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Zhai H, Zhang L, Xia J, Li C. The Efficiency of Respiratory Exercises in Rehabilitation of Low Back Pain: A Systematic Review and Meta-Analysis. J Sport Rehabil 2024; 33:189-200. [PMID: 38377983 DOI: 10.1123/jsr.2023-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Low back pain (LBP) is a common musculoskeletal disorder, and respiratory exercise is considered a nonsurgical management method. Therefore, this systematic review and meta-analysis aims to estimate the results of randomized controlled trials on the effect of respiratory training in reducing LBP and its dose relationship. METHODS The present study was conducted from January 2020 to January 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2020). Relevant studies were searched in multiple databases including PubMed, Web of Science, the Cochrane Library, EBSCO, Scopus, ScienceDirect, Wan Fang and China Knowledge Network, ClinicalTrials.gov, and Google Scholar, using a combination of MeSH/Emtree terms and free-text words. The heterogeneity of the studies was assessed using the I2 statistic. RESULTS A total of 14 publications were included in the meta-analysis, with a total sample size of 698 individuals, aged 60-80 years. Respiratory exercise was effective in relieving LBP (standardized mean difference = -0.87, P < .00001) and improving physical disability (standardized mean difference = -0.79, P < .00001). The type of breathing and the total duration of breathing exercises were found to be the source of heterogeneity in this study by subgroup analysis. Subgroup analysis revealed that the most significant effect sizes of breathing resistance exercise to reduce LBP and the most significant effect sizes of breathing relaxation techniques to alleviate physical disability were performed 3 to 5 times per week and period >4 weeks. Respiratory exercise reducing LBP and improving functional disability was most effective when the total duration of the intervention was >500 minutes. Funnel plots showed that the results of the 2 overall studies were reliable without publication bias. CONCLUSIONS Respiratory exercise can effectively reduce LBP and improve physical disability. Therefore, these exercises can be regarded as a part of a LBP management plan. We recommend an exercise program with 30 to 50 minutes, 3 to 5 times per week, and >4 weeks of breathing resistance exercise program as the most effective for treating LBP.
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Affiliation(s)
- Haiting Zhai
- Sports Coaching College, Beijing Sport University, Beijing, China
- School of Basic Sciences for Aviation, Naval Aviation University, Yantai, China
| | - Liqing Zhang
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - JiXiang Xia
- School of Basic Sciences for Aviation, Naval Aviation University, Yantai, China
| | - Cheng Li
- School of Basic Sciences for Aviation, Naval Aviation University, Yantai, China
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2
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Jiang X, Sun W, Chen Q, Xu Q, Chen G, Bi H. Effects of breathing exercises on chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. J Back Musculoskelet Rehabil 2024; 37:13-23. [PMID: 37718775 DOI: 10.3233/bmr-230054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND A range of studies concerning the effects of breathing exercises on chronic low back pain (CLBP) have been proven inconclusive. OBJECTIVE The study aimed to evaluate the effectiveness of breathing exercises for the treatment of CLBP. METHODS We considered randomized controlled trials in English or Chinese that used breathing exercises for the treatment of CLBP. An electronic search was performed in the MEDLINE, EMBASE, Web of Science, Cochrane Library, CNKI, Wan Fang, and CBM databases for articles published up to November 2022. Two reviewers independently screened the articles, assessed the risk of bias using the Cochrane risk of bias tool, and extracted the data. The outcomes included pain, lumbar function and pulmonary function post-intervention. RESULTS A total of thirteen studies (n= 677) satisfied the inclusion criteria. The meta-analysis results demonstrated a significant effect of breathing exercises on the Visual Analog Scale (VAS) score (SMD =-0.84, 95% CI: -1.24 to -0.45, P< 0.0001), the Oswestry Disability Index (ODI) score (SMD =-0.74, 95% CI: -0.95 to -0.54, P< 0.00001), Forced Vital Capacity (FVC) score (MD = 0.24, 95% CI: 0.10 to 0.37, P= 0.0006), Forced Expiratory Volume in 1 second /Forced Vital Capacity (FEV1/FVC) (MD = 1.90, 95% CI: 0.73 to 3.07, P= 0.001), although there was no significant difference between the breathing exercises and control interventions for Forced Expiratory Volume in the first second (FEV1) score (MD = 0.22, 95% CI = [0.00, 0.43], P= 0.05), and Maximal Voluntary Ventilation (MVV) score (MD = 8.22, 95% CI = [-4.02, 20.45], P= 0.19). CONCLUSION Breathing exercises can reduce pain, assist people with lumbar disabilities, and improve pulmonary function, and could be considered as a potential alternative treatment for CLBP.
