Relationship between Hamstring Length and Gluteus Maximus Strength with and without Normalization in Patients with Mechanical Low Back Pain

Nasr Awad Abdelkader, Walaa Mohsen Mohamed, Nagy Ahmed Zaky, Hamada Ahmed Hamada, Nadia Abdelazim Fayaz

Nasr Awad Abdelkader, Walaa Mohsen Mohamed, Nagy Ahmed Zaky, Hamada Ahmed Hamada, Nadia Abdelazim Fayaz – Relationship between Hamstring Length and Gluteus Maximus Strength with and without Normalization in Patients with Mechanical Low Back Pain. Fizjoterapia Polska 2021; 21(2); 16-20

Abstract
Background. Muscle strength is an important tool for the assessment of muscle function and is strongly influenced by body size. Therefore, utilization of strength body-size-independent measurements for muscle strength testing is important in comparing the strength measured in large populations. Mechanical low back pain is the commonest musculoskeletal disorder in clinical practice and is associated with gluteus maximus weakness and hamstring tightness. Objective. This study aimed to determine the correlation between hamstring length and gluteus maximus strength with and without normalization in patients with mechanical low back pain. Methods. Seventy-three patients diagnosed with mechanical low back pain participated in this study. First, gluteus maximus strength was measured isometrically as a force (kg) and then converted to torque (Nm). Gluteus maximus strength was normalized for body weight and height using the following formula:% (body weight × height) = torque (N × m) ×100 / body weight (N) × height (m), then the hamstring length was measured using the active knee extension test. Results. The study population consisted of 38 females and 35 males with mean age, body mass and height values of 31.42 ± 6.78 years, 75.63 ± 12.77 kg, and 170.43 ± 9.24 cm respectively. The Spearman product-moment correlation between hamstring length and gluteus maximus strength revealed that there was a positive strong correlation (p < 0.05) between hamstring length and gluteus maximus strength with and without normalization. Conclusion. Contrary to our expectations, there was a highly significant positive correlation between gluteus maximus strength (with normalization) and hamstring length, and a positive correlation between gluteus maximus strength (without normalization) and hamstring length.
Key words:
Hamstring length, Gluteus maximus strength, Normalization, Mechanical low back pain
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Effect of stretching exercises in treatment of muscle strain: A systematic review

Karima Abdelaty Hassan, Marwa Abdelfattah Abdelrahman, Nadia Abdelazim Fayaz, Nasr Awad Abdelkader

Karima Abdelaty Hassan, Marwa Abdelfattah Abdelrahman, Nadia Abdelazim Fayaz, Nasr Awad Abdelkader – Effect of stretching exercises in treatment of muscle strain: A systematic review. Fizjoterapia Polska 2020; 20(5); 96-104

Abstract

Background. Although stretching may play a role in treatment of muscle strain, its significance is still conflicting and previous studies show a low level of evidence. Objective. To find the latest evidence regarding the effectiveness of stretching as a treatment to patients with grade I&II muscle strain. Methods. A comprehensive electronic database search of PubMed, Cochrane Library Database, and the Physiotherapy Evidence Database (PEDro) was conducted for randomized controlled trials (RCTs) in English language from January 2008 to October 2019 on adults with muscle strain treated by stretching exercise. Manual searching was conducted for reference list of included studies. Two reviewers independently reviewed and assessed each article for inclusion. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to rate methodological quality and risk of bias. Results. A total of five RCTs with a total number of 197 patients were analyzed. Three trials used stretching exercises versus conventional physical therapy (basic range of motion exercise, postural stabilization, and concentric and eccentric exercises) showed the positive efficacy of static stretching on flexibility, strength and ROM. Two trials used stretching based rehabilitation versus other treatment (vibration and cryotherapy) revealed superior effect of stretching rather than any other treatment. Conclusion. The clinical efficacy of stretching may correlate with using static stretching in treatment of grade I&II muscle strain. The effects of combining stretching with other modalities may be superior to conventional physical therapy treatment and can result in better outcomes.

Key words:
muscle strain, stretching exercises, systematic review
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