نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد آسیب شناسی و حرکات اصلاحی ورزشی/ دانشکده تربیت بدنی و علوم ورزشی/ دانشگاه علامه طباطبایی/ تهران

2 استادیار دانشکده تربیت بدنی و علوم ورزشی/ دانشگاه علامه طباطبایی/ تهران

چکیده

زمینه و هدف: کمردرد یکی از شایع ترین معضات بهداشتی جوامع مختلف دنیا، به ویژه در کشورهای صنعتی به شمار می رود؛ از این رو پیداکردن راهکارهایی برای پیشگیری و درمان آن، امری ضروری به حساب می آید. هدف از انجام این تحقیق، بررسی تأثیر تمرینات ثبات مرکزی بر بهبود ناتوانی و قدرت عضات ناحیه شکم و پشت در افراد مبتا به کمردرد مزمن ناشی از فتق دیسک بود. روش تحقیق: 30 بیمار مرد و زن مبتا به کمردرد مزمن ناشی از فتق دیسک مراجعه کننده به بخش فیزیوتراپی کلینیک درمانی شهر تهران به صورت هدفمند برای شرکت در تحقیق انتخاب شدند و به صورت تصادفی به دو گروه مساوی تجربی و کنترل تقسیم گردیدند. گروه تجربی به مدت 8 هفته تمرینات ثبات مرکزی و درمان های رایج، اما گروه کنترل در مدت زمان مشابه، تنها درمان های رایج را دریافت کردند. برای ارزیابی متغیرها از پرسشنامه ناتوانی اوسوستری، آزمون پایین آوردن مستقیم پاها برای قدرت عضات شکم و دینامومتر برای قدرت عضات پشت استفاده شد. برای تجزیه و تحلیل داده ها از آزمون تحلیل کوواریانس استفاده گردید و سطح معنی داری 05/p≤0 در نظر گرفته شد. یافته ها: هشت هفته تمرینات ثبات مرکزی باعث کاهش معنی دار میزان ناتوانی (001/p=0)، افزایش معنی دار قدرت عضات شکم (p=0/001) و قدرت عضات پشت (001/p=0) گروه تجربی نسبت به گروه کنترل شد. نتیجه گیری: تجویز تمریناتثبات مرکزی با در نظر گرفتن احتیاط لازم، می تواند در بهبود ناتوانی و قدرت عضلانی افراد مبتا به کمردرد مزمن ناشی از فتق دیسک موثر باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The effect of 8 weeks of core stabilization exercises on disability, abdominal and back muscle strength in patients with chronic low back pain due to disc herniation

نویسندگان [English]

  • Himan Ebrahimi 1
  • Ramin Balouchi 2
  • Rasoul Eslami 2
  • Mahdi Shahrokhi 1

1

2

چکیده [English]

Bachground and Aim: Low back pain is one of the most common health problems in communications across the world, especially in industrialized countries; hence it would be necessary to find some ways to prevent and treat the low back pain. The aim of this study was to investigate the effect of core stabilization exercises on disability and abdominal and back muscle strength in patients with chronic low back pain caused by disc herniation. Materials and Methods: 30 male and female patients with chronic low back pain caused referred to physical therapy clinics purposefully selected and randomly were divided into two groups as experimental and control. The experimental group was received core stabilization exercises and conventional treatment; but the
control group received only conventional treatment for 8-weeks. The Oswestry questionnaire was used to assess the variables of disability, moreover, the Straight leg raising test for abdominal muscle strength and dynamometer test for back muscle strength also were used. Analysis of covariance was used to test data and the significance level was considered as p≤0.05. Results: The result indicated that 8-weeks of core stabilization exercises significantly reduced the disability (p=0.001). Moreover, increase in abdominal muscle strength (p=0.001) and back muscles strength were significantly higher (p=0.001) in the experimental group as compared to the control group. Conclusion: Prescribing core stabilization exercises by taking the necessary precautions, can be effective to reduce disability and improving muscle strength in patients with chronic low back pain caused by disc herniation.

کلیدواژه‌ها [English]

