Klinik Araştırma
BibTex RIS Kaynak Göster

The Impact of Lumbar Stabilization and Thoracic Mobilization Exercises on Pain, Disability and Quality of Life in Individuals with Chronic Low Back Pain

Yıl 2024, Cilt: 5 Sayı: 3, 123 - 131
https://doi.org/10.58770/joinihp.1571454

Öz

This study aimed to evaluate the efficacy of adding thoracic mobilization to lumbar stabilization exercises for managing chronic low back pain (CLBP). Fifty-four CLBP patients were randomly assigned to two groups: the Lumbar Stabilization (LS) group and the Lumbar Stabilization plus Thoracic Mobilization (LS+TM) group. Pain intensity, functional disability, and quality of life were assessed using the Visual Analog Scale (VAS), Quebec Low Back Pain Disability Scale (QLPSD), and EuroQOL-5D-3L, respectively. Both groups participated in a six-week intervention with three sessions per week. Significant improvements were observed in pain intensity, functional disability, and quality of life for both groups (p < 0.05). However, post-intervention analyses indicated that the LS+TM group experienced superior reductions in functional disability and greater enhancements in quality of life compared to the LS group (p < 0.05). While both exercise regimens were effective in managing CLBP, the addition of thoracic mobilization to lumbar stabilization exercises provided more significant benefits in functional recovery and overall well-being.

