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The Effect of Diaphragm Muscle Training on Chronic Low Back Pain

Not Applicable
Conditions
Low Back Pain
Diaphragm
Interventions
Other: Complex training
Other: Diaphragm training
Registration Number
NCT03600207
Lead Sponsor
Szeged University
Brief Summary

Brief Summary: Low back pain is very common problem in all the developed countries and affects children to elderly. Based on the etiology the low back pain is divided into two type: nonspecific and specific low back pain. If the pathological reason is known it is defined as specific and if the reason for the pain is unknown it is defined as nonspecific low back pain. The postulated reason for nonspecific low back pain is the segmental instability of the lumbar spine. Diaphragm muscle has a role in maintaining the segmental stability. The aim of this study to reduce the severity of the low back pain with improving the stability of the lumbar spine by using diaphragm training.

Detailed Description

The study is a randomized controlled trial. The participants are divided randomly into two groups. One of the groups take part in a complex training which contains stretching, strengthening, mobilizing exercises and proprioceptive training and this training is completed by diaphragm strengthening exercises. This group is defined as diaphragm training group. The members of the diaphragm training group use the POWERbreathe Medic Plus device. Opposed to the diaphragm training group the members of the control group take part only in the complex training without strengthening the diaphragm muscle. The pain intensity is assessed by Visual Analogue Scale and the diameter of the stabilizer muscles' belly is measured by B-mode ultrasound examination, using Zonare Z.One Ultrasound System (Mountain View, CA, USA). The thickness of the transversus abdominis muscle, the lumbar multifidus muscle and the diaphragm muscle is assessed in two different positions: during lying and during sitting position with weightlifting. The muscles are measured in two different states: a relaxed and a contracted state. Functional tests and a balance platform (NeuroCom) are used to measure the stability, and the function of the diaphragm is assessed by using a POWERbreathe KH2 device.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Chronic low back pain
  • Do not take part in other treatment
  • Be able to learn the usage of diaphragm trainer
Exclusion Criteria
  • Balance problems with neurological cause
  • Malignant tumor
  • Serious organ disease
  • Respiratory disease
  • A previous surgical intervention which affected the trunk
  • The patient is unable to cooperate

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control group -complex trainingComplex trainingcomplex training
Experimental group -diaphragm trainingDiaphragm trainingdiaphragm training
Experimental group -diaphragm trainingComplex trainingdiaphragm training
Primary Outcome Measures
NameTimeMethod
Thickness of the stabilizer muscles' belly8 weeks

The thickness of the stabilizer muscles's belly is measured with an ultrasound examination (Zonare Z.One Ultrasound System). The assessed muscles are transversus abdominis muscle, diaphragm muscle and lumbar multifidus muscle before and after the intervention.

Pain assessed by Visual Analogue Scale (followed by its scale information in the Description)8 weeks

The severity of the pain is measured with Visual Analogue Scale (VAS) before and after the intervention. This is a semi-objective, self-report device that is used extensively to measure such complaints as pain. The sclale is a 10 cm line. The scale is anchored by 'no pain' (0 score) and 'worst imaginable pain' (score of 10). Therefore the higher values represent a worse outcome. When using the Visual Analogue Scale, the participants had to mark on a 10 cm long line the average severity of lumbar pain and we measured the distance of their mark from the zero point in cm-s.

Secondary Outcome Measures
NameTimeMethod
Respiratory muscles' function8 weeks

Respiratory muscles' function is measured with POWERbreathe KH2 device before and after the intervention.

Limits of stability in sitting8 weeks

It is measured by modified Functional and Lateral Reach Test before and after the intervention. Modified means the sitting position.

Functional skills8 week

The functional skills are measured by the standard Timed Up and Go Test, Four Square Step Test and Fingertip to Toe Test before and after the intervention.

Balance and stability8 weeks

The balance and the stability of the participants is measured with a force platform (NeuroCom Basic Balance Master) using CTSIB and Unilateral Stance protocol before and after the intervention.

Trial Locations

Locations (1)

SZTE-Egészségtudományi és Szociális Képzési Kar

🇭🇺

Szeged, Hungary

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