Tag: low back pain

Effectiveness of spinal manipulation in chronic mechanical low back pain: a gender-based comparative study

Şerife Özcan, Hasan Kerem Alptekin3, Jülide Hazneci, Sefa Haktan Hatık, İlker Can Büyükkırlı, Reyhan Gümüşburun

Şerife Özcan, Hasan Kerem Alptekin3, Jülide Hazneci, Sefa Haktan Hatık, İlker Can Büyükkırlı, Reyhan Gümüşburun– Effectiveness of spinal manipulation in chronic mechanical low back pain: a gender-based comparative study –  Fizjoterapia Polska 2025; 25(5); 92-98

DOI: https://doi.org/10.56984/8ZGA431X3Z8

Abstract
Background. The purpose of this study was to compare and evaluate the effects of spinal manipulation in patients with chronic mechanical low back pain with respect to gender.
Methods. A total of 62 volunteers diagnosed with chronic mechanical low back pain were included in the study. Participants were divided into two groups based on gender: female (n = 31) and male (n = 31). Functional disability was assessed using the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). Pain intensity and characteristics were evaluated using the Visual Analog Scale (VAS) and the McGill Pain Questionnaire. Quality of life was assessed with the WHOQOL-Bref, sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and treatment satisfaction with the Treatment Satisfaction Scale (TSS). All assessments were conducted at three time points: before treatment, immediately after treatment, and one month following treatment completion. Goniometric measurements of the hip and lumbar spine were also performed. Both groups received identical interventions consisting of spinal manipulation applied twice weekly, for a total of eight sessions over four weeks.
Results. Statistically significant within-group improvements were observed across all outcome measures at post-treatment and at the one-month follow-up compared with baseline, with the exception of the Treatment Satisfaction Scale (p < 0.05). When outcomes were compared between female and male groups, no statistically significant differences were identified (p > 0.05).
Conclusion. Gender does not influence the effectiveness of spinal manipulation in the management of chronic mechanical low back pain.
Key words
low back pain, spinal manipulation, sex factors
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Effect of neurokinetic therapy on core muscle dysfunction among subjects with low back pain

Theepan Kumar, Kumaresan A, Surya Vishnuram

Theepan Kumar, Kumaresan A, Surya Vishnuram – Effect of neurokinetic therapy on core muscle dysfunction among subjects with low back pain –  Fizjoterapia Polska 2025; 25(4); 169-172

DOI: https://doi.org/10.56984/8ZGA431YVHR

Abstract
Objective. Core muscle dysfunction is commonly identified as a contributing factor to low back pain. This study examined the effects of Neurokinetic Therapy (NKT) on core muscle dysfunction in individuals with low back pain.
Methods. Sixty-six subjects aged 20–50 years with chronic nonspecific low back pain were randomized into two groups (NKT and control). The NKT group received treatment for eight weeks. Manual muscle testing was conducted during this period alongside the identification of dysfunctional movement patterns and biweekly neuromotor reprogramming sessions.
Results. The primary outcome, core muscle endurance, improved significantly in the NKT group. Plank endurance time increased from a mean of 45.2 seconds (SD 10.5) at baseline to 61.0 seconds (SD 12.4) post-intervention, while the control group showed a smaller improvement. Side-bridge endurance times also demonstrated a greater increase in the NKT group (30.4 seconds [SD 8.2] to 42.6 seconds [SD 9.3]) compared to the control group. The Wilcoxon test confirmed these improvements were statistically significant (p < 0.01).
Conclusion. The findings suggest that interventional techniques such as NKT should be incorporated into clinical practice for managing chronic low back pain, especially when core dysfunction is present.
Key words
Neurokinetic Therapy, core muscles, low back pain, muscle dysfunction
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Impact of Feldenkrais exercise on elderly patients with low back pain: a systematic literature review

Annisa Putri Fahmawati, Rina Yuniana

Annisa Putri Fahmawati, Rina Yunianag – Impact of Feldenkrais exercise on elderly patients with low back pain: a systematic literature review –  Fizjoterapia Polska 2025; 25(4); 27-32

