Clinical lumbar instability and core stabilization exercise: a literature review
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Published:
Dec 18, 2015
Keywords:
clinical lumbar instability core stabilization exercise diagnostic criteria stability
Main Article Content
Abstract
Clinical lumbar instability is increasingly recognized as one of the significant causes of chronic low back pain. The patients with clinical lumbar instability require the effective exercise intervention to improve the stability of their lumbar spine. This article reveals the etiology and clinical diagnosis of clinical lumbar instability, the effective treatment as core stabilization exercise (CSE) and also provides some relevant researches on CSE for improving outcome measurements in patients with clinical lumbar instability. Commonly, clinical signs and the specific clinical tests including instability catch sign, apprehension sign, painful catch test and prone instability test are considered as clinical diagnostic criteria due to absence of radiological findings in patients with clinical lumbar instability. Moderate to high impacted evidences on the effectiveness of CSE to improve pain-related outcomes and deep trunk muscle activation have been reported in patients with clinical lumbar instability but further studies regarding long-term effectiveness of CSE and the use of precise instrument to detect deep trunk muscle activation are still required.
Article Details
How to Cite
Areeudomwong, P. (2015). Clinical lumbar instability and core stabilization exercise: a literature review. Asia-Pacific Journal of Science and Technology, 20(4), 465–479. https://doi.org/10.14456/kkurj.2015.39
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Review Articles
References
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[17]White AA, Panjabi MM. Clinical biomechanics of the spine. 2nd ed. Philadelphia: JB Lippincott; 1990.
[18] Marshell PW, Murphy BA. Delayed abdominal muscle onsets and self-report measures of pain and disability in chronic low back pain. J Electromyogr Kinesiol. 2010;20(5): 833-9.
[19] Silfies SP, Mehta R, Smith SS, Karduna AR. Differences in feedforward trunk muscle activity in subgroups of patients with mechanical low back pain. Arch Phys Med Rehabil. 2009;90(7): 1159-69.
[20] Fritz JM, Erhard RE, Hagen BF. Segmental instability of the lumbar spine. Phys Ther. 1998;78(8): 889-96.
[21] Demoulin C, Cany-Serres S, Distrée V, Grosdent S, Depaifve A, Vanderthommen M, et al. Specificity and sensitivity of identifiers specific to clinical lumbar spine instability. Paper presented at the Conference on the 7th Interdisciplinary World Congress on Low Back and Pelvic Pain; 2010 Nov 9-12; Los Angeles, America.
[22] Areeudomwong P, Puntumetakul R, Jirarattanaphochai K, Wanpen S, Kanpittaya J, Chatchawan U, et al. Core stabilization exercise improves pain intensity, functional disability and trunk muscle activity of patients with clinical lumbar instability: a pilot randomized controlled study. J Phys Ther Sci. 2012;24(10):1007-12.
[23] Javadian Y, Behtash H, Akbari M, Taghipour-Darzi M, Zekavat H. The effects of stabilizing exercises on pain and disability of patients with lumbar segmental instability. J Back Musculoskelet Rehabil. 2012;25(3):149-55.
[24] Kumar SP. Efficacy of segmental stabilization exercise for lumbar segmental instability in patients with mechanical low back pain: A randomized placebo controlled crossover study. North Am J Med Sci. 2011;3(10):456-61.
[25] O’Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22(24):2959-67.
[26] Puntumetakul R, Areeudomwong P, Emasithi A, Yamauchi J. Effect of 10-week core stabilization exercise training and detraining on pain-related outcomes in patients with clinical lumbar instability.
Patient Prefer Adherence. 2013;7:1189.
[27] Hodges PW, Martin Eriksson AE, Shirley D, Gandevia SC. Intra- abdominal pressure increases stiffness of the lumbar spine. J Biomech. 2005;38(9):1873-80.
[28] O’Sullivan PB, Twomey L, Allison GT. Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther. 1998;27(2):114-24.
[29] Ganju A. Isthmic spondylolisthesis. Neurosurg Focus. 2002; 13(1): 1-6.
[30] Stokes IAF, Henry SM, Single RM. Surface EMG electrodes do not accurately record from lumbar multifidus muscles. Clin Biomech. 2003;18(1):9-13.
Adherence. 2015; 9: 1.
[2] Izzo R, Gianluigi G, Giuseppe G, Mario M. Biomechanics of the spine. Part I: spinal stability. Eur J Radiology. 2013;8(1):118-26.
[3] Boyling JD, Jull G. Grieve’s modern manual therapy. 4th ed. London: Churchill Livingstone; 2004.
[4] Panjabi MM. The stabilizing system of spine. Part II neutral zone and instability hypothesis. J Spinal Disord. 1992;5(4):390-7.
