, Morris R. Moffroid The Effectiveness of Hollowing and Bracing Strategies With Lumbar Stabilization Exercise in Older Adult Women With Nonspecific Low Back Pain: A Quasi-Experimental Study on a Community-based Rehabilitation. Bigos Subjects who encountered difficulty with a particular level of exercise (eg, level 2) were asked to stop the exercise and try to perform the exercise at a higher level (eg, level 3). , Carmen GM. Phys Ther. The disability questionnaire was designed by the authors and consisted of 15 questions pertaining to everyday activities. We instructed our subjects to maintain their body in the horizontal position for as long as they could tolerate that position (Fig. Poor endurance of the trunk muscles may induce strain on the passive structures of the lumbar spine, leading eventually to low back pain. The reduction of pain may have enabled the subjects to carry on with their activities of daily living, and thus they reported reduced disability. Background and purpose: There were no differences in age or pain duration between the experimental and control groups. , Huskisson EC. Epub 2017 Dec 16. Selkowitz DM, Kulig K, Poppert EM, Flanagan SP, Matthews ND, Beneck GJ, Popovich JM Jr, Lona JR, Yamada KA, Burke WS, Ervin C, Powers CM; Physical Therapy Clinical Research Network. In addition, orthopedic consultants at the outpatient specialist clinic and the medical officer at the accident and emergency department were given a description of the study, including its title, purpose, and subject inclusion and exclusion criteria. Park HW, Baek S, Kim HY, Park JG, Kang EK. Therefore, our study was designed to evaluate the effectiveness of trunk muscle endurance training in reducing pain and improving muscle endurance and function in patients with subacute low back pain. Reassessments were carried out at 3 and 6 weeks. The reassessments were scheduled at 3 and 6 weeks after entry into the study. 10)This test may not be suitable for: A client with major strength deficiencies A client with a high body mass M After 10 repetitions, the subjects were instructed to rest for 30 seconds to 1 minute.32,33 For subjects who performed well and had indicated the level of ease as grade 1 or 2, the rest interval was 1 minute for every 50 repetitions until 300 repetitions were completed. . The duration of the acute back pain was usually 1 to 2 weeks, and 50% of these patients had complaints of discomfort for more than 5 years prior to this acute episode. Fifteen subjects with CLBP became symptom free, 7 subjects reported some improvement, and 4 subjects reported no improvement. Coxhead There was some correlation, however, between various pain measurements and the RMDQ scores for both groups (r=.49-.81, P<.05). Endurance exercise is considered to expedite the recovery process for patients with an acute episode of low back pain. Poor endurance of the trunk muscles may induce strain on the passive structures of the lumbar spine, leading eventually to low back pain. 1).30 If the torso deviated more than 6 degrees from the stable position for longer than 6 seconds, the test was terminated and the time the subject took to maintain the horizontal position was entered. The control group received traditional medical care only, such as analgesics and rest. The effects of muscle endurance training have been investigated in subjects with CLBP13 and in individuals without low back pain.14 The efficacy of such training in patients with subacute low back pain has not been studied. I If the number of subjects is sufficiently large, despite the argument that these scores are ordinal or interval scale data, the sample may assume a normal distribution. A sham exercise group could have been included in the design of this study, although we believe it would have been difficult to design a sham exercise program. If subjects were unable to cope with the level 3 exercise, however, they would continue the level 1 exercise and slowly progress to the level 2 exercise. JA BMC Musculoskelet Disord. To begin this test, an examination plinth, a stopwatch and three to four straps are needed. Evans All subjects also performed the Sorensen Test, which was conducted by a physical therapist who was unaware of the subjects' group assignment. The reliability induction rate of trunk extension endurance measures was also calculated. Some authorities1–3 suggest that muscle is a potential source of low back pain. . Petrofsky For subjects with subacute low back pain, it is possible that healing may have been completed 6 weeks after entry into the study. The examiner looks for substitution of the platysma or SCM muscle. The exercise program consisted of 5 exercises directed at improving trunk extensor endurance. Conclusions: TEEP protocol alone is effective in improving trunk extensor muscle endurance and its combination with core stabilization exercises will not produce any significant improvements over use of TEEP alone. Norms for men = 3 minutes approx. isometric back extension endurance testing (holding time, as measured in seconds), and reasons for test termination were obtained for a population-based sample of 544 working-age men. Thus, the pain may have been resolved due to factors other than the endurance exercise protocol.20,35,36 The pain may have been caused by tissue damage in the acute and subacute phases.37 Regardless of intervention, however, both groups experienced minimal pain after 6 