scholarly journals The effect of sacroiliac joint manipulation compared to manipulation and static stretching of the posterior oblique sling group of muscles in participants with chronic sacroiliac joint syndrome

2017 ◽  
Author(s):  
◽  
Shaylene Swanepoel

Sacroiliac joint syndrome is diagnosed in patients who complain of various painful symptoms associated to their lower back, for example: hip and groin pain, sciatica pain, and / or a need to frequently urinate. They further report that their pain is further intensified when standing from sitting, stair walking, bending forward or from sitting or standing too long. Sacroiliac joint syndrome has been widely accepted by health professions as a contributor to low back pain. Spinal manipulation has shown to be an effective method for pain relief of this condition. Studies have been done using physical therapy in conjunction with manipulation in treating sacroiliac joint syndrome. However, little research has been done on the effects of static stretching and manipulation combined. The posterior oblique sling group of muscles is created by the biceps femoris, gluteus maximus, erector spinae and latissimus dorsi muscles. The sacroiliac joint can be affected by the functional relationship of the posterior oblique sling muscles. These muscles are involved in forces across the sacroiliac joint. Tightness of muscles can affect the sacroiliac joint. Flexibility is an essential element of normal biomechanical functioning. Flexibility of muscles, tendons and ligaments can influence a joints range of motion. There is evidence that suggests that stretching could increase a joint’s range of motion which was evident one or more days after the stretching protocol in people without clinically significant contractures. Upon review of the related literature, it appears that there is insufficient literature assessing the clinical effectiveness of static stretching of the posterior oblique muscle sling group with respect to sacroiliac joint syndrome. Therefore this study is aimed at providing insight into the role of the posterior oblique muscle sling group in participants with and chronic sacroiliac joint syndrome. It is hypothesized that effective treatment of these muscles will allow for a more effective outcome of symptoms. The study design chosen was a randomised, clinical trial consisting of thirty voluntary participants’ between the ages 18 to 45 years suffering from chronic sacroiliac joint syndrome. There were two groups of fifteen participants, who received four treatment consultations within a two week period. Participants placed into Group One received sacroiliac joint manipulation only, while participants in Group Two received static stretching of the posterior oblique muscle sling and sacroiliac joint manipulation. Subjective and objective readings were taken at the first, third and fourth (final) consultations. The Numerical Pain Rating Scale (NRS) and the Oswestry Low Back Pain Disability Index (OSW) questionnaires were used to assess the subjective findings whilst the objective measurements were collected from results of algometer and inclinometer readings. The intra-group analysis revealed there was a statistically significant improvement within both groups for NRS, OSW, and inclinometer results. It appeared that Group Two fared better in terms of the algometer (pressure) results. The inter-group analysis revealed that all comparisons apart from the algometer readings had no statistically significant improvement between the two groups. From the intra-group comparisons of the objective data, participants in both groups experienced a statistically significant improvement. However, Group Two fared better in terms of the algometric pressure readings (p = 0.001). This study confirms that both treatment protocols were effective in reducing the signs and symptoms associated with sacroiliac joint syndrome. Although the readings were not statistically significant, there is evidence that Group Two responded better than Group One in terms of the algometer readings (Figure 4.13). There is insufficient literature on studies related to the posterior oblique sling muscles, and therefore, comparisons are needed with respect to the posterior oblique muscle sling group and its effects on the sacroiliac joint. This study concludes that overall there was no statistically significant difference between the two groups and recommends that further studies be undertaken with a greater number of participants to gauge if a more significant result can be achieved.

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mohamadreza Hatefi ◽  
Farideh Babakhani ◽  
Mohadeseh Ashrafizadeh

