Effects of dynamic and static stabilization exercises on pain and functionality in chronic low back pain

Yıl 2012, Cilt: 23 Sayı: 2, 65 - 72, 01.08.2012

Öz

Anahtar Kelimeler

-

Kronik bel ağrısında dinamik ve statik stabilizasyon ve fonksiyonel düzeye etkileri

Öz

Amaç: Çalışma kronik bel ağrısı tedavisinde dinamik ve statik stabilizasyon egzersizlerinin ağrı ve fonksiyonellik üzerine etkinliğini araştırmak amacıyla yapıldı. Yöntem: Kronik bel ağrısı tanısı olan 30 hasta çalışmaya katıldı. Hastalar rastgele yöntemle statik egzersiz grubu ve dinamik egzersiz grubu olmak üzere ikiye ayrıldı. Her iki gruba da fizyoterapi programı haftada 3 gün olmak üzere, 6 hafta süre ile uygulandı. Hastalar Vizüel Analog Skalası ile ağrı, Oswestry Fonksiyonel Skala ile fonksiyonel düzey yönünden tedavi öncesi ve sonrasında değerlendirildi. Sonuçlar: Hem statik stabilizasyon hem de dinamik egzersiz grubunda tedavi sonrasında başlangıca göre anlamlı farklar olduğu kaydedildi (p0.05). Tartışma: Çalışmamızdan elde ettiğimiz sonuçlarla, hem statik stabilizasyon hem de dinamik egzersizlerin ağrı ve fonksiyonel düzey üzerinde olumlu etkileri olduğu bulundu. Ancak statik stabilizasyon egzersizlerin, uygulanması kolay ve herhangi bir egzersiz gereci gerektirmemesi nedeniyle klinikte pratik olarak tercih edilebileceği görüşüne varıldı

