Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2014 | 22 | 1 | 35-41

Article title

Chronic Low Back Pain, Core Stability and Francis Bacon: Implications for Contemporary Physiotherapy – A Narrative Review

Content

Title variants

Languages of publication

EN

Abstracts

EN
Background: Chronic low back pain (LBP) is the most common cause of disability, hence multiple attempts have been undertaken to develop therapeutic strategies aimed at addressing the issue. The most commonly used strategies include motor control exercises of deep core muscles that stabilize the lower back. However, on the practical side, they require application of special devices, such as ultrasonography or electromyography as well as instructions and support provided by trained personnel. Despite the lack of high-quality empirical evidence, these exercises are extensively used in clinical practice.Narrative Review: The vast body of literature collected suggests that the cause of chronic LBP should be sought in the structural and functional alterations within different levels of the central nervous system. These alterations and maladaptations apply to both the molecular and tissue levels. Nevertheless, successful treatment of these changes is currently possible due to an affordable, cognitive therapeutic approach. It encompasses a number of strategies that aim to restore the normal function of the nervous system using brain plasticity processes. These include graded motor imagery, mirror therapy, graded exposure, pain education, sensory training and pain coping strategies.Conclusions: Lack of clear advantage in the application of the core stability exercises over other, potentially cheaper alternatives, implies a shift-paradigm from the existing biomedical model of chronic LBP treatment towards modern cognitive approaches. As results of numerous studies confirm the validity of the approach aimed at restoring the structure and function of the central nervous system in contrast to the still common concept of treatment of the peripheral tissues of the body, more rigorous systematic reviews and meta-analysis are required. Evidence from this kind of evaluation may contribute to the shift in current beliefs regarding the treatment of chronic LBP.

Publisher

Year

Volume

22

Issue

1

Pages

35-41

Physical description

Dates

published
1 - 2 - 2014
received
20 - 2 - 2015
online
30 - 9 - 2015
accepted
6 - 5 - 2015

Contributors

  • PhD candidate at Department of Physical Education, The Jerzy Kukuczka Academy of Physical Education, ul. Mikołowska 72, 40-065 Katowice, Poland
author
  • Department of Kinesiotherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice

