Effect of breathe held at maximum expiration on pain, range of motion, quality of life and breathing function on patients with low back ache

Study Objectives: To check whether Does breathe held at maximal expiration could decrease pain and improve the range of motion, QOL and breathing function in non specific low back ache patients. Low back pain is a very common problem in general population. 70-85% of people have back pain at some time in their life. (Andersson, 1997) Low back pain is defined as pain localized between the 12th rib and the inferior gluteal folds, with or without radiation to legs. (Thompson et al., 2000) The mechanism of low back pain may be due repetitive loads on back causes decrease in the elasticity of disk. (Thompson et al., 2000; Andreas Prescher, 1998) Fissures and tears occur within annular fibers, which decrease the ability of the disk to provide stiffness during movement. Available literature demonstrate the definite impact of low back pain on psychological and functional status affecting health related quality of life of patients. (Kovacs Francisco et al., 2004) Some authors have evaluated the cause or effect relationship between the altered biomechanics of spine leading to back pain. (Lane et al., 1993; O’Neill et al., 1999) In addition, recent evidences suggest that diaphragm contribute biomechanically to maintain trunk stability It has been found that diaphragm by activation of the phrenic nerve resulted in an increase in intra-abdominal pressure with subsequently enhanced spinal stiffness. (Hodges et al., 2005) Diaphragm plays two roles - acts as trunk stabilizer and help in respiration. (Hodges and Gandevia, 2000) Valsalva maneuver has several effects that improve spinal stability. Design: An Experimental Study. Methods: A total of 40 subjects were recruited for the study on the basis of inclusion and exclusion criteria after obtaining informed consent. The subjects were divided into two groups Group A (Breathe Held at Maximum Expiration n=20), and Group B (Traditional Core Stability Exercises n=20). Outcome Measure: Pain using Visual Analogue Scale, ROM using SLR and Breathing function using SEBQ and Quality of Life using WHO QOL-Bref Scale. Results: Analysis of Pain, ROM, Breathing Function and QOL showed that both the group proved to be effective in decreasing the Pain, ROM, Breathing Function and QOL level independently. When results were compared between the groups, Group A showed better improvement than Group B. However the results were statistically insignificant. Conclusion: This study depected that breathe held at maximum expiration technique is effective on decreasing pain, improving ROM and breathe function along with QOL in patients with LBA.