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Braz J Phys Ther. 2018 Oct 17. pii: S1413-3555(18)30510-0. doi: 10.1016/j.bjpt.2018.10.005. [Epub ahead of print]

Proprioceptive neuromuscular facilitation training improves pain-related and balance outcomes in working-age patients with chronic low back pain: a randomized controlled trial.

Author information

1
Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand. Electronic address: pattanasin.are@mfu.ac.th.
2
Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.

Abstract

BACKGROUND:

Proprioceptive neuromuscular facilitation training and general trunk exercises have been applied to treat chronic low back pain patients. However, there is currently little study to support the use of one treated intervention over the other to improve clinical outcomes and balance ability.

OBJECTIVE:

To examine the effects of proprioceptive neuromuscular facilitation training on pain intensity, disability and static balance ability in working-age patients with chronic low back pain.

METHODS:

Forty-four chronic low back pain participants aged 18-50 years were randomized either to a three-week proprioceptive neuromuscular facilitation training or to a control group receiving general trunk exercises. Pain intensity, disability and static balance ability were measured before and after the three-week intervention.

RESULTS:

The proprioceptive neuromuscular facilitation training intervention showed a statistically significantly greater reduction in pain intensity and improved functional disability than the controls at three weeks (between-group difference: pain intensity 1.22 score, 95% CI: 0.58 to 1.88, p<0.001; disability 2.23 score, 95% CI: 1.22 to 3.24, p<0.001. The proprioceptive neuromuscular facilitation training intervention also had statistically better parameters of static balance ability than the control group (between-group difference: ellipse sway area during eye opened and closed conditions 129.09mm2, 95% CI: 64.93 to 175.25, p<0.01 and 336.27mm2, 95% CI: 109.67 to 562.87, p<0.05, respectively; the centre of pressure velocity during eye opened and eye closed conditions 6.68mm/s, 95% CI: 4.41 to 8.95, p<0.01 and 6.77mm/s, 95% CI: 4.01 to 9.54, p<0.01, respectively).

CONCLUSION:

The three-week proprioceptive neuromuscular facilitation training provides better pain intensity, disability and static balance ability than general trunk exercises for working-age individuals with chronic low back pain but the effects do not reach the clinical meaningful level. The therapists should consider carefully when making recommendations regarding these interventions, taking into account effectiveness and costs.

KEYWORDS:

Balance; Disability; Low back pain; Training

PMID:
30361077
DOI:
10.1016/j.bjpt.2018.10.005

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