Back Extensor Research Articles

Sagittal Spinal Mobility and Back Extensor Muscle Function in Older Females with Age-Related Hyperkyphosis

Introduction: Spinal range of motion (ROM) is a potential and modifiable variable that may contribute to the maintenance of upright sagittal alignment. The present study aimed to compare spinal ROM in older females with and without hyperkyphosis and investigate associations between thoracic kyphosis and spinal ROM, back extensor strength (BES), and back extensor endurance (BEE).Materials and Methods: Sagittal spinal curvature and ROM were measured with the Spinal Mouse. Also, BES and BEE were assessed with a load cell. Variables were compared between older females with and without hyperkyphosis with the independent sample t test. We used the Pearson correlation coefficient to calculate associations between variables. Multiple linear regression was used to find which variable is best associated with kyphosis.Results: Lumbar and total spinal ROM were lower in the hyperkyphosis compared to the normal group (P<0.05). Thoracic kyphosis was associated with total lumbar ROM (r=-0.30, P=0.03), total spinal ROM (r=-0.35, P=0.01), BES (r=-0.73, P< 0.001), and BEE (r=-0.60, P< 0.001). Multiple linear regression analysis after adjusting for age, weight, and BMI showed that BES (P<0.001) and BEE (P=0.01) but not spinal ROM (P=0.16) were significantly associated with thoracic kyphosis.Conclusion: Females with hyperkyphosis had lower spinal ROM than those with normal kyphosis. While thoracic kyphosis was significantly associated with total lumbar ROM, total spinal ROM, BES, and BEE, multivariate regression showed that ROM was not a significant contributor to thoracic kyphosis. BES and BEE were significant contributors to thoracic kyphosis and should be targeted in the rehabilitation of hyperkyphosis.

The WATER study: Which AquaTic ExeRcises increase muscle activity and limit pain for people with low back pain?

ObjectiveAquatic exercise therapy is used for the treatment and management of chronic low back pain (CLBP). However, to the authors’ knowledge, no studies to date have compared muscle activity between different aquatic exercises performed by people with CLBP. As such, this study assessed and compared muscle activity, pain, perceived exertion and exercise intensity between different rehabilitative aquatic exercises. DesignCross-sectional. SettingA 25-m indoor swimming pool within a university building. ParticipantsTwenty participants with non-specific CLBP. AssessmentTwenty-six aquatic exercises in shallow water (1.25-m depth). Muscle activity was quantified bilaterally for the erector spinae, multifidus, gluteus maximus and medius, rectus abdominis, and external and internal obliques. Main outcomesMean and peak muscle activity, pain (visual analogue scale), perceived exertion (Borg scale) and exercise intensity (heart rate). ResultsHip abduction/adduction and extension/flexion exercises produced higher activity for gluteal muscles. Variations of squat exercises increased the activity of back extensors. Higher abdominal muscle activity was produced with exercises that made use of buoyancy equipment and included leg and trunk movements while floating on the back, and with some proprioceptive and dynamic lower limb exercises. Pain occurrence and intensity were very low, with 17 exercises being pain free. ConclusionsThis study provides evidence on trunk and gluteal muscle activity, pain, intensity and perceived exertion for people with CLBP performing aquatic exercises. The findings may be useful when prescribing exercises for rehabilitation, as physiotherapists seek to implement progression in effort and muscle activity, variation in exercise type, and may wish to target or avoid particular muscles. Contribution of the Paper•This is the first study to compare trunk or gluteal muscle activity between 26 different aquatic rehabilitative exercises performed by people with CLBP.•Pain occurrence and intensity of aquatic exercises are very low, with most exercises being completely pain free.•The following aquatic exercises are particularly effective in increasing muscle activity: (a) hip abduction/adduction and extension/flexion exercises for gluteus maximus and medius; (b) squat exercises for back extensors (erector spinae and multifidus); and (c) exercises that make use of support buoyancy equipment and include leg movements while floating on the back for abdominals (rectus abdominis, and external and internal obliques).

