The effect of ten training sessions with Pilates method in standard activation of trunk stabilizer muscles in functional tasks in individuals with low back pain

• Grant number: 15/10615-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): October 01, 2015
• Effective date (End): September 30, 2016
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Nise Ribeiro Marques
• Grantee: Dayane Dias Pereira
• Host Institution: Faculdade de Filosofia e Ciências (FFC). Universidade Estadual Paulista (UNESP). Campus de Marília. Marília , SP, Brazil

Abstract

Chronic non-specific low back pain is one of the highest incidence diseases in the world, affecting active younger people. Several studies demonstrated that the etiology of non-specific low back pain has a link with the muscle activation abnormalities, which decreases the strength and resistance of the trunk stabilizer muscles, causing low back pain. Currently, the lumbar-pelvic segmental stabilization exercises, such as the Pilates Method, have been popularly prescribed to reachability this dysfunction, making this method ideal for clinical practice in physical therapy. OBJECTIVE: To analyze the effect of 10 sessions of Pilates Method training on electromyographic activation (EMG) of the trunk stabilizer muscles during activities of daily living in individuals with non-specific low back pain. METHODS: Adult subjects (19-59 years; IBGE, 2011) of both sex, with low back pain group (WLBP), will participate of this study. The participants will be separated into two groups: control group (CG) and intervention group (IG), which will perform five-week training with Pilates Method exercises. The data collection procedures will be performed in a single session, being collected personal data, anthropometric, and functionality to characterize the subjects. Three maximum isometric voluntary contractions (MIVC) for flexion and extension of 5 seconds with a rest of 30 seconds will be performed. In addition, the gait test (GT), postural perturbation test (PPT), loading lifting test (LLT), and the sit and raise from a chair test (SRT) will be performed. To GT the participants will walk in their preferred gait speed, through a 20-meter platform, being selected 10 gait cycles for muscle activation analysis. The PPT will be performed with 10 dominant shoulder flexion in, approximately 180º, from the vertical relaxed position and with the upper limbs beside the body, with total elbow extension. The muscle activation analysis on LLT will be performed from four fixed load-lifting corresponding to 25% of subjects' body weight, the movement will be performed according to individual execute motion, removing the load from the ground and placing it on a platform positioned in 90º direction in relation to the greater trochanter of the femur. On SRT, the movement will be performed five consecutive times in a comfortable position, with hip and knee flexion of approximately 90º, with the lower limb resting on the ground and the upper limb crossing in front of the trunk. From this position, the subjects should raise from the chair until they reach the standing position with the trunk fully straight. After an initial assessment, the subjects will be trained with Pilates Method exercises for five consecutive weeks, twice weekly for a period of 50 minutes. When they complete 10 exercises sessions, a final assessment will be performed. The EMG signal of the internal oblique (IO) and multifídus (MU) will be recorded. EMG signal will be processed using a pass-band filter of 20-500 Hz, rectified by full-wave method and smoothed by low-pass Butterworth filter with 4th order and a cut-off frequency of 6 Hz, to create the linear envelope. The mean of the linear envelope will be normalized by the MIVC of each muscle. For all measured variables the normality of the data will be tested to select the appropriate statistical, setting the significant value of p < 0.05.(AU)