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Affiliation(s)
- Xiaoyu Jiang
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Wenyu Sun
- Department of Rehabilitation Medicine, Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
| | - Qiang Chen
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Qiling Xu
- College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Guoming Chen
- Department of Rehabilitation Medicine, Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
| | - Hongyan Bi
- Department of Rehabilitation Medicine, Affiliated Hospital of Shandong University of Chinese Medicine, Jinan, Shandong, China
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Masroor S, Tanwar T, Aldabbas M, Iram I, Veqar Z. Effect of Adding Diaphragmatic Breathing Exercises to Core Stabilization Exercises on Pain, Muscle Activity, Disability, and Sleep Quality in Patients With Chronic Low Back Pain: A Randomized Control Trial. J Chiropr Med 2023; 22:275-283. [PMID: 38205226 PMCID: PMC10774616 DOI: 10.1016/j.jcm.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2023] [Accepted: 07/22/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The purpose of this study was to test the effect of adding diaphragmatic breathing exercises (DBEs) to core stabilization exercises (CSEs) for patients with chronic low back pain (CLPB). Methods Twenty-two patients with CLPB were randomly allocated to the experimental (DBE + CSE) or control group (CSE only). They were given 12 treatment sessions 3 times a week for 4 weeks. Patients were evaluated before and after the 12 sessions. Surface electromyography of transverse abdominis, Oswestry Disability Index, Fear Avoidance Belief Questionnaire, Pittsburgh Sleep Quality Index, Numeric Pain Rating Scale, and chest expansion were used as outcome measures for pain, muscle activity, disability, and sleep quality. Results The outcome measure scores showed statistical significance of (P = .01) in time effect on muscle activity, sleep quality, disability score, pain score, fear-avoidance belief of patients and chest expansion; and group effect on Fear Avoidance Belief Questionnaire and physical activity parameter (P = .05). An interaction effect (time x group) on muscle activity for right transverse abdominus during tuck in (P = .01) and chest expansion (P = .01) was also found; however, no significant difference was found related to other parameters. Conclusion The combination of DBE and CSE interventions compared to CSE alone showed improvement in the measured parameters for patients with CLBP. Incorporating DBE with CSE also improved muscle activation and chest expansion.
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Affiliation(s)
- Sana Masroor
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Tarushi Tanwar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Mosab Aldabbas
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Iram Iram
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Zubia Veqar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Gherscovici ED, Mayer JM. Impact of Indoor Air Quality and Breathing on Back and Neck Pain: A Systematic Review. Cureus 2023; 15:e43945. [PMID: 37638265 PMCID: PMC10447999 DOI: 10.7759/cureus.43945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 08/29/2023] Open
Abstract
Back pain and neck pain are important public health concerns and are among the most common and disabling conditions globally. However, the relationships among indoor air quality (IAQ), breathing parameters (pulmonary function, respiratory disorders), and back pain and neck pain have not been adequately assessed. The purpose of this study was to systematically review the literature about the impact of IAQ and breathing parameters on back pain and neck pain (PROSPERO ID: CRD42022380515). CINAHL, EMBASE, PEDRo, and PubMed databases were searched through January 19, 2023. Inclusion criteria for study eligibility were observational studies (except case reports) or randomized controlled trials (RCTs), published in peer-reviewed journals in the English language, human research, original research, examined the relationships between IAQ, or breathing parameters with back pain or neck pain. Review procedures were conducted and reported according to PRISMA recommendations. Empirical evidence statements were developed for observational studies, and grades of evidence statements were developed for RCTs. Sixty-seven eligible studies were found (54 observational studies and 13 RCTs) that enrolled 345,832 participants. None of the studies assessed the combined impact of IAQ and breathing parameters on back pain or neck pain. No level 1 studies were found, which precludes making strong statements about causality and strong recommendations about the efficacy of IAQ and breathing exercise interventions for reducing pain and disability related to back pain and neck pain. Evidence indicates that poor IAQ and respiratory disorders are related to an increased risk of back pain and neck pain. Conflicting evidence exists about the association between pulmonary function with back pain and neck pain. Evidence for breathing exercise interventions was mixed with numerous limitations. This review provides preliminary evidence on the relationships of IAQ and breathing parameters with back pain and neck pain, which can be used to guide future research and clinical implementation efforts. Assuming positive findings in subsequent research, a wide range of stakeholders involved with this complex human-building-environment interface can be equipped to address IAQ and breathing parameters, along with other established risk factors to help those suffering from back pain and neck pain.