Effect of spinal extension exercises on mechanical low back pain in work from home IT professionals in India

Introduction: Prolonged sitting with awkward posture and long working hours are the predisposing factors for developing Mechanical Low Back Pain (LBP) in IT professionals. Poor dynamic trunk extension performance is associated with back-related permanent work disability and recurrence of LBP. The purpose of this study was to find and analyze the effect of spinal Extension exercises on Mechanical Low Back Pain in work from home IT professionals. Methods: In this comparative study, 50 work from home IT professionals from various companies were approached through emails. Subjects were randomized into two groups: Group A (n=25) was study group, and Group B (n=25) was control group. Subjects from both groups exercised three times per week for 4 months and followed the ergonomics. Pain intensity, functional disability, and strength of back extensor muscle were assessed at baseline and at the end of week 4. Results: Group A had lower pain intensity (3.24 ± 1.45 vs 4.76 ± 1.53) and functional disability (4.24 ± 2.14 vs 11.44 ± 1.75) and significantly higher back extensor strength (25.44 ± 4.3 vs 22.24 ± 4.58; P<0.05) than Group B at the end of week 4. Conclusion: Spinal Extension Exercises should be incorporated in work from home IT professionals with mechanical low back pain to stabilize back muscles and improve physical functioning with minimal discomfort. In line with this, IT professionals should also be made aware of the risk factors associated with mechanical low back pain and should be encouraged for maintenance of physical health and fitness.

Impairments in trunk muscles performance and proprioception in older adults with hyperkyphosis

ABSTRACT Background and objectives Thoracic hyperkyphosis is one of the most common postural deformities in the geriatric population. This study investigated whether trunk proprioception, muscle strength, and endurance differ between older adults with hyperkyphosis and the age-matched control group. This study also aimed to explore the association of kyphotic posture with muscle performance, position sense, and force sense. Methods Ninety-seven elderly volunteers (61 with hyperkyphosis and 36 normal controls) participated in this cross-sectional study. The kyphosis degree, trunk position sense, force sense, back muscle strength, and endurance were assessed in all participants. Results The results showed lower back extensor strength and endurance, also higher force and position sense error in the hyperkyphotic group than the control group. In addition, the findings revealed that back extensor strength and endurance, as well as trunk position sense, were associated with kyphotic posture in older adults. Discussion and Implications This study suggests that back extensor strength and endurance and trunk position sense and force sense are potentially modifiable impairments associated with thoracic kyphosis in older adults with hyperkyphosis. It seems monitoring these potentially contributing factors would be helpful in the assessment and treatment of hyperkyphotic older individuals.

Evaluation of Dynamic Endurance of Back Extensors in Asymptomatic College Girls: An Observational Cross-Sectional Study

Background: Prolonged sitting and reading can leads to reduced activity of trunk extensors and shown to be related to provoke back pain in near future among students. Various tests are used to evaluate the strength and endurance of abdominal and back extensors muscles which helps therapist in assessment, diagnosis and prognosis. This study evaluates endurance of the trunk extensor group of muscles using Repetitive Arch Up Test (RAUT) among college going students. Aims: The aim of this study is to check the endurance of trunk extensor group of muscles in 19-23 years old female students studying in college. Material & Methodology: This is a cross-sectional observational study done on 30 female participants between age group of 19-23 years studying for more than 8 hours in sitting position at one physiotherapy college. Repetitive Arch Up Test (RAUT) was used to measure endurance of back extensors. Data was collected and statistical analysis was done. Results: The collected Data showed that, the mean and SD of RAUT is 22.73 ± 9.896, which suggest that there was significant reduction in the endurance of lumbar spine extensors in the undergraduate physiotherapy students attending lectures for 8 hours/day,6 days/week. Conclusion: The present study concluds that, the trunk extensor endurance is markedly reduced in undergraduate physiotherapy students who currently do not have back pain. But if not treated can lead to risk of developing low back pain in future. Keywords: Back muscle endurance, College students, Repetitive Arch-up test.

