PurposeThe aim of this study was to assess the effects of diaphragm training on low back pain and thickness of stabilizer muscles of the lumbar spine.Patients and methodsFifty-two individuals were recruited with a history of chronic low back pain in our randomized controlled trial. The participants were divided randomly into two groups. One of the groups took part in a complex training program and completed with diaphragm training (DT group, n=26). The control (C) group took part only in the complex training (n=21). The thickness of transversus abdominis, diaphragm, and lumbar multifidus muscle was measured with ultrasonography in two positions: lying and sitting. All muscles were assessed in relaxed and in contracted state in the lying position and in a relatively relaxed (calm sitting) and relatively contracted state (during weightlifting) in the sitting position.ResultsAfter the training, severity of the pain was significantly reduced in both the groups. Regarding the thickness of the muscles, there were no changes in group C. The thickness of transversus abdominis increased significantly in relaxed and in relatively relaxed state, but there were no changes in contracted and relatively contracted state in group DT. As for the diaphragm muscle, there were significant increase in the state of supine position and in relatively contracted state, but there was no notable change in relatively relaxed state. With regard to the thickness of lumbar multifidus, a significant increase was only found in the left-sided muscle in relaxed, relatively relaxed, and relatively contracted state and in case of the right-sided one in relatively contracted state in group DT.ConclusionOur results suggest that diaphragm training has an effect also on the thickness of other active stabilizers of the lumbar spine, such as transversus abdominis and lumbar multifidus muscles.

The stability limit of the trunk is reduced in patients with low back pain. The thoracic diaphragm is one of the stabilizer muscles of the trunk. The aim of this study was to assess the effect of diaphragm-strengthening training on inspiratory function and stability limits of the trunk. Fifty-two people with chronic low back pain were included in the study and divided into 2 groups. One group participated in a conventional training programme together with diaphragm-strengthening training, and the other group participated in conventional training only. Both groups underwent 8 weeks of training, 60-min duration, 2 times/week. The results imply that conventional training together with diaphragm-strengthening training may be superior to conventional exercises alone in improving inspiratory function and stability limits of the trunk in patients with chronic lumbar pain. Objective: To determine the effects of diaphragmstrengthening training on the stability limits of the trunk and inspiratory function in patients with low back pain. Design: A randomized comparative trial including a diaphragm training group that took part in conventional training together with diaphragm strengthening, and a control group that took part in conventional training only. Both groups participated in an 8-week training, 2 times/week. All subjects underwent the same measurement protocol before and after the intervention. Patients: The study included 52 subjects with chronic low back pain. Methods: The inspiratory functions (chest excursion, maximal inspiratory pressure, peak inspiratory flow, and volume of inspired air) and stability limits of the trunk with the subject in the sitting position (modified functional and lateral reach test) were assessed. Results: Maximal inspiratory pressure and stability limit tests showed a statistically significant improvement only in the diaphragm training group. Statistically significant improvements in chest excursion and peak expiratory flow tests were found in both groups; however, the improvement was more greater in the diaphragm training group. Conclusion: Conventional exercises together with diaphragm training result in a greater improvement than conventional exercises alone in patients with chronic low back pain.

As proprioceptive training is popular for injury prevention and rehabilitation, we evaluated its effect on balance parameters and assessed the frequency spectra of postural sway linked with the various sensory channels. We recorded the Center of Mass displacement of 30 healthy student research participants (mean age = 21.63; SD = 1.29 years) with a single force plate under eyes open (EO) and eyes closed (EC) positions while standing on either a firm or foam surface, both before and after an 8-week balance training intervention on a foam surface with EC. We subjected the data to frequency power spectral analysis to find any differences between the frequency bands, linked with various sensory data. On the foam surface in the EC condition, the sway path decreased significantly after proprioceptive training, but, on the firm surface in the EC condition, there was no change. On the foam surface in the EC condition, there was also a significant decrease in frequency power postproprioceptive training in the medium-to-low frequency band. While our data indicate better posttraining balance skills, improvements were task specific to the trained condition, with no transfer of the acquired skill, even to a similar, easier condition. As training improved the middle-low frequency band, linked with vestibular signals, this intervention is better described as balance than "proprioceptive" training.

Purpose We examined the effects of exercise therapy on postural stability, multifidus thickness, and pain intensity in patients with low-back pain. Materials and methods Subjects were divided into a chronic low-back pain (CLBP; n = 10) group and a healthy control (C; n = 10) group. Group CLBP took part in an 8-week training programme, whereas group C did not. The thickness of the multifidus in both groups was assessed using ultrasonography before and after 8 weeks, in prone and kneeling positions, in relaxed and contracted states. A standing heel-raising test was used to assess postural stability. Results After the intervention in group CLBP, the thickness of the contracted multifidus increased in the prone position, whereas the thickness of both the contracted and relaxed multifidus decreased in the kneeling position. In group C after 8 weeks, multifidus thickness decreased in both positions, while both relaxed and contracted. Group C performed the standing heel-raising test significantly better than group CLBP before the 8-week period. After the training, group CLBP improved significantly, but no changes were found in group C. Discussion and conclusions Changes in thickness of the multifidus correlate with improved postural stability and decreased pain intensity. Decreasing thickness in healthy individuals may be an early sign of developing CLBP.

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