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Bello B.1, Adeniyi F.A.2
1Bayero University, Physiotherapy, Kano, Nigeria, 2University of Ibadan, Physiotherapy, Ibadan, Nigeria
Background: Chronic Mechanical Low Back Pain (CMLBP) is a common disabling health problem among the general population. Multifidus muscle inhibition accompanying CMLBP plays a major role in perpetuating the pain and functional disability. Lumbar stabilisation exercise (LSE) and treadmill walk (TW) are established treatments for CMLBP. However, it is not known which of the two techniques is more effective.
Purpose: This study was conducted to compare the effects of lumbar stabilisation exercise and treadmill walk on multifidus muscle activation, pain and functional disability in individuals with CMLBP.
Methods: Participants with chronic mechanical low back pain were randomized in two groups:
Group 1 (n=25) performed lumbar stabilization exercise using McGill protocol and
Group 2 (n=25) walking exercise on a treadmill using the Bruce protocol.
Treatment was applied three times weekly for eight weeks. Outcomes assessed at baseline and end of eighth week of study were: Pain Intensity (PI) using Visual Analogue scale, Functional Disability (FD) using Oswestry Disability Index Questionnaire; and amplitude of multifidus muscle activation (MMA) using a surface electromyography machine. Data were analysed using descriptive statistics, paired and independent t-tests at α0.05. This trial was approved by the University of Ibadan and University College Hospital Joint Ethics Committee (protocol study - NHREC/05/01/2008a) and registered under ClinicalTrials.gov (NCT02901327).
Results: No significant differences were seen for baseline anthropometric and clinical characteristics between the groups (p>0.05). For pre-post treatment comparisons, both groups had significant improvements in the pain intensity, functional disability and multifidus muscle activation scores (p 0.05).
The group 1 when compared with the group 2, had lower scores in pain intensity (2.60±0.48 vs 4.50±0.12), functional disability (24.20±4.06 vs 40.00±10.56), with a significant higher multifidus muscle activation levels (40.00±4.16 vs 26.95±4.04) (p 0.05).
Conclusion(s): Lumbar stabilization exercises are more effective than treadmill walk in the activation of multifidus muscle, reduction in pain intensity and functional disability in individuals with chronic mechanical low back pain.
Implications: Based on findings of the study, both lumbar stabilization exercise and treadmill walk are effective in the treatment of chronic mechanical low back pain. However, lumbar stabilization exercise as a cheap, less gadget - dependent and do-it-yourself approach will be more required in a low income and high population density clinic like ours in Nigeria for the treatment of chronic mechanical low back pain.
Funding acknowledgements: No any Funding received for this study.
Topic: Musculoskeletal: spine
Ethics approval: University of Ibadan and University College Hospital Joint Ethics Committee approved the study (protocol study - NHREC/05/01/2008a).
All authors, affiliations and abstracts have been published as submitted.
