Ann Rehabil Med.  2020 Jun;44(3):246-255. 10.5535/arm.19100.

Efficacy and Safety of Abdominal Trunk Muscle Strengthening Using an Innovative Device in Elderly Patients With Chronic Low Back Pain: A Pilot Study

• Kato S
• Demura S
• Kurokawa Y
• Takahashi N
• Shinmura K
• Yokogawa N
• Yonezawa N
• Shimizu T
• Kitagawa R
• Tsuchiya H

• KMID: 2504445
• DOI: http://doi.org/10.5535/arm.19100

Abstract

Objective
To examine the efficacy and safety of an innovative, device-driven abdominal trunk muscle strengthening program, with the ability to measure muscle strength, to treat chronic low back pain (LBP) in elderly participants.
Methods
Seven women with non-specific chronic LBP, lasting at least 3 months, were enrolled and treated with the prescribed exercise regimen. Patients participated in a 12-week device-driven exercise program which included abdominal trunk muscle strengthening and 4 types of stretches for the trunk and lower extremities. Primary outcomes were adverse events associated with the exercise program, improvement in abdominal trunk muscle strength, as measured by the device, and improvement in the numerical rating scale (NRS) scores of LBP with the exercise. Secondary outcomes were improvement in the Roland-Morris Disability Questionnaire (RDQ) score and the results of the locomotive syndrome risk test, including the stand-up and two-step tests.
Results
There were no reports of increased back pain or new-onset abdominal pain or discomfort during or after the device-driven exercise program. The mean abdominal trunk muscle strength, NRS, RDQ scores, and the stand-up and two-step test scores were significantly improved at the end of the trial compared to baseline.
Conclusion
No participants experienced adverse events during the 12-week strengthening program, which involved the use of our device and stretching, indicating the program was safe. Further, the program significantly improved various measures of LBP and physical function in elderly participants.

Keyword

Abdominal muscles; Elderly; Low back pain; Physical therapy; Strengthening

Figure

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  Fig. 1. Innovative exercise device for the abdominal trunk muscle. (A) Photograph of a device-equipped patient. Using the device, the patient can measure their abdominal trunk muscle strength or perform strengthening exercise in sitting position without requiring trunk movement. (B) Photograph of the device. It consists of an inflatable cuff and a mechanical manometer to measure pressure.

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  Fig. 2. Time course of the pressure value calculated by the mechanical manometer of the device during the measurement of abdominal trunk muscle strength. “A” indicates the time point when the patient’s abdominal muscles begin to contract against the pressure. “B” shows the reduction in pressure in the cuff after the peak pressure is attained.

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  Fig. 3. Time course of the pressure value calculated by the mechanical manometer of the device during abdominal trunk muscle strengthening. The participants exerted the force necessary for the pressure in the cuff to reach 50% to 80% of the peak pressure measured at the beginning of the exercise. Intermittent muscle contractions were performed once every 10 seconds, with 5 seconds of muscle contraction and 5 seconds of rest in the 10-minute session.

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  Fig. 4. Four types of stretching exercises conducted in the trial. (A) Lumbar flexion, and knee and hip flexions in the supine position, stretching the back and gluteal muscles. (B) Lumbar rotation in the supine position, stretching the abdominal muscles. (C) Straight leg raising in the supine position, stretching the hamstrings. (D) Lumbar extension and knee flexion in the prone position, stretching the abdominal, iliopsoas, and knee extensor muscles.

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