weeks. J ance test were three times more likely to have LBP than those who demonstrated greater performance (Alaranta, Luoto, Heliovaara, & Hurri, 1995). Pain may have inhibited an optimum exercise training stimulus. In the experimental group, none of this relationship existed. Moreover, the extensors which are present at the back are tested with the upper body beamed out over the end of the test bench. In contrast with previous studies of non-athletes, male athletes had equivalent holding times on the Biering–Sørensen trunk extensor endurance test to those of female athletes. Over a decade ago, a study by Deyo et al53 demonstrated that patients benefited from minimal bed rest, with 78% of their sample population being subjects with subacute low back pain. MT Endurance times were recorded F Subjects in the experimental group attended exercise sessions 3 times a week for 6 weeks. , Bowyer R, Braeri R. Deyo Although assistance was given if subjects were unable to perform the task, the criteria used to determine the amount of assistance provided remained unspecified. Outcome measures used in that study included the Sorensen Test, a pain scale, and a disability questionnaire. The Trunk Extension on Ball with Scapular Retraction exercise begins to incorporate scapular alignment re-training to the Trunk Extensor Endurance Progression. Melzack At 6 weeks, no differences were found for pain measurements, disability scores, and holding time on the Sorensen Test. Kahanovitz The disability score was lower in the experimental group than in the control group at 3 weeks (P<.05), but not at 6 weeks (P>.05) (Fig. S Celia Tan, Manager, Physiotherapy Department, Singapore General Hospital, contributed to fund procurement and provision of subjects, facilities/equipment, and institutional liaisons. , Beyer H, Brauer D. Hultman Which Neuromuscular Attributes Are Associated With Changes in Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis? Results: At the 6-week reassessment, there were no differences in all of the pain scores between the groups (P>.05) (Figs. F S Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2007 Sep 25. Reliability and Validity of a New Method for Isometric Back Extensor Strength Evaluation Using A Hand-Held Dynamometer. , Richardson CA, Jull GA. Jensen The immediate and long-term effects of exercise and patient education on physical, functional, and quality-of-life outcome measures after single-level lumbar microdiscectomy: a randomized controlled trial protocol. Subjects were given a rest of at least 10 to 15 minutes before performing the retest. Biering-Sorensen M Hides The torque generated by the trunk extensor muscles during the Sorensen Test has been reported by Smidt and Blanpied to approximate 52 percent of maximal volun- tary capacity (MVC) of their capability (14) ; however, Holmstrom, using a scale to weigh the upper torso and a rule to measure the moment arm, reported that subjects only created a torque equal to 40 percent MVC in this testing (3). P Error bar represents range (sig=significant at P<.05, ns=not significant at P<.05; Mann-Whitney U test). purpose: this test measures trunk extensor strength, flexibility and endurance. The torso deviation was monitored using the B-Tracker,* a multiaxial electrogoniometer specifically designed to measure angular displacement of the spine. Trunk extensor endurance training reduced pain and improved function at 3 weeks but resulted in no improvement at 6 weeks when compared with the control group. The ease of coping with the exercise was assessed using a categorical scale. . They were asked to stop if their response was scale grade 4 or 5. , Twomey LT. Indahl Oxford University Press is a department of the University of Oxford. Although subjects in the experimental group attended the exercise program under the supervision of the researcher 3 times a week, subjects in the control group were not given the same amount of contact time. Because the effectiveness of endurance training of the trunk extensors was demonstrated, we suggest that future studies should evaluate the effectiveness of a program incorporating early muscle reconditioning for 3 weeks, followed by task-specific training and workplace integration. Arch Phys Med Rehabil. All subjects were informed of the protection of their rights and gave written informed consent. Teske , Nordin M, Kahanovitz N, Frankel V. Plum However, female athletes had significantly lower holding times on the side bridge endurance tests than their male counterparts. Effects of Lumbar Strengthening Exercise in Lower-Limb Amputees With Chronic Low Back Pain. This test may Endurance of trunk muscles in persons with chronic low back pain: assessment, performance, training. , Moritz U, Andersson M. Jorgensen Co Instructions 1. Evidence suggests that muscle endurance is lower for people with low back pain than for individuals without low back pain.5–7 Using the Sorensen Test as a measure of spinal extensor endurance, some researchers5–7 have found a difference in holding time between subjects with chronic low back pain (CLBP) and individuals without low back pain.5–7 These findings seem to suggest that poor trunk extensor endurance is associated with prolonged or recurrent back pain. 2007 Dec;87(12):1608-18; discussion 1577-9. doi: 10.2522/ptj.20060297. Karlsson M, Bergenheim A, Larsson MEH, Nordeman L, van Tulder M, Bernhardsson S. Syst Rev. The cervical spine should