Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial

Abstract

Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial [I] Efeitos da reeducação postural global e do isostretching em pacientes com lombalgia crônica não-específi ca: ensaio clínico aleatório [A] Fábio Alexandre Moreschi Guastala [a] , Mayara Hilda Guerini [ Abstract Introduction: Low back pain is one of the most prevalent musculoskeletal disorders, but little is known about postural methods in its treatment. Objective: Analyze changes in muscle strength, lexibility, function and pain in patients with chronic low back pain that underwent isostretching and global posture reeducation (GPR). Methods: Thirty-nine patients, aged between 40 and 59 years, were evaluated before and after treatment protocols regarding: lexibility for sit and reach, muscle strength, functional capacity using the Rolland-Morris Questionnaire, and intensity of pain by Visual Analog Scale. The sample was randomized into two groups (1-GPR; 2-Isostretching), all of whom were treated individually through 12 sessions lasting 45 minutes each, twice a week. Results: After treatment, median reduction in pain intensity of 28 mm in group 1 and 32 mm in group 2 was observed, and a median improvement in functional capacity in group 1 of 8.5 points and 7 points in group 2 (p < 0,05). A mean improvement of severn repetitions in trunk extensor muscle strength was observed in group 1 and in group 2; by dynamometry of 10 kg / f in group 1 and 12.5 kg / f in group 2 of ten abdominal repetitions strength in group 1 and four repetitions in group 2 (p < 0.05).In the Sit and Reach, Group 1 had a total mean increase of 3cm, and group 2 had 1.6cm (p < 0.05). Conclusion: Both groups were effective in improvement of muscle strength, lexibility, pain and functional capacity. Keywords

Effects of Global Postural Reeducation versus Specific Therapeutic Neck Exercises on Pain, Disability, Postural Control, and Neuromuscular Efficiency in Women with Chronic Nonspecific Neck Pain: Study Protocol for a Randomized, Parallel, Clinical Trial

“…Some studies support the clinical effectiveness of GPR in treating patients with different musculoskeletal disorders and impairments [57][58][59][60][61][62][63], including cranio-cervico-mandibular complex [64][65][66][67][68][69][70][71][72]. The main aims of GPR are to reduce postural impairments and regain muscle symmetry and adequate posture through global active muscular stretching postures and joint decompressions, with breath control, motor control, contractions of antagonist muscles, and sensory integration exercises conducted by manual contacts in order to provide proprioceptive information to the patient [61,[73][74][75][76][77]. These techniques are focused on reducing pain and improving body awareness and physical conditions, such as increased mobility, flexibility, muscle strength, and functional capacity [55,56,75,78,79], to finally obtain muscle balance and postural symmetry [61,67].…”

“…The main aims of GPR are to reduce postural impairments and regain muscle symmetry and adequate posture through global active muscular stretching postures and joint decompressions, with breath control, motor control, contractions of antagonist muscles, and sensory integration exercises conducted by manual contacts in order to provide proprioceptive information to the patient [61,[73][74][75][76][77]. These techniques are focused on reducing pain and improving body awareness and physical conditions, such as increased mobility, flexibility, muscle strength, and functional capacity [55,56,75,78,79], to finally obtain muscle balance and postural symmetry [61,67]. These findings must be considered with caution due to the heterogeneity of the results and the low quality of the studies that reported these results [55,56,59].…”

Eficácia do stretching global ativo no ganho de flexibilidade em jogadores de handebol de alto nível

“…14 A Reeducação Postural Global divide o corpo em cadeias musculares, sendo as Cadeias Mestra Posterior e Anterior as principais. 21 A grande cadeia mestra posterior ou cadeia de extensão tem como principais componentes: músculos do arco do pé, tríceps sural, isquiotibiais, tibial anterior, glúteos profundos e espinhais. [21][22] A grande cadeia mestra anterior, à qual se liga a cadeia inspiratória, tem como principais músculos: escalenos, intercostais, tendão superior do diafragma, psoas, adutores e anteriores da perna.…”

“…21 A grande cadeia mestra posterior ou cadeia de extensão tem como principais componentes: músculos do arco do pé, tríceps sural, isquiotibiais, tibial anterior, glúteos profundos e espinhais. [21][22] A grande cadeia mestra anterior, à qual se liga a cadeia inspiratória, tem como principais músculos: escalenos, intercostais, tendão superior do diafragma, psoas, adutores e anteriores da perna. 23 Sendo assim, neste trabalho foi utilizado o Método Stretching Global Ativo (SGA), realizado por meio da reeducação global a partir do alongamento progressivo.…”

Challenges in postural orientations for workers away from work with low back pain

“…Physical therapy is indicated to treat low back pain, and the postural orientations are strategies used to prevent greater harm, among other interventions [17,18]. Educational practices constitute the basis of health education and should be centered on the problematization of the everyday routine, valorization of the individuals' experiences and those of social groups, as well as the recognition of the affected individuals' different realities [19].…”