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PubMed1975

Temperature-dependent transitions of the myosin-product intermediate at 10 degrees during Mn(II)-ATP hydrolysis by myosin from rabbit psoas muscle.

The initial burst of Pi liberation during the hydrolysis of Mn(II)-ATP by heavy meromyosin from rabbit psoas muscle was investigated. Below 10 degrees, the initial burst of Pi liberation was inhibited by the pre-addition of ADP without any change in the steady-state activity, but it was not inhibited above 10 degrees. The burst size was about one mole per mole of heavy meromyosin. The initial burst of Pi liberation in Mg-ATP hydrolysis at 8 degrees, however, was not inhibited by the pre-addition of ADP. These results, obtained with psoas muscle heavy meromyosin, were almost the same as those obtained with heavy meromyosin from rabbit leg and back muscles (Hozumi and Tawada (1975) Biochim. Biophys. Acta 376, 1-12) and, therefore, indicate that in Mn-ATP above 10 degrees there is at the burst site a predominant myosin -product complex generated by ATP hydrolysis. Similarly, below 10 degrees there is a myosin-product complex identical with the one generated by adding ADP (and Pi) to myosin.

Adenosine Triphosphatases↗

PubMed2004

Urethral replacement: a comparison between small intestinal submucosa grafts and spontaneous regeneration.

OBJECTIVE: To evaluate the use of commercially available single-layer small intestinal submucosa (SIS) for urethral replacement, both as an onlay and as a tube, in a rabbit model. MATERIALS AND METHODS: Thirty-six male rabbits were assigned to four experimental groups. Group 1 had the ventral wall of the penile urethra excised for 15 mm; in group 2 this created defect was patched with a SIS onlay graft; group 3 had complete excision of a 15 mm segment of the penile urethra; and in group 4, this created defect was replaced with a SIS tube graft. In all rabbits the urethra was stented for 2 weeks. A retrograde urethrogram was taken in all rabbits before death at 3, 6 and 12 weeks after surgery. The urethra was then exposed, examined carefully and excised for histopathological examination. RESULTS: In groups 1 and 2 the retrograde urethrograms were normal in 13 rabbits and there was relative narrowing in two rabbits in group 1 and three in group 2. In groups 3 and 4 all rabbits developed urethral fistulae or strictures. Histological examination of the urethra showed epithelial regeneration supported by smooth muscle backing in all rabbits in group 1, while rabbits in group 2 showed no regeneration of smooth muscle. By contrast, rabbits in groups 3 and 4 showed incomplete regeneration and progressive fibrosis. CONCLUSIONS: Single-layer SIS is not a suitable urethral substitute in this animal model. When used as an onlay, healing is inferior to spontaneous urethral regeneration, as SIS impedes smooth muscle cell regeneration. When used as a tube, there is complete scarring and urethral luminal occlusion.

Animals↗

PubMed1997

The effect of dynamic strength back exercise and/or a home training program in 57-year-old women with chronic low back pain. Results of a prospective randomized study with a 3-year follow-up period.

STUDY DESIGN: A prospective, randomized investigation. OBJECTIVES: To compare the effect of dynamic strength back muscle training with that of a home training program and to evaluate the long-term effect of the home training program in patients with chronic low back pain. SUMMARY OF BACKGROUND DATA: In a health survey of 57-year-old women, those with chronic low back pain were selected using the Nordic Questionnaire. Of 172 women with low back pain, 74 participated in the study. METHODS: The participants were randomly assigned to either dynamic strength back exercises at a fitness center and a home training program or to the home training program for the first 3 months, after which both groups continued to pursue the home training program. Follow-up observation was by examination at 3 and 12 months and by mailed questionnaire after 3 years. The primary effect variables were disability, sick-leave, and use of health care services. RESULTS: Both training groups manifested significant improvement at the 3- and 12-month follow-up examinations, yet the adherence rate was much better in the group assigned to the fitness center. Those who adhered to the training program for the first year manifested significant improvement according to the 3-year follow-up questionnaire. There was a significant reduction in the number of women on sick-leave and in use of health care services after 1 year, but not after 3 years. CONCLUSIONS: The home training program was as effective as the supervised dynamic strength muscle training program and yielded lasting improvement after at least 1 year of adherence. The adherence rate was much better, however, when the training was supervised at the start.

Back↗

PubMed1999

Hard, soft tissue and in vitro cell response to porous nickel-titanium: a biocompatibility evaluation.

