Physical Therapy Management of Patients With Chronic Low Back Pain and Hip Abductor Weakness

Peterson, Seth; Denninger, Thomas R.

doi:10.1519/jpt.0000000000000148

Cited by 7 publications

(4 citation statements)

References 35 publications

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“…As noted, hip abduction strength has a significant relationship with Quebec LBP Disability Questionnaire scores, but our findings indicate that nearly a 12‐kg increase in strength would be required to yield clinically meaningful improvement. Recently, in a case series of older adults with chronic LBP, Peterson et al (50) found that targeting hip abductor weakness yielded meaningful changes in LBP‐related disability on a similar instrument, the Oswestry Disability Index; however, this study should be interpreted with caution given the weakness of case series study designs and the different methodology used for hip strength assessment. Chronic LBP is a complex and multifactorial phenomenon, with several potential underlying mechanisms that may affect pain‐related disability (9).…”

Section: Discussionmentioning

confidence: 83%

Hip Range of Motion and Strength Predict 12‐Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies

Coyle

Knox

Pohlig

et al. 2021

ACR Open Rheumatology

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The objective of this study was to investigate whether poor hip range of motion (ROM) and strength predict 12-month physical function decline among older adults with chronic low back pain (LBP) and whether hip osteoarthritis modifies those relationships.Methods. At baseline, passive ROM and strength measurements were taken for hip flexion, extension, abduction, adduction, internal rotation, and external rotation; ultrasound images and self-reported symptoms were used to evaluate hip osteoarthritis presence (eg, osteophytes and hip pain). At baseline and 12 months, performance-based (repeated chair rise, self-selected gait speed, 6-minute walk test [6MWT]) and self-reported (Quebec LBP Disability Questionnaire, Late-Life Function & Disability Instrument [LLFDI] basic and advanced lower extremity scales) physical function outcomes were assessed. Regression models were constructed for each outcome predicted by baseline hip ROM and strength measures, with adjustment for potential covariates. To avoid collinearity, hip ROM and strength measures with the strongest unadjusted correlations were included in final models. The hip osteoarthritis presence by hip ROM/strength interaction was also explored.Results. Hip abduction strength predicted repeated chair rise (β = −0.297, P < 0.001), gait speed (β = 0.160, P = 0.003), 6MWT (β = 0.159, P ≤ 0.001), Quebec LBP Disability Questionnaire (β = −0.152, P = 0.003), and LLFDI basic lower extremity scale (β = 0.171, P = 0.005) outcomes. Regarding hip ROM, extension predicted repeated chair rise (β = −0.110, P = 0.043) and LLFDI advanced lower extremity scale (β = 0.090, P = 0.007) outcomes, external rotation predicted gait speed (β = 0.122, P = 0.004) outcomes, and abduction predicted LLFDI basic lower extremity scale (β = 0.114, P = 0.026) outcomes. The hip osteoarthritis interaction was not significant for any model.Conclusion. Reduced hip strength and ROM predict physical function decline; hip osteoarthritis presence may not modify these relationships.The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

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Section: Discussionmentioning

confidence: 83%

Hip Range of Motion and Strength Predict 12‐Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies

Coyle

Knox

Pohlig

et al. 2021

ACR Open Rheumatology

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“…There are also studies in enhancing the core stability by improving hip function and hip muscle strength. The strength of abductor muscle group of hip joint was strengthened in three elderly patients with CNLBP, which improved the waist dysfunction and released pain (Peterson and Denninger, 2017). Low back pain was relieved by performing hip traction and strength training in 30 patients with CNLBP (Winter, 2015).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Exercise Intervention Based Upon the Selective Functional Movement Assessment in an Athlete With Non-specific Low Back Pain: A Case Report and Pilot Study

