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Volume 10, Issue 1 (Spring 2023)                   J Prevent Med 2023, 10(1): 72-87 | Back to browse issues page

Ethics code: IR.SH AHROODUT.REC.1401.024


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Naderi A, Rahimi M, Yazdian A. Effect of Six Weeks of TRX Exercise on General and Specific Motor Function and Quality of Life of Middle-aged Women With Lumbar Motor Control Impairment. J Prevent Med 2023; 10 (1) :72-87
URL: http://jpm.hums.ac.ir/article-1-668-en.html
1- Department of Sport Sciences, Faculty of Physical Education and Sport Sciences, Shahrood University of Technology, Shahrood, Iran.
2- Department of Corrective Exercise and Sport Injury, Faculty of Physical Education and Sport Sciences, Shahid Rajaee Teacher Training University, Tehran, Iran.
3- Department of Sport Science, Physical Education and Sport Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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Introduction
One of the important mechanisms involved in the development of back pain is the reduction of coordination and motor control (MC) in the trunk. According to the conducted research, when the control of back muscle movement undergoes changes due to inappropriate postures or repetitive and faulty movement patterns, a person has less ability to control the movements and function of the back when changing positions. Therefore, it causes back pain or other musculoskeletal disorders in the lower back. Considering that the diagnosis of faulty movement patterns or kinesiopathology is one of the key factors for the prevention and treatment of musculoskeletal pain, movement disorders are important for health professionals. The main assumption is that impaired MC and lack of awareness of maladaptive movement patterns cause pain persistence. Health professionals usually make clinical decisions based on observation of MC. O’Sullivan reported the decrease in MC and excessive movement of the spinal segments as the cause of pain. Sahrmann in his theory of relative flexibility suggested that movement occurs through the path of least resistance. For example, if the movement of the pelvis is relatively stiff compared to the movement of the back, movement occurs in the lower back, which can eventually lead to back pain. In many studies, exercises have been recommended to improve back pain. One of these exercises is the total body resistance exercise (TRX) which is a new type of training method that uses gravity or body weight with the help of a lever bar and resistance cord. So far, no research has investigated the effect of these exercises on the functional movement and MC screening test scores of middle-aged women with MC impairment in low back; Therefore, the current study aims to investigate the effect of 6 weeks of TRX on the general and specific performance of middle-aged women with lumbar MC impairment.

Methods
This is a quasi-experimental study with a pre-test/post-test design using a control group, which was conducted in 2019 at the Block Power Fitness Club of Enghelab Sports Complex in Tehran, Iran. Participants were 30 middle-aged women (with an age range of 35 to 55 years) suffering from lumbar MC impairment who were selected purposefully and based on the entry and exit criteria from the north, northwest and east of Tehran. Lumbar-specific motor function was evaluated by Luomajoki lumbar movement control dysfunction screening method, and the general motor function was evaluated by functional movement screening (FMS) method. Participants in the intervention group began TRX exercises approximately one week after the initial assessments. The exercises were done for six weeks, 3 sessions per week, every other day, in the Block Power Fitness Club. Whitin-group differences were analyzed by paired t-test and between-group differences were analyzed by analysis of covariance. All analyses were done in SPSS software, version 21. The significance level was set at 0.05.

Results
The results of the paired t-test showed that the mean scores of FMS tests (i.e. deep squat, in-line lunge, rotatory stability, shoulder mobility, swimming on the floor, active straight-leg raise, and hurdle step) improved significantly from pre-test to post-test in the experimental group performed 6 weeks of TRX exercises (P<0.01). The mean score of Luomajoki Lumbar Movement Control Dysfunction Screening tests (Waiter’s bow, sitting knee extension, rocking backwards, prone lying knee flexion, posterior pelvic tilt, single-leg stance) also improved significantly from pre-test to post-test in the TRX group (P<0.01). For the control group, there was no significant difference between pre-test and post-test scores in any variables (P<0.05). After controlling the effect of the pre-test as a covariate, the results of analysis of covariance showed that 6 weeks of TRX had a significant effect on the general and specific motor function and the quality of life (QoL) of middle-aged women with lumbar MC impairment (P<0.01).

Discussion
The results of this study showed that six weeks of TRX exercises had a significant effect on the general motor function (FMS tests scores) and specific motor function (Luomajoki tests scores) of middle-aged women with lumbar MC impairment. The effect size of this exercise on general motor function ranged 0.88-1.50; for specific motor function, it was in the range of 0.95-2.7, and for the QoL it was 1.65. The role of the trunk muscles in protecting the spine from harmful pressures has been reported in different studies. These muscles help maintain the natural alignment of the body when standing and control the body when bending and straightening. According to this theory, reduced endurance of the trunk muscles causes muscle fatigue and increases the pressure on the soft tissue and passive structures of the lumbar spine. In addition, since the endurance capacity of the muscles is an indication of their ability to withstand fatigue, it is thought that people with lower muscular endurance in the trunk muscles are more exposed to structural pressures, which may lead to inappropriate pressures on the spine and cause back pain. It is recommended that physiotherapy and corrective movement specialists use TRX to improve general and specific motor function in middle-aged women with lumbar MC impairment.

Ethical Considerations
Compliance with ethical guidelines

This study approved by Research Ethics Committee of Shahrood University of Technology (Code: IR.SHAHROODUT.REC.1401.024).

Funding
This research is taken from MSc thesis of Atefeh Yazdian, approved by Department of Sport Science, Islamic Azad University, Science and Research Branch.

Authors' contributions
Conceptualization and Investigation: Aynollah Naderi and Atefe Yazdian; Methodology, writing–original draft and review & editing, resources and supervision: All authors.

Conflicts of interest
The authors have no conflicts of interest to declare that are relevant to the content of this study.

Acknowledgements
The authors sincerely thank all the people who cooperated in this research.

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Type of Study: Orginal | Subject: Special
Received: 2022/10/22 | Accepted: 2023/07/1 | Published: 2023/07/1

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