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Affiliation(s)
| | - John M Mayer
- Research & Development, Healthy Buildings LLC, Malibu, USA
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5
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Jonely H, Jayaseelan D, Costello E, Signorino J, Wooten L, Murray D, Woolstenhulme J. Changes in pulmonary function following thoracic spine manipulation in a healthy inactive older adult population-a pilot study. J Phys Ther Sci 2023; 35:492-496. [PMID: 37405180 PMCID: PMC10315198 DOI: 10.1589/jpts.35.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/03/2023] [Indexed: 07/06/2023] Open
Abstract
[Purpose] Pulmonary function pathology is primarily treated pharmacologically, with a range of medication side effects. Few studies have systematically examined non-pharmacologic approaches such as joint manipulation effects on pulmonary function. This study examined the immediate and short-term effects of thoracic manipulation on pulmonary function. [Participants and Methods] Twenty-one physically inactive otherwise healthy participants aged 50 years or older were randomly assigned to either receive three sessions of thoracic manipulation (n=10) or three sessions of "sham intercostal training" (n=11). Outcome measures included forced vital capacity, maximal voluntary ventilation and thoracic excursion during maximal inhalation and exhalation. [Results] There was a statistically significant difference in maximal voluntary ventilation in the manipulation group, when measured within a week of the third intervention session and immediate effects in thoracic excursion during exhalation in the sham group following a single intervention session. There were no significant changes in other measures. [Conclusion] Spinal manipulation had no immediate effect on pulmonary function, however, affected an improvement in maximal voluntary ventilation within 7 days following a third session. The sham intervention showed a change in thoracic excursion during exhalation after the first session. Future research is necessary to further explore the relationship between thoracic manipulation and pulmonary function.
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Affiliation(s)
- Holly Jonely
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Dhinu Jayaseelan
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Ellen Costello
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Joseph Signorino
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
- Division of Physical Therapy, Shenandoah University,
USA
| | - Liana Wooten
- Department of Public Health and Community Medicine, School
of Medicine, Doctor of Physical Therapy Program, Tufts University, USA
| | - Donal Murray
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Josh Woolstenhulme
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
- Department of Physical Therapy and Athletic Training,
Meridian Health Sciences Center, Idaho State University, USA
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Lee GT, Himler P, Rhon DI, Young JL. Home Exercise Programs Are Infrequently Prescribed in Trials of Supervised Exercise for Individuals With Low Back Pain: A Scoping Review of 292 Randomized Controlled Trials. J Orthop Sports Phys Ther 2023; 53:120-142. [PMID: 36645192 DOI: 10.2519/jospt.2023.11448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES: To (1) determine how often home exercise programs (HEPs) are prescribed in supervised exercise trials for low back pain (LBP) and (2) describe characteristics of the HEP programs (design, purpose, dose, and adherence). DESIGN: Scoping review. LITERATURE SEARCH: PubMed, CINAHL, and Ovid MEDLINE were searched from January 1, 2010, to August 17, 2021. STUDY SELECTION CRITERIA: Randomized controlled trials that included adults with LBP who received exercise interventions. DATA SYNTHESIS: The presence or absence of a prescribed HEP and any details of the HEP including design, dose, and adherence were extracted and summarized. RESULTS: Of 2689 potentially relevant trials, 292 were eligible for inclusion. Ninety-four trials (32%) included a HEP. The most commonly prescribed home exercises were core stability, trunk strengthening, and motor control exercises. There was great variation in the frequency and duration with which HEPs were prescribed. Adherence to HEPs was measured in fewer than half of the trials, and the methods for measuring adherence were inconsistent. Adherence to HEPs ranged from 29% to 82% in the 21 trials that reported adherence. CONCLUSION: Home exercise programs are not regularly prescribed in supervised exercise trials for LBP. There was considerable variation in prescribing HEPs and monitoring exercise adherence in trials of exercise-based treatments for adults with LBP. There is no consistent method used to measure participants' adherence to HEPs, and adherence percentages vary widely. J Orthop Sports Phys Ther 2023;53(3):120-142. Epub: 16 January 2023. doi:10.2519/jospt.2023.11448.
