scholarly journals Myofascial release versus Mulligan sustained natural apophyseal glides’ immediate and short-term effects on pain, function, and mobility in non-specific low back pain

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10706
Author(s):  
Vignesh Bhat P ◽  
Vivek Dineshbhai Patel ◽  
Charu Eapen ◽  
Manisha Shenoy ◽  
Steve Milanese
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Patient Specific ◽  
Low Back ◽  
Short Term ◽  
Myofascial Release ◽  
Lumbar Flexion ◽  
Significant Difference ◽  
Strengthening Exercises

Background Myofascial release (MFR) and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques routinely practiced in the management of non-specific low back pain (NSLBP). As a solo intervention or along with other therapies, both methods have reported positive results for individuals with NSLBP. However, which technique improves NSLBP-related pain, restricted range of motion (ROM) and disability, warrants further research. Objective To study the comparative effects of MFR and SNAGs on pain, disability, functional ability, and lumbar ROM in NSLBP. Method A parallel-group study was conducted at tertiary care hospitals. Sixty-five Sub-acute or chronic NSLBP patients were allocated to receive strengthening exercises along with either MFR (n = 33) or SNAGs (n = 32) for six treatment sessions over one week. An independent assessor evaluated outcome measures such as the Visual Analog Scale (VAS), Patient-Specific Function Scale (PSFS), and ROM at baseline, immediate (after 1st treatment), and short-term (post-sixth day of the intervention). The Modified Oswestry disability index (MODI) was assessed at baseline and short-term. Results Within-group analysis found clinically and statistically significant (p < 0.05) changes for VAS and PSFS at immediate and short-term for both the groups. The lumbar extension also showed improvement immediately and in the short-term. Improvement in Lumbar flexion was seen only in the SNAGs group over the short-term. A statistically significant improvement was seen for MODI in both the groups but was not clinically significant in the MFR group. The analysis observed no statistically significant difference (p < 0.05) between the groups at both the immediate and short-term. Conclusions Pain and restricted function associated with NSLBP can be improved using SNAGs or MFR, along with strengthening exercises. For limited lumbar flexion ROM, Mulligan SNAGs have a better outcome than MFR over the short-term. Hence, both manual therapy techniques can be incorporated along with exercises for immediate and short-term management of sub-acute to chronic NSLBP. Clinical Trial Registration. CTRI/2018/12/016787 (http://ctri.nic.in/Clinicaltrials/).

Systematic review and meta-analysis of effects of acupuncture on pain and function in non-specific low back pain

2020 ◽  
Vol 38 (4) ◽  
pp. 235-243
Author(s):  
Yun-xia Li ◽  
Su-e Yuan ◽  
Jie-qiong Jiang ◽  
Hui Li ◽  
Yue-jiao Wang
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Controlled Trials ◽  
Low Back ◽  
Short Term ◽  
Significant Difference

Objective: To assess the effectiveness of acupuncture for non-specific low back pain (NSLBP) through systematic review of published randomised controlled trials (RCTs). Methods: Studies were identified in electronic databases from their inception to February 2018, and were grouped according to the control interventions. The outcomes of interest were pain intensity and disability. Methodological quality was evaluated using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. The review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: 25 trials (n=7587 participants) were identified and included in a meta-analysis. The results showed that acupuncture was more effective at inducing pain relief than: no treatment (standardised mean difference (SMD) −0.69, 95% CI −0.99 to −0.38); sham acupuncture in the immediate term (SMD −0.33, 95% CI −0.49 to −0.18), short term (SMD −0.47, 95% CI −0.77 to −0.17), and intermediate term (SMD −0.17, 95% CI −0.28 to −0.05); and usual care in the short term (SMD −1.07, 95% CI −1.81 to −0.33) and intermediate term (SMD −0.43, 95% CI −0.77 to −0.10). Also, adjunctive acupuncture with usual care was more effective than usual care alone at all time points studied. With regard to functional improvement, the analysis showed a significant difference between acupuncture and no treatment (SMD −0.94, 95% CI −1.57 to −0.30), whereas the other control therapies could not be assessed. Conclusion: We draw a cautious conclusion that acupuncture appears to be effective for NSLBP and that acupuncture may be an important supplement to usual care in the management of NSLBP.