Abstract Purpose The benefits of providing static stretching exercise targeting the hips in patients with non-specific Low Back Pain (NSLBP) are not well established. The objective of the study was to verify the effects of static stretching on function, pain and range of motion on patients with non-specific Low Back Pain (NSLBP). Methods Thirty females with NSLBP were randomly assigned to two control (n = 15) and experimental (n = 15) groups. The experimental group received 3 stretch practice sessions per week for a period of 8 weeks. The Oswestry low back pain Disability Questionnaire (ODI), visual analog scale (VAS), and passive hip range of motion (PROM) were employed before and after the intervention. Results The results of mixed model analysis of variance indicate that the group × time interactions was not significant (p > 0.05) for all measurement outcomes. However, there was a main effect for Time (ODI: p = 0.002, VAS: p = 0.001, PROM-R: p = 0.016, PROM-L: p = 0.001). Such that the ODI, VAS, PROM-R, and PROM-L were showed significant differences before and after the intervention in the experimental group. Conclusions The results demonstrated a significant difference in PROM, pain, and disability after 8 weeks of stretching exercises in participants with NSLBP and limited hip extension. Therefore, it would be reasonable to infer that NSLBP might be partly related to hip flexors tightness.


Author(s):  
I Made Dhita Prianthara ◽  
I Made Jawi ◽  
Wahyuddin ◽  
I Nengah Sandi ◽  
I Putu Adiartha Griadhi ◽  
...  

Background: Mechanical low back pain is pain that resulting from poor posture which cause decreased disability and limitation of lumbar range of motion. Purpose: The purpose of this study was to prove mulligan bent leg raise more effective to increase lumbosacral range of motion and decreased disability than slump stretching among tile craftsman with Mechanical low back pain in Darmasaba village. Methods: This research was an experimental study with pre and post test control group design. Sample of this study is tile craftsman with mechanical low back pain with 20 samples aged 30-55. Samples were divided into two groups, which the first group (n = 10) was given Mulligan bent leg raise, while the second group was given slump stretching. Do exercise 3 times a week for 4 weeks. Lumbar range of motion was measured with modified-modified schober test while level of disability was measured with modified oswestry disability index. Result: Paired Sample T-test in Group 1 and Group 2 obtained p=0,000 that showed in each Group 1 and Group 2 there is significant difference. Independent Samples Test of Group 1 and Group 2 showed the result p=0,000 which mean that there is significant difference in increased lumbar range of motion and decreased disability. Conclusion: Mulligan bent leg raise more effective to increase lumbosacral range of motion and decreased disability than slump stretching to tile craftsman with mechanical low back pain in Darmasaba village.


2021 ◽  
Author(s):  
Alikemal Yazici ◽  
Tuba Yerlikaya ◽  
Adile Oniz

Abstract Background The aim of this study was to examine degeneration in the lumbar musculus multifidus (L.MF) and lumbar musculus erector spina (L.ES) muscles in patients with mechanical chronic low back pain, non-radiculopathy chronic low back pain with discopathy, and healthy individuals. The relationships with low back pain were examined by comparing the results according to gender, pain, and lumbar segments. Material and Method: Evaluation was made of 36 healthy control subjects (Group 1), 37 patients with mechanical low back pain (Group 2) and 41 non-radiculopathy, lumbar discopathy patients (Group 3). On axial magnetic resonance images at the L3-S1 level, asymmetry between the left and right sides was examined in respect of L.MF and L.ES surface cross-sectional areas (CSA), total surface cross-sectional area (TCSA = L.MF + L.ES), and fat infiltration. Results The mean CSA values showed a significant difference only in the right L.MF in the healthy control group (p = 0.011). No statistically significant difference was seen between the groups in the comparisons of TCSA, and a statistically significant difference was determined in respect of fat infiltration in the right and left L.MF and the left L.ES (p = 0.011, p = 0.001, p = 0.027, respectively). When the CSA and TCSA were examined according to gender within the groups, the values were found to be statistically significantly higher in males (p < 0.001). The CSA and TCSA values of the L.MF and L.ES showed a significant difference between segments (L3-L4, L4-L5, L5-S1) (p < 0.001). No asymmetry was observed between the left /right CSA and TCSA values of the groups. Fat infiltration showed a significant difference according to gender and segments (p < 0.001). Conclusion Fat infiltration in the L.MF muscle is related to mechanical low back pain and lumbar discopathy. That there was no difference between the groups in the CSA and TCSA values demonstrates the need for measurement of muscle atrophy associated with fat infiltration or functional cross-section area rather than CSA and TCSA.


