The efficacy of lumbar extension traction for sagittal alignment in mechanical low back pain: A randomized trial

2013 ◽  
Vol 26 (2) ◽  
pp. 213-220 ◽  
Author(s):  
Aliaa Attiah Mohamed Diab ◽  
Ibrahim Moustafa Moustafa
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Trial ◽  
Sagittal Alignment ◽  
Low Back ◽  
Lumbar Extension

Lombatherm study news of an international randomized trial on low back pain

2018 ◽  
Vol 33 (S1) ◽  
pp. 55-56
Author(s):  
R Forestier ◽  
N Molinari ◽  
FB Erol Forestier ◽  
A Francon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Trial ◽  
Low Back

scholarly journals Changes in pain sensitivity and spinal stiffness in relation to responder status following spinal manipulative therapy in chronic low Back pain: a secondary explorative analysis of a randomized trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Casper Glissmann Nim ◽  
Gregory Neil Kawchuk ◽  
Berit Schiøttz-Christensen ◽  
Søren O’Neill
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Trial ◽  
Clinical Improvement ◽  
Spinal Manipulation ◽  
Pain Sensitivity ◽  
Spinal Manipulative Therapy ◽  
Low Back ◽  
Manipulative Therapy ◽  
Pressure Pain Thresholds

Abstract Background In a prior randomized trial, we demonstrated that participants receiving spinal manipulative therapy at a pain-sensitive segment instead of a stiff segment experienced increased mechanical pressure pain thresholds. We hypothesized that the targeted segment mediated this increase through a segment-dependent neurophysiological reflective pathway. Presently, it is not known if this decrease in pain sensitivity is associated with clinical improvement. Therefore, we performed an explorative analysis to examine if changes in experimental pain sensitivity (mechanical and thermal) and lumbar stiffness were further dependent on clinical improvement in disability and patient-reported low back pain. Methods This study is a secondary explorative analysis of data from the randomized trial that compared 132 participants with chronic low back pain who received lumbar spinal manipulative therapy applied at either i) the stiffest segment or ii) the segment having the lowest pain threshold (i.e., the most pain-sensitive segment). We collected data at baseline, after the fourth session of spinal manipulation, and at 14-days follow-up. Participants were dichotomized into responders/non-responders using different clinical variables (disability and patient-reported low back pain) with varying threshold values (0, 30, and 50% improvement). Mixed models were used to assess changes in experimental outcomes (stiffness and pain sensitivity). The fixed interaction terms were time, segment allocation, and responder status. Results We observed a significant increase in mechanical pressure pain thresholds for the group, which received spinal manipulative therapy at the most pain-sensitive segment independent of whether they improved clinically or not. Those who received spinal manipulation at the stiffest segment also demonstrated increased mechanical pain sensitivity, but only in the subgroup with clinical improvement. We did not observe any changes in lumbar stiffness. Conclusion Our results suggest the existence of two different mechanistic pathways associated with the spinal manipulation target. i) A decrease of mechanical pain sensitivity independent of clinical outcome (neurophysiological) and ii) a decrease as a reflection of the clinical outcome. Together, these observations may provide a novel framework that improves our understanding of why some respond to spinal manipulative therapy while others do not. Trial registration ClinicalTrials.gov identifier: NCT04086667 registered retrospectively September 11th 2019.

scholarly journals An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers

2020 ◽  
pp. 001872082096608
Author(s):  
Pongsatorn Saiklang ◽  
Rungthip Puntumetakul ◽  
James Selfe ◽  
Gillian Yeowell
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Muscle Fatigue ◽  
Chronic Low Back Pain ◽  
Muscle Activity ◽  
Trunk Muscle ◽  
Low Back ◽  
Prolonged Sitting ◽  
Lumbar Extension

Objective The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. Background Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. Method Thirty participants with CLBP were randomly allocated: (a) control—sitting without exercise, and (b) intervention—supported dynamic lumbar extension with the ADIM technique. Results Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. Conclusion The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. Application Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.

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