Effectiveness of Muscle Energy Technique versus Positional Release Therapy on Range of Motion and Pain in Non-Specific Low Back Pain

Low back ache is the largest cause of sick leave, and half of the population will have experienced a significant incident of low back ache by the age of 30. In India, low back ache prevalence has been reported to be around 23.09%. Severe pain in the lower back is sequel of numerous causes, such as faulty posture, muscular dysfunction (e.g.: muscular imbalance and short or weak muscle), overuse, instability and articular dysfunction in the low back, accident or trauma and most commonly road vehicle accidents. In 85%–90% of cases of lower back ache are non-specific in nature. The function and co-ordination of the muscles that stabilise the lumbar spine, especially the back extensor muscles are often impaired in patients with low back pain. Erector spinae strain and fatigue is one of the causes of back pain. A total of 30 subjects with acute low back pain participated in this study. Group A were treated with hot moist pack and muscle energy technique (MET), whereas Group B were treated with hot moist pack and positional release therapy (PRT). Both the groups received a conventional training protocol for 3 days a week for 4 weeks. The result from these tables shows changes in both the groups, with statistically significant changes were noticed in Group B. The present study showed that both PRT and MET within hot moist packs could be of benefit in the treatment of acute low back pain associated erector spinae muscle spasm. There was significant difference in the intensity of pain within the groups and between the groups after 4 weeks of treatment. Reduction in pain intensity was significant in the PRT group. Pain relief was achieved with both Group A and Group B, but was appreciably more significant in the PRT group. There is a significant difference between both Groups A and B. Hence, PRT is more effective than MET.

Manual Therapy Followed by Dynamic Strengthening Exercise Along With Conventional Physiotherapy Versus Manual Therapy Along With Conventional Physiotherapy on The Improvement of Pain and Functional Disability In Patients With Chronic Non-Specific Low Back Pain: A Randomized-Controlled Pilot Study

Chronic low back pain (LBP), defined as back pain persisting for more than 12 weeks, affects over 50% of the general population.[1] It is the second most common factor for patients in search of primary care services.[2]According to the US National Center for Health Statistics, 14% of new patients admitted to a hospital for treatment had low back pain, representing 13 million people.[3] Also, it is estimated that over 70% of adults have had at least one episode of LBP in their lifetime.[4]In 2007, another study revealed that lower back region pain is caused by disc degeneration, spondylolisthesis, lumbar stenosis, epidural hematoma, and other causes, and 3% of all patients discharged from hospitals have symptomatic low back pain.[5] Because the causes of LBP are variable, different exercise regimens have been used to treat patients, including lumbar flexion, extension, isometric flexion, passive extension, and intensive dynamic back exercise regimens, and many of these exercise regimens have not yielded satisfactory results.[6]Recently, some studies have focused on exercises that aim to maintain or improve lumbar spine stability, such as lumbar stabilization exercises, which are aimed at improving the neuromuscular control, strength, and endurance of the muscles that are fundamental to maintaining spinal and trunk stability through several groups of muscles, particularly transverse abdominis and lumbar multifidi, but also other paraspinal, abdominal, diaphragmatic, and pelvic muscles.[7] Unsubstantiated suggestions that stabilization training may be useful in reducing pain and disability for all patients with nonspecific LBP, have appeared in the literature,[8] but these assertions have not been definitively demonstrated. Weakness of the abdominal muscles among the trunk muscles of low back pain patients is generally prevalent, and the strengthening of the abdominal muscles is essential in the recovery of the spinal neutral position.[9] When imbalance between the abdominal muscles of the trunk and extensor muscles occurs, it triggers slow back pain and reduces stabilization of the lumbar.[10]The ability to actively control the muscles of the hip plays an important part in lumbar segmental stability. If the sacroiliac joint moves excessively, it results in pressure on the joints and disks between the L5–S1 vertebral body, sacroiliac joint, and pubic symphysis, which leads to functional failure of the sacroiliac joint and low back pain. This causes the gluteus maximus muscle to contract, creating a self-locking mechanism, thereby providing stability to the sacroiliac joint.[11]There are various forms of exercise that can be prescribed based on different schools of thought, which include intensive dynamic back extensor exercises (motor control exercises), yoga and aerobic exercises.[12]Graded strengthening exercises are aimed at improving the neuromuscular control, strength, and endurance of the muscles that are central to maintaining dynamic spinal and trunk stability. The effect of graded lumbar stabilization exercises has been studied in subjects with recurrent LBP (8). Dynamic strengthening exercises can strengthen the spinal column and supporting structures.[13] An electromyography study to compare recruitment of the rectus abdominis and erector spinae muscles during dynamic strengthening exercise revealed higher muscle activity in these muscles.[14]Therefore, the aim of this study is to compare the effects of graded lumbar strengthening exercises and lumbar dynamic strengthening exercises on the maximal isometric contraction strength of the lumbar extensors, pain severity, and functional disability in patients with nonspecific chronic LBP. According to many studies, the first step of the physiotherapy treatment pyramid is education of the patient.[15] In another study, researchers explored several research studies that included evidence on conservative treatments,[16] which included manual therapy or conservative physiotherapy, which included exercises, mobilization, McKenzie approach treatment, manipulation, strengthening programs, advice, and other manual therapy techniques, which have strong evidence of effectiveness for chronic low back pain patients.[17] According to a study,[18] rest and exercise are effective for low back pain patients.

