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Effects of a multidisciplinary programme on postural stability in patients with chronic recurrent low back pain: preliminary findings

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Abstract

Purpose

This longitudinal study investigated the effects of a multidisciplinary rehabilitation programme on postural stability in patients with low back pain. While the consequences of such rehabilitation programme have been described for pain, mobility, strength, and functional disability, the effects on postural stability have not been examined so far.

Methods

Thirty-four patients suffering from chronic low back pain were included to participate in a multidisciplinary rehabilitation programme. We assessed postural stability, pain, strength of the lumbar extensor muscles, and functional disability. The examinations were performed before the intervention, after 20 training sessions (“half-way point”), and at the end of the rehabilitation programme.

Results

All outcome measures improved significantly from baseline to the first follow-up evaluation and remained constant until completion of the rehabilitation programme.

Conclusions

A multidisciplinary outpatient rehabilitation programme may improve postural stability, muscle strength, pain, and functional disability in patients with chronic low back pain.

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References

  1. Airaksinen O, Brox JI, Cedraschi C et al (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(2):S192–S300

    Article  PubMed  PubMed Central  Google Scholar 

  2. Salaffi F, De Angelis R, Stancati A et al (2005) Health-related quality of life in multiple musculoskeletal conditions: a cross-sectional population based epidemiological study. II. the MAPPING study. Clin Exp Rheumatol 23:829–839

    CAS  PubMed  Google Scholar 

  3. Hides JA, Stokes MJ, Saide M et al (1994) Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine (Phila Pa 1976) 19:165–172

    Article  CAS  Google Scholar 

  4. Saur P, Hildebrandt J, Pfingsten M et al (1996) Multidisciplinary treatment program for chronic low back pain, part 2. Somatic aspects. Schmerz 10:237–253

    Article  CAS  PubMed  Google Scholar 

  5. Radebold A, Cholewicki J, Polzhofer GK et al (2001) Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976) 26:724–730

    Article  CAS  Google Scholar 

  6. Leitner C, Mair P, Paul B et al (2009) Reliability of posturographic measurements in the assessment of impaired sensorimotor function in chronic low back pain. J Electromyogr Kinesiol 19:380–390

    Article  CAS  PubMed  Google Scholar 

  7. della Volpe R, Popa T, Ginanneschi F et al (2006) Changes in coordination of postural control during dynamic stance in chronic low back pain patients. Gait Posture 24:349–355

    Article  CAS  PubMed  Google Scholar 

  8. Nies N, Sinnott PL (1991) Variations in balance and body sway in middle-aged adults. Subjects with healthy backs compared with subjects with low-back dysfunction. Spine (Phila Pa 1976) 16:325–330

    Article  CAS  Google Scholar 

  9. Guzman J, Esmail R, Karjalainen K et al (2002) Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain. Cochrane Database Syst Rev CD000963

  10. Hayden JA, van Tulder MW, Malmivaara A et al (2005) Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev CD000335

  11. Hwang JA, Bae SH, Do Kim G et al (2013) The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients. J Phys Ther Sci 25:1189–1192

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hayden JA, van Tulder MW, Malmivaara AV et al (2005) Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med 142:765–775

    Article  PubMed  Google Scholar 

  13. Jackson JK, Shepherd TR, Kell RT (2011) The influence of periodized resistance training on recreationally active males with chronic nonspecific low back pain. J Strength Cond Res 25:242–251

    Article  PubMed  Google Scholar 

  14. Nelson BW, O’Reilly E, Miller M et al (1995) The clinical effects of intensive, specific exercise on chronic low back pain: a controlled study of 895 consecutive patients with 1-year follow up. Orthopedics 18:971–981

    CAS  PubMed  Google Scholar 

  15. Kell RT, Asmundson GJ (2009) A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain. J Strength Cond Res 23:513–523

    Article  PubMed  Google Scholar 

  16. Pieber K, Herceg M, Quittan M et al (2014) Long-term effects of an outpatient rehabilitation program in patients with chronic recurrent low back pain. Eur Spine J 23:779–785

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nashner LM, Peters JF (1990) Dynamic posturography in the diagnosis and management of dizziness and balance disorders. Neurol Clin 8:331–349

    CAS  PubMed  Google Scholar 

  18. Hirabayashi S, Iwasaki Y (1995) Developmental perspective of sensory organization on postural control. Brain Dev 17:111–113

    Article  CAS  PubMed  Google Scholar 

  19. Wrisley DM, Stephens MJ, Mosley S et al (2007) Learning effects of repetitive administrations of the sensory organization test in healthy young adults. Arch Phys Med Rehabil 88:1049–1054

    Article  PubMed  Google Scholar 

  20. Ford-Smith CD, Wyman JF, Elswick RK Jr et al (1995) Test-retest reliability of the sensory organization test in noninstitutionalized older adults. Arch Phys Med Rehabil 76:77–81