et al. 2020

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Objectives: To illustrate the effectiveness of the Selective Functional Movement Assessment (SFMA) as a guide to exercise intervention on chronic non-specific low back pain (CNLBP). Methods: A 23-year-old male volleyball athlete with CNLBP was evaluated using the SFMA to assess the degree of physical dysfunctions. And then two-stage exercise protocol was designed based on the results of SFMA. The athlete conducted the exercise intervention for 8 weeks, 1 h each time, three times a week. Transverse abdominal muscles and multifidus muscle thickness, the degree of low back pain, and the degree of physical dysfunctions were measured at pre-intervention, midintervention, and post-intervention. Results: Based on the results of SFMA, the exercise protocol in the first 4-week session was designed mainly to develop the mobility of ankle, hip, and chest and the stability of lumbar, hip, and knee, in order to improve core strength and gluteal muscle strength. The second 4-week session was an advanced stage with the increase of exercise load on the basis of flexibility and stability; its main purpose was to loosen the hamstring muscles and continue strengthening the core stability and finally help the participant to establish the correct movement pattern and solve the problems of dysfunctions. After 8-week exercise intervention, all movement patterns became functional/non-painful except the deep squat pattern; the Quebec Back Pain Disability Scale score decreased from 11 to 2; visual analog scale score decreased from 4 to 2; the thicknesses of the transverse abdominis muscles (right side: 0.2 vs. 0.31 cm, left side: 0.22 vs. 0.33 cm) and multifidus muscles (right side: 2.09 vs. 2.26 cm, left side: 2.15 vs. 2.29 cm) were both increased. Conclusion: In this case, the SFMA helped to recognize problems related to mobility and stability on the hip joint, thoracic spine, and even areas far away from the lumbar spine in an athlete with CNLBP that were not seen with more conventional examination

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“…Strengthening sendiri dilakukan dengan mengkontraksi kan otot yang dituju dan dilakukan menahan beban secara diam atau isometric yang dimana dapat meningkatkan kekuatan otot tapi semakin sering melakukan latihan intensitas atau beban yang tahan bisa ditambahkan sesuai kekuatan pasien. 7 Hasil dari assement yang meliputi pemeriksaan fisik, dan pemeriksaan spesifik bisa didaptkan hasil px mengalami lower back pain neurogenik yang disebabkan pada daerah lumbal, dan dari hasil pemeriksaan penunjang terdapat hasil adanya degenerative pada lumbal pasien yang menyebabkan spondylosis. Dengan adanya lbp sendiri px mengalami functional limitation seperti bekerja.…”

Section: ) Strengthening Exerciseunclassified

Penatalaksanaan Fisioterapi Kasus Lower back pain e.c Spondylosis Lumbal; Studi Kasus.

Rosadi¹,

Wardojo²,

Algifari³

2022

jif

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Latar Belakang : Nyeri punggung bawah atau LBP adalah nyeri yang terbatas pada regio lumbal, tetapi gejalanya lebih merata dan tidak hanya terbatas pada satu radiks saraf, namun secara luas berasal dari diskus intervertebralis lumbal Nyeri punggung bawah (low back pain) adalah nyeri di daerah punggung bawah, yang mungkin disebabkan oleh masalah saraf, iritasi otot atau lesi tulang. Spondilo berasal dari bahasa Yunani yang berarti vertebra/ tulang belakang. Spondilosis lumbalis dapat diartikan sebagai perubahan pada sendi tulang belakang dengan ciri khas bertambahnya degenerasi diskus intervertebralis yang diikuti perubahan pada tulang dan jaringan lunak atau dapat berarti pertumbuhan berlebihan dari tulang (osteofit). Kunci manajemen yang sukses untuk pasien adalah dua hal yaitu asessment yang akurat untuk mengidentifikasi yang di alami pasien agar dapat menetukan tujuan untuk treatment yang ditopang dengan pengetahuan yang seksama dari individu pasien. Tujuan :Untuk mengetahui efektivitas terapi latihan, manual terapi, stretching, dan elektroterapi TENS terhadap Spondylosis Lumbal. Hasil : Didapatkan hasil penurunan setelah dilakukan treatment pada px tn b. pada pertemuan ke 2 sudah mengalami penurunan nyeri dengan pengukuran NRS, baik pada nyeri gerak, dan nyeri diam, yang pada peetemuan pertama pada nyeri gerak 8, dan nyeri diam 5, saat dilakukan evaluasi pada treatment pertemuan ke 2 mendapatkan hasil nyeri gerak 5 dan nyeri diam 2.

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Physical Therapy Management of Patients With Chronic Low Back Pain and Hip Abductor Weakness

Cited by 7 publications

References 35 publications

Hip Range of Motion and Strength Predict 12‐Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies

Hip Range of Motion and Strength Predict 12‐Month Physical Function Outcomes in Older Adults With Chronic Low Back Pain: The Delaware Spine Studies

The Effect of Exercise Intervention Based Upon the Selective Functional Movement Assessment in an Athlete With Non-specific Low Back Pain: A Case Report and Pilot Study

Penatalaksanaan Fisioterapi Kasus Lower back pain e.c Spondylosis Lumbal; Studi Kasus.

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