The Effect of Eight Weeks Aquatic and Dynamic Neuromuscular Stabilization Exercises on Postural Sways and Foot Pressure Distribution Symmetry in Patients with Nonspecific Chronic Low Back Pain

Document Type : Research Paper

Authors

1 MSc, Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran.

2 buali sina university

3 3Department of sport physiology, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, I. R. Iran.

Abstract

Background and aim: Low back pain is the most common musculoskeletal disorder that is the cause of disability and absence from work. The aim of this study was to assess the effect of six weeks of aquatic and dynamic neuromuscular stabilization (DNS) exercises on postural sways and the plantar pressure distribution symmetry (PPDS) in patients with non-specific chronic low back pain (n-CLBP).
Materials and methods: Thirty-six n-CLBP patients were randomly divided into three groups: DNS group (n = 12), aqua exercises (n = 12) and control (n = 12). The PPDS and postural sways were assessed by PT-scan. The experimel groups participated in the interventions for 6 weeks (three times per week) and the control group did not receive any treatment during this period.
Results: The results of this study showed that, there was no significant difference between groups in postural sways and the PPDS (p>0/05). Also, paired sample t-test results showed that intervention groups had significant differences in PPDS, the center of pressure path length and sways area from pre-tests to post-tests (P <0.05). Moreover, the aqua group had a reduction in the standard deviation of the center of pressure medial-lateral sways (SDx). (p<0/05).
Conclusion: According to the results of the current study, aqua and DNS exercises improve postural sways and PPDS in patients with n-CLBP. Therefore, in rehabilitation programs, the use of DNS exercises by activation of spinal stabilizing muscles similar to common aqua exercises is recommended to improve patients' postural sways and the PPDS.

