Amaç: Kronik Non-Spesifik Bel Ağrısı (KNSBA), ağrının belirli bir nedene bağlanamaması ve tedavi programlarının şekillendirilmesinin zorluğu nedeniyle dünya çapında önemli bir toplum sağlığı sorunu haline gelmiştir. Çalışmanın amacı kronik non-spesifik bel ağrısı (KNSBA)'lı bireyler ve sağlıklı bireylerde sırt kas kuvveti, kor endurans, fiziksel aktivite düzeyi, denge ve fonksiyonel durumun karşılaştırılmasıdır. Gereç ve Yöntemler: Çalışmaya 18-40 yaş aralığında olan KNSBA'lı (n=80) ve sağlıklı (n=80) toplam 160 birey dahil edildi. Bireylerin sırt kas kuvvetinin değerlendirilmesi amacıyla sırt dinamometresi, kor enduransın değerlendirilmesi için Mekik Endurans Testi, Sorensen Testi ve Yan Köprü Testi, fiziksel aktivite düzeyinin belirlenmesi için Uluslararası Fiziksel Aktivite Anketi-Kısa Form (UFAA-KF), statik dengelerinin değerlendirilmesi amacıyla tek ayak üzerinde durma testi (TAÜD), dinamik dengelerinin değerlendirilmesi için ''Y'' Denge Testi ve fonksiyonel durumun belirlemesi amacıyla Oswestry Özürlülük İndeksi (OÖİ) kullanıldı. Bulgular: KNSBA'lı bireylerin sırt kas kuvveti (p=0,005), kor endurans [Mekik Endurans Testi (p=0,001), Sorensen Testi (p=0,006), Yan Köprü Testi (sağ p=0,033; sol p=0,013)] ve OÖİ (p=0,001) sonuçlarının sağlıklı bireylere göre daha düşük olduğu belirlendi (p<0,05). Bunun yanında UFAA-KF (p=0,562), TAÜD (sağ p=0,255; sol p=0,042), ''Y'' Denge Testi (sağ p=0,763; sol p=0,891) ölçüm sonuçları incelendiğinde iki grup arasında istatistiksel olarak anlamlı fark bulunamadı (p>0,05). Sonuç: KNSBA'lı bireylerin sırt kas kuvvetlerinin, kor enduranslarının ve fonksiyonel durumlarının sağlıklı bireylere göre daha düşük olduğu belirlendi. KNSBA'lı bireylerin rehabilitasyon programlarında sırt kas kuvvetinin, kor enduransın ve fonksiyonel durumun geliştirilmesine yönelik tedavi stratejilerinin geliştirilmesi gerektiği düşünülmektedir.
Anahtar Kelimeler: Bel ağrısı; kas kuvveti; fiziksel dayanıklılık; postüral denge
Objective: Chronic Non-Specific Low Back Pain (CNSLBP) has become a major public health problem worldwide due the difficulty of attributing pain to a specific cause and difficulty of planning the treatment programs. The aim of this study was to compare of trunk muscle strength, core endurance, physical activity, balance and functional status in individuals with CNSLBP and healthy individuals. Material and Methods: This study included total of 160 individuals with CNSLBP (n=80) and healthy individuals (n=80) who were between 18-40 years of age. For the evaluation of back muscle strength back dynamometer and for core endurance Trunk Flexor Endurance, Sorensen, Side Bridge Tests, for physical activity level International Physical Activity Questionnaire-Short Form (IPAQ-SF), for static balance single leg stance test (SLST), for dynamic balance "Y" Balance Test and for functional status the Oswestry Disability Index (ODI) was used. Results: The back muscle strength (p=0,005), core endurance [Trunk Flexor Endurance Test (p=0,001), Sorensen Test (p=0,006) and Side Bridge Test (right p=0,033;left p=0,013)] and ODI (p=0,001) results of individuals with CNSBP were lower than healthy individuals (p<0,05). No statistically significant difference were found between the two groups for IPAQ-SF (p=0,562), SLST (right p=0,255;left p=0,042) and 'Y' Balance Test (right p=0,763;left p=0,891) (p>0,05). Conclusion: Individuals with CNSLBP were found to have lower back muscle strength, core endurance and functional status than healthy individuals. It is considered that treatment strategies to improve back muscle strength, core endurance and functional status should be included in rehabilitation programs of individuals with CNSLBP.
Keywords: Low back pain; muscle strength; physical endurance; postural balance
- Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379(9814):482-91. [Crossref]
- Malla S, Chahal A, Tiku RK, Kaul B. Effect of motor control exercise on swiss ball and PNF technique on non- specific low back pain. Int J Med Res Heal Sci. 2018;7(4):114-24.
- Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389 (10070):736-47. [Crossref]
- van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol. 2010;24(2):193-204. [Crossref] [PubMed]
- Karimi N, Ebrahimi I, Kahrizi S, Torkaman G. Evaluation of postural balance using the biodex balance system in subjects with and without low back pain. Pakistan J Med Sci. 2008;24(3):372-7.
- Muthukrishnan R, Shenoy SD, Jaspal SS, Nellikunja S, Fernandes S. The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain. Sport Med Arthrosc Rehabil Ther Technol. 2010;2:13. [Crossref] [PubMed] [PMC]
- Ambegaonkar JP, Mettinger LM, Caswell SV, Burtt A, Cortes N. Relationships between core endurance, hip strength, and balance in collegiate female athletes. Int J Sports Phys Ther. 2014;9(5):604-16.
- Borghuis J, Hof AL, Lemmink KA. The importance of sensory-motor control in providing core stability: implications for measurement and training. Sport Med. 2008;38(11):893-916. [Crossref] [PubMed]
- Bae CR, Jin Y, Yoon BC, Kim NH, Park KW, Lee SH. Effects of assisted sit-up exercise compared to core stabilization exercise on patients with non-specific low back pain: a randomized controlled trial. J Back Musculoskelet Rehabil. 2018;31(5):871-80. [Crossref] [PubMed]
- Vanti C, Conti C, Faresin F, Ferrari S, Piccarreta R. The relationship between clinical instability and endurance tests, pain, and disability in nonspecific low back pain. J Manipulative Physiol Ther. 2016;39(5):359-68. [Crossref] [PubMed]
- da Silva RA, Vieira ER, Fernandes KBP, Andraus RA, Oliveira MR, Sturion LA, et al. People with chronic low back pain have poorer balance than controls in challenging tasks. Disabil Rehabil. 2018;40(11):1294-300. [Crossref] [PubMed]
- Ruhe A, Fejer R, Walker B. Center of pressure excursion as a measure of balance performance in patients with non-specific low back pain compared to healthy controls: a systematic review of the literature. Eur Spine J. 2011;20(3):358-68. [Crossref] [PubMed] [PMC]
- Tsigkanos C, Gaskell L, Smirniotou A, Tsigkanos G. Static and dynamic balance deficiencies in chronic low back pain. J Back Musculoskelet Rehabil. 2016;29(1):887-93. [Crossref] [PubMed]
- Behennah J, Conway R, Fisher J, Osborne N, Steele J. The relationship between balance performance, lumbar extension strength, trunk extension endurance, and pain in participants with chronic low back pain, and those without. Clin Biomech (Bristol, Avon). 2018;53: 22-30. [Crossref] [PubMed]
- van den Berg-Emons RJ, Schasfoort FC, de Vos LA, Bussmann JB, Stam HJ. Impact of chronic pain on everyday physical activity. Eur J Pain. 2007;11(5):587-93. [Crossref] [PubMed]
- Hendrick P, Milosavljevic S, Hale L, Hurley DA, McDonough S, Ryan B, et al. The relationship between physical activity and low back pain outcomes: a systematic review of observational studies. Eur Spine J. 2011;20 (3):464-74. [Crossref] [PubMed] [PMC]
- Hannibal NS, Plowman S, Looney MA, Brandenburg J. Reliability and validity of low back strength/muscular endurance field tests in adolescents. J Phys Act Health. 2006;3(2):78-90. [Crossref]
- Ozcan Kahraman B, Salik Sengul Y, Kahraman T, Kalemci O. Developing a reliable core stability assessment battery for patients with nonspecific low back pain. Spine (Phila Pa 1976). 2016;41(14):E844-50. [Crossref] [PubMed]
- Appiah-Dwomoh EK, Muller S, Mayer F. Reproducibility of static and dynamic postural control measurement in adolescent athletes with back pain. Rehabil Res Pract. 2018;2018: 8438350. [Crossref] [PubMed] [PMC]
- Jackson AW, Morrow JR Jr, Brill PA, Kohl HW 3rd, Gordon NF, Blair SN. Relations of sit-up and sit-and-reach tests to low back pain in adults. J Orthop Sport Phys Ther. 1998;27(1): 22-6. [Crossref] [PubMed]
- Ng JK, Richardson CA, Jull GA. Electromyographic amplitude and frequency changes in the iliocostalis lumborum and multifidus muscles during a trunk holding test. Phys Ther. 1997;77(9):954-61. [Crossref] [PubMed]
- Moreau CE, Green BN, Johnson CD, Moreau SR. Isometric back extension endurance tests: a review of the literature. J Manipulative Physiol Ther. 2001;24(2):110-22. [Crossref] [PubMed]
- Demoulin C, Vanderthommen M, Duysens C, Crielaard JM. Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint Bone Spine. 2006;73(1):43-50. [Crossref] [PubMed]
- McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80(8):941-4. [Crossref]
- Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95. [Crossref] [PubMed]
- Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278-84. [Crossref] [PubMed]
- Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8-15. [Crossref] [PubMed]
- Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the Star Excursion Balance Test. N Am J Sport Phys Ther. 2009;4(2):92-9.
