MohammadBagher Shamsi1, Javad Sarrafzadeh2, Aliashraf Jamshidi2, Navid Arjmand3, Farshid Ghezelbash4. 1. Rehabilitation and Sport Medicine Department, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Dolat Abad Street, Kermanshah, Iran. Electronic address: Mshamsi@kums.ac.ir. 2. Physiotherapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mohseni Square, Tehran, Iran. 3. Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran. Electronic address: arjmand@sharif.edu. 4. Division of Applied Mechanics, Department of Mechanical Engineering, École Polytechnique, Montréal, Canada.
Abstract
BACKGROUND:Motor control exercise was claimed to improve spinal stability in patients with chronic non-specific back pain, but to investigate the effectiveness of this exercise, other outcome measures have been used rather than spinal stability itself. The aim of our study is to assess motor control exercise effects on spinal stability using a biomechanical model. METHODS: Fifty-one patients were assigned to either motor control or general exercises. Before and after trainings, participants were tested for spinal stability at seven isometric tasks. Electromyography signals were recorded from ten superficial muscles, and a hybrid EMG-driven musculoskeletal model estimated spinal stability indices at each task. FINDINGS:Pain and disability significantly decreased in both groups. After trainings, patients had both increase and decrease in stability depending on the task, and stability did not increase/decrease uniformly in all patients. In the motor control group, stability increased at all positions but reached to significance only at right lateral pulling. In the general exercise group, except for pulling the trunk backward, stability decreased at other positions and reached to statistical significance only at pulling the trunk forward. No significant difference between groups was found in changing stability after the intervention. INTERPRETATION: Interventions yielded no significant difference in disability, pain and stability index between two groups. Significant increase of stability in the motor control group at right lateral pulling may be attributed to more activity of abdominal muscles, and significant decrease of stability in the general exercise group at forward pulling may be attributed to more optimal activity of back muscles.
RCT Entities:
BACKGROUND: Motor control exercise was claimed to improve spinal stability in patients with chronic non-specific back pain, but to investigate the effectiveness of this exercise, other outcome measures have been used rather than spinal stability itself. The aim of our study is to assess motor control exercise effects on spinal stability using a biomechanical model. METHODS: Fifty-one patients were assigned to either motor control or general exercises. Before and after trainings, participants were tested for spinal stability at seven isometric tasks. Electromyography signals were recorded from ten superficial muscles, and a hybrid EMG-driven musculoskeletal model estimated spinal stability indices at each task. FINDINGS:Pain and disability significantly decreased in both groups. After trainings, patients had both increase and decrease in stability depending on the task, and stability did not increase/decrease uniformly in all patients. In the motor control group, stability increased at all positions but reached to significance only at right lateral pulling. In the general exercise group, except for pulling the trunk backward, stability decreased at other positions and reached to statistical significance only at pulling the trunk forward. No significant difference between groups was found in changing stability after the intervention. INTERPRETATION: Interventions yielded no significant difference in disability, pain and stability index between two groups. Significant increase of stability in the motor control group at right lateral pulling may be attributed to more activity of abdominal muscles, and significant decrease of stability in the general exercise group at forward pulling may be attributed to more optimal activity of back muscles.
Authors: Alexandre Henrique Nowotny; Mariene Guizeline Calderon; Pablo Albuquerque de Souza; Andreo Fernando Aguiar; Guillaume Léonard; Bruno Mazziotti Oliveira Alves; Cesar Ferreira Amorim; Rubens Alexandre da Silva Journal: BMJ Open Sport Exerc Med Date: 2018-11-22