The effects of the CORE programme on pain at rest,movement-induced and secondary pain,active range of motion,and proprioception in female office workers with chronic low back pain: a randomized controlled trial

Abstract

Objective:

To investigate the effects of the CORE programme on pain at rest, movement-induced pain, secondary pain, active range of motion, and proprioception deficits in female office workers with chronic low back pain.

Design:

Randomized controlled trial.

Setting:

Rehabilitation clinics.

Subjects:

A total of 53 participants with chronic low back pain were randomized into the CORE group and the control group.

Intervention:

CORE group participants underwent the 30-minute CORE programme, five times per week, for eight weeks, with additional use of hot-packs and transcutaneous electrical nerve stimulation, while the control group used only hot-packs and transcutaneous electrical nerve stimulation.

Main measures:

Participants were evaluated pretest, posttest, and two months after the intervention period to measure resting and movement-induced pain, pressure pain as secondary pain, active range of pain-free motion, and trunk proprioception.

Results:

Pain intensity at rest (35.6 ±5.9 mm) and during movement (39.4 ±9.1 mm) was significantly decreased in the CORE group following intervention compared with the control group. There were significant improvements in pressure pain thresholds (quadratus lumborum: 2.2 ±0.7 kg/cm²; sacroiliac joint: 2.0 ±0.7 kg/cm²), active range of motion (flexion: 30.8 ±14.3°; extension: 6.6 ±2.5°), and proprioception (20° flexion: 4.3 ±2.4°; 10° extension: 3.1 ±2.0°) in the CORE group following intervention (all p < 0.05). These improvements were maintained at the two-month follow-up. The control group did not show significant improvements in any measured parameter.

Conclusion:

The CORE programme is an effective intervention for reducing pain at rest and movement-induced pain, and for improving the active range of motion and trunk proprioception in female office workers with chronic low back pain.

Keywords

Movement-induced pain CORE programme chronic low back pain proprioception active range of motion

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References

Klenerman

Slade

Stanley

. The prediction of chronicity in patients with an acute attack of low back pain in a general practice setting. Spine 1995; 20: 478–484.

Alcouffe

Manillier

Brehier

Fabin

Faupin

. Analysis by sex of low back pain among workers from small companies in the Paris area: severity and occupational consequences. Occup Environ Med 1999; 56: 696–701.

Danneels

Vanderstraeten

Cambier

Witvrouw

De Cuyper

. CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 2000; 9: 266–272.

Lee

Cholewicki

Reeves

Zazulak

Mysliwiec

. Comparison of trunk proprioception between patients with low back pain and healthy controls. Arch Phys Med Rehabil 2010; 91: 1327–1331.

Hodges

van den Hoorn

Dawson

Cholewicki

. Changes in the mechanical properties of the trunk in low back pain may be associated with recurrence. J Biomech 2009; 42: 61–66.

Reeves

Cholewicki

Milner

. Muscle reflex classification of low-back pain. J Electromyogr Kinesiol 2005; 15: 53–60.

Steiger

Wirth

De Bruin

Mannion

. Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect (s) of performance? A systematic review. Eur Spine J 2012; 21: 575–598.

Wang

Zheng

. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One 2012; 7: e52082.

van Middelkoop

Rubinstein

Kuijpers

. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine 2011; 20: 19–39.

10.

Brill

Couzens

. The core program: Fifteen minutes a day can changes your life. 1st ed. New York: Bantam Books, 2003.

11.

Cleland

Gillani

Bienen

Sadosky

. Assessing dimensionality and responsiveness of outcomes measures for patients with low back pain. Pain Pract 2011; 11: 57–69.

12.

Saghaei

. Random allocation software for parallel group randomized trials. BMC Med Res Methodol 2004; 4: 26.

13.

Vance

CGT

Rakel

Blodgett

. Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: a randomized controlled trial. Phys Ther 2012; 92: 898–910.

14.

Weiner

Rudy

Kim

Golla

. Do medical factors predict disability in older adults with persistent low back pain? Pain 2004; 112: 214–220.

15.

Gupta

McBeth

Macfarlane

. Pressure pain thresholds and tender point counts as predictors of new chronic widespread pain in somatising subjects. Ann Rheum Dis 2007; 66: 517–521.

16.

Hirayama

Yamagata

Ogata

Shimizu

Ikeda

Takahashi

. Relationship between low-back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation. Eur Spine J 2006; 15: 41–47.

17.

Newcomer

Laskowski

Larson

. Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects. Spine 2000; 25: 245–250.

18.

Juhl

Lund

Roos

Zhang

Christensen

. A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals. Arthritis 2012; 2012: 136245.

19.

Goldby

Moore

Doust

Trew

. A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine 2006; 31: 1083–1093.

20.

Koumantakis

Watson

Oldham

. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther 2005; 85: 209–225.

21.

Imai

Kaneoka

Okubo

. Trunk muscle activity during lumbar stabilization exercises on both a stable and unstable surface. J Orthop Sports Phys Ther 2010; 40: 369–375.

22.

Carpes

Reinehr

Mota

. Effects of a program for trunk strength and stability on pain, low back and pelvis kinematics, and body balance: a pilot study. J Bodyw Mov Ther 2008; 12: 22–30.

23.

Kumar

. Efficacy of segmental stabilization exercise for lumbar segmental instability in patients with mechanical low back pain: A randomized placebo controlled crossover study. N Am J Med Sci 2011; 3: 456–461.

24.

Roland

. A critical review of the evidence for a pain-spasm-pain cycle in spinal disorders. Clin Biomech 1986; 1: 102–109.

25.

Granges

Littlejohn

. Pressure pain threshold in pain-free subjects, in patients with chronic regional pain syndromes, and in patients with fibromyalgia syndrome. Arthritis Rheum 1993; 36: 642–646.

26.

Hides

Stokes

Saide

Jull

Cooper

. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine 1994; 19: 165–172.

27.

Cholewicki

McGill

. Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain. Clin Biomech 1996; 11: 1–15.

28.

Panjabi

. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992; 5: 383–389.

29.

Woolf

. Central sensitization: implications for the diagnosis and treatment of pain. Pain 2011; 152: S2–S15.

30.

Hong

Simons

. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. Arch Phys Med Rehabil 1998; 79: 863–872.

31.

Lewis

Hewitt

Billington

Cole

Byng

Karayiannis

. A randomized clinical trial comparing two physiotherapy interventions for chronic low back pain. Spine 2005; 30: 711–721.

32.

Lee

Hyun

Kim

. Influence of pilates mat and apparatus exercises on pain and balance of businesswomen with chronic low back pain. J Phy Ther Sci 2014; 26: 475–477.

33.

You

Kim

Chon

. The effect of a novel core stabilization technique on managing patients with chronic low back pain: a randomized, controlled, experimenter-blinded study. Clin Rehabil 2014; 28: 460–469.

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