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Over Half of Clinical Trials of Mobilization and Manipulation for Patients With Low Back Pain May Have Limited Real-World Applicability: A Systematic Review of 132 Clinical Trials. J Orthop Sports Phys Ther 2022; 52:532-545. [PMID: 35722756 DOI: 10.2519/jospt.2022.10962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the existing body of trials assessing manual therapy for low back pain (LBP) to determine where it falls on the efficacyeffectiveness continuum. DESIGN Methodology systematic review. LITERATURE SEARCH PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and PEDro (Physiotherapy Evidence Database) were searched for trials published between January 1, 2000, and April 30, 2021. STUDY SELECTION CRITERIA We included randomized clinical trials investigating joint mobilization and manipulation for adults with nonspecific LBP that were available in English. DATA SYNTHESIS We used the Rating of Included Trials on the Efficacy-Effectiveness Spectrum (RITES) tool to score included trials across 4 domains: participant characteristics, trial setting, flexibility of intervention(s), and clinical relevance of experimental and comparison intervention(s). Proportions of trials with greater emphasis on efficacy or effectiveness were calculated for each domain. RESULTS Of the 132 included trials, a greater proportion emphasized efficacy than effectiveness for domains participant characteristics (50% vs 38%), trial setting (71% vs 20%), and flexibility of intervention(s) (61% vs 25%). The domain clinical relevance of experimental and comparison intervention(s) had lower emphasis on efficacy (41% vs 50%). CONCLUSION Most trials investigating manual therapy for LBP lack pragmatism across the RITES domains (ie, they emphasize efficacy). To improve real-world implementation, more research emphasizing effectiveness is needed. This could be accomplished by recruiting from more diverse participant pools, involving multiple centers that reflect common clinical practice settings, involving clinicians with a variety of backgrounds/experience, and allowing flexibility in how interventions are delivered. J Orthop Sports Phys Ther 2022;52(8):532-545. Epub: 19 June 2022. doi:10.2519/jospt.2022.10962.
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Jung SH, Hwang UJ, Ahn SH, Kim JH, Kwon OY. Does mobilisation of the thoracic spine using mechanical massage affect diaphragmatic excursion in individuals with thoracic hyperkyphosis? J Back Musculoskelet Rehabil 2022; 35:517-523. [PMID: 34657875 PMCID: PMC9198757 DOI: 10.3233/bmr-210143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Thoracic mobilisation improves thoracic hyperkyphosis and respiratory function. Diaphragmatic excursion is associated with respiratory function; however, limited studies have assessed the effect of thoracic mobilisation on diaphragmatic excursion. OBJECTIVE This study aimed to investigate the effects of thoracic mobilisation on diaphragmatic excursion and respiratory function in individuals with thoracic hyperkyphosis. METHODS Participants were recruited through Internet advertising and participated voluntarily. Nineteen healthy participants (age: 33.37 ± 6.56 years; height: 170.32 ± 7.92 cm; weight: 69.77 ± 14.70 kg) with thoracic hyperkyphosis underwent thoracic mobilisation for 8 weeks. Diaphragmatic excursion, thoracic kyphosis, and respiratory function were measured. Thoracic mobilisation was provided using a mechanical massage device. RESULTS Thoracic mobilisation for 8 weeks significantly improved diaphragmatic excursion during deep breathing (p= 0.015), forced vital capacity (p< 0.01), and thoracic hyperkyphosis (p< 0.01). CONCLUSIONS Thoracic mobilisation can be recommended in respiratory rehabilitation programs to increase diaphragmatic excursion and respiratory function for the management and prevention of respiratory dysfunction in individuals with thoracic hyperkyphosis.
