اثر تمرینات ثبات مرکزی و طب سوزنی بر درد و ناتوانی عملکردی در زنان میانسال مبتلا به کمردرد مزمن غیراختصاصی

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناس فیزیوتراپی و کارشناسی ارشد آسیب شناسی ورزشی و حرکات اصلاحی، گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، کرج، ایران

2 استادیار آسیب شناسی ورزشی و حرکات اصلاحی، گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، کرج، ایران

3 استادیار آسیب‌شناسی ورزشی و حرکات اصلاحی، گروه آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، کرج، ایران

چکیده

مقدمه و اهداف
هدف تحقیق حاضر مقایسه اثربخشی هشت هفته تمرینات ثبات مرکزی و طب سوزنی بر برخی شاخص­های کمردرد مزمن غیر اختصاصی زنان میانسال بود.
مواد و روش­ ها
در مطالعه نیمه­ تجربی حاضر 45 زن میانسال مبتلا به کمردرد مزمن غیراختصاصی به عنوان آزمودنی شرکت داشتند که به صورت تصادفی به سه گروه مساوی کنترل، طب سوزنی و تمرین ثبات مرکزی (هر گروه 15 نفر) تقسیم شدند. قبل و بعد از اعمال هشت هفته مداخله، درد و ناتوانی عملکردی به ترتیب با استفاده از مقیاس عینی درد و پرسش­نامه کبک اندازه­گیری شد. با استفاده از آزمون آماری آنووا و تی زوجی به ترتیب نتایج بین گروهی و درون­گروهی تحلیل گردید.
یافته ­ها
نتایج تحقیق حاضر نشان داد در هر دو گره طب سوزنی و تمرینات ثبات مرکزی شدت درد و ناتوانی به طور معناداری کاهش یافت (05/0>p). با این حال تفاوت معناداری بین دو مداخله در پس­آزمون مشاهده نشد (05/0<p).
نتیجه­ گیری
با توجه به نتایج تحقیق حاضر به نظر می­رسد هر دو مداخله طب سوزنی و تمرینات ثبات مرکزی می­تواند موجب کاهش شدت درد و ناتوانی عملکردی در زنان مبتلا به کمردرد مزمن غیراختصاصی شود. با این حال هنوز نمی­توان در مورد برتری یکی از آن دو اظهار نظر کرد و همچنان به مطالعات بیشتری در این زمینه نیاز است.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effect of Eight Weeks of Core Stability and Acupuncture on Pain and Disability in Middle Age Females with Non-Specific Chronic Low Back Pain

نویسندگان [English]

  • Zahra Bagheri 1
  • Mohammad Hosein Nasermelli 2
  • Behnaz Ganji Namin 3
1 BSc of Physiotherapy, Master of Science in Sport Injuries and Corrective Exercises, Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Azad University of Karaj, Karaj, Iran
2 Assistant Professor of Sport Injuries and Corrective Exercises, Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Azad University of Karaj, Karaj, Iran
3 Assistant Professor of Sport Injuries and Corrective Exercises, Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Azad University of Karaj, Karaj, Iran
چکیده [English]

Background and Aims: The present study was conducted to compare the effectiveness of eight weeks of core stability and acupuncture on pain and disability in middle age females with non-specific chronic low back pain.
Materials and Methods: A total of 45 females with non-specific chronic low back pain participated in the current semi-experimental study and were randomly divided into three groups: acupuncture, core stability training, and control. Before and after the intervention, visual analogue scale and the QUEBEC disability index were used to assess pain intensity and disability, respectively. The differences between and within groups were analyze running ANOVA and pair t-test, respectively.
Results: The results showed that the disability and intensity pain decreased significantly in the acupuncture and stability training groups [P≤0.05], yet no significant difference was found between the two interventions in the post-test [P≥0.05].
Conclusion: According to the results, it seems that both acupuncture and core stability training can decrease pain and functional disability intensity in females with non-specific chronic low back pain. However, still, we cannot claim on the superiority of one of them, and thus further studies are needed.

