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:: Volume 10, Issue 1 (Winter 2018) ::
Iran J War Public Health 2018, 10(1): 47-52 Back to browse issues page
Effect of 12-Week Corrective Training on Lumbar Multifidus Muscle Asymmetry and Pain Intensity in Veterans With One-sided Below-knee Amputation Suffering From Chronic Low Back Pain
E. Faraji 1, A.H. Barati 2, H. Sadeghi 1, H.R. Fateh 3, M. Allami * 4, M.R. Soroush 5
1- Sport Injuries & Corrective Exercise Department, Physical Education & Sport Sciences Faculty, Kharazmi University, Tehran, Iran
2- Sport Injuries & Corrective Exercise Department, Physical Education & Sport Sciences Faculty, Shahid Beheshti University, Tehran, Iran
3- PhD Physical Medicine & Rehabilitation Department, Medicine Faculty, Tehran University of Medical Sciences, Tehran, Iran, Tehran Iran
4- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
5- Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran, No 17, Janbazan Medical and Engineering Research Center (JMERC), Farokh Street, Mogadase Ardabili Street, Tehran, Iran
Abstract:   (697 Views)
Aims: Asymmetry while walking in people with lower limb amputation induces asymmetry in muscular activity, fatigue, instability in the spine cord, and low back pain. The aim of this study was to assess the effect of 12-week corrective training on lumbar multifidus muscle asymmetry and pain intensity in veterans with one-sided below-knee amputation suffering from chronic low back pain.
Materials & Methods: In this semi-experimental study with pre-test post-test design, 20 male veterans with one-sided below-knee amputation at Kowsar orthosis and prosthesis center in Tehran, Iran were selected by voluntary sampling method in 2016. After the initial assessment of the individuals, the selected training was taught to the veterans. The training program was performed during 12 weeks (5 days per week). After completing the training period, the electromyography of multifidus muscles and pain intensity assessment were performed again. Muscle asymmetry was measured in activity of maximum voluntary contraction of the muscles and muscular endurance (Sorenson test). Data were analyzed by dependent t-test.
Findings: Compared with the pre-test, in the post-test, pain intensity significantly decreased, and significant increase was observed in maximum contraction of the lumbar multifidus muscle of the amputation side (p<0.05); however, multifidus muscle asymmetry did not change significantly in maximum muscle contractility and muscular endurance (p>0.05).
Conclusion: The corrective training has a positive effect on the pain intensity in male veterans with one-sided below-knee amputation suffering from chronic low back pain, but it does not affect multifidus muscle asymmetry in maximum contraction of muscle and muscular endurance.
Keywords: Exercise, Low Back Pain, Veterans, Amputation
Full-Text [PDF 400 kb]   (151 Downloads)    
Type of Study: Research | Subject: Veteran’s Health
Received: 2017/08/1 | Accepted: 2017/10/25 | Published: 2017/12/26
English Expanded Abstract [HTML 29 KB]  (8 Download)
References
1. Silverman AK, Neptune RR. Differences in whole-body angular momentum between below-knee amputees and non-amputees across walking speeds. J Biomech. 2011;44(3):379-85. [DOI:10.1016/j.jbiomech.2010.10.027]
2. Sagawa Y Jr, Turcot K, Armand S, Thevenon A, Vuillerme N, Watelain E. Biomechanics and physiological parameters during gait in lower-limb amputees: A systematic review. Gait Posture. 2011;33(4):511-26. [DOI:10.1016/j.gaitpost.2011.02.003]
3. Childers WL, Kistenberg RS, Gregor RJ. Pedaling asymmetries in cyclists with unilateral transtibial amputation: Effect of prosthetic foot stiffness. J Appl Biomech. 2011;27(4):314-21. [DOI:10.1123/jab.27.4.314]
4. Schmalz T, Blumentritt S, Reimers CD. Selective thigh muscle atrophy in trans-tibial amputees: An ultrasonographic study. Arch Orthop Trauma Surg. 2001;121(6):307-12. [DOI:10.1007/s004020000227]
5. Childers WL, Kistenberg RS, Gregor RJ. The biomechanics of cycling with a transtibial amputation: Recommendations for prosthetic design and direction for future research. Prosthet Orthot Int. 2009;33(3):256-71. [DOI:10.1080/03093640903067234]
6. Michaud SB, Gard SA, Childress DS. A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation. J Rehabil Res Dev. 2000;37(1):1-10.
