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The Effects of Maintained Muscle Contraction of Abdominal and Pelvic Floor Muscles on 3D Pelvic Stability in Individuals with Chronic Low Back Pain During Gait

  • Yu, Min (Department of Physical Therapy, College of Medical Sciences, Jeonju University) ;
  • Choi, Yu-Ri (Department of Physical Therapy, College of Medical Sciences, Jeonju University) ;
  • Choi, Jeong-Eun (Department of Physical Therapy, College of Medical Sciences, Jeonju University) ;
  • Jeon, Seong-Yeon (Department of Physical Therapy, College of Medical Sciences, Jeonju University) ;
  • Kim, Yong-Wook (Department of Physical Therapy, College of Medical Sciences, Jeonju University)
  • 투고 : 2022.07.05
  • 심사 : 2022.07.27
  • 발행 : 2022.08.31

초록

PURPOSE: This study was designed to investigate the effects of keeping contraction of abdominal and pelvic floor muscles on 3D pelvic stability in individuals with nonspecific chronic low back pain (CLBP) during normal speed walking. METHODS: The subjects were 20 adults with CLBP deformity and had moderate pain intensity of the visual analog scale. A three-dimensional camera capture system was used to collect kinematic pelvic motion data with and without contraction of the abdominal and pelvic floor muscles during gait. The subjects were asked to walk on a walkway in the lab room and they were attached 40 reflective markers to their pelvic segment and lower extremities. A Visual3D Professional V6 program and Vicon Nexus software were used to analyze 3D pelvic kinematic data. RESULTS: There were significant differences between with and without contraction of the abdominal and pelvic floor muscles of the pelvic depression and the total pelvic motion in coronal plane during gait (p < .05). However, there were no significant differences in any of the maximal motion of the pelvic segment in sagittal and transverse motion plane according to the different muscle contraction conditions (p > .05). CONCLUSION: The results of this study suggest that maintaining co-contraction of the abdominal and pelvic floor muscles in individuals with CLBP increased pelvic stability and contributed to preventing excessive pelvic movements during gait.

키워드

과제정보

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Ministry of Science and ICT (No. 2022R1F1A1064097).

참고문헌

  1. Ferreira ML, Ferreira PH, Latimer Jane, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain. 2007;131(1):31-7. https://doi.org/10.1016/j.pain.2006.12.008
  2. Maher CG, Latimer J, Hodges PW, et al. The effect of motor control exercise versus placebo in patients with chronic low back pain. BMC Musculoskelet Disord. 2005;6:54. https://doi.org/10.1186/1471-2474-6-54
  3. Urits I, Burshtein A, Sharma M, et al. Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep. 2019;23(3):23. https://doi.org/10.1007/s11916-019-0757-1
  4. Bernard S, Gentilcore-Saulnier E, Masse-Alarie H, et al. Is adding pelvic floor muscle training to an exercise intervention more effective at improving pain in patients with non-specific low back pain? A systematic review of randomized controlled trials. Physiotherapy. 2021;110:15-25. https://doi.org/10.1016/j.physio.2020.02.005
  5. Moon OK, Lee SB. A Study of the Relationship between Pelvic Floor Muscles and Lumbar Stabilization. J Korean Phys Ther Sci. 2008;15(1):87-95.
  6. Cruz-Diaz D, Bergamin M, Gobbo S, et al. Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complement Ther Med. 2017;33:72-7. https://doi.org/10.1016/j.ctim.2017.06.004
  7. Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther. 1999;4(2):74-86. https://doi.org/10.1054/math.1999.0169
  8. Rocca Rossetti S. Functional anatomy of pelvic floor. Arch Ital Urol Androl. 2016;88(1):28-37. https://doi.org/10.4081/aiua.2016.1.28
  9. Eickmeyer SM. Anatomy and Physiology of the Pelvic Floor. Phys Med Rehabil Clin N Am. 2017;28(3):455-60. https://doi.org/10.1016/j.pmr.2017.03.003
  10. Sapsford RR, Hodges PW, Richardson CA, et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31-42. https://doi.org/10.1002/1520-6777(2001)20:1<31::AID-NAU5>3.0.CO;2-P
  11. Lee AY, Baek SO, Cho YW, et al. Pelvic floor muscle contraction and abdominal hollowing during walking can selectively activate local trunk stabilizing muscles. J Back Musculoskelet Rehabil 2016;29(4):731-9. https://doi.org/10.3233/BMR-160678
  12. Lewis CL, Laudicina NM, Khuu A, et al. The human pelvis: variation in structure and function during gait. Anat Rec (Hoboken). 2017;300(4):633-42. https://doi.org/10.1002/ar.23552
  13. Dunphy C, Casey S, Lomond A, et al. Contralateral pelvic drop during gait increases knee adduction moments of asymptomatic individuals. Hum Mov Sci. 2016;49:27-35. https://doi.org/10.1016/j.humov.2016.05.008
  14. Stover MD, Edelstein AI, Matta JM. Chronic Anterior Pelvic Instability: Diagnosis and Management. J Am Acad Orthop Surg. 2017;25(7):509-17. https://doi.org/10.5435/JAAOS-D-15-00338
  15. Kim Y. Effect of correction of leg length discrepancy on the biomechanical characteristics of the pelvis and hip joints among standing workers. Work. 2022;71(4):1129-36. https://doi.org/10.3233/WOR-205160
  16. Rum L, Brasiliano P, Vannozzi G, et al. Non-specific chronic low back pain elicits kinematic and neuromuscular changes in walking and gait termination. Gait Posture. 2021;84:238-44. https://doi.org/10.1016/j.gaitpost.2020.12.005
  17. Lee HD, Kim HR, Kim HJ, et al. The Effects of Trunk Stability Education in Pelvic Stabilization. J Korean Soc Integrative Med. 2013;1(4):57-66. https://doi.org/10.15268/ksim.2013.1.4.057
  18. Collins TD, Ghoussayni SN, Ewins DJ, et al. A six degrees-of-freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set. Gait Posture. 2009;30(2): 173-80. https://doi.org/10.1016/j.gaitpost.2009.04.004
  19. Neumann DA. Kinesiology of the musculoskeletal system: Foundations for physical rehabilitation (1st ed). St. Louis. Mosby. 2002.
  20. Kim B, Yim J. Core stability and hip exercises improve physical function and activity in patients with non-specific low back pain: A randomized controlled trial. Tohoku J Exp Med. 2020;251(3):193-206. https://doi.org/10.1620/tjem.251.193
  21. Yu Q, Huang H, Zhang Z, et al. The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural system. BMC Musculoskelet Disord. 2020;21(1):596. https://doi.org/10.1186/s12891-020-03617-3
  22. Youn HJ, Kim JS. The effect of abdominal drawing-in maneuver and pelvic floor muscle contraction in individuals with and without low back pain. J Korean Soc Phys Med. 2016;11(1):53-60. https://doi.org/10.13066/kspm.2016.11.1.53