Keywords

References

Malliou, P., Gioftsidou, A., Beneka, A., & Godolias, G. (2006). Measurements and evaluations in low back pain patients. Scandinavian journal of medicine & science in sports, 16(4), 219-230.‏
Oliveira, C. B., Maher, C. G., Pinto, R. Z., Traeger, A. C., Lin, C. W. C., Chenot, J. F., ... & Koes, B. W. (2018). Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. European Spine Journal, 27(11), 2791-2803.‏
Manchikanti, L., Singh, V., Falco, F. J., Benyamin, R. M., & Hirsch, J. A. (2014). Epidemiology of low back pain in adults. Neuromodulation: Technology at the Neural Interface, 17, 3-10.‏
Naghavi, M., Abajobir, A. A., Abbafati,    C., Abbas, K. M., Abd-Allah, F., Abera, S. F., & Fischer, F. (2017). Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. The lancet, 390(10100), 1151-1210.‏
Van Dieën, J. H., Reeves, N. P., Kawchuk, G., Van Dillen, L. R., & Hodges, P. W. (2019). Motor control changes in low back pain: divergence in presentations and mechanisms. journal of orthopaedic & sports physical therapy, 49(6), 370-379.‏
Taylor, S., Frost, H., Taylor, A., & Barker, K. (2001). Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain. Physiotherapy Research International, 6(3), 170-178.‏
Silfies, S. P., Squillante, D., Maurer, P.,
Westcott, S., & Karduna, A. R. (2005). Trunk muscle recruitment patterns in specific chronic low back pain populations. Clinical biomechanics, 20(5), 465-473.‏
Nawoczenski, D. A., Ketz, J., & Baumhauer, J. F. (2008). Dynamic kinematic and plantar pressure changes following cheilectomy for hallux rigidus: a mid-term followup. Foot & ankle international, 29(3), 265-272.‏
Radebold, A., Cholewicki, J., Polzhofer, G. K., & Greene, H. S. (2001). Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine, 26(7), 724-730.‏
Macedo, L. G., Maher, C. G., Latimer, J., & McAuley, J. H. (2009). Motor control exercise for persistent, nonspecific low back pain: a systematic review. Physical therapy, 89(1), 9-25.‏
Olson, D. A., Kolber, M. J., Patel, C., Pabian, P., & Hanney, W. J. (2013). Aquatic exercise for treatment of low-back pain: a systematic review of randomized controlled trials. American Journal of Lifestyle Medicine, 7(2), 154-160.‏
Twomey, L. T., & Taylor, J. R. (1987). Age changes in lumbar vertebrae and intervertebral discs. Clinical orthopaedics and related research, (224), 97-104.‏
Parker, K. M., & Smith, S. A. (2003). Aquatic-aerobic exercise as a means of stress reduction during pregnancy. The Journal of Perinatal Education, 12(1), 6.‏
Shi, Z., Zhou, H., Lu, L., Pan, B., Wei, Z., Yao, X., ... & Feng, S. (2018). Aquatic exercises in the treatment of low back pain: a systematic review of the literature and meta-Analysis of eight studies. American journal of physical medicine & rehabilitation, 97(2), 116-122.‏
Waller, B., Lambeck, J., & Daly, D. (2009). Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clinical rehabilitation, 23(1), 3-14.‏
Yalfani, A., Maleki, B., & Raeisi, Z. (2019). The effect of aquatic exercise therapy on the pain, disability and gait parameters of women with chronic low back pain. Research in Sport Medicine and Technology, 17(18), 57-67. (In Persian)
Davidek, P., Andel, R., & Kobesova, A. (2018). Influence of dynamic neuromuscular stabilization approach on maximum kayak paddling force. Journal of human kinetics, 61(1), 15-27.‏
Ghavipanje, V., Rahimi, N. M., & Akhlaghi, F. (2022). Six Weeks Effects of Dynamic Neuromuscular Stabilization (DNS) Training in Obese Postpartum Women With Low Back Pain: A Randomized Controlled Trial. Biological research for nursing, 24(1), 106-114.‏
Bokarius, V. (2008). Long-term efficacy of dynamic neuromuscular stabilization in treatment of chronic musculoskeletal pain. Age, 18(25), 3.‏
Gandomi F, Sofivand P, Fadaei Dehcheshmeh P. (2021). Studying the Pattern of Foot Pressure Distribution, Symmetry Index, and Center of Pressure Sways in Women with Back Pain Due to Lumbar Disc Herniation:: A Descriptive Study. J Rafsanjan Univ Med Sci. 20 (5): 487-502. (In Persian)
Dehcheshmeh, P. F., & Gandomi, F. Foot Pressure Distribution Symmetry, Vertical Ground Reaction Force and Postural Sways in Professional Athletes with Proper or Poor Lumbopelvic Control1.‏ (In Persian)
Ansari, S., Elmieh, A., & Alipour, A. (2021). The effect of aquatic exercise on functional disability, flexibility and function of trunk muscles in postmenopausal women with chronic non-specific low back pain: Randomized controlled trial. Science & Sports, 36(3), e103-e110.‏
Balaiy S, Amiri R, Sedaghati P, Daneshmandi H. (2021). Evaluation of the effectiveness of selected strength training at an unstable level and hydrotherapy on lower limb muscle strength, balance and fear of falling in the elderly. Journal for Research in Sport Rehabilitation. 8(16).
Mahdieh, L., Zolaktaf, V., & Karimi, M. T. (2020). Effects of dynamic neuromuscular stabilization (DNS) training on functional movements. Human movement science, 70, 102568.‏
Alvani, E., Ziya, M., & Sahebozamani, M. (2020). The effect of dynamic neuromuscular stability (DNS) training on dynamic balance and functional disability in athletes with non-specific chronic low back pain. Journal for Research in Sport Rehabilitation, 8(15), 127-138.‏
Boucher, P., Teasdale, N., Courtemanche, R., Bard, C., & Fleury, M. (1995). Postural stability in diabetic polyneuropathy. Diabetes care, 18(5), 638-645.‏
Fayez, E. S., & ELSAYED, E. (2012). Foot Pressure Asymmetry in Patients with Mechanical Low Back Pain. Med J Cairo Univ, 80(2), 7-10.‏
Lee, J. H., Fell, D. W., & Kim, K. (2011). Plantar pressure distribution during walking: comparison of subjects with and without chronic low back pain. Journal of Physical Therapy Science, 23(6), 923-926.‏
Yoon, J. S. (2008). The relation study of weight distribution and strength of Lower extremity with and without Low back pain in middle-aged woman. Exercise science: official journal of the Korea Exercise Science Academy, 17, 309-316.‏
Segel, J. D., & Crawford, S. (2014). Anatomy of the COP gait line and computer-aided gait analysis. In Pm's Tech Forum/Orthotics & Biomechanics (Vol. 33, No. 7, pp. 151-6).‏
Reaisi Z, Asghari M, Zarali A. (2020). The effect of eight weeks combined exercise in water on pain and postural sway in female with non-specific chronic low back pain. Journal for Research in Sport Rehabilitation. 8(15). 115-126.
Frank, C., Kobesova, A., & Kolar, P. (2013). Dynamic neuromuscular stabilization & sports rehabilitation. International journal of sports physical therapy, 8(1), 62.‏
Kibler, W. B., Press, J., & Sciascia, A. (2006). The role of core stability in athletic function. Sports medicine, 36(3), 189-198.‏
Son, M. S., Jung, D. H., You, J. S. H., Yi, C. H., Jeon, H. S., & Cha, Y. J. (2017). Effects of dynamic neuromuscular stabilization on diaphragm movement, postural control, balance and gait performance in cerebral palsy. NeuroRehabilitation, 41(4), 739-746.‏
Psycharakis, S. G., Coleman, S. G., Linton, L., Kaliarntas, K., & Valentin, S. (2019). Muscle activity during aquatic and land exercises in people with and without low back pain. Physical therapy, 99(3), 297-310.
 
‏
 
Journal for Research in Sport Rehabilitation
Volume 10, Issue 19 - Serial Number 19
February 2023
Pages 143-163

Files

Share

How to cite

Statistics