Author(s):  
Hadiqa Adnan ◽  
Misbah Ghous ◽  
Syed Shakil Ur Rehman ◽  
Irum Yaqoob

Abstract Objectives: The objective of the study was to determine the effects of static exercise program verses Swiss ball training for core muscles of the lower back and pelvic region in patients with low back pain after child delivery. Methods: This was a prospective single blind randomized control trial conducted on a sample of 30 patients with low back pain from March 2018to December 2018. Patients were divided into 2 groups through seal envelop method i.e. static core exercises group (n=15) and Swiss ball training group (n=15). The outcome measures used for this study were numeric pain rating scale (NPRS), Oswestry disability index (ODI), goniometry and Core stability assessment scale. Data was analyzed by SPSS 21. Results: The mean age of patients in static core exercises group was 28.38 ± 4.8 years and mean age of Swiss Ball training group was 29.57 ± 3.3 years. Between group analysis showed non-significant difference whereas within group analysis showed significant improvement at post intervention. Conclusions: Both groups showed significant difference in reduction of pain (NPRS), in disability level due to LBP (ODI), better ROM flexion/extension of lumbar and achieving better strength at core stability assessment scale (CSA). These findings suggest that both exercise protocols are equally effective in rehabilitation of postpartum low back pain. Keywords: low back pain     Postpartum        Swiss ball training   Static Continuous...


Author(s):  
Alagiathiruvevenkadam Ilayaraja ◽  
MK Franklin Shaju ◽  
Singh Sumer Singh ◽  
Edwin Raj Gerald ◽  
D Sathyanarayana ◽  
...  

Introduction: Musculoskeletal spinal disorders are an immense problem in industrialised societies resulting in tremendous personal and economic costs. Younger adults (30 to 60-year-old) are more likely to experience Low Back Pain (LBP) from the disc space or from back muscle strain or other soft tissue strain. Experiencing it earlier in life may lead to recurrent and chronic LBP in adulthood. Dry Needling (DN) which are utilised to treat low back torment in current patterns. Low Level Laser Treatment (LLLT) is utilised to treat LBP by concentrating on the trigger focuses. Aim: To identify the effectiveness of DN and LLLT in the management of selected outcome variables among patients with nonspecific LBP. Materials and Methods: The Quasi experimental study was conducted among a total of 30 subjects who met the inclusion criteria. The subjects were divided into 15 each as group A (DN) and group B (LLLT). The Numerical Pain Distress Scale (NPDS), Quebec Back Pain Disability Scale (QBPDS) and lumbar flexion range of motion were assessed, before and after two weeks of intervention program to identify the effectiveness. Data analysis was done through SPSS and graph pad, using paired t-test and independent t-test. Results: Both groups have shown improvement after two weeks of intervention treatment program. Both groups showed significant difference in relieving pain, reducing disability and improving lumbar range of motion on nonspecific LBP individually. However, there was no significant difference found between the groups, thus null hypothesis was accepted and rejecting the alternate hypothesis. Conclusion: Both the techniques are equally effective in reducing the pain, disability level and improving range of motion individually after two weeks of intervention.


2021 ◽  
Author(s):  
Alikemal Yazici ◽  
Tuba Yerlikaya ◽  
Adile Oniz

Abstract Background: The aim of this study was to investigate the degeneration of lumbar musculus multifidus (L.MF) and lumbar musculus erector spinae (L.ES) muscles in healthy individuals and patients with mechanical low back pain and lumbar discopathy without root compression (radiculopathy), and to examine the relationship between low back pain by comparing the results according to gender, pain and lumbar segments between the groups. Methods: The study included 30 healthy individuals (Group 1), 30 patients with mechanical low back pain (Group 2) and 30 patients with lumbar discopathy without root compression (radiculopathy) (Group 3). Pain severity was evaluated using a Visual Analogue Scale (VAS). Right and left L.MF and L.ES cross-sectional areas (CSA), total cross-sectional areas (TCSA =L.MF+L.ES), fat infiltrations, and asymmetries between the right and left sides were evaluated. L.MF and L.ES muscles CSA and TCSA, fat infiltrations, asymmetries between the right and left sides were evaluated in the patients at the L3-S1 level, in axial Magnetic Resonance Imaging.Results: The mean value of the CSA differed between the groups only in the right L.MF and in the healthy group (p=0.011). No statistically significant difference was observed between the TCSA values of the groups, but a significant difference was found between the groups in terms of fat infiltration in right and left L.MF and left L.ES (p=0.011, p=0.001, p=0.027, respectively). When CSA and TCSA were examined according to gender within the group, the values were found to be significantly higher in males (p<0.001). The CSA and TCSA values ​​of L.MF and L.ES differed between segments (L3-L4, L4-L5, L5-S1) (p<0.001). There was no asymmetry between the right/left CSA and TCSA of the groups. Fat infiltration differed according to gender (p=0.001) and segments (p<0.001).Conclusion: Fat infiltration in the lumbar multifidus muscle was associated with mechanical low back pain and lumbar discopathy. The fact that there was no difference between the cross-sectional area and the total cross-sectional area between the groups indicates the need to measure the FCSA or muscle atrophy due to fat infiltration in the evaluation of muscle mass, rather than CSA and TCSA.