References

  • 1. Adamczyk W, Sobczak Z, Gryckiewicz S, Hadała M. Ocena braku kontroli wyprostu lędźwiowego odcinka kręgosłupa. Funkcjonalna ocena i terapia w oparciu o metodę Kinetic Control. PraktFizjoterRehabil, 2013; 38: 12-17
  • 2. Allison GT, Morris SL, Lay B. Feedforward responses of transversus abdominis are directionally specific and act asymmetrically: implications for core stability theories. J Orthop Sports PhysTher, 2008; 38: 228-37
  • 3. Allison GT, Morris SL. Transversus abdominis and core stability: has the pendulum swung? Brit J Sport Med, 2008; 42: 930-1
  • 4. Apkarian AV, Baliki MN, Geha PY. Towards a theory of chronic pain. ProgNeurobiol, 2009; 87: 81-97
  • 5. Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, Gitelman DR. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci, 2004; 24: 10410-5[PubMed][Crossref]
  • 6. Benedetti F, Amanzio M. The placebo response: how words and rituals change the patient's brain. Patient EducCouns, 2011; 84: 413-9
  • 7. Benedetti F. Placebo and the new physiology of the doctor-patient relationship. Physiol Rev, 2013; 93: 1207-46[PubMed][Crossref]
  • 8. Brown S, McGill SM. Transmission of muscularly generated force and stiffness between layers of the rat abdominal wall. Spine, 2009; 34: 70-5[Crossref]
  • 9. Buckalew N, Haut MW, Morrow L, Weiner D. Chronic pain is associated with brain volume loss in older adults: preliminary evidence. Pain Med, 2008; 9: 240-8[Crossref][PubMed]
  • 10. Butler D, Moseley GL. Explain Pain. Adelaide, Australia: NOI Group Publishing; 2003
  • 11. Comerford MJ, Mottram SL. Movement and stability dysfunction-contemporary developments. Man Ther, 2001; 6: 15-26[PubMed][Crossref]
  • 12. Curtis J, McTeer W, White P. Exploringeffectsofschoolsportexperiences on sportparticipacion in laterlife. Sociol Sport J, 1999;16: 348-65
  • 13. Dillingham T. Evaluation and management of low back pain: andoverview. State of the Art Reviews, 1995; 9: 559-74
  • 14. Engel GL. The need for a new medical model: a challenge for biomedicine. Science, 1977; 196: 129-136[Crossref]
  • 15. Ferreira ML, Smeets RJ, Kamper SJ, Ferreira PH, Machado LA. Can we explain heterogeneity among randomized clinical trials of exercise for chronic back pain? A meta-regression analysis of randomized controlled trials. PhysTher, 2010b; 90: 1383-403
  • 16. Ferreira PH, Ferreira ML, Maher CG, Refshauge K, Herbert RD, Hodges PW. Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. Brit J Sport Med, 2010a; 44: 1166-72[Crossref]
  • 17. Fig G. Sport-specific conditioning: strength training for swimmers - training the core. Strength Cond J, 2005; 27: 40-1
  • 18. Flor H, Braun C, Elbert T, Birbaumer N. Extensive reorganization of primary somatosensory cortex in chronic back pain patients. NeurosciLett, 1997; 224: 5-8
  • 19. Flor H, Denke C, Schäfer M, Grüsser S. Effect of sensory discrimination training on cortical reorganisation and phantom limb pain. Lancet, 2001; 357: 1763-4[PubMed][Crossref]
  • 20. Gnat R, Spoor K, Pool-Goudzwaard A. Simulated transversus abdominis muscle force does not increase stiffness of the pubic symphysis and innominate bone: an in vitro study. ClinBiomech, 2013; 28: 262-7
  • 21. Grachev ID, Fredrickson BE, Apkarian AV. Abnormal brain chemistry in chronic back pain: an in vivo proton magnetic resonance spectroscopy study. Pain, 2000; 89: 7-18[Crossref]
  • 22. Grenier SG, McGill SM. Quantification of lumbar stability by using 2 different abdominal activation strategies. Arch Phys Med Rehab, 2007; 88: 54-62[Crossref]
  • 23. Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, York J Das A, McAuley JH. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain. Arthritis Rheum, 2009; 60: 3072-80[PubMed][Crossref]
  • 24. Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehab, 2005; 86: 1753-62[Crossref]
  • 25. Hodges P, Cresswell A, Thorstensson A. Preparatory trunk motion accompanied rapid upper limb movement. Exp Brain Res, 1999; 124: 69-79[Crossref]