7. Devan H, Hendrick P, Ribeiro DC, Hale LA, Carman A. Asymmetrical movements of the lumbopelvic region: Is this a potential mechanism for low back pain in people with lower limb amputation?. Med Hypotheses. 2014;82(1):77-85. [DOI:10.1016/j.mehy.2013.11.012]
8. Kong WZ, Goel VK, Gilbertson LG, Weinstein JN. Effects of muscle dysfunction on lumbar spine mechanics: A finite element study based on a two motion segments model. Spine. 1996;21(19):2197-206. [DOI:10.1097/00007632-199610010-00004]
9. Panjabi MM. The stabilizing system of the spine (Part II). Neutral zone and instability hypothesis. J Spinal Disord. 1992;5(4):390-6. [DOI:10.1097/00002517-199212000-00002]
10. Moseley GL. Impaired trunk muscle function in sub-acute neck pain: Etiologic in the subsequent development of low back pain?. Man Ther. 2004;9(3):157-63. [DOI:10.1016/j.math.2004.03.002]
11. Niemeläinen R, Briand MM, Battié MC. Substantial asymmetry in paraspinal muscle cross-sectional area in healthy adults questions its value as a marker of low back pain and pathology. Spine. 2011;36(25):2152-7. [DOI:10.1097/BRS.0b013e318204b05a]
12. Wook Ha Kim, Sang Ho Lee, Dong Yeob Lee. Changes in the cross-sectional area of multifidus and psoas in unilateral sciatica caused by lumbar disc herniation. J Korean Neurosurg Soc. 2011;50(3):201-4. [DOI:10.3340/jkns.2011.50.3.201]
13. Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf Yde C. Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?. BMC Med. 2007;5:2. [DOI:10.1186/1741-7015-5-2]
14. Hides J, Stokes M, Saide M, Jull G, Cooper D. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine. 1994;19(2):165-72. [DOI:10.1097/00007632-199401001-00009]
15. Prinsen EC, Nederhand MJ, Rietman JS. Adaptation strategies of the lower extremities of patients with a transtibial or transfemoral amputation during level walking: A systematic review. Arch Phys Med Rehabil. 2011;92(8):1311-25. [DOI:10.1016/j.apmr.2011.01.017]
16. Faraji E, Sadegi H, Fateh HR, Allami M. Factors related to low back pain severity in veterans with unilateral below knee amputation. Iran J War Public Health. 2017;9(4):185-90. [Persian] [DOI:10.29252/acadpub.ijwph.9.4.185]
17. Airaksinen O, Brox J, Cedraschi C, Hildebrandt J, Klaber Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Supple 2):S192-300. [DOI:10.1007/s00586-006-1072-1]
18. Huang Q, Li D, Yokotsuka N, Zhang Y, Ubukata H, Huo M, et al. The intervention effects of different treatment for chronic low back pain as assessed by the cross-sectional area of the multifidus muscle. J Phys Ther Sci. 2013;25(7):811-3. [DOI:10.1589/jpts.25.811]
19. Danneels L, Vanderstraeten G, Cambier D, Witvrouw E, Bourgois J, Dankaerts W, et al. Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. Br J Sports Med. 2001;35(3):186-91. [DOI:10.1136/bjsm.35.3.186]
20. Akbari A, Khorashadizadeh S, Abdi GH. The effect of motor control exercise versus general exercise on lumbar local stabilizing muscles thickness: Randomized controlled trial of patients with chronic low back pain. J Back Musculoskelet Rehabil. 2008;21:105-12. [DOI:10.3233/BMR-2008-21206]
21. Maraschin M, Ferrari S, Cacciatori C. The effect of functional stabilization training on the cross sectional area of the deep stabilizers muscles in healthcare workers with chronic low back pain: A pilot, prospective and uncontrolled study. Sci Riabil. 2014;16:12-21. [Italian]
