Effects of sleep hygiene and breathing exercises on pain, disability, and sleep in patients with chronic low back pain

Abstract

Purpose: This study aims to investigate the effects of adding sleep hygiene education and breathing exercises to core stabilization exercises on pain, disability, and sleep parameters in patients with chronic low back pain (CLBP). Methods: Individuals diagnosed with CLBP were randomly assigned to three groups. The first group, received only TENS and superficial heat, forming the classical physiotherapy group (CPT). The second group received TENS and superficial heat combined with stabilization exercises, forming the lumbar stabilization exercise group (LSE). The third group received TENS, superficial heat, lumbar stabilization exercises, breathing exercises, and sleep hygiene education, forming the sleep hygiene and breathing exercise group (SHBE). All groups underwent a 3-week face-to-face treatment phase initially. Subsequently, the LSE and SHBE groups continued with a 5-week home exercise program. Pain intensity was assessed using the Visual Analogue Scale and the short form of the McGill Pain Questionnaire; disability with the Oswestry Disability Index; sleep quality with the Pittsburgh Sleep Quality Index, and daytime sleepiness with the Epworth Sleepiness Scale. Assessments were conducted at baseline, at 3 weeks (post-treatment), and at 8 weeks (follow-up). Results: Compared to baseline, significant differences were observed between groups at post-treatment and follow-up periods. The LSE and SHBE groups were more effective than the CPT group in reducing pain intensity, decreasing disability levels, improving sleep quality, and reducing daytime sleepiness (p<0.05). However, no significant differences were found between the LSE and SHRE groups for these parameters (p>0.05). Conclusion: This study demonstrates that the LSE and SHBE groups were more effective than the CPT group in improving pain, disability, and sleep parameters. However, the addition of sleep hygiene education and breathing exercises did not provide additional benefits compared to core stabilization exercises alone in patients with CLBP. More comprehensive studies are needed to evaluate long-term effects.

Keywords

• Low back pain
• Core stabilization
• Sleep hygiene
• Breathing exercises
• Sleep.

Kronik bel ağrılı hastalarda uyku hijyeni ve solunum egzersizlerinin ağrı, özürlülük ve uykuya etkisi

Abstract

Amaç: Kronik bel ağrısı (KBA) olan hastalarda kor stabilizasyon egzersizlerine eklenen uyku hijyeni eğitimi ve solunum egzersizlerinin ağrı, özürlülük, uyku parametreleri üzerindeki etkilerini araştırmayı amaçlamaktadır. Yöntem: KBA tanısı konan bireyler, randomize olarak üç gruba ayrıldı. Birinci grup yalnızca TENS ve yüzeyel ısı uygulanan klasik fizyoterapi grubu (KFT), ikinci grup TENS, yüzeyel ısı ve kor stabilizasyon egzersizlerini içeren lumbar stabilizasyon egzersizi grubu (LSE) ve üçüncü grup TENS, yüzeyel ısı, kor lumbar stabilizasyon egzersizleri, solunum egzersizleri ve uyku hijyeni eğitimi uygulanan uyku hijyeni ve solunum egzersizleri grubudur (UHSE). Tüm gruplar, ilk aşamada 3 haftalık yüzyüze tedavi aldı. Daha sonra LSE ve UHSE grupları ilave olarak 5 hafta boyunca ev programlarına devam ettiler. Ağrı şiddeti Vizüel Ağrı Skalası ve McGill Ağrı Kısa Formu, özürlülük Oswestry Özürlülük İndeksi, uyku kalitesi Pittsburgh Uyku Kalite İndeksi ve gündüz uykululuğu Epworth Uykululuk Ölçeği ile değerlendirildi. Değerlendirmeler tedavi başlangıcında, 3. haftada (tedavi sonrası) ve 8. haftada (takip dönemi) yapıldı. Bulgular: Başlangıç değerlerine kıyasla, tedavi sonrası ve takip döneminde gruplar arasında anlamlı farklar saptandı. LSE ve UHSE grupları, KFT grubuna göre ağrı şiddetini azaltma, özürlülük düzeyini düşürme, uyku kalitesini artırma ve gündüz uykululuğunu azaltmada daha etkili bulundu (p<0.05). Ancak, LSE ve UHSE grupları arasında bu parametrelerde anlamlı bir fark tespit edilmedi (p>0.05). Sonuç: Bu çalışma, LSE ve UHSE gruplarının, KFT grubuna kıyasla ağrı, özürlülük ve uyku parametrelerini iyileştirmede daha etkili olduğunu gösterdi. Uyku hijyeni eğitimi ve solunum egzersizlerinin eklenmesi, yalnızca kor stabilizasyon egzersizlerine kıyasla KBA hastalarında ek bir fayda sağlamadı. Uzun vadeli etkileri değerlendirmek için daha kapsamlı çalışmalara ihtiyaç vardır.

Keywords

• Bel ağrısı
• Kor stabilizasyon
• Uyku hijyeni
• Solunum egzersizleri
• Uyku.

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