Kaynakça

  • Akodu, A., Akinbo, S., & Odebiyi, D. (2014). Effect of Stabilization Exercise on Lumbar Multifidus Muscle Thickness in Patients with Non-specific Chronic Low Back Pain. Iranian Rehabilitation Journal, 12(2), 6–10.
  • Akuthota, V., Ferreiro, A., Moore, T., & Fredericson, M. (2008). Core stability exercise principles. Current Sports Medicine Reports, 7(1), 39–44. https://doi.org/10.1097/01.CSMR.0000308663.13278.69
  • Atlas, S. J., & Nardin, R. A. (2003). Evaluation and treatment of low back pain: An evidence-based approach to clinical care. Muscle & Nerve, 27(3), 265–284. https://doi.org/10.1002/mus.10311
  • Barut, K., Taştaban, E., & Şendur, Ö. (2023). THE EFFECT OF LUMBAR STABILIZATION EXERCISES ON CHRONIC LOW BACK PAIN PATIENTS. SDÜ Tıp Fakültesi Dergisi, 30(4), 610–618. https://doi.org/10.17343/sdutfd.1309984
  • Ben Kibler, W., & Sciascia, A. (2004). Kinetic chain contributions to elbow function and dysfunction in sports. Clinics in Sports Medicine, 23(4), 545–552, viii. https://doi.org/10.1016/j.csm.2004.04.010
  • Burkhart, S. S., Morgan, C. D., & Kibler, W. B. (2003). The disabled throwing shoulder: Spectrum of pathology Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy: The Journal of Arthroscopic & Related Surgery: Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 19(6), 641–661. https://doi.org/10.1016/s0749-8063(03)00389-x
  • Chang, W.-D., Lin, H.-Y., & Lai, P.-T. (2015). Core strength training for patients with chronic low back pain. Journal of Physical Therapy Science, 27(3), 619–622. https://doi.org/10.1589/jpts.27.619
  • Clark, P., Lavielle, P., & Martínez, H. (2003). Learning from pain scales: Patient perspective. The Journal of Rheumatology, 30(7), 1584–1588.
  • Divya, null, Parveen, A., Nuhmani, S., Ejaz Hussain, M., & Hussain Khan, M. (2020). Effect of lumbar stabilization exercises and thoracic mobilization with strengthening exercises on pain level, thoracic kyphosis, and functional disability in chronic low back pain. Journal of Complementary & Integrative Medicine, 18(2), 419–424. https://doi.org/10.1515/jcim-2019-0327
  • Gomes-Neto, M., Lopes, J. M., Conceição, C. S., Araujo, A., Brasileiro, A., Sousa, C., Carvalho, V. O., & Arcanjo, F. L. (2017). Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis. Physical Therapy in Sport: Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, 23, 136–142. https://doi.org/10.1016/j.ptsp.2016.08.004
  • Heo, M.-Y., Kim, K., Hur, B.-Y., & Nam, C.-W. (2015). The effect of lumbar stabilization exercises and thoracic mobilization and exercises on chronic low back pain patients. Journal of Physical Therapy Science, 27(12), 3843–3846. https://doi.org/10.1589/jpts.27.3843
  • Kaya, N. (n.d.). Larinjektomili Bireylerin Sa¤l›¤a ‹liflkin Yaflam Kalitesini De¤erlendirmede EuroQol Ölçe¤inin Güvenirlik ve Geçerli¤i (*).
  • Kibler, W. B., Press, J., & Sciascia, A. (2006). The role of core stability in athletic function. Sports Medicine (Auckland, N.Z.), 36(3), 189–198. https://doi.org/10.2165/00007256-200636030-00001
  • Kostadinović, S., Milovanović, N., Jovanović, J., & Tomašević-Todorović, S. (2020). Efficacy of the lumbar stabilization and thoracic mobilization exercise program on pain intensity and functional disability reduction in chronic low back pain patients with lumbar radiculopathy: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 33(6), 897–907. https://doi.org/10.3233/BMR-201843
  • Koumantakis, G. A., Watson, P. J., & Oldham, J. A. (2005). Trunk muscle stabilization training plus general exercise versus general exercise only: Randomized controlled trial of patients with recurrent low back pain. Physical Therapy, 85(3), 209–225.
  • Kweon, M., Hong, S., Jang, G. U., Ko, Y. M., & Park, J. W. (2013). The Neural Control of Spinal Stability Muscles during Different Respiratory Patterns. Journal of Physical Therapy Science, 25(11), 1421–1424. https://doi.org/10.1589/jpts.25.1421
  • Leetun, D. T., Ireland, M. L., Willson, J. D., Ballantyne, B. T., & Davis, I. M. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Medicine and Science in Sports and Exercise, 36(6), 926–934. https://doi.org/10.1249/01.mss.0000128145.75199.c3
  • Loeser, J. D., & Treede, R.-D. (2008). The Kyoto protocol of IASP Basic Pain Terminology. Pain, 137(3), 473–477. https://doi.org/10.1016/j.pain.2008.04.025
  • Melikoglu, M. A., Kocabas, H., Sezer, I., Bilgilisoy, M., & Tuncer, T. (2009). Validation of the Turkish version of the Quebec back pain disability scale for patients with low back pain. Spine, 34(6), E219-224. https://doi.org/10.1097/BRS.0b013e3181971e2d
  • Michaelson, P., Michaelson, M., Jaric, S., Latash, M. L., Sjölander, P., & Djupsjöbacka, M. (2003). Vertical posture and head stability in patients with chronic neck pain. Journal of Rehabilitation Medicine, 35(5), 229–235. https://doi.org/10.1080/16501970306093
  • Moseley, G. L. (2004). Impaired trunk muscle function in sub-acute neck pain: Etiologic in the subsequent development of low back pain? Manual Therapy, 9(3), 157–163. https://doi.org/10.1016/j.math.2004.03.002
  • Niederer, D., & Mueller, J. (2020). Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression. PloS One, 15(1), e0227423. https://doi.org/10.1371/journal.pone.0227423
  • Panjabi, M. M. (1992). The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. Journal of Spinal Disorders, 5(4), 390–396; discussion 397. https://doi.org/10.1097/00002517-199212000-00002
  • Shamsi, M. B., Sarrafzadeh, J., & Jamshidi, A. (2015). Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests. Physiotherapy Theory and Practice, 31(2), 89–98. https://doi.org/10.3109/09593985.2014.959144
  • Speksnijder, C. M., Koppenaal, T., Knottnerus, J. A., Spigt, M., Staal, J. B., & Terwee, C. B. (2016). Measurement Properties of the Quebec Back Pain Disability Scale in Patients With Nonspecific Low Back Pain: Systematic Review. Physical Therapy, 96(11), 1816–1831. https://doi.org/10.2522/ptj.20140478
  • Treede, R.-D., Jensen, T. S., Campbell, J. N., Cruccu, G., Dostrovsky, J. O., Griffin, J. W., Hansson, P., Hughes, R., Nurmikko, T., & Serra, J. (2008). Neuropathic pain: Redefinition and a grading system for clinical and research purposes. Neurology, 70(18), 1630–1635. https://doi.org/10.1212/01.wnl.0000282763.29778.59
  • Turk, D. C., & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. Journal of Consulting and Clinical Psychology, 70(3), 678–690. https://doi.org/10.1037//0022-006x.70.3.678
  • Wang, X.-Q., Zheng, J.-J., Yu, Z.-W., Bi, X., Lou, S.-J., Liu, J., Cai, B., Hua, Y.-H., Wu, M., Wei, M.-L., Shen, H.-M., Chen, Y., Pan, Y.-J., Xu, G.-H., & Chen, P.-J. (2012). A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PloS One, 7(12), e52082. https://doi.org/10.1371/journal.pone.0052082
  • Yilmaz Yelvar, G. D., Çirak, Y., Dalkilinç, M., Demir, Y. P., Baltaci, G., Kömürcü, M., & Yelvar, G. D. Y. (2016). Impairments of postural stability, core endurance, fall index and functional mobility skills in patients with patello femoral pain syndrome. Journal of Back and Musculoskeletal Rehabilitation. https://doi.org/10.3233/BMR-160729