  • 26. Hodges PW, Eriksson AE, Shirley D, Gandevia SC. Intra-abdominal pressure increases stiffness of the lumbar spine. J Biomech, 2005; 38: 1873-80[PubMed][Crossref]
  • 27. Hodges PW, Richardson CA. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Arch Phys Med Rehabil, 1999a; 80: 1005-12[Crossref][PubMed]
  • 28. Hodges PW, Richardson CA. Transversus abdominis and the superficial abdominal muscles are controlled independently in a postural task. NeurosciLett, 1999b; 265: 91-4
  • 29. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Cl Rh, 2010; 24: 769-81[Crossref]
  • 30. Key J. 'The core': understanding it, and retraining its dysfunction. J BodywMovTher, 2013; 17: 541-59
  • 31. Kirkesola G. Neurac - a new treatment method for chronic musculosekeltal pain. Fysioterapeuten, 2009; 76: 16-25
  • 32. Knapik A,Saulicz E, Rottermund J, Saulicz M, Myśliwiec A, Linek P. Einfluss von Leistungssport auf die Beweglichkeit in späteren Lebensjahren. Deut Z Sportmed, 2014; 65: 16-21
  • 33. Koppenhaver SL, Hebert JJ, Fritz JM, Parent EC, Teyhen DS, Maqel JS. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Arch Phys Med Rehabil, 2009; 90: 87-94[Crossref][PubMed]
  • 34. Lederman E. The myth of core stability. J BodywMovTher, 2010; 1: 84-98
  • 35. Lee CW, Hwangbo K, Lee IS. The Effects of Combination Patterns of Proprioceptive Neuromuscular Facilitation and Ball Exercise on Pain and Muscle Activity of Chronic Low Back Pain Patients. J PhysTherSci, 2014; 26: 93-96
  • 36. Leeuw M, Goossens ME, van Breukelen GJ, de Jong JR, Heuts PH, Smeets RJ, Köke AJ, Vlaeyen JW. Exposure in vivo versus operant graded activity in chronic low back pain patients: results of a randomized controlled trial. Pain, 2008; 138: 192-207[Crossref][PubMed]
  • 37. Lloyd D, Findlay G, Roberts N, Nurmikko T. Differences in low back pain behavior are reflected in the cerebral response to tactile stimulation of the lower back. Spine, 2008; 33: 1372-7[Crossref][PubMed]
  • 38. Macedo LG, Maher CG, Latimer J, McAuley JH. Motor control exercise for persistent, nonspecific low back pain: a systematic review. PhysTher, 2009; 89: 9-25
  • 39. Macedo LG, Smeets RJ, Maher CG, Latimer J, McAuley JH. Graded activity and graded exposure for persistent nonspecific low back pain: a systematic review. PhysTher, 2010; 90: 860-79
  • 40. McGill S. Low Back Disorder: Evidence-Based Prevention and Rehabilitation. Champaign, IL: Human Kinetics, 2002
  • 41. McMeeken JM, Beith ID, Newham DJ, Milligan P, Critchley DJ. The relationship between EMG and change in thickness of transversus abdominis. ClinBiomech, 2004; 19: 337-42
  • 42. Melzack R. Pain and the neuromatrix in the brain. J Dent Educ, 2001; 65: 1378-82[PubMed]
  • 43. Michaleff ZA, Maher CG, Lin CW, Rebbeck T, Jull G, Latimer J, Connelly L, Sterling M. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Lancet, 2014; 384: 133-41[PubMed][Crossref]
  • 44. Moseley GL, Flor H. Targeting cortical representations in the treatment of chronic pain: a review. Neurorehab Neural Re, 2012; 26: 646-52[Crossref]
  • 45. Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology, 2006; 67: 2129-34 [Crossref]
  • 46. Moseley GL. Joining forces-combining cognition-targeted motor control training with group or individual pain physiology education: a successful treatment for chronic low back pain. J ManipPhysiolTher, 2003; 11: 88-94
  • 47. Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother, 2002; 48: 297-302[Crossref][PubMed]
  • 48. O’Sullivan P. Diagnosis and classification of chronic low back pain disorders: Maladaptive movement and motor control impairments as underlying mechanism. Man Ther, 2005; 10: 242-55[Crossref]
  • 49. Peres MF, Lucchetti G. Coping strategies in chronic pain. Curr Pain Headache Rep, 2010; 14: 331-8[PubMed][Crossref]
  • 50. Pilates, JH, Miller, WJ. Pilate’s Return to Life through Contrology. Presentation Dynamics Inc, 1945
  • 51. Reeves NP, Narendra KS, Cholewicki J. Spine stability: the six blind men and the elephant. ClinBiomech, 2007; 22: 266-74
