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The Relationship between Core Stability, Pain and Disability in Persons with Chronic Non-Specific Low Back Pain

Yıl 2023, Cilt: 4 Sayı: 3, 420 - 431, 31.12.2023

Öz

Abstract

Purpose: In our study, we aimed to examine the relationships between lumbopelvic core stability level, pain intensity and functional disability level in persons with chronic non-specific low back pain.

Methods: This prospective cohort study was conducted with persons with chronic non-specific low back pain. A 10 cm horizontal visual analog scale was used to measure pain intensity, Oswestry Disability Index was used to measure functional disability, and Sahrmann Core Stability Test was used to assess lumbopelvic core stability. In statistical analysis, Spearman’s rank correlation coefficient was used to examine the correlations of the data. The significance value was determined as p<0.05.

Results: In our study, 36 persons with chronic non-specific low back pain with a median age of 35 years were evaluated. It was determined that there was a high negative correlation between the core stability level and pain intensity (r=-0.781; p<0.001), a moderate negative correlation between functional disability level and core stability level (r=-0.652; p<0.001) and a moderate positive correlation between functional disability level and pain intensity (r=0.656; p<0.001).

Conclusion: According to our study results, the decrease in lumbopelvic core stability in persons with chronic non-specific low back pain leads to an increase in pain intensity and functional disability. Accordingly, improvement of lumbopelvic core stability in persons with non-specific low back pain may lead to a decrease in pain intensity and functional disability.

