Objectives: The aim of the thesis is to demonstrate, through a randomized trial, that the iliopsoas must be considered in all effects a stabilizer of the lumbar spine like the most “noble” transverse abdomen, pelvic floor, diaphragm and multifid; therefore, rehabilitation intervention for patients suffering from functional instability must also take into account this important muscle for better outcome. Participants: eight participants (5 males and 3 females) divided into two groups (4 experimental and 4 control). Interventions: the two groups were offered two different rehabilitation interventions, both lasting 6 weeks. The requirement was for both groups to perform the exercises on alternate days. The experimental group was given a protocol consisting of ex novo exercises focused on the iliopsoas and more specifically that sought an eccentric contraction of it. The control group, on the other hand, was given a protocol consisting of “classical” core stability exercises. Main outcome measures: composite distance (Y balance test) was measured and compared in both groups at T0 and T1 to assess the change in dynamic stability in patients. The trend between T0 and T1 of pain (Quebec Back Pain Disability Scale) was considered. One-tailed t-test of composite distance and pain to assess whether the data obtained were significant or not. Correlation index to assess whether the two variables used are dependent or not and therefore whether or not one variable affects the other and vice versa. Results: QBPDS results for pain, experimental (-0.72 ± 0.10) and control (-0.39 ± 0.32); one-tailed P(T<=t) student t test 0.067; experimental CI (-0.61, -0.83) and control CI (-0.032, -0.748). YBT results for right leg composite distance, experimental (16.04 ± 4.49) and control (12.96 ± 4.63); t test student P(T<=t) one tail 0.2194; experimental CI (10.95, 21.13) and control CI (7.71, 18.20). YBT results for left leg composite distance, experimental (16.42 ± 5.23) and control (10.83 ± 8.90); student t test P(T<=t) one tail 0.1923; experimental CI (10.50, 22.34) and control CI (0.76, 20.90). Experimental correlation index -0.1977 and control 0.4482. Conclusion: In both groups the items considered improved. There is a significant difference in the decrease of pain, according to the QBPDS scale, considering p < 0.10, it can be said that in the decrease of pain the experimental protocol is revealed in 93% of the cases better than the control group protocol.
Obbiettivi: l’obbiettivo della tesi è quello di dimostrare, attraverso un trial randomizzato, che il ruolo dell’ileopsoas deve essere riconsiderato e diventare a tutti gli effetti quello di stabilizzatore della colonna lombare al pari dei più “nobili” trasverso dell’addome, pavimento pelvico, diaframma e multifido; quindi, l’intervento riabilitativo per pazienti affetti da instabilità funzionale deve tener conto anche di questo importante muscolo per ottenere un miglior out come. Partecipanti: otto partecipanti (5 maschi e 3 femmine) suddivisi in due gruppi (4 sperimentale e 4 di controllo). Interventi: ai due gruppi sono stati proposti due diversi interventi riabilitativi, entrambi di durata di 6 settimane. La richiesta è stata per entrambi i gruppi di eseguire gli esercizi a giorni alterni. Al gruppo sperimentale è stato dato un protocollo formato da esercizi ex novo incentrati sull’ileopsoas e più precisamente che ne ricercavano una contrazione eccentrica. Al gruppo di controllo, invece, è stato consegnato un protocollo formato da esercizi di core stability “classica”. Principali misure di out come: la distanza composita (Y balance test) è stata misurata e confrontata in entrambi i gruppi a T0 e T1 per valutare la variazione di stabilità dinamica nei pazienti. È stato considerato l’andamento tra T0 e T1 del dolore (scala Quebec Back Pain Disability Scale). T test a una coda della distanza composita e del dolore per valutare se i dati ottenuti sono o meno significativi. Indice di correlazione per valutare se le due variabili utilizzate sono o meno dipendenti e quindi poter o meno affermare che una variabile influenza l’altra e viceversa. Risultati: risultati QBPDS per il dolore, sperimentale (-0.72 ± 0.10) e controllo (-0.39 ± 0.32); test t di student P(T<=t) una coda 0.067; IC sperimentale (-0.61,-0.83) e IC controllo (-0.032, -0.748). Risultati YBT per la distanza composita gamba destra, sperimentale (16.04 ± 4.49) e controllo (12.96 ± 4.63); test t student P(T<=t) una coda 0.2194; IC sperimentale (10.95, 21.13) e IC controllo (7.71, 18.20). Risultati YBT per la distanza composita gamba sinistra, sperimentale (16.42 ± 5.23) e controllo (10.83 ± 8.90); test t student P(T<=t) una coda 0.1923; IC sperimentale (10.50, 22.34) e IC controllo (0.76, 20.90). Indice di correlazione sperimentale -0.1977 e controllo 0.4482. Conclusione: In entrambi i gruppi gli items considerati sono migliorati. È presente una differenza significativa nella diminuzione del dolore, secondo la scala QBPDS, considerando p < 0.10. Si può affermare che nella diminuzione del dolore il protocollo sperimentale si rivela nel 93% dei casi migliore del protocollo del gruppo di controllo.
Il ruolo del muscolo ileopsoas nel trattamento di pazienti con instabilità lombare: confronto tra due programmi di esercizi
BORTOLOT, MARCO
2021/2022
Abstract
Objectives: The aim of the thesis is to demonstrate, through a randomized trial, that the iliopsoas must be considered in all effects a stabilizer of the lumbar spine like the most “noble” transverse abdomen, pelvic floor, diaphragm and multifid; therefore, rehabilitation intervention for patients suffering from functional instability must also take into account this important muscle for better outcome. Participants: eight participants (5 males and 3 females) divided into two groups (4 experimental and 4 control). Interventions: the two groups were offered two different rehabilitation interventions, both lasting 6 weeks. The requirement was for both groups to perform the exercises on alternate days. The experimental group was given a protocol consisting of ex novo exercises focused on the iliopsoas and more specifically that sought an eccentric contraction of it. The control group, on the other hand, was given a protocol consisting of “classical” core stability exercises. Main outcome measures: composite distance (Y balance test) was measured and compared in both groups at T0 and T1 to assess the change in dynamic stability in patients. The trend between T0 and T1 of pain (Quebec Back Pain Disability Scale) was considered. One-tailed t-test of composite distance and pain to assess whether the data obtained were significant or not. Correlation index to assess whether the two variables used are dependent or not and therefore whether or not one variable affects the other and vice versa. Results: QBPDS results for pain, experimental (-0.72 ± 0.10) and control (-0.39 ± 0.32); one-tailed P(T<=t) student t test 0.067; experimental CI (-0.61, -0.83) and control CI (-0.032, -0.748). YBT results for right leg composite distance, experimental (16.04 ± 4.49) and control (12.96 ± 4.63); t test student P(T<=t) one tail 0.2194; experimental CI (10.95, 21.13) and control CI (7.71, 18.20). YBT results for left leg composite distance, experimental (16.42 ± 5.23) and control (10.83 ± 8.90); student t test P(T<=t) one tail 0.1923; experimental CI (10.50, 22.34) and control CI (0.76, 20.90). Experimental correlation index -0.1977 and control 0.4482. Conclusion: In both groups the items considered improved. There is a significant difference in the decrease of pain, according to the QBPDS scale, considering p < 0.10, it can be said that in the decrease of pain the experimental protocol is revealed in 93% of the cases better than the control group protocol.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/39943