Evaluation of Functional and Neuromuscular Changes After Exercise Rehabilitation for Low Back Pain Using a Swiss Ball: A Pilot Study
Received 17 September 2005; received in revised form 15 February 2006; accepted 25 April 2006.
Abstract
Objective
The purpose of this pilot study was to use a multidimensional model to evaluate deficits in patients with low back pain (LBP) over the course of a 12-week rehabilitation program using the Swiss ball.
Methods
A within-subjects, repeated-measures design based at the University exercise training clinic was used. Twenty patients with chronic nonspecific LBP (12 men, 8 women; symptom duration, 4.8 years; 38.8 ± 12.1 years old; height, 1.76 ± 0.06 m; weight, 76.15 ± 7.21 kg) participated in this study. Self-report measures were the Oswestry Disability Index, Visual Analog Scale, Medical Outcomes 12-Item Short Form Health Survey, and Self-Efficacy For Exercise Scale. Physiologic measures were electromyography measurement of feedforward muscle activation, flexion relaxation phenomenon, myoelectric fatigue, endurance capacity measured by the Sorenson test, and a modified sit-up test. Individuals performed 12 weeks of progressive exercise periodized every 4 weeks using a Swiss ball. Outcome measures were assessed at baseline, 4 weeks, 8 weeks, 12 weeks, and at a 3-month follow-up. Repeated-measures analysis for variance for time differences and regression analysis for variance in Oswestry scores were performed.
Results
The Oswestry score for self-reported disability significantly decreased over the intervention (F4,14 = 19.456, P < .001). Significant improvements in pain and disability maintained to the 3 months of follow-up. There were significant changes in perceptions of physical and mental well-being, erector spinae fatigue, and flexion relaxation measures. Change in flexion relaxation explained 38% of the improvement in Oswestry scores at the 12-week measurement.
Conclusions
This study showed that the Swiss ball may be successfully used in a rehabilitation context for patients with LBP. This pilot study has used a novel approach to assess improvements during a rehabilitation program, which may be used in the future to explain differences between different treatment modalities.
aClinical Supervisor, Exercise Rehabilitation Clinic, Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand
bAcademic Director, Exercise Rehabilitation Clinic, Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand
Submit requests for reprints to: Paul W.M. Marshall, PG Dip Sci, Department of Sport and Exercise Science, University of Auckland, Tamaki Campus, Private Bag 92019, Auckland, New Zealand.
ABSTRACT