Efficacy of Trunk Proprioceptive Neuromuscular Facilitation Training on Chronic Low Back Pain

Background and Purpose: Improving functional performance in patients with chronic low back pain is of primary importance. The purpose of this study was to examine the effects proprioceptive neuromuscular facilitation (PNF) programs on trunk muscle endurance, flexibility, and functional performance in subjects with chronic low back pain (CLBP). Method: Thirty men (23.3250 ±2.60 (mean ± SD) years of age) who had complaints of CLBP were randomly assigned to 2 groups: Group A (experimental group) and group B (control group). To determine the effect of training, subjects were assessed on measures of trunk muscle endurance, lumbar mobility prior to and after 4- weeks of intervention. Disability and back pain intensity also were measured with the modified Oswestry Index and VAS respectively. Results: Paired sample t-test indicated that Groups A demonstrated significant improvements in lumbar mobility, static and dynamic muscle endurance, pain and modified Oswestry Index, measurements. However group B also shows improvement on the measure of functional ability and pain. Conclusion: the results of the study suggest that the PNF programs are appropriate for improving trunk muscle endurance, trunk mobility, pain and functional ability in people with CLBP. Back pain affects millions of people and is one of the most common maladies prompting patients to seek medical attention and remain most common cause of time off work.(19,20) The lifetime prevalence of low back pain in the general population approaches 85% with 2%-5% of people affected yearly. Furthermore, over 80% of such patients report recurrent episode. It is estimated that the rate of improvement is similar regardless of the type of care initially sought, and that 95% of the patients were able to return to their usual activity of daily living no longer than 6 months after the health care visit for an episode of LBP . However, few (7.7%) of them will develop chronic low back pain (CLBP).(20) Although CLBP affects a small portion of the population, the medical cost of this group of patient is very high (80%).This group has been widely reported to be associated with large amount of care seeking and disability. (20, 4) In patients with CLBP, a specific pain generator is not always found which often makes diagnosis and treatment challenging. Most often, it is not associated with an underlying structural abnormality.(6,14) Although low back pain is self limiting and benign disease that tend to improve simultaneously overtime, varied therapeutic interventions are available for the treatment of low back pain. However effectiveness associated with most of the intervention has not been demonstrated.(12) For the management of the patient with acute low back pain, there is never any shortage of devices, most of which are successful probably due to natural history of spontaneous remission that occurs in the majority of cases. When the pain become chronic, however, interest wanes, and the longer the history less likely is the patient to receive really constructive therapy.(17) There are various interventions available for the treatment of CLBP, where most of them focus mainly