org/10.1016/j.ctcp.2008.06.001

Poiraudeau, S., & Revel, M. (2000). Rehabilitation therapy in chronic low back pain. Joint Bone Spine, 67(6), 582-587. doi: http://dx.doi.org/10.1016/S1297-319X(00)00210-4

Prentice, E. W. (2011). Rehabilitation techniques for sports medicine and athletic training (Fifth ed.): McGraw-Hill

Rajaratnam, B. S., Lam, C. M., Seah, H. H. S., Chee, W. S., Leung, Y. S. E., Ong, Y. J. L., & Kok, Y. Y. (2009). Can stretching exercises reduce your risks of experiencing low back pain? In C. Lim & J. H. Goh (Eds.), 13th International Conference on Biomedical Engineering (Vol. 23, pp. ): Springer Berlin Heidelberg.

Samukawa, M., Hattori, M., Sugama, N., & Takeda, N. (2011). The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties. Manual Therapy, 16(6), 618-622. doi: http://dx.doi.org/10.1016/j.math.2011.07.003

Silveira, G., Sayers, M., & Waddington, G. (2010). Effect of static and dynamic stretching on hamstring flexibility in the warm-up. Journal of Science and Medicine in Sport, 12, Supplement 2(0), e10-e11. doi: http://dx.doi.org/10.1016/j.jsams.2009.10.023

Standaert, C. J., Weinstein, S. M., & Rumpeltes, J. (2008). Evidence-informed management of chronic low back pain with lumbar stabilization exercises. The Spine Journal, 8(1), 114-120. doi: http://dx.doi.org/10.1016/j.spinee.2007.10.015

Stuber, K. J., Bruno, P., Sajko, S., & Hayden, J. A. (2014). Core stability exercises for low back pain in athletes: a systematic review of the literature. Clinical Journal of Sport Medicine, 24(6), 448-456.

Thakur, A. (2009). Running economy: Acute effect of active isolated stretching. (M.S. 1495982), Lamar University - Beaumont, United States -- Texas. Retrieved from http://search.proquest.com/docview/875564288?accountid=42518 ProQuest Dissertations & Theses (PQDT); ProQuest Dissertations & Theses (PQDT) database.

Vianin, M. (2008). Psychometric properties and clinical usefulness of the Oswestry Disability Index. Journal of Chiropractic Medicine, 7, 161–163.

Waqqash, E., Adnan, R., Yusof, S. M., Sulaiman, N., & Ismail, S. I. (2014). Efficacy of core stability exercise and muscular stretching on chronic low-back pain. Paper presented at the Proceedings of the International Colloquium on Sports Science, Exercise, Engineering and Technology 2014 (ICoSSEET 2014).

You, J. H., Kim, S.-Y., Oh, D. -W., & Chon, S. -C. (2014). The effect of a novel core stabilization technique on managing patients with chronic low back pain: A randomized, controlled, experimenter-blinded study. Clinical rehabilitation, 28(5), 460-469.




DOI: https://doi.org/10.15282/mohe.v8i1.210