Effects of contrast strength training with elastic band program on sprint, jump, strength, balance and repeated change of direction in young female handball players

Maximal strength, power and his derivates (sprint, change of direction repeatedly and jump) are considered as major determinants of success in elite handball players. Contrast strength training with elastic band (CSTEB) program is form of resistance training, and may play an important method of training to improve this quality. This study examined the effects of 10-week contrast strength training with elastic band (CSTEB) program on physical performance in young female handball players. Thirty participants (age: 15.7 ± 0.3 years; body mass: 63.7 ± 3.7 kg; body height: 166.8 ± 3.8 cm; body fat: 26.9 ± 3.4; and Maturity-offset: 2.9 ± 0.3 years) were randomly assigned between experimental group (EG; n = 15) and control group (CG; n = 15). Two-way analyses of variance (group × time) were assessed for handgrip; back extensor; medicine ball throw; 30-m sprint times; Modified Illinois change-of-direction (Illinois-MT); four jump tests [(squat jump (SJ), countermovement jump (CMJ), countermovement jump with arms (CMJA) and five jump test (5JT)]; static (stork) and dynamic (Y balance) balance tests; and repeated sprint T-test (RSTT). The EG enhanced all strength performance [handgrip right, handgrip left, back extensor strength and medicine ball throw (p < 0.001)] compared to CG. The EG enhanced all sprint performance. The EG also improved performance in the Illinois-MT. All jump performance improved significantly [SJ (p = 0.007), CMJ (p = 0.001) and CMJA (p = 0.001)] except 5JT in the EG. Of the same, 3 of 4 repeated sprint T-test scores [RSTT-Best-Time, RSTT-Mean-Time and RSTT-Total-Time] increased significantly in the EG relative to the CG. Conversely, there were no significant changes in balance performance between groups. It is concluded that 10-weeks of CSTEB improved physical performance (strength, sprint, change of direction, jump, and repeated change of direction) measures in young female handball players.

Test-retest reliability of a load cell setup, Ito, and timed loaded standing tests for measuring muscle strength and endurance in older adults with and without hyperkyphosis

BackgroundThe association of back muscle weakness with greater thoracic kyphosis has been widely documented. Reliable and easy-to-use techniques are needed to monitor changes in muscle function over time and assess the effectiveness of therapeutic interventions. Therefore, the present study aimed to evaluate the test-retest reliability of a designed load-cell setup and two clinical tests, namely Ito and Timed loaded standing (TLS) tests for measuring back muscle function (i.e., strength and endurance) in older adults with and without hyperkyphosis. MethodFifty-three older people (28 with thoracic hyperkyphosis and 25 normal age-matched controls) completed the present test-retest reliability study. A two-way random model of the Intraclass Correlation Coefficient (ICC2,3) was used to estimate relative reliability. Absolute reliability was assessed by calculating Standard Error of the Measurements (SEM) and Minimal Detectable Change (MDC). ResultsThe findings showed excellent test-retest reliability in all performed tests for this population (ICC = 0.95–0.99). In addition, the MDC values for measuring endurance time via load cell, Ito, and TLS tests in the hyperkyphosis group, were 16.5, 28.2, and 35.1 s, respectively. These values ranged from 36 to 39 s for the control group. ConclusionThe present study suggests high test-retest reliability of the designed load-cell setup, Ito, and TLS for assessing back extensor muscle strength and endurance in older adults with and or without hyperkyphosis.

Lumbar Loads and Muscle Activity During Flywheel and Barbell Leg Exercises.

