Effect of the Diaphragm Stretching Technique on Nonspecific Low Back Pain

Официальное название

Effect of the Diaphragm Stretching Technique on Symptomatology in Young Adults With Nonspecific Low Back Pain: Randomized Controlled Trial

Обзор

This study aims to analyze the efficacy of diaphragm stretching technique on symptomatology in young adults with nonspecific low back pain.

Подробное описание

Nonspecific low back pain occurs when there is an imbalance in the lower back between functional load and the ability to perform daily tasks. It is characterized as such when there is no specific and well-determined diagnosis and there are no structural changes.

The diaphragm and abdominal muscles together create a hydraulic effect in the abdominal cavity, which helps stabilize the spine, providing rigidity to the lumbar spine by increasing intra-abdominal pressure. Diaphragmatic changes in patients diagnosed with low back pain may contribute to the lack of spinal control activity through several mechanisms. Thus, it is concluded that the diaphragm is anatomically related to the lumbar spine, through its muscle fibers.

There are articles that relate the topic of low back pain with Osteopathic Manual Treatment, demonstrating that, despite this lack of scientific evidence, the results obtained at a clinical level are favorable.

This study aims to evaluate the effectiveness of diaphragm stretching techniques on symptoms experienced by young adults with non-specific low back pain.

In this study, the investigators will analyze the effects of the diaphragm stretching technique on the following variables: the sniff nasal inspiratory pressure test (SNIP test) , Visual Analogue Scale (VAS) score, the Schober test and measurement of the distance between the fingers and the ground during anterior flexion of the trunk, without flexion of the lower limbs (also known as the Finger Tip Test).

Вмешательства

• Другое Placebo Technique
  In the control group, manual contact will be carried out without any therapeutic intention. This contact will be maintained for the same period of time as the experimental group.
• Другое Diaphragm Stretching
  The participant will be in supine position and the researcher will be at the headrest of the examination table, placing his hands on the lower costal margin. Superior direction traction is performed during inspiration, remaining during expiration. The procedure is repeated for a maximum period of 4 minutes.

Первичные конечные точки

• Change in level of inspiratory capacity immediately after intervention [Срок оценки: Immediately after the intervention]
• Change in the level of disability derived from low back pain immediately after the intervention [Срок оценки: Immediately after the intervention]
• Change in the level of functionality of the lumbar spine immediately after the intervention [Срок оценки: Immediately after the intervention]
• Change in the level of functionality of the lumbar spine immediately after the intervention [Срок оценки: Immediately after the intervention]

Критерии участия

Критерии включения

• Nonspecific low back pain;
• Age between 18 and 30.

Критерии исключения

• Serious cardiovascular and cardiorespiratory causes;
• Spinal pathologies and injuries to the lumbar spine;
• Cancer patients;
• Pacemaker or implant carriers;
• Pregnant women or volunteers suspected of being pregnant.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Лечение

Центры проведения

Португалия · 1 центр

• Escola Superior de Saúde do Porto — Porto

Публикации

• Hodges PW, Eriksson AE, Shirley D, Gandevia SC. Intra-abdominal pressure increases stiffness of the lumbar spine. J Biomech. 2005 Sep;38(9):1873-80. doi: 10.1016/j.jbiomech.2004.08.016. PMID 16023475
• Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. J Physiol. 2001 Dec 15;537(Pt 3):999-1008. doi: 10.1111/j.1469-7793.2001.00999.x. PMID 11744772
• Bains KNS, Kashyap S, Lappin SL. Anatomy, Thorax: Diaphragm. 2023 Jul 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK519558/ PMID 30137842
• Hodges PW, Cresswell AG, Daggfeldt K, Thorstensson A. In vivo measurement of the effect of intra-abdominal pressure on the human spine. J Biomech. 2001 Mar;34(3):347-53. doi: 10.1016/s0021-9290(00)00206-2. PMID 11182126
• Fernandez-Lopez I, Pena-Otero D, Atin-Arratibel MLA, Eguillor-Mutiloa M. Effects of Manual Therapy on the Diaphragm in the Musculoskeletal System: A Systematic Review. Arch Phys Med Rehabil. 2021 Dec;102(12):2402-2415. doi: 10.1016/j.apmr.2021.03.031. Epub 2021 Apr 29. PMID 33932362
• Finta R, Nagy E, Bender T. The effect of diaphragm training on lumbar stabilizer muscles: a new concept for improving segmental stability in the case of low back pain. J Pain Res. 2018 Nov 28;11:3031-3045. doi: 10.2147/JPR.S181610. eCollection 2018. PMID 30568484
• Fitting JW. Sniff nasal inspiratory pressure: simple or too simple? Eur Respir J. 2006 May;27(5):881-3. doi: 10.1183/09031936.06.00007906. No abstract available. PMID 16707389
• Grimstone SK, Hodges PW. Impaired postural compensation for respiration in people with recurrent low back pain. Exp Brain Res. 2003 Jul;151(2):218-24. doi: 10.1007/s00221-003-1433-5. Epub 2003 May 21. PMID 12759796

Идентификаторы

NCT: NCT06375018 · OST1_011

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