Document Type : Original Articles
Authors
1 Department of Corrective Exercise and Sport Pathology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
2 Department of Exercise Physiology and Corrective Exercise, Faculty of Sport Sciences, Urmia University, Urmia, Iran
Abstract
Background: Back pain is one of the most common disorders, caused by various factors and leading to diverse consequences. This study aimed to compare specific postural and functional indicators in adolescent boys with and without non-specific chronic low back pain.
Methods: The present study employed a causal-comparative design. A total of 30 adolescent male students with non-specific chronic low back pain and 30 healthy adolescent male students were purposefully selected. Individuals with non-specific chronic low back pain were identified using a visual pain scale and confirmed by a physical medicine specialist. Kyphosis and lordosis were assessed using a flexible ruler, proprioception was evaluated through the lumbar angle active reconstruction test at a 30-degree angle using a goniometer, core stability was measured using McGill functional tests, upper limb function was assessed with the Upper Limb Y Test, and static and dynamic balance were evaluated using the Stork Test and the Lower Limb Y Test, respectively. An independent t-test was used to compare the average variables between the two groups.
Results: The findings revealed significant differences in proprioception, core stability, and static and dynamic balance between the groups with and without non-specific chronic low back pain. However, the two groups observed no significant differences between other variables.
Conclusions: These results highlight the importance of proprioception, core stability, and static and dynamic balance in adolescent boys with non-specific chronic low back pain. Rehabilitation protocols for this population should prioritize developing and strengthening these components.
Keywords
- Aasa B, Berglund L, Michaelson P, Aasa U. Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial. Journal of orthopaedic & sports physical therapy. 2015;45(2):77-85.
- Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases. 2014;73(6):968-74.
- Dolphens M, Vansteelandt S, Cagnie B, Vleeming A, Nijs J, Vanderstraeten G, et al. Multivariable modeling of factors associated with spinal pain in young adolescence. European Spine Journal. 2016;25(9):2809-21.
- Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356-67.
- Schwertner DS, Oliveira RA, Koerich MH, Motta AF, Pimenta AL, Gioda FR. Prevalence of low back pain in young Brazilians and associated factors: Sex, physical activity, sedentary behavior, sleep and body mass index. Journal of back and musculoskeletal rehabilitation. 2020;33(2):233-44.
- Al-Toriri MN, Shamsi S. Effect of Plantar Flexor Stretching Exercises in Low Back Pain Management.
- Mok NW, Yeung EW, Cho JC, Hui SC, Liu KC, Pang CH. Core muscle activity during suspension exercises. Journal of science and medicine in sport. 2015;18(2):189-94.
- Potthoff T, de Bruin ED, Rosser S, Humphreys BK, Wirth B. A systematic review on quantifiable physical risk factors for non-specific adolescent low back pain. Journal of pediatric rehabilitation medicine. 2018;11(2):79-94.
- O'Sullivan PB, Beales DJ, Smith AJ, Straker LM. Low back pain in 17 year olds has substantial impact and represents an important public health disorder: a cross-sectional study. BMC public health. 2012;12(1):1-8.
- 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 Journal of Medical Sciences. 2008;24(3):372-7.
- Danneels L, Cools A, Vanderstraeten G, Cambier D, Witvrouw E, Bourgois J, et al. The effects of three different training modalities on the cross‐sectional area of the paravertebral muscles. Scandinavian journal of medicine & science in sports. 2001;11(6):335-41.
- Mannion A, Caporaso F, Pulkovski N, Sprott H. Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function. European Spine Journal. 2012;21:1301-10.
- Zander T, Rohlmann A, Calisse J, Bergmann G. Estimation of muscle forces in the lumbar spine during upper-body inclination. Clinical Biomechanics. 2001;16:S73-S80.
- Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Clinical Spine Surgery. 1998;11(1):46-56.
- George SZ, Childs JD, Teyhen DS, Wu SS, Wright AC, Dugan JL, et al. Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009). BMC musculoskeletal disorders. 2007;8(1):1-11.
- 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. LWW; 2012.
- Pourahmadi M, Takamjani IE, Sarrafzadeh J, Mohsenifar H, Fazeli SH, Bagheri R, et al. Effect of chronic low back pain on lumbar spine lordosis during sit-to-stand and stand-to-sit. Journal of Manipulative and Physiological Therapeutics. 2020;43(2):79-92.
- Lima M, Ferreira AS, Reis FJJ, Paes V, Meziat-Filho N. Chronic low back pain and back muscle activity during functional tasks. Gait & posture. 2018;61:250-6.
- Arendt-Nielsen L, Graven-Nielsen T, Svarrer H, Svensson P. The influence of low back pain on muscle activity and coordination during gait: a clinical and experimental study. Pain. 1996;64(2):231-40.
- Ringheim I, Indahl A, Roeleveld K. Reduced muscle activity variability in lumbar extensor muscles during sustained sitting in individuals with chronic low back pain. PLoS One. 2019;14(3):e0213778.
- Minghelli B. Musculoskeletal spine pain in adolescents: Epidemiology of non-specific neck and low back pain and risk factors. Journal of Orthopaedic Science. 2020;25(5):776-80.
- Chiwaridzo M, Naidoo N. Differences in personal and lifestyle characteristics among Zimbabwean high school adolescents with and without recurrent non-specific low back pain: a two part cross-sectional study. Archives of physiotherapy. 2015;5:1-8.
- Ryans I, Montgomery A, Galway R, Kernohan W, McKane R. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology. 2005;44(4):529-35.
- Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. The Journal of pain. 2003;4(7):407-14.
- Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine. 2001;8(12):1153-7.
