Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Role of Latissimus Dorsi and Lower Trapezius in Chronic Mechanical Low Back Pain due to Thoraco-lumbar Dysfunction


Affiliations
1 Government Physiotherapy College, India
2 Government Medical College, India
3 Sarvajanic College of Physiotherapy, New Civil Hospital, Surat, Gujarat, India
     

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Study Design: Randomized controlled single blinded clinical trial.

Objective: To identify prevalence of thoraco-lumbar dysfunction (TLD) and analyze the role of latissimus dorsi and Lower Trapezius in it.

Summary of background data: 30% of chronic mechanical back pains are due to TLD. The thoracolumbar and Lower Trapezius muscles control the dynamic and postural stability of the lower spine. Though core stabilization exercises are widely recommended for low back pain, but no reports are available for exercises specific to thoraco-lumbar dysfunction.

Methods: 30 subjects in age group of 25 to 40 years with non traumatic, chronic mechanical low back pain were identified for study and randomly divided into two groups. Group-A (n=15): core stabilization exercises with Latissimus dorsi and Group-B (n=15): latissimus dorsi strengthening, core stabilization and Lower trapezius exercises. Primary outcome measure was pain intensity (VAS score). Secondary outcome measures were general health (SF-36) and back pain disability (Aberdeen back pain disability score). Outcome measurement scores were compared using paired t-test.

Results: Core muscles, latissimus dorsi along with lower trapezius strengthening alone is more effective in relieving pain and improving life than strengthening of core muscles and latissimus dorsi alone.

Conclusion: Identification of TLD as a cause of low back pain is recommended in all non-traumatic, chronic, mechanical low back pains. Strengthening of Latissimus dorsi along with Lower Trapezius relieves thoraco-lumbar related back pain.


Keywords

Low Back Pain (LBP), Thoraco-Lumbar Dysfunction, Latissimus Dorsi(LD) Strengthening, Dorso-Lumbar Fascia(DLF)
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  • Schwarzer A et al. The relative contribution of the disc and zygapophyseal joint in chronic low back pain. Spine 1994; 19:801-06.

  • Maigne R. (1980). Low Back Pain of thoracolumbar Origin. Arch. Phys. Med. Rehabil.,61;389-95

  • Vleeming A, Pool-Goudzwaard AL, Stoeckart R,et al. The posterior layer of the thoraco-lumbar fascia, its function in load transfer from spine to legs. Spine 1995; 20(7):753-58.

  • Hides JA, CA Richardson and GA Jull. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine 1996; 21(23): 2763-69.

  • O’Sullivan PB, et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 1997; 22(24): 2959-67.

  • O’Sullivan PB. Lumbar segmental ‘instability’: clinical presentation and specific stabilizing exercise management. Man Ther 2000; 5(1): 2-12.

  • O’Sullivan PB, L Twomey and GT Allison’.Altered abdominal muscle recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther 1998. 27(2):114-24.

  • Poivaudeaus, Lefevre-Colau MM, Mayoux- Benhamou MA, Revel M. Which rehabilitation for which back pain. Rev Prat 2000 Oct 15;50(16):1779-83.

  • Hides JA, GA and CA Richardson, Long-term effects of specific stabilizing exercises for firstepisode low back pain. Spine 2001; 26(11): E243- 48.

  • Akuthota V, Nadler Sf. Core strengthening. Arch Phys Med Rehabil 2004 March; 85(3 suppl):586- 92.

  • Maigne R. Diagnosis and treatment of pain of vertebral origin. A manual medicine approach. Baltimore: Williams & Wilkins, 1996:411-17.

  • Kendall FP, Kendall-McCreary E, Provance P. Muscles: Testing and Function, 4th ed. Lippincott Williams & Williams, 1993.

  • Bogduk N, Macintosh JE. The applied anatomy of the thoracolumbar fascia. Spine 1984 Mar;9(2):164-70.

  • Barker P J, Briggs C A, Bogeski G 2004 Tensile transmission across the lumbar fascia in unembalmed cadavers: effects of tension to various muscular attachments. Spine 29(2): 129- 138.

  • Barker PJ, Briggs CA. Attachments of the posterior layer of lumbar fascia. Spine 1999 Sep 1;24(17):1757- 64.

  • Brukner and Khan. Core stability. In: 3ed. Clinical sports medicine. Mcgraw-Hill Australia: 2006: 158- 159.

  • Arokoski JP, Valta T, Kankaanpaa M, Airaksinen O. Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients. Arch Phys Med Rehabil 2004 May; 85(5):823-32.

  • Joseph Kurnik. Thoracolumbar junction responsible for 40% of low back pain. Dynamic Chiropractic, Dec 15, 2000; 18(26). Available at: website http:// www.chiroweb.com/archives/ 18/26/14.4html . Accessed July 14, 2007.

  • Janet A. Gerard, D.A.B.C.O., Steven L. Kleinfield, D.A.B.C.O.Special Test Gerard Way, Brooklyn, United States. [DNLM: 1. Orthopedic— methods—handbooks. 2. Musculoskeletal Diseases—diagnosis—handbooks. WE 39 G3560 1993] RD734.5.P58G47 1993 617.3’0028—dc20 DNLM/DLC for Library of Congress.Churchill Livingstone Inc. 1993.

  • Janda V, Schmid HJA. Muscles as a pathogenic factor in back pain. In: Proceedings of the International of Orthopaedic Manipulative Therapists (4th conference, 17-18). Auckland, New Zealand; 1980.


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  • Role of Latissimus Dorsi and Lower Trapezius in Chronic Mechanical Low Back Pain due to Thoraco-lumbar Dysfunction

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Authors

Sanjiv Kumar Sharma
Government Physiotherapy College, India
Sajid Saiyad
Government Medical College, India
D. N. Bid
Sarvajanic College of Physiotherapy, New Civil Hospital, Surat, Gujarat, India

Abstract


Study Design: Randomized controlled single blinded clinical trial.

Objective: To identify prevalence of thoraco-lumbar dysfunction (TLD) and analyze the role of latissimus dorsi and Lower Trapezius in it.

Summary of background data: 30% of chronic mechanical back pains are due to TLD. The thoracolumbar and Lower Trapezius muscles control the dynamic and postural stability of the lower spine. Though core stabilization exercises are widely recommended for low back pain, but no reports are available for exercises specific to thoraco-lumbar dysfunction.

Methods: 30 subjects in age group of 25 to 40 years with non traumatic, chronic mechanical low back pain were identified for study and randomly divided into two groups. Group-A (n=15): core stabilization exercises with Latissimus dorsi and Group-B (n=15): latissimus dorsi strengthening, core stabilization and Lower trapezius exercises. Primary outcome measure was pain intensity (VAS score). Secondary outcome measures were general health (SF-36) and back pain disability (Aberdeen back pain disability score). Outcome measurement scores were compared using paired t-test.

Results: Core muscles, latissimus dorsi along with lower trapezius strengthening alone is more effective in relieving pain and improving life than strengthening of core muscles and latissimus dorsi alone.

Conclusion: Identification of TLD as a cause of low back pain is recommended in all non-traumatic, chronic, mechanical low back pains. Strengthening of Latissimus dorsi along with Lower Trapezius relieves thoraco-lumbar related back pain.


Keywords


Low Back Pain (LBP), Thoraco-Lumbar Dysfunction, Latissimus Dorsi(LD) Strengthening, Dorso-Lumbar Fascia(DLF)

References