Publication: Kronik mekanik bel ağrılı hastalarda lumbopelvik stabilizasyon egzersiz eğitiminin etkinliği
Abstract
Kronik bel ağrısı olguların büyük çoğunluğunda mekanik nedenlerden kaynaklanır. Son yıllarda bel bölgesindeki izole kas gruplarını güçlendirmeye yönelik programlardan çok kas kontrolunu artırmayı hedefleyen egzersiz programları tercih edilmektedir. Bu çalışmada mekanik nedenlere bağlı kronik bel ağrılı hastalarda lumbopelvik stabilizasyon egzersizleri ile konvansiyonel abdominal ve bel kaslarını kuvvetlendirici egzersizlerin etkinlikleri karşılaştırıldı. Kronik mekanik bel ağrılı 30 hasta çalışmaya alındı ve iki gruba randomize edildi. Çalışma grubundaki hastalar 8 hafta boyunca lumbopelvik stabilizasyon egzersizleri yaptılar. Kontrol grubu ise aynı süre boyunca abdominal ve bel kaslarına yönelik izometrik-izotonik egzersizleri içeren konvansiyonel bir program izledi. Her iki gruptaki hastalara aynı yüzeyel, derin ısı ve analjezik akım modaliteleri uygulandı. Klinik etkinlik değerlendirmeleri çalışma başında, 2, 4, 6 ve 8. haftalarda izometrik stabilite testi, görsel anolog skala (VAS), manuel kas testi, hareket açıklığı ölçümleri, Rolland-Morris fonksiyonel aktivite değerlendirme testi, Oswestry dizabilite değerlendirme testi ölçümleri ile yapıldı. Her iki grupta izometrik stabilite testi, hareket açıklığı ve manuel kas testinde anlamlı ilerleme kaydedildi, fakat gruplar arası farklılık istatistiksel olarak anlamlı değildi. Sekiz haftalık tedavi sonunda çalışma grubunun VAS, Oswestry ve Roland Morris skorları kontrol grubuna göre daha iyi bulundu. Her iki egzersiz yöntemi de kronik mekanik bel ağrılı hastalarda etkin idi. Fakat, lumbopelvik stabilizasyon egzersizleri ağrı ve fonksiyonel parametreler açısından daha yararlı bulundu.
Chronic low back pain is due to mechanical reasons in the majority of the cases. In recent years, exercise programs aimed to increase muscle control are preferred, rather than programs for strengthening isolated muscles around low back region. We investigated the efficacy of lumbopelvic stabilization exercises in comparison with conventional strengthening exercises of the abdominal and low-back muscles in patients with chronic mechanical low back pain. Thirty patients with chronic mechanical low back pain were enrolled and recruited into two groups. For 8 weeks, the first group received lumbopelvic stabilization exercise program, whereas the second group was given conventional program including isometric-isotonic exercises for abdominal and low back musculature. Both groups were given the same additional superficial, deep heat and analgesic electrotherapy modalities. Clinical efficacy was evaluated by assessing at the baseline, 2nd, 4th, 6th, and 8th weeks of treatment by isometric stability, visual analogue scale (VAS) for pain, manual muscle testing, range of motion measurements, Rolland-Morris Functional Activities Evaluation Test, and Oswestry Disability Evaluation Test. Both groups had significant improvements in themselves in relation to isometric stability test, range of motion, and manual muscle strength. However, the differences between the two groups were not significant. After 8 weeks of treatment, the first group had better VAS scores, Oswestry scores, and Rolland Morris functional evaluation scores than the 2nd group. Both exercises were found effective in the treatment of chronic low back pain. However, lumbopelvic stabilization exercises seemed to be more beneficial than standard strengthening exercises on pain reduction and functional parameters.
Chronic low back pain is due to mechanical reasons in the majority of the cases. In recent years, exercise programs aimed to increase muscle control are preferred, rather than programs for strengthening isolated muscles around low back region. We investigated the efficacy of lumbopelvic stabilization exercises in comparison with conventional strengthening exercises of the abdominal and low-back muscles in patients with chronic mechanical low back pain. Thirty patients with chronic mechanical low back pain were enrolled and recruited into two groups. For 8 weeks, the first group received lumbopelvic stabilization exercise program, whereas the second group was given conventional program including isometric-isotonic exercises for abdominal and low back musculature. Both groups were given the same additional superficial, deep heat and analgesic electrotherapy modalities. Clinical efficacy was evaluated by assessing at the baseline, 2nd, 4th, 6th, and 8th weeks of treatment by isometric stability, visual analogue scale (VAS) for pain, manual muscle testing, range of motion measurements, Rolland-Morris Functional Activities Evaluation Test, and Oswestry Disability Evaluation Test. Both groups had significant improvements in themselves in relation to isometric stability test, range of motion, and manual muscle strength. However, the differences between the two groups were not significant. After 8 weeks of treatment, the first group had better VAS scores, Oswestry scores, and Rolland Morris functional evaluation scores than the 2nd group. Both exercises were found effective in the treatment of chronic low back pain. However, lumbopelvic stabilization exercises seemed to be more beneficial than standard strengthening exercises on pain reduction and functional parameters.