[5] Wong DA, Transfeldt E. Macnab’s backache. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
[6] Silfies SP, Squillante D, Maurer P, Westcott S, Karduna AR. Trunk muscle recruitment patterns in specific chronic low back pain populations. Clin Biomech. 2005;20(5):465-73.
[7] Cook C, Brismel JM, Sizer JSP. Subjective and objective descriptors of clinical lumbar instability: a Delphi study. Man Ther. 2006;11(1):11-21.
[8] Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary development of a clinical prediction rule for determining which patients with low back pain will response to a stabilization exercise program. Arch Phys Med Rehabil. 2005;86(9):1753-62.
[9] Kotilainen E, Valtonen S. Clinical instability of the lumbar spine after microdiscectomy. Acta Neurochir (Wien). 1993;125(1-4):120-6. (10) Magee DJ. Orthopaedic physical assessment. 4th ed. Philadelphia: WB Saunders; 2006.
[11] Mascarenhas AA, Thomas I, Sharma G, Cherian JJ. Clinical and radiological instability following standard fenestration discectomy. Indian J Orthop. 2009;43(4):347-51.
[12] Richardson CA, Hodges P, Hides J. Therapeutic exercise for lumbipelvic stabilization: a motor control approach for the treatment and prevention of low back pain. 2nd ed. Edinburgh: Churchill Livingstone; 2004.
[13] Demoulin C, Distrée V, Tomassella M, Crielaard J-M, Vanderthommen M. Lumbar functional instability: a critical appraisal of the literature. Ann Readapt Med Phys. 2007; 50(8):677-84.
[14] Panjabi MM: The stabilizing system of the spine. Part I Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-9.
[15] Dagenais S, Haldeman S. Evidence-based management of low back pain. St. Louis Missouri: Elsevier Mosby; 2012. [16] Leone A, Guglielmi G, Cassar- Pullicino VN, Bonomo L. Lumbar intervertebral instability: a review. Radiology. 2007;245(1):62-77.
[17]White AA, Panjabi MM. Clinical biomechanics of the spine. 2nd ed. Philadelphia: JB Lippincott; 1990.
[18] Marshell PW, Murphy BA. Delayed abdominal muscle onsets and self-report measures of pain and disability in chronic low back pain. J Electromyogr Kinesiol. 2010;20(5): 833-9.
[19] Silfies SP, Mehta R, Smith SS, Karduna AR. Differences in feedforward trunk muscle activity in subgroups of patients with mechanical low back pain. Arch Phys Med Rehabil. 2009;90(7): 1159-69.
[20] Fritz JM, Erhard RE, Hagen BF. Segmental instability of the lumbar spine. Phys Ther. 1998;78(8): 889-96.
[21] Demoulin C, Cany-Serres S, Distrée V, Grosdent S, Depaifve A, Vanderthommen M, et al. Specificity and sensitivity of identifiers specific to clinical lumbar spine instability. Paper presented at the Conference on the 7th Interdisciplinary World Congress on Low Back and Pelvic Pain; 2010 Nov 9-12; Los Angeles, America.
[22] Areeudomwong P, Puntumetakul R, Jirarattanaphochai K, Wanpen S, Kanpittaya J, Chatchawan U, et al. Core stabilization exercise improves pain intensity, functional disability and trunk muscle activity of patients with clinical lumbar instability: a pilot randomized controlled study. J Phys Ther Sci. 2012;24(10):1007-12.
[23] Javadian Y, Behtash H, Akbari M, Taghipour-Darzi M, Zekavat H. The effects of stabilizing exercises on pain and disability of patients with lumbar segmental instability. J Back Musculoskelet Rehabil. 2012;25(3):149-55.
[24] Kumar SP. Efficacy of segmental stabilization exercise for lumbar segmental instability in patients with mechanical low back pain: A randomized placebo controlled crossover study. North Am J Med Sci. 2011;3(10):456-61.
[25] O’Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22(24):2959-67.
[26] Puntumetakul R, Areeudomwong P, Emasithi A, Yamauchi J. Effect of 10-week core stabilization exercise training and detraining on pain-related outcomes in patients with clinical lumbar instability.
Patient Prefer Adherence. 2013;7:1189.
[27] Hodges PW, Martin Eriksson AE, Shirley D, Gandevia SC. Intra- abdominal pressure increases stiffness of the lumbar spine. J Biomech. 2005;38(9):1873-80.
[28] O’Sullivan PB, Twomey L, Allison GT. Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther. 1998;27(2):114-24.
[29] Ganju A. Isthmic spondylolisthesis. Neurosurg Focus. 2002; 13(1): 1-6.
[30] Stokes IAF, Henry SM, Single RM. Surface EMG electrodes do not accurately record from lumbar multifidus muscles. Clin Biomech. 2003;18(1):9-13.