Effects of Strengthening and Stretching Exercises on Pain and ROM of Trunkin Females with Low Back Pain: A pilot study
Keywords:Strengthening exercise, Stretching exercise, Low back pain, Lumbopelvic muscles
This research aimed to investigate the effect of the strengthening and stretching exercises of lumbopelvic muscles and also to examine the effect of this exercises on lower back pain and movements of the trunk. Female subjects aged between 20-30 years were recruited, 9 people received an exercise program to increase strengthening of abdominal muscle, focusing on transversusabdominis muscle and gluteus muscle together with exercise to increase the flexibility of iliopsoas and back muscles for 4 weeks. Lower back pain level, ROM of trunk, strength, and flexibility of lumbopelvic muscles were measured before and after they received an exercise programs. The data obtained were statistically calculated using Wilcoxon signed-rank test, median, and interquartile range. The results showed that their lower back pain significantly decreased (p < 0.05). The strength of transversusabdominis, gluteus, the flexibility of the iliopsoas, and back muscles including the ROM of trunk were increased significantly (p < 0.05). To summarize, it may be concluded that two types of exercise programs to increase strength and flexibility of all 4 groups of lumbopelvicmuscles can reduce lower back pain, increase the ROM of trunk, strength, and flexibility of muscles in participants with lower back pain in 4 weeks.
Amabile, A. H., Bolte, J. H., & Richter, S. D. (2017).
Atrophy of gluteus maximus among women with
a history of chronic low back pain. PLoS One,
Batsis, J. A., & Buscemi, S. (2011). Sarcopenia,
sarcopenic obesity and insulin resistance. Medical
complications of type 2 diabetes (pp. 233-
. Croatia InTech.
Been, E., & Kalichman, L. (2014). Lumbar lordosis.
The spine journal, 14(1), 87-97.
Brown, N., Bubeck, D., Haeufle, D. F. B., Weickenmeier,
J., Kuhl, E., Alt, W., & Schmitt, S. (2017). Weekly
time course of neuro-muscular adaptation to
intensive strength training. Frontiers in
Physiology, 8, 1-6.
Candotti, C. T., Noll, M., Marchetti, B. V., Rosa, B. N. d.,
Medeiros, M. d. G. S., Vieira, A., & Loss, J. F.
(2015). Prevalence of back pain, functional
disability, and spinal postural changes. Fisioter
Mov, 28(4), 711-722.
Cho, H. Y., Kim, E. H., & Kim, J. (2014). Effects of the
CORE exercise program on pain and active
range of motion in patients with chronic low
back pain. Journal of Physical Therapy Science,
DeRosa, C., & Porterfield, J. A. (2007). Anatomical linkages
and muscle slings of the lumbopelvic region.
In Vleeming A, Mooney V, Stoeckart R, (ed.)
Movement, stability & lumbopelvic pain: integration
of research and therapy. (pp. 47-62)
New York: Churchill Livingstone (Elsevier).
Descarreaux, M., Normand, M. C., Laurencelle, L., &
Dugas, C. (2002). Evaluation of a specific home
exercise program for low back pain. Journal of
Manipulative and Physiological Therapeutics,
Frana, F. R., Burke, T. N., & Caffaro, R. R. (2012).
Effects of muscular stretching and segmental
stabilization on functional disability and pain
in patients with chronic low back pain: A
randomized, controlled trial. Journal of
Manipulative and Physiological Therapeutics,
Frana, F. R., Burke, T. N., Hanada, E. S., & Marques,
A. P. (2010). Segmental stabilization and
muscular strengthening in chronic low back
pain-a comparative study. Clinics (Sao Paulo),
Jeong, U.-C., Sim, J. H., Kim, C. Y., Hwang-Bo, G., &
Nam, C. W. (2015). The effects of gluteus muscle
strengthening exercise and lumbar stabilization
exercise on lumbar muscle strength and balance
in chronic low back pain patients. Journal of Physical
Therapy Science, 27(12), 3813 - 3816.
