Flexion-relaxation Phenomenon Research Articles

The Flexion Relaxation Phenomenon in Patients with Radiculopathy and Low Back Pain: A Cross-Sectional Study.

Although the measurements of the lumbar spine and pelvic flexion have shown that subjects with radiculopathy exhibited greater decreases of motion when compared with subjects with low back pain, there is still a lack of evidence regarding the changes in flexion relaxation ratio in patients with radiculopathy. The aims of this study were to investigate the flexion relaxation ratio and flexion of the lumbar spine and pelvis in subjects with low back pain (LBP) and LBP with radiculopathy (LBPR) in comparison with healthy subjects (CG-control group). A total of 146 participants were divided in three groups: LBP patients (54 males; 21 females); LBPR patients (26 males; 11 females); and CG subjects (16 males; 18 females). The lumbar spine and pelvis flexion was recorded using optoelectronic motion capture system. The electrical activity of the erector spinae muscles was assessed by surface electromyography during flexion-extension movements. Comparisons between groups were made using one-way ANOVA tests and Mann-Whithney U test with the level of statistical significance at 0.05. The lumbar and pelvic flexion and electromyography of the erector spinae muscle showed significant differences between LBP and LBPR patients compared to CG. Patients LBPR showed significantly smaller angles of lumbar and pelvic flexion compared to LBP patients and CG. An increase in the erector spinae muscle activity during flexion was also observed in patients with radiculopathy. The increased muscular activity of the erector spinae is related to the reduced flexion of the lumbar spine in order to protect the lumbar spine structure. Measurements of trunk, lumbar spine and pelvic flexion, and the flexion relaxation ratio may allow us to predict better outcomes or responsiveness to treatment of LBPR patients in the future.

Impact of yoga asanas on flexion and relaxation phenomenon in women with chronic low back pain: Prophet model prospective study.

Chronic nonspecific low back pain (NSLBP) is a prevalent condition with socioeconomic and healthcare challenges. The flexion-relaxation phenomenon (FRP) evaluation is a valid clinical tool forlow back pain(LBP) assessment. Yoga, a holistic mind-body practice, has been explored as anLBPintervention. This study aimed to evaluate the impact of yoga asanas on the FRP in women with NSLBP.The study included healthy and chronic NSLBP females who underwent an eight-session yoga asanas program, with the first session conducted in-clinic and the rest delivered with tele-approach. Outcome measures included pain intensity, flexion-relaxation ratio (FRR), and trough surface electromyography collected during trunk maximum voluntary flexion (MVF).The study included 11 healthy and 10 NSLBP women. Repeated measures test in chronic NSLBP group showed a significant decrease in pain intensity after the 4 weeks follow-up (visual analogscale[VAS]:6.80 ± 1.48 vs. 3.30 ± 1.25; p < 0.001) and anFRR improvement after the intervention (5.12 ± 0.93 vs. 9.49 ± 0.92; p < 0.001). VAS and FRR effect sizes were 0.77 and 0.47, respectively. Therefore, we performed a Prophet evaluation to assess FRR trends, finding a growth rate (k) of 0.405 ± 0.448, with a forecast 1 month after the end of the intervention approaching the trend line of the control group.The findings suggested that tele-yoga asana might have a positive impact on pain intensity and the FRP in chronic LBP. Further research is warranted to confirm the long-term effects of yoga for managing LBP.

Role of the Flexion Relaxation Phenomenon in the Analysis of Low Back Pain Risk in the Powerlifter: A Proof-of-Principle Study.

Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back(ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. We included a group of 18 male (aged 24-39y) powerlifters of 93kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP.

