The validity and reliability of a biofeedback system during segmental stabilisation in patients with low back pain

Pienaar, Andries Willem (2009-12)

Thesis (DPhil (Sport Science))—University of Stellenbosch, 2006.

Thesis

ENGLISH ABSTRACT: Worldwide epidemiological findings strongly indicate low back pain as a growing epidemic despite the latest diagnostic and treatment methods used (Jellema et al., 2001:377; Woolf & Pfleger, 2003:646; Kopec et al., 2004:70; Frost & Sullivan, 2006; Dagenais et al., 2008:9). From this clinical problem, a need arose to quantify lumbar muscle performance for the safe monitoring of rehabilitation programmes and assessments. The quantification of muscular strength is especially important from a kinematic viewpoint, because activities of daily living are dependent on muscular strength (Nobori & Maruyama, 2007:9). Furthermore, it is of utmost importance to combine the complex muscular system with the complexity of motor control (Richardson et al., 2005) and biomechanics (McGill, 2007), to specifically address the problem of low back pain. Scientists have developed a better understanding of muscle function or dysfunction pertaining to low back pain and highlighted the clinical importance of quantitative muscle testing of the lumbar spine. Various clinical assessment devices and methods such as ultrasound, kinesiologic electromyography, isokinetic dynamometry and the Biering-Sorensen test are being used to record muscle atrophy and dysfunction of the m. lumbar multifidi at L5. However, some of these assessments are very costly and some are clinically unsafe, and therefore the need for reliable and valid low back tests still exists. In the study presented, a system called the pressure air biofeedback (PAB) device was developed, to scientifically assess m. lumbar multifidus’ isometric contraction in asymptomatic (n=24) and low back pain (n=18) subjects. A closed chain test model with a neutral spine posture in zero degrees upright sitting was used. This study compared results of m. lumbar multifidus’ isometric contraction between tests of pressure air biofeedback, electromyography and real-time ultrasound.

AFRIKAANSE OPSOMMING: Wêreldwye epidemiologiese bevindings toon aan dat lae rugpyn ‘n groeiende epidemie is, ongeag die nuutste diagnostiese en behandelings metodes (Jellema et al., 2001:377; Woolf & Pfleger, 2003:646; Kopec et al., 2004:70; Frost & Sullivan, 2006; Dagenais et al., 2008:9). Hierdie kliniese probleem het gelei tot ‘n behoefte aan die kwantifisering van lumbale rug spierkrag, sodat rehabilitasie programme en toetse veilig gemonitor kan word. Die kwantifisering van spierkrag is veral belangrik vanuit ‘n kinematiese oogpunt, omdat meeste daaglikse aktiwiteite van spierkrag afhanklik is (Nobori & Maruyama, 2007:9). Verder, is dit van uiterste belang om die komplekse muskulêre sisteem met die kompleksiteit van motoriese spierbeheer (Richardson et al., 2005) en biomeganika (McGill, 2007) te kombineer om spesifiek die probleem van lae rugpyn aan te spreek. Wetenskaplikes het gedurende die laaste paar jaar ‘n beter begrip van spierfunksie of –disfunksie, wat met lae rugpyn verband hou, ontwikkel. Dit het die kliniese belangrikheid van kwantitatiewe spier-assessering van die lae rug benadruk. Verskeie kliniese toetsinstrumente en –metodes, soos bv. ultra-klank, kinesiologiese elektromiografie, isokinetiese dinamometrie en die Biering- Sorensen toets word gebruik om spieratrofie en disfunksie van die m. lumbale multifidus by die vyfde lumbale vlak (L5) te meet. Verskeie van hierdie toetse is egter baie duur en klinies onveilig en daarom bestaan daar steeds ‘n behoefte vir ‘n betroubare en geldige toets vir lae rug spierkrag. In hierdie navorsingstudie het die navorser ‘n lugdruk bioterugvoeringsinstrument, genaamd die PAB apparaat, ontwerp. Die PAB apparaat is gebruik om isometriese spierkontraksies van die m. lumbale multifidus wetenskaplik te toets in asimptomatiese (n=24) en lae rugpyn (n=18) proefpersone. ‘n Geslote ketting toetsmetode, met ‘n neutrale rugpostuur in ‘n regop-sit posisie van nul grade, is gebruik.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/1427
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