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Abstract(s)
Chronic low back pain (CLBP) leads to impaired motor control and function of the trunk muscles. Different approaches for motor control exercise, like Carolyn Richardson and Stuart McGill, improve the core abdominal function in a long-term, providing lumbar dynamic stability. However, there is no consensus regarding the intervention on deep muscles feedward delay.
To compare the effect of motor control exercise for dynamic stability accoring the Richardson and McGill approaches on abdominal muscles’ electromyographic (EMG) onset timing, during rapid arm movements, and pain intensity in subjects whit CLBP.
Experimental study with a sample of 29 subjects volunteers with CLBP, randomly in Motor Control Exercise_Richardson Approach Group (MCE_Richardon) (n=9), Motor Control Exercise McGill Approach Group (MCE_McGill) (n=11) and Control Group (CG) (n=9). To evaluate timing of EMGonset during rapid arm flexion, abduction and extension movements was used surface electromyography of transversus abdominal/ internal oblique (TrA/IO), external oblique (EO), rectus abdominis (RA) and anterior, medium and posterior deltoids. The pain intensity was measured by visual analog scale. The experimental groups were subjected to diffrent motor control exerciso programs during 8 weeks, one according to the Richardson approach and another according to the McGill approach. The CG did not undertake any intervention. The assessements took place before and after 8 weeks of the application of exercise programs. The Kruskal-Wallis one-way analysis of variance test was used to comparisons between groups, while the Dunn Test was used, with a significance level 0.05.
After 8 weeks of completion the diferente motor control exercise programs (M1), EMG onset of the TrA/IO was significantly lower on the MCE_Richardson group, when compared with the CG, in all rapid arm movements (flexion: p=0.011; abduction p=0.010; extension: p=0.010). EMG onset of EO and RA was significantly lower on the MCE_McGill group, when compared with the CG, in all rapid arm movements (flexion: p=0.009 and p= 0.005; abduction: p=0.038 and p=0.016 and extension: p=0.005 and p=0.044, respectively). At M1, it was found that the pain intensity on MCE_Richardson was significantly lower when compared to CG (p˂0.001).
Motor control exercise according to the Carolyn Richardson approach seems to have more effect on local stabilizing muscles (TrA/IO) while the approach of Stuar McGill appears to have more effect on global stabilizing muscles (EO and RA). However, only MCE_Richardson had a significant reduction on low back pain intensity.
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Keywords
Chronic low back pain Core abdominal EMG onset Motor control exercise Richardson approach Motor control exercise MsGill approach