| Summary: | 碩士 === 國立陽明大學 === 物理治療研究所 === 91 === Background and Purpose. Lumbar instability was considered to be a significant factor in patients with chronic low back pain (LBP). Three interrelated systems have been identified to play an essential role in maintaining spinal stability. These are passive support system, active support system, and neural control system. Injury and pain may occur if any element of the above-mentioned spinal stability system is compromised. Although there were few randomized controlled trials available, most review reports concluded that exercise treatment provided the best evidence of effectiveness in terms of improving function and reducing the recurrence rate of LBP. Recently specific stabilization exercises become a popular program for patients with chronic LBP. The purpose of this study is to evaluate the effects of a lumbar stabilization program using a sling exercise protocol in the treatment of patients with chronic LBP. Methods. The study employed a randomized controlled trial (RCT) design. Fifty-eight patients with chronic LBP were randomly assigned into either the experimental group (regular treatment plus additional lumbar stabilization exercises using a sling exercise training apparatus) or the control group (regular treatment only). The intervention time lasted for 10 weeks. Outcome measures included (1) Roland Morris Disability Questionnaire (RMDQ), (2) Physical performance tests, (3) The lumbar stability : leg-loading test, (4) the lumbar kinesthesia test, and (5) a global rating scale. All measures were tested at the initial assessment, after 4-week, and 10-week intervention. Statistical Analysis. Multivariate Analysis of Variance (MANOVA) with repeated measures and the appropriate post-hoc tests have been used to compare differences of RMDQ and the physical performance tests between the experimental and the control groups (p<0.01). Chi-square tests were used to compare differences of the leg loading test, the lumbar kinesthesia test, and the global rating scale between groups (p<0.05). Results. After 10-week intervention, the experimental group showed significant improvement in Roland- Morris Disability Questionnaire (RMDQ) and all physical performance tests over time; and the control group showed statistically improvement only in RMDQ and the 50-foot walk test (p<0.01). There were significant between-group differences in all physical performance tests, the leg loading test, and the global rating scale after 10-week intervention. Discussion and Conclusion. Although both groups had significant improvement in disability after 10-week intervention, the experimental group showed more improvement compared with the control group in all physical performance tests, the lumbar stability test, and the overall improvement. Therefore, this lumbar stabilization exercises provided additional effect in improving the lumbar stability and functional performance.
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