Original Editor - Peter Copeland, George Smith, Bryn Roberts as part of the
Nottingham University Spinal Rehabilitation Project Show
Introduction[edit | edit source]Low back pain (LBP) is an umbrella of conditions with 80% of adults estimated to experience LBP at some point during their life [1]. Low back pain refers to pain between the bottom of the ribs and the buttock crease.
This article focuses on non specific chronic low back pain (NSCLBP) and its relations with fitness. Fitness [edit | edit source]Plank exercise, core activation Physical fitness is a set of attributes that people have or achieve. Being physically fit has been defined as the ability to carry out daily tasks with vigour and alertness, without undue fatigue and with ample energy to enjoy leisure-time pursuits and meet unforeseen emergencies[5] Being physically fit depends on how well a person fulfils each of the components of being healthy.When it comes to fitness, these components are[6]:
The following sections will look at each of these components individually, relating it to LBP. Cardiorespiratory Endurance[edit | edit source]Cardiorespiratory endurance indicates how well the body can supply fuel during physical activity via the body’s circulatory and respiratory systems. Aerobic activities that help improve cardiorespiratory endurance are those that cause an elevated heart rate for a sustained period of time. eg swimming, brisk walking, jogging, cycling[6] LPB relevance
Muscular Endurance [edit | edit source]Fitness also includes muscular endurance, which is the ability of a muscle to continue exerting force without tiring.[6]
Strength and Low Back Pain[edit | edit source]The core is the group of trunk and hip muscles that surround the spine, abdominal viscera and hip. Core muscles are essential for proper load balance within the spine, pelvis, and kinetic chain. Core strengthening has a strong theoretical basis in treatment and prevention of LBP, as well as other musculoskeletal afflictions. A reduction in core strength can lead to lumbar instability.[3] Muscle strengthening exercises form part of the NICE treatment guidelines for Early management of persistent non-specific low back pain. The importance of the core relate to its function ie sparing the spine from excessive load and transfer force from the lower body to the upper body and vice versa.
Measures of Back Strength: For information here look at Physiotherapy Assessment section of Core Stability Few of us will have access to a isokenetic machine to measure trunk strength, as shown in video below.
Body Composition [edit | edit source]Obesity can lead to altered body positions eg exaggerated lumbar lordosis The body is composed of water, protein, minerals, and fat. A person can potentially maintain the same weight but radically change the ratio of each of the components that make up their body. A two-component model of body composition divides the body into a fat component and fat-free component. Body fat (storage fat) in excess can increase susceptibility to chronic illness, health complications, and LBP. Numerous studies have been conducted highlighting the relationship between increased fat content and the likelihood/prevalence of lower back pain.
Flexibility[edit | edit source]Flexibility refers to the range of movement across a joint. Flexibility is important because it improves the ability of the kinetic chain to work smoothly and can help prevent injuries. It is specific to each joint and depends on a number of variables, including the tightness of ligaments and tendons. Relevance to CLBP
Conclusions[edit | edit source]A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain concluded thus: A general exercise programme that combines muscular strength, flexibility and aerobic fitness is beneficial for rehabilitation of non-specific chronic low back pain. Increasing core muscular strength can assist in supporting the lumbar spine. Improving the flexibility of the muscle-tendons and ligaments in the back increases the range of motion and assists with the patient’s functional movement. Aerobic exercise increases the blood flow and nutrients to the soft tissues in the back, improving the healing process and reducing stiffness that can result in back pain.[3] And remember the important message is that embarking on any regular exercise will be of benefit to an overall person’s health including reducing back pain. With exercise they will look and feel better.[6] References[edit | edit source]
Is exercise good for lower back pain?Exercise is good for low back pain -- but not all exercises are beneficial. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor.
Which statement is correct regarding the prevention and management of low back pain quizlet?Which statement is correct regarding the prevention and management of low-back pain? Exercises should be performed at least three days per week.
Which of the following is an absolute contraindication to exercise testing?Absolute contraindications for exercise ECG
Acute myocardial infarction (AMI) within 48 hours – due to risk of aggravating the infarction, as well as inducing ventricular arrhythmias.
Which of the following is among the health benefits associated with regular physical activity?Being physically active can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities.
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