The Comparison on the Effect of Thoracic Flexibility Exercise and Lumbar Stabilization Exercise on Pain and Heart Rate Variability of Patients with Chronic Low Back Pain
AUTHORS
Donghwan Park,Department of Physical therapy, Gyeongin Rehabilitation Center Hospital, Korea
Kang Seong Lee*,Department of Biomedical Engineering Welfare Technology, Hanseo University, Korea
ABSTRACT
To compare the effects of Thoracic Flexibility Exercise (TFE) with those of Lumbar Stabilization Exercise (LSE) in patients with chronic low back pain. Participants were randomly assigned to TFE (n=11) or LSE (n=11) groups. Chronic low back pain patients in both groups underwent standard physiotherapy for 35 minutes per session. Additionally, TFE and LSE exercises were performed 3 times per week for 4 weeks. The visual analog scale, autonomic nerve activity, and standard deviation normal to normal were measured after 4 weeks of training. After 4 weeks of training, the visual analog scale, autonomic nerve activity, and standard deviation normal to normal improved significantly in both groups after intervention compared to the baseline (p<0.05). Further, the visual analog scale, autonomic nerve activity, and standard deviation normal to normal improved more significantly in the TFE group than in the LSE group (p<0.05). This study demonstrates that TFE and LSE are both beneficial for improving pain and heart rate variability. However, TFE was superior to SLE with respect to improving the visual analog scale, autonomic nerve activity, and standard deviation normal to normal.
KEYWORDS
Thoracic flexibility exercise, Lumbar stabilization exercise, Pain, Heart rate variability
REFERENCES
[1] T.W. Kang, J. H. Lee, D. H. Park, and H. S. Cynn, “Effect of 6-week lumbar stabilization exercise performed on stable versus unstable surfaces in automobile assembly workers with mechanical chronic low back pain,” Work, vol.60, pp.445-454, (2018) DOI: 10.3233/WOR-182743(CrossRef)(Google Scholar)
[2] D. A. MacDonald, A. P. Dawson, and P. W. Hodges, “Behavior of the lumbar multifidus during lower extremity movements in people with recurrent low back pain during symptom remission,” journal of orthopaedic & sports physical therapy, vol.41, no.3, pp.155-64, (2011) DOI: 10.2519/jospt.2011.3410(CrossRef)(Google Scholar)
[3] P. Schofield, “Assessment and management of pain in older adults with dementia: a review of current practice and future directions,” Current opinion in supportive and palliative care, vol.2, no.2, pp.128-132, (2008) DOI: 10.1097/SPC.0b013e3282ffb406(CrossRef)(Google Scholar)
[4] S. Telles, S. K. Sharma, R. K. Gupta, A. K. Bhardwaj, and A. Balkrishna, “Heart rate variability in chronic low back pain patients randomized to yoga or standard care,” BMC complementary and alternative medicine, vol.16, no.1, pp.279-286, (2016) DOI: 10.1186/s12906-016-1271-1(CrossRef)(Google Scholar)
[5] M. E. Berry, I. T. Chapple, J. P. Ginsberg, K. J. Gleichauf, J. A. Meyer, and M.L. Nagpal, “Non-pharmacological intervention for chronic pain in veterans: a pilot study of heart rate variability biofeedback,” Global advances in health and medicine, vol.3, no.2 pp.28-33, (2014) DOI: 10.7453/gahmj.2013.075(CrossRef)(Google Scholar)
[6] S. F. Zavarize, M. A. Paschoal, and S. M. Wechsler, “Effects of physiotherapy associated to virtual games in pain perception and heart rate variability in cases of low back pain,” Manual Therapy, Posturology & Rehabilitation Journal Revista Manual Therapy, vol.14, pp.1-7, (2016)
[7] F. R. França, T. N. Burke, R. R. Caffaro, L. A. Ramos, and A. P. Marques, “Effects of muscular stretching and segmental stabilization on functional disability and pain in patients with chronic low back pain: a randomized, controlled trial,” Journal of Manipulative and Physiological Therapeutics, vol.35, no.4, pp.279-85, (2012) DOI: 10.1016/j.jmpt.2012.04.012(CrossRef)(Google Scholar)