scholarly journals Effects of a protocol with manual therapy and postural techniques for non-specific low back pain

2020 ◽  
pp. 1-5
Author(s):  
Daniele Alves da Silva ◽  
Maria Ester Ibiapina Mendes de Carvalho ◽  
Laiana Sepúlveda de Andrade Mesquita
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Public Hospital ◽  
Sensitivity Threshold ◽  
Low Back ◽  
Quadratus Lumborum ◽  
Significant Difference ◽  
Pain Symptoms ◽  
Post Hoc

Background: The effects of postural reeducation on low back pain (LBP) are well documented in the literature, as well as studies using manual therapy (MT). However, no studies were found that investigate the use of a protocol using both MT and postural techniques. Objective: To verify the effects of a protocol that associates the MT and postural techniques in pain symptoms and functionality of subjects with chronic non-specific LBP. Methods: The participants of this study were 09 patients from the physiotherapy outpatient clinic of a public hospital. The evaluation of the subjects was carried out with the application of the Visual Analog Scale for Pain, Oswestry Disability Index (ODI) and Pressure Algometry. Patients were treated with a protocol composed of manipulative and postural techniques performed twice a week for five weeks. Two new evaluations were performed after the 5th and 10th sessions. For statistical analysis, the ANOVA test was used followed by the Tukey post-hoc test, considering p< 0.05. Results: In all the evaluated variables it was observed a greater difference of the scores between the initial and the tenth evaluation. There was significant improvement in the pain (p = 0.0167) and in the algometry of the piriformis and quadratus lumborum. There was no significant difference in disability (p = 0.0595). Conclusion: The protocol with MT and postural techniques promoted improvement of pain and increase of pressure sensitivity threshold in patients with chronic non-specific LBP.

scholarly journals Effectiveness of Pilates exercises on non-specific low back pain to determine pain and disability

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 825-829
Author(s):  
P Manikandan ◽  
G Mohan Kumar ◽  
V Rajalaxmi ◽  
C Priya ◽  
G Yuvarani ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Disability ◽  
Conventional Group ◽  
Patient Specific ◽  
Low Back ◽  
Mean Values ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction and Aim: Low back discomfort is one of the commonest musculoskeletal problems. The Pilates exercises are an approach to stretching and strengthening techniques and specifically train all the core muscles. The intend of the current study was to verify the influences of the Pilates exercises among pain and disability among patients with Non-specific Low Back Pain (NSLBP).     Materials and Methods: A 100 non-specific low back pain subjects were randomly selected for this experimental study. The study includes of non-specific LBP age group between 25 to 40 years, both male and female patients with pain and disability and this study excludes spinal fractures and Pregnant Women. The estimations were taken utilizing Visual Analogue scale (VAS), Patient Specific Functional Scale (PSFS) and Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Subjects are allotted in two groups, Group A (Pilates group) receives Pilate’s exercise and Group B (conventional group) receives conventional exercise. Exercises were given for 3 times a week for 12 weeks and a regular follow up was done for every 4 weeks.   Results: Group A (Pilates group) were found to be more effective than Group B (conventional group). It shows a highly significant difference in mean values at P ? 0.001. This implies that Pilates exercise is more beneficial in decreasing pain and functional disability.   Conclusion: On comparing the mean values, Group A (Pilates group) showed significant improvement at the end of the study when compared with Group B (conventional group).

scholarly journals Therapeutic Techniques in Rehabilitation of Core Stability Muscles among Patients with Mechanical Low Back Pain

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Azzam Alarab ◽  
Hamza Shaheen
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Demographic Data ◽  
Core Stability ◽  
Low Back ◽  
Therapeutic Massage ◽  
Significant Difference ◽  
Strengthening Exercises ◽  
Group B ◽  
The Impact