Assessing the Sensitivity of the Ratio Method in Identifying the Flexion-Relaxation Phenomenon in People With Non-specific Low Back Pain and Healthy People

Background and Aims There are different methods for quantifying the flexion-relaxation phenomenon (FRP). However, there is little standardization for them. This study aimes to evaluate the sensitivity of the ratio method in identifying the FRP in people with non-specific low back pain (LBP) and healthy people. Methods In this study,10 patients with nonspecific LBP and 10 healthy people participated voluntarily. They performed a trunk flexion with a straight knee. Each trunk flexion was done in four modes: (1) standing in the starting position, (2) trunk flexion at a fixed speed (using a metronome), (3) full flexion, and (4) trunk extension to the standing position. Each mode took 5 seconds and was performed 3 times. Then, the FRP was investigated using the ratio method as well as the visual inspection method. Results The sensitivity of all ratios in identifying the FRP in healthy people was 100%, except for the third ratio (the root mean square of EMG activity in a standing position divided by the root mean square in flexion mode), which was 60%. In the LBP group, the sensitivity of the first ratio was 70%; for the second ratio, it was 80%; for the third ratio, 40%; for the fourth ratio, 50%; for the fifth mode (the root mean square in extension mode divided by the root mean square in full flexion mode), 40%; and for the sixth mode, 50%. Conclusion All ratios (except for the second ratio) are valid for identifying the FRP in healthy people, but caution should be taken in using the ratio method for people with LBP; only the second ratio (maximum EMG activity in the extension mode divided by the average EMG activity in the full flexion mode) should be used for these individuals.

Comparison of Flexion Relaxation Phenomenon After Single-Level and Multi-Level Anterior Cervical Discectomy and Fusion

A prospective cohort study. This study aims to assess the influence of the number of fused segments on cervical paravertebral muscles by comparing the changes of the cervical flexion relaxation phenomenon (FRP) after single-level versus multi-level anterior cervical discectomy and fusion (ACDF). A total of 115 patients underwent ACDF were retrospectively recruited, and divided into 1-level group (n=44), 2-level group (n=40) and 3-4-level group (n=31). The flexion relaxation experiment was carried out 3 days preoperatively and 12 months postoperatively by surface electromyography (SEMG). Patients were examined by the neck Visual Analogue Scale (VAS), the cervical Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) and C2-7 range of motion (ROM). There was a significant difference in the time-related changes of FRR among the three groups before and after surgery (F=85.701, P<0.001). 35 patients (79.55%) with 1 level ACDF and 11 patients (27.5%) with 2 levels ACDF had FRP restored to normal at 12 months postoperatively. However, only one patient (3.33%) had normalized FRP after 3-4 levels ACDF. There were significant differences in the time-related changes of the normalized SEMG RMS values in each phase before and after surgery (P=0.018, P<0.001, P<0.001, P<0.001). A significant correlation was found between the changes in C2-7ROM and FRR in three groups (P=0.007, 0.003 and 0.036). Single-level ACDF contributes to normalize the FRP of cervical paravertebral muscles, which, however, is not ideally recovered by 2-level ACDF. On the contrary, 3 or 4-level ACDF could not normalize the cervical FRP. Our research supported the passive structure hypothesis.

Creep deformation of viscoelastic lumbar tissue during sustained submaximal trunk flexion postures

Most in-vivo human experiments exploring creep deformation of viscoelastic lumbar tissue have used a maximum trunk flexion posture to engage the lumbar passive tissues. Recent evidence suggests that static trunk flexion tasks requiring submaximal trunk flexion can lead to gradual changes in the lumbar lordosis and this leads to our hypothesis that maintaining submaximal trunk flexion postures may lead to significant creep deformation of the viscoelastic lumbar tissues. Sixteen participants maintained a trunk flexion posture that was ten degrees less than the trunk flexion posture eliciting flexion-relaxation phenomenon for 12 min with breaks for a maximal trunk flexion protocol every three minutes. Trunk kinematic and extensor EMG measures were captured during the static, submaximal trunk flexion protocol as well as during the maximal trunk flexion protocol to provide evidence of creep development in the lumbar passive tissues. Results revealed that 12-minutes of submaximal trunk flexion led to significant increases in peak lumbar flexion angle (1.3°) and EMG-off lumbar flexion angle for L3/L4 paraspinals (2.9°). During the submaximal trunk flexion protocol, the changes in the lumbar flexion angle at 3–6 min and 6–9 min (average Δ5.4°) were significantly greater than at 0–3 min (Δ2.0°). The contribution of this study is the demonstration that sustained submaximal trunk flexion posture (i.e., constant global system) can lead to creep deformation of the viscoelastic lumbar tissue due to the increased lumbar flexion (i.e., altered local system) and may be attributed to a reduction in lumbar lordosis as the extensor muscles fatigue.

