The Effects of Lumbar Stabilization Exercise on Pain and Range of Motion in the Shoulder
- So Hee Han1, Mi Ah Han2, So Yeon Ryu2, Seong Woo Choi2
- Received September 12, 2014 Accepted March 03, 2015
- ABSTRACT
-
- Background
- Lumbar stabilization exercise was used to improve spinal mobilization and stabilization. This research was conducted to investigate the effects of lumbar stabilization exercise programs on shoulder pain and range of motion among a group of elderly individuals.
- Methods
- The study subjects were 28 elderly patients from C hospital, Gochang, Jeollabukdo. They were randomly divided into 3 groups: lumbar stability exercise group, passive upper arm exercise group, and conservative therapy group. The therapies were conducted for 4 weeks. Shoulder pain and range of motion were measured both before and after therapies. The homogeneity of study subjects was analyzed using the chi-square and Kruskal-Wallis tests. For the pre-/post-status comparison, the Wilcoxon’s signed-ranks tests and Kruskal-Wallis tests were conducted.
- Results
- General characteristics including age, sex, and disease history of the 3 groups were comparable. After 4 weeks of exercise, shoulder pain was significantly reduced in the lumbar stability exercise group (6.4±2.9 vs. 3.6±3.1, P=.026) and range of motion was significantly increased in the same group. More specifically, right flexion (121.1±12.0° vs. 137.9±11.9°, P=.008), right abduction (96.6±21.8° vs. 129.7±50.7°, P=.008), and left abduction (92.0±21.8° vs. 110.3±21.2°, P=.038) increased significantly.
- Conclusions
- Shoulder pain and range of motion improved significantly in the lumbar stability exercise group. Further study is needed to look into the longer effects of this exercise program using more subjects.
Table 1.
General characteristics of study subjects
| Lumbar stability exercise (N=9) | Passive upper arm exercise (N=10) | Conservative therapy (N=9) | P | |
|---|---|---|---|---|
| Sex | ||||
| Male | 2 (22.2) | 1 (10.0) | 1 (11.1) | 0.709a |
| Female | 7 (77.8) | 9 (90.0) | 8 (88.9) | |
| Age, y | 78.2±8.0 | 79.1±4.6 | 83.0±6.2 | 0.275b |
| Height, cm | 154.8±7.5 | 151.4±9.1 | 150.9±11.8 | 0.351b |
| Weight, kg | 50.2±8.9 | 48.1±7.9 | 47.1±12.5 | 0.314b |
| Disease history Hypertension | 7 (77.8) | 6 (60.0) | 6 (66.7) | 0.706a |
| Arthritis | 3 (33.3) | 4 (40.0) | 3 (33.3) | 0.961a |
| Dementia | 4 (44.0) | 5 (50.0) | 4 (44.4) | 0.940a |
Table 2.
The effect of lumber stabilization exercise on pain in shoulder
| Group | Before exercise | After exercise | Difference (after-before) | Pa |
|---|---|---|---|---|
| Pain at rest | ||||
| Lumbar stability exercise | 6.4±2.9 | 3.6±3.1 | -2.9±3.3 | 0.026 |
| Passive upper arm exercise | 5.8±2.7 | 3.4±2.3 | -2.4±3.5 | 0.063 |
| Conservative therapy | 5.6±3.8 | 5.6±1.7 | 0.0±4.1 | 1.000 |
| Pb | 0.824 | 0.130 | 0.246 | |
| Pain with motion Lumbar stability exercise | 7.1±2.3 | 6.9±3.0 | -.22±3.52 | 0.861 |
| Passive upper arm exercise | 7.0±2.5 | 6.2±2.4 | -.80±2.14 | 0.279 |
| Conservative therapy | 4.9±3.0 | 6.6±2.4 | 2.00±4.00 | 0.179 |
| Pb | 0.169 | 0.658 | 0.110 |
Table 3.
The effects of lumber stabilization exercise on shoulder range of motion (°)
| Group | Before exercise | After exercise | Difference (after-before) | Pa |
|---|---|---|---|---|
| Right flexion | ||||
| Lumbar stability exercise | 121.1±12.0 | 137.9±11.9 | 16.9±12.4 | 0.008 |
| Passive upper arm exercise | 114.6±20.1 | 121.5±15.3 | 6.9±19.3 | 0.285 |
| Conservative therapy Pb | 116.5±23.9 0.719 | 117.0±26.3 0.070 | 0.6±9.0c 0.043 | 0.906 |
| Left flexion | ||||
| Lumbar stability exercise | 123.3±12.3 | 132.8±15.0 | 9.51±17.32 | 0.123 |
| Passive upper arm exercise | 116.0±22.5 | 117.1±24.9 | 1.18±18.67 | 0.678 |
| Conservative therapy Pb | 100.16±25.4 0.073 | 105.9±26.4 0.101 | 5.72±14.99 0.628 | 0.153 |
| Right abduction | ||||
| Lumbar stability exercise | 96.6±21.8 | 129.7±50.7 | 33.0±40.4 | 0.008 |
| Passive upper arm exercise | 77.5±18.5 | 95.1±19.1 | 17.7±18.8 | 0.028 |
| Conservative therapy | 87.2±33.7 | 89.8±17.6c | 2.6±25.9 | 0.767 |
| Pb | 0.213 | 0.020 | 0.158 | |
| Left abduction Lumbar stability exercise | 92.0±21.8 | 110.3±21.2 | 18.3±20.0 | 0.038 |
| Passive upper arm exercise | 77.6±25.4 | 86.3±20.4 | 8.7±16.4 | 0.103 |
| Conservative therapy | 77.9±34.4 | 80.5±17.4c | 2.6±23.7 | 0.678 |
| Pb | 0.347 | 0.009 | 0.374 |
- REFERENCES
- REFERENCES
- 1.. You YY, Kim HS. Comparing the effects on elderly women of bearing weights and lumbar stabilization using lumbar muscle exercises. J Kor Soc Phys Ther 2010;22(5):17-23.2.. Statistics Korea. Population Projections 2010-2060 [Internet]. Daejeon (KR): Statistics Korea, c2011 [cited 2012 Oct 20]. Available from:. http://kostat.go.kr/portal/korea/index.action.3.. Costic RS, Jari R, Rodosky MW, Debski RE. Joint compression alters the kinematics and loading patterns of the intact and capsule-transected AC joint. J Orthop Res 2003;21(3):379-85.