Anahtar Kelimeler

Kronik ağrı , Bel ağrısı , Egzersiz tedavisi , Stabilizasyon egzersizleri

Kaynakça

• O’Sullivan PB, Lumbar segmental ‘instability’: clinical presentation and specific stabilizing exercise management. Man Ther. 2000;5:2-12.
• van Tulner M, Koes B, Bombardier C. Low back pain. Best Pract Res Clin Rheumatol. 2002;16:761- 775.
• Arokoski JP, Valta T, Airaksinen O, et al. Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil. 2001;82:1089- 1098.
• Demoulin C, Distree V, Tomasella M, et al. Lumbar functional instability: a critical appraisal of the literature. Ann Readapt Med Phys. 2007;50:677-684.
• Magee DJ. Lumbar spine, assessment of postur. In: Allen A, eds. Orthopedic Physical Assessment. 4th Ed. Philadelphia: Saunders; 1997: 467-565, 873-904.
• Descarreaux M, Normand MC, Laurencelle L, et al. Evaluation of a specific home exercise program for low back pain. J Manipulative Physiol Ther. 2002;25:467-503.
• Malliou P, Gioftsidou A, Beneka A, et al. Measurements and evaluations in low back pain patients. Scand J Med Sci Sports. 2006;16:219-230.
• Vezina MJ, Hubley-Kozey CL. Muscle activation in therapeutic exercises to improve trunk stability. Arch Phys Med Rehabil. 2000;81:1370-1379.
• Laskowski ER, Newcomer-Aney K, Smith J. Refining rehabilitation with proprioception training: expediting return to play. Phys Sportsmed.
• Parkhurst TM, Burnett CN. Injury and proprioception in the lower back. J Orthop Sports Phys Ther. 1994;19:282-295.
• Yamashita T, Cavanaugh JM, El-Bohy AA, et al. Mechanosensitive afferent units in the lumbar facet joint. J Bone Joint Surg. 1990;72:865-870.
• Cholewicki J, Polzhofer GK, Radebold A. Postural control of trunk during unstable sitting. J Biomech. 2000;33:1733-1737.
• Rainville J, Hartigan C, Martines E, et al. Exercise as a treatment for chronic low back pain. Spine J. 2004;4:106-115.
• Rasmussen-Barr ER, Nilsson-Wikmar L, Arvidsson I. Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man Ther. 2003;8:233-241.
• Hayden JA, van Tulder MW, Malmivaara AV, et al. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142:765-775.
• Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142:776-785.
• Niemistö L, Lahtinen-Suopanki T, Rissanen P, et al. A randomized trial of combined manipulation, stabilizing exercises, and physician consultation alone for chronic low back pain. Spine. 2003;28):2185- 2191.
• Yakut E, Düger T, Öksüz Ç, et al. Validation of the Turkish version of the Oswesrty Disability Index for patients with low back pain. Spine. 2004;29:581-585.
• Malanga GA, Nadler SF Nonoperative treatment of low back pain. Mayo Clin Proc. 1999;74:1135-1148.
• Cairns MC, Harrison K, Wright C. Pressure biofeedback: a useful tool in the quantification of abdominal muscular dysfunction? Physiotherapy. 2000;86:127-138. 21. Lima
• POP, Oliveira RR, Costa LOP, et al.
• Measurement properties of the pressure biofeedback
• unit in the evaluationof transversus abdominis
• muscle activity: a systematic review.Physiotherapy. 2011;97:100–106.
• Haynes W. Rolling exercises designed to train the deep spinal muscles. J Bodyw Mov Ther. 2003;3:153- 164.
• Herrington L, Davies R. The influence of pilates training on the ability to contract the transversus abdominis muscle in asymptomatic individuals. J Bodyw Mov Ther. 2005;9:52–57.
• Souza GM, Baker LL, Powers CM. Electromyographic activity of selected trunk muscles during dynamic spine stabilization exercises. Arch Phys Med Rehabil. 2001;82:1551-1557.
• Mattila M, Hurme M, Alaranta H, et al. The multifidus muscle in patients with lumbar disc herniation. Spine. 1986;11:732-738.
• Sung PS. Multifidi muscles median frequency before and after spinal stabilization exercises. Arch Phys Med Rehabil. 2003;84:1318-1318.
• Lehman GJ, Gordon T, Langley J, et al. Replacing a swiss ball for an exercise bench causes variable changes in trunk muscle activity during upper limb strength exercises. Dyn Med. 2005;3:6.
• Lehman GJ, Hoda W, Oliver S. Trunk muscle activity during bridging exercises on and off a swissball. Chiropr Osteopat. 2005;13:14.
• Kim H-J, Chung S, Kim H, et al. Influences of trunk muscles on lumbar lordosis and angle. Eur Spine J. 2006;15:409-414.
• Suni JH, Oja P, Miilunpalo SI, et al. Health-related fitness test battery for adults: associations with perceived health, mobility, and back function and symptoms. Arch Phys Med Rehabil. 1998;79:559- 569.
• Hartigan C, Rainville J, Sobel JB, et al. Long-term exercise adherence after intensive rehabilitation for chronic low back pain. Med Sci Sports Exerc.
• Slade SC, Keating J L. Trunk-strengthening exercises for chronic low back pain: a systematic review. J Manipulative Physiol Ther. 2006;29:163-173.
• Torstensen TA, Koes B, Glamsrod E, et al. The effect of conservative therapies on patients suffering from chronic low back pain. Spine. 1996;21:656-657.
• Roland M, Fairbank J: The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine. 2000;25:3115-3124.
• Sarı Z, Şener G, Yakut Y, et al. Bel problemli hastalarda yüksek voltaj kesikli akımın ağrı ve bel kas kuvvetine etkisi: rastgele kontrollü çalışma. Fizyoter Rehabil. 2010;21:101-107.
• Eker L, Tüzün EH, Daşkapan A, et al. The relationship between EQ-5D and SF-36 instruments in patients with low back pain. Fizyoter Rehabil. 2007;18:3-10.