The association between different physical activity levels and flexion-relaxation phenomenon in women: a cross-sectional study

BackgroundTo investigate whether the flexion-relaxation phenomenon differs in women with different physical activity levels.MethodsSeventy-two subjects were recruited for this study. The electromyographic activity of the erector spinae and multifidus muscles was recorded during a flexion task using a surface electromyographic device. The flexion-relaxation and extension-relaxation ratios were calculated. Participants were classified into different physical activity level groups based on their responses to the International Physical Activity Questionnaire. A Welch analysis of variance was conducted to compare the flexion-relaxation ratio and extension-relaxation ratio between groups.ResultsA significant difference in the flexion-relaxation and extension-relaxation ratio was observed in both the erector spinae and multifidus muscles between different levels of physical activity.ConclusionsIn this study, we observed that female participants with high levels of physical activity showed a more pronounced flexion-relaxation phenomenon compared to those with moderate and low levels of physical activity. No significant difference was found between moderate and low physical activity levels. The findings of our study highlight the association between physical activity and the mechanics of the spinal stabilising muscles.

Sensitivity and specificity of the flexion and extension relaxation ratios to identify altered paraspinal muscles' flexion relaxation phenomenon in nonspecific chronic low back pain patients.

Among the main methods used to identify an altered flexion relaxation phenomenon (FRP) in nonspecific chronic low back pain (NSCLBP), it has been previously demonstrated that flexion relaxation ratio (FRR) and extension relaxation ratio (ERR) are more objective than the visual reference method. To determine the sensitivity and specificity of the different methods used to calculate the ratios in terms of their ability to identify an altered FRP in NSCLBP. Forty-four NSCLBP patients performed a standing maximal trunk flexion task. Surface electromyography (sEMG) was recorded along the erector spinae longissimus (ESL) and multifidus (MF) muscles. Altered FRP based on sEMG was visually identified by three experts (current standard). Six FRR methods and five ERR methods were used both for the ESL and MF muscles. ROC curves (with areas under the curve (AUC) and sensitivity/specificity) were generated for each ratio. All methods used to calculate these ratios had an AUC higher than 0.9, excellent sensitivity (>90%), and good specificity (80-100%) for both ESL and MF muscles. Both FRP ratios (FRR and ERR) for MF and ESL muscles, appear to be an objective, sensitive and specific method for identifying altered FRP in NSCLBP patients.

Passive exoskeletons alter low back load transfer mechanism

Previous studies that tested passive back-support exoskeletons focused only on active low-back tissue. Therefore, this study examines the effect from a passive back-support exoskeleton by investigating changes in the load transfer mechanism between active and passive tissue in the low back. Twelve healthy male participants performed a full range of trunk flexion–extension movements under three conditions—FREE (no exoskeleton), the backX, or the CoreBot exoskeleton—while holding 0 kg, 4 kg, and 8 kg loads. Body kinematics and electromyography were recorded. Results showed that the average muscle activity of the lumbar erector spinae (LES) was significantly reduced while wearing the exoskeletons, with a 5.9%MVC reduction with the backX and a 3.3%MVC reduction with the CoreBot. Earlier occurrence of the flexion-relaxation phenomenon induced by the trunk extension moment of exoskeletons played an important role in reducing LES muscle activity because the LES returned to a relaxed state earlier (EMG-Off: a 3.1° reduction with the backX, and a 1.8° reduction with the CoreBot; EMG-On: a 2.3° reduction with the backX, and a 1.4° reduction with the CoreBot). In addition, the maximum lumbar flexion angle (a 2.2° reduction with the backX and a 1.5° reduction with the CoreBot) showed significant decreases compared to the FREE condition, indicating that exoskeleton use can prevent low-back passive tissue from being fully activated. These results suggested the overall effects of passive back-support exoskeletons in reducing loads on both active and passive tissue in the low back.

