Does inspiration efficiency influence the stability limits of the trunk in patients with chronic low back pain?

Abstract

The stability limit of the trunk is reduced in patients with low back pain. The thoracic diaphragm is one of the stabilizer muscles of the trunk. The aim of this study was to assess the effect of diaphragm-strengthening training on inspiratory function and stability limits of the trunk. Fifty-two people with chronic low back pain were included in the study and divided into 2 groups. One group participated in a conventional training programme together with diaphragm-strengthening training, and the other group participated in conventional training only. Both groups underwent 8 weeks of training, 60-min duration, 2 times/week. The results imply that conventional training together with diaphragm-strengthening training may be superior to conventional exercises alone in improving inspiratory function and stability limits of the trunk in patients with chronic lumbar pain. Objective: To determine the effects of diaphragmstrengthening training on the stability limits of the trunk and inspiratory function in patients with low back pain. Design: A randomized comparative trial including a diaphragm training group that took part in conventional training together with diaphragm strengthening, and a control group that took part in conventional training only. Both groups participated in an 8-week training, 2 times/week. All subjects underwent the same measurement protocol before and after the intervention. Patients: The study included 52 subjects with chronic low back pain. Methods: The inspiratory functions (chest excursion, maximal inspiratory pressure, peak inspiratory flow, and volume of inspired air) and stability limits of the trunk with the subject in the sitting position (modified functional and lateral reach test) were assessed. Results: Maximal inspiratory pressure and stability limit tests showed a statistically significant improvement only in the diaphragm training group. Statistically significant improvements in chest excursion and peak expiratory flow tests were found in both groups; however, the improvement was more greater in the diaphragm training group. Conclusion: Conventional exercises together with diaphragm training result in a greater improvement than conventional exercises alone in patients with chronic low back pain.

Effects of Respiratory Muscle Training on Functional Ability, Pain-Related Outcomes, and Respiratory Function in Individuals with Low Back Pain: Systematic Review and Meta-Analysis

“…Only the study by Janssens et al [ 38 ] compared an RMT intervention with a sham RMT. A strength training program (frequently oriented toward the lower back) was performed in all groups, with the experimental group additionally performing an RMT program in 10 studies [ 14 , 15 , 16 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. Seven studies assessed IMT alone, employing threshold loading devices [ 14 , 15 , 38 , 40 , 41 , 45 ], except for the Park at al.…”

“…A strength training program (frequently oriented toward the lower back) was performed in all groups, with the experimental group additionally performing an RMT program in 10 studies [ 14 , 15 , 16 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. Seven studies assessed IMT alone, employing threshold loading devices [ 14 , 15 , 38 , 40 , 41 , 45 ], except for the Park at al. [ 44 ] study, which used the therapist’s hands to offer inspiration resistance.…”

“…Heterogeneity was not significant for any pulmonary function out-Commente circles in fig Figure 4. Synthesis forest plot for respiratory muscle strength and pulmonary function for respiratory muscle training versus control group [14,16,38,39,[41][42][43][44].…”

“…weeks[14,15,38,40,41,45] for 2[15,41] and 7[14,38,40,45] times per week (Table1). None of the studies reported serious adverse events.…”

The effect of inspiratory muscle training on the maintenance of swimming abilities

“…Exercise consisted of 30 rapid maximum forced inhalations and relaxed exhalations, twice a day. The intensity (resistance on the device) was set to 60% of the maximal inspiratory power (S-index) (McConnell, 2011;Finta, Boda, Nagy and Bender, 2020), which was measured in the first measurements. A specific intensity of 60% MIP has been justified as effective IMT based on optimal response in context of blood flow and generated pressure (Sheel et al, 2001, McConnell andGriffiths, 2010).…”