22. Hides JA, Stanton WR, McMahon S, Sims K, Richardson CA. Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain. J Orthop Sports Phys Ther. 2008;38(3):101-8. [DOI:10.2519/jospt.2008.2658]
23. Gaffney BM, Murray AM, Christiansen CL, Davidson BS. Identification of trunk and pelvis movement compensations in patients with transtibial amputation using angular momentum separation. Gait Posture. 2016;45:151-6. [DOI:10.1016/j.gaitpost.2016.01.015]
24. Morgenroth DC, Orendurff MS, Shakir A, Segal A, Shofer J, Czerniecki JM. The relationship between lumbar spine kinematics during gait and low-back pain in transfemoral amputees. Am J Phys Med Rehabil. 2010;89(8):635-43. [DOI:10.1097/PHM.0b013e3181e71d90]
25. Rueda FM, Diego IMA, Sánchez AM, Tejada MC, Montero FMR, Page JCM. Knee and hip internal moments and upper-body kinematics in the frontal plane in unilateral transtibial amputees. Gait Posture. 2013;37(3):436-9. [DOI:10.1016/j.gaitpost.2012.08.019]
26. Devan H, Carman AB, Hendrick PA, Ribeiro DC, Hale LA. Perceptions of low back pain in people with lower limb amputation: A focus group study. Disabil Rehabil. 2015;37(10):873-83. [DOI:10.3109/09638288.2014.946158]
27. National Academy of Sports Medicine. NASM essentials of corrective exercise training. Philadelphia: Lippincott Williams and Wilkins; 2010.
28. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56. [DOI:10.1016/0304-3959(83)90126-4]
29. Drake JD, Fischer SL, Brown SH, Callaghan JP. Do exercise balls provide a training advantage for trunk extensor exercises? A biomechanical evaluation. J Manipulative Physiol Ther. 2006;29(5):354-62. [DOI:10.1016/j.jmpt.2006.04.011]
30. Moffroid MT. Endurance of trunk muscles in persons with chronic low back pain: assessment, performance, training. J Rehabil Res Dev. 1997;34(4):440-7.
31. Lee AY, Kim EH, Cho YW, Kwon SO, Son SM, Ahn SH. Effects of abdominal hollowing during stair climbing on the activations of local trunk stabilizing muscles: A cross-sectional study. Ann Rehabil Med. 2013;37(6):804-13. [DOI:10.5535/arm.2013.37.6.804]
32. Kim Y, Son J, Yoon B. Intensive unilateral neuromuscular training on non-dominant side of low back improves balanced muscle response and spinal stability. Eur J Appl Physiol. 2013;113(4):997-1004. [DOI:10.1007/s00421-012-2513-7]
33. Thomas E, Silman AJ, Croft PR, Papageorgiou AC, Jayson MI, Macfarlane GJ. Predicting who develops chronic low back pain in primary care: A prospective study. BMJ. 1999;318(7199):1662-7. [DOI:10.1136/bmj.318.7199.1662]
34. Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001;26(11):E243-8. [DOI:10.1097/00007632-200106010-00004]
35. Willemink MJ, Van Es HW, Helmhout PH, Diederik AL, Kelder JC, Van Heesewijk JP. The effects of dynamic isolated lumbar extensor training on lumbar multifidus functional cross-sectional area and functional status of patients with chronic nonspecific low back pain. Spine. 2012;37(26):E1651-8. [DOI:10.1097/BRS.0b013e318274fb2f]
36. McCaskey MA, Schuster Amft C, Wirth B, Suica Z, De Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck-and low back pain rehabilitation: A systematic literature review. BMC Musculoskelet Disord. 2014;15:382. [DOI:10.1186/1471-2474-15-382]