[Article] [PubMed]4.. van den Dolder PA, Roberts DL. A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain. Aust J Physiother 2003;49(3):183-8.
[Article] [PubMed]5.. Koh ES, Lim JY. The management of shoulder pain in the elderly: focusing on clinical characteristics and conservative treatment. J Korean Geriatr Soc 2013;17(1):1-6.
[Article]6.. Sung KW. Content analysis of exercise programs for the elderly in Korean and foregin articles. J Korean Acad Community Health Nurs 2007;18(1):56-68.7.. Bae JH. The effects of physical activity participation on health fitness variable and physical self description for elderly peoples. Korean J School Phys Educ 2004;14(2):13-23.8.. Lee WJ, Park S, Park JW. Influence of trunk stabilization exercise upon the lumbar stabilization and foot pessure in patients with back pain. J Korean Soc Phys Ther 2014;26(1):21-6.9.. Karatas M, Cetin N, Bayramoglu M, Dilek A. Trunk muscle strength in relation to balance and functional disability in uni-hemispheric stroke patients. A J Phys Med Rehabil 2004;83(2):81-7.
[Article] [PubMed]10.. Kim JS, Ju MY, Bae SS. The effect of dynamic lumbar stabilization exercise on low back pain patients. J Korean Soc Phys Ther 2001;13(3):495-507.11.. Hwang BJ, Kim JW. Effects of lumbar stabilization exercise on lumbar and lower extremity strength of the elderly women. J Korean Soc Phys Med. 2011;6(3):267-75.12.. Jung YW, Bae SS. The effects of lumbar stabilizing exercise on the functional recovery and the range of motion of low back pain patients J Korean Soc Phys Ther 2004;16(1):157-82.13.. Koh MH. The effect of core stability exercise on the paretic upper extremity function and standing balance in the patients with stroke [dissertation]. Youngin: Yongin University; 2012.14.. An SY. The effect of core stability exercise on function of upper extremities and activities daily of living in patients with stroke [dissertation]. Yongin: Yongin University; 2009.15.. Brill PW. The Core Program. 1st edition.. New York: Bantam Books; 2002.16.. Park SM. Effects of trunk muscular strength training on muscular strength, range of motion, and pain of patients with rotator cuff tear [dissertation]. Daegu: Daegu University; 2011.17.. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil 2004;85(3 Suppl 1):S86-92.
[PubMed]18.. Kim EJ, Hwang BJ, Kim JH. The Effect of Core Strength Exercises on Balance and Walking in Patients with Stroke. J Korean Soc Phys Ther 2009;21(4):17-22.19.. Kim MS. Effect of upper extremity movement of a core stability strength exercise in patient with hemiplegia [dissertation]. Yongin: Yongin University; 2005.20.. Song JM, Kim SM. The effect of trunk stability exercise on balance and gait in stroke patients. J Korean Soc Phys Med 2010;5(3):413-20.21.. Lister JL, Del Rossi G, Ma F, Stoutenberg M, Adams JB, Tobkin S, et al. Scapular stabilizer activity during Bodyblade, cuff weights, and Thera-Band use. J Sport Rehabil 2007;16(1):50-67.
[Article] [PubMed]22.. Nam YH. The effects of resistance and stretching exercise on range of motion and pain relaxation in middle-age women with shoulder pain [dissertation]. Incheon: Incheon University; 2007.23.. Lee CY, Lee HR, Jung YJ, Chung HA, Chang MY. The comparison of kinesthesia on dominent and non-dominent hand according to age. J OTAD 2007;2(2):56-63.24.. Seabury JJ, Adams WC, Ramey MR. Influence of pedalling rate and power output on energy expenditure during bicycle ergometry. Ergonomics 1977;20(5):491-8.
[Article] [PubMed]25.. Cornelius W, Jackson A. The effects of cryotherapy and PNF on hip extensor flexibility. Athl Train JNATA 1984;19:183-99.26.. Kim YS. Effects of senior aerobics program on physical self-efficacy and mental health in the elderly [dissertation]. Seoul: Dongduk Women's University; 2003.27.. Lehmann JF, Warren CG, Scham SM. Therapeutic heat and cold. Clin Orthop Relat Res 1974;99:207-45.
[Article] [PubMed]28.. Hong SK, Kang HY. The effect on the pain, discomfort in daily living and life satisfaction of flexibility exercise and local health in rural elderly with osteoarthritis. J Rheuma Health 1999;6(2):197-210.29.. Yoo HJ. Effects of hot cataplasm on knee pain, range of motion and physical functions in elderly with degenerative arthritis [dissertation]. Jeonju: Chonbuk University; 2012.30.. Hecht PJ, Bachmann S, Booth RE Jr, Rothman RH. Effects of thermal therapy on rehabilitation after total knee arthroplasty. A prospective randomized study. Clin Orthop Relat Res 1983;178:198-201.31.. Kim SH, Kim MH, Kim JS. Effects of heat therapy according to the application time among the elderly with osteoarthritis. J Rheuma Health 2003;10(1):7-18.