EFFECT OF PROPRIOCEPTIF NEUROMUSCULAR FACILITATION AND LUMBAR STABILIZATION EXERCISES ON MUSCLE STRENGTH AND MUSCLE ENDURANCE IN PATIENTS WITH LUMBAR DISC HERNIA
Abstract
Background/Objective: This study investigates the effect of lumbar stabilization and proprioceptive neuromuscular facilitation (PNF) training on muscle strength and muscle endurance. Methods: Sixty-four participants between the ages of 15 and 69 years, graded “protrusion and bulging lumbar herniation” according to the Macnab Classification, were divided into four groups of 16: lumbar stabilization training (strength training, 5 days/week for 4 weeks); PNF training (5 days/week for 4 weeks); physical therapy (hot pack, TENS, ultrasound, 5 days/week for 4 weeks); and control (without any application). Sociodemographic features were recorded and muscle strength tested. Before and after exercise, a visual analog scale (VAS) and Oswestry Disability Index (ODI) were measured by a physical therapist. After 4 weeks, the evaluations were repeated. Results: There were significant increases in muscle strength and muscle endurance in the lumbar stabilization group, who also showed significant improvement in pain intensity at rest and during activity, and in ODI (p<0.05). Similar results were observed in the PNF group (p<0.05), although not to the same extent. Patients undergoing physical therapy showed significant differences only in pain intensity at rest, at activity, and in ODI (p<0.05). There were no significant differences in the control group. Conclusion: Undertaking an appropriate physiotherapy and rehabilitation program aiming to reduce waist circumference of patients with low muscle strength and low muscle endurance will help to increase muscle strength and endurance and reduce pain, and contribute toward the correction of functional disabilities.
Article visualizations:
Keywords
Full Text:
PDFReferences
Dundar U., Kavuncu V. Diagnosis and treatment of lumbar disc herniation. Journal of Current Clinical Medicine. 2007;11:45–53. [in Turkish]
Sarper T. Epidemiology of low back pain. Journal of Current Clinical Medicine. 2006;11:10–14. [in Turkish]
Casso G., Cachin C., Van M.G., et al. Return-to-work status 1 year after muscle reconditioning in chronic low back pain patients. Joint Bone Spine. 2004;71:136–139.
Twomey L., Taylor J. Exercise and spinal manipulation in the treatment of low back pain. Spine. 1995;20:615–619.
Yıldız O. Low back pain. In: Beyazova M., Kutsal Y.G., eds. Physical Medicine and Rehabilitation, Volume 2. Ankara: Sun Publications Section; 2000:1465–1483. [in Turkish]
Ozcan E. Conservative Treatment of Low Back Pain Patients. Istanbul: Nobel Bookstore; 2002:187–219. [in Turkish]
Yakut E., Duger T., Oksuz C., et al. Validation of the Turkish version of the Oswestry disability index for patients with low back. Spine. 2004;29(5):581–585.
Yılmaz F., Yılmaz A., Merdol F., et al. Efficacy of dynamic lumbar stabilization exercise in lumbar microdiscectomy. J Rehabil Med. 2003;35:163–167.
Mälkiä E. Muscular performance as a determinant of physical ability in Finnish adult population. Helsinki (Finland): Publications of the Social Insurance Institution 1983: Report No. AL:23.
Nicholeison T., Jorgensen K. Trunk strength, back muscle endurance and low back trouble. Scand J Rehabil Med. 1985;17:121–127.
Kavcic N., Grenier S., McGill SM. Quantifying tissue loads and spine stability while performing commonly prescribed low back stabilization exercises. Spine. 2004;29:2319–2329.
Adler S.S., Beckers D., Buck M. PNF in Practice. 3rd ed. Germany: Springer, 2008.
Ozbayır T. Neurological trauma. In: Karadakovan A, Aslan FE, eds. Maintenance of Internal Medicine and Surgery. Adana: Nobel Bookstore; 2010:1245–1274. [in Turkish]
Boos N., Semmer N., Elfering A. Natural history of individuals with asymptomatic disc abnormalities in magnetic resonance imaging: predictors of low back pain-related medical consultation and work incapacity. Spine. 2000;25:1484–1492.
Nordin M., Compella M. Exercises and the modalities. When, what and why? Neurol Clin North Am. 1999;17:75–111.
Tuzun C., Yorulmaz I., Cindas A., et al. Acute and chronic low back pain in patients with clinical and radiological findings. Turkish Journal of Physical Medicine and Rehabilitation. Volume 44, Issue 6. Galen Publishing; 1998. [in Turkish]
Durand M.J., Brassard B., Hong Q.N. Responsiveness of the physical work performance evaluation, a functional capacity evaluation, in patients with low back pain. J Occup Rehabil. 2008;18:58–67.
Kahanovitz N., Viola K., Galagher M. Long term strength assessments of postoperative discectomy patients. Spine. 1989;14:402–403.
Mattila M., Hurme M., Alaranta H., et al. The multifidus muscle in patients with lumbar disc herniation. A histochemical and morphometric analysis of intraoperative biopsies. Spine. 1986;11(7):732–738.
Dolan P., Greenfield K., Nelson R.J., et al. Can exercise therapy improve the outcome of microdiscectomy. Spine. 2000;25:1523–1532.
Barr K.P., Griggs M., Cadby T. Lumbar stabilization: core concepts and current literature, Part 1. Am J Phys Med Rehabil. 2005;84:473–480.
Kwang Y., Park M.S., Kyochul S. The effects on the pain ındex and lumbar flexibility of obese patients with low back pain after PNF scapular and PNF pelvic patterns. J Phys Ther Sci. 2014;26:1571–1574.
Henchoz Y., Kai-lik So A. Exercise and nonspecific low back pain: a literature review. Joint Bone Spine. 2008;75:533–539.
França F.R., Burke T.N., Hanada E.S., et al. Segmental stabilization and muscular strengthening in chronic low back pain—a comparative study. Clinics (Sao Paulo). 2010;65:1013–1017.
Tuğcu I., Onder M.E., Yazıcıoglu K., et al. Chronic mechanical low back functional effectiveness of school-administered with exercise and physical therapy modalities in pain. Turkish Journal of Physical Medicine and Rehabilitation. 2008;54:63–68. [in Turkish]
Grubisic F., Grazio S., Jajic Z., et al. Therapeutic ultrasound in chronic low back pain treatment. Reumatizam. 2006;53:18–21.
Shahbandar L., Press J. Diagnosis and nonoperative management of lumbar disk herniation. Oper Tech Sports Med. 2005;13:114–121.
Renkawitz T., Boluki D., Grifka J. The association of low back pain, neuromuscular imbalance, and trunk extension strength in athletes. Spine J. 2006;6:673–683.
DOI: http://dx.doi.org/10.46827/ejpe.v0i0.2330
Refbacks
- There are currently no refbacks.
Copyright (c) 2019 Mustafa Gulsen, Mitat Koz
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright © 2015 - 2023. European Journal of Physical Education and Sport Science (ISSN 2501 - 1235) is a registered trademark of Open Access Publishing Group. All rights reserved.
This journal is a serial publication uniquely identified by an International Standard Serial Number (ISSN) serial number certificate issued by Romanian National Library (Biblioteca Nationala a Romaniei). All the research works are uniquely identified by a CrossRef DOI digital object identifier supplied by indexing and repository platforms. All authors who send their manuscripts to this journal and whose articles are published on this journal retain full copyright of their articles. All the research works published on this journal are meeting the Open Access Publishing requirements and can be freely accessed, shared, modified, distributed and used in educational, commercial and non-commercial purposes under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