Porous nickel-titanium (NiTi) alloys have demonstrated bone attachment as well as tissue ingrowth in the past. However, very few studies have compared porous NiTi soft and hard tissue reactions, and in vitro cell response. We therefore have evaluated the general muscle and bone reaction to porous nickel-titanium. The latter material was implanted in rabbit tibias and back muscle, and assessed after three, six and twelve weeks of implantation. Porous NiTi specimens did not cause any adverse effect regardless of both implantation site and post-surgery recovery time. Muscle tissue exhibited thin tightly adherent fibrous capsules with fibers penetrating into implant pores. We observed that attachment strength of the soft tissue to the porous implant seemed to increase with post-implantation time. Bone tissue demonstrated good healing of the osteotomy. There was bone remodeling characterized by osteoclastic and osteoblastic activity in the cortex. This general good in vivo biocompatibility with muscle and bone tissue corresponded very well with the in vitro cell culture results we obtained. Fibroblasts seeded on porous nickel-titanium sheets managed to grow into the pores and all around specimen edges showing an another interesting cytocompatibility behavior. These results indicate good biocompatibility acceptance of porous nickel-titanium and are very promising towards eventual NiTi medical device approbation.

Adipose Tissue↗

PubMed1975

Resorption of 125I-labeled fibrin bioplast from the dorsal muscle of rats.

Fibrin bioplast is an implant material made from plasticized fibrin. The resorption and route of elimenation of 125I-tagged bioplast plates implanted into the back muscle of rats have been studied in 18 experiments. Variation in radioactivity of the implant, appearance of the activity in the urine and fecal output, supplemented with information on the radioactivity of the implant site and that of isolated organs, reveal that the elimination of bioplast begins on the 12th day and proceeds at an even rate without pathological tissue reactions. By the 42nd day 10 to 12% of the original material is present. The elimination of the implant material is complete and occurs mainly with urine through the kidneys.

Animals↗

PubMedDate not supplied

Cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm.

Two groups of 20 patients each, with mild to moderate acute low back pain with associated muscle spasm of ten days' duration or less, were treated with a combination of cyclobenzaprine and naproxen or naproxen alone in a randomized, 14-day open-label trial. Cyclobenzaprine was added to the naproxen regimen as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful, musculoskeletal conditions. The clinical characteristics of each study group, including the number of worker's compensation patients, were comparable. Combination therapy was associated with less objective muscle spasm and tenderness and greater motion of the lumbosacral spine (P less than 0.05). There were trends toward faster resolution of functional deficits and pain with combined therapy. Combination therapy was associated with more side effects, due primarily to drowsiness from the cyclobenzaprine. The results of this study demonstrated that patients with muscle spasm associated with acute low back strain benefited from the use of combination therapy consisting of a nonsteroidal anti-inflammatory agent (naproxen) and a muscle relaxant (cyclobenzaprine).

Adult↗

PubMed1998

One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up.

STUDY DESIGN: A study of postural control during one-footed and externally disturbed two-footed stance among healthy control subjects and patients with chronic low back pain at the beginning of a functional back restoration program and 6 months later at follow-up examination. OBJECTIVES: To study postural control cross-sectionally among control subjects and patients with low back pain, and to evaluate the effects of functional restoration on the postural control parameters in a follow-up examination. SUMMARY OF BACKGROUND DATA: Deficits of motor skills and coordination have been reported in association with musculoskeletal disorders. It has been found that patients with chronic low back pain have impaired psychomotor control, but the impairment is reversible with successful low back rehabilitation. It is insufficiently known how functional activation and intensive physical training affect postural control. METHODS: Sixty-one healthy volunteers (32 men, 29 women) and altogether 99 patients with low back pain participated in the study. Sixty-eight patients (33 men, 35 women) had moderate and 31 (18 men, 13 women) had severe low back pain. Postural stability was measured with a force platform. In two-footed stance, vibration stimulation on calf and back muscles was used to disturb the balance. Center point of force-velocity (cm/sec), average position shift in anteroposterior direction (cm), and maximal position shift in lateral direction (cm) were used as the parameters. RESULTS: Reliability of all tests was acceptable. Center point of force-velocity was the most sensitive parameter and the one-footed measurement the most sensitivetest for evaluating postural stability. At the beginning, the patients with severe low back pain had poorer one-footed postural control compared with the control subjects (P = 0.0003). The subgroup of patients with moderate low back pain participated in the restoration program. The outcome of the restoration program was considered good if the disability because of low back pain (Oswestry index) decreased during the restoration program and poor if the disability increased or did not change. The one-footed postural stability remained primarily at the same level as the initial results in the control and good outcome groups, but became significantly poorer in the poor outcome group. The difference between poor outcome and control groups was statistically significant (P = 0.04). CONCLUSIONS: Impaired postural stability seems to be one factor in multidimensional symptomatology of patients with chronic low back trouble. Postural stability is easily disturbed in case of impairment in strength, coordination, or effective coupling of muscles in the lumbar and pelvic area. Patients with chronic low back pain seem to experience impairment in these functions, which should be taken into consideration when back rehabilitation programs are planned.