- Seidi F, Rajabi R, Ebrahimi I, Alizadeh MH, Minoonejad H. The efficiency of corrective exercise interventions on thoracic hyper-kyphosis angle. Journal of back and musculoskeletal rehabilitation. 2014;27(1):7-16.
- Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine. 2007;32(23):2630-7.
- Newcomer KL, Laskowski ER, Yu B, Johnson JC, An K-N. Differences in repositioning error among patients with low back pain compared with control subjects. Spine. 2000;25(19):2488-93.
- McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Archives of physical medicine and rehabilitation. 1999;80(8):941-4.
- Gorman PP, Butler RJ, Plisky PJ, Kiesel KB. Upper Quarter Y Balance Test: reliability and performance comparison between genders in active adults. The Journal of Strength & Conditioning Research. 2012;26(11):3043-8.
- Sadeghi H, Noori S. Reliability of functional balance static, semi-dynamic and dynamic tests in Ectomorph women aged youth. Journal of Exercise Science and Medicine. 2015;7(1):35-55.
- Lopes M, Lopes S, Patinha T, Araújo F, Rodrigues M, Costa R, et al. Balance and proprioception responses to FIFA 11+ in amateur futsal players: Short and long-term effects. Journal of sports sciences. 2019;37(20):2300-8.
- Asheghan M, Hashemi SE, Sobhani V, Shakibaee A, Aqda AK, Arabzadeh E. The relationship between forward head position and dorsal kyphosis with non-specific chronic low back pain in military mans. Journal of Military Medicine. 2021;23(2):186-93.
- Mirbagheri S-S, Rahmani-Rasa A, Farmani F, Amini P, Nikoo M-R. Evaluating kyphosis and lordosis in students by using a flexible ruler and their relationship with severity and frequency of thoracic and lumbar pain. Asian spine journal. 2015;9(3):416.
- Feng Q, Jiang C, Zhou Y, Huang Y, Zhang M. Relationship between spinal morphology and function and adolescent non-specific back pain: a cross-sectional study. Journal of back and musculoskeletal rehabilitation. 2017;30(3):625-33.
- Liu N, Guo X, Chen Z, Qi Q, Li W, Guo Z, et al. Radiological signs of Scheuermann disease and low back pain: Retrospective categorization of 188 hospital staff members with 6-year follow-up. Spine. 2014;39(20):1666.
- Tatsumi M, Mkoba EM, Suzuki Y, Kajiwara Y, Zeidan H, Harada K, et al. Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania. BMC Musculoskeletal Disorders. 2019;20(1):1-5.
- Sarikaya S, Özdolap Ş, Gümüştasş Ş, Koç Ü. Low back pain and lumbar angles in Turkish coal miners. American journal of industrial medicine. 2007;50(2):92-6.
- Youdas JW, Garrett TR, Egan KS, Therneau TM. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Physical therapy. 2000;80(3):261-75.
- O'Sullivan P, Waller R, Wright A, Gardner J, Johnston R, Payne C, et al. Sensory characteristics of chronic non-specific low back pain: a subgroup investigation. Manual therapy. 2014;19(4):311-8.
- Tong MH, Mousavi SJ, Kiers H, Ferreira P, Refshauge K, van Dieën J. Is there a relationship between lumbar proprioception and low back pain? A systematic review with meta-analysis. Archives of physical medicine and rehabilitation. 2017;98(1):120-36. e2.
- Cholewicki J, Silfies SP, Shah RA, Greene HS, Reeves NP, Alvi K, et al. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine. 2005;30(23):2614-20.
- Beyranvand R, Mirnasouri R, Mostofi S, Salari A. The Effect of Low Back Pain on Functional Stability of the Upper Limb in Gymnast Athletes. Journal of Rafsanjan University of Medical Sciences. 2018;17(8).
- Zandi S, Rajabi R, Minoonejad H, Mohseni-Bandpei M. Upper quarter functional stability in female volleyball players with and without anterior shoulder instability, with consideration of arm dominance. Archives of Rehabilitation. 2016;16(4):346-55.
- Webb BG, Rettig LA. Gymnastic wrist injuries. Current sports medicine reports. 2008;7(5):289-95.
- Sundaram B, Doshi M, Pandian J. Postural stability during seven different standing tasks in persons with chronic low back pain-a cross-sectional study. Indian J Physiother Occup Ther. 2012;6(2):22-7.
- Dickerson CR, Alenabi T, Martin BJ, Chaffin DB. Shoulder muscular activity in individuals with low back pain and spinal cord injury during seated manual load transfer tasks. Ergonomics. 2018;61(8):1094-101.
- O’Sullivan PB, Grahamslaw KM, Kendell M, Lapenskie SC, Möller NE, Richards KV. The effect of different standing and sitting postures on trunk muscle activity in a pain-free population. Spine. 2002;27(11):1238-44.
- Moorhouse KM, Granata KP. Trunk stiffness and dynamics during active extension exertions. Journal of biomechanics. 2005;38(10):2000-7.
- Mazaheri M, Coenen P, Parnianpour M, Kiers H, van Dieën JH. Low back pain and postural sway during quiet standing with and without sensory manipulation: a systematic review. Gait & posture. 2013;37(1):12-22.
- Leitner C, Mair P, Paul B, Wick F, Mittermaier C, Sycha T, et al. Reliability of posturographic measurements in the assessment of impaired sensorimotor function in chronic low back pain. Journal of Electromyography and Kinesiology. 2009;19(3):380-90.
- 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. European Spine Journal. 2011;20:358-68.
- da Silva RA, Vieira ER, Fernandes KB, Andraus RA, Oliveira MR, Sturion LA, et al. People with chronic low back pain have poorer balance than controls in challenging tasks. Disability and Rehabilitation. 2018;40(11):1294-300.