Trampas A, Mpeneka A, Malliou V, Godolias G, Vlachakis P.
J Sport Rehabil. 2014 Dec 4. [Epub ahead of print]
Abstract
CONTEXT: Previous studies showed improved dynamic balance performance after core stability (CS) exercises in chronic low back pain populations. Although clinical massage plus exercise are likely to better enhance analgesia than exercise alone, their efficacy on balance remains unclear.
OBJECTIVE: To evaluate the immediate effects of CS exercises plus myofascial trigger point (MTrP) therapy in comparison to CS exercises alone on dynamic balance performance, pressure pain threshold (PPT) and cross-sectional area of active MTrPs in patients with clinical instability of the lumbar spine and chronic myofascial pain syndrome.
DESIGN: Randomized, assessor-blind, test-retest.
SETTING: University research laboratory.
PATIENTS: Ten physically active adults (5 males, 5 females).
MAIN OUTCOME MEASURES: Single-leg dynamic balance performance and side-to-side ratios in two planes of motion (frontal, sagittal), as well as PPT and cross-sectional area of active MTrPs were measured using stabilometry, pressure algometery and real-time ultrasound scanning, respectively.
INTERVENTIONS: The first group performed CS exercises alone, whereas the same exercise program was applied in the second group plus cross-fiber frictions on active MTrPs (3.5 min/MTrP).
RESULTS: Within-group statistically and clinically significant differences were observed only for group II in PPT. However, group I also exhibited a large effect size with clinically significant changes from baseline on this outcome. Furthermore, patients in group II clinically improved their balance ratios and differed from group I at post-test in the sagittal plane dynamic balance performance of the painful side.
CONCLUSION: CS exercises immediately increase the PPT of active MTrPs in physically active adults with clinical instability of the lumbar spine and chronic myofascial pain syndrome. When MTrP therapy is added, side-to-side asymmetries in dynamic balance are minimized.