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Effects and underlying mechanisms of unstable shoes on chronic low back pain

OBJECTIVE: To investigate the effects that wearing unstable shoes has on
disability, trunk muscle activity, and lumbar spine range of motion (ROM) in
patients with chronic lower back pain (CLBP). DESIGN: Randomized controlled
trial. SETTING: Orthopedic Surgery Service. PARTICIPANTS: We randomized 40 adults
with nonspecific CLBP either to an unstable shoes group
( n = 20) or to the
control group ( n = 20). INTERVENTION: The participants in the unstable shoes
group were advised to wear these shoes for a minimum of six hours a day for four
weeks. Control group participants were asked to continue wearing their regular
shoes. OUTCOME MEASURES: Our primary outcome was measurement of back-related
dysfunction, assessed using the Roland-Morris Disability Questionnaire. Secondary
outcomes included changes in electromyographic (EMG) activity of erector spinae
(ES), rectus abdominis (RA), internus obliquus (IO), and externus obliquus (EO)
muscles, and changes in lumbar spine ROM. RESULTS: Between-group analysis
highlighted a significant decrease in disability in the unstable shoes group
compared to the control (-5, 95% confidence interval (CI) = -8.4 to -1.6). Our
results revealed a significant increase in the percentage of RA, ES, IO, and EO
EMG activity and in lumbar spine ROM in the unstable shoes group compared to the
control group. Moreover, our results showed a significant negative correlation
between disability and the percentage of ES, RA, and IO muscle activity at the
end of the intervention. CONCLUSION: This study shows that the use of unstable
shoes contributes to improvements in disability, which are likely related to
increased trunk muscle activity and lumbar spine ROM.

Langue : ANGLAIS

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