Long-term Stretching Program in Older Active Adults Increases Muscle Strength

Abstract

*Corresponding author email : marcoadded@terra.com.br Symbiosis Group Symbiosis www.symbiosisonline.org www.symbiosisonlinepublishing.com Influence of Stretching and Strengthening of the Iliopsoas Associated with Lumbar Segmental Stabilization Exercises in Patients with Low Back Pain: The pilot study Claudia Puzzoni Volpato 1 , Marco Aurélio Nemitalla Added 2 *, Graziella Candido de Paula X. Richter 2 , Valter Tanaka 2 , Nilza Aparecida Almeida de Carvalho 3 and Diego Galace de Freitas 3 1 Staff Physical Therapist, Irmandade da Santa Casa de Misericórdia de São Paulo, Rehabilitation Service, São Paulo-SP, Brazil 2 Master of Science student, Staff Physical Therapist, Irmandade da Santa Casa de Misericórdia de São Paulo, Rehabilitation Service, São Paulo-SP, Brazil 3 Associate Professor and Physical Therapist Staff, Irmandade da Santa Casa de Misericórdia, Physical Therapy Department, São Paulo-SP, Brazil Journal of Exercise, Sports & Orthopedics Open Access Research Article which insert in the thoracic cavity[4-6] , with both systems necessary for stability and control of movements[7] . Evidence suggests that the structure and function of the truncal deep muscles are altered in individuals with LBP[1,8- 12,35]. This has led to increased focus on exercises which aim to maintain this stability, improving neuromuscular control and attenuating recurrent LBP[4,7,13-16] . Stabilization exercises are essential in order to provide a base for movement of the arms and legs when supporting weight and to protect the medulla and spinal nerves[17] . Exercise stabilization programs (ST) aim to improve strength, resistance, and motor control of the abdominal and lumbar muscles, with emphasis on the transverse abdominis (TA) and multifidus (MT) (deep trunk muscles) [6,18]. Paravertebral and abdominal muscles such as the pelvic musculature and the diaphragm are also important targets for exercise [6]. The contraction of the TA and the MT occur normally upon movement in asymptomatic individuals Hebert et al [8,19-21]; however, in those with LBP contraction of these muscles is slow and prolonged [1,6,8,20,21], indicating a potential risk for lessening of vertebral stability along with problems associated with motor control [6] . In individuals with lumbago, the large MT undergo atrophy ipsilateral to the point of pain [6,15,22], a decrease in size, activation time and amplitude, dysfunction in co-activation with the abdominal musculature [13] and as well as an increase in intramuscular fat [1,23]. These changes in muscle characteristics can be corrected through ST [8], with recuperation of the MT being the most rapid [7]. These exercises should begin in a simple form, associating respiration with contraction of the TA and MT [4], evolving to different postures with movement of the members [4,16,24] and finally including functional posstures[4]. Abstract Low back pain (LBP) is one of the principal causes of incapacity. One treatment approach for this pathology involves segmental stabilization. The iliopsoas muscle is also considered a potential stabilizer of the lumbar spine. Objective : To compare the effects of stretching and strengthening of the iliopsoas muscle associated with segmental stabilization versus stabilization alone, in the treatment for LBP. Methods: Fourteen patients were randomized into three groups. The first group was given only segmental stabilization training (ST); the second was submitted to ST and stretching of the iliopsoas muscle (ST-Stretch), and the third was given ST and strengthening of the iliopsoas (ST-Strength). Results : The group ST (p = 0.006) and ST-Strength (p=0.092) showed significant improvement in the VAS scale. The extension flexibility showed statistically significant improvement in the group ST- strength group (p=0.038). Conclusion: ST alone, or associated with strengthening of the iliopsoas, proved more effective for improving lumbar pain and flexibility compared to ST Stretch.