2018 ◽  
Vol 166 (3) ◽  
pp. 140-145 ◽  
Author(s):  
Joanna E Surtees ◽  
N R Heneghan

ObjectiveTo investigate whether general group exercise (GGE) offers the same outcomes compared with a specific spinal group exercise (SSGE) for chronic low back pain (CLBP) in a military population.DesignRetrospective service evaluation using routine service activity data.SettingA UK military rehabilitation centre.ParticipantsA total of 106 patients with CLBP.InterventionsThree-week intensive (5 days per week, 15-day intervention) rehabilitation course for patients with CLBP. Six SSGE groups (n=64); CLBP only. Six GGE groups (n=42); CLBP patients grouped with chronic lower limb (LL) injuries.Outcome measuresOswestry Disability Index (ODI), Numerical Pain-Rating Scores and the Modified Multi-Stage Fitness Test (Mod-MSFT). Long-term effects were measured by Medical Employment Standard (MES) status and physiotherapy follow-up at 3 and 12 months.ResultsA between-group analysis showed no significant difference in GGE compared with SSGE. Mean changes (SD) in pain were −2.71±2.35 and −1.20±1.99 (p=0.018), ODI were −3.6±5.7 and −4±8.5 respectively (p=0.649) and Mod-MSFT 28.4±30.8 and 29.7±31.7 respectively (p=0.792). At 3 months, a greater proportion of the GGE were having ongoing physiotherapy; GGE=50%, SSGE=30.2%, (p=0.016) although some differences were evident across MES with 32.5 % of GGE compared with 20.6 % of SSGE being medically fit with no restrictions. At 12 months, groups were largely comparable for follow-up physiotherapy and MES; 22.5% of GGE and 20.6% of SSGE continued to have physiotherapy input; 47.5% of GGE and 50.8% of SSGE were medically fit with no restrictions.ConclusionPatients with CLBP who completed a 3-week rehabilitation programme had comparable outcomes when grouped with patients with LL, although only improvements in pain in the GGE group achieved a meaningful change. Further evaluation of potential costs and savings to service costs is now required.


Author(s):  
Sue A. Ferguson ◽  
William S. Marras ◽  
Robert R. Crowell

Most current functional capacity evaluations focus on sagittal range of motion, strength testing as well as simulation of daily activities and job tasks as measures of wellness. The goal of this study was to evaluate the dynamic functional motion capacity of normals and low back pain patients in the three cardinal planes of the body. The hypothesis was that injury would not only affect sagittal motion but also lateral and twisting motions that would load the spine in a different manner. Trunk motion parameters of range of motion (ROM), velocity and acceleration were measured in all three planes of the body as subjects performed three separate experimental tasks, eliciting motion in each plane of the body. The MANOVA results showed a significant difference between the patients and normals. The final discriminant function model predicting membership for the two groups contained ROM, velocity, and acceleration parameters with two measures from each experimental task. The cross-validation error rate for the model was 4%. These results provide insight into new methods for functional capacity evaluation of low back pain patients which may influence return to work decisions.


2016 ◽  
Vol 21 ◽  
pp. 100-108 ◽  
Author(s):  
Divya Bharatkumar Adhia ◽  
Stephan Milosavljevic ◽  
Steve Tumilty ◽  
Melanie D. Bussey

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