اثر آزمایشات کنترل حرکتی بر حس عمقی و کنترل حرکت کمر در بیماران کمردردی مبتلا به اختلال کنترل حرکت

نوع مقاله : مقاله پژوهشی

نویسنده

گروه آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکده علوم انسانی، دانشگاه آزاد اسلامی، واحد ساری، ساری، ایران.

چکیده

اهداف: بیماران مبتلا به کمردرد غیراختصاصی مزمن دچار اختلال در حس عمقی و کنترل حرکت کمر هستند و این اختلالات با میزان درد این بیماران ارتباط دارد. هدف از مطالعه حاضر، بررسی تأثیر آزمایشات کنترل حرکتی بر حس عمقی و کنترل حرکات کمر بیماران مبتلا به کمردرد غیراختصاصی مزمن است.
مواد و روش‌ها: 48 بیمار مبتلا به کمردرد مکانیکی با استفاده از پرسش‌نامه اوسوستوری انتخاب شدند و به ‌طور تصادفی به دو گروه آزمایشات کنترل حرکت (25 نفر) و گروه کنترل (23 نفر) تقسیم شدند؛ گروه آزمایشی هشت هفته آزمایش تعیین‌شده را انجام داد و گروه کنترل هیچ آزمایشی انجام نداد. برای سنجش حس عمقی و کنترل حرکت کمر بیماران به ‌ترتیب از گونیامتر و آزمون کنترل حرکت لوماجوگی استفاده شد. برای مقایسه درون‌گروهی بین متغیرها از آزمون تی زوجی و برای مقایسه بین‌گروهی متغیرها از آزمون تی مستقل استفاده شد (0/05≥P).
یافته‌ها: نتایج تحقیق نشان داد که تفاوت معناداری بین پیش‌آزمون و پس‌آزمون گروه آزمایشی در مقایسه با گروه کنترل در متغیر حس عمقی و کنترل حرکت کمر وجود دارد و بین دو گروه تفاوت معناداری مشاهده شد.
نتیجه‌گیری: آزمایشات کنترل حرکت بر افزایش حس عمقی و کنترل حرکت کمر بیماران مبتلا به کمردرد غیراختصاصی مزمن تأثیر داشته و آزمایشات کنترل حرکت می‌تواند بر درمان کمردرد مزمن غیراختصاصی اثرگذار باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Effect of Motor Control Exercise on Proprioception and Lumbar Motor Control of Women With Chronic Nonspecific Low Back Pain and Motor Control Impairment

نویسنده [English]

  • Seyyedeh Yasaman Asadi
Department of Sport Jnjury and Corrective Exercise, Faculty of Human Science, Sari Branch, Islamic Azad University, Sari, Iran.
چکیده [English]

Background and Aims: Patients with Non-Specific Low Back Pain (NSLBP) experience impairment in proprioception and lumbar motor control which are associated with pain. This study aims to evaluate the effect of motor control exercise on proprioception and lumbar motor control of women with chronic NSLBP and motor control impairment.
Methods: Participants were 48 women with chronic NSLBP who were selected based on the Oswestry Disability Index score. They were randomly assigned into two groups of exercise (n=25) and control (n=23). The exercise group performed 8 weeks of motor control exercises, while the control group did not perform any exercises. To assess proprioception and lumbar motor control of patients, goniometer and Luomajoki’s motor control test were used, respectively. Paired t-test was used for within-group comparison of pre-test and post-test scores, and independent t-test was used for between-group comparison. The significance level was set at 0.05.
Results: There was a significant difference between the pre-test and post-test scores in the exercise group compared to the control group in the variables of proprioception and lumbar motor control. Significant difference was also found between the two groups.
Conclusion: Motor control exercise is effective for the treatment of NSLBP in women by improving their proprioception and lumbar motor control.

کلیدواژه‌ها [English]

