Lumbar instability (LI) comprises one subgroup of those with chronic low back pain (CLBP); it indicates the impairment of at least one of the spinal stabilizing systems, and radiographic criteria of translation and rotation are used for its diagnosis. Previous studies have developed and tested a screening tool for LI where patients with sub-threshold lumbar instability (STLI) were detected in the initial stage of lumbar pathology using radiographs as a gold standard for diagnosis. The radiographic measurement in STLI lies between the range of translation and rotation of the LI and asymptomatic lumbar motion. However, there are no studies indicating the validity and cut-off points of the screening tool for STLI. The current study aimed to determine the validity of an LI screening tool to support the diagnostic process in patients with STLI. This study design was cross-sectional in nature. A total of 135 participants with CLBP, aged between 20 and 60 years, who had undergone flexion and extension radiographs, answered a screening tool with 14 questions. The cut-off score for identifying STLI using the screening tool was at least 6/14 positive responses to the LI questions. The findings suggested that the LI screening tool we tested is effective for the detection of STLI. The tool can be used in outpatient settings.
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.
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