be held in neutral or flexion throughout the test (extension is not permitted). , Inskip H, Meade TW, et al. Electromyographic frequency spectrum signals usually return to normal after subjects have rested for 5 minutes.31 The 10- to 15-minute rest period, therefore, should have provided adequate rest before the retest. trunk muscle endurance tests in low back pain. As the pain scores decreased, the RMDQ scores also decreased. Trunk extensor-to-flexor muscles imbalances are major contributors to the etiology of back pain (Moffroid, 1997). A post hoc test demonstrated no differences between groups, and the improvement made in both groups was not statistically significant. Pain and disability scores did not assume normality using the Lilliefors modification of the Kolmogorov-Smirnov test (N=54). Test-retest reliability for the Sorensen Test was demonstrated by an intraclass correlation coefficient (3,1) of .84 for subjects who were pain-free, using 6 degrees over 6 seconds as the termination criteria.28 We believe this value is sufficiently reliable. DG Error bar represents range (sig=significant at P<.05, ns=not significant at P<.05; Mann-Whitney U test). They were advised to telephone the researcher (BC) if there were any problems during this period. There were differences between the 2 groups at 3 weeks in regard to pain intensity during the evaluation session and pain experienced over the preceding 24 hours, the total MPQ PRI, the sensory component of the MPQ PRI, and the RMDQ. , Delitto A, Cibulka MT. Decrease in the endurance of postural muscles has been associated with postural defects and deformities (Mbada et al, 2010). E Ten repetitions of back extensor stretches were performed before and after the endurance exercise program. Gains in endurance of the back extensors following training have been shown to occur in subjects without low back pain.18,19 Muscle endurance was measured by the Sorensen Test19 and the time taken for the peak torque to decrease to 50% of its original value as measured by a dynamometer.18 Moffroid et al14 found 22% improvement in muscle endurance performance of the trunk extensors using the Sorensen Test after a 6-week exercise program for women without low back pain. Differences in sensory Pain Rating Index (PRI) scores between the experimental and control groups. . develop normative sex- and athlete-specific percentiles for a trunk stabilization and muscular endurance by using a prone forearm plank test in college-aged students. [4,5] J Manipulative Physiol Ther. Subjects were instructed to read the back care booklet provided by the physical therapy department. 3,4 Individuals with low back pain have significantly lower hold times than those without low back pain. Moffroid Your comment will be reviewed and published at the journal's discretion. More than 80% of the subjects with CLBP had symptoms of more than 5 years' duration. E Each exercise was repeated 9 times. , Nicolaisen T. Marras Other studies have supported these findings regarding trunk extensor mus-cular endurance and LBP in the adult population (Jorgenson & Nicolaisen, 1987; Latimer, Maher, Refshauge, & The aim of this study was to evaluate the effectiveness of trunk extensor endurance training in reducing pain and decreasing disability in subjects with subacute low back pain (ie, onset of back pain within 7 days to 7 weeks). National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Error bar represents range (sig=significant at P<.05, ns=not significant at P<.05; Mann-Whitney U test). A Haigh NIH 345–6). Error bar represents range (sig=significant at P<.05, ns=not significant at P<.05; Mann-Whitney U test). A record was kept by the physical therapist. If the pain diminished within 5 minutes after the exercise, they were asked to continue the exercise but to hold the exercise position for only 5 seconds. 2 • The Sorensen test has been validated as a differential diagnostic test for low back pain. Muscle endurance of the trunk extensor was measured using the Sørensen test. They were given postural and back care advice and the back care booklet, as described for the experimental group. 164 ± 51 s, range 59–320 s. For the right and left side bridge endurance tests, holding times were, respectively, 105 ± 44 s, range 35–259 s, and 103 ± 41 s, range 34–238 s (Table 5). CE 9)This is a timed test involving a static, isometric contraction of the trunk that stabilize the spine. In the study by Moffroid et al,14 subjects without low back pain exercised for 2 sessions a day. Spitzer Our findings further support those of Deyo et al.53. The Roland-Morris Disability Questionnaire (RMDQ) was used to measure disability, and the Sorensen Test was used to measure trunk extensor endurance. Lilliefors modification of the Kolmogorov-Smirnov test demonstrated that data obtained from the Sorensen Test assumed normality. The Sorensen Test measures the trunk extensors' capability of sustaining an antigravity position over time. Only: randomized controlled trial of patients with long-term mechanical low-back pain: a systematic review and.! Years ' duration and 6 weeks after entry into the program professionals or practicing. N, Anderson DE, Bean JF extensor strength, flexibility and endurance were also given the... Supported by the authors and consisted of 5 exercises directed at improving trunk extensor strength flexibility! 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