    Article  CAS  PubMed  Google Scholar 

  21. Duncan PW, Weiner DK, Chandler J et al (1990) Functional reach: a new clinical measure of balance. J Gerontol 45:M192–M197

    Article  CAS  PubMed  Google Scholar 

  22. Isles RC, Choy NL, Steer M et al (2004) Normal values of balance tests in women aged 20–80. J Am Geriatr Soc 52:1367–1372

    Article  PubMed  Google Scholar 

  23. Carlsson AM (1983) Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 16:87–101

    Article  CAS  PubMed  Google Scholar 

  24. Robinson ME, Greene AF, O’Connor P et al (1992) Reliability of lumbar isometric torque in patients with chronic low back pain. Phys Ther 72:186–190

    CAS  PubMed  Google Scholar 

  25. Bullinger M, Morfeld M, Kohlmann T et al (2003) SF-36 Health Survey in Rehabilitation Research. Findings from the North German Network for Rehabilitation Research, NVRF, within the rehabilitation research funding program. Rehabilitation (Stuttg) 42:218–225

    Article  CAS  Google Scholar 

  26. Wiesinger GF, Nuhr M, Quittan M et al (1999) Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain. Spine (Phila Pa 1976) 24:1099–1103

    Article  CAS  Google Scholar 

  27. Choi G, Raiturker PP, Kim MJ et al (2005) The effect of early isolated lumbar extension exercise program for patients with herniated disc undergoing lumbar discectomy. Neurosurgery 57:764–772 (discussion 764–772)

    Article  PubMed  Google Scholar 

  28. Vincent KR, Braith RW, Feldman RA et al (2002) Improved cardiorespiratory endurance following 6 months of resistance exercise in elderly men and women. Arch Intern Med 162:673–678

    Article  PubMed  Google Scholar 

  29. Smith D, Bissell G, Bruce-Low S et al (2011) The effect of lumbar extension training with and without pelvic stabilization on lumbar strength and low back pain. J Back Musculoskelet Rehabil 24:241–249

    PubMed  Google Scholar 

  30. American College of Sports Medicine Position Stand (1998) The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 30:975–991

    Article  Google Scholar 

  31. de Vet HC, Terwee CB, Ostelo RW et al (2006) Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes 4:54

    Article  PubMed  PubMed Central  Google Scholar 

  32. Mientjes MI, Frank JS (1999) Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing. Clin Biomech 14:710–716

    Article  CAS  Google Scholar 

  33. Hodges PW, Richardson CA (1998) Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J Spinal Disord 11:46–56

    Article  CAS  PubMed  Google Scholar 

  34. Marshall P, Murphy B (2006) Changes in the flexion relaxation response following an exercise intervention. Spine (Phila Pa 1976) 31:E877–E883

    Article  Google Scholar 

  35. Rhee HS, Kim YH, Sung PS (2012) A randomized controlled trial to determine the effect of spinal stabilization exercise intervention based on pain level and standing balance differences in patients with low back pain. Med Sci Monit 18:CR174–CR181

    Article  PubMed  PubMed Central  Google Scholar 

  36. Ostelo RW, de Vet HC (2005) Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol 19:593–607

    Article  PubMed  Google Scholar 

  37. Kim Y-W (2012) Correlation between the sensory organization test and the functional reach test in balance evaluation of elderly individuals. Journal of Physical Therapy Science 24:675–679

    Article  Google Scholar 

  38. Hodges PW, Richardson CA (1997) Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement. Exp Brain Res 114:362–370

    Article  CAS  PubMed  Google Scholar 

  39. Tang PF, Moore S, Woollacott MH (1998) Correlation between two clinical balance measures in older adults: functional mobility and sensory organization test. J Gerontol A Biol Sci Med Sci 53:M140–M146

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Medical University of Vienna, General Hospital of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Karin Pieber, Malvina Herceg & Richard Crevenna

  2. Institute for Sport Science, University of Innsbruck, Innsbruck, Austria

    Robert Csapo

  3. Department of Physical Medicine and Rehabilitation, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria

    Günther Wiesinger

  4. Landsteiner Institute of Remobilisation and Functional Health, Vienna, Austria

    Michael Quittan

  5. Department of Physical Medicine and Rehabilitation, General Hospital Linz, Linz, Austria

    Christian Mittermaier

Authors
  1. Karin Pieber
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  2. Malvina Herceg
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  3. Robert Csapo
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  4. Günther Wiesinger
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  5. Michael Quittan
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  6. Richard Crevenna
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  7. Christian Mittermaier
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Corresponding author

Correspondence to Karin Pieber.

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Pieber, K., Herceg, M., Csapo, R. et al. Effects of a multidisciplinary programme on postural stability in patients with chronic recurrent low back pain: preliminary findings. Eur Spine J 25, 1219–1225 (2016). https://doi.org/10.1007/s00586-015-4293-3

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  • DOI: https://doi.org/10.1007/s00586-015-4293-3

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