Sjöberg, M, Eiken, O, Norrbrand, L, Berg, HE, and Gutierrez-Farewik, EM. Lumbar loads and muscle activity during flywheel and barbell leg exercises. J Strength Cond Res 37(1): 27-34, 2023-It is anticipated that flywheel-based leg resistance exercise will be implemented in future long-duration space missions, to counter deconditioning of weight-bearing bones and postural muscles. The aim was to examine low back loads and muscle engagements during flywheel leg press (FWLP) and flywheel squat (FWS) and, for comparisons, free-weight barbell back squat (BBS). Eight resistance-trained subjects performed 8 repetition maximums of FWLP, FWS, and BBS. Motion analysis and inverse dynamics-based musculoskeletal modeling were used to compute joint loads and muscle forces. Muscle activities were measured with electromyography (EMG). At the L4-L5 level, peak vertebral compression force was similarly high in all exercise modes, whereas peak vertebral posteroanterior shear force was greater ( p < 0.05) in FWLP and BBS than in FWS. Among the back-extensor muscles, the erector spinae longissimus exerted the greatest peak force, with no difference between exercises. Peak force in the lumbar multifidus was lower ( p < 0.05) during FWLP than during FWS and BBS. Peak EMG activity in the lumbar extensor muscles ranged between 31 and 122% of maximal voluntary isometric contraction across muscles and exercise modes, with the greatest levels in the lumbar multifidus. The vertebral compression forces and muscle activations during the flywheel exercises were sufficiently high to presume that when implementing such exercise in space countermeasure regimens, they may be capable of preventing muscle atrophy and vertebral demineralization in the lumbar region.

Sex-Dependent Estimation of Spinal Loads During Static Manual Material Handling Activities-Combined in vivo and in silico Analyses.

Manual material handling (MMH) is considered as one of the main contributors to low back pain. While males traditionally perform MMH tasks, recently the number of females who undertake these physically-demanding activities is also increasing. To evaluate the risk of mechanical injuries, the majority of previous studies have estimated spinal forces using different modeling approaches that mostly focus on male individuals. Notable sex-dependent differences have, however, been reported in torso muscle strength and anatomy, segmental mass distribution, as well as lifting strategy during MMH. Therefore, this study aimed to use sex-specific models to estimate lumbar spinal and muscle forces during static MHH tasks in 10 healthy males and 10 females. Motion-capture, surface electromyographic from select trunk muscles, and ground reaction force data were simultaneously collected while subjects performed twelve symmetric and asymmetric static lifting (10 kg) tasks. AnyBody Modeling System was used to develop base-models (subject-specific segmental length, muscle architecture, and kinematics data) for both sexes. For females, female-specific models were also developed by taking into account for the female’s muscle physiological cross-sectional areas, segmental mass distributions, and body fat percentage. Males showed higher absolute L5-S1 compressive and shear loads as compared to both female base-models (25.3% compressive and 14% shear) and female-specific models (41% compressive and 23.6% shear). When the predicted spine loads were normalized to subjects’ body weight, however, female base-models showed larger loads (9% compressive and 16.2% shear on average), and female-specific models showed 2.4% smaller and 9.4% larger loads than males. Females showed larger forces in oblique abdominal muscles during both symmetric and asymmetric lifting tasks, while males had larger back extensor muscle forces during symmetric lifting tasks. A stronger correlation between measured and predicted muscle activities was found in females than males. Results indicate that female-specific characteristics affect the predicted spinal loads and must be considered in musculoskeletal models. Neglecting sex-specific parameters in these models could lead to the overestimation of spinal loads in females.

Assessment of Lumbar Extensor Muscles in the Context of Trunk Function, a Pilot Study in Healthy Individuals

A comprehensive assessment of trunk function, including the lumbar extensor muscles, appears to be important in various conditions affecting axial musculature. This pilot cross-sectional observational study aimed to define a battery of tests that comprehensively assess trunk muscle function (strength and muscular endurance). Sixty subjects without low back pain (LBP) underwent measurement of isometric lower back extensor strength using a hand-held dynamometer (HHD) in three positions; measurement of respiratory muscle strength; and Biering-Sørensen, prone-plank, and side-bridge tests. The repeatability, short-term and long-term reliability using the HHD device in different postural positions was confirmed. The greatest isometric lower back extensor strength was generated in the sitting position by male subjects. Time of effort in the Biering-Sørensen test was longer in women and older subgroups than in men and younger individuals, although this was not the case for the other two muscular endurance tests. This pilot monitoring of trunk muscle strength and endurance in healthy volunteers may lead to a better understanding of trunk muscle function. Based on this methodological background, the authors aim to use the defined battery of tests in their further studies in a group of patients with LBP and certain neuromuscular diseases to verify its usefulness in clinical practice.