کلیدواژه‌ها [English]

  • Non-specific Chronic Low Back Pain
  • Functional Disability
  • acupuncture
  • Core stability training
1. Esfandiari E, Masoumi M, Yavari A, Saeedi H, Allami M. Efficacy of Long-Term Outcomes and Prosthesis Satisfaction in War Related Above Knee Amputees Of Tehran In 1387. 2011. [In Persian]##

2. 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. 2011. [In Persian] ##

3. Zadro J, Shirley D, Sanchez-Romera J, Ordoñana J, Ferreira P. Does Familial Aggregation of Chronic Low Back Pain Impact on Recovery? A Population-Based Twin Study. Spine. 2017. ##

4. Yiengprugsawan V, Hoy D, Buchbinder R, Bain C, Seubsman S-a, Sleigh AC. Low back pain and limitations of daily living in Asia: longitudinal findings in the Thai cohort study. BMC Musculoskeletal Disorders. 2017;18(1):19. ##

5. Rittweger J, Just K, Kautzsch K, Reeg P, Felsenberg D. Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: a randomized controlled trial. Spine. 2002;27(17):1829-34. ##

6. Swinkels IC, van den Ende CH, van den Bosch W, Dekker J, Wimmers RH. Physiotherapy management of low back pain: does practice match the Dutch guidelines? Australian Journal of Physiotherapy. 2005;51(1):35-41. ##

7. Yang Q, Wang Z, Yang L, Xu Y, Chen LM. Cortical thickness and functional connectivity abnormality in chronic headache and low back pain patients. Human Brain Mapping. 2017. ##

8. Hemmati S, Rajabi R, Karimi N. Effects of consecutive supervised core stability training on pain and disability in women with nonspecific chronic low back pain. Koomesh. 2011;12(3):244-52. [In Persian] ##

9. Lalit H, Moitra M, Goyal M. Trunk Balance is Important to an Exercise Routine in Patients with Specific Low Back Pain. Indian Journal of Physiotherapy and Occupational Therapy. 2014;8(3):91. ##

10. Cairns MC, Foster NE, Wright C. Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine. 2006;31(19):E670-E81. ##

11. Stanković A, Lazović M, Kocić M, Zlatanović D. Spinal segmental stabilization exercises combined with traditional strengthening exercise program in patients with chronic low back pain. Acta Facultatis Medicae Naissensis. 2008;25(3):165-70. ##

12. Yuan J, Purepong N, Hunter RF, Kerr DP, Park J, Bradbury I, et al. Different frequencies of acupuncture treatment for chronic low back pain: an assessor-blinded pilot randomised controlled trial. Complementary Therapies in Medicine. 2009;17(3):131-40. ##

13. Ernst E. Acupuncture ineffective, attention effective? Archives of internal medicine. 2008;168(5):551##-

14. Froud R, Patterson S, Eldridge S, Seale C, Pincus T, Rajendran D, et al. A systematic review and meta-synthesis of the impact of low back pain on people’s lives. BMC musculoskeletal disorders. 2014;15(1):50. ##

15. Carlsson CP, Sjölund BH. Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. The Clinical journal of pain. 2001;17(4):296-305. ##

16. Ilbeigi S, Nikbin L, Afzalpour ME. The effect of six weeks of core stability exercise on pain and trunk muscle endurance in girl students with chronic non-specific low back pain. Journal of Health Chimes| Torbat Heydariyeh University of Medical Sciences. 2014;2(2):5-13. ##

17. Ebrahimi H, Blaouchi R, Eslami R, Shahrokhi M. Effect of 8-week core stabilization exercises on low back pain, abdominal and back muscle endurance in patients with chronic low back pain due to disc herniation. Physical Treatments-Specific Physical Therapy Journal. 2014;4(1):25-32. ##

18. Nezhad Roomezi S, Rahnama N, Habibi A, Negahban H. The effect of core stability training on pain and performance in women patients with non-specific chronic low back pain. J Res Rehabil Sci. 2012;8(1):57-64. [In Persian] ##

19. Hedayati R, Kahrizi S, Parnianpoor M, Bahrami F, KazemNejad A, Mobeyni B. Timing variability Options predictive of stability training program in patients with recurrent non-specific low back pain. MedSciJModdares2010.13(2):51-61. [In Persian] ##

20. Karimi N, Ezzati K, Rahgozar M, Zarvar M, Esmaeli K. The satisfaction from stabilization exercises in patients with chronic mechanical non-specific low back pain. J HamedanUni Med Sci. 2009;16(2):39-44. ##

