Eligibility assessment (n=184) Excluded (n=57) Unwillingness (n=20) Unmet inclusion criteria (n=37) Group assignment (n=127) The experimental group: Receiving stretching exercise intervention (n=64) 2-month follow-up The control group: Usual activity (n=63) Attrition from the study (n=8) Undesirable exercise program (n=2) Physical discomfort (n=3) Unable to cooperate (n=3) 4-month follow-up Attrition from the study (n=10) Undesirable study (n=6) Unable to cooperate (n=4) Attrition from the study (n=3) Undesirable exercise program (n=1) Physical discomfort (n=2) 6-month follow-up Attrition from the study (n=3) Undesirable study (n=1) Physical discomfort (n=1) Unable to cooperate (n=1) Analyzed (n=64) Analysis Analyzed (n=63) Flow chart of the participants recruitment in this study.
Warming-up exercise Back pain exercise 1. Pelvic tilt exercise Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. 2. Partial curl Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles and flatten your back against the floor. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Breathe out as you come up. 3. Lying supine hamstring stretch Lie on your back with a small rolled towel under your waist (lower back). Place your left leg down with knee straight. Bend your right hip so your knee is pointing to the ceiling. Hold your right thigh by interlocking your fingers. Keep your elbows straight while holding and straightening your right knee and move the foot toward the ceiling. Switch sides. 4. Double Knees Lying on the floor, pull your knees into your chest and clasp your to Chest hands under your knees. Gently press your hips to the floor. 5. Spinal Twist Lying on the floor, place your right foot on the left knee. Using your left hand, gently pull your right knee towards the floor, twisting your spine and keeping your left arm straight out, hips and shoulders on the floor. Switch sides. 6. Press-up back Lie on your stomach with your hands under your shoulders. Push extensions with your hands so your shoulders begin to lift off the floor. 7. Cat Stretch In a hands and knees position, place your hands under the shoulders and the knees under your hips. Let your head drop down while at the same time tuck your hips under and raise themiddleofyourbackashighasyoucan. 8. Camel Stretch In a hands and knee position, place your hands under the shoulders and the knees under your hips. Raise your head up whileatthesametimeraiseyourhipsupandallowyour stomach to fall to the floor. 9. Stretches back of leg and lower back 10. Stretches lower back, side of hip and neck 11. Stretches side of hip, hamstrings Core Muscles Training 1. Alternate arm and leg (bird dog) exercise 2. Hip flexor stretch Sit on floor, legs straight out at sides. Bend left leg in at knee. Slowly bend forward from hips toward foot of straight leg until you feel a slight stretch. Do not dip head forward at start of stretch. Repeat on other side, foot of straight leg upright, ankles and toes relaxed. Sit on floor with left leg straight out in front. Bend right leg, cross right foot over, place outside left knee. Bend left elbow and rest it outside right knee. Place right hand behind hips on floor. Turn head over right shoulder, rotate upper body right. Switch sides. Sit on floor with right leg straight out in front. Bend left leg, cross left foot over, place outside right knee. Pull left knee across body toward opposite shoulder. Switch sides. Try to keep your body straight at all times, and don t let one hip drop lower than the other. Start on the floor, on your hands and knees. Tighten your stomach muscles. Raise one leg off the floor and hold it straight out behind you. Do not let your hip drop down, because that will twist your trunk. Lower your leg and switch to the other leg. Kneel with one knee bent and one leg behind you. Position your forward knee over your foot. Keeps other knee touching the floor. Slowly push your hips forward until you feel the stretch in the upper thigh of your rear leg. 10 minutes 30 minutes 10 seconds, 8 12 times 3seconds, 10 times 30 seconds, 2 4 times 15 30 seconds, 2 4 times 5times 5seconds, 10 times 5seconds, 10 times 10 20 seconds 10 15 seconds 10 20 seconds 10 30 seconds, 8 12 times 15 30 seconds, 2 4 times (Continued )
3. Standing Quadriceps Stretch Relax exercise Stand a little way, away from wall and place left hand on wall for support. Standing straight, grasp top of left foot with right hand. Pull heel toward buttock, and hold 10 20 seconds. 10 20 seconds, 8 12 times 10 minutes c <
t c p Age (year) 30.67 (4.45) 37.70 (8.88) 5.65.01 Weight (kg) 54.14 (7.61) 56.36 (9.93) 1.14.16 Education 3.63.16 Vocation 2 (4) 6 (10) College 38 (59) 31 (49) University 24 (37) 26 (41) Marital status 2.09.15 Single 52 (82) 46 (73) Married 12 (18) 17 (27) Working unit 1.85.61 Medical 18 (27) 33 (52) Surgical 46 (73) 30 (48) Frequency of low back pain 0.46.79 Every day 14 (22) 15 (24) 1 2 times/week 24 (37) 20 (31) 1 2 times/month 26 (41) 28 (45) Previous management of pain 2.44.87 Analgesics 9 (14) 6 (10) Visiting a doctor 6 (10) 4 (6) Exercise 13 (20) 11 (18) Do nothing 28 (43) 26 (41) Rest 8 (13) 16 (25) Low back pain education 3.26.35 No 52 (82) 57 (91) Yes 12 (18) 6 (9) VASP visual analog scale for pain. Demographic characteristics and pretest means (SD) by group.
= = p VASP Time 0 4.12 (1.81) 4 7 4.06 (2.07) 4 7 4.61.110 Time 1 3.75 (1.61) 2 6 3.69 (2.08) 3 7 5.89.040 Time 2 2.94 (1.56) 1 4 3.46 (1.87) 2 6 6.65.011 Time 3 2.17 (1.42) 0 3 3.48 (1.77) 1 5 27.71.002 Exercise self-efficacy Time 0 51.35 (1.27) 33 63 52.03 (0.04) 32 63 589.12.142 Time 1 57.15 (1.21) 35 70 52.15 (1.89) 35 62 429.69.065 Time 2 54.33 (0.61) 35 69 52.68 (0.06) 32 66 141.95.021 Time 3 55.83 (0.62) 37 70 52.55 (1.32) 34 64 209.41.003 VASP visual analog scale for pain. Time 0: baseline; Time 1: 2-month post-test; Time 2: 4-month post-test; Time 3: 6-month post-test.