The Influence of Nordic Walking on Spinal Posture, Physical Function, and Back Pain in Community-Dwelling Older Adults: A Pilot Study.

Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults. Thirty-one community-dwelling older adults aged ≥ 60 years participated in a twice weekly Nordic walking training program for 12 weeks. The outcome measures, including spinal posture, physical functions, back pain, and the strength and endurance of back extensor muscles were assessed before and after a 12-week program. After training, spinal posture, back pain, and the strength and endurance of back extensor muscles did not show any statistically significant changes. Among the seven clinical tests of physical function, only the 30 s arm curl test, the 30 s chair stand test, and the single leg stance test showed significant improvements. Nordic walking has limited influence on age-related hyperkyphosis and back pain, but may be effective for physical function. The results of this study can provide useful information for people involved in the prevention and treatment of physical dysfunction in community-dwelling older adults.

The Possibilities of Physical Training Methods in the Recovering of Cognitive Functions After Cardiac Surgery

To assess the duration of benefits on back pain and back extensor strength in women with osteoporosis who had previously participated in a randomized controlled trial (RCT) involving either exercise or wearing a spinal orthosis.A 6-month postintervention follow-up of women who were involved in the interventions in the RCT.The study was conducted in a primary health care center in Stockholm, Sweden.In this follow-up study 31 women participated in the spinal orthosis group, and 31 women participated in the exercise group, with a median age of 76 years in both groups (N=62). All women were diagnosed as having osteoporosis, had back pain with or without vertebral fracture, and were 60 years or older, which were the inclusion criteria in the RCT.The participants received no controlled supervision. The spinal orthosis group was asked to wear the orthosis, and the training group was asked to follow an exercise program for another 6 months voluntarily.Back extensor strength was measured with a computerized device; back pain was estimated by the visual analog scale and by Borg CR-10.After 6 months there were no significant differences between the groups in back extensor strength or back pain. Analyses within the groups showed that achieved results during 6 months intervention in the RCT were maintained after 6 months of voluntary use of the spinal orthosis and training. In the spinal orthosis group, back extensor strength mean was 81.7 N, and back pain median was 3 mm. In the training group back extensor strength mean was 72.8 N, and back pain median was 3 mm. There were no changes for any other measurements performed.Voluntary use of the spinal orthosis or exercise during a 6-month follow-up period maintained the increase in back extensor muscle strength obtained during the RCT. Estimation of back pain was not influenced. This indicates that the women had continued to use the spinal orthosis and exercise.

Assessment of the influence of intermittent ischemic compression of latent trigger points on changes on the range of the lumbar spine mobility and myoelectric changes in the dorsal extensor muscle

Introduction: Pain in the lumbar spine (L) is a very serious health problem. The appearance of pain in the area of the back muscles with palpable small, sensitive points may indicate the presence of myofascial trigger points. There are many techniques used in the therapy of trigger points, including ischemic compression, which gives a therapeutic effect in the form of biomechanical normalization of muscle tissue restoring the normal functional state of a given muscle. Aim of the study: The aim of the study was to assessment of the influence of intermittent ischemic compression of latent trigger points on changes on the range of motion of the L spine and on myoelectric changes in the back extensor muscle. Material and Methods: The study included 32 students who were subjected to a single technique of intermittent ischemic compression according to Chaitow. The participants of the study performed the Thomayer test before and after the therapy to assess the range of spine mobility. The myoelectric changes in the back extensor muscle were assessed using NORAXON's EMG before and after the treatments following a protocol specifically developed for this purpose. The statistical analysis of the data was calculated using the Statistica 13 program. Results: One-time ischemic intermittent compression of the back extensor muscle statistically significantly increased the range of spine motion. The mean value of the tension of the back extensor muscle at rest after the therapy was reduced, showing statistically significant changes. The myoelectric changes in the back extensor muscle during flexion were not statistically significant Conclusions: The results showed the effectiveness of the ischemic intermittent compression technique in increasing the range of spine mobility after the treatment on the back extensor muscle. Intermittent ischemic compression leads to a decrease in the resting tension of the back extensor muscle, without affecting any significant changes during the flexion movement.