21. Cho H-y, Kim E-h, Kim J. 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. 2014;26(8):1237-40. ##

22. Shamsi MB, Sarrafzadeh J, Jamshidi A. Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests. Physiotherapy theory and practice. 2015;31(2):89-98. ##

23. George SZ, Childs JD, Teyhen DS, Wu SS, Wright AC, Dugan JL, et al. Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009). BMC musculoskeletal disorders. 2007;8(1):92. ##

24. Wallwork TL, Stanton WR, Freke M, Hides JA. The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Manual therapy. 2009;14(5):496-500. ##

25. Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001;26(11):e243-e8. ##

26. Salvati M. The effects of disfunctions of postural stability control and effectiveness spine stability training in chronic low back pain patients: Dissertation). Tehran; 2002. [In Persian] ##

27. Tousignant-Laflamme Y, Laroche C, Beaulieu C, Bouchard A-J, Boucher S, Michaud-Létourneau M. A randomized trial to determine the duration of analgesia following a 15-and a 30-minute application of acupuncture-like TENS on patients with chronic low back pain. Physiotherapy Theory and Practice. 2017:1-9. ##

28. Chevalier A, Armstrong K, Gokal R. Microcurrent point stimulation applied to acupuncture points for the treatment of non-specific lower back pain. HSOA J Altern Complem Integr. 2016;2:016. ##

29. Glazov G, Yelland M, Emery J. Low-dose laser acupuncture for non-specific chronic low back pain: a double-blind randomised controlled trial. Acupuncture in Medicine. 2013:acupmed-2013-010456. ##

30. Liu Y-T, Chiu C-W, Chang C-F, Lee T-C, Chen C-Y, Chang S-C, et al. Efficacy and safety of acupuncture for acute low back pain in emergency department: a pilot cohort study. Evidence-Based Complementary and Alternative Medicine. 2015;2015. ##

31. Vas J, Aranda-Regules JM, Modesto M, Aguilar I, Barón-Crespo M, Ramos-Monserrat M, et al. Auricular acupuncture for primary care treatment of low back pain and posterior pelvic pain in pregnancy: study protocol for a multicentre randomised placebo-controlled trial. Trials. 2014;15(1):288. ##

32. MacPherson H, Vickers A, Bland JM, Torgerson DJ, Corbett MS, Spackman E, et al. Acupuncture for chronic pain and depression in primary care:: a programme of research. Programme Grants for Applied Research. 2017:1-342. ##

33. Elden H, Ladfors L, Olsen MF, Ostgaard H-C, Hagberg H. Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. Bmj. 2005;330(7494):761##.

34. Kizhakkeveettil A, Rose KA, Kadar GE, Hurwitz EL. Integrative Acupuncture and Spinal Manipulative Therapy Versus Either Alone for Low Back Pain: A Randomized Controlled Trial Feasibility Study. Journal of manipulative and physiological therapeutics. 2017;40(3):201-13. ##

35. Cherkin DC, Eisenberg D, Sherman KJ, Barlow W, Kaptchuk TJ, Street J, et al. Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Archives of Internal Medicine. 2001;161(8):1081-8. ##

36. Niemistö L, Rissanen P, Sarna S, Lahtinen-Suopanki T, Lindgren K-A, Hurri H. Cost-effectiveness of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain: a prospective randomized trial with 2-year follow-up. Spine. 2005;30(10):1109-15. ##

37. Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial. Pain. 2007;131(1):31-7. ##

38. Gudavalli MR, Cambron JA, McGregor M, Jedlicka J, Keenum M, Ghanayem AJ, et al. A randomized clinical trial and subgroup analysis to compare flexion–distraction with active exercise for chronic low back pain. European Spine Journal. 2006;15(7):1070-82. ##

39. Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers in surgery and medicine. 2003;32(3):233-8. ##

40. Shakeri A, Sokhangoei Y, Hoseini Y. Comparison among the Short-Term Effect of Massage Therapy, Central Stability Exercise and Combination Method on Limits of Stability in Patients with Chronic Non-Specific Low Back Pain. The Horizon of Medical Sciences. 2017;23(1):13-9. [In Persian] ##