Influence of Lumbar Posture on Back Muscles Flexion Relaxation Phenomenon among University Students with Chronic Non-Specific Low Back Pain

Influence of Lumbar Posture on Back Muscles Flexion Relaxation Phenomenon among University Students with Chronic Non-Specific Low Back Pain

The occurrence of flexion-relaxation phenomenon in elite cyclists during trunk forward bending

ABSTRACT Flexion-relaxation phenomenon (FRP) is a well-knownphenomenon in spinal extensor muscles. According to the literature, prolongedflexed posture leads to creepphenomenon and affects the active and passive neuromuscular control of thespinal column. The purpose of this study was to investigateFRP occurrence in elite cyclists that prolonged flexion posture is an integralpart of their professional life. Their muscles’ contractionpattern during forward bending was also compared. Electromyography(EMG) was recorded during flexion andextension from standing position in thoracic erector spinae (TES), lumbarerector spinae (LES) and gluteus maximus (Gluteus max) in 15 healthy male elite cyclists. In addition, thekinematic data related to the trunk angles were simultaneously recorded by amotion analysis system. Two-way ANOVA was used to assess the effects of musclegroup and direction of movement on maximum amplitude of EMG activity. Among 15 cyclists, FRP was detectable in 60%, 87%and 73% of the participants in TES, LES and Gluteus max, respectively, and happened between 74% and 82% of the trunk flexion. There was nostatistically significant difference in onset and offset of muscles FRP. Despite prolonghyper kyphotic posture, FRP was identifiable in TES, LES and Gluteus max muscles of elitecyclists.

Electromyographic evaluation of the clinical and biomechanical effects of yoga on the flexion-relaxation phenomenon: a Prophet approach

Myoelectric silencing of the spinal erector muscles in the trunk flexion posture is indicative of greater spine sharing loads. The evaluation of the flexion relaxation phenomenon is a valid clinical tool able to contribute to the low back pain management [1]. In the broad scenario of low back pain therapy, there is increasing interest in non-traditional interventions such as Yoga, although the scientific evidence does not always analyze the biomechanical significance [2]. Therefore, the aim of this observational study was to evaluate the clinical and biomechanical effects of Yoga on the flexion-relaxation phenomenon of the lumbar erector muscles, through surface electromyography (sEMG) combined with an inertial sensor. Healthy young adults (ages 18 to 40) were selected as participants without chronic nonspecific low back pain for at least three months. The intervention consisted of a Yoga program lasting one hour specific for the lumbar spine Asana, for 4 sessions (2 times/week for 2 weeks), the first in presence and the other three in tele-approach. At the end of each session an evaluation was carried out, thus setting the T0 as the baseline, until the end of the fourth session as T4. The trunk flexion-relaxation phenomenon was performed by asking the participant to slowly flex the trunk forward to full flexion, pausing for 3 seconds and then returning to the standing starting position. The sEMG signal coupled to an inertial sensor was collected to quantify the flexion-relaxation ratio (FRR). Then, using a Prophet model, which allows time series prediction, we have traced the forecast of the FRR trend of the erector spinal muscles of the lumbar spine (Fig. 1). We included 13 healthy women (mean age: 28±8 years; BMI 20.0±0.9 kg/m2). No significant asymmetries were evaluated and Friedman's test reported slight significant differences (left L1-L2 p=.039, right p=0.041; left L4-L5 p=0.045, right p=0.040). Therefore, we performed a Prophet evaluation to analyze FRR trends, finding a growth rate of 0.45±0.3 for left L1-L2, 0.38±0.4 on the right, 0.25±0.4 for L4-L5 on the left and 0.25±0.3 on the right. With an Rhat≤1.01, excluding possible convergence problems. At one month from the end of the intervention, all lower confidence intervals curve remained above the thresholds of the baseline assessments. This study aimed to evaluate the role of Yoga in the prevention of lumbar spine disorders through the kinematic and electromyographic evaluation of the flexion-relaxation phenomenon. Processing the results using a Prophet approach predicts a positive influence even after the end of the Yoga sessions. Surface electromyography coupled to an inertial sensor provides reliable assessments of the lumbar spine, a prediction model can guarantee evidence on the positive introduction of Yoga asanas in the clinical management of any development of low back pain. In light of these results, future prospective studies might focus on the effects of yoga in clinical and biomechanical terms on patients with chronic nonspecific low back pain.