DOI: https://doi.org/10.56984/8ZGA431U0Y0

Abstract
The aging process leads to a decline in physiological capacity among the elderly, including a decrease in musculoskeletal function and an increased risk of lower back pain (LBP). One of the emerging non-pharmacological interventions is Feldenkrais Exercise (FE), which is a conscious movement approach focused on enhancing body awareness, mobility, and functional integration. The aim of this study is to examine the impact of Feldenkrais Exercise on elderly individuals suffering from lower back pain. The method employed in this research is a systematic literature review utilizing the PRISMA approach. Data sources were obtained from national and international articles (Scopus and Google Scholar) within the last 7 years. A total of 6 articles were selected based on inclusion criteria relevant to the topics of Feldenkrais, LBP, and the elderly. Results of this research indicate that Feldenkrais Exercise is effective in enhancing dynamic balance and functional activities; reducing fear and risk of falling; maintaining executive function and cognitive vitality; decreasing the intensity of lower back pain; and overall improving quality of life. The conclusion drawn from this study is that Feldenkrais Exercise can be considered an effective holistic and non-invasive approach to enhance movement function and quality of life for elderly individuals suffering from lower back pain.
Key words
Feldenkrais exercise, elderly, low back pain
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Investigating the role of proprioceptive neuromuscular facilitation and Brugger’s exercises in enhancing functional ability and flexibility in chronic low back pain

Saranraj Palanivel, Rajadurai. S, Muralidharan CK, Arun Vijay Subbarayalu, Arun. B, Susmitha. P, Dharshini. C

Saranraj Palanivel, Rajadurai. S, Muralidharan CK, Arun Vijay Subbarayalu, Arun. B, Susmitha. P et al. – Investigating the role of proprioceptive neuromuscular facilitation and Brugger’s exercises in enhancing functional ability and flexibility in chronic low back pain –  Fizjoterapia Polska 2025; 25(3); 387-391

DOI: https://doi.org/10.56984/8ZG7D19SU5U

Abstract
Background. Low back pain is defined as pain and discomfort localized below the costal margin and above the inferior gluteal folds, with or without leg pain. The aim of this study was to compare the effectiveness of proprioceptive neuromuscular facilitation (PNF) and Brugger’s exercises in reducing disability and improving flexibility in subjects with chronic low back pain.
Methodology. This study was conducted on 30 subjects with low back pain, randomly assigned into two equal groups. Group A received Brugger’s exercises, and Group B received proprioceptive neuromuscular facilitation techniques. The modified Oswestry Low Back Pain Questionnaire and the standing reach test were used to evaluate differences between groups.
Results. Statistical analysis showed that proprioceptive neuromuscular facilitation techniques were more effective than Brugger’s exercises in improving functional ability and flexibility in subjects with chronic low back pain.
Conclusion. In this study, proprioceptive neuromuscular facilitation combined with Brugger’s exercises had a positive effect on reducing disability and improving flexibility in individuals with low back pain, as measured by the standing reach test and the Oswestry Low Back Pain Questionnaire before and after therapy.
Key words
low back pain, proprioceptive neuromuscular facilitation exercises, Brugger’s exercise, flexibility, functional ability
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Effectiveness of muscle energy technique along with strengthening exercise among college students with lower cross syndrome

Aswin Kumaraguru, Anitha.A, Shenbaga Sundaram Subramanian, Karthick.K, Jeslin. G.N, Neha Lakshmanan, Dinesh Sampath Kumar, Sivaraghav Sathish Kumar

Aswin Kumaraguru et al. – Effectiveness of muscle energy technique along with strengthening exercise among college students with lower cross syndrome –  Fizjoterapia Polska 2025; 25(2); 290-293

