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Effectiveness of Spinal Stabilization Exercises on Dynamic Balance in Adults with Subacute and Chronic Low Back Pain: A Randomized Clinical Trial.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Effectiveness of Spinal Stabilization Exercises on Dynamic Balance in Adults with Subacute and Chronic Low Back Pain: A Randomized Clinical Trial./
作者:	Alshehre, Yousef.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
面頁冊數:	218 p.
附註:	Source: Dissertations Abstracts International, Volume: 81-10, Section: B.
Contained By:	Dissertations Abstracts International81-10B.
標題:	Physical therapy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27953936
ISBN:	9798607304997

Effectiveness of Spinal Stabilization Exercises on Dynamic Balance in Adults with Subacute and Chronic Low Back Pain: A Randomized Clinical Trial.
Alshehre, Yousef.

Effectiveness of Spinal Stabilization Exercises on Dynamic Balance in Adults with Subacute and Chronic Low Back Pain: A Randomized Clinical Trial. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 218 p.

Source: Dissertations Abstracts International, Volume: 81-10, Section: B.

Thesis (Ph.D.)--Texas Woman's University, 2019.

This item must not be sold to any third party vendors.

Background: Dynamic balance deficits have been identified as significant impairments in patients with low back pain (LBP). Although studies on the effect of spinal stabilization exercises (SSEs) on postural control in patients with LBP has been encouraging, balance measures used in these studies primarily assessed static postural control and lacked dynamic components. The Y-Balance Test (YBT) is a functional test, which assesses dynamic balance, and has been used in clinical practice. Given that dynamic balance is a vital aspect of everyday life, it is important to routinely include a relatively quick and cost-effective balance test in physical therapy (PT) practice, and to incorporate an exercise program that is useful for maintaining and improving balance in LBP populations. However, there is a lack of evidence supporting the effectiveness of SSEs on improving dynamic balance. Purpose: To determine the effectiveness of SSEs on dynamic balance in adults with subacute and chronic LBP. Specifically, performance on the YBT was compared between participants with subacute and chronic LBP who received an SSE program and those who received a general exercise (GE) program. In addition, to examine whether or not the participants who received an SSE program would have greater improvement in pain intensity and disability level than those who received a GE program. Methods: Fifty-three participants who had LBP more than 6 months were recruited in the study, and 40 participants completed the 8-week intervention study. All eligible participants were assigned randomly into either an SSE group (n = 20, 38.8 ± 11.8 years old) or a GE group (n=20, 41.0 ± 13.3 years old), which consisted of flexibility and range-of-motion exercises. Three outcome measurements were collected in this study, including dynamic balance measured by the YBT, pain intensity measured by the Numeric Pain Rating Scale (NPRS), and disability level measured by the Modified Oswestry Low Back Pain Disability Questionnaire (OSW). The outcome measures were collected at baseline, and two weeks, four weeks, and eight weeks after intervention was initiated. Participants' dynamic balance was measured using the YBT in the anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions. For each participant, the measured reach distances were normalized to their leg length. The normalized composite score was used for data analysis. All participants were asked to attend 1-2 supervised PT sessions for a total of 4-8 sessions, and to perform their assigned exercises at least five times per week at home in the first 4 weeks of the 8-week intervention. In the last 4 weeks, the participants performed exercises at home with no supervised PT sessions. Three separate 2 x 4 analyses of variance (ANOVAs) with repeated measures were used to determine any differences in the three outcome measures between groups. Follow-up analysis was performed if there was a significant interaction. Results: The statistical results revealed that there was a significant interaction of group by time for dynamic balance (p < 0.001), but not for the NPRS or OSW. Post-hoc analysis revealed that there was a significant difference between groups from two weeks (p = 0.002) compared to four weeks, with the SSE group demonstrating higher YBT composite scores than the GE group. However, there were no significant between-group differences from baseline to two weeks (p =0.098), and from 4 weeks to 8 weeks (p = 0.413). In addition, the results showed that all participants had a significant improvement in dynamic balance, pain intensity, and disability level over time.Conclusion: The results indicate that SSEs were more effective than GEs in improving dynamic balance, but not pain intensity nor disability level in adults with chronic LBP (CLBP), specifically, during the four weeks of supervised PT sessions with a home exercise program. SSEs may minimize faulty movement strategies and compensatory muscle contractions by properly coordinating abdominal and back musculature during functional tasks, which possibly led to better dynamic balance. However, GEs appeared to have an effect equivalent to that of SSEs after 8-week intervention, consisting of 4 weeks of supervised intervention and another 4 weeks of unsupervised intervention. In addition, all participants had reduction in pain intensity and disability level over eight weeks after the intervention. However, no differences were found between the two groups. Clinical relevance: The results of the study provide evidence for clinicians to include SSEs for improving dynamic balance in the management of patients with CLBP.