The flexion-relaxation phenomenon is related to trunk range of motion in low back pain patients: An immersive virtual reality study

The flexion-relaxation phenomenon is related to trunk range of motion in low back pain patients: An immersive virtual reality study

Influence of a Sacroiliac Belt on Pain and Functional Impairment in Patients With Low Back Pain: A Randomized Trial

ObjectiveThe purpose of this study was to assess the protective influence of the Serola Sacroiliac Belt on pain and functional impairment in individuals with low back pain (LBP) during 5 days of strenuous manual labor. MethodsThirty-three participants (mean ± standard deviation: age, 43.2 ± 11.4 years; height, 1.74 ± 0.11 m; body mass index, 88.3 ± 16.7 kg) with LBP were randomized to either condition A (wearing the Serola Sacroiliac Belt during a 10-minute daily repeated strenuous lifting task) during week 1 or condition B (not wearing a Serola Sacroiliac Belt during the same lifting task) in week 2 or vice versa. All 33 participants completed 1 week under condition A and 1 week under condition B for comparison. At the beginning and end of each week, the following dependent variables were measured: lumbar spine pain on a 0 to 10 Numeric Rating Scale (NRS), spine and thigh discomfort on a Nordic Musculoskeletal Questionnaire, and completion of a toe-touch surface electromyography flexion relaxation phenomenon test. ResultsDuring the week that participants used the Serola Sacroiliac Belt, spine pain increased 0.2 compared with 0.9 on the NRS for those who did not use the belt. No statistically significant difference was observed for Nordic Musculoskeletal Questionnaire data or the flexion relaxation phenomenon test in this study. ConclusionThe findings of this preliminary study suggest participants using the Serola Sacroiliac Belt while performing a daily repeated lifting task had less progression of their LBP. However, this protective value did not meet the recommended NRS for minimally clinically important difference, and there was no effect on functional impairment.

Effects of Hamstring Flexibility on Pain, Muscle Characteristic, Flexion-Relaxation Phenomenon of Chronic Low Back Pain

Effects of Hamstring Flexibility on Pain, Muscle Characteristic, Flexion-Relaxation Phenomenon of Chronic Low Back Pain

The influence of sedentary behavior on lumbar-pelvic kinematics during squatting and forward bending among physically active students

Prolonged sitting may involve several mechanisms that make it a risk factor for low back pain. The aim of this study was to investigate lumbar-pelvic kinematics and multifidus muscle (MF) activity during squatting and forward bending in relation to the sedentary behavior of physically active students. Sixty-three students were divided into two groups according to the time spent in a sitting position during the day: “high” (>7hours/day); “low” (≤7hours/day). Lumbar-pelvic ratios, ranges of motion, angular velocities, and MF flexion-relaxation phenomenon were investigated. Data were obtained using the optical motion analysis system, and surface electromyography. The results indicated that lumbar-pelvic ratios during both tasks and velocity of lumbar spine during squatting were significantly greater in the “high” than in the “low” sitting group. Muscle activity showed no differences between groups. Prolonged sitting can be considered a factor that slightly, but statistically significantly influences the lumbar-pelvic kinematics in physically active people.

Comparison of flexion relaxation phenomenon between female yogis and matched non-athlete group

BackgroundTrunk flexion is a common exercise during daily activities. Flexion relaxation phenomenon (FRP) occurs during forward bending in which there is a sudden silence of erector spinae (ES) muscles. The pattern of forward bending differs in yoga practitioners. This learned pattern probably predisposes yogis to injuries. The hypothesis of this study was that FRP differs in yogis in comparison to non-yogis individuals.MethodsThis observational cross-sectional study was performed on 60 women assigned into yogis and non-athlete groups. Each participant was asked to bend forward and then return to the initial position. ES activity was recorded at L3 level, 4 cm from mid line during the trial. Trunk inclination and lumbar flexion angles were calculated at FRP onset and cessation moments.ResultsThe FRP occurred in 80% of yoga practitioners in comparison to 96.7% in the control group. Trunk inclination angle was significantly greater at FRP initiation in yogis compared to control group. Lumbar flexion angle was not different between the groups.ConclusionsIt is concluded that the altered pattern of forward bending observed in yogis may change patterns of ES muscles activity if it becomes part of a person's daily lifestyle which might predispose these muscles to fatigue and subsequent injuries; however, further studies are warranted for clarification.

