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The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial.

ABSTRACT: BACKGROUND:Various exercises have been proposed to mitigate chronic low back pain (LBP). However, to date, no one particular exercise has been shown to be superior. Hence, the aim of this study was to compare the efficiency between 2 exercises: the individualized graded lumbar stabilization exercise (IGLSE) and walking exercise (WE). METHODS:A randomized controlled trial was conducted in 48 participants with chronic LBP. After screening, participants were randomized to 1 of 4 groups: flexibility exercise, WE, stabilization exercise (SE), and stabilization with WE (SWE) groups. Participants underwent each exercise for 6 weeks. The primary outcome was visual analog scale (VAS) of LBP during rest and physical activity. Secondary outcomes were as follows: VAS of radiating pain measured during rest and physical activity; frequency of medication use (number of times/day); Oswestry disability index; Beck depression inventory; endurances of specific posture; and strength of lumbar extensor muscles. RESULTS:LBP during physical activity was significantly decreased in all 4 groups. Exercise frequency was significantly increased in the SE and WE groups; exercise time was significantly increased in the SE group. The endurance of supine, side lying, and prone posture were significantly improved in the WE and SWE groups. CONCLUSIONS:Lumbar SE and WE can be recommended for patients with chronic LBP because they not only relieve back pain but also prevent chronic back pain through improving muscle endurance.

SUBMITTER: Suh JH

PROVIDER: S-EPMC6616307 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial.

Suh Jee Hyun JH Kim Hayoung H Jung Gwang Pyo GP Ko Jin Young JY Ryu Ju Seok JS

Medicine 20190601 26

<h4>Background</h4>Various exercises have been proposed to mitigate chronic low back pain (LBP). However, to date, no one particular exercise has been shown to be superior. Hence, the aim of this study was to compare the efficiency between 2 exercises: the individualized graded lumbar stabilization exercise (IGLSE) and walking exercise (WE).<h4>Methods</h4>A randomized controlled trial was conducted in 48 participants with chronic LBP. After screening, participants were randomized to 1 of 4 grou ...[more]

PMID: 31261549

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Project description:Low Back Pain is a major public health problem all over the western world. Active approaches including exercise in the treatment of low back pain results in better outcomes for patients, but it is not known exactly which types of back exercises are most beneficial or whether general physical activity provide similar benefits. Nordic Walking is a popular and fast growing type of exercise in Northern Europe. Initial studies have demonstrated that persons performing Nordic Walking are able to exercise longer and harder compared to normal walking thereby increasing their cardiovascular metabolism. Until now no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to low back pain. The primary aim of this study is to investigate whether supervised Nordic Walking can reduce pain and improve function in a population of chronic low back pain patients when compared to unsupervised Nordic Walking and advice to stay active. In addition we investigate whether there is an increase in the cardiovascular metabolism in persons performing supervised Nordic Walking compared to persons who are advised to stay active. Finally, we investigate whether there is a difference in compliance between persons receiving supervised Nordic Walking and persons doing unsupervised Nordic Walking.One hundred and fifty patients with low back pain for at least eight weeks and referred to a specialized secondary sector outpatient back pain clinic are included in the study. After completion of the standard back centre treatment patients are randomized into one of three groups: A) Nordic Walking twice a week for eight weeks under supervision of a specially trained instructor; B) Unsupervised Nordic Walking for eight weeks after one training session with an instructor; C) A one hour motivational talk including advice to stay active. Outcome measures are pain, function, overall health, cardiovascular ability and activity level.No results available at this point.This study will investigate the effect of Nordic Walking on pain and function in a population of people with chronic LBP.

Project description:BackgroundWalking is an easily prescribed physical activity for people with low back pain (LBP). However, the evidence for its effectiveness to improve pain and disability levels for people with chronic low back pain (CLBP) within a community setting has not been evaluated. This study evaluates the effectiveness of a clinician guided, pedometer-driven, walking intervention for increasing physical activity and improving clinical outcomes compared to education and advice.MethodsRandomized controlled trial recruiting N = 174 adults with CLBP. Participants were randomly allocated into either a standardized care group (SG) or pedometer based walking group (WG) using minimization allocation with a 2:1 ratio to the WG. Prior to randomization all participants were given a standard package of education and advice regarding self-management and the benefits of staying active. Following randomization the WG undertook a physiotherapist guided pedometer-driven walking program for 12 weeks. This was individually tailored by weekly negotiation of daily step targets. Main outcome was the Oswestry Disability Index (ODI) recorded at baseline, 12 weeks, 6 and 12 months. Other outcomes included, numeric pain rating, International Physical Activity Questionnaire (IPAQ), Fear-Avoidance Beliefs Questionnaire (FABQ), Back Beliefs questionnaire (BBQ), Physical Activity Self-efficacy Scale, and EQ-5D-5L quality of life estimate.ResultsN = 138 (79%) participants completed all outcome measures at 12 weeks reducing to N = 96 (55%) at 12 months. Both observed and intention to treat analysis did not show any statistically significant difference in ODI change score between the WG and the SG at all post-intervention time points. There were also no significant between group differences for change scores in all secondary outcome measures. Post hoc sensitivity analyses revealed moderately disabled participants (baseline ODI ≥ 21.0) demonstrated a greater reduction in mean ODI scores at 12 months in the WG compared to SG, while WG participants with a daily baseline step count < 7500 steps demonstrated a greater reduction in mean ODI scores at 12 weeks.ConclusionsOverall, we found no significant difference in change of levels of (ODI) disability between the SG and WG following the walking intervention. However, ODI responses to a walking program for those with moderate levels of baseline disability and those with low baseline step count offer a potential future focus for continued research into the benefit of walking as a management strategy for chronic LBP.Trial registrationUnited States National Institutes of Health Clinical Trails registry (http://ClinicalTrials.gov/) No. NCT02284958 (27/10/2014).

Dataset Information

The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial.

Publications

The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial.

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