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The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain.

Muthukrishnan R, Shenoy SD, Jaspal SS, Nellikunja S, Fernandes S - Sports Med Arthrosc Rehabil Ther Technol (2010)

Bottom Line: Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288).Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).UTRN095032158-06012009423714.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India. shwet1999@yahoo.com.

ABSTRACT

Background: The purpose of the present study was to examine the differential effect of core stability exercise training and conventional physiotherapy regime on altered postural control parameters in patients with chronic low back pain (CLBP). As heterogeneity in CLBP population moderates the effect of intervention on outcomes, in this study, interventions approaches were used based on sub-groups of CLBP.

Methods: This was an allocation concealed, blinded, sequential and pragmatic control trial. Three groups of participants were investigated during postural perturbations: 1) CLBP patients with movement impairment (n = 15, MI group) randomized to conventional physiotherapy regime 2) fifteen CLBP patients with control impairment randomized to core stability group (CI group) and 3) fifteen healthy controls (HC).

Results: The MI group did not show any significant changes in postural control parameters after the intervention period however they improved significantly in disability scores and fear avoidance belief questionnaire work score (P < 0.05). The CI group showed significant improvements in Fx, Fz, and My variables (p < 0.013, p < 0.006, and p < 0.002 respectively with larger effect sizes: Hedges's g > 0.8) after 8 weeks of core stability exercises for the adjusted p values. Postural control parameters of HC group were analyzed independently with pre and post postural control parameters of CI and MI group. This revealed the significant improvements in postural control parameters in CI group compared to MI group indicating the specific adaptation to the core stability exercises in CI group. Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288). Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).

Conclusions: In this study core stability exercise group demonstrated significant improvements after intervention in ground reaction forces (Fz, Mz; g > 0.8) indicating changes in load transfer patterns during perturbation similar to HC group.

Trial registration: UTRN095032158-06012009423714.

No MeSH data available.


Related in: MedlinePlus

Flowchart of participant recruitment, retention & interim analyses; *p < 0.05 and p < 0.016: Armitage-McPherson adjusted critical p values based on no. of interim analyses (k) i.e., for first and fifth interim analyses respectively.
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Figure 1: Flowchart of participant recruitment, retention & interim analyses; *p < 0.05 and p < 0.016: Armitage-McPherson adjusted critical p values based on no. of interim analyses (k) i.e., for first and fifth interim analyses respectively.

Mentions: Random number table was used to generate randomization sequence. Pre-numbered identical envelopes were used for allocation concealment. The trial process for all patients was depicted in figure 1.


The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain.

Muthukrishnan R, Shenoy SD, Jaspal SS, Nellikunja S, Fernandes S - Sports Med Arthrosc Rehabil Ther Technol (2010)

Flowchart of participant recruitment, retention & interim analyses; *p < 0.05 and p < 0.016: Armitage-McPherson adjusted critical p values based on no. of interim analyses (k) i.e., for first and fifth interim analyses respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2903540&req=5

Figure 1: Flowchart of participant recruitment, retention & interim analyses; *p < 0.05 and p < 0.016: Armitage-McPherson adjusted critical p values based on no. of interim analyses (k) i.e., for first and fifth interim analyses respectively.
Mentions: Random number table was used to generate randomization sequence. Pre-numbered identical envelopes were used for allocation concealment. The trial process for all patients was depicted in figure 1.

Bottom Line: Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288).Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).UTRN095032158-06012009423714.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India. shwet1999@yahoo.com.

ABSTRACT

Background: The purpose of the present study was to examine the differential effect of core stability exercise training and conventional physiotherapy regime on altered postural control parameters in patients with chronic low back pain (CLBP). As heterogeneity in CLBP population moderates the effect of intervention on outcomes, in this study, interventions approaches were used based on sub-groups of CLBP.

Methods: This was an allocation concealed, blinded, sequential and pragmatic control trial. Three groups of participants were investigated during postural perturbations: 1) CLBP patients with movement impairment (n = 15, MI group) randomized to conventional physiotherapy regime 2) fifteen CLBP patients with control impairment randomized to core stability group (CI group) and 3) fifteen healthy controls (HC).

Results: The MI group did not show any significant changes in postural control parameters after the intervention period however they improved significantly in disability scores and fear avoidance belief questionnaire work score (P < 0.05). The CI group showed significant improvements in Fx, Fz, and My variables (p < 0.013, p < 0.006, and p < 0.002 respectively with larger effect sizes: Hedges's g > 0.8) after 8 weeks of core stability exercises for the adjusted p values. Postural control parameters of HC group were analyzed independently with pre and post postural control parameters of CI and MI group. This revealed the significant improvements in postural control parameters in CI group compared to MI group indicating the specific adaptation to the core stability exercises in CI group. Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288). Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).

Conclusions: In this study core stability exercise group demonstrated significant improvements after intervention in ground reaction forces (Fz, Mz; g > 0.8) indicating changes in load transfer patterns during perturbation similar to HC group.

Trial registration: UTRN095032158-06012009423714.

No MeSH data available.


Related in: MedlinePlus