High erector spinae endurance reduced low back pain in postmenopausal women

Main Article Content

Maria Regina Rachmawati

Abstract

Low back pain (LBP) is the most frequent health problem in all age groups, including postmenopausal women, who are at risk of disability, due to degenerative processes affecting all organ systems, including the erector spinae muscles. In addition, postmenopausal women also experience a decrease in esterogen levels, which stimulates osteoclastic activity and initiates a reduction in bone mineral density (BMD). The aims of the present study were to determine the relationship between LBP prevalence and erector spinae endurance, BMD reduction, and body mass index (BMI) respectively. This was a cross-sectional study, conducted on 213 postmenopausal women, selected by simple random sampling. Assessment of pain, expressed on a visual analog scale (VAS), was performed by interviews and measurement of erector spinae muscle endurance time using a modified Biering-Sorensen technique, while BMD was assessed by bone densitometry. The results of the study showed that the postmenopausal women had a mean age of 53.5 ± 3.6 years. The prevalence of LBP and osteoporosis in the postmenopausal women was 58.2% and 21.6%, respectively. A significant positive linear correlation was found between BMI and VAS (r=0.165; p=0.016). In addition, the t-test demonstrated a significant difference in mean VAS scores between good and poor erector spinae endurance (p=0.008). However, the chi-square test showed no significant relationship between reduced BMD and LBP (p>0.05). It is recommended that low back pain in postmenopausal women be managed by strengthening exercises of the erector spinae.

Article Details

How to Cite
Rachmawati, M. R. (2011). High erector spinae endurance reduced low back pain in postmenopausal women. Universa Medicina, 30(2), 111–119. https://doi.org/10.18051/UnivMed.2011.v30.111-119
Section
Review Article

References

McBeth J. Epidemiology of musculoskeletal pain. Best Pract Res Clin Rheumatol 2007;21:403–25.

Van Tulder MW, Koes BW. Chronic low back pain and sciatica. Clin Evid 2002;7:1032–48.

Ehrlich GE. Low back pain. Bull WHO 2003;81: 671-6.

Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull WHO 2003;81: 646-56.

Nikolov VT, Petkova MP, Kolev NV. Obesity and low back pain in postmenopausal women. J Biomed Clin Res 2009;2:99-102.

Harrianto R, Samara D, Tjhin P, Wartono M. Manual handling as risk factor of low back pain among workers. Univ Med 2009;28:170-8.

Rachmawati MR, Samara D, Tjhin P, Wartono M, Bastian Y. Musculo-skeletal pain and posture decrease step length in young adults. Univ Med 2009;28:92-9.

Nourbakhsh MR, Arab AM. Relationship between mechanical factors and incidence of low back pain. J Orthop Sports Phys Ther 2002;32: 447-60.

Süüden E, Ereline J, Gapeyeva H, Pääsuke M. Low back muscle fatigue during Sørensen endurance test in patients with chronic low back pain: relationship between electromyographic spectral compression and anthropometric characteristics. Electromyogr Clin Neurophysiol 2008;48:185-92.

Hamilton N, Weimar W, Luttgens K. Kinesiology: scientific basis of human motion. Boston: Mc Graw Hill;2008.

Hides J, Jull G, Richardson C. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine 2001;26:E243–8.

Biering-Sorensen F. Physical measurements as risk indicators for low-back trouble over a one-year period. Spine 1984;9:106–19.

Demoulin C, Vanderthommen M, Duysens C, Crielaard J. Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint Bone Spine 2006;73:43-50.

Van Tulder M, Malmivaara A, Esmail R, Koes B. Exercise therapy for low back pain: a systematic review within the framework of the Cochrane collaboration back review group. Spine 2000;25:2784–96.

Bono CM, Einhorn TA. Overview of osteoporosis: pathophysiology and determinants of bone strength. Eur Spine J 2003;12 Suppl 2: S90-6.

Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A. Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone 2000;27:585–90.

Seeman E, Delmas PD. Bone quality the material and structural basis of bone strength and fragility. N Engl J Med 2006;354:2250-61.

World Health Organization. Appropriate body mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63.

Biering-Sorensen F, Bendix AF. Working off low back pain. Lancet 2000;355:1929-30.

Krege JH, Siminoski K, Adachi JD, Misurski DA, Chen P. A simple method for determining the probability a new vertebral fracture is present in postmenopausal women with osteoporosis. Osteoporos Int 2006;17:379–86.

Edmond SL, Kiel DP, Samelson EJ, Hayes MK, Felson DT. Vertebral deformity, back symptoms, and functional limitations among older women: the framingham study. Osteoporos Int 2005;16: 1086–95.

Limpaphayom KK, Taechakraichana N, Jaisamrarn U, Bunyavejchevin S, Chaikittisilpa S, Poshyachinda M, et al. Prevalence of osteopenia and osteoporosis in Thai women. Menopause 2001;8:65–9.

Haussler B, Gothe H, Gol D, Glaeske G, Pientka L, Felsenberg D. Epidemiology, treatment and costs of osteoporosis in Germany—the Bone EVA Study. Osteoporos Int 2007;18:77–84.

Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol 2003;13: 361-70.

Ahn S, Song R. Bone mineral density and perceived menopausal symptoms: factors influencing low back pain in postmenopausal women. J Adv Nurs 2009;65:1228-36.

Taechasubamorn P, Nopkesorn T, Pannarunothai S. Comparison of physical fitness between rice farmers with and without chronic low back pain: a cross-sectional study. J Med Assoc Thai 2010; 93:1415-21.

Ebadi S, Ansari NN, Henschke N, Naghdi S, van Tulder MW. The effect of continuous ultrasound on chronic low back pain: protocol of a randomized controlled trial. BMC Musculoskel Disord 2011;12:59.

Payne N, Gledhill N, Katzmarzyk PT. Health-related fitness, physical activity and history of back pain. Can J Appl Physiol 2000;24:236–49.