  • Motor control exercise
  • Proprioception
  • Lumbar motor control

مراجع

  1. O’Sullivan P. Diagnosis and classification of chronic low back pain disorders: Maladaptive movement and motor control impairments as underlying mechanism. Manual Therapy. 2005; 10(4):242-55. [DOI:10.1016/j.math.2005.07.001] [PMID]
  2. Braga AB, Rodrigues AC, de Lima GV, de Melo LR, de Carvalho AR, Bertolini GR. Comparison of static postural balance between healthy subjects and those with low back pain. Acta Ortopedica Brasileira. 2012; 20(4):210-2. [DOI:10.1590/S1413-78522012000400003] [PMID] [PMCID]
  3. Madigan ML, Davidson BS, Nussbaum MA. Postural sway and joint kinematics during quiet standing are affected by lumbar extensor fatigue. Human Movement Science. 2006; 25(6):788-99. [DOI:10.1016/j.humov.2006.04.004] [PMID]
  4. Mientjes M, Frank J. Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing. Clinical Biomechanics (Bristol, Avon). 1999; 14(10):710-6. https://pubmed.ncbi.nlm.nih.gov/10545625/
  5. Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Journal of Spinal Disorders. 1998; 11(1):46-56. [DOI:10.1097/00002517-199802000-00008] [PMID]
  6. Silfies SP, Squillante D, Maurer P, Westcott S, Karduna AR. Trunk muscle recruitment patterns in specific chronic low back pain populations. Clinical Biomechanics (Bristol, Avon). 2005; 20(5):465-73. [DOI:10.1016/j.clinbiomech.2005.01.007] [PMID]
  7. Descarreaux M, Blouin JS, Teasdale N. Force production parameters in patients with low back pain and healthy control study participants. Spine. 2004; 29(3):311-7. [DOI:10.1097/01.BRS.0000105983.19980.A8] [PMID]
  8. Costa LO, Maher CG, Latimer J, Hodges PW, Herbert RD, Refshauge KM, et al. Motor control exercise for chronic low back pain: A randomized placebo-controlled trial. Physical Therapy. 2009; 89(12):1275-86. [DOI:10.2522/ptj.20090218] [PMID]
  9. Barker KL, Dawes H, Hansford P, Shamley D. Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool. Archives of Physical Medicine and Rehabilitation. 2003; 84(9):1319-23. [DOI:10.1016/S0003-9993(03)00266-1]
  10. Brumagne S, Cordo P, Verschueren S. Proprioceptive weighting changes in persons with low back pain and elderly persons during upright standing. Neuroscience Letters. 2004; 366(1):63-6. [DOI:10.1016/j.neulet.2004.05.013] [PMID]
  11. Wand BM, O’Connell NE, Di Pietro F, Bulsara M. Managing chronic nonspecific low back pain with a sensorimotor retraining approach: Exploratory multiple-baseline study of 3 participants. Physical Therapy. 2011; 91(4):535-46. [DOI:10.2522/ptj.20100150] [PMID]
  12. Strauss-Blasche G, Ekmekcioglu C, Vacariu G, Melchart H, Fialka-Moser V, Marktl W. Contribution of individual spa therapies in the treatment of chronic pain. The Clinical Journal of Pain. 2002; 18(5):302-9. [DOI:10.1097/00002508-200209000-00005] [PMID]
  13. Larivière C, Gagnon DH, Mecheri H. Trunk postural control in unstable sitting: Effect of sex and low back pain status. Clinical Biomechanics (Bristol, Avon). 2015; 30(9):933-9. [DOI:10.1016/j.clinbiomech.2015.07.006] [PMID]
  14. Wenig CM, Schmidt CO, Kohlmann T, Schweikert B. Costs of back pain in Germany. European Journal of Pain. 2009; 13(3):280-6. [DOI:10.1016/j.ejpain.2008.04.005] [PMID]
  15. Nazarzadeh Bozorgi M, Letafatkar A, Sabounchi R, Sobhan Manesh A, Rafieefar A. [The effect of sensory-motor exercise program on motion control and pain score in patients with non-specific chronic low back pain (Persian)]. Koomesh. 2015; 16(4):563-74. https://koomeshjournal.semums.ac.ir/article-1-2434-fa.html
  16. Burnett AF, Cornelius MW, Dankaerts W, O’Sullivan PB. Spinal kinematics and trunk muscle activity in cyclists: A comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation. Manual Therapy. 2004; 9(4):211-9. [DOI:10.1016/j.math.2004.06.002] [PMID]
  17. Louw A, Farrell K, Wettach L, Uhl J, Majkowski K, Welding M. Immediate effects of sensory discrimination for chronic low back pain: A case series. New Zealand Journal of Physiotherapy. 2015; 43(2):58-63. [DOI:10.15619/NZJP/43.2.06]
  18. Wand BM, Catley MJ, Luomajoki HA, O’Sullivan KJ, Di Pietro F, O’Connell NE, et al. Lumbar tactile acuity is near identical between sides in healthy pain-free participants. Manual Therapy. 2014; 19(5):504-7. [DOI:10.1016/j.math.2014.01.002] [PMID]
  19. Wand BM, Abbaszadeh S, Smith AJ, Catley MJ, Moseley GL. Acupuncture applied as a sensory discrimination training tool decreases movement-related pain in patients with chronic low back pain more than acupuncture alone: A randomised cross-over experiment. British Journal of Sports Medicine. 2013; 47(17):1085-9. [DOI:10.1136/bjsports-2013-092949] [PMID]
  20. Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, et al. Neck pain: Clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American physical therapy association. Journal of Orthopaedic and Sports Physical Therapy. 2008; 38(9):1-34. [DOI:10.2519/jospt.2008.0303] [PMID]