- Hertel J, Miller SJ, Denegar CR. Original research reports intratester and intertester reliability during the star excursion balance tests. Sport Rehabil. 2000;9(2):104-16. [Crossref]
- Yakut E, Duger T, Oksuz C, Yorukan K, Turan D, Frat T, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976). 2004;29(5):581-5. [Crossref] [PubMed]
- Fairbank JC, Couper J, Davies JB, O'Brien JP. The oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-3.
- Fritz JM, Irrgang JJ. A comparison of a modified oswestry low back pain disability questionnaire and the quebec back pain disability scale. Phys Ther. 2001;81(2):776-88. [Crossref] [PubMed]
- Catala MM, Schroll A, Laube G, Arampatzis A. Muscle strength and neuromuscular control in low-back pain: elite athletes versus general population. Front Neurosci. 2018;12: 436. [Crossref] [PubMed] [PMC]
- Davarian S, Maroufi N, Ebrahimi I, Farahmand F, Parnianpour M. Trunk muscles strength and endurance in chronic low back pain patients with and without clinical instability. J Back Musculoskelet Rehabil. 2012;25(2):123-9. [Crossref] [PubMed]
- Cho KH, Beom JW, Lee TS, Lim JH, Lee TH, Yuk JH. Trunk muscles strength as a risk factor for nonspecific low back pain: a pilot study. Ann Rehabil Med. 2014;38(2):234-40. [Crossref] [PubMed] [PMC]
- Latimer J, Maher CG, Refshauge K, Colaco I. The reliability and validity of the Biering-Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine (Phila Pa 1976). 1999;24(20):2085-9. [Crossref] [PubMed]
- Abdelraouf OR, Abdel-Aziem AA. The relationship between core endurance and back dysfunction in collegiate male athletes with and without nonspecific low back pain. Int J Sports Phys Ther. 2016;11(3):337-44.
- Hemmati L, Rojhani-Shirazi Z, Malek-Hoseini H, Mobaraki I. Evaluation of static and dynamic balance tests in single and dual task conditions in participants with nonspecific chronic low back pain. J Chiropr Med. 2017;16(3):189-94. [Crossref] [PubMed] [PMC]
- Mientjes MI, Frank JS. Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing. Clin Biomech. 1999;14(10):710-6. [Crossref]
- Braga AB, Rodrigues ACDMA, de Lima GVMP, de Melo LR, de Carvalho AR, Bertolini GRF. Comparison of static postural balance between healthy subjects and those with low back pain. Acta Ortop Bras. 2012;20(4). [Crossref] [PubMed] [PMC]
- Sherafat S, Salavati M, Takamjani IE, Akhbari B, Rad SM, Mazaheri M, et al. Effect of dual-tasking on dynamic postural control in individuals with and without nonspecific low back pain. J Manipulative Physiol Ther. 2014;37(3): 170-9. [Crossref] [PubMed]
- Salavati M, Mazaheri M, Negahban H, Ebrahimi I, Jafari AH, Kazemnejad A, et al. Effect of dual-tasking on postural control in subjects with nonspecific low back pain. Spine (Phila Pa 1976). 2009;34(13):1415-21. [Crossref] [PubMed]
- Verbunt JA, Westerterp KR, van der Heijden GJ, Seelen HA, Vlaeyen JW, Knottnerus JA. Physical activity in daily life in patients with chronic low back pain. Arch Phys Med Rehabil. 2001;82(6):726-30. [Crossref] [PubMed]
- van Weering MG, Vollenbroek-Hutten MM, Tonis TM, Hermens HJ. Daily physical activities in chronic lower back pain patients assessed with accelerometry. Eur J Pain. 2009;13(6):649-54. [Crossref] [PubMed]
- Astfalck RG, O'Sullivan PB, Straker LM, Smith AJ. A detailed characterisation of pain, disability, physical and psychological features of a small group of adolescents with non-specific chronic low back pain. Man Ther. 2010;15(3): 240-7. [Crossref] [PubMed]
- Griffin DW, Harmon DC, Kennedy NM. Do patients with chronic low back pain have an altered level and/or pattern of physical activity compared to healthy individuals? A systematic review of the literature. Physiotherapy. 2012;98(1):13-23. [Crossref] [PubMed]
- Goetzel RZ, Hawkins K, Ozminkowski RJ, Wang S. The health and productivity cost burden of the "top 10" physical and mental health conditions affecting six large U.S. employers in 1999. J Occup Environ Med. 2003;45(1):5-14. [Crossref] [PubMed]
.: Process List