Assessment of lower extremity isokinetic muscle strength in individuals with chronic low back pain

Abstract

Purpose: The study aimed to investigate the lower extremity isokinetic muscle strength alterations and the relations between isokinetic muscle strength and symptom severity in patients with chronic low back pain.

Methods: Forty-eight patients with chronic low back pain aged between 20-50 years (mean age: 33.4±10.2 years) and 47 healthy individuals aged between 19-50 years (mean age: 31.7±9 years) participated in this study. Pain severity of individuals with chronic low back pain was assessed by using the Visual Analogue Scale (VAS) and the disability rate was according to Oswestry Disability Index (ODI). Quadriceps and hamstring isokinetic muscle strength of the participants were evaluated by using Biodex System 4 (Biodex Corp., Shirley, NY) at the speed of 90°/s.

Results: In the chronic low back pain group, the mean resting pain severity was 3.7±2.7 cm, the mean activity pain severity was 5.8±2.4 cm, the mean night pain severity was 2.6±3.3 cm according to VAS. The mean disability rate was 21.64±12.11. There was no difference between the groups in terms of concentric and isometric strength of the quadriceps and hamstring muscles (p>0.05). No correlation was determined between muscle strength and pain and disability outcomes (p>0.05).

Conclusion: According to our results, quadriceps and hamstring isokinetic muscle strength is not different from healthy individuals in patients with chronic low back pain. Quadriceps and hamstring isokinetic muscle strength is not related to pain and disability. 

Kronik Bel Ağrılı Bireylerde Alt Ekstremite İzokinetik Kas Kuvvetinin Değerlendirilmesi

Abstract

Amaç: Bu çalışmada kronik bel ağrısı olan hastalarda alt ekstremite izokinetik kas kuvveti değişikliklerini incelemek ve izokinetik kas kuvveti ile semptom şiddeti arasındaki ilişkinin araştırılması amaçlandı.

Yöntem: Bu çalışmaya 20-50 yaş aralığında (ortalama yaş: 33.4±10.2 yıl) 48 kronik bel ağrılı ve 19-50 yaş aralığında (ortalama yaş: 31.7±9.0 yıl) 47 sağlıklı birey katıldı. Kronik bel ağrılı bireylerin ağrı şiddeti Vizüel Analog Skalası (VAS) kullanarak, özür düzeyi Oswestry Disabilite İndeksi (ODİ) kullanılarak değerlendirildi. Bireylerin quadriceps ve hamstring izokinetik kas kuvveti Biodex Sistem 4 (Biodex Corp, Shirley, NY) kullanılarak 90°/sn hızda değerlendirildi.

Bulgular: Kronik bel ağrılı grupta istirahat ağrısı şiddeti VAS’a göre ortalama: 3.7±2.7 cm, aktivite ağrısı şiddeti ortalama: 5.8±2.4 cm, gece ağrısı şiddeti ortalama: 2.6±3.3 cm idi. ODİ yüzdesi ortalama 21.64±12.11 idi. Quadriceps ve hamstring kaslarının konsentrik ve izometrik kuvveti açısından gruplar arasında fark yoktu (p>0.05). Kas kuvveti ile ağrı ve disabilite sonuçları arasında ilişki olmadığı bulundu (p>0.05; r<0.20).

Sonuç: Sonuçlarımıza göre, quadriceps ve hamstring izokinetik kas kuvveti kronik bel ağrısı olan hastalarda sağlıklı bireylerden farklı değildir. Quadriceps ve hamstring izokinetik kas kuvveti ile ağrı ve disabilite ilişkili değildir.  

Keywords

• bel ağrısı,özür değerlendirmesi

References

1. 1. Hoy D, March L, Brooks P, et al. The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:968-974.
2. 2. Manchikanti L, Singh V, Falco FJ, et al. Epidemiology of low back pain in adults. Neuromodulation. 2014;17:3-10.
3. 3. Gilgil E, Kaçar C, Bütün B, et al. Prevalence of low back pain in a developing urban setting. Spine (Phila Pa 1976). 2005;30:1093-1098.
4. 4. Dündar PE, Özyurt BC, Özmen D. Manisa’da kırsal bir bölgede kadınlarda bel ağrısı sıklığı; ev işleri ve diğer faktörlerle ilişkisi. Ağrı Dergisi. 2006;18:51-56.
5. 5. Şenköylü A. Bel ağrısında kırmızı bayraklar. Türk Fiz Tıp Rehab Derg. 2011;57:Ek2(1)0-0.
6. 6. Lee JH, Hoshino Y, Nakamura K, et al. Trunk muscle weakness as a risk factor for low back pain. A 5-year prospective study. Spine (Phila Pa 1976). 1999;24:54-57.
7. 7. Moffroid M, Reid S, Henry SM, et al. Some endurance measures in persons with chronic low back pain. J Orthop Sports Phys Ther. 1994;20:81-87.
8. 8. Grabiner MD, Jeziorowski JJ. Isokinetic trunk extension discriminates uninjured subjects from subjects with previous low back pain. Clin Biomech (Bristol, Avon). 1992;7:195-200.

9. 9. Tsuboi T, Satou T, Egawa K, et al. M. Spectral analysis of electromyogram in lumbar muscles: fatigue induced endurance contraction. Eur J Appl Physiol Occup Physiol. 1994;69:361-366.
10. 10. Hides JA, Stokes MJ, Saide M, el al. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine (Phila Pa 1976). 1994;19:165-172.
11. 11. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine (Phila Pa 1976). 1996;21:2640-2650.
12. 12. McGregor AH, Hukins DW. Lower limb involvement in spinal function and low back pain. J Back Musculoskelet Rehabil. 2009;22:219-222.
13. 13. Kankaanpää M, Taimela S, Laaksonen D, el al. Back and hip extensor fatigability in chronic low back pain patients and controls. Arch Phys Med Rehabil. 1998;79:412-417.
14. 14. Chaitow L, Liebenson C. Muscle Energy Techniques. 2nd ed. Edinburgh, UK: Elsevier/Churchill Livingstone; 2001.
15. 15. Suter E, Lindsay D. Back muscle fatigability is associated with knee extensor inhibition in subjects with low back pain. Spine (Phila Pa 1976). 2001;15;26:361-366.
16. 16. Cai C, Kong PW. Low back and lower-limb muscle performance in male and female recreational runners with chronic low back pain. J Orthop Sports Phys Ther. 2015;45:436-443.
17. 17. Yakut E, Düger T, Oksüz C, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976). 2004;29:581-585.
18. 18. Pallant J. SPSS Kullanma Kılavuzu SPSS İle Adım Adım Veri Analizi. Ankara: Anı Yayıncılık; 2017.
19. 19. Bernard JC, Bard R, Pujol A, et al. Muscle assessment in healthy teenagers, comparison with teenagers with low back pain. Ann Readapt Med Phys. 2008;51:263-283.
20. 20. Lee JH, Ooi Y, Nakamura K. Measurement of muscle strength of the trunk and the lower extremities in subjects with history of low back pain. Spine (Phila Pa 1976). 1995;20:1994-1996.
21. 21. Rossi MK, Pasanen K, Heinonen A, et al. Incidence and risk factors for back pain in young floorball and basketball players: A Prospective study. Scand J Med Sci Sports. 2018;28:2407-2415.
22. 22. Rissanen A, Alaranta H, Sainio P, et al. Isokinetic and nondynamometric tests in low back pain patients related to pain and disability index. Spine. 1994;19:1963-1967.