Adult↗

PubMed1980

Vertebral muscles of the back and tail of the albino rat (Rattus norvegicus albinus).

The dorsal and ventral vertebral muscles of the back and the tail of the albino Norway rat are described and discussed. These muscles were analyzed because they are undoubtably used during the sexual posturing, lordosis, of the female rat, as well as participating in a variety of other behaviors. The muscles are described by region (thoracic-lumbar or sacrocaudal), and the classifications of Vallois are followed where possible. Of the epaxial (dorsal) muscles, the three longitudinal systems of muscles, the transversospinalis, the longissimus, and the iliocostalis systems, can be identified in the albino rat. Muscles of the transversospinalis system are fused in the lumbar region, distinct and specialized in the thoracic region, and form the tail muscle extensor caudae medialis caudally. The iliocostalis system of the lumbar region is fused with one component of the lumbar longissimus system to form lateral longissimus. Anteriorly, iliocostalis thoracis and cervicis represent the iliocostalis system. The lumbar longissimus system is represented by the longissimus component of lateral longissimus, medial longissimus, and a short-fiber component. Longissimus dorsi is the anterior continuation of the longissimus portion of the lateral longissimus. The short-fiber component also continues into the thoracic region, where it becomes difficult to separate out from longissimus dorsi. Medial longissimus represents the excursion into the lumbar region of the long, tendinous, tailbase-tail muscle, longissimus caudae; the caudal portion of this muscle is extensor caudae lateralis. The remaining dorsal muscle described is the tail muscle, abductor caudae dorsalis. The hyposomal (ventral) muscles described are quadratus lumborum and the intertransversarii, present in the lumbar region; the muslces iliococcygeus, pubococcygeus and coccygeus which arise from the medial face of the pelvis and insert onto the proximal tail; the long, tendinous, tail muscles, flexor caudae brevis and longus; and the ventral and lateral set of segmental tail muscles. The innervation of the lumbar transversospinalis muscles by the medial branches and of lateral longissimus by the lateral branches of the dorsal rami of the spinal nerves was traced and confirmed by electrical stimulation of the nerve branches. The innervation of medial longissimus is also described. Additionally, movements of the vertebral column produced by direct unilateral or bilateral muscle stimulation were observed for a number of the muscles.

Animals↗

PubMed2005

A novel method to estimate the stiffness of the equine back.

Diagnosis of back problems in equine orthopedics can be a difficult task. The aim of our study was to develop a new method for estimating the stiffness of the equine back in vivo. We measured the activity of the long back muscle at two locations on both sides at thoracic vertebrae T12 and T16 of 15 horses flexing and extending their back at stance using telemetric surface electromyography, while simultaneously recording the motion of the back with a video camera system. Out of these paired data sets we computed a transfer function in the frequency domain and evaluated its capability of capturing the biomechanical behavior. The transfer function was evaluated via correlation between calculated and actual motion resulting in correlation coefficients of 0.89 for lateral flexion and 0.83 for ventral extension at T16 and 0.82 for lateral flexion and 0.83 for ventral extension at T12. The transfer function was fitted to a filter polynomial of second order, and related to the motion equation. By comparison of coefficients we gained an estimate for the stiffness of the back resulting in a mean value of approximately 6100 N/m for lateral flexion and 650 N/m for ventral extension. This new method enables clinicians in equine orthopedics to estimate back stiffness in horses, and it also provides reality grounded values for biomechanical models of the equine back.

Animals↗

PubMed2006

Evaluation of the flexion relaxation phenomenon of the trunk muscles in sitting.