ISBN: 9798607304997Subjects--Topical Terms:

588713
Physical therapy.
Subjects--Index Terms:

Back pain

Effectiveness of Spinal Stabilization Exercises on Dynamic Balance in Adults with Subacute and Chronic Low Back Pain: A Randomized Clinical Trial.
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520 $a Background: Dynamic balance deficits have been identified as significant impairments in patients with low back pain (LBP). Although studies on the effect of spinal stabilization exercises (SSEs) on postural control in patients with LBP has been encouraging, balance measures used in these studies primarily assessed static postural control and lacked dynamic components. The Y-Balance Test (YBT) is a functional test, which assesses dynamic balance, and has been used in clinical practice. Given that dynamic balance is a vital aspect of everyday life, it is important to routinely include a relatively quick and cost-effective balance test in physical therapy (PT) practice, and to incorporate an exercise program that is useful for maintaining and improving balance in LBP populations. However, there is a lack of evidence supporting the effectiveness of SSEs on improving dynamic balance. Purpose: To determine the effectiveness of SSEs on dynamic balance in adults with subacute and chronic LBP. Specifically, performance on the YBT was compared between participants with subacute and chronic LBP who received an SSE program and those who received a general exercise (GE) program. In addition, to examine whether or not the participants who received an SSE program would have greater improvement in pain intensity and disability level than those who received a GE program. Methods: Fifty-three participants who had LBP more than 6 months were recruited in the study, and 40 participants completed the 8-week intervention study. All eligible participants were assigned randomly into either an SSE group (n = 20, 38.8 ± 11.8 years old) or a GE group (n=20, 41.0 ± 13.3 years old), which consisted of flexibility and range-of-motion exercises. Three outcome measurements were collected in this study, including dynamic balance measured by the YBT, pain intensity measured by the Numeric Pain Rating Scale (NPRS), and disability level measured by the Modified Oswestry Low Back Pain Disability Questionnaire (OSW). The outcome measures were collected at baseline, and two weeks, four weeks, and eight weeks after intervention was initiated. Participants' dynamic balance was measured using the YBT in the anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions. For each participant, the measured reach distances were normalized to their leg length. The normalized composite score was used for data analysis. All participants were asked to attend 1-2 supervised PT sessions for a total of 4-8 sessions, and to perform their assigned exercises at least five times per week at home in the first 4 weeks of the 8-week intervention. In the last 4 weeks, the participants performed exercises at home with no supervised PT sessions. Three separate 2 x 4 analyses of variance (ANOVAs) with repeated measures were used to determine any differences in the three outcome measures between groups. Follow-up analysis was performed if there was a significant interaction. Results: The statistical results revealed that there was a significant interaction of group by time for dynamic balance (p < 0.001), but not for the NPRS or OSW. Post-hoc analysis revealed that there was a significant difference between groups from two weeks (p = 0.002) compared to four weeks, with the SSE group demonstrating higher YBT composite scores than the GE group. However, there were no significant between-group differences from baseline to two weeks (p =0.098), and from 4 weeks to 8 weeks (p = 0.413). In addition, the results showed that all participants had a significant improvement in dynamic balance, pain intensity, and disability level over time.Conclusion: The results indicate that SSEs were more effective than GEs in improving dynamic balance, but not pain intensity nor disability level in adults with chronic LBP (CLBP), specifically, during the four weeks of supervised PT sessions with a home exercise program. SSEs may minimize faulty movement strategies and compensatory muscle contractions by properly coordinating abdominal and back musculature during functional tasks, which possibly led to better dynamic balance. However, GEs appeared to have an effect equivalent to that of SSEs after 8-week intervention, consisting of 4 weeks of supervised intervention and another 4 weeks of unsupervised intervention. In addition, all participants had reduction in pain intensity and disability level over eight weeks after the intervention. However, no differences were found between the two groups. Clinical relevance: The results of the study provide evidence for clinicians to include SSEs for improving dynamic balance in the management of patients with CLBP.
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