The immediate effect of the abdominal drawing-in maneuver technique on stature change in seated sedentary workers with chronic low back pain

The influence of cultural and religious factors on cross-national variations in the prevalence of chronic back and neck pain: an analysis of data from the global burden of disease 2019 study

Introduction

Low back pain and neck pain are among the most commonly reported forms of chronic pain worldwide, and are associated with significant distress, disability and impairment in quality of life. Though these categories of pain can be analyzed and treated from a biomedical perspective, there is evidence that they are both related to psychological variables such as depression and anxiety. The experience of pain can be significantly influenced by cultural values. For example, cultural beliefs and attitudes can influence the meaning attached to the experience of pain, the responses of others to a sufferer's pain, and the likelihood of seeking medical care for particular symptoms. Likewise, religious beliefs and practices can influence the both experience of pain and the responses to it. These factors have also been associated with variations in the severity of depression and anxiety.

Methods

In the current study, data on the estimated national prevalence of both low back pain and neck pain, obtained from the 2019 Global Burden of Disease Study (GBD 2019), is analyzed in relation to cross-national variations in cultural values, as measured using Hofstede's model (n =115 countries) and in religious belief and practice, based on the most recent Pew Research Center survey (n = 105 countries). To address possible confounding factors, these analyses were adjusted for variables known to be associated with chronic low back or neck pain, namely smoking, alcohol use, obesity, anxiety, depression and insufficient physical activity.

Results

It was found that the cultural dimensions of Power Distance and Collectivism were inversely correlated with the prevalence of chronic low back pain, and Uncertainty Avoidance was inversely correlated with the prevalence of chronic neck pain, even after adjustment for potential confounders. Measures of religious affiliation and practice were negatively correlated with the prevalence of both conditions, but these associations were not significant after adjusting for cultural values and confounders.

Discussion

These results highlight the existence of meaningful cross-cultural variations in the occurrence of common forms of chronic musculoskeletal pain. Psychological and social factors that could account for these variations are reviewed, along with their implications for the holistic management of patients with these disorders.

Estimation of Spinal Muscle Performance in Work From Home Information Technology Professionals of Karad, India in 2021

Background

It is seen that information technology (IT) professionals are at higher risk of developing mechanical low back pain due to numerous factors such as a sedentary lifestyle, attaining inappropriate posture for a prolonged period of time, work stresses, and inadequate exercise which lead to overload on the back musculature. Working from home has become the new normal for these professionals in which they attain abnormal posture which leads to pressure on the muscles and thus there is a need to estimate and analyze spinal muscle performance among IT professionals.

Materials and Methods

Our main objectives were to estimate the spinal muscle performance in work-from-home IT professionals of Karad and to find the association between spinal muscle performance with respect to age, gender, and body mass index (BMI). Depending on inclusion and exclusion criteria, 120 IT professionals working from home were selected for this study by simple random sampling. Written consent was taken and a detailed outcome assessment was done by using the static and dynamic abdominal test, extensor test, internal/external oblique test, and back rotators test. Also, functional performance was measured using the back performance scale. SPSS version 20 was used to carry out the analysis of data and results were obtained.

Results

In participants of sample size 120 (100%), 27 (26%) were normal, 30 (32%) good, 24 (20%) fair, 21 (14%) poor, 18 (8%) trace; whereas, static extensor strength was 16 (12%) normal, 9 (18%) good, 24 (28%) fair, 18 (36%) poor, 3 (6%) trace. For oblique's, static strength was 10 (20%) normal, 12 (24%) good, 15 (30%) fair, 9 (18%) poor, 4 (8%) trace; whereas, for back rotators strength was 10 (20%) normal, 17 (34%) good, 15 (30%) fair, 8 (16%) poor. The mean number of repetitions for the dynamic endurance test for extensors was 11, for abdominals wase 24 and for obliques was 12. A back performance scale was found with a minimum score of 6 and a maximum score of 11 for activity limitation. There was statistically significant found to be between spinal muscle performance and age (P = 0.041), BMI (P = 0.027).

Conclusion

In this study it was found that spinal muscle performance was decreased in IT professionals. It was concluded that there was a significant reduction in static extensor performance compared to static abdominal muscle performance. Also, the spinal muscle performance of extensors was less as compared to that of abdominals. The data also revealed that there was a remarkable association that was seen between spinal muscle performance and age as well as spinal performance and BMI.