STUDY DESIGN: A normative, single-group study was conducted. OBJECTIVE: To investigate the flexion relaxation phenomenon in the thoraco-lumbopelvic muscles among a pain-free population when moving from an upright to a slump sitting posture. SUMMARY OF BACKGROUND DATA: The presence of the flexion relaxation phenomenon (FRP) of the back muscles is well documented at end-range spinal flexion when standing. This phenomenon is commonly found disrupted in low back subjects. However, whether FRP occurs in sitting remains controversial. METHODS: The sample consisted of 24 healthy pain-free adults. Surface electromyography was used to measure activity in the superficial lumbar multifidus (SLM), the thoracic erector spinae (TES), and the transverse fibers of the internal oblique (IO) muscles while subjects moved from an erect to a slump sitting posture. An electromagnetic motion-tracking device simultaneously measured thoracolumbar kinematics during this task. RESULTS: There was a significant decrease in both the SLM and the IO activity when moving from an erect to a slump sitting posture (P = 0.001 and P = 0.004, respectively), indicating the presence of FRP. TES activity was highly variable. While 13 subjects exhibited an increase in activity (P = 0.001), 11 demonstrated a decrease in activity (P = 0.001), indicating the presence of FRP. FRP occurred in the mid-range of spinal flexion for the SLM, IO and TES when present. CONCLUSION: The findings show that the SLM and the IO are facilitated in neutral lordotic sitting postures and exhibit FRP at mid range flexion while moving from upright sitting to slump sitting. These findings show that FRP in sitting differs from that in standing. Variable motor patterns (activation or FRP) of the TES were observed. These findings suggest that sustaining mid to end-range flexed sitting spinal postures result in relaxation of the spinal stabilizing muscles.

Adult↗

PubMed2000

Lumbar erector spinae oxygenation during prolonged contractions: implications for prolonged work.

Owing to the recent interest in torso stabilization exercises together with many questions regarding the duration of prolonged isometric holds in occupational settings, the authors attempted to assess the level of back muscle oxygenation during prolonged isometric contractions. Specifically, this study recorded relative oxygen saturation of haemoglobin/myoglobin using Near Infrared Spectroscopy (NIRS) in the L3 erector mass during prolonged isometric contractions at intensities from 2 to 30% of maximum voluntary contraction (MVC). It was hypothesized that available oxygen to these muscles is severely compromised even at moderate levels of activation observed in occupational work. Eight volunteers without a history of lower back pain or injury participated in this study. The exercise task involved isometric contraction of the lower erector spinae at five different levels of each subject's maximal voluntary contraction: 2, 5, 10, 20 and 30% MVC, presented in random order. Subjects were placed in a sitting position, with a curved plastic plate secured horizontally to the pelvis to minimize movement at the hip joint. During extensor exertions, they were restrained with a harness that was attached at chest level to a load cell. Each isometric contraction was performed for 30 s followed by 1 min of rest. All levels of contraction demonstrated reduction in oxygen. Given the concern for motion artefact on the NIRS signal, sham trials were conducted where the subjects went through the procedure of attaching the pulling cable but no active pull was performed. These trials showed no change in the NIRS signal. At this time NIRS appears to be the only non-invasive instrumentation available to indicate total available muscle oxygen during low level, prolonged work. Although the specific tissue volume sampled by NIRS cannot be positively identified, it appears that tissue oxygenation in the lumbar extensor musculature is reduced as a function of contraction intensity, even at levels as low as 2% of MVC. These data have implications for prolonged work where postures requiring isometric contractions are sometimes held for hours, and where musculoskeletal illness has been linked to prolonged contraction levels above 2%MVC--these data suggest a possible biological pathway.

Adult↗

PubMed1990

Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain.

An attempt was made to determine the effect of pregnancy on the abdominal muscles and to correlate changes in abdominal muscles strength with low-back pain during pregnancy. The study included 328 women. Group A consisted of 164 pregnant women; group B consisted of 164 non-pregnant women. The race, age, height, weight, parity, profession, time devoted to physical fitness per week, abdominal length, and relation between the abdominal length to height were recorded. A detailed history relating to backache prior to and during pregnancy was obtained. Each woman was asked to perform a single sit-up. The results of the study indicate that about 10% of pregnant women develop severe low-back pain that interferes with daily life activities. About 49% of the non-pregnant women complained of LBP. The pain did not interfere with activities of daily living. During pregnancy, due to overstretching of the abdominal muscles, the ability to perform a sit-up is significantly decreased. Whereas all non-pregnant women could perform a sit-up, 16.6% of pregnant women could not perform a single sit-up. There was no statistically significant correlation between the sit-up performance and backache. It may be concluded that during pregnancy the abdominal muscles become insufficient.