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Affiliation(s)
| | | | | | | | - Oh-Yun Kwon
- Corresponding author: Oh-Yun Kwon, 234 Maeji-ri, Heungeup-Myeon, Wonju, Kangwon-Do 26493, South Korea. Tel.: +82 33 760 2427; Fax: +82 33 760 2496; E-mail:
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Ziaeifar M, Sarrafzadeh J, Noorizadeh Dehkordi S, Arab AM, Haghighatkhah H, Zendehdel Jadehkenari A. Diaphragm thickness, thickness change, and excursion in subjects with and without nonspecific low back pain using B-mode and M-mode ultrasonography. Physiother Theory Pract 2021; 38:2441-2451. [PMID: 34061721 DOI: 10.1080/09593985.2021.1926022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Previous studies have demonstrated that respiratory dysfunction has a potential association with low back pain (LBP). Despite the role of the diaphragm for respiration and spinal stability, knowledge of the function of both sides of the diaphragm in subjects with LBP is still limited.Objective: This study aimed to compare the structural integrity and function of the right and left hemidiaphragm by ultrasonography (USG) in subjects with and without nonspecific chronic low back pain (NS-CLBP).Methods: A total of 37 subjects with NS-CLBP and 34 healthy subjects participated in this case-control study. The thickness, thickness change, and excursion of the right and left hemidiaphragm were compared within and between the groups during quiet breathing (QB) and deep breathing (DB) through B-mode and M-mode ultrasound imaging.Results: The LBP group had a significantly smaller degree of right hemidiaphragm thickness change (P = .001) compared with the healthy control group, with a strong effect size. Nevertheless, there was no significant change for diaphragm thickness and excursion between the two groups. The result showed that, in the healthy group, the right hemidiaphragm had a significantly smaller thickness at expiration and larger thickness change compared with the left hemidiaphragm, with a moderate effect size. Based on the multivariate prediction analysis, the right hemidiaphragm thickness change might significantly predict LBP.Conclusion: We found that participants with LBP had a smaller degree of right hemidiaphragm thickness change. Also, the right hemidiaphragm thickness change might significantly predict LBP.
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Affiliation(s)
- Maryam Ziaeifar
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
| | - Javad Sarrafzadeh
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
| | - Shohreh Noorizadeh Dehkordi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
| | - Amir Massoud Arab
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamidreza Haghighatkhah
- Radiology Department of Diagnosis Imaging Shohadae Tajrish Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Alieh Zendehdel Jadehkenari
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mirdamad Blvd, Tehran, Iran
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Eight-Week Inspiratory Muscle Training Alters Electromyography Activity of the Ankle Muscles During Overhead and Single-Leg Squats: A Randomized Controlled Trial. J Appl Biomech 2020; 37:13-20. [PMID: 33049701 DOI: 10.1123/jab.2019-0315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022]
Abstract
This study was conducted to evaluate the effects of 8-week inspiratory muscle training on activity in the ankle muscles of athletes with chronic low-back pain. A randomized controlled trial involving 45 men and women with chronic low-back pain was carried out. Electromyography activity in the tibialis anterior, peroneus longus, gastrocnemius medialis, and gastrocnemius lateralis muscles of the dominant leg was recorded. Secondary outcomes included biopsychosocial indices, such as pain, disability, anxiety and depression, fear-avoidance beliefs, and fear of (re)injury. Static and dynamic overhead squat tests showed that inspiratory muscle training decreased activity in the tibialis anterior, peroneus longus, and gastrocnemius medialis muscles. In the static single-leg squat test and the descending phase of the dynamic equivalent, such a decrease was observed in all the 4 muscles. Inspiratory muscle training significantly reduced pain severity and activity in the tibialis anterior, peroneus longus, and gastrocnemius medialis muscles during the ascending phase of the dynamic single-leg squat test. On the basis of the findings, 8 weeks of inspiratory muscle training may constitute useful rehabilitation for reducing excessive activity in ankle joint muscles and aiding chronic low-back pain recovery.