The Effect of Two Types of Back Pillow Support on Transversus Abdominis and Internal Oblique Muscle Fatigue, Patient Satisfaction, and Discomfort Score during Prolonged Sitting

Natural rubber is considered an economic plant in Thailand and is used to manufacture many products. Foam back pillows have proven to have various benefits for the lower back. However, no study has compared the effects of foam and rubber pillows. Therefore, the current study aimed to compare the efficacy of foam and rubber pillows on transversus abdominis and internal oblique muscle fatigue, patient satisfaction, and discomfort scores during 60 min of prolonged sitting. Thirty healthy participants were invited to the study and randomized into three sitting conditions over three consecutive days. The three groups were as follows: control, foam pillow, and rubber pillow. Our results revealed that the discomfort score increased with the sitting time in all three groups (p < 0.05). The control group had the highest discomfort when compared to the rubber pillow group at 30 min (T4; p = 0.007) and 60 min (T7; p = 0.0001), as well as the foam pillow group at 60 min (T7; p = 0.0001). Participants were more satisfied sitting with the two types of back pillows at the initial time (T1; p = 0.0001) and at 60 min (T7; p = 0.0001) when compared with the control group. Furthermore, the participants were more satisfied with using rubber pillows rather than foam pillows throughout the sitting period (p = 0.0001). The control group experienced more transversus abdominis and internal oblique muscle fatigue at 60 min (T7) of sitting compared to the initial time (T1) (p = 0.038). Thus, sitting with pillow support can decrease deep trunk muscle fatigue, and using a pillow made from natural rubber may ensure greater satisfaction and less discomfort for the user.

Innovative seated vertical lumbar traction allows simultaneous computer work while inducing spinal height changes similar to supine lying

BACKGROUND

Lumbar intervertebral disc height loss has been associated with spinal height change (SHC) and low back pain (LBP), including stenosis. Non-invasive methods to improve disc height loss require forms of lying down, which are unconducive to computer work.

OBJECTIVE

Intermittent vertical traction (VT) integrated with seated computer work may provide ergonomic alternatives for increasing SHC to promote LBP relief. The primary aim was to develop and introduce a safe VT prototype and dosage to induce and measure SHC. Prototype comfort and LBP ratings were exploratory secondary aims.

METHODS

Forty-one participants were stadiometry-measured for pre- and post-intervention SHC from seated VT at 35% body weight removed, supine lying (SL), and sitting at a computer (SIT) without VT. Pain ratings were recorded for those self-reporting LBP. VT prototype evaluations were compiled from a 3-question, 7-point Likert-style survey.

RESULTS

SHC increased by 3.9 ± 3.4 mm in VT, 1.7 ± 3.4 mm in SIT, and 4.3 ± 3.1 mm in SL (P< 0.000). Post hoc findings were significant between VT and SIT (P< 0.000), and SL and SIT (P< 0.000). VT and SL LBP ratings both decreased, but not SIT.

CONCLUSION

Intermittent seated VT is a promising alternative for postural relief during seated computer work, producing SHC similar to lying down without compromising workflow.

The Effect of Teach-Back Combined with King Interactive Standard Mode on the Life of COPD Patients

Background

COPD is a common clinical chronic airway inflammatory disease that occurs mostly in middle-aged and older adults over the age of 40. The incidence of COPD is increasing year by year and the onset of age is gradually becoming younger.

Objective

To observe the effect of teach-back combined with king interaction on the life of patients with chronic obstructive pulmonary disease (COPD).

Methods

A total of 100 COPD patients admitted to our hospital from Jan 2021 to Jan 2022 were retrospectively selected to be divided into 50 cases in the control group and 50 cases in the observation group according to the nursing methods. The control group was treated with routine nursing intervention, while the observation group was treated with teach-back combined with king interactive standard mode intervention. The differences in Self-Care Ability Assessment Scale (ESCA) score, St. George's Respiratory Questionnaire (SGRQ) score, Mental State Assessment Scale (MSSNS) score, 6-minute walking distance (6MWD), and pulmonary function indexes were compared between the two groups before and after the intervention. The success rate and patient compliance of each index in the groups were also recorded.

Results

After 3 months and 6 months of intervention, the total SGRO score and its factor scores of self-care skills, self-care responsibility, self-concept, health knowledge level in them were all higher than those before the intervention, while the total SGRO score and its factor scores of respiratory symptoms, activity limitation, disease influence, and so on were all decreased compared with those before the intervention. The ESCA score of the observation group was significantly higher than that of the control one after 3 months and 6 months of intervention, while the SGRQ score was significantly lower than that of the control one, with statistical significance (P < 0.05). After 3 months of intervention, the total score of MSSNS and the scores of anxiety, depression, loneliness, and other factors in both groups were decreased compared with those before intervention. After 6 months of intervention, the total score of MSSNS and scores of each factor in both groups were decreased compared with those before intervention, and the MSSNS scores in the observation group were significantly lower than those in the control group after the intervention, which was statistically significant (P < 0.05). After 3 months and 6 months of intervention, 6MWD, forced vital capacity (FVC), forced expiratory value in 1 second (FEV1), and FVC/FEV1 in them were all higher than those before intervention, and 6MWD and pulmonary function were significantly higher in the observation group than in the control group after 3 and 6 months of intervention, which was statistically significant (P < 0.05). The ESCA score, SGRQ score, MSSNS score, pulmonary function compliance rate, and compliance rate in the observation group were significantly higher than those in the control group, which was statistically significant (P < 0.05).