Kaynakça

  • Aggarwal, A., Kumar, S., Madan, R., & Kumar, R. (2011). Relationship among different tests of evaluating low back core stability. Journal of Musculoskeletal Research, 14(02), 1250004. https://doi.org/10.1142/S0218957712500042
  • Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A. F., Reis, S., Staal, J. B., Ursin, H., Zanoli, G., & COST B13 Working Group on Guidelines for Chronic Low Back Pain (2006). Chapter 4. European guidelines for the management of chronic nonspecific low back pain. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 15 Suppl 2(Suppl 2), S192–S300. https://doi.org/10.1007/s00586-006-1072-1
  • Bombardier, C. (2000). Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine, 25(24), 3100–3103. https://doi.org/10.1097/00007632-200012150-00003
  • Cassidy, J. D., Carroll, L. J., & Côté, P. (1998). The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine, 23(17), 1860–1867. https://doi.org/10.1097/00007632-199809010-00012
  • Ceylan, A., & Demirdel, E. (2022). Mekanik Bel Ağrısı Olan Bireylerin Kor Endurans ile Esneklik, Denge ve Alt Ekstremite Performans İlişkisi: Kesitsel Bir Araştırma. Turkiye Klinikleri Journal of Health Sciences, 7(4). https://doi.org/10.5336/healthsci.2022-89682
  • Cho, I., Jeon, C., Lee, S., Lee, D., & Hwangbo, G. (2015). Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. Journal of physical therapy science, 27(6), 1983–1985. https://doi.org/10.1589/jpts.27.1983
  • Cholewicki, J., Silfies, S. P., Shah, R. A., Greene, H. S., Reeves, N. P., Alvi, K., & Goldberg, B. (2005). Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine, 30(23), 2614–2620. doi.org/10.1097/01.brs.0000188273.27463.bc
  • Crisco, J. J., 3rd, & Panjabi, M. M. (1991). The intersegmental and multisegmental muscles of the lumbar spine. A biomechanical model comparing lateral stabilizing potential. Spine, 16(7), 793–799. https://doi.org/10.1097/00007632-199107000-00018
  • de Souza, I. M. B., Sakaguchi, T. F., Yuan, S. L. K., Matsutani, L. A., do Espírito-Santo, A. S., Pereira, C. A. B., & Marques, A. P. (2019). Prevalence of low back pain in the elderly population: a systematic review. Clinics (Sao Paulo, Brazil), 74, e789. https://doi.org/10.6061/clinics/2019/e789
  • Doualla, M., Aminde, J., Aminde, L. N., Lekpa, F. K., Kwedi, F. M., Yenshu, E. V., & Chichom, A. M. (2019). Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC musculoskeletal disorders, 20(1), 25. https://doi.org/10.1186/s12891-019-2403-9
  • Field, A. P. (2013). Discovering statistics using IBM SPSS Statistics (4th ed.). Thousand Oaks, CA: Sage.
  • Freburger, J. K., Holmes, G. M., Agans, R. P., Jackman, A. M., Darter, J. D., Wallace, A. S., Castel, L. D., Kalsbeek, W. D., & Carey, T. S. (2009). The rising prevalence of chronic low back pain. Archives of internal medicine, 169(3), 251–258. https://doi.org/10.1001/archinternmed.2008.543
  • Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis care & research, 63 Suppl 11, S240–S252. https://doi.org/10.1002/acr.20543
  • Hodges P. W. (2003). Core stability exercise in chronic low back pain. The Orthopedic clinics of North America, 34(2), 245–254. https://doi.org/10.1016/s0030-5898(03)00003-8
  • Hodges, P. W., & Richardson, C. A. (1998). Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Journal of spinal disorders, 11(1), 46–56.
  • Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The Epidemiology of low back pain. Best practice & research. Clinical rheumatology, 24(6), 769–781. https://doi.org/10.1016/j.berh.2010.10.002
  • Hungerford, B., Gilleard, W., & Hodges, P. (2003). Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine, 28(14), 1593–1600.
  • 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
  • Krismer, M., & Van Tulder, M. (2007). Low back pain (non-specific). Best practice & research clinical rheumatology, 21(1), 77-91. https://doi.org/10.1016/j.berh.2006.08.004
  • Kumar, T., Kumar, S., Nezamuddin, M., & Sharma, V. P. (2015). Efficacy of core muscle strengthening exercise in chronic low back pain patients. Journal of back and musculoskeletal rehabilitation, 28(4), 699–707. https://doi.org/10.3233/BMR-140572
  • Langley, G. B., & Sheppeard, H. (1985). The visual analogue scale: its use in pain measurement. Rheumatology international, 5(4), 145–148. https://doi.org/10.1007/BF00541514
  • Manek, N. J., & MacGregor, A. J. (2005). Epidemiology of back disorders: prevalence, risk factors, and prognosis. Current opinion in rheumatology, 17(2), 134–140. https://doi.org/10.1097/01.bor.0000154215.08986.06
  • Petit, A., & Roquelaure, Y. (2015). Low back pain, intervertebral disc and occupational diseases. International journal of occupational safety and ergonomics : JOSE, 21(1), 15–19. https://doi.org/10.1080/10803548.2015.1017940
  • Smeets, R., Köke, A., Lin, C. W., Ferreira, M., & Demoulin, C. (2011). Measures of function in low back pain/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland-Morris Disability Questionnaire (RDQ). Arthritis care & research, 63 Suppl 11, S158–S173. https://doi.org/10.1002/acr.20542
  • Wagner, D. R., Tatsugawa, K., Parker, D., & Young, T. A. (2007). Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High altitude medicine & biology, 8(1), 27–31. https://doi.org/10.1089/ham.2006.0814
  • Yakut, E., Düger, T., Oksüz, C., Yörükan, S., Ureten, K., Turan, D., Frat, T., Kiraz, S., Krd, N., Kayhan, H., Yakut, Y., & Güler, C. (2004). Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine, 29(5), 581–585.

KRONİK NON-SPESİFİK BEL AĞRILI BİREYLERDE KOR STABİLİTE, AĞRI VE DİSABİLİTE ARASINDAKİ İLİŞKİ

Yıl 2023, Cilt: 4 Sayı: 3, 420 - 431, 31.12.2023

Öz

Öz

Amaç: Çalışmamızda, kronik non-spesifik bel ağrısı olan bireylerde lumbopelvik kor stabilite seviyesi, ağrı şiddeti ve fonksiyonel disabilite düzeyi arasındaki ilişkileri incelemeyi amaçladık.

Yöntem: Bu prospektif kohort çalışması, kronik non-spesifik bel ağrılı bireyler ile gerçekleştirildi. Bireylerin ağrı şiddetini ölçmek için vizuel analog skala, fonksiyonel disabilite düzeyini belirlemek için Oswestry Özürlülük Skalası, lumbopelvik kor stabilite seviyesini değerlendirmek için Sahrmann Core Stabilite Testi uygulandı. İstatistiksel analizde, verilerin korelasyonları incelemek için Spearman’ın sıra korelasyon katsayısı kullanıldı. Anlamlılık değeri p<0,05 olarak belirlendi.