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11
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Jonsson K, Peterson M. Peak expiratory flow rate and thoracic mobility in people with fibromyalgia. A cross sectional study. Scand J Pain 2019; 19:755-763. [PMID: 31343985 DOI: 10.1515/sjpain-2019-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/19/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Fibromyalgia (FM) is characterized by chronic widespread pain and affects approximately 1-3% of the general population. Respiratory function has not been given much consideration in people with FM. Few studies have been published concerning FM and respiratory function and conflicting data still exist. The aim of this study was to compare differences in forced expiration, but also to investigate chest expansion, spinal mobility and segmental pain intensity between a group with fibromyalgia and healthy controls. METHODS Forty-one women with diagnosed FM based on American College of Rheumatology 1990 criteria and forty-one controls without pain matched for age and gender participated in this cross-sectional study. For evaluation of forced expiration, a Wright peak expiratory flow rate meter was used. A tape measure was used to measure the mobility of the thorax at maximum inhalation and exhalation known as chest expansion. Spinal mobility was measured with the Cervico-thoracic ratio method. The spinal mobility was measured as range of motion from C7 to 15 cm below in flexion and manual palpation was conducted between C7-T5. For differences in pain intensity a palpation-index was defined for each level, respectively; C7-T1, T1-2, T2-3, T3-4 and T4-5 by calculating the mean value for the four different palpation points for each motion segment. A combined measure of expiration and thoracic mobility (expiratory/inspiratory ratio) was calculated by dividing peak expiratory flow rate (L/min) with chest expansion (cm). Statistical analyses included descriptive statistics to describe subjects and controls, means and standard deviation to compare differences between groups and student-t and Chi-square (χ2) tests, using SPSS 22 software. Confidence interval was set to 95%. RESULTS In the FM group 17 had the diagnosis for more than 5 years and 24 less than 5 years. The FM group demonstrated significantly lower forced expiration (p < 0.018), less thoracic expansion (p < 0.001), reduced spinal mobility (p < 0.029), higher expiratory-inspiratory ratio value (p < 0.001) and increased palpation pain over C7-T5 (p < 0.001) compared to healthy controls. There were more smokers in the FM group (n = 9) compared to the controls (n = 5) though this difference was not statistically significant (p < 0.24) and excluding the few smokers yielded similar result. No significant correlations for manual palpation, chest expansion, peak expiratory flow rate and spinal mobility were found in the FM group. CONCLUSIONS Women with FM demonstrated significantly lower forced expiration and thoracic mobility compared to healthy controls. IMPLICATIONS The results of this study point to a plausible restriction of respiratory function which in turn may have effect on physical endurance and work capacity in people with FM.
