Effectiveness of sensomotoric training in reducing lower back pain – literature review

Uvod: Bolečina, v spodnjem delu hrbta, je eden izmed najbolj razširjenih simptomov in vedno večja, tako zdravstvena, kot tudi ekonomska težava. Ker je večina primerov nespecifičnih, je posledično težko določiti natančno etiologijo bolečine in primeren način zdravljenja. Okvara senzo-motoričnega nadzora, kar se nanaša na vse senzorične in motorične procese, ki nadzirajo poravnavo in gibanje hrbtenice, da lahko dosega normalno funkcijo in obremenitev, je eden od mogočih mehanizmov nastanka in/ali vztrajanja bolečine v spodnjem delu hrbta, na kar pa bi lahko vplivali s senzo-motorično vadbo. Namen: Namen diplomskega dela je, s pomočjo pregleda literature, objavljene v obdobju zadnjih petih let, preveriti učinkovitost senzo-motorične vadbe na zmanjšanje bolečine v spodnjem delu hrbta pri odrasli populaciji. Metode dela: Iskanje literature je potekalo decembra 2020 v elektronski bazi PubMed s kombinacijami ključnih besed: balance training AND low back painPNF AND low back pain in proprioceptive training AND low back pain. Rezultati: V analizo je bilo vključenih šest raziskav. Štiri so preučevale učinkovitost PNF-vadbe, ena učinkovitost naprave HUBER in ena naprave Posturomed, na zmanjševanje jakosti bolečine. Pet raziskav je zaznalo statistično značilne in klinično pomembne spremembe pri eksperimentalni skupini, medtem ko v kontrolni skupini ni bila nobena sprememba klinično pomembna. Primerjava med skupinama je pri petih raziskavah pokazala statistično značilne razlike v prid eksperimentalne skupine, ki pa niso dosegle klinično pomembne vrednosti. Razprava in zaključek: Zaradi različno kvalitetno izvedenih tehnik, različnih definicij bolečine v spodnjem delu hrbta in različnih trenutkov meritev (kdaj pred intervencijo, kdaj po intervenciji, kasnejše meritve dolgoročnih učinkov) so rezultati težje primerljivi. Tudi nekateri vzorci se v določenih lastnostih zelo razlikujejo od ostalih. Ne glede na razlike med raziskavami pa je mogoče zaključiti, da so učinki senzo-motorične vadbe ugodni. Vse raziskave so pokazale tudi dolgoročni učinek. Ker so bile opažene spremembe majhne, je priporočeno, da se senzo-motorična vadba kombinira z drugimi učinkovitimi metodami zdravljenja ali vsaj lajšanja bolečine v spodnjem delu hrbta.Introduction: Lower back pain is one of the most common symptoms and a growing health and economic problem. Because most cases are nonspecific, it is consequently difficult to determine the exact etiology of pain and the appropriate course of treatment. Sensory-motor control impairment, which refers to all sensory and motor processes that control the alignment and movement of the spine to achieve normal function and load, is one of the possible mechanisms of lower back pain formation and / or persistence, which could be affected by sensory-motor exercise. Purpose: The purpose of this thesis is to review the effectiveness of sensorimotor exercise in reducing lower back pain in the adult population through a review of the literature published over the past five years. Methods: The literature search took place in December 2020 in the electronic database PubMed with keyword combinations: balance training AND low back painPNF AND low back pain and proprioceptive training AND low back pain. Results: Six studies were included in the analysis. Four studied the effectiveness of PNF-exercise, one the effectiveness of the HUBER device, and one the Posturomed device on reducing pain intensity. Five studies detected statistically and clinically significant changes in the experimental group, while no change was clinically significant in the control group. Comparison between the groups in five studies showed statistically significant differences in favor of the experimental group, which, however, did not reach clinically significant values. Discussion and conclusion: Due to different quality of techniques, different definitions of lower back pain and different moments of measurements (sometimes before the intervention, sometimes after the intervention, later measurements of long-term effects), the results are more difficult to compare. Also, some samples are very different from others in certain properties. Regardless of the differences between the studies, it can be concluded that the effects of sensorimotor exercise are beneficialall research has also shown a long-term effect. Because the observed changes were small, it is recommended that sensorimotor exercise be combined with other effective methods of treatment or at least relief of lower back pain