Lumbar Stabilization, Strengthening and Stretching in Chronic Low Back Pain

NCT01124201 | Completed DMC

• 1 other identifier: 1249/06
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study was to compare the efficacy of three exercise programs in patients with chronic low back pain: Segmental stabilization, superficial strengthening and stretching. Groups were contrasted regarding pain, functional disability and TrA muscle activation capacity. The three groups of exercise improved pain and functional disabilities, and the Segmental stabilization group was better in the ability to recruit TrA muscle.

Conditions

Chronic Low Back Pain

Keywords

low back pain; clinical trial; stabilization; muscle stretching exercises; exercise therapy

Outcome Measures

Primary Outcomes (3)

• Pain (visual analogical scale and McGill pain questionnaire)

  Six weeks

• Functional disability (Oswestry disability questionnaire)

  Six weeks

• TrA muscle activation capacity (Pressure Biofeedback Unit = PBU)

  Six weeks

Study Arms (3)

Stabilization group

EXPERIMENTAL

In the Segmental Stabilization group exercises focused on the transversus abdominis and lumbar multifidus muscles.

Other: Stabilization , strengthening and stretching

Strengthening group

EXPERIMENTAL

In the Superficial Strengthening group, exercises focused on the rectus abdominis, abdominus obliquus internus, abdominus obliquus externus and erector spinae muscles.

Other: Stabilization , strengthening and stretching

Stretching group

EXPERIMENTAL

Stretching group: erector spinae, posterior connective tissues and ischiotibials muscles

Other: Stabilization , strengthening and stretching

Interventions

Stabilization , strengthening and stretching OTHER

Interventions were conducted over 6 weeks, twice per week, lasting 30 minutes each. Sessions were supervised by the investigator, and participants were instructed to report any adverse event. Groups were instructed not to participate in any other physical program during the study. Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles). Patients were evaluated for pain , functional disability,and ability to contract the TrA before and after the treatment.

Also known as: Pressure Biofeedback Unit

Stabilization group; Strengthening group; Stretching group

Eligibility Criteria

• Age: 23 Years - 53 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• low back pain for more than 3 months
• patients willing to participate and could participate in an exercise program safely and without cognitive impairments that would limit their participation.

You may not qualify if:

• past history of back surgery
• rheumatologic disorders
• spine infections
• spine exercise training in the 3 months before study onset.

Sponsors & Collaborators

• University of Sao Paulo General Hospital: lead
• Fundação de Amparo à Pesquisa do Estado de São Paulo: collaborator

Study Sites (1)

University of Sao Paulo General Hospital

São Paulo, São Paulo, Brazil

Location

Related Publications (6)

• Barr KP, Griggs M, Cadby T. Lumbar stabilization: a review of core concepts and current literature, part 2. Am J Phys Med Rehabil. 2007 Jan;86(1):72-80. doi: 10.1097/01.phm.0000250566.44629.a0.

  PMID: 17304690 BACKGROUND

• MacDonald DA, Moseley GL, Hodges PW. The lumbar multifidus: does the evidence support clinical beliefs? Man Ther. 2006 Nov;11(4):254-63. doi: 10.1016/j.math.2006.02.004. Epub 2006 May 23.

  PMID: 16716640 BACKGROUND

• Ferreira PH, Ferreira ML, Maher CG, Refshauge K, Herbert RD, Hodges PW. Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. Br J Sports Med. 2010 Dec;44(16):1166-72. doi: 10.1136/bjsm.2009.061515. Epub 2009 May 26.

  PMID: 19474006 BACKGROUND

• Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004 Jan;107(1-2):176-90. doi: 10.1016/j.pain.2003.10.017.

  PMID: 14715404 BACKGROUND

• Hayden JA, van Tulder MW, Malmivaara AV, Koes BW. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005 May 3;142(9):765-75. doi: 10.7326/0003-4819-142-9-200505030-00013.

  PMID: 15867409 BACKGROUND

• Franca FR, Burke TN, Hanada ES, Marques AP. Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study. Clinics (Sao Paulo). 2010;65(10):1013-7. doi: 10.1590/s1807-59322010001000015.

  PMID: 21120303 DERIVED

Related Links

• Link to my thesis in portuguese.

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Fabio R França, MSc

  University of Sao Paulo

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: May 13, 2010
• First Posted: May 14, 2010
• Study Start: February 1, 2007
• Primary Completion: March 1, 2008
• Study Completion: June 1, 2009
• Last Updated: May 14, 2010

Record last verified: 2007-03

Locations

BR (1)