Abdomen↗

PubMed2005

In vivo measurement of lower back deformations with Fourier-transform profilometry.

Through the variation of their cross sections, the in vivo response of lower back muscles to low loading in an upright seated posture is explored by the Fourier-transform profilometry technique. The maximization of its sensitivity allows us to reach an adequate resolution for the evaluation of low-back displacements. Refinements of the fringe pattern analysis permit the minimization of errors. The experiments show an asymmetric distribution of the displacement during head rotation movements. Significant contribution of the lower back to grasping exertions is also observed. These results are thought to be useful for early defect detection in the lower back.

Anatomy, Cross-Sectional↗

PubMed2002

Recovery of electromyograph median frequency after lumbar muscle fatigue analysed using an exponential time dependence model.

The recovery of the median frequency of the power spectrum of the electromyogram (EMG) after fatigue has been studied to obtain reference data for healthy subjects (n = 55). In a seated position, the subjects performed a 45 s isometric back muscle contraction at 80% of maximal voluntary contraction, followed by 5 s contractions after 1, 2, 3, and 5 min in the recovery phase. In an additional reliability study (n = 11), this was performed six times. Surface EMG was recorded on four sites, namely, bilaterally from the lumbar muscles at the level of the first (L1) and fifth (L5) vertebrae. By non-linear regression, an exponential time dependence model was used to analyse the recovery of median frequency, giving recovery half-time as a resulting measure. Agreement with exponential time dependence was very good (coefficient of determination r(2) = 0.98) in the analysis of mean data (n = 55), with recovery half-times in the range 32-39 s on the four recording sites. Analysis of individual recordings, for which r(2) values in general were lower, revealed further details. Median values of the half-times in general agreed well with the half-times obtained from the analysis of mean data. Recovery half-time and median frequency slope during contraction were not correlated; this is in agreement with what may be expected from an exponential time dependence. Non-significant negative slopes occurred on apparently randomly selected sites, possibly indicating varying muscle coordination in the seated test method. The reliability of the half-time was not sufficient to allow for follow-up measurements on individuals, due to the fluctuations of the recovery data in recordings from individuals.

Adult↗

PubMed2002

Free flap transfer to the dorsum of the rat: a new technique to avoid autocannibalization in free flap studies.

In this report the authors describe a new method that avoids autocannibalization by free transfer of a flap to the dorsum of the rat by means of a simple exposure technique. A total of 22 Wistar rats of both sexes (weight, 200-290 g) were used in this experiment. An anatomic study performed in 12 rats revealed that a wide exposure could be created in the axillary fossa by retracting the inferior tip of the scapular bone superiorly (after severing its attachments with the deep extrinsic back muscles), the latissimus dorsi muscle laterally, and the serratus anterior muscle medially. Furthermore, after obtaining vessel diameter measurements, it was ascertained that the subscapular and the lateral thoracic vessels could serve as the recipient vessels. Based on the anatomic study, a total of 10 conventional groin cutaneous flaps, measuring 2 x 3 cm in size, were harvested based on the femoral vessels and transferred to the dorsum of the same animal by the exposure method as just described, with microvascular anastomoses performed between the femoral vessels of the flap and either the subscapular artery and the lateral thoracic vein (N = 5) or the lateral thoracic artery and vein (N = 5). Results showed that 9 of the 10 transplanted flaps were totally viable on postoperative day 7, giving a success rate of 90%, with one failing flap belonging to the latter group. The authors conclude that by this simple method of recipient vessel exposure in the axillary fossa, free flap transfer to the dorsum of the rat is a simple and reproducible technique by microvascular anastomoses performed between the pedicle vessels of a flap and the subscapular artery and the lateral thoracic vein. This model offers the unique advantage of a dorsally located flap that is protected by autocannibalization. Moreover, daily observation and monitoring of the flap are easy and practical without the need to have the animal wear protective material such as vest.

Animals↗

PubMed1999

Does strengthening the abdominal muscles prevent low back pain--a randomized controlled trial.

