Context: People with chronic low back pain (CLBP) suffer from weaknesses in their core muscle activity and dysfunctional breathing. Inspiratory muscle training (IMT) was recently developed to treat this condition. Objectives: The present study was conducted to investigate the effect of IMT on core muscle activity, pulmonary parameters, and pain intensity in athletes with CLBP. Design: This study was designed as a single-blind, randomized, controlled trial. Setting: Clinical rehabilitation laboratory. Participants: A total of 23 male and 24 female athletes with CLBP were randomly divided into the experimental and control groups. Main Outcome Measures: The experimental group performed IMT for 8 weeks, 7 days per week and twice daily, using POWERbreathe KH1, beginning at 50% of maximum inspiratory pressure with a progressively increasing training load. The surface electromyography muscle activity of the erector spinae, multifidus, transverse abdominis and rectus abdominis, respiratory function and Visual Analogue Scale score were also measured before and after the intervention in both groups. The repeated-measures analysis of variance and 1-way analysis of covariance were further used to compare the intragroup and intergroup results following the intervention. Results: The findings of the study revealed that multifidus and transverse abdominis activity, as well as respiratory function, increased significantly in the IMT group (P < .05). Moreover, a descending trend was observed in the Visual Analogue Scale score in the experimental group (P < .05). Conclusion: The results showed that IMT can improve respiratory function, increase core muscle activity, and, consequently, reduce pain intensity in athletes with CLBP.

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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.

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.

The respiratory function is often overlooked in people with Low Back Pain (LBP), while it is one of the factors for the continuation and recurrence of lumbar spine injury. Aim of this study was survay the immediate effect of Respiratory Muscle Sprint-Interval Training (RMSIT) on the plantar pressure variables of athletes with LBP. Methods: This randomized controlled trial was conducted on two groups with LBP, one experimental group (24 patients) and one control group (23 patients). The plantar pressure variables were recorded using a plantar pressure measurement device. The experimental group performed the RMSIT protocol. The RMSIT was fulfilled as six sets of 30-second deep breathing exercises (with two minutes of rest between sets) with constant tidal volume, maximum breathing rate, and added resistance. The paired t-test and one-way covariance tests were used to analyze the data. Results: The results of (95%) confidence ellipse showed that RMSIT caused a significant decrease in the amount area of sway, but the exercise did not make a significant difference in the length of minor axis and length of the major axis. The results of the Center of Presure (COP) factors showed that the training program significantly reduced the amount of path length, the standard deviation in the Y axis, but the results did not show a significant difference in the velocity and standard deviation in the X axis in the experimental group. The results demonstrated no significant difference between the experimental and control group in the plantar pressure symmetry indices. Discussion: It can be concluded that, these exercises can be used to reduce some postural oscillation indices in athletes with LBP.