Bulgular: Çalışmamız kapsamında yaşlarının ortanca değeri 35 yıl olan kronik non-spesifik bel ağrılı 36 birey değerlendirildi. Bireylerin kor stabilite seviyesi ile ağrı şiddeti arasında yüksek düzeyde negatif korelasyon olduğu belirlendi (p<0,001; r=-0,781). Fonksiyonel disabilite düzeyi ile kor stabilite seviyesi arasında orta düzeyde negatif korelasyon (p<0,001; r=-0,652); fonksiyonel disabilite düzeyi ile ağrı şiddeti arasında orta düzeyde pozitif korelasyon olduğu belirlendi (p<0,001; r=0,656).

Sonuç: Çalışma sonuçlarımıza göre kronik non-spesifik bel ağrılı bireylerde lumbopelvik kor stabilitedeki azalma ağrı şiddetinin ve fonksiyonel disabilitenin artmasına yol açmaktadır. Buna göre non-spesifik bel ağrılı bireylerde lumbopelvik kor stabilitenin geliştirilmesi ile bireylerin ağrı şiddetinde ve fonksiyonel disabilite düzeyinde azalma sağlanabilir.

Kaynakça

  • Aggarwal, A., Kumar, S., Madan, R., & Kumar, R. (2011). Relationship among different tests of evaluating low back core stability. Journal of Musculoskeletal Research, 14(02), 1250004. https://doi.org/10.1142/S0218957712500042
  • Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A. F., Reis, S., Staal, J. B., Ursin, H., Zanoli, G., & COST B13 Working Group on Guidelines for Chronic Low Back Pain (2006). Chapter 4. European guidelines for the management of chronic nonspecific low back pain. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 15 Suppl 2(Suppl 2), S192–S300. https://doi.org/10.1007/s00586-006-1072-1
  • Bombardier, C. (2000). Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine, 25(24), 3100–3103. https://doi.org/10.1097/00007632-200012150-00003
  • Cassidy, J. D., Carroll, L. J., & Côté, P. (1998). The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine, 23(17), 1860–1867. https://doi.org/10.1097/00007632-199809010-00012
  • Ceylan, A., & Demirdel, E. (2022). Mekanik Bel Ağrısı Olan Bireylerin Kor Endurans ile Esneklik, Denge ve Alt Ekstremite Performans İlişkisi: Kesitsel Bir Araştırma. Turkiye Klinikleri Journal of Health Sciences, 7(4). https://doi.org/10.5336/healthsci.2022-89682
  • Cho, I., Jeon, C., Lee, S., Lee, D., & Hwangbo, G. (2015). Effects of lumbar stabilization exercise on functional disability and lumbar lordosis angle in patients with chronic low back pain. Journal of physical therapy science, 27(6), 1983–1985. https://doi.org/10.1589/jpts.27.1983
  • Cholewicki, J., Silfies, S. P., Shah, R. A., Greene, H. S., Reeves, N. P., Alvi, K., & Goldberg, B. (2005). Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine, 30(23), 2614–2620. doi.org/10.1097/01.brs.0000188273.27463.bc
  • Crisco, J. J., 3rd, & Panjabi, M. M. (1991). The intersegmental and multisegmental muscles of the lumbar spine. A biomechanical model comparing lateral stabilizing potential. Spine, 16(7), 793–799. https://doi.org/10.1097/00007632-199107000-00018
  • de Souza, I. M. B., Sakaguchi, T. F., Yuan, S. L. K., Matsutani, L. A., do Espírito-Santo, A. S., Pereira, C. A. B., & Marques, A. P. (2019). Prevalence of low back pain in the elderly population: a systematic review. Clinics (Sao Paulo, Brazil), 74, e789. https://doi.org/10.6061/clinics/2019/e789
  • Doualla, M., Aminde, J., Aminde, L. N., Lekpa, F. K., Kwedi, F. M., Yenshu, E. V., & Chichom, A. M. (2019). Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC musculoskeletal disorders, 20(1), 25. https://doi.org/10.1186/s12891-019-2403-9
  • Field, A. P. (2013). Discovering statistics using IBM SPSS Statistics (4th ed.). Thousand Oaks, CA: Sage.
