Lumbar segmental stabilization, strengthening and stretching in chronic low back pain: a comparative study

Author(s)

Fabio Jorge Renovato França

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2009-12-16

Examining board members

Amelia Pasqual Marques; Elizabeth Alves Gonçalves Ferreira; Debora Bevilaqua Grossi

• Advisor: Amelia Pasqual Marques

Abstract

INTRODUCTON: Low back pain is a health important problem present in all industrialized countries, affecting 70% to 80% of adult population in some moment of life, most frequently in young adults, in economically active phase. It is in second place among the causes of work absenteeism. Although a number of exercises for low back pain is great, there are no evidence of what kind of exercise is more effective. OBJECTIVE: to contrast the efficacy of segmental stabilization, lumbar stretching and trunk and abdominal strengthening exercises on pain, functional disability and the recruitment TrA muscle of patients with chronic low back pain. METHODS: Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus) (n=15, mean age 42,02 ± 8,15), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) (n=15, mean age 41,71±6,41) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles) (n=15 mean age 41,53 ± 4,41). Patients attended two weekly sessions during six weeks and were evaluated for pain (visual analogue scale and McGill Pain Questionnaire), functional disability (Oswestry disability index), and ability to contract the TrA (Pressure biofeedback unit) before and after the treatment. The treatment program consisted of 30 minutes sessions. The Anova oneway and Tukey´s Post Hoc were used to compare groups. The significance level adopted was 5%. RESULTS: Significant pain relief and functional disability improvements were observed after treatment in three groups (p<0,001). The segmental stabilization group showed greater gains in all variables (p<0,001) and in TrA activation, the relative gains were 48,32%, 6,56% and -5,11%, in ES, AL and FS groups, respectively. CONCLUSION: The three groups of exercise improved pain and functional disabilities, and the ES group was better in the ability to recruit TrA muscle (PBU). In AL and FS groups was not observed improvement in TrA muscle. (AU)

• FAPESP's process: 07/01102-0 - Lumbar segmental stabilization, strengthening and stretching in chronic low back pain: a comparative study
• Grantee: Fábio Jorge Renovato França
• Support Opportunities: Scholarships in Brazil - Master