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A quantitative investigation into the effectiveness of a 2x2, crossover, randomized control trial, for individuals suffering from non-specific chronic lower back pain, using a physical exercise-focused clinical intervention on the transverse abdominus/ multifidus (stability) and rectus abdominals/ erector spinae (dynamic) muscles.
Abstract
A plethora of research has been conducted on interventions to reduce non-specific
lower back pain and improve the quality of life of sufferers. However, there is a lack of
distinction on the complementary nature of these interventions. Our primary research goal
was to assess the effectiveness of stability- and dynamic-style clinical interventions, focusing
on exercises to strengthen specific trunk muscles, including the transverse
abdominis/multifidus (stability-AB), and rectus abdominis/ erector spinae (dynamic). We
aimed to determine the effectiveness of these interventions in reducing non-specific chronic
lower back pain. Our research questions focused on whether a two-part clinical intervention
targeting specific core muscle groups (dynamic or stability) improves pain outcomes, whether
exercises targeting specific core muscle groups improve disability index physical impairment
and overall low back pain rating scale scores, and if there is a difference between intervention
groups and the sequential order of intervention for these outcomes. Additionally, we wanted
to investigate the correlation between these outcome measures and trunk endurance strength
scores. Seven participants were randomly assigned to either the stability (N =4) or dynamic
(N = 3) exercise group. Outcome measures included back and leg pain, lower back pain
visual analogue scale scores, disability index, physical impairment, and total Low Back Pain
Rating Scale (LBPRS) scores. Four measures of trunk endurance strength were taken using
Mcgill's Torso Endurance Test Battery (MTETB), which involves trunk extension, trunk
flexor, and trunk lateral tests on both the left and right sides. Assessments were performed
before the first clinical intervention, after the first intervention, and after the completion of
the final intervention. Each intervention phase lasted 4 weeks for each participant before they
switched to the opposing exercise group. The scores of back and leg pain, lower back pain,
disability index, and physical impairment all improved significantly after both interventions.
We found no difference between the groups during these intervention phases, or any potential
crossover/sequential effect, except for the dynamic group showing a significant improvement
in physical impairment scores after the first intervention, which remained consistent between
interventions one and two. In conclusion, both exercise approaches were similar across all
our outcome measures and may serve as complementary interventions for individuals
suffering from non-specific chronic low back pain.
Type
Thesis
Type of thesis
Series
Citation
Date
2024
Publisher
The University of Waikato
Supervisors
Rights
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