Investigation of Abdominal Muscle Performance and Stabilization Exercises in Persons with and without Low Back Pain
Open Access
- Author:
- Haladay, Douglas Eugene
- Graduate Program:
- Kinesiology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- October 14, 2011
- Committee Members:
- John Henry Challis, Dissertation Advisor/Co-Advisor
John Henry Challis, Committee Chair/Co-Chair
Andris Freivalds, Committee Member
Sayers John Miller Iii, Committee Member
William E Buckley, Committee Member
Craig R Denegar, Committee Member - Keywords:
- abdominal muscle performance
low back pain
stabilization exercise - Abstract:
- Chronic low back pain (LBP) has reached epidemic proportions as it is one of the most prevalent and expensive health care problems in the United States. A large number of conservative care interventions are available for this syndrome; however, the efficacy of these treatments has not been demonstrated through vigorous scientific investigation. Clinicians need both valid measures and effective interventions in order to efficiently manage this population. The purpose of this dissertation was to evaluate the quality of present reviews of specific stabilization exercises for chronic LBP, estimate the strength of the relationship between common abdominal muscle performance tests and surface electromyography activity and hip resultant joint moments (RJM), determine if these tests can detect change following core stabilization exercise training, and describe the treatment effectiveness of a specific stabilization program versus a generalized stabilization program for persons with LBP due to instability. Study 1 was a systematic review of systematic reviews of specific spinal stabilization exercises. In Study 2, surface EMG activity of the upper and lower rectus abdominis, internal oblique, and external oblique muscles was obtained, while anterior superior iliac spine movement was simultaneously detected via motion analysis. Study 3 and 4 evaluated abdominal muscle performance in healthy participants and participants with low back pain respectively, in which double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) grades were determined by monitoring movement with a motion analysis system. Additionally, the Modified Oswestry Index and Visual Analog Scale were administered in Study 4. Both the DLLT and LAMP may be suitable for the examination of abdominal muscle performance as they have moderate to good correlations with abdominal muscle surface electromyography and hip RJM. The DLLT and LAMP do not correlate well with one another suggesting that they might measure different aspects of abdominal muscle performance. The LAMP is more responsive than the DLLT in detecting change following general stabilization training in healthy adults. Stabilization exercises, both specific and general, are effective in decreasing pain and disability in persons with chronic LBP, especially those with instability. These findings provide the foundation for future validation of these measures and development of interventions for persons with LBP.