DOI: https://doi.org/10.56984/8ZG00E1MU5D

Abstract
Aim. Poor posture, prolonged sitting, and a sedentary lifestyle are common among students, causing muscle imbalances, increased lordosis, and a lateral shift in the center of gravity. These conditions affect muscle strength and can cause lower cross syndrome. This study aims to assess the effectiveness of MET and strengthening exercises in college students with lower cross syndrome.
Material and methods. It is a double-blinded study in which subjects diagnosed with lower cross syndrome were recruited after giving consent. Subjects were allocated into the METs group (n = 20) and the conventional group (n = 20). The baseline evaluation for anterior pelvic tilt was done using Kinovea software. The curl-up test and squat test for abdominal and gluteal muscle strength were recorded.
Results. Statistical analyses, using mean and standard deviation, revealed significant improvements in anterior pelvic tilt, abdominal curl, and squats post-intervention in the METs group compared to the conventional group (p < 0.0001 for all). Post-intervention values were 10.30 ± 1.45, 42.05 ± 2.44, and 36.70 ± 3.23, respectively.
Conclusion. Results prove that the subjects of the METs group improved their anterior pelvic tilt, abdominal strengthening, and gluteal strengthening more than those of the conventional group.
Key words
low back pain, anterior pelvic tilt, muscle energy technique, strengthening exercise, Thomas test, Kinovea software, curl up test
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Enhancing recovery: the impact of foam roller-assisted stabilization exercises on low back pain — a comparative analysis with conventional therapies

Revanth M, Kamalakannan M, Hariharan J, Priyadharshini V, Dinesh S, Priyanga Seemathan, Praveenkumar R

 

Revanth M et al. – Enhancing recovery: the impact of foam roller-assisted stabilization exercises on low back pain — a comparative analysis with conventional therapies –  Fizjoterapia Polska 2025; 25(1); 369-375

DOI: https://doi.org/10.56984/8ZG007DLGP0

Abstract
Background. Low back pain (LBP) is one of the most prevalent musculoskeletal conditions affecting individuals worldwide, often resulting in significant disability and reduced quality of life. As the leading cause of years lost to disability globally, the burden of LBP continues to rise alongside an aging and expanding population. Regular exercise plays a pivotal role in alleviating LBP by enhancing spinal muscle strength, improving flexibility, and optimizing posture. Interferential therapy (IFT), a transcutaneous electrical stimulation modality utilizing medium-frequency currents, is a well-established intervention for musculoskeletal disorders. This study evaluates the effectiveness of stabilization exercises using a foam roller in comparison to conventional exercise in individuals with LBP.
Methods. A total of 82 participants meeting the inclusion and exclusion criteria were randomized into two groups: a stabilization exercise group (n = 41) and a conventional exercise group (n = 41). Both groups received IFT alongside their respective exercise protocols. Each intervention session lasted 30 minutes and was administered five times per week for three weeks.
Results. Post-intervention assessments using the Modified Oswestry Disability Index (MODQ) revealed a mean score of 18.8 in the stabilization exercise group compared to 22.93 in the conventional exercise group, with a statistically significant p-value of < 0.0001. These findings demonstrate a superior reduction in pain and disability in the stabilization exercise group.
Conclusion. Stabilization exercises incorporating a foam roller provide enhanced therapeutic benefits for individuals with LBP compared to conventional exercises. The foam roller introduces an unstable surface, challenging participants and promoting greater core activation and postural control.
Key words
foam roller, low back pain, stabilization exercise, interferential therapy (IFT), Modified Oswestry Disability Index (MODQ)
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Low back pain-related misbeliefs: across-sectional study in Kingdom of Saudi Arabia

Abdullah F Alhumayani, Abdulaziz A Alzaidani, Ahmed Abdelmoniem Ibrahim, Hisham Mohamed Hussein, Ibrahim M. Dewir, Mostafa Sayed

Abdullah F Alhumayani, Abdulaziz A Alzaidani, Ahmed Abdelmoniem Ibrahim, Hisham Mohamed Hussein, Ibrahim M. Dewir, Mostafa Sayed – Low back pain-related misbeliefs: across-sectional study in Kingdom of Saudi Arabia –  Fizjoterapia Polska 2024; 24(5); 259-266

