Le réentraînement à l’effort de la lombalgie chronique nécessite-t-il un renforcement musculaire isocinétique quotidien du tronc ?

Abstract

Objective

The goal of this study was to determine the benefits of a functional retraining programme (with or without daily isokinetic reinforcement of the trunk muscles) in patients with lower-back pain.

Method

Two groups of 30 patients took part in the study. The control group (CG) underwent a four-week reconditioning program in a day hospital, whereas a second interventional group (IG) additionally performed daily isokinetic training of the trunk muscles. Three evaluations were carried out: before hospitalization (T₁), immediately after hospitalization (T₂) and three months postrehabilitation (T₃).

Results

We observed an improvement in each parameter after rehabilitation, regardless of the group. A decrease in the DALLAS scores revealed a reduced impact of lower-back pain on the patients’ lives. Pain experienced fell by 24%, analgesic treatment was significantly decreased (CG: − 53%; IG: − 56%), muscle endurance was improved (quadriceps: + 30%, abdominal muscles: + 20%, paraspinal muscles: + 23%, quadratus lumborum: + 33%) and the patients were more supple, as revealed by a decrease in the finger-to-ground distance (at T₁, CG: 12.9 ± 6.1 cm; IG: 13.6 ± 5.5 cm at T₁; CG: 2.2 ± 5.4 cm; IG: 2.8 ± 5.1 cm at T₂). The sole difference for CG and IG at T₂ resulted from an improvement in the performance of the trunk extensor muscles, which was significantly greater in the IG (CG: + 14%; IG: + 20%). Three months after rehabilitation, the benefits were still present for the two groups and, indeed, were even greater for certain parameters.

Conclusion

Regardless of the protocol, the patients improved in both physical and psychological terms and these improvements were maintained over a short period, at least. Our results confirmed that one functional recovery programme is not superior to another for patients with lower-back pain.