Ethics code: DYPCPT/574-B(28)/2021)
Deshmukh M, Pokle S, Baxi G, Palekar T, Gopiyani I. The Effect of Quadratus Lumborum Muscle Energy Technique on Low Back Pain and Diaphragmatic Electrophysiological Outcomes. Iranian Rehabilitation Journal 2023; 21 (4) :695-702
URL:
http://irj.uswr.ac.ir/article-1-1699-en.html
1- Dr DY Patil College of Physiotherapy, Dr DY Patil Vidyapeeth Pune, Pimpri, India.
Abstract: (2962 Views)
Objectives: Quadratus lumborum (QL) is included in the list of accessory muscles of expiration. This muscle contracts to depress the ribs. It stabilizes the diaphragm for respiration. A tight/stiff QL prevents the rib cage from fully expanding to take a deep breath and pulls over the diaphragm and surrounding tissues. This affects chest expansion and breathing patterns. This leads to faulty posture adaptation and disruption in breathing patterns. This study aims to assess the effect of muscle energy technique (MET) of QL on pain, and diaphragm activity in individuals with nonspecific low back pain.
Methods: This study was conducted using a quasi-experimental study and the research population included 65 individuals with non-specific low back pain. Two groups were formed based on the score of self-evaluation of the breathing questionnaire, SEBQ <11, and SEBQ >11 and pre-intervention assessment of numeric pain rating scale (NPRS), surface electromyography (EMG) of the diaphragm, maximum inspiratory pressure (Pimax) and chest expansion was assessed. MET to QL was given and immediate post-measurements of the same were assessed. Considering the normality, data were analyzed using paired t-test and Wilcoxon’s rank sum test using Medcalc software, version 22.017.
Results: Numeric pain rating scale (NPRS) of both groups was statistically significant (P<0.0001), amplitude in SEBQ >11 was significant (P<0.0166), and Pimax was highly significant in both groups (P=0.0001).
Discussion: MET of QL affects pain and lung function in patients with nonspecific low back pain.
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• While the muscle energy technique (MET) of quadratus lumborum (QL) significantly improves QL function, its impact on breathing dysfunction is unknown. The effect of MET of QL on pulmonary parameters was evaluated in the present research. Each metric comprising pain, surface electromyography (EMG) of the diaphragm, Pimax, and chest expansion shows a significant improvement. The carryover effect of MET on QL as well as other accessory muscles of breathing is recommended for further research
Plain Language Summary
Studies have proven that in low back pain, the breathing pattern is abnormal. To keep our body balanced, several muscles work in harmony. However, in low back pain, this coordination is lost and leads to imbalance, which, in turn, leads again to complications that are more obvious than breathing abnormality, and if left untreated, may worsen the back pain and breathing. Therefore, to overcome this problem, we divided patients with low back pain, with or without breathing abnormality based on the score of one questionnaire used for breathing. Both groups were treated with a manual therapy session used in physiotherapy practices. The muscle chosen was quadratus lumborum (QL), which is a core stabilizer, as well as the accessory muscle for breathing. Pre and post-evaluation of parameters, such as the capacity of lungs to expand, the strength of primary muscle of breathing in terms of pressure exerted while inhalation, and the physiological changes during inhalation. We found positive results after one session of manual therapy. It proves that if we focus on the correction of breathing in any musculoskeletal condition, it will be beneficial to the better prognosis of the complaint and also help to prevent future consequences.
Article type:
Original Research Articles |
Subject:
Physiotherapy Received: 2022/06/9 | Accepted: 2023/09/5 | Published: 2023/12/1
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