Question

Please summarize this article: The Effects of Stabilization and Mckenzie Exercises on Transverse Abdominis and Multifidus Muscle Thickness, Pain, and Disability: A Randomized Controlled Trial in NonSpecific Chronic Low Back Pain in Journal of Physical Therapy Science 25(12):1541-5, December 2013 by: Mohammad Hosseinifar, Mohammad Akbari, Hamid Behtash, Mohsen Amiri, and Javad Sarrafzadeh

Answer 1

This study is done to compare the effectiveness between stabilization exercise and McKenzie exercise on pain ,disability and thickness of transverse abdominis and multifidus muscle among individuals with non specific chronic low back pain.

selection criteria are :

Inclusion criteria : age group from 18 to 50 years , pain between the region of costal margin and buttocks with or without reference to the lower extremity ( both radicular pain) , pain lasted for more than 3 months .

Exclusion criteria: History of recent fracture , trauma or surgery in the lumbar region, spondylosis, spondylolisthesis, neurological disorders, systemic diseases and cardiovascular diseases.

30 subjects were included

Treatment duration: 3 times per week for 6 weeks .

Pre test was done to examine the baseline measurements of pain , disability and thickness of the TrA and MF muscles with VAS , functional rating index questionnaire and sonography or ultrasound imaging respectively.

30 subjects were divided into 2 groups , each group underwent specific exercises.

One group performed stabilization exercises , which has 6 steps .

1. segmental control exercise(SCE) with emphasis on training the isolated contractions of TrA ,MF and pelvic floor muscles .
2. SCE with emphasis on co-concentration of all the three muscles in prone , supine and four point kneeling position .
3. Closed kinematic chain segmental control exercise.
4. SCE with low load applied by adding leverage of the limbs during open chain exercises.
5. SCE in functional activities or task
6. Co contraction of TrA and MF muscles during external load and addition of light aerobic activities like walking jogging etc.

Another group underwent McKenzie exercise, which has 6 exercises,

1. four extension type exercises and two flexion type exercises .

extension type exercise performed in prone and standing positions.

flexion type exercises performed in supine and sitting positions.

The result showed pain decreased in both the groups with application of stabilization and McKenzie exercise, but disability decreased only in group performed stabilization exercises.

stabilization exercises were more effective in increasing the thickness of right TrA during abdominal draw in maneuver and thickness of left TrA during active straight leg raise.

Hence, this study states that stabilization exercises is more effective than McKenzie exercise on pain , disability and thickness of TrA muscle among specific chronic low back pain subjects.