| Objective: The purpose of this study was to investigate the different effects of occupational sitting,leisure-time sitting and occupational with leisure-time sitting on low back function.Meanwhile,this study provided subjects with LBP and pain developers(PD)with core stability treatment and core stability treatment combined with PFM training to investigate the effects of 2 training programs on low back conditions,determine the differences between training programs with and without PFM training,and provide new ideas for rehabilitation of LBP from prolonged sitting.Methods: Sixty female participants had been recruited,and they were divided into 3 groups according to sit mainly during work or leisure time or both.Each group was then divided into 2 groups according to good or poor sitting posture.Patients were measured thickness and activation of transversus abdominis(Tr A)and lumbar multifidus(LM),the activation of pelvic floor muscle(PFM),trunk muscle endurance,spine mobility,sitting posture,general health questionnaire-28(GHQ-28)score,Oswestry Disability Index(ODI)and Visual Analog Scale score(VAS).Then pain developers(34 participants)were chosen,divided randomly into no-treatment group,core stability training group and core stability training combined with PFM training group.Training was given 3 times/ week,for 4 consecutive weeks.Patients did the same tests as above.Univariate analysis of variance or nonparametric test was used to compare the test results between each subgroup.Paired Sample T test or nonparametric test was used to compare the test results before and after treatment in each group.Results:(1)The thickness of LM was significantly lower in leisure-time sitting while lying than in occupational sitting group and occupational with leisure-time sitting group(p<0.05).And the thickness of LM was lower in leisure-time sitting while sitting than occupational with leisure-time sitting group(p<0.05).(2)After 4-week treatment,the activation of Tr A in core stability training group was significantly improved(p<0.01)and higher than no-treatment group(p<0.05).(3)After 4-week treatment,the activation of PFM in PFM training group was improved in supine position(p<0.05)and higher than core stability training group(p<0.05).In sitting position,the activation of PFM in core stability training group is reduced(p<0.05)and lower than PFM training group(p<0.01).(4)After 4-week treatment,the back muscle endurance in no-treatment group was reduced(p<0.01).The trunk muscle endurance was improved in core stability training muscle group(p<0.05),and significant improved in pelvic floor muscle training group(p<0.01).The endurance of flexor,extensor and right lateral abdominal muscle in PFM training group was higher than in no-treatment group(p<0.05).(5)After 4-week treatment,participants in PFM training group had more neutral position in lumbar area(p<0.05).(6)After 4-week treatment,the ODI in core stability group was improved significantly(p<0.01)and in PFM training group was also improved(p<0.05).(7)After 4-week treatment,the pain reduced in normal situation and after 2-hour prolonged sitting in PFM training group(p<0.01).Conclusions:(1)The muscle thickness of LM in leisure-time sitting was lower.However,different sitting situations had similar effects on activation of deep stability muscles,muscle thickness of Tr A,low back muscle endurance,sitting posture,LBP and psychological state.(2)Core stability training combined with PFM exercise had better effects on the overall fuction of deep muscle,trunk muscle endurance,sitting posture,disability and pain release. |