Difference between Neurodynamic Mobilization and Stretching Exercises for Chronic Discogenic Sciatica

Abstract Background: Sciatica has noxious symptoms and critical functional disabilities, which disturbs people lives. Physio-therapy modalities play the most important role in the con-servative management of sciatica. Aim of Study: To compare the effectiveness of the slider, tensioner neurodynamic mobilization techniques and stretching exercises on pain intensity, range of motion (ROM) of ankle dorsiflexion, and functional disability in patients with chronic discogenic sciatica. Patients and Methods: Thirty-six patients with unilateral chronic discogenic sciatica from both sexes, their ages ranged from 21-50 years, were randomly allocated into three equal groups. Group (A) received slider neurodynamic mobilization technique only, while group (B) received tensioner neurody-namic mobilization technique only, and group (C) received stretching exercises of back extensors, hamstrings and gas-trocnemius muscles only. In addition to ergonomic advice given to all the three groups. Treatment was given three days per week for two consecutive weeks. The outcome measures were assessed pre and post treatment. Pain intensity was measured using visual analogue scale. ROM of ankle dorsi-flexion was measured using the universal goniometer. Func-tional disability was measured using the Oswestry disability index. Results: There were found significant differences in both; the slider and tensioner neurodynamic mobilization techniques as compared to stretching exercises in pain intensity and functional disability. There were found no significant differ-ences between the three groups in ankle dorsiflexion ROM. Conclusion: Slider and tensioner neurodynamic mobili-zation techniques are more effective than stretching exercises in terms of reducing pain intensity and improving functional disability without significant differences between them in improving ankle dorsiflexion ROM.

Wearing an Activating Spinal Orthosis and Physical Training in Women With Osteoporosis and Back Pain: A Postintervention Follow-Up Study

ObjectiveTo assess the duration of benefits on back pain and back extensor strength in women with osteoporosis who had previously participated in a randomized controlled trial (RCT) involving either exercise or wearing a spinal orthosis. DesignA 6-month postintervention follow-up of women who were involved in the interventions in the RCT. SettingThe study was conducted in a primary health care center in Stockholm, Sweden. ParticipantsIn this follow-up study 31 women participated in the spinal orthosis group, and 31 women participated in the exercise group, with a median age of 76 years in both groups (N=62). All women were diagnosed as having osteoporosis, had back pain with or without vertebral fracture, and were 60 years or older, which were the inclusion criteria in the RCT. InterventionsThe participants received no controlled supervision. The spinal orthosis group was asked to wear the orthosis, and the training group was asked to follow an exercise program for another 6 months voluntarily. Main Outcome MeasuresBack extensor strength was measured with a computerized device; back pain was estimated by the visual analog scale and by Borg CR-10. ResultsAfter 6 months there were no significant differences between the groups in back extensor strength or back pain. Analyses within the groups showed that achieved results during 6 months intervention in the RCT were maintained after 6 months of voluntary use of the spinal orthosis and training. In the spinal orthosis group, back extensor strength mean was 81.7 N, and back pain median was 3 mm. In the training group back extensor strength mean was 72.8 N, and back pain median was 3 mm. There were no changes for any other measurements performed. ConclusionsVoluntary use of the spinal orthosis or exercise during a 6-month follow-up period maintained the increase in back extensor muscle strength obtained during the RCT. Estimation of back pain was not influenced. This indicates that the women had continued to use the spinal orthosis and exercise.

Musculoskeletal Disorders in Tyre Manufacturing Workers.

