A Review on the Effect of Rehabilitation Exercises Based on Core Muscles Stability and ‎Strengthening on the Mechanics of Transitional Movements in People with Non-Specific ‎Back Pain

Document Type : Review Article

Authors

Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology ‎University of Mohaghegh Ardabili, Ardabil, Iran

Abstract

Purpose:
Low back pain is a common problem in world and one of the most common causes of physical disability. The aim of this review study was to investigate the effects of rehabilitation exercises with a central muscle stabilization approach on kinetic, kinematic and electromyographic variables during walking, running, trunk flexion and extension movements in patients with back pain.
Methods:
Search process for Persian and English articles from the beginning of January 2000 to August 2023 were performed in Google Scholar, ISC, Scopus, Pub Med, WOS, and SID databases. Finally, based on selection criteria, 19 articles were selected for final analysis through detailed reviews. The participants had non-specific back pain. Studies that included exercise protocols and control group were used in the present study. The dependent variables were kinematics and kinetics and muscle activity during transitional movements. Downs and Black questionnaires were used to evaluate the quality of the articles.
Results:
The results of four articles showed that rehabilitation exercises with muscle endurance approach can improve the electrical activity of muscles and reduce back pain. The results of seven articles showed that strengthening, stretching and massage exercises can be effective in improving pain through correcting the person's vertical alignment. Other articles in a period of at least eight weeks showed that strengthening the central muscles of the body can lead to neuromuscular adaptation and increase muscle fibers recruitment in patients with back pain.
Conclusion:
The present review have shown  that rehabilitation exercises with the approach of strengthening the central muscles of the body can lead to improving the flexibility of the trunk muscles, correcting the person's vertical alignment and reducing the back pain.