Conclusion

The use of teach-back combined with king interactive standard mode in COPD patients can improve the patient's self-care ability, reduce psychological negative emotions, and improve the quality of life.

An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers

OBJECTIVE

The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants.

BACKGROUND

Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain.

METHOD

Thirty participants with CLBP were randomly allocated: (a) control-sitting without exercise, and (b) intervention-supported dynamic lumbar extension with the ADIM technique.

RESULTS

Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting.

CONCLUSION

The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP.

APPLICATION

Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.

Comparison of core stabilization techniques on ultrasound imaging of the diaphragm, and core muscle thickness and external abdominal oblique muscle electromyography activity

BACKGROUND

To restore core stability, abdominal drawing-in maneuver (ADIM), abdominal bracing (AB), and dynamic neuromuscular stabilization (DNS) have been employed but outcome measures varied and one intervention was not superior over another.

OBJECTIVE

The purpose of this study was to compare the differential effects of ADIM, AB, and DNS on diaphragm movement, abdominal muscle thickness difference, and external abdominal oblique (EO) electromyography (EMG) amplitude.

METHODS

Forty-one participants with core instability participated in this study. The subjects performed ADIM, AB, and DNS in random order. A Simi Aktisys and Pressure Biofeedback Unit (PBU) were utilized to measure core stability, an ultrasound was utilized to measure diaphragm movement and measure abdominal muscles thickness and EMG was utilized to measure EO amplitude. Analysis of variance (ANOVA) was conducted at P< 0.05.

RESULTS

Diaphragm descending movement and transverse abdominis (TrA) and internal abdominal oblique (IO) thickness differences were significantly increased in DNS compared to ADIM and AB (P< 0.05). EO amplitude was significantly increased in AB compared to ADIM, and DNS.

CONCLUSIONS

DNS was the best technique to provide balanced co-activation of the diaphragm and TrA with relatively less contraction of EO and subsequently producing motor control for efficient core stabilization.

The Effect of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique on Stature Change during Prolonged Sitting in Sedentary Workers with Chronic Low Back Pain

To enhance stature recovery, lumbar spine stabilization by stimulating the deep trunk muscle activation for compensation forces originating from the upper body was introduced. The abdominal drawing-in maneuver (ADIM) technique has been found mainly to activate deep trunk muscles. The purpose of the current study was to determine whether 5 weeks of training of deep trunk muscles using the ADIM technique could improve stature recovery, delay trunk muscle fatigue, and decrease pain intensity during prolonged sitting. Thirty participants with chronic low back pain (CLBP) conducted a core stabilization exercise (CSE) with the ADIM technique for 5 weeks. Participants were required to sit for 41 min before and after the exercise intervention. Stature change was measured using a seated stadiometer with a resolution of ±0.006 mm. During sitting, the stature change, pain intensity, and trunk muscle fatigue were recorded. A comparison between measurements at baseline and after 5 weeks of training demonstrated: (i) stature recovery and pain intensity significantly improved throughout the 41 min sitting condition; (ii) the bilaterally trunk muscle showed significantly decreased fatigue. The CSE with the ADIM technique was shown to provide a protective effect on detrimental reductions in stature change and trunk muscle fatigue during prolonged sitting in young participants under controlled conditions in a laboratory. This information may help to prevent the risk of LBP from prolonged sitting activities in real life situations.

Impact Analysis of 20-Week Multimodal Progressive Functional-Proprioceptive Training among Sedentary Workers Affected by Non-Specific Low-Back Pain: An Interventional Cohort Study

According to the latest data published by the WHO, 1.71 billion people suffer from musculoskeletal disorders and 568 million are affected by back pain, making these the most significant occupational health problems. The aim of this study was to analyze the effects of a newly developed Multimodal Workplace Training Program implemented among young sedentary employees in order to treat and prevent these problems. The 20-week Training Program was conducted at the National Instruments Corporations’ Hungarian subsidiary in Debrecen between January and June, 2019. Pre- and post-intervention questionnaires were used to assess subjective parameters. Baseline and follow-up physical examinations were performed using the SpinalMouse, Y-Balance, Sit and Reach, Prone and Side Plank, Timed Abdominal Curl, and Biering-Sorensen tests. The results for 76 subjects were eligible for statistical analysis. Our Training Program was effective in several aspects, including a reduction in musculoskeletal symptoms and improvements in posture (p < 0.001), in dynamic (p < 0.01) and static-isometric (p < 0.001) core strength, in flexibility (p < 0.001), in spinal inclination in the sagittal (p < 0.001) and frontal (p < 0.01) plane, and in balance and coordination (p < 0.05). The Multimodal Progressive Functional–Proprioceptive Training was highly effective, and the application of such a complex training program can be recommended in workplace settings.

The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up

Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.