Implementation of a Physiotherapy Intervention for Patients With Chronic Low Back Pain
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Electromyographic analysis of the trunk erector of patients with chronic low back pain .
研究概览
简要总结
The lumbar spine is currently one of the most affected areas by nociceptive processes , referred back pain, which can be provided from a herniated intervertebral disc . Such conditions are considered a public health problem , since considerably affect the population , mainly young adults , which may lead to functional disability and absenteeism . Soon , his treatment involves high costs and rehabilitation time indefinite , generating great scientific interest focused on the search for new techniques that can provide an acceleration of functional recovery of these individuals .
Thus , the establishment of evaluation protocols that provide quantitative data concerning the functional capacity is of utmost importance . From the electromyographic analysis , one can measure the electrical activity of muscle and identify abnormal patterns of response. For the identification of kinematic changes becomes useful equipment capable of recording the speed and angle of movement, as the accelerometer . Another evaluation method applicable to cases of herniated disc and back pain is the force platform to quantify the ground reaction force during the stance phase of the movement . Also , the quality of life should be taken into account as routinely observed psychological impairment involving issues related to vitality, emotional and social aspects , which can be identified through the questionnaire of quality of life ( SF -36 ) .
With regard to physical therapy intervention , we seek to use resources to compose promising treatment program along with conventionalexercises. A novel therapy in the treatment of back pain is the whole body vibration , as it promotes increased range of muscle spindles via increasing the tonic vibration reflex and consequently improving the mechanism of involuntary muscle control . Thus , the association between an accurate assessment , exercises and therapy vibratory seeks early rehabilitate individuals affected by back pain or herniated disc , delaying or even avoiding surgery .
详细描述
There are currently various treatment techniques have been employed for the rehabilitation of patients with functional back pain in general. However , it is essential to search for resources to compose the therapeutic treatment program along with conventional exercises.
With regard to the functional rehabilitation , physical therapy , has emphasized the muscles directly involved in the painful process (Richardson et al . , 1999) . Through exercises primarily used in functional rehabilitation , it is possible to treat and prevent impairments , restore function , promote physical and social well being . The therapeutic approach of the column follows the same principles as other structures , keeping up the proper precautions concerning the region's proximity to the spinal cord and nerve roots ( Kisner , Colby , 2005) . On this basis several treatments have been proposed , however , the most effective therapy is still a matter of controversy .
It is known that back pain can result in neurological imbalances , mainly affecting the deep muscles of the trunk and paraspinal , multifidus and transversus abdominis ( LINDGREN et al . , 1993; HIDES ; Richardson , Jull , 1996; HODGES ; Richardson , Jull , 1996). We observe a reduction in these shooting action potential and changes in motor control , represented by weakness, atrophy and reduced functional capacity ( HODGES ; MOSELEY , 2003; MACDONALD ; MOSELEY ; HODGES , 2006; RENKAWITZ ; BOLUKI ; Grifka , 2006 , RICHARDSON ; HODGES ; HIDES , 2004; BARR ; GRIGGS ; Cadby , 2007) .
Therefore, an appropriate exercise program should be able to provide muscular support , minimizing the risk of disability by recovering the functionality of the spine ( McFeely ; GRACEY , 2006). For this purpose it is recommended to strengthen the abdominal muscles , lower back and lower limbs ( HANDA et al . , 2000; CALMELS et al . , 2004; Lidder ; BAXTER ; GRACEY , 2004; HAYDEN et al . , 2005; McFeely ; GRACEY , 2006; RODACKI et al . , 2008) .
Currently the lumbar stabilization is considered a beneficial technique in the treatment of patients with low back pain , because in addition to reduce painful symptoms , promotes strengthening the stabilizing muscles such as multifidus and transversus abdominis . ( O'Sullivan , TWOMEY ; Allison 1997, Richardson et al. 1999; HIDES ; jull ; Richardson , 2001; YILMAZ et al. 2,003 ; Choi et al. 2005).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Inclusion criteria:
- •Lack of diseases or complaints of back pain;
- •Medical diagnosis of lumbar disc herniation , evidenced by imaging studies;
- •Low back pain or sciatica in the presence of antalgic postures;
- •80% stake in therapy sessions;
- •Individuals who agree to participate in this study and signed an informed consent form.
排除标准
- •Presence of vertebral pathologies or symptoms that involve the same;
- •The use of anti -inflammatory steroids or nonsteroidal;
- •Women in menstrual period;
- •Pregnant or postpartum;
- •Cognitive deficits;
- •Hyperesthesia, hypoesthesia or anesthesia evaluated muscle group;
- •Surgery in the previous column;
- •The presence of infiltration of corticosteroids in less than six months;
- •The use of anti -inflammatory steroids or nonsteroidal;
- •The use of analgesics;
- •Cognitive deficits;
- •Collections in menstrual period;
- •Pregnant and postpartum;
- •Hemorrhage;
- •Malignancy;
- •Diabetes mellitus;
- •Deep venous thrombosis;
- •Regions healing;
- •Acute inflammation;
- •Fracture healing;
- •Pressure ulcers.
研究组 & 干预措施
Exercises
This group will consist of 20 individuals, 10 with lumbar disc herniation and 10 with chronic low back pain who underwent treatment with exerxises.
干预措施: Exercises (Other)
结局指标
主要结局
Electromyographic analysis of the trunk erector of patients with chronic low back pain .
时间窗: Thirty seconds.
All groups performed the evaluation of muscle electrical activity , using a surface electromyography , 2 channels ( EMG System ® ) , model EMG 230C - USB , composed of an analog-digital converter 12-bit resolution and power supply to battery to avoid interference from the power grid . The parameters used were : sampling frequency of 2,000 Hz , unit uV , -2000 Xmin , Ymax 2000 Coef . The 0 and Coef . B 500. The electrodes were then fixed in pairs , respecting the distance of 2 cm between them ; longitudinally over the belly of the erector muscles of the trunk . Data were collected in the prone and standing for 30 seconds , during which the subject performed the isotonic contraction muscle evaluated .
次要结局
- Analysis of pain using a visual analogue scale .(Two days.)
研究者
Djenifer Queiroz de Souza
Djenifer Queiroz de Souza
Laboratório de Engenharia de Reabilitação Sensorio Motora