  • 52. Ryan CG, Gray HG, Newton M, Granat MH. Pain biology education and exercise classes compared to pain biology education alone for individuals with chronic low back pain: a pilot randomised controlled trial. Man Ther, 2010; 15: 382-7[Crossref][PubMed]
  • 53. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. 1996. ClinOrthopRelat Res, 2007; 455: 3-5
  • 54. Schabrun SM, Jones E, ElguetaCancino EL, Hodges PW. Targeting chronic recurrent low back pain from the top-down and the bottom-up: a combined transcranial direct current stimulation and peripheral electrical stimulation intervention. Brain Stimul, 2014; 7: 451-9[PubMed][Crossref]
  • 55. Schmidt-Wilcke T, Leinisch E, Ganssbauer S, Draganski B, BogdahnU, Altmeppen J, May A. Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients. Pain, 2006; 125: 89-97[Crossref]
  • 56. Shinkle J, Nesser TW, Demchak TJ, McMannus DM. Effect of core strength on the measure of power in the extremities. J Strength Cond Res, 2012; 26: 373-80[PubMed][Crossref]
  • 57. Smeets RJ, Severens JL, Beelen S, Vlaeyen JW, Knottnerus JA. More is not always better: cost-effectiveness analysis of combined, single behavioral and single physical rehabilitation programs for chronic low back pain. Eur J Pain, 2009; 13: 71-81[Crossref][PubMed]
  • 58. Smeets RJ, Vlaeyen JW, Hidding A, Kester AD, van der Heijden GJ, van Geel AC, Knottnerus JA. Active rehabilitation for chronic low back pain: cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]. BMC MusculoskeletDisord, 2006; 7: 5
  • 59. Smeets RJ, Vlaeyen JW, Hidding A, Kester AD, van der Heijden GJ, Knottnerus JA. Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Pain, 2008; 134: 263-76[Crossref]
  • 60. Smeets RJ. Do lumbar stabilising exercises reduce pain and disability in patients with recurrent low back pain? Aust J Physiother, 2009; 55: 138[Crossref][PubMed]
  • 61. Stokes IA, Gardner-Morse MG, Henry SM. Abdominal muscle activation increases lumbar spinal stability: analysis of contributions of different muscle groups. ClinBiomech, 2011; 26: 797-803
  • 62. Tokuno CD, Cresswell AG, Thorstensson A, Carpenter MG. Recruitment order of the abdominal muscles varies with postural task. Scand J Med SciSpor, 2013; 23: 349-54[Crossref]
  • 63. Tsao H, Hodges PW. Immediate changes in feedforward postural adjustments following voluntary motor training. Exp Brain Res, 2007; 181: 537-46[Crossref][PubMed]
  • 64. Van Oosterwijck J, Nijs J, Meeus M, Truijen S, Craps J, Van den Keybus N, Paul L. Pain neurophysiology education improves cognitions, pain thresholds, and movement performance in people with chronic whiplash: a pilot study. J Rehabil Res Dev, 2011; 48: 43-8[Crossref]
  • 65. Vasseljen O, Unsgaard-Tøndel M, Westad C, Mork PJ. Effect of core stability exercises on feed-forward activation of deep abdominal muscles in chronic low back pain: a randomized controlled trial. Spine, 2012; 37: 1101-8[PubMed][Crossref]
  • 66. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C et al. Years lived with disability (YLDs) for 1160 sequelae of289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012; 380: 2163-96
  • 67. Waddell G. The Back Pain Revolution. Churchill Livingstone: Edinburgh 2004
  • 68. Wand BM, Parkitny L, O’Connell NE, Luomajoki H, McAuley JH, Thacker M, Moseley GL. Cortical changes in chronic low back pain: Current state of the art and implications for clinical practice. Man Ther, 2011; 16: 15-20[PubMed][Crossref]
  • 69. Wand BM, Tulloch VM, George PJ, Smith AJ, Goucke R, O'Connell NE, Moseley GL. Seeing it helps: movement-related back pain is reduced by visualization of the back during movement. Clin J Pain, 2012; 28: 602-8[PubMed][Crossref]
  • 70. Wong AY, Parent EC, Funabashi M, Stanton TR, Kawchuk GN. Do various baseline characteristics of transversus abdominis and lumbar multifidus predict clinical outcomes in nonspecific low back pain? A systematicreview. Pain, 2013; 154: 2589-602 [Crossref][PubMed]

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_1515_pha-2015-0006
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.