[8] D. H. Park, J. W. Won, J. H. Roh, and E. H. Ko, “Effects of the thoracolumbar exercise program on static standing balance and pain in low back pain patients,” Orthopaedic Physical Therapy Practice, vol.24, no.2, pp.78-84, (2012)
[9] M. Y. Heo, K. Kim, B. Y. Hur, and C. W. Nam, “The effect of lumbar stabilization exercises and thoracic mobilization and exercises on chronic low back pain patients,” Journal of physical therapy science, vol.27, no.12, pp.3843-3856, (2015) DOI: 10.1589/jpts.27.3843(CrossRef)(Google Scholar)
[10] N. Handa, H. Yamamoto, T. Tani, T. Kawakami, and R. Takemasa, “The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain,” Journal of orthopedic science, vol.5, no.3, pp.210-216, (2000) DOI: 10.1007/s007760050153(CrossRef)(Google Scholar)
[11] S. Edmondston and K. Singer, “Thoracic spine: anatomical and biomechanical considerations for manual therapy,” Manual therapy, vol.2, no.3, pp.132-143, DOI: 10.1054/math.1997.0293(CrossRef)(Google Scholar)
[12] M. M. Panjabi, “The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement,” Journal of spinal disorders, vol.5. pp.383-389, (1992)
[13] F. R. França, T. N. Burke, E. S. Hanada, and A. P. Marques, “Segmental stabilization and muscular strengthening in chronic low back pain: a comparative study,” Clinics, vol.65, no.10, pp.1013-1017, (2010) DOI: 10.1590/S1807-59322010001000015(CrossRef)(Google Scholar)
[14] G. Kim, and O. Kim, “The effect of flexibility training on health related fitness in healthy adults,” J Phys Edu, Vol.39, pp.285-293, (2000)
[15] J. Siebenga, V. Leferink, M. Segers, M. Elzinga, F. Bakker, H. J. ten Duis, P. M. Rommens, and P. Patka, “A prospective cohort study comparing the VAS spine score and Roland-Morris disability questionnaire in patients with a type A traumatic thoracolumbar spinal fracture,” European Spine Journal, vol.17, no.8, pp.1096-1100, (2008) DOI: 10.1007/s00586-008-0705-y(CrossRef)(Google Scholar)
[16] H. J. Moon, K. H. Choi, D. H. Kim, H. J. Kim, Y. K. Cho, K. H. Lee, J. H. Kim, and Y. J. Choi, “Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain,” Annals of rehabilitation medicine, vol.37, no.1, pp. 110-117, (2013) DOI: 10.5535/arm.2014.38.6.876(CrossRef)(Google Scholar)
[17] R. McKenzie, and P. Van Wijmen, “Treat your own back,” Spinal publications, New Zealand
[18] L. Lundy-Ekman, “Neuroscience-E-Book: Fundamentals for Rehabilitation,” Elsevier Health Sciences St. Louis, Missouri, (2013)
[19] D. W. Vaughn and E. W. Brown, “The influence of an in-home based therapeutic exercise program on thoracic kyphosis angles,” Journal of Back and Musculoskeletal Rehabilitation, vol.20, no.4, pp.155-165, (2007)
[20] M. S. Reis, J. L. Q. Durigan, R. Arena, B. R. O. Rossi, R. G. Mendes, and A. Borghi-Silva, “Effects of posteroanterior thoracic mobilization on heart rate variability and pain in women with fibromyalgia,” Rehabilitation research and practice, vol.2014, pp.1-6 Article ID 898763, (2014) DOI: 10.1155/2014/898763(CrossRef)(Google Scholar)
[21] G. Minarini, M. Ford, and J. Esteves, “Immediate effect of T2, T5, T11 thoracic spine manipulation of asymptomatic patient on autonomic nervous system response: Single-blind, parallel-arm controlled-group experiment,” International Journal of Osteopathic Medicine, vol.30, pp.12-17, (2018) DOI: 10.1016/j.ijosm.2018.10.002(CrossRef)(Google Scholar)
[22] Y. Yang, Y. H. Kim, Y. K. Kim, J. G. Hur, J. C. Song, and Y. S. Kim, “Effects of thoracic spinal exercise program in VDT workers: pain relief and increased flexibility,” Korean Journal of Occupational and Environmental Medicine, vol.16, no.3, pp.250-261, (2004)