Kronik Bel Ağrısı Olan Bireylerde Lomber Stabilizasyon ve Torasik Mobilizasyon Egzersizlerinin Ağrı, Engellilik ve Yaşam Kalitesi Üzerindeki Etkisi

Yıl 2024, Cilt: 5 Sayı: 3, 123 - 131
https://doi.org/10.58770/joinihp.1571454

Öz

Bu çalışmanın amacı, kronik bel ağrısı (KBA) tedavisinde lomber stabilizasyon egzersizlerine ek olarak torasik mobilizasyon uygulamasının etkinliğini değerlendirmektir. Elli dört kronik bel ağrısı hastası, Lomber Stabilizasyon (LS) grubu ve Lomber Stabilizasyona ek Torasik Mobilizasyon (LS+TM) grubu olmak üzere iki gruba rastgele atanmıştır. Ağrı şiddeti, fonksiyonel disabilite ve yaşam kalitesi sırasıyla Görsel Analog Skalası (GAS), Quebec Bel Ağrısı Disabilite Skalası (QLPSD) ve EuroQOL-5D-3L ile değerlendirilmiştir. Her iki grup da haftada üç seans olmak üzere altı haftalık bir müdahale programına katılmıştır. Her iki grupta da ağrı şiddeti, fonksiyonel disabilite ve yaşam kalitesinde anlamlı iyileşmeler gözlemlenmiştir (p < 0,05). Ancak, müdahale sonrası analizlerde LS+TM grubunun, LS grubuna kıyasla fonksiyonel disabilitede (η2=0.768) ve yaşam kalitesinde (η2=0.731) etki büyüklüğü yüksekti (p < 0,05). Her iki egzersiz de kronik bel ağrısının yönetiminde etkili olsa da, torasik mobilizasyonun lomber stabilizasyon egzersizlerine eklenmesi, fonksiyonel iyileşme ve genel iyilik hali üzerinde daha önemli faydalar sağlamıştır.