  • Core stabilization exercises
  • Low back pain
  • Disc herniation
  • Muscle strength
1. Ahmadi-Pour, M. 2008. The effect of isometric exercise on increases strength muscles flexor and extensor spine with students with low back pain. Master of Science Thesis in Physical Education and Sport Sciences, Kharazmi University. [Persian]
2. Akuthota, V., Ferreiro, A., Moore, T., Fredericson, M. 2008. Core stability exercise principles. Current Sports Medicine Reports, vol. 7, no. 1, pp. 39-44.
3. Alizamani, S., Ghasemi, GH., Salehi, H., Marandi, M. 2011. Effects of pilates exercises on patients with chronic low back pain, Journal of Sport Medicine. vol. 3, pp. 37-5 5. [Persian]
4. Aluko, A., DeSouza, L., Peacock, J. 2012. The effect of core stability exrcises onvariayions in acceleration of trunk movement, pain, and disability during an episode of acute nonspecific low back pain: a pilot clinical trial. Journal of Manipulative and Physiological Therapeutics, vol. 12, no. 12, pp. 33-49
5. Escamilla, F., Lewis, C., Bell, D., Daffron, J., Lambert, S. 2010. Core muscle activation during Swiss ball and traditional abdominal exercises. Journal of Orthopaedic & Sports Physical Therapy, vol. 40, no. 5, pp. 265-276.
6. Farahpour, N., Marvi Esfahani, M. 2003. Effect of exercise on proprioceptive system function in patients with chronic low back pain. The Journal of Mazandaran University of Medical Sciences, vol. 14, no. 42, pp. 12-25. [Persian]
7. Gard, G., Gille, KA., Grahn, B. 2000. Functional activities and psychosocial factors in the rehabilitation of patients with low back pain. Scandinavian Journal of Caring Sciences, vol. 14, no. 2, pp. 75- 81.
8. Ghaderi, F. 2001. Effects of active spinal stablizition exercises on lumbar muscle performace in sagital plane in healthy subjects. Master of science Thesis in Physical Education and Sport Sciences, Iran University of Medical Sciences. [Persian]
9. Hemati, S. 2009. Effect of deep core stabilization exercises on pain and some kinematic parameters of gait in women with chronic low back pain compared with healthy women. Master of Science Thesis in Physical Education and Sport Sciences, Iran, University of Tehran. [Persian]
10. Henrique, L. 2006. Lumbar lordosis a study of angle values and of vertebral bodies and intervertebral discs role. Acta Ortopedica Brasileira, vol. 14, no. 4, pp.24-37
11. Hodges, PW. 2003. Core stability exercise in chronic low back pain. Orthopedic Clinics of North America, vol. 34, pp. 245-254.
12. Hosseini-Far, M., Akbari, A., Shahraki-Nasab, A. 2008. The effect of McKenzie and lumbar stabilization exercises on pain and functional improvement in patients with chronic low back pain. The Journal of Shahrekord University of Medical Sciences, vol. 11, no. 8, pp.1-9. [Persian]
13. Moon, H., Choi, K., Kim, D., Kim, H., et al. 2012. 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.
14. Hyun Kim, I., Hyun Kim, J., Lee, J., Kim, M., et al. 2012. The effect of an early trunk sterngth and the Oswestry disability index after herniated nucleus pulposus surgery. Journal of Physical Therapy Science. vol. 24, pp. 165-168.
15. Karimi, N., Golpour, M., Arab, A., Ezati, K., et al. 2011. Effect of intensive training and performance monitoring of spinal stabilization in patients with chronic non-specific low back pain. Professional Journal of Physiotherapy, vol.1, no. 1, pp. 1-13. [Persian]
16. Kiani Dehkordi, K., Ebrahim, K., Frastic, P. 2008. Effective treatment of stretch step to keep changes in the face of resistance and liberation of the hip joint in patients with chronic low back pain. Journal of Movement Science and Sport, vol. 2, no. 12, pp. 11-22. [Persian]
17. Krause, DA., Youdas, JW., Hollman, JH., Smith, J. 2005. Abdominal muscle performance as measured by the double leg-lowering test. Archives of Physical Medicine and Rehabilitation, vol. 86, pp. 1345-1348.
18. Kulig, K. Beneck, GJ. Selkowitz, DM. Flanagan, SP., et al. 2009. An intensive, progressive exercise program reduces disability and improves functional performance in patients after single-level lumbar microdiskectomy. Physical Therapy, vol. 89, pp. 1145-1157.
19. Lee, GK., Choronister, J., Bishop, M. 2008. The effects of phychosocial factors on quality of life among individuals whit chronic pain. Rehabilitation Counseling Bulletin, vol. 51, pp. 177. 
20. Limburg, PJ., Sinaki, M., Rogers, JW., Caskey, PE., et al. 1991. A useful technique for measurement of back strength in osteoporotic and elderly patients. Mayo Clinic Proceedings, vol. 66, no. 1, pp. 39-44.
21. Mannion, AF., Adams, MA., Cooper, RG., Dolan, P. 1995. Prediction of maximal back muscle strength from indices of body mass and fat-free body mass. Rheumatology, vol. 38, pp. 652-655.
22. Mino-Nejad, H. 2006. Compare the degree of thoracic and lumbar curves to determine its relationship with EMG activity of the extensor muscles in athletes and non athletes. Master of science Thesis in Physical Education and Sport Sciences, Tehran University.
23. Momeni, S. 2009. Effect of trunk muscle endurance training on pain and disability index in patients with chronic LBP. Master of science Thesis in Physical Education and Sport Sciences, Arak University.
24. Nachemson, A., Waddell, G., Norlund, Al. 2000. Epidemiology of neck and low back pain. Neck and Back pain: the scientific evidence of causes, diagnosis and treatment. Philadelphia, vol. 6, p. 165.
25. Ogawa, T., Matsuzaki, H., Uei, H., Nakajima, S., et al. 2005. Alteration of gene expression in intervertebral disc degeneration of passive cigarette- smoking rats: separate quantitation in separated nucleus pulpous and annulus fibrous. Pathobiology, vol. 72, no. 3, pp. 146-151.
26. Plastanga, N., Field, D., Soames, R. 1998. Anatomy & Human Movement: Structure and Function. 3th ed. Oxford. Butterworth-Heinemann, pp. 189-201.
27. Reid, M. 2004. An assessment of health needs of chronic low back pain patients from general practice. Journal of Health Psychology,vol. 9, pp. 451-462.
28. Renkawitz, T., Boluki, D., Grifka, J. 2006. The association of low back pain, neuromuscular imbalance, and trunk extension strength in athletes. The Spine Journal, vol. 6, pp. 673-683.
29. Sekendiza, B., Altuma, O., Korkusuza, F., Akmb, S. 2007. Effects of pilates exercise on trunk strength, endurance and flexibility in sedentary adult females. Journal of Bodywork and movement Therapies, vol. 11, pp. 318-326.
30. Tsao, H., Hodges, PW. 2008. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. Journal of Electromyography and Kinesiology, vol. 18, no. 4, pp. 559-567.