Key, J. (2010). Back pain: A movement problem. Chaina:
Kisner, C., & Colby, L. A. (1996). Therapeutic
exercise: Foundations and techniques (6th ed.).
Philadelphia: F.A. Davis.
Kumar, A., Zutshi, K., & Narang, N. (2011). Efficacy
of trunk proprioceptive neuromuscular
facilitation training on chronic low back
pain. International Journal of Sports Science and
Engineering, 5(3), 174-180.
Kumar, T., Kumar, S., Nezamuddin, M., & Sharma, V.
P. (2015). Efficacy of core muscle strengthening
exercise in chronic low back pain patients.
Journal of Back and Musculoskeletal Rehabilitation,
Ma, V. Y., Chan, L., & Carruthers, K. J. (2014).
Incidence, prevalence, costs, and impact on
disability of common conditions requiring
rehabilitation in the United States: Stroke, spinal
cord injury, traumatic brain injury, multiple
sclerosis, osteoarthritis, rheumatoid arthritis,
limb loss, and back pain. Archives of Physical
Medicine and Rehabilitation, 95, 986 - 995.
Malai, S., Pichaiyongwongdee, S., & Sakulsriprasert,
P. (2015). Immediate effect of hold-relax
stretching of iliopsoas muscle on transversus
abdominis muscle activation in chronic
non-specific low back pain with lumbar
hyperlordosis. Journal of the Medical Association
of Thailand, 98(5), s6 - 11.
Winters, M. V., Blake, C. G., Trost, J. S., Marcello-
Brinker, T. B., Lowe, L., Garber, M. B., &
Wainner, R. S. (2004). Passive versus active
stretching of hip flexor muscles in subjects with
limited hip extension: A randomized clinical
trial. Physical Therapy, 84(9), 800-807.
Nourbakhsh, M. R., Arabloo, A. M., & Salavati, M.
(2006). The relationship between pelvic cross
syndrome and chronic low back pain. Journal of
Back and Musculoskeletal Rehabilitation, 19(4),
Page, P., & Ellenbecker, T. S. (2003). The Scientific
and clinical application of elastic resistance.
(pp. 290). Human Kinetics.
Puntumetakul, R., Yodchaisarn, W., Chatchawan,
U., Peungsuwan, P., Eungpinichpong, W.,
Nilphanomchai, R., & Leerattana, S. (2015).
Immediate effects between core stabilization
exercise and strengthening exercise on postural
balance in patient with chronic non-specific low
back pain. Journal of Medical Technology and
Physical Therapy 27(3), 320-329.[In Thai].
Rajalakshmi, D., & Kumar, N. S. S. (2012).
Strengthening transversus abdominis in
pregnancy related pelvic pain: The pressure
biofeedback stabilization training. Global
Journal of Health Science, 4(4), 55-61.
Schlink, M. B. (1996). Muscle imbalance patterns
associated with low back syndromes, In Watkins
R.G., (ed.) The spine in sports (pp.146-156)
St Louis: Mosby.
Vera-Garcia, F. J., Grenier, S. G., & McGill, S. M. (2000).
Abdominal muscle response during curl-ups on
both stable and labile surfaces. Physical
Therapy, 80(6), 564-569.
Winters, M. V., Blake, C. G., Trost, J. S., & Wainner, R.
S. (2004). Passive versus active stretching of
hip flexor muscles in subjects with limited hip
extension: a randomized clinical trial. Physical
Therapy, 84(9), 800-807.
Yaruang, N., & Intahphuak, S. ( 2016). Effects of stretching
exercise program on low back pain in rice
farmers. Journal of The Royal Thai Army Nurses,
(3), 73-81. [In Thai].
Yoo, Y. D., & Lee, Y. S. (2012). The Effect of core
stabilization exercises using a sling on pain
and muscle strength of patients with chronic
low back pain. Journal of Physical Therapy
Science, 24(8), 671-674.