Kaynakça

  • Akodu, A., Akinbo, S., & Odebiyi, D. (2014). Effect of Stabilization Exercise on Lumbar Multifidus Muscle Thickness in Patients with Non-specific Chronic Low Back Pain. Iranian Rehabilitation Journal, 12(2), 6–10.
  • Akuthota, V., Ferreiro, A., Moore, T., & Fredericson, M. (2008). Core stability exercise principles. Current Sports Medicine Reports, 7(1), 39–44. https://doi.org/10.1097/01.CSMR.0000308663.13278.69
  • Atlas, S. J., & Nardin, R. A. (2003). Evaluation and treatment of low back pain: An evidence-based approach to clinical care. Muscle & Nerve, 27(3), 265–284. https://doi.org/10.1002/mus.10311
  • Barut, K., Taştaban, E., & Şendur, Ö. (2023). THE EFFECT OF LUMBAR STABILIZATION EXERCISES ON CHRONIC LOW BACK PAIN PATIENTS. SDÜ Tıp Fakültesi Dergisi, 30(4), 610–618. https://doi.org/10.17343/sdutfd.1309984
  • Ben Kibler, W., & Sciascia, A. (2004). Kinetic chain contributions to elbow function and dysfunction in sports. Clinics in Sports Medicine, 23(4), 545–552, viii. https://doi.org/10.1016/j.csm.2004.04.010
  • Burkhart, S. S., Morgan, C. D., & Kibler, W. B. (2003). The disabled throwing shoulder: Spectrum of pathology Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy: The Journal of Arthroscopic & Related Surgery: Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 19(6), 641–661. https://doi.org/10.1016/s0749-8063(03)00389-x
  • Chang, W.-D., Lin, H.-Y., & Lai, P.-T. (2015). Core strength training for patients with chronic low back pain. Journal of Physical Therapy Science, 27(3), 619–622. https://doi.org/10.1589/jpts.27.619
  • Clark, P., Lavielle, P., & Martínez, H. (2003). Learning from pain scales: Patient perspective. The Journal of Rheumatology, 30(7), 1584–1588.
  • Divya, null, Parveen, A., Nuhmani, S., Ejaz Hussain, M., & Hussain Khan, M. (2020). Effect of lumbar stabilization exercises and thoracic mobilization with strengthening exercises on pain level, thoracic kyphosis, and functional disability in chronic low back pain. Journal of Complementary & Integrative Medicine, 18(2), 419–424. https://doi.org/10.1515/jcim-2019-0327
  • Gomes-Neto, M., Lopes, J. M., Conceição, C. S., Araujo, A., Brasileiro, A., Sousa, C., Carvalho, V. O., & Arcanjo, F. L. (2017). Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis. Physical Therapy in Sport: Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, 23, 136–142. https://doi.org/10.1016/j.ptsp.2016.08.004
  • Heo, M.-Y., Kim, K., Hur, B.-Y., & Nam, C.-W. (2015). The effect of lumbar stabilization exercises and thoracic mobilization and exercises on chronic low back pain patients. Journal of Physical Therapy Science, 27(12), 3843–3846. https://doi.org/10.1589/jpts.27.3843
  • Kaya, N. (n.d.). Larinjektomili Bireylerin Sa¤l›¤a ‹liflkin Yaflam Kalitesini De¤erlendirmede EuroQol Ölçe¤inin Güvenirlik ve Geçerli¤i (*).
  • Kibler, W. B., Press, J., & Sciascia, A. (2006). The role of core stability in athletic function. Sports Medicine (Auckland, N.Z.), 36(3), 189–198. https://doi.org/10.2165/00007256-200636030-00001
  • Kostadinović, S., Milovanović, N., Jovanović, J., & Tomašević-Todorović, S. (2020). Efficacy of the lumbar stabilization and thoracic mobilization exercise program on pain intensity and functional disability reduction in chronic low back pain patients with lumbar radiculopathy: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 33(6), 897–907. https://doi.org/10.3233/BMR-201843
  • Koumantakis, G. A., Watson, P. J., & Oldham, J. A. (2005). Trunk muscle stabilization training plus general exercise versus general exercise only: Randomized controlled trial of patients with recurrent low back pain. Physical Therapy, 85(3), 209–225.
  • Kweon, M., Hong, S., Jang, G. U., Ko, Y. M., & Park, J. W. (2013). The Neural Control of Spinal Stability Muscles during Different Respiratory Patterns. Journal of Physical Therapy Science, 25(11), 1421–1424. https://doi.org/10.1589/jpts.25.1421