The study was designed to compare between the effect of strengthening exercises and mobilization techniques among patients with mechanical low back pain. Sixteen participants were included in this study, three patients for each group were excluded. They were classified into two groups. Group A, strengthening exercises, therapeutic massage, and group B, mobilization techniques, therapeutic massage. Each group had three sessions per week, for four weeks. The participants were assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI).  Independent samples were collected, t-test was used to study the similarity of demographic data between groups, Wilcoxon Signed Ranks Test was used to study the change between pre- and post-treatment. The Mann-Whitney test was used to study the comparison between the two treatments. The comparison revealed that for VAS there was a significant difference between groups in term of the strengthening exercises group (P >0.05). For ODI, there were no statically significant differences between groups (P <0.05), but the impact of both techniques suggests that strengthening exercises have a higher effect comparing to mobilization techniques on pain. The study indicated that the strengthening exercises were more effective than mobilization techniques on pain. And finally, the study revealed that there was no significant difference between both groups on ODI.

EMG Analysis of Lumbar Muscle Activations During Resisted and Unresisted Core Strength Exercises

2020 ◽  
Vol 9 (2) ◽  
pp. 12-24
Author(s):  
S. Saranya ◽  
S. Poonguzhali ◽  
N. Madhu Baala ◽  
S. Karunakaran
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Activation ◽  
Maximum Voluntary Contraction ◽  
Patient Specific ◽  
Low Back ◽  
Core Strength ◽  
Strength Exercises ◽  
Significant Difference ◽  
Trunk Extension

Non-specific low back pain is the result of improper loading of the spine, requiring patient specific treatment of low-back muscles. 20 healthy subjects performed selective core strength exercises and surface electromyogram (EMG) signals were acquired from Erecter spinae and Multifidus muscles. Root Mean Square (RMS) EMG normalized with Maximum Voluntary Contraction (%MVC) indicated bilateral symmetry in muscles showing no compensations during exercises. T-tests results showed no significant difference in RMS between exercises performed with and without resistance (p>0.05) suggestive of EMG as a prominent resource in evaluating unresisted muscle strength. Muscle activation during Trunk extension exercise were nominal (80%) and maximum (100%) for the superman Boat exercise suggesting hyperextension. Quadruped exercises were activated submaximally (60%) and can be suggested for core strength training of low back pain patients as preliminary exercise followed by trunk extension during rehabilitative treatment. The Superman Boat exercise can be suggested for sports persons to build their core strength.

Critical analysis and unique management of Gridhrasi w.s.r. to Sciatica - A Case Report

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Rangarajan B. ◽  
Dr. Muralidhara .
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Total Population ◽  
The Body ◽  
Walking Distance ◽  
Common Symptom ◽  
Low Back ◽  
Short Term ◽  
Lower Back

Gridhrasi (Sciatica) is a disorder in which low back pain is found, that spreads through the hip, to the back of the thigh and down the inside of the leg. Mechanical low back pain (LBP) remains the second most common symptom related reason for seeing a physician. 85% of total population will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. There are many causes for low back pain, however true sciatica is a symptom of inflammation or compression of the sciatica nerve. The sciatica nerve carries impulses between nerve roots in the lower back and the muscles and nerve of the buttocks, thighs and lower legs. Compression of a nerve root often occurs as a result of damage to one of the discs between the vertebrae. In some cases, sciatic pain radiate from other nerves in the body. This is called referred pain. Pain associated with sciatica often is severe, sharp and shooting. It may be accompanied by other symptom, such as numbness, tingling, weakness and sensitivity to touch. There is only conservative treatment giving short term relief in pain or surgical intervention with side effect. But these are not successful and therefore those who are suffering from this are always in search of result oriented remedy. Walking distance and SLR test were taken for assessment parameter, VAS score was adopted for pain. Before treatment patient was not able to walk even 4 to 5 steps due to severe pain, was brought on stretcher and his SLR was 30° of right side. After 22 days of treatment he was able to walk up to 500 meters without any difficulty, SLR was changed to 60° and patient had got 80 % relief in pain. This case report showed that Ayurvedic protocol is potent and safe in the treatment of Gridhrasi.

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