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Affiliation(s)
- Kent Jonsson
- Department of Geriatric and Rehabilitation Medicine, Nykoping Hospital, Nykoping, Sweden.,Department of Public Health and Caring Sciences, Section of Family Medicine, Uppsala University, Uppsala, Sweden
| | - Magnus Peterson
- Department of Public Health and Caring Sciences, Section of Family Medicine, Uppsala University, Uppsala, Sweden.,Samariterhemmet Academic Primary Health Care Centre, Region Uppsala, Sweden
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12
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Gholami Borujeni B, Yalfani A. Reduction of postural sway in athletes with chronic low back pain through eight weeks of inspiratory muscle training: A randomized controlled trial. Clin Biomech (Bristol, Avon) 2019; 69:215-220. [PMID: 31614295 DOI: 10.1016/j.clinbiomech.2019.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/05/2019] [Accepted: 09/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Postural control and respiratory function are mechanically and neuromuscularly dependent on each other. The present study was conducted to determine the effects of inspiratory muscle training on postural sway in athletes with chronic low back pain. METHODS Twenty-four patients were randomly selected as the experimental group and 23 patients as the control group. The experimental group underwent the inspiratory muscle training protocol for eight weeks, seven days per week and twice daily. The postural sway variables were recorded using a plantar pressure measurement device. The postural sway variables were recorded when performing overhead and single leg squat. Patient's perceived low back pain was assessed using Visual Analog Scale. Disability was assessed using the Athletes Disability Index questionnaire. Patient depression/anxiety was assessed using the Patient Health Questionnaire-4. FINDINGS The results of the two-way ANOVA in the overhead squat test showed that postural sway indices significantly decreased in the experimental group after 8-weeks intervention compared to the pre-test values. The results of the two-way ANOVA in single leg squat test showed significant differences between the pre- and post-test in the experimental group in the postural sway indices except for the factor of standard deviation Y, also compared to the pre-test value, pain was significantly decreased in the experimental group. INTERPRETATION The 8-weeks inspiratory muscle training decreased postural sway in athletes with chronic low back pain when performing the overhead and single leg squat. In addition, the pain index decreased after 8-weeks of inspiratory muscle training.
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Affiliation(s)
- Behnam Gholami Borujeni
- Department of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, Bu Ali Sina University, Hamedan, Iran.
| | - Ali Yalfani
- Department of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, Bu Ali Sina University, Hamedan, Iran.
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Borujeni BG, Yalfani A. Effect of respiratory muscle training session on ankle muscle activity in athletes with chronic low back pain performing overhead squats: a randomized controlled trial. INT J EVID-BASED HEA 2019; 18:256-264. [PMID: 31567604 DOI: 10.1097/xeb.0000000000000204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM The current study was conducted to evaluate the effect of a respiratory muscle training session on ankle muscle activity in athletes with chronic low back pain performing overhead squats. METHODS The current double-blind, randomized, controlled trial was conducted on 24 patients randomly selected as the training group and 23 patients as the control group. The training group received the respiratory muscle training protocol. The electromyography activity of the tibialis anterior, peroneus longus, gastrocnemius medialis and gastrocnemius lateralis muscles of the dominant leg was recorded in the participants. RESULTS The findings showed that a session of respiratory muscle training reduced the activities of some ankle joint muscles when performing overhead squats, including tibialis anterior in the static and dynamic overhead squat tests and peroneus longus in the ascending phase. In the dynamic test, the angle to reach peak activity changed in tibialis anterior in the descending phase and also in tibialis anterior and peroneus longus in the ascending phase. CONCLUSION Effects of respiratory muscle training prevented excessive ankle joint muscle activity through stimulating local muscles while performing overhead squats, which had indicated an improved postural control and multisectional proprioception to maintain postural stability and stimulated the local muscles of the core area.
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Affiliation(s)
- Behnam Gholami Borujeni
- Department of Corrective Exercises and Sport Injury, Faculty of Physical Education and Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
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Is spinal mobilization effective for low back pain?: A systematic review. Complement Ther Clin Pract 2019; 34:51-63. [DOI: 10.1016/j.ctcp.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/04/2018] [Accepted: 11/04/2018] [Indexed: 12/14/2022]
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Zafereo J, Wang-Price S, Roddey T, Brizzolara K. Regional manual therapy and motor control exercise for chronic low back pain: a randomized clinical trial. J Man Manip Ther 2018. [DOI: 10.1080/10669817.2018.1433283] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Jason Zafereo
- Department of Physical Therapy, University of Texas Southwestern Medical Center , Dallas, TX, USA
| | - Sharon Wang-Price
- School of Physical Therapy, Texas Woman’s University , Dallas, TX, USA
| | - Toni Roddey
- School of Physical Therapy, Texas Woman’s University , Dallas, TX, USA
| | - Kelli Brizzolara
- School of Physical Therapy, Texas Woman’s University , Dallas, TX, USA
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