Effect of Trunk Stabilization Exercises using a Gym Ball with or without Electromyography-Biofeedback in Patients with Chronic Low Back Pain: An Experimental Study

Abstract

Objective: To investigate the effects of trunk stabilization exercise in combination with EMG biofeedback on transverse abdominis (TrA) activation capacity in patients with chronic low back pain (CLBP).

Methods: Ninety patients with CLBP participated to the study: 45 patients were randomly allocated to trunk stabilization exercises combined with EMG biofeedback, and the other 45 patients were allocated to trunk stabilization exercises with no EMG biofeedback. The primary outcome was TrA activation capacity, and the secondary outcomes were pain and the functional disability.

Results: Both the group has shown significant improvements in all the outcomes (p<0.05). However, in the EMG biofeedback group, the improvement of TrA activation capacity was higher at week 6 and 8 compared to other group (p<0.05). Similarly, a higher reduction of functional disability was noted at week 6 and 8 in EMG biofeedback group (p<0.05). In addition, a greater reduction of pain intensity was noted at week 8 in EMG biofeedback group (p<0.05).

Conclusions: The addition of EMG biofeedback to trunk stabilization exercises compared to trunk stabilization exercises alone has shown greater gains in TrA activation capacity, reduction in pain intensity, and disability in patients with chronic low back pain.

Zusammenfassung

Ziel: Untersuchung der Effekte von Rumpf-Stabilisationsübungen in Kombination mit EMG-Biofeedback am M. transversus abdominis (TrA) bei Patienten mit chronischen Rückenschmerzen im unteren Rücken (CLBP).

Methoden: 90 Patienten mit CLBP haben an der Studie teilgenommen: 45 Patienten wurden zufällig Rumpf-Stabilisationsübungen mit EMG-Biofeedback zugewiesen und den anderen 45 Patienten wurden Rumpf-Stabilisationsübungen ohne EMG-Biofeedback zugeordnet. Das primäre Outcome war die Aktivierbarkeit des TrA und das sekundären Outcome Schmerz und funktionelle Einschränkungen.

Ergebnisse: Beide Gruppen haben erhebliche Verbesserungen in allen Ergebnissen (p<0,05) gezeigt. In der EMG-Biofeedback-Gruppe war die Verbesserung der Aktivierbarkeit des TrA höher in den Wochen 6 und 8 im Vergleich zur anderen Gruppe (p<0,05). Ebenso konnte eine höhere Reduzierung der funktionellen Einschränkungen in den Wochen 6 und 8 in der EMG-Biofeedback-Gruppe (p<0,05) festgestellt werden. Darüber hinaus konnte eine größere Reduktion der Schmerzintensität in der Woche 8 bei der EMG-Biofeedback-Gruppe (p<0,05) verzeichnet werden.

Schlussfolgerungen: Die Unterstützung von Rumpf-Stabilisationsübungen durch EMG-Biofeedback verglichen mit Rumpf-Stabilisierungsübungen ohne EMG-Biofeedback erzielte bessere Ergebnisse bei der Aktivierbarkeit des TrA, der Reduktion der Schmerzintensität und der funktionellen Einschränkungen bei Patienten mit chronischen Rückenschmerz.

Keywords

exercise therapy - low back pain - musculoskeletal diseases - pain - physiotherapy - rehabilitation

Schlüsselwörter

Physiotherapie - Rehabilitation - Relaxation - Schmerz - Muskel-Skelett- Erkrankungen - Bewegungstherapie

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