EFFECTIVENESS OF DIFFERENT PHYSICAL THERAPY EXERCISE TECHNIQUES IN CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED STUDY

Abstract

Purpose: Exercise therapy is the most common conservative treatment for low back pain. Exercise has generally been associated pain and kinesiophobia. In this context, especially paraspinal muscles need to be focused on. For this reason, the aim of our study is to evaluate different types of exercises that will help increase neuromuscular facilitation and core stability in paraspinal muscles by considering patient satisfaction. Methods: A total of thirty-seven female patients with chronic low back pain were included in the study. The Oswestry Low Back Pain Questionnaire was used to assess functionality. Core stability was evaluated with a stabilizer. Pain intensity and satisfaction were measured with Visual Analog Scale. Patients' kinesiophobia levels were assessed by using Tampa Kinesiophobia Scale. Patients were randomized into three groups according to the interventions as: Proprioceptive Neuromuscular Facilitation exercise group (n = 9), core stability exercise group (n = 14) and control (n = 14) group. The duration of applications was 3 days per week with a total of 6 weeks. Results: There were group differences for core muscle strength (p = .045), Oswestry scores (p = .001), pain intensity score (p = .003) and Tampa score (p = .001). There were significant gains for Core muscle strength and Oswestry scores for Proprioceptive Neuromuscular Facilitation and Core stability groups (p < .05). Conclusion. Core stabilization exercises have additional effects to improve rehabilitation outcomes for patients. Besides that, the level of patient satisfaction was importantly different between all groups in favor to Core stability in chronic low back pain.

Keywords

• Core stability
• exercise
• low back pain
• patient satisfaction
• proprioceptive neuromuscular facilitation

KRONİK BEL AĞRISINDA FARKLI FİZYOTERAPİ EGZERSİZ TEKNİKLERİNİN ETKİNLİĞİ: RANDOMİZE KONTROLLÜ BİR ÇALIŞMA

Öz

Amaç: Bel ağrısı için en yaygın konservatif tedavi egzersizdir. Egzersiz genellikle ağrı ve kinezyofobi ile ilişkilendirilmiştir. Bu bağlamda özellikle paraspinal kaslara da odaklanılması da gerekmektedir. Bu nedenle çalışmamızın amacı, paraspinal kaslarda nöromüsküler fasilitasyon ve core stabilitesini artırmaya yardımcı olacak farklı egzersiz türlerini hasta memnuniyetini göz önünde bulundurarak değerlendirmek idi. Yöntem: Kronik bel ağrısı olan otuz yedi kadın hasta çalışmaya dahil edildi. Fonksiyonellik değerlendirilmesi için Oswestry Bel Ağrısı Ölçeği kullanıldı. Core stabilizasyon stabilizatör ile değerlendirildi. Ağrı şiddeti ve memnuniyet Vizüel Analog Skala ile ölçüldü. Hastaların kinezyofobi düzeyleri Tampa Kinezyofobi Ölçeği ile değerlendirildi. Hastalar rastgele üç gruba ayrıldı; Proprioseptif Nöromuskuler Fasilitasyon egzersiz grubu (n=9), Core stabilizasyon grubu (n=14) ve kontrol grubu. Uygulama süresi haftada 3 gün toplam 6 hafta idi. Sonuçlar: Core kas kuvveti (p = 0,045), Oswestry skoru (p = 0,001), ağrı şiddet skoru (p = .003) ve Tampa skoru (p = 0,001) gruplar arasında farklılık gösterdi. Proprioseptif Nöromuskuler Fasilitasyon ve Core stabilizasyon egzersiz grubunda Core kas kuvveti ve Oswestry skorlarında anlamlı kazanımlar elde edildi (p <0,05). Sonuçlar: Kronik bel ağrısında Core stabilizasyon egzersizlerinin hastaların rehabilitasyon sonuçlarını geliştirmek için ek etkileri vardır. Bunun yanı sıra Core stabilizasyon lehine hasta memnuniyet düzeyi tüm gruplar arasında önemli ölçüde farklı idi.

Anahtar Kelimeler

• core stabilizasyon
• egzersiz
• bel ağrısı
• hasta memnuniyeti
• Proprioseptif Nöromuskuler Fasilitasyon

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