37. Mannion AF, Caporaso F, Pulkovski N, Sprott H. Spine stabilisation exercises in the treatment of chronic low back pain: A good clinical outcome is not associated with improved abdominal muscle function. Eur Spine J. 2012;21(7):1301-10. [DOI:10.1007/s00586-012-2155-9]
38. Wand BM, O'Connell NE. Chronic non-specific low back pain-sub-groups or a single mechanism?. BMC Musculoskelet Disord. 2008;9:11. [DOI:10.1186/1471-2474-9-11]
39. Siddall PJ, Stanwell P, Woodhouse A, Somorjai RL, Dolenko B, Nikulin A, et al. Magnetic resonance spectroscopy detects biochemical changes in the brain associated with chronic low back pain: A preliminary report. Anesth Analg. 2006;102(4):1164-8. [DOI:10.1213/01.ane.0000198333.22687.a6]
40. Baliki MN, Chialvo DR, Geha PY, Levy RM, Harden RN, Parrish TB, et al. Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J Neurosci. 2006;26(47):12165-73. [DOI:10.1523/JNEUROSCI.3576-06.2006]
41. Schmidt Wilcke T, Leinisch E, Gänssbauer S, Draganski B, Bogdahn U, Altmeppen J, et al. Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients. Pain. 2006;125(1):89-97. [DOI:10.1016/j.pain.2006.05.004]
42. Wand BM, Parkitny L, O'Connell NE, Luomajoki H, McAuley JH, Thacker M, et al. Cortical changes in chronic low back pain: Current state of the art and implications for clinical practice. Man Ther. 2011;16(1):15-20. [DOI:10.1016/j.math.2010.06.008]
43. Woby SR, Roach NK, Urmston M, Watson PJ. Outcome following a physiotherapist-led intervention for chronic low back pain: The important role of cognitive processes. Physiother. 2008;94(2):115-24. [DOI:10.1016/j.physio.2007.08.008]
44. Steiger F, Wirth B, De Bruin E, Mannion A. Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review. Eur Spine J. 2012;21(4):575-98. [DOI:10.1007/s00586-011-2045-6]
45. Pillastrini P, Ferrari S, Rattin S, Cupello A, Villafa-e JH, Vanti C. Exercise and tropism of the multifidus muscle in low back pain: A short review. J Phys Ther Sci. 2015;27(3):943-5. [DOI:10.1589/jpts.27.943]
46. Anaforoğlu B, Erbahçeci F, Aksekili MA. The effectiveness of a back school program in lowerlimb amputees: A randomized controlled study. Turk J Med Sci. 2016;46(4):1122-9. [DOI:10.3906/sag-1503-131]
47. Casale R, Ceccherelli F, Labeeb AAEM, Biella GE. Phantom limb pain relief by contralateral myofascial injection with local anaesthetic in a placebo-controlled study: Preliminary results. J Rehabil Med. 2009;41(6):418-22. [DOI:10.2340/16501977-0353]
48. Ajimsha MS, Daniel B, Chithra S. Effectiveness of myofascial release in the management of chronic low back pain in nursing professionals. J Bodyw Mov Ther. 2014;18(2):273-81. [DOI:10.1016/j.jbmt.2013.05.007]
49. Corio F, Troiano R, Magel JR. The effects of spinal stabilization exercises on the spatial and temporal parameters of gait in individuals with lower limb loss. J Prosthet Orthot. 2010;22(4):230-6. [DOI:10.1097/JPO.0b013e3181f2f905]
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Faraji E, Barati A, Sadeghi H, Fateh H, Allami M, Soroush M. Effect of 12-Week Corrective Training on Lumbar Multifidus Muscle Asymmetry and Pain Intensity in Veterans With One-sided Below-knee Amputation Suffering From Chronic Low Back Pain. Iran J War Public Health. 2018; 10 (1) :47-52
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