Keywords


  1. Ehrlich GE. Back pain. J Rheumatol Suppl 2003; 67: 26-31.
  2. Graves JM, Fulton-Kehoe D, Martin DP, Jarvik JG, Franklin GM. Factors associated with early magnetic resonance imaging utilization for acute occupational low back pain: a population-based study from Washington State workers' compensation. Spine 2012; 37(19): 1708-1718.
  3. Daneshjoo A, Dadgar H. The prevalence of low back pain and its relationship with physical activity, age and BMI in Fars Payam-e Noor University staff. J Res Rehabil Sci 2011; 7(3):302-310. [Persian]
  4. Evans L, O’Donohoe T, Morokoff A, Drummond K. The role of spinal surgery in the treatment of low back pain. Med J Aust 2023; 218(1): 40-45.
  5. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, et al. What low back pain is and why we need to pay attention. Lancet 2018; 391(10137): 2356-2367.
  6. Roren A, Daste C, Coleman M, Rannou F, et al. Physical activity and low back pain: a critical narrative review. Ann Phys Rehabil Med 2023; 66(2): 101650.
  7. Koes BW, Van Tulder M, Thomas S. Diagnosis and treatment of low back pain. BMJ 2006; 332(7555): 1430-1434.
  8. Yang KH, King A. Mechanism of facet load transmission as a hypothesis for low-back pain. Spine. 1984; 9(6): 557-565.
  9. Jafarnezhadgero A, Ghane G, Valizadehorang A, Malekabadi Am. Comparison of Lower Limb Muscular Activities during Three Different Running Patterns in Pronated Feet Individuals with and without Low Back Pain. Anesthesiology and Pain 2020; 11(3): 77-87. [Persian]
  10. Jafarnezhadgero AA, Oroji A, Letafatkar A, Shojaodin SS. The Effect of Movement-Pattern Training on Selected Landing Kinematic Variables in Athletes with Non-Specific Chronic Low Back Pain: A Randomized Clinical Trial. Journal of Rafsanjan University of Medical Sciences 2021; 20(6): 631-644. 
  11. Patrick N, Emanski E, Knaub MA. Acute and chronic low back pain. Med Clin North Am 2014; 98(4): 777-789.
  12. Yip VYB. New low back pain in nurses: work activities, work stress and sedentary lifestyle. J Adv Nurs 2004; 46(4): 430-440.
  13. Bolboli L, Jafarnezhadgero A, Fakhri E. Effect of Rehabilitation with Beta Medicine Ball on Ground Reaction Force Components in Low Back Pain Patients during Walking. Iranian Journal of Rehabilitation Research 2021; 7(4): 38-45. [Persian]
  14. Javadipoor Z, Norasteh AA, Babagoltabar Samakoush H. Comparison of endurance and strength of trunk muscles and balance in female students with and without back pain. The Scientific Journal of Rehabilitation Medicine. 2022; 12(2): 276-289.
  15. Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther 2005; 85(3): 209-225.
  16. Mohammadi V, Letafatkar A, Jafarnezhadgero AA. Effects of Core Stability Training on Kinematic and Kinetic Variables in Patients With Chronic Low Back Pain. Physical Treatments-Specific Physical Therapy Journal. 2023; 13(1): 55-66. [Persian]
  17. Saulicz M, Saulicz A, Myśliwiec A, Knapik A, et al. Effect of Nordic Walking Training on Physical Fitness and Self-Assessment of Health of People with Chronic Non-Specific Lower Back Pain. International J Environ Res Public Health 2023; 20(9): 5720.
  18. Monticone M, Ambrosini E, Rocca B, Magni S, et al. A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study. Eur Spine J 2014; 23(10): 2105-2113.
  19. Krekoukias G, Sakellari V, Anastasiadi E, Gioftsos G, et al. Gait kinetic and kinematic changes in chronic low back pain patients and the effect of manual therapy: a randomized controlled trial. J Clin Med 2021; 10(16): 3593.
  20. Madadi-Shad M, Jafarnezhadgero AA, Sheikhalizade H, Dionisio VC. Effect of a corrective exercise program on gait kinetics and muscle activities in older adults with both low back pain and pronated feet: A double-blind, randomized controlled trial. Gait Posture 2020; 76: 339-345.
  21. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 1998; 52(6): 377-384.
  22. Maul I, Läubli T, Oliveri M, Krueger H. Long-term effects of supervised physical training in secondary prevention of low back pain. Eur Spine J 2005; 14(6): 599-611.
  23. Nambi G, Abdelbasset WK, Alqahtani BA, Alrawaili SM, et al Isokinetic back training is more effective than core stabilization training on pain intensity and sports performances in football players with chronic low back pain: A randomized controlled trial. Medicine 2020; 99(21):e20418.
  24. Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. J Orthop Sports Phys Ther 2006; 36(7): 472-484.
  25. Shnayderman I, Katz-Leurer M. An aerobic walking programme versus muscle strengthening programme for chronic low back pain: a randomized controlled trial. Clin Rehabil 2013; 27(3): 207-214.
  26. Kendall KD, Emery CA, Wiley JP, Ferber R. The effect of the addition of hip strengthening exercises to a lumbopelvic exercise programme for the treatment of non-specific low back pain: A randomized controlled trial. J Sci Med Sport 2015; 18(6): 626-631.
  27. Lee C-W, Hwangbo K, Lee I-S. The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and muscle activity of chronic low back pain patients. J Phys Ther Sci 2014; 26(1): 93-96.
  28. Kim B, Yim J. Core stability and hip exercises improve physical function and activity in patients with non-specific low back pain: a randomized controlled trial. Tohoku J Exp Med 2020; 251(3): 193-206.
  29. Ahmed H, Iqbal A, Shaphe MA. Efficacy of electromyography biofeedback training on trunk stability in chronic low back pain. Indian J Phys Occup Ther 2013; 7(3): 81-86.
  30. Leo Rathinaraj A, Sreeja M, Arun B, Sundar KS, Premlal R. A surface electromyographic study to assess the effect of spinal segmental stabilization [multifidus] exercise program in chronic mechanical low back pain patients. Eur Ortho Traumatol 2012; 3:161-168.
  31. Mohammadi V, Letafatkar A, Sadeghi H, Jafarnezhadgero A, Hilfiker R. The effect of motor control training on kinetics variables of patients with non-specific low back pain and movement control impairment: Prospective observational study. J Bodyw Mov Ther 2017; 21(4): 1009-1016.
  32. Nowotny AH, Calderon MG, de Souza PA, Aguiar AF, et al. Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial. BMJ open sport Exerc Med 2018; 4(1): e000452.
  33. Hartvigsen J, Morsø L, Bendix T, Manniche C. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial. BMC Musculoskelet Disord 2010; 11: 30.
  34. Bagheri H, Abdolvahab M, Raji P, Jalili M, et al. The effects of progressive resistance training of the upper and lower extremity strength and the effect of this increase in power over the activities of daily living in elderly men, Modern Rehabilitation 2010; 4(1): 51-59. [Persian]
  35. Alavi Mehr SM, Mousavi SH, Jafarnezhadgero A. The effect of a selected exercise protocol on trunk and lower limb muscle activity of older adults with both low back pain and pronated feet during walking. Sport Sci Health Res 2022; 14(1): 129-140. [Persian]