Background:Tyre manufacturing workers are at risk of developing WRMSDs as their job repeatedly involves elevated arm postures, lifting of tyres, pushing or pulling trolleys, trunk bending and twisting.Aim:To assess WRMSDs in tyre manufacturing workers.Methodology:This was an observational study involving 99 tyre manufacturing workers. Persons with any history of recent trauma, major hospitalization or surgery in past 12 months were excluded. Workers were screened according to Nordic questionnaire for assessing the musculoskeletal disorders and REBA analysis was done. They were also assessed for flexibility of hamstring using AKE test and isometric endurance of back extensors using Sorenson test.Results:97% workers were under 30 years of age and 91% were males. The average duration of work was 27 months. In the past 12 months, 36% workers reported low back pain, 24.2% shoulder pain, 24.2% neck pain, 19% knee pain and 20% ankle/foot pain. REBA analysis revealed TBR and PCR manufacturing workers to be at higher and lower end of medium risk category, respectively. Average AKE values were 39.450 and 38.450 on the right and left, respectively, indicating that hamstring tightness was common, average back muscle endurance was 40.68 sec. However, AKE or back muscle endurance was not statistically related to back pain (P > 0.05).Conclusion:Tyre workers showed involvement of multiple joints. LBP was predominant complaint but was not related to hamstrings tightness or back muscle endurance.

Correlation between Spinal Curvature, Back and Abdominal Muscle Strength and Physical Activity in Premenopausal Women with Low Back Pain

Context: Premenopause is the time before the cessation of menstruation and onset of menopausal symptoms. Information regarding the degree of association of spinal curvature, back and abdominal muscles strength, and physical activity to low back pain (LBP) in premenopausal women is underreported which is useful for awareness, prevention, and optimal treatment. Aims: The aim is to determine the correlation between spinal curvature, back and abdominal muscle strength, and physical activity in premenopausal women with LBP. Materials and Methods: Eighty-four premenopausal women aged between 45 and 55 years were selected based on the inclusion criteria. Three physical characteristics: spinal curvature, back and abdominal muscle strength, and physical activity were measured for all the subjects, and the relative association of each characteristic with LBP was assessed. International Physical Activity Questionnaire (IPAQ) short form was administered to all the participants, flexicurve was used for spinal curve measurement, and manual muscle testing for abdominal and back extensor strength was recorded. Statistical Analysis: Data were analyzed by descriptive statistics and correlated using Pearson's correlation. Results: The mean kyphosis was 36.79° ± 6.41° and lordosis was 33° ± 7.75° According to MRC grading mean abdominal strength was 3.57 ± 0.68 (Grade 3: 53.6%; Grade 4: 35.7% and Grade 5: 10.7%) and back strength was 3.22 ± 0.52 (Grade 2: 4.8%; Grade 3: 67.9% and Grade 4: 27.4%). The mean IPAQ score observed was 1.94 ± 0.64 (low: 23.8%; moderate: 58.3% and high: 17.9%). Conclusion: An inverse relationship was observed between age, IPAQ score, lumbar lordosis, and back and abdominal muscle strength, with increasing age in premenopausal women there was a decrease in physical activity, lumbar lordosis, and back and abdominal muscle strength.

Neck and back muscle chains hypomobility in women with migraine

ObjectiveTo compare the mobility of neck and back flexor and extensor muscle chains in women with migraine, chronic migraine and headache-free. MethodsThis is a cross-sectional study. The muscle chain test was performed based on the theoretical assumptions of the Busquet method, in women with migraine (MG, n = 24), chronic migraine (CMG, n = 36) and headache-free (CG, n = 27). The evaluation of neck and back mobility was performed by an examiner expert in the Busquet method with the aid of cervical range of motion (CROM®) device (neck muscles) and the Tiltmeter® application (back muscles). ResultsCompared to woman headache-free, women with migraine (MD = -12° [CI95% = −19°, -5°] and chronic migraine (MD = -15° [CI95% = −21°, -8°] present reduced mobility in the neck extensor muscle chain. Also, in the back extensor muscle chain, migraine vs headache-free (MD = -9° [CI95% = −15°, -2°]) and chronic migraine vs headache-free (MD = -10° [CI95% = −16°, -4°]) and in the back flexor muscle chain, migraine vs headache-free (MD = -6° [CI95% = −10°, −0.1°]) and chronic migraine vs headache-free (MD = -7 [CI95% = −11°, -2°]), with an effect sizes varying between 1.19 e 2.38. No difference was found between groups for neck flexor muscle chain. Conclusion: Women with migraine and chronic migraine have hypomobility of the neck and back extensor muscle chains, and of the back flexor chain.