  • Freburger, J. K., Holmes, G. M., Agans, R. P., Jackman, A. M., Darter, J. D., Wallace, A. S., Castel, L. D., Kalsbeek, W. D., & Carey, T. S. (2009). The rising prevalence of chronic low back pain. Archives of internal medicine, 169(3), 251–258. https://doi.org/10.1001/archinternmed.2008.543
  • Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis care & research, 63 Suppl 11, S240–S252. https://doi.org/10.1002/acr.20543
  • Hodges P. W. (2003). Core stability exercise in chronic low back pain. The Orthopedic clinics of North America, 34(2), 245–254. https://doi.org/10.1016/s0030-5898(03)00003-8
  • Hodges, P. W., & Richardson, C. A. (1998). Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Journal of spinal disorders, 11(1), 46–56.
  • Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The Epidemiology of low back pain. Best practice & research. Clinical rheumatology, 24(6), 769–781. https://doi.org/10.1016/j.berh.2010.10.002
  • Hungerford, B., Gilleard, W., & Hodges, P. (2003). Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine, 28(14), 1593–1600.
  • 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
  • Krismer, M., & Van Tulder, M. (2007). Low back pain (non-specific). Best practice & research clinical rheumatology, 21(1), 77-91. https://doi.org/10.1016/j.berh.2006.08.004
  • Kumar, T., Kumar, S., Nezamuddin, M., & Sharma, V. P. (2015). Efficacy of core muscle strengthening exercise in chronic low back pain patients. Journal of back and musculoskeletal rehabilitation, 28(4), 699–707. https://doi.org/10.3233/BMR-140572
  • Langley, G. B., & Sheppeard, H. (1985). The visual analogue scale: its use in pain measurement. Rheumatology international, 5(4), 145–148. https://doi.org/10.1007/BF00541514
  • Manek, N. J., & MacGregor, A. J. (2005). Epidemiology of back disorders: prevalence, risk factors, and prognosis. Current opinion in rheumatology, 17(2), 134–140. https://doi.org/10.1097/01.bor.0000154215.08986.06
  • Petit, A., & Roquelaure, Y. (2015). Low back pain, intervertebral disc and occupational diseases. International journal of occupational safety and ergonomics : JOSE, 21(1), 15–19. https://doi.org/10.1080/10803548.2015.1017940
  • Smeets, R., Köke, A., Lin, C. W., Ferreira, M., & Demoulin, C. (2011). Measures of function in low back pain/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland-Morris Disability Questionnaire (RDQ). Arthritis care & research, 63 Suppl 11, S158–S173. https://doi.org/10.1002/acr.20542
  • Wagner, D. R., Tatsugawa, K., Parker, D., & Young, T. A. (2007). Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High altitude medicine & biology, 8(1), 27–31. https://doi.org/10.1089/ham.2006.0814
  • Yakut, E., Düger, T., Oksüz, C., Yörükan, S., Ureten, K., Turan, D., Frat, T., Kiraz, S., Krd, N., Kayhan, H., Yakut, Y., & Güler, C. (2004). Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine, 29(5), 581–585.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Koruyucu Sağlık Hizmetleri
Bölüm Araştırma Makaleleri
Yazarlar

Mehmet Akif Güler 0000-0003-0543-2016

Ertuğrul Demirdel 0000-0002-7139-0523

İlknur Albayrak 0000-0002-8980-1837

Alaaddin Nayman 0000-0003-3213-8576

Ezgi Akyıldız Tezcan 0000-0002-4988-1270

Yayımlanma Tarihi 31 Aralık 2023
Gönderilme Tarihi 21 Eylül 2023
Kabul Tarihi 12 Ekim 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 3

Kaynak Göster

APA Güler, M. A., Demirdel, E., Albayrak, İ., Nayman, A., vd. (2023). KRONİK NON-SPESİFİK BEL AĞRILI BİREYLERDE KOR STABİLİTE, AĞRI VE DİSABİLİTE ARASINDAKİ İLİŞKİ. Selçuk Sağlık Dergisi, 4(3), 420-431.