Effects of sling exercises on pain, function, and corticomuscular functional connectivity in individuals with chronic low back pain- preliminary study

Bo-Jhen Chen; Tzu-Ying Liu; Hsin-Chi Wu; Mei-Wun Tsai; Shun-Hwa Wei; Li-Wei Chou

doi:10.1371/journal.pone.0288405

Effects of sling exercises on pain, function, and corticomuscular functional connectivity in individuals with chronic low back pain- preliminary study

PLoS One. 2023 Nov 30;18(11):e0288405. doi: 10.1371/journal.pone.0288405. eCollection 2023.

Authors

Bo-Jhen Chen¹, Tzu-Ying Liu², Hsin-Chi Wu^{1

3}, Mei-Wun Tsai², Shun-Hwa Wei², Li-Wei Chou²

Affiliations

¹ Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (R.O.C.).
² Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.).
³ Department of Medicine, Tzu Chi University, Hualien, Taiwan (R.O.C.).

Abstract

Background: Individuals with chronic low back pain (CLBP) exhibit altered brain function and trunk muscle activation.

Aim: This study examined the effects of sling exercises on pain, function, and corticomuscular coherence (CMC) in healthy adults and individuals with CLBP.

Methods: Eight individuals with CLBP and 15 healthy adults received sling exercise training for 6 weeks. Before and after training, participants performed two motor tasks: rapid arm lifts and repeated trunk flexion-extension tasks, and electromyography of the trunk muscles and electroencephalography of the sensorimotor cortex were recorded. Chi-squared test and Mann-Whitney U tests were used for between group comparison, and Wilcoxon signed-rank tests were used for pre- and post-training comparison. Spearman's Rank Correlation Coefficient (Rs) was used to identify for the relationship between motor performance and Corticomuscular coherence.

Results: Sling exercises significantly improved pain (median from 3 to 1, p = .01) and Oswestry Disability Index scores (median from 2.5 to 2, p = .03) in the CLBP group. During rapid arm lifts, individuals with CLBP showed lower beta CMC of the transverse abdominis and internal oblique (Tra/IO) (0.8 vs. 0.49, p = .01) and lumbar erector spinae (0.70 vs. 0.38, p = .04) than the control group at baseline. During trunk flexion-extension, the CLBP group showed higher gamma CMC of the left Tra/IO than the control group at baseline (0.28 vs. 0.16 , p = .001). After training, all CMC became statistically non-significant between groups. The training induced improvement in anticipatory activation of the Tra/IO was positively correlated with the beta CMC (rs = 0.7851, p = .02).

Conclusion: A 6-week sling exercises diminished pain and disability in patients with CLBP and improved the anticipatory activation and CMC in some trunk muscles. These improvements were associated with training induced changes in corticomuscular connectivity in individuals with CLBP.

Copyright: © 2023 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Chronic Pain* / therapy
Electromyography
Exercise
Exercise Therapy
Humans
Low Back Pain* / therapy
Paraspinal Muscles
Torso

Grants and funding

This research was funded by the Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (https://www.tzuchi.com.tw/en/) (No. TCRD-TPE-104-11) to Mr. B. Chen. The funder had no role in study design, data collection and interpretation.