OBJECTIVE: To investigate the effects of abdominal muscle strengthening exercise on low back pain (LBP) risk reduction. METHODS: We compared the effects of abdominal muscle strength (AMS) exercise and back education with back education only on 402 asymptomatic subjects with weak AMS. The primary outcome was the percentage of subjects with at least one episode of LBP at 24 months. A diary was used to monitor compliance. RESULTS: There were no statistically significant differences between experimental (E) and control (C) subjects at 24 months for LBP episodes (E: 34.7%, C: 30.4%; C-E = 4.2%, P2 = 0.481; 95% CI -16.1%, 7.6%). The LBP episodes were also not statistically significantly different at 6 months (E: 13.2%, C: 16.1%; C-E: 2.9%, P2 = 0.493; 95% CI -5.3%, 11.0%) or at 12 months (E: 24.8%, C: 23.6%; C-E = -1.2%, P2 = 0.818; 95% CI -11.6%, 9.2%). Adjusting the data for strata and baseline AMS did not alter the findings. Imputed results for LBP episodes at 6 months (C-E: 4.8%, P2 = 0.191; 95% CI -2.4%, 12.0%), 12 months (C-E: -1.0%, P2 = 0.821; 95% CI -9.5%, 7.6%), and 24 months (C-E: -3.3%, P2 = 0.483; 95% CI -12.6%, 5.9%) were also not statistically significantly different. CONCLUSION: Back education and abdominal exercise instructions are similar to back education alone. There were no group differences in LBP episodes, possibly due to noncompliance with the exercise program. While the estimated benefit of 2.9% at 6 months from the complete data and 4.8% from the imputed data were not statistically significant, a larger study or future metaanalyses may be needed to confirm whether there is a clinical benefit or whether these results should be considered a chance finding.

Abdominal Muscles↗

PubMed1999

Personal risk factors for first-time low back pain.

STUDY DESIGN: A prospective study of personal risk factors for first-time low back pain. OBJECTIVES: To construct and validate a multivariate model to predict low back pain. SUMMARY OF BACKGROUND DATA: Various physical and psychological factors have been reported to increase the risk of low back pain, but conflicting results may be attributable to inaccurate "clinical" measures and to poorly validated statistical models. METHODS: A total of 403 health care workers aged 18-40 years volunteered for the study. None had any history of "serious" back pain requiring medical attention or time off work. The volunteers completed the following questionnaires: the modified somatic perception questionnaire, the Zung depression scale, and the Health Locus of Control. Anthropometric factors were quantified using standard techniques. The 3Space Isotrak device (Polhemus, VT) was used to measure lumbar curvature and hip and lumbar spine mobility. Leg and back strength and back muscle fatiguability were measured in functional postures. Postal follow-up questionnaires, sent after 6, 12, 18, 24, 30, and 36 months, inquired about back pain, and multivariate logistic regression was used to identify risk factors at each follow-up. RESULTS: The response rate fell from 99% at 12 months to 90% at 36 months, at which time 90 volunteers reported "serious" back pain and 266 reported "any" back pain. The following were consistent predictors of serious back pain: reduced range of lumbar lateral bending, a long back, reduced lumbar lordosis, increased psychological distress, and previous nonserious low back pain. Only the latter three were consistent predictors of "any" back pain. Physical factors had the most influence in a sub-population of volunteers who were new to the job. CONCLUSIONS: Personal risk factors explained up to 12% of first-time low back pain.

Adolescent↗

PubMed1992

Stretching in the rehabilitation of low-back pain patients.

The major objective of this investigation was to study the effectiveness of the physical conditioning program used at the University of Miami Comprehensive Pain and Rehabilitation Center in restoring certain elements of the functional abilities of individuals suffering from chronic low-back pain and to evaluate the effectiveness of using a systematically applied, aggressive stretching maneuver as an add-on therapy in the treatment of chronic low-back pain patients. The effect(s) of the proposed stretching maneuver was evaluated. Twenty-eight chronic low-back pain patients were randomly assigned to one of two groups. The control group underwent a multimodal rehabilitation program, and the experimental group underwent the same rehabilitation program in addition to the systematic stretching maneuver under investigation. The results obtained showed that patients undergoing the multimodal rehabilitation program with and without the proposed systematic stretching maneuver showed a significant improvement in their functional abilities as seen from the significant increase in the static strength of the back extensors, with corresponding significant increase in back muscle myoelectric signals. Also, a significant decrease in their pain level was reported after 2 weeks of continuous treatment. The use of the systematic stretching maneuver enhanced the functional gains of chronic low-back pain patients compared to the control group.

Back Pain↗