DOI: https://doi.org/10.56984/8ZG020CU1SF

Abstract
Introduction. Pain in the lower back has gained considerable attention within the medical community because of its major socioeconomic impact. Misconceptions and myths are widespread in many communities, especially in developing countries, which affects the prognosis of LBP. Aim of the study. The major goal of this study was to investigate the current LBP-related beliefs among the Saudi Arabian adult population. Methods. A cross-sectional, self-administered survey design was used to investigate the current beliefs related to LBP among 519 Saudi Arabian adults in different areas of Saudi Arabia (East, West, North, South, and Middle regions), conducted by Taif University from January 2023 to August 2023. The survey, including the LBP Beliefs Questionnaire (LBPBQ), demographic questions, and inquiries about LBP history, was made available online on a digital platform. Results. The most prevalent disbeliefs are “Back pain indicates the presence of organic injury or serious disease” (31.2% disagreed), “Back pain means one should refrain from physical activity” (36.61% disagreed), “Bed rest is the mainstay of therapy” (25.05% disagreed), “Remaining physically active is the best remedy against back pain” (38.4% rather agreed on this reversed-score question), “Someone with back pain can do things himself to ease recovery” (45.09% agreed on this reversed-score question), “Psychological factors such as thoughts and feelings can influence pain intensity” (38.73% rather agreed on this reversed-score question). Conclusion. Several misbeliefs related to LBP are still extant in the adult population in Saudi Arabia, particularly regarding physical activity, lack of self-control, pain medication, and the need for surgery.
Key words misbelief, low back pain, attitude, knowledge
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The efficacy of treatment with the use of Tergumed 700 system in a group of males with low back pain (LBP)

Jacek Wilczyński, Piotr Sobolewski, Rafał Zieliński, Alicja Kasprzak, Jakub Bąk, Marta Mierzwa Molenda

Jacek Wilczyński, Piotr Sobolewski, Rafał Zieliński, Alicja Kasprzak, Jakub Bąk, Marta Mierzwa Molenda – The efficacy of treatment with the use of Tergumed 700 system in a group of males with low back pain (LBP) –  Fizjoterapia Polska 2024; 24(5); 147-154

DOI: https://doi.org/10.56984/8ZG020C1F2S

Abstract The aim of the study was to evaluate the efficacy of treatment with the use of the Tergumed 700 system in a group of males with low back pain (LBP) syndrome based on the dynamics of changes in the isometric strength of the lumbar spine muscles and the imbalances thereof. Thirty-six males were examined, 19 in the study group (A) and 17 in the control group (B). Magnetic resonance imaging (MRI) of the lumbar spine was applied to assess the degree of degenerative changes. The isometric strength and imbalance of the lumbar spine muscles were tested using the Tergumed 700 system. In the study group (A), traditional Richardson’s core stabilization exercises and therapy with the Tergumed 700 system were performed. In the control group (B), only Richardson’s core stabilization exercises were conducted. The therapy lasted 6 weeks. The examination was performed four times: before the therapy, and after 2, 4, and 6 weeks following the therapy commencement. After six weeks, in the test group (A), the lumbar extensor muscle strength (p = 0.006), left-sided rotator muscle strength (p = 0.015), and right-sided rotator muscle strength (p = 0.001) improved. However, in the control group (B), significant improvement after the same period was found only in the lumbar extensor muscle strength (p = 0.042). As a result of the programmed treatment based on the patient’s current condition test, the lumbar back pain syndrome therapy using the Tergumed 700 system combined with central stabilization exercises according to Richardson was found to be most effective.
Key words low back pain, Tergumed 700 system, isometric muscle strength, muscle imbalance
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Mediators of pain neuroscience education on disability of patients with nonspecific chronic low back pain

Ibrahim S. Aljulaymi, Anne Thackeray, Julie M. Fritz, John S. Magel, Pascal R. Deboeck, Mohammed A.Qasheesh, Faris A. Alodaibi, Rania N. Almeheyawi, Fahad H. Alshehri, Hatem H. Allam, Hosam Alzahrani,Ibrahim M. Dewir