  21. Dankaerts W, O’sullivan P, Burnett A, Straker L. The use of a mechanism-based classification system to evaluate and direct management of a patient with non-specific chronic low back pain and motor control impairment: A case report. Manual Therapy. 2007; 12(2):181-91. [DOI:10.1016/j.math.2006.05.004] [PMID]
  22. Hirata RP, Salomoni SE, Christensen SW, Graven-Nielsen T. Reorganised motor control strategies of trunk muscles due to acute low back pain. Amsterdam: Elsevier Human Movement Science; 2015. [DOI:10.1016/j.humov.2015.04.001] [PMID]
  23. Niam S, Cheung W, Sullivan PE, Kent S, Gu X. Balance and physical impairments after stroke. Archives of Physical Medicine and Rehabilitation. 1999; 80(10):1227-33. [DOI:10.1016/S0003-9993(99)90020-5]
  24. Newcomer KL, Laskowski ER, Yu B, Johnson JC, An K-N. Differences in repositioning error among patients with low back pain compared with control subjects. Spine. 2000; 25(19):2488-93. [DOI:10.1097/00007632-200010010-00011] [PMID]
  25. Musavi S, Faeizipour H, Talebian S. [Investigating the changes of the motion process to the positional responses of trunk muscles in healthy people and patients with low back pain (Persian)]. Journal of Medical Sciences. 2003; 61(4):326-37. https://www.sid.ir/fa/Journal/ViewPaper.aspx?ID=2512
  26. Baena-Beato PA, Arroyo-Morales M, Delgado-Fernêndez M, Gatto-Cardia MC, Artero EG. Effects of different frequencies (2-3 days/week) of aquatic therapy program in adults with chronic low back pain: A non-randomized comparison trial. Pain Medicine. 2013; 14(1):145-58. [DOI:10.1111/pme.12002] [PMID]
  27. Cuesta-Vargas AI, García-Romero JC, Arroyo-Morales M, Diego-Acosta ÁM, Daly DJ. Exercise, manual therapy, and education with or without high-intensity deep-water running for nonspecific chronic low back pain: A pragmatic randomized controlled trial. American Journal of Physical Medicine and Rehabilitation. 2011; 90(7):526-34. [DOI:10.1097/PHM.0b013e31821a71d0] [PMID]
  28. Gibson J, McCarron T. Feedforward muscle activity: An investigation into the onset and activity of internal oblique during two functional reaching tasks. Journal of Bodywork and Movement Therapies. 2004; 8(2):104-13. https://www.sciencedirect.com/science/article/abs/pii/S1360859203001025
  29. Han SK, Kim MC, An CS. Comparison of effects of a proprioceptive exercise program in water and on land the balance of chronic stroke patients. Journal of Physical Therapy Science. 2013; 25(10):1219-22. [DOI:10.1589/jpts.25.1219] [PMID] [PMCID]
  30. Svedenhag J, Seger J. Running on land and in water: Comparative exercise physiology. Medicine and Science in Sports and Exercise. 1992; 24(10):1155-60. [DOI:10.1249/00005768-199210000-00014] [PMID]
  31. Kool JP, Oesch PR, Bachmann S, Knuesel O, Dierkes JG, Russo M, et al. Increasing days at work using function-centered rehabilitation in nonacute nonspecific low back pain: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2005; 86(5):857-64. [DOI:10.1016/j.apmr.2004.10.044] [PMID]
  32. Hayden J, Van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. The Cochrane Database of Systematic Reviews. 2005; 20(3):CD000335. [DOI:10.1002/14651858.CD000335.pub2] [PMID]
  33. Rackwitz B, de Bie R, Limm H, von Garnier K, Ewert T, Stucki G. Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials. Clinical Rehabilitation. 2006; 20(7):553-67. [DOI:10.1191/0269215506cr977oa] [PMID]
  34. Hodges PW. Pain and motor control: From the laboratory to rehabilitation. Journal of Electromyography and Kinesiology. 2011; 21(2):220-8. [DOI:10.1016/j.jelekin.2011.01.002] [PMID]
  35. Farahpour N, Moroori Isfahani M. [Investigating the importance of muscular endurance and anthropometric features as warning factors in chronic low back pain and the need for continuing exercise after pain relieved (Persian)]. Harkat. 2003; 18:5-23. https://www.sid.ir/fa/Journal/ViewPaper.aspx?ID=1769
  36. O’Sullivan PB. Masterclass. Lumbar segmental ‘instability’: clinical presentation and specific stabilizing exercise management. Manual Therapy. 2000; 5(1):2-12. [DOI:10.1054/math.1999.0213] [PMID]
  37. Liddle SD, Baxter GD, Gracey JH. Chronic low back pain: Patients’ experiences, opinions and expectations for clinical management. Disability and Rehabilitation. 2007; 29(24):1899-909. [DOI:10.1080/09638280701189895] [PMID]
  38. Seltzer SF, Seltzer JL. Tactual sensitivity of chronic pain patients to non-painful stimuli. Pain. 1986; 27(3):291-5. [DOI:10.1016/0304-3959(86)90156-9]
دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 10، شماره 2
خرداد و تیر 1400
صفحه 294-305

فایل ها

سابقه مقاله

  • تاریخ دریافت: 18 خرداد 1399
  • تاریخ بازنگری: 24 خرداد 1399
  • تاریخ پذیرش: 03 تیر 1399
  • تاریخ اولین انتشار: 01 خرداد 1400

هم رسانی

ارجاع به این مقاله

آمار