Effect of Selective Home-Based Exercises on Chronic Low Back Pain in Unilateral Below Knee Amputees

Different studies have shown different effects of exercise on low back pain. The aim of the present study was to assess the effect of selective home-based exercises on chronic low back pain in unilateral below knee amputees. In this randomized controlled clinical trial with pretest-posttest design conducted in 2016, 53 unilateral below knee amputees with chronic low back pain referred to Kowsar orthotic and prosthetic center to assess their health status were selected by random sampling method. They were randomly assigned to intervention group (n=29) and control group (n=24). An interventional exercise program for myofascial release, stretching, activation, and integration (5 days a week) was performed for the intervention group, but the intervention group did not receive any intervention. A numeric rating scale and an Oswestry Disability Index, abdominal endurance test, Modified Biering-Sørensen Test, and electromyography (EMG) signals were used to measure the effect of exercise on low back pain. The data were analyzed by SPSS software 20, using paired- samples and independent t-test. At the end of the training program in the intervention group, there was a significant decrease in pain score and disability index and a significant increase in extensor muscle endurance and  flexor muscle endurance (p<0.05). The electrical activity of lumbar multifidus and elector spinae muscles activity improved in the intervention group in comparison with control group (p<0.05). A comprehensive program with parts of myofacial release, stretching, activation, and integration affects the low back pain in lower limb amputees.