Ibrahim S. Aljulaymi et al. – Mediators of pain neuroscience education on disability of patients with nonspecific chronic low back pain –  Fizjoterapia Polska 2024; 24(5); 136-146

DOI: https://doi.org/10.56984/8ZG020C6WFT

Abstract Objective. The objective of this study was to explore the mediators (pain self-efficacy, pain catastrophizing, back pain beliefs) of Pain Neuroscience Education (PNE) on disability for patients with chronic low back pain (LBP) in Saudi Arabia (SA). Methods. An observational multisite pre-post study design was utilized. This study was done at the Physical Therapy (PT) Clinics related to the Ministry of Health in SA, from December 2020 to December 2021. Chronic LBP patients were recruited into a 2-week PT program. Ten eligible physical therapists across six PT clinics were involved in the study who treat musculoskeletal and LBP patients. There were two groups (usual care of physical therapy “US-PT” vs. “PNE”). The mediators and disability were evaluated at the baseline (T0) and 2-week follow-up (T1). Results. A total of 249 patients met the selection criteria and consented to participate in the study. 131 patients received UC-PT only and 118 patients received PNE in addition to UC-PT. Baseline patient characteristics showed the mean age was 41.41 (SD = 12.03), and 144 of the participants (57.8%) were female. Increased pain self-efficacy (95% CI = −3.99, −1.15), decreased pain catastrophizing (95% CI = −3.42, −0.88), and decreased belief that they were disabled by pain (95% CI = −2.43, −0.33) fully mediated the PNE effect on disability at a 2-week interval. Conclusion. PNE participants showed greater improvement from baseline to 2 weeks on each cognitive factor hypothesized to mediate the effect of PNE on disability. The study results provided guidance on how to target treatment recommendations to gain the maximum benefits from PNE. Also, this study generated evidence that is useful for physical therapists and researchers to improve PNE to optimize chronic LBP patient outcomes.
Key words low back pain, pain neuroscience education, mediation analysis, pain self-efficacy, physical therapists
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Revelation of muscle energy technique and positional release technique in mitigating low back pain, disability, and hyperlordosis in patients with low back pain: A comprehensive review

Jency Thangasheela Gnanasigamani, VinodhKumar Ramalingam, Franklin Saju Madhavadian Kurusumuthu

Jency Thangasheela Gnanasigamani, VinodhKumar Ramalingam, Franklin Saju Madhavadian Kurusumuthu – Revelation of muscle energy technique and positional release technique in mitigating low back pain, disability, and hyperlordosis in patients with low back pain: A comprehensive review –  Fizjoterapia Polska 2024; 24(4); 271-281

DOI: https://doi.org/10.56984/8ZG01A8M4N1

Abstract
Background. Low back pain, often known as LBP, is a complicated ailment that has many associated risks, including those related to age, gender, lifestyle, social and psychological background, physical demands of work, social support, pain perception, and much more. Its frequency steadily rises with age and is typically nonspecific or mechanical in nature, with axially abnormal loading that might cause ache in the lower lumbar region. Strain-counter strain (SCS) or positional release technique (PRT) and muscle energy technique (MET) are identified as eligible management for LBP; however, in which way both techniques help to control LBP is to be evaluated.
Objectives. To discuss the potential role of MET and PRT in reducing LBP and to find the space between previous and current practice of MET and PRT in correcting the lordosis angle in the lumbar region and disability in LBP patients.
Methods. English-language articles were searched online, using the PEDro, PubMed, and Google Scholar databases. Keywords were MET, PRT, LBP, and lumbar lordosis. The articles were published from 2001 to 2022, of which 100 were found to be relevant and 20 to meet the inclusion criteria. They included LBP-related articles with MET and PRT techniques of management, excluding those not related to lumbar lordosis or to those two techniques.
Conclusion. Based on the 20 articles reviewed, it was concluded that MET and PRT played a significant role in decreasing participants’ LBP pain, lordosis angle, and functional impairment.
Keywords
low back pain, muscle energy technique, positional release technique, lordosis angle, functional impairment
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