Motor Control Exercise as a stand-alone treatment or associated with a Pain Neurosciense Education approach: effects on pain intensity and muscle onset timing in individuals with Chronic Low Back Pain

Dias, Nuno Fernando Freitas

http://hdl.handle.net/10400.22/17239

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Authors

Dias, Nuno Fernando Freitas

Advisor(s)

Carvalho, Paulo

Abstract(s)

Chronik Low Back Pain (CLBP) leads to empaired motor control function of the trunk muscles, disability and pain. Motor control exercise approach according to Carolyn Richardson is one of the most used exercise strategies in this condition. In addition to this, Pain Neuroscience Education (PNE) has been widely used to direct influence pain knowledge, management and perception of individuals with CLBP. To assess the Effect of a PNE approach when added to a motor control exercise program, based on Carolyn Richardson' s concept. Experimental study with a sample of 29 subjects, volunteers with CLBP, randomly allocated in Motor Control Exercise Group (MGG) (n=9), Motor Control Exercise associated with a PNE approach group (MG_EDG) (n=11) and Control Group (CG) (n=9). Muscle onset timing was collected using surface electromyography of abdominal muscles, transversus abdominal/internal oblique (TrA/10), external oblique (EO), rectus abdominis (RA) and anterior, médium and posterior deltoids, during rapid arm flexion, abducation and extension. Pain intensity was measured with Visual Analog Scale. Both experimental groups completed na 8-week motor control exercise program and the MC_EDG also had 3 PNE sessions. The CG did not undertake any intervention. The Kruskal-Wallis one-way analysis of variance test was used for the comparisons between groups, while the Dunn Test was used to perform the post-hoc analysis, with a significance level 0,05. After 8 weeks of completion of the motor control exercise program and the PNE sessions (M1), pain intensity and the TrA/10EMG onset timing, in all arms movements, was significantly lower in the MC_EDG when compared to the GC (p< 0,05). Motor Control Exercise approach, according to Carolyn Richardson, has greater effects on TrA/10EMG onset timing and pain intensity when associated with a PNE approach.