Y. Alshehre1,2, K. Alkhathami3,2, K. Brizzolara2, M. Weber2, S. Wang-Price2
1University of Tabuk, Department of Physical Therapy, Tabuk, Saudi Arabia, 2Texas Woman’s University, School of Physical Therapy, Dallas, United States, 3Shaqra University, Department of Health Rehabilitation, Shaqra, Saudi Arabia

Background: Dynamic balance deficits have been identified as significant impairments in patients with chronic low back pain (CLBP). Although studies on the effect of spinal stabilization exercises (SSEs) on postural control in patients with LBP has been encouraging, balance measures used in these studies primarily assessed static postural control and lacked dynamic components. The Y-Balance Test (YBT) is a test, which assesses dynamic balance, and has been used in clinical practice. Given that dynamic balance is a vital aspect of everyday life, it is important to routinely include a relatively quick and cost-effective balance test in physical therapy (PT) practice, and to incorporate an exercise program that is useful for maintaining and improving balance in LBP populations.

Purpose: The purpose of this study was to determine the effectiveness of SSEs on dynamic balance in adults with CLBP.

Methods: Fifty-three participants who had LBP more than 6 months were recruited in the study, and 40 participants completed the 8-week intervention study. All eligible participants were assigned randomly into either an SSE group (n = 20, 38.8 ± 11.8 years old) or a general exercise (GE) group (n=20, 41.0 ± 13.3 years old), which consisted of flexibility and range-of-motion exercises. Participants’ dynamic balance was measured using the YBT in the anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions. For each participant, the measured reach distances were normalized to their leg length. The normalized composite score was used for data analysis. The YBT scores were collected at baseline, and two weeks, four weeks, and eight weeks after intervention was initiated. All participants were asked to attend 1-2 supervised PT sessions for a total of 4-8 sessions, and to perform their assigned exercises at home in the first 4 weeks of the 8-week intervention. In the last 4 weeks, the participants performed exercises at home with no supervised PT sessions.

Results: The statistical results revealed that there was a significant difference between groups from two weeks to four weeks (p = 0.002), with the SSE group demonstrating higher YBT composite scores than the GE group. However, there were no significant between-group differences from baseline to two weeks (p =0.098), and from 4 weeks to 8 weeks (p = 0.413).

Conclusion(s): The results indicate that SSEs were more effective than GEs in improving dynamic balance in adults with CLBP, specifically, during the four weeks of supervised PT sessions with a home exercise program. SSEs may minimize faulty movement strategies and compensatory muscle contractions by properly coordinating abdominal and back musculature during functional tasks, which possibly led to better dynamic balance. However, GEs appeared to have an effect equivalent to that of SSEs after 8-week intervention, consisting of 4 weeks of supervised intervention and another 4 weeks of unsupervised intervention.

Implications: The results of the study provide evidence for clinicians to include SSEs for improving dynamic balance in management of patients with CLBP.

Funding, acknowledgements: The authors would like to thank the Texas Physical Therapy Foundation (TPTF) for funding this study.

Keywords: instability, movement impairment, postural stability

Topic: Musculoskeletal: spine

Did this work require ethics approval? Yes
Institution: Texas Woman’s University (TWU)
Committee: TWU Institutional Review Boards (IRBs) Review and Approved this Research Project
Ethics number: 19982

All authors, affiliations and abstracts have been published as submitted.

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