  • Leetun, D. T., Ireland, M. L., Willson, J. D., Ballantyne, B. T., & Davis, I. M. (2004). Core stability measures as risk factors for lower extremity injury in athletes. Medicine and Science in Sports and Exercise, 36(6), 926–934. https://doi.org/10.1249/01.mss.0000128145.75199.c3
  • Loeser, J. D., & Treede, R.-D. (2008). The Kyoto protocol of IASP Basic Pain Terminology. Pain, 137(3), 473–477. https://doi.org/10.1016/j.pain.2008.04.025
  • Melikoglu, M. A., Kocabas, H., Sezer, I., Bilgilisoy, M., & Tuncer, T. (2009). Validation of the Turkish version of the Quebec back pain disability scale for patients with low back pain. Spine, 34(6), E219-224. https://doi.org/10.1097/BRS.0b013e3181971e2d
  • Michaelson, P., Michaelson, M., Jaric, S., Latash, M. L., Sjölander, P., & Djupsjöbacka, M. (2003). Vertical posture and head stability in patients with chronic neck pain. Journal of Rehabilitation Medicine, 35(5), 229–235. https://doi.org/10.1080/16501970306093
  • Moseley, G. L. (2004). Impaired trunk muscle function in sub-acute neck pain: Etiologic in the subsequent development of low back pain? Manual Therapy, 9(3), 157–163. https://doi.org/10.1016/j.math.2004.03.002
  • Niederer, D., & Mueller, J. (2020). Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression. PloS One, 15(1), e0227423. https://doi.org/10.1371/journal.pone.0227423
  • Panjabi, M. M. (1992). The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. Journal of Spinal Disorders, 5(4), 390–396; discussion 397. https://doi.org/10.1097/00002517-199212000-00002
  • Shamsi, M. B., Sarrafzadeh, J., & Jamshidi, A. (2015). Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests. Physiotherapy Theory and Practice, 31(2), 89–98. https://doi.org/10.3109/09593985.2014.959144
  • Speksnijder, C. M., Koppenaal, T., Knottnerus, J. A., Spigt, M., Staal, J. B., & Terwee, C. B. (2016). Measurement Properties of the Quebec Back Pain Disability Scale in Patients With Nonspecific Low Back Pain: Systematic Review. Physical Therapy, 96(11), 1816–1831. https://doi.org/10.2522/ptj.20140478
  • Treede, R.-D., Jensen, T. S., Campbell, J. N., Cruccu, G., Dostrovsky, J. O., Griffin, J. W., Hansson, P., Hughes, R., Nurmikko, T., & Serra, J. (2008). Neuropathic pain: Redefinition and a grading system for clinical and research purposes. Neurology, 70(18), 1630–1635. https://doi.org/10.1212/01.wnl.0000282763.29778.59
  • Turk, D. C., & Okifuji, A. (2002). Psychological factors in chronic pain: Evolution and revolution. Journal of Consulting and Clinical Psychology, 70(3), 678–690. https://doi.org/10.1037//0022-006x.70.3.678
  • Wang, X.-Q., Zheng, J.-J., Yu, Z.-W., Bi, X., Lou, S.-J., Liu, J., Cai, B., Hua, Y.-H., Wu, M., Wei, M.-L., Shen, H.-M., Chen, Y., Pan, Y.-J., Xu, G.-H., & Chen, P.-J. (2012). A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PloS One, 7(12), e52082. https://doi.org/10.1371/journal.pone.0052082
  • Yilmaz Yelvar, G. D., Çirak, Y., Dalkilinç, M., Demir, Y. P., Baltaci, G., Kömürcü, M., & Yelvar, G. D. Y. (2016). Impairments of postural stability, core endurance, fall index and functional mobility skills in patients with patello femoral pain syndrome. Journal of Back and Musculoskeletal Rehabilitation. https://doi.org/10.3233/BMR-160729
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Rehabilitasyon
Bölüm Araştırma Makaleleri
Yazarlar

Onur Atakan Doğan 0009-0002-9342-9406

Emine Atıcı 0000-0002-6547-4798

Özgür Sürenkök 0000-0003-1558-8989

Erken Görünüm Tarihi 16 Aralık 2024
Yayımlanma Tarihi
Gönderilme Tarihi 21 Ekim 2024
Kabul Tarihi 13 Aralık 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 5 Sayı: 3

Kaynak Göster

IEEE O. A. Doğan, E. Atıcı, ve Ö. Sürenkök, “The Impact of Lumbar Stabilization and Thoracic Mobilization Exercises on Pain, Disability and Quality of Life in Individuals with Chronic Low Back Pain”, Journal of Innovative Healthcare Practices, c. 5, sy. 3, ss. 123–131, 2024, doi: 10.58770/joinihp.1571454.