Activity In Low Back Pain Patients Research Articles

The effects of isometric exercise types on pain and muscle activity in patients with low back pain.

The purpose of the present study is to evaluate the effects of isometric exercise types on low back pain (LBP) patients. Isometric exercise types were mat exercise and I-Zer exercise. Subjects were divided into 3 groups: LBP control group, LBP mat exercise group, and LBP I-Zer exercise group in 23–25 aged men. Visual analogue scale (VAS) and electromyography (EMG) were used to evaluate the degree of pain and the muscle activity in LBP patients. Root mean square (RMS), median frequency (MDF), and mean frequency (MNF) were checked by EMG power spectrum analysis on longissimus thoracic (LT), iliocostalis lumborum (IL), mulitifidus (M), and rectus abdominis (RA). LBP mat exercise program and LBP I-Zer exercise program were conducted 5 sets once time, 3 times per week during 6 weeks. The two-way ANOVA with repeated measure was used to check the pain degree and muscle activity. The present results showed that muscle activity in the LBP I-Zer exercise group was increased compared to the LBP mat exercise group and LBP control group (P<0.05). LBP I-Zer exercise group and LBP mat exercise group showed increased mean frequency in LT, IL, M, and RA muscles than the LBP control group. Therefore, LBP patients performed isometric exercise may have positive effect to reduce pain degree and to increase muscle activity. Especially, LBP I-Zer exercise type showed more effectiveness in reducing pain degree and enhancing muscle activity.

Disturbed muscular adaptation and changed motor strategies in recurrent low back pain patients during stair walking after experimental back-muscle fatigue

Background: The majority of low back pain (LBP) patients experience no symptoms after 4 weeks but up to 70–80% will relapse within one year and up to 40% develops recurrent LBPand reduced functional capacity.Recurrent LBP thereby is a major cause of dysfunction, decreased quality of life and economical expenditures. The evidence on causality is generally low, but motor control is a potential factor linked with LBP. The trunk-muscle activity is affected by pain but the majority of the evidence is based on investigation of non-functional motor tasks. The transfer of results to functional and complex motor tasks is challenged, since the motor output is a result of the interaction between central and peripheral dynamic mechanisms. Experimental fatigue of the backmuscles in healthy and LBP patients affects the control of the trunk and the muscle activity is earlier affected in patients during exercising towards fatigue. Disturbed control of the muscular control can influence the development of LBP but the underlying mechanisms and consequences on motor control during motor tasks requiring motor planning and higher stability and dynamic force development remains unknown. Purpose: To explore the trunk muscle activity and motor task timing in healthy and recurrent LBP patients during stair ascend and descend before and after lumbarmuscle fatiguing. Methods: 45 participants (25 LBP) performed 10 concurrent ascend and descend steps before and after fatiguing the back extensors by repetitive dynamic exercises to exhaustion. 3 ascending and 3 descending gait phases were detected. The duration of the phases and changes in i-EMG activity from surface EMG-recordings of 3 back-, 3 abdominaland 2 gluteus-muscles before and after fatigue were calculated and compared by ANOVA statistics. Results: The duration of the step tasks were shorter in LBP patients before (P< 0.01) and after (P< 0.01) fatiguing the back extensors. Fatigue furthermore resulted in increased duration during phases with preparation of single-leg weightbearing (P< 0.001) and decreased during the weight bearing phases (P< 0.001). Back extensor fatigue resulted in increased back and abdominal muscle activity in healthy (P< 0.01) and unchanged muscle activity in LBP patients in most phases, but during the descend phase with single-legged weight bearing the activity remained unchanged in healthy and decreased in LBP patients (P< 0.001). Conclusion(s): Back extensor muscle fatigue resulted in increased trunk muscle activity in healthy and unchanged trunk muscle activity in LBP patients during stair stepping and the patients could be at higher risk of inappropriate load of potential painful structures. In phases with high stability demands the patients utilized movement strategies that in short-term might reduce the stability demands, but the long-term structural consequence is unknown. Furthermore it remains unknown if these strategies will affect recurrent LBP patients during other functional motor tasks and more research is needed to explore these questions. Implications: Affected control of the spine in high stability demands is important in evaluation of recurrent LBP patients. More research is needed to explore the basic mechanisms and the potential role of motor control during functional motor tasks in LBP development.

Physical activity in daily life in patients with chronic low back pain

Verbunt JA, Westerterp KR, van der Heijden GJ, Seelen HA, Vlaeyen JW, Knottnerus JA. Physical activity in daily life in patients with chronic low back pain. Arch Phys Med Rehabil 2001;82:726-30. Objectives: To evaluate disuse (ie, a decreased daily physical activity level) in patients with chronic low back pain (LBP) and to evaluate the construct validity of accelerometry for measuring physical activity in daily life. Design: Case-control study in a cross-sectional design; comparison of accelerometry to the criterion standard (doubly labeled water technique). Setting: Normal daily living (unrestricted by the measurement devices). Patients: Thirteen patients with chronic nonspecific LBP and 13 age- and gender-matched healthy controls. Main Outcome Measures: Physical activity in daily life, expressed as whole-body acceleration measured with a triaxial accelerometer (Tracmor), and as the ratio between average daily metabolic rate (ADMR), measured by the doubly labeled water technique, and resting metabolic rate (RMR), measured by the ventilated hood. Both techniques were used simultaneously for 14 days. Results: Mean physical activity level in patients and controls did not differ significantly. The correlation between the Tracmor and ADMR and RMR was.72 (p <.01). Conclusions: Decreased physical activity levels in this sample of chronic LBP patients was not confirmed. The Tracmor is a valid instrument for measuring daily activity in LBP patients.