Background: Core muscle activation is an effective intervention for the management of Low Back Pain (LBP). This study developed new feedback for detecting activation of the transversus abdominis muscle in the lumbar spine. The purpose of this study was to examine the validity and reliability of the feedback device for transversus abdominis muscle contraction. Methods: The participants in this study were 20 healthy males and females (aged 24.1 ± 6.8 years). The feedback sensor was attached to the lumbar support at the front of the trunk. The participants performed an abdominal drawing-in maneuver in order to activate the transversus abdominis muscle, and values from the feedback sensor were collected at the same time. Ultrasound imaging of the transversus abdominis muscle was also collected simultaneously. The feedback sensor collected values at different clinical levels of the pressure biofeedback unit at 64, 66, 68, and 70 mmHg. The protocol was repeated with a 24-hr interval. Intra-class correlation coefficient, coefficient of variation and standard error of measurements were used to examine reliability. The validity of the values obtained from the relationship between the feedback sensor and transversus abdominis muscle thickness was analyzed using Pearson’s correlation coefficients. Results: Test–retest reliability of the feedback sensor was excellent (ICC = 0.946, CV = 2.6%, SEMs = 0.54%). Values of the feedback sensor reported a significantly moderate correlation with the gold standard ultrasound measurement (r = - 0.514, p < 0.001). Conclusion: The feedback device demonstrated potential reliability and validity for clinical use by indicating activation of the transversus abdominis muscle.
Background. A novel lumbar support device to be used by people with chronic nonspecific low back pain (CNLBP) was designed, developed and tested in this trial. The study investigated the immediate effects of the novel lumbar support device on pain modulation and core muscle function in comparison to the traditional lumbar support among people with CNLBP. Methods. This study was a single-blinded, repeated measures, randomized controlled trial with four parallel groups design. A total of 80 patients with CNLBP were randomly allocated using stratified block randomization by pain severity to one of the four groups: traditional lumbar support (TLS) as a control group (N = 20), novel lumbar support with hot pack (NLSD + HP) (N = 20), novel lumbar support with biofeedback device (NLSD + BO) (N = 20), and finally the novel lumbar support with an in-built hot pack and biofeedback device (NLSD + HP with BO) as an experimental intervention group (N = 20). Pain intensity (PI), tissue blood flow (TBF), cold pain threshold (CPT), hot pain threshold (HPT), thickness of transversus abdominis muscle (TrA), and lumbopelvic stability (LPS) were assessed at baseline and immediately post-intervention by a blinded assessor. A two-way repeated-measures ANOVA with post-hoc analysis was used to analyze the data. Results. All 80 participants across the 4 groups had similar outcome measures at baseline (p > 0.05). Among the participants in the NLSD + HP with BO (Group 4), a significant interaction was noticed in all of the primary outcomes including PI (p < 0.001), TBF (p < 0.001), CPT (p < 0.001), HPT (p < 0.001), PPT (p < 0.001), TrA thickness (p < 0.001) and as well as on the secondary outcome lumbopelvic stability (p < 0.001). Post hoc analysis showed that the results from the NLSD + HP with BO (Group 4) was superior than the TLS group in all of the primary and secondary outcomes (p < 0.05). Conclusions. The immediate effects of the NLSD + HP with BO demonstrated potential beneficial outcomes on PI, PPT, CPT, HPT, TrA and LPS in comparison to TLS among participants with CNLBP. Further clinical trial evaluating the long-term clinical effects of the novel lumbar support device is needed to understand the overall benefits of the device and its usefulness for people with CNLBP.
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