Changing the pattern of the back-muscle flexion-relaxation phenomenon through flexibility training in relatively inflexible young men.

Although several studies have investigated the back-muscle flexion–relaxation phenomenon (FRP), the effect of individual flexibility on the FRP has been discussed infrequently, with very limited data on the influence of flexibility training on the FRP. This study thus examined the effect of flexibility training on the change of back-muscle FRP pattern in relatively inflexible young men. We collected and analyzed the valid data from 20 male participants (10 each with high and low flexibility included in the control and trained groups, respectively) when flexing their trunks at seven trunk flexion positions (0°–90°, in increments of 15°); their erector spinae and hamstring activation, pelvic tilt, and lumbosacral angle were then recorded. After 7 weeks of flexibility training for the low-flexibility group, no difference in flexibility was discovered between this group and the control (originally high-flexibility) group. The trunk flexion experiment was then repeated. The results showed that before the training stage, the low-flexibility group had lower erector spinae and higher hamstring activation, a larger pelvic tilt, and a smaller lumbosacral angle. By contrast, after training, the erector spinae and hamstring activation, pelvic tilt, and lumbosacral angle were significantly changed, and no intergroup differences were observed in FRP patterns. The study results suggest that flexibility training changes lumbopelvic movement and thereby reduces the degree of the back-muscle FRP when trunk flexion is performed.

The flexion relaxation phenomenon in nonspecific chronic low back pain: prevalence, reproducibility and flexion-extension ratios. A systematic review and meta-analysis.

The flexion relaxation phenomenon (FRP) is characterized by the reduction of paraspinal muscle activity at maximum trunk flexion. The FRP is reported to be altered (persistence of spinal muscle activity) in nonspecific chronic low back pain (NSCLBP) and is considered a promising biomarker. The aim of this systematic review was to synthetize current knowledge on FRP in the NSCLBP population regarding prevalence, the reliability of FRP measurement using surface electromyography (sEMG), the average value, and variation of the relaxation ratios (RR). Five databases were searched (PubMed, EMBASE, Web of Sciences, Cochrane Library, Pedro). A qualitative analysis was done for all included studies and meta-analysis studying prevalence, mean value of flexion relaxation ratio (FRR) and extension relaxation ratio (ERR), and difference between asymptomatic and NSCLBP FRR. Twenty-seven studies were included for qualitative analysis and 21 studies for meta-analysis. The prevalence of the altered FRP was 55% (95%CI [32-79%]) in the NSCLBP population. The studies on reliability reported good within-session and between-session reproducibility. In the NSLBP population, the mean FRR was 2.96 (95%CI [2.02; 3.90]) and the mean ERR was 4.07 (95%CI [2.08; 6.07]). The difference between asymptomatic and NSCLBP FRR was - 1.19 (95%CI [- 1.92, - 0.45]). In all meta-analysis, the I2 index was > 80%. An altered FRP is frequently found in NSCLBP population using sEMG and the test has a good reproducibility. The difference between asymptomatic and NSCLBP FRR was significant. Nevertheless, considering the high heterogeneity observed, additional research is required to confirm the value of RR.

CORE TRAINING UNDER SUSPENSION EXERCISE THERAPY ON TREATMENT OF LOW BACK PAIN

ABSTRACT Introduction: The main clinical feature of chronic nonspecific low back pain (CNLBP) is lower back pain, and suspension sports therapy has a specific effect in this case. Objective: To investigate the changes of flexion-relaxation phenomenon in patients with lower back pain after core control training of suspension exercise therapy (SET). Methods: 84 subjects who met the inclusion and exclusion criteria of chronic low back pain in this experiment were randomly divided into an experimental group and a control group. The experimental group was treated with suspension training. The control group only received acupuncture. We then determined the muscle fascia tension and core stability of the lower lumbar region. Results: The visual analog scale (VAS) and Oswestry dysfunction index (ODI) evaluations of the two groups of patients were different. Conclusion: Suspended core stabilization training has a significant long-term effect in reducing lower back pain and improving waist function in patients with chronic nonspecific low back pain. Level of evidence II; Therapeutic studies - investigation of treatment results.