Lumbal mekaniği olumsuz etkileyen Hamstring gerginliğine yönelik egzessiz programlarının karşılaştırılması

Abstract

SUMMARY `A COMPARISON OF THE EXERCISE PROGRAMMES DESIGNED FOR HAMSTRING TIGHTNESS WHICH AFFECTS LUMBAL MECHANICS NEGATIVELY` Bayram ÜNVER P.T. Low back pain has already reached epidemic proportions nowadays. It is a problem of the muscuiosceleta! system which causes considerable manpower and financial losses. The length of hamstring muscles affects pelvic tilt and lumbal curve. Tight hamstring muscles limit hip mobility during activities and cause the vertebral column to be overloaded in majority of movements performed without bending the knees. The stress, originating from this excessive load, is placed especially on the lumbo-sacral vertebrae, posterior annular part of the disc, posterior ligaments and erector spinal muscles. Additionally, the indirect effect on the posture eventually leads to excessive stress on the ligaments and degeneration of the articulation triad of the vertebra. The result is chronic back and low back pain. The hamstrings, unable to reach their sufficient length, exert negative effects on the outcome of conservative and surgical treatment by leading to abnormal movement patterns. This prospective study was carried out at Dokuz Eylül University, School of Physiotherapy during November 1996- November 1997. The subjects were randomly chosen among the patients who were seen at Orthoapedics and Traumatology Department for low back pain and leg pain, without any accompanying neurologic and motor deficiency. The subjects, 40 in number, ail with hamstring tightness, were randomly divided into four groups, 10 patients in each group. In group one 30 seconds passive, in group two 60 seconds passive, in group three 30 seconds hold-relax and in group four 60 seconds hold-relax stretching exercises were administered. The treatment period was of two months duration and each patient received 3 session per week and 10 repetitions per session. A reduction in low back pain and improvement in functional level, compared to pre- treatment period, were observed in all groups, as a consequence of the decrease in hamstring tightness (p<0.05). Active and passive stretching exercises are effective in relieving hamstring tightness. Compared to passive stretching, active (Hold-relax) techniques were found to be moreeffective(p<0.05). The passive stretching of sixty-second duration, compared to that of thirty- second duration, was found to yield more flexibiiity(p<0.05). However, no difference was found, in terms of relieving hamstring tightness, between the hold-relax technique of thirty- second duration and that of sixty -seconds duration. In conclusion, relieving hamstring tightness helps to prevent the development, continuation and recurrance of back problems. Active stretching techniques can be preferred to passive stretching. A thirty-seconds duration is enough in active stretching exercises. However, a sixty-seconds duration is suggested for passive stretching. Key words: Low Back Pain, Hamstring Tightness, Passive Stretching, Active(hold- relax) Stretching, Stretching Duration.

SUMMARY `A COMPARISON OF THE EXERCISE PROGRAMMES DESIGNED FOR HAMSTRING TIGHTNESS WHICH AFFECTS LUMBAL MECHANICS NEGATIVELY` Bayram ÜNVER P.T. Low back pain has already reached epidemic proportions nowadays. It is a problem of the muscuiosceleta! system which causes considerable manpower and financial losses. The length of hamstring muscles affects pelvic tilt and lumbal curve. Tight hamstring muscles limit hip mobility during activities and cause the vertebral column to be overloaded in majority of movements performed without bending the knees. The stress, originating from this excessive load, is placed especially on the lumbo-sacral vertebrae, posterior annular part of the disc, posterior ligaments and erector spinal muscles. Additionally, the indirect effect on the posture eventually leads to excessive stress on the ligaments and degeneration of the articulation triad of the vertebra. The result is chronic back and low back pain. The hamstrings, unable to reach their sufficient length, exert negative effects on the outcome of conservative and surgical treatment by leading to abnormal movement patterns. This prospective study was carried out at Dokuz Eylül University, School of Physiotherapy during November 1996- November 1997. The subjects were randomly chosen among the patients who were seen at Orthoapedics and Traumatology Department for low back pain and leg pain, without any accompanying neurologic and motor deficiency. The subjects, 40 in number, ail with hamstring tightness, were randomly divided into four groups, 10 patients in each group. In group one 30 seconds passive, in group two 60 seconds passive, in group three 30 seconds hold-relax and in group four 60 seconds hold-relax stretching exercises were administered. The treatment period was of two months duration and each patient received 3 session per week and 10 repetitions per session. A reduction in low back pain and improvement in functional level, compared to pre- treatment period, were observed in all groups, as a consequence of the decrease in hamstring tightness (p<0.05). Active and passive stretching exercises are effective in relieving hamstring tightness. Compared to passive stretching, active (Hold-relax) techniques were found to be moreeffective(p<0.05). The passive stretching of sixty-second duration, compared to that of thirty- second duration, was found to yield more flexibiiity(p<0.05). However, no difference was found, in terms of relieving hamstring tightness, between the hold-relax technique of thirty- second duration and that of sixty -seconds duration. In conclusion, relieving hamstring tightness helps to prevent the development, continuation and recurrance of back problems. Active stretching techniques can be preferred to passive stretching. A thirty-seconds duration is enough in active stretching exercises. However, a sixty-seconds duration is suggested for passive stretching. Key words: Low Back Pain, Hamstring Tightness, Passive Stretching, Active(hold- relax) Stretching, Stretching Duration.