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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      The Effects Of Myofascial Release Technique Combined With Core Stabilization Exercise In Elderly With Non-Specific Low Back Pain: A Randomized Controlled, Single-Blind Study

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          Abstract

          Purpose

          To evaluate the effects of Myofascial Release Technique (MRT) with a roller massager combined with core stabilization exercises (CSE) in elderly with non-specific low back pain (NSLBP).

          Patients and methods

          A total of forty-five participants were randomly divided into two groups (CSE and CSE+MRT). A core stabilization exercise program was applied for the participants in the CSE group for 3 days per week for a total of 6 weeks. In addition to the core stabilization exercises, myofascial relaxation technique with a roller massager was performed for 3 days per week for 6 weeks for the participants in the CSE+MRT group. Participants were assessed in terms of pain, low back disability, lower body flexibility, kinesiophobia, core stability endurance, spinal mobility, gait characteristics and quality of life both pre- and post-treatment.

          Results

          It was found that the improvement in core stability endurance (p=0.031) and spinal mobility (in the sagittal plane) (p=0.022) was greater in the CSE+MRT group compared to the CSE group. There was no significant difference between the two groups in terms of pain, low back disability, lower body flexibility, kinesiophobia, gait characteristics and quality of life (p>0.05).

          Conclusion

          The current study suggests that myofascial release technique with a roller massager combined with core stabilization exercises can be a better choice in the treatment of NSLBP in elderly.

          ClinicalTrials.gov Identifier

          NCT03898089.

          Most cited references61

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          Non-specific low back pain.

          Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.
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            Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance.

            Two studies are presented that investigated 'fear of movement/(re)injury' in chronic musculoskeletal pain and its relation to behavioral performance. The 1st study examines the relation among fear of movement/(re)injury (as measured with the Dutch version of the Tampa Scale for Kinesiophobia (TSK-DV)) (Kori et al. 1990), biographical variables (age, pain duration, gender, use of supportive equipment, compensation status), pain-related variables (pain intensity, pain cognitions, pain coping) and affective distress (fear and depression) in a group of 103 chronic low back pain (CLBP) patients. In the 2nd study, motoric, psychophysiologic and self-report measures of fear are taken from 33 CLBP patients who are exposed to a single and relatively simple movement. Generally, findings demonstrated that the fear of movement/(re)injury is related to gender and compensation status, and more closely to measures of catastrophizing and depression, but in a much lesser degree to pain coping and pain intensity. Furthermore, subjects who report a high degree of fear of movement/(re)injury show more fear and escape/avoidance when exposed to a simple movement. The discussion focuses on the clinical relevance of the construct of fear of movement/(re)injury and research questions that remain to be answered.
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              Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis.

              The contribution of transversus abdominis to spinal stabilization was evaluated indirectly in people with and without low back pain using an experimental model identifying the coordination of trunk muscles in response to a disturbances to the spine produced by arm movement. To evaluate the temporal sequence of trunk muscle activity associated with arm movement, and to determine if dysfunction of this parameter was present in patients with low back pain. Few studies have evaluated the motor control of trunk muscles or the potential for dysfunction of this system in patients with low back pain. Evaluation of the response of trunk muscles to limb movement provides a suitable model to evaluate this system. Recent evidence indicates that this evaluation should include transversus abdominis. While standing, 15 patients with low back pain and 15 matched control subjects performed rapid shoulder flexion, abduction, and extension in response to a visual stimulus. Electromyographic activity of the abdominal muscles, lumbar multifidus, and the surface electrodes. Movement in each direction resulted in contraction of trunk muscles before or shortly after the deltoid in control subjects. The transversus abdominis was invariably the first muscle active and was not influenced by movement direction, supporting the hypothesized role of this muscle in spinal stiffness generation. Contraction of transversus abdominis was significantly delayed in patients with low back pain with all movements. Isolated differences were noted in the other muscles. The delayed onset of contraction of transversus abdominis indicates a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine.
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                Author and article information

                Journal
                Clin Interv Aging
                Clin Interv Aging
                CIA
                clinintag
                Clinical Interventions in Aging
                Dove
                1176-9092
                1178-1998
                09 October 2019
                2019
                : 14
                : 1729-1740
                Affiliations
                [1 ]School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University , Kırsehir, Turkey
                [2 ]School of Physical Therapy and Rehabilitation, Dokuz Eylül University , Izmir, Turkey
                [3 ]Department of Physical Medicine and Rehabilitation, Kırsehir Ahi Evran University Training and Research Hospital , Kırşehir, Turkey
                Author notes
                Correspondence: Gulsah Ozsoy School of Physical Therapy and Rehabilitation, Kırsehir Ahi Evran University , Kırsehir, TurkeyTel +905534802563Fax +903862805371 Email fzt.gulsah@hotmail.com
                Author information
                http://orcid.org/0000-0001-5678-771X
                http://orcid.org/0000-0003-0174-8224
                http://orcid.org/0000-0001-9048-1116
                http://orcid.org/0000-0003-3886-4819
                http://orcid.org/0000-0002-1163-9972
                http://orcid.org/0000-0001-5898-1698
                http://orcid.org/0000-0002-4655-0986
                http://orcid.org/0000-0002-5616-5723
                Article
                223905
                10.2147/CIA.S223905
                6790630
                31631992
                71ca2b63-439f-4799-a71a-c465b90e91e1
                © 2019 Ozsoy et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 20 July 2019
                : 18 September 2019
                Page count
                Figures: 3, Tables: 4, References: 70, Pages: 12
                Categories
                Original Research

                Health & Social care
                myofascial release technique,core stabilization exercises,non-specific low back pain

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