Do additional proprioception exercises to stabilization exercises have more beneficial effects on pain, muscle strength and functionality in chronic low back pain?

Abstract

Purpose: This study has been carried out to investigate the efficacy of proprioception exercises in addition to stabilization exercises on pain intensity level, muscle strength and functionality in patients with chronic low back pain. Methods: 16 female and 14 male, a total of 30 patients with chronic low back pain have been recruited in this study. They have been divided into two similar groups as Group 1 ( n1 1⁄415) and Group 2 ( n21⁄415). Their mean age was 33.4±13.6 years for Group 1 and 31.3±11.3 years for Group 2. Previous surgery, acute disc diseases, rheumatic diseases, metabolic diseases, spinal stenosis, enfections, vertebral fractures and malignancy were the exclusion criteria. Patients in Group 1 (Stabilization Group) have been treated with stabilization exercises while patients in Group 2 ( Stabilizationþproprioception) have got proprioception exercises in addition to stabilization exercises in their rehabilitation program. Visual Analogue Scale has been used to measure pain intensity level and Oswestry Functional Scale for assessing functional level of the back. Their back and abdominal muscle strength had been analysed with Biodex System Pro 3 Isokinetic System. Treatment period for the both groups was 6 weeks with 3 sessions per week. Results: There was significant pain relief in resting and activity for the both groups after the treatment, but the differences between the groups were not significant. Both groups had obvious improvements in peak torque and average peak torque values of trunk flexors and extansors after the rehabilitation. Peak torque/ body weight both for flexors and extansor have increased in Group 1. Group 2 has showed significant improvement in peak torque / body weight value for the flexors, but not for the extansors. There were no significant differences in various flexor and extensor muscle strength values between the groups. Group 1 and Group 2 have showed singificant improvements in their functional level after the treatment. The functional score was 3.9±2.9 points for the Group 1 (before: 7.7±2.7 points) and, 3±1.3 points for the Group 2 (before: 8.9±3.1 points) after the rehabilitation. However, The groups did not differ significantly for it (p> 0.05). Conclusions: The effects of stabilization exercises and stabilizationþ proprioception exercises have been found similar. Each of them have beneficial effect in rehabilitation of chronic low back pain. Although both exercises can be used to relieve pain, to increase muscle strength and to enhance back functions for the patients with chronic low back pain, the future studies will be needed to clarify the additional effects of proprioception.