Effects of Floor and Swiss Ball Exercise on the Rehabilitation of Back Pain

Back pain is common; approximately nine of ten adults experiencing it at some point in their lives, and five of ten working adults experience back pain each year.(A.T. Patel, and A.A. Ogle., 2007) Some estimate that as many of 95% of people will experience back pain at some point in their lifetime. It is the most common cause of chronic pain and is a major contributor to missed work and disability. (Church E, Odle T, 2007) For most individuals, back pain is self-limiting. Most people with back pain do not experience chronic severe pain but rather persistent or intermittent pain that is mild or moderate. In most cases of herniated disks and stenosis, rest, injections or surgery have similar general pain-resolution outcomes on average after one year. It is the single leading cause of disability worldwide.(Manchikanti L, et.al. 2009).

Moderate-quality evidence exists that suggests that the combination of education and exercise may reduce an individual's risk of developing an episode of low back pain. Lesser-quality evidence points to exercise

alone as a possible deterrent to the risk of the condition.( Patel et al., 2017)

The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible, to restore the individual's ability to function in everyday activities, to help the patient cope with residual pain, to assess for side effects of therapy and to facilitate the patient's passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain at a manageable level to progress with rehabilitation, which then can lead to long-term pain relief. Also, for some people the goal is to use nonsurgical therapies to manage the pain and avoid major surgery, while for others surgery may represent the quickest path to pain relief.(Baron R, et.al. 2016). Exercise is one of the most important parts of a treatment program for people with pain that lasts more than a few days. In fact, if any one have many minor episodes of neck or back pain, exercise usually should be part of the treatment. For the more lasting problems, exercise is a must. One of the few solid scientific research studies in this area of medicine

feeling better and those who were feeling worse. They studied people who had a low back injury at work, and were treated with various methods of treatment. The people were not all treated by the same doctors or in the same way. Swissball are highly effective when used for general fitness and these exercises can either be done in the home or gymnasiums. For this it is not having to lie on a hard floor, instead it gives training much more comfortably a primary benefit of exercising with a Swiss ball as opposed to exercising directly on a hard flat surface is that the body responds to the instability of the ball to remain balanced, engaging many more muscles to do so. Those muscles become stronger over time to keep balance. Most frequently, the core body muscles, the abdominal muscles and back muscles are the focus of exercise ball fitness programs. Athletic rehabilitation is the reconditioning of an injured athlete to his or her highest level of function in the shortest possible time. This level of function is generally higher than that of a non athlete. Athletic trainers must be skilled in developing programs to effectively rehabilitate an athlete in minimal amount of time. Depending on the nature and the conditions surrounding the injury Rehabilitation require a progressive, systematic program that develops range of motion, muscular strength and endurance, co-ordinated movements, functional activities and circula respiratory endurance. Although each of these phase overlap maximal development of any phase requires prior development of the preceeding phase. Rehabilitation also includes total body conditioning maintenance occurring concurrently with restoration of the injured area. So the athlete can meet the physical demands of athletic activity when returning to participation (Batt et al. 1996) . Marshall and Murphy (2008) selected sixteen-week intervention for chronic patients with low back pain (LBP) to find out the effect of supervised Swiss ball exercise and found Self-rated disability improved more after the treatment period for individuals who received supervised exercise compared with advice alone. Marshall and Murphy (2006) made a pilot study was to use a multidimensional model to evaluate deficits in patients with low back pain (LBP) over the course of a 12-week rehabilitation program using the Swiss ball. The score for self-reported disability significantly decreased over the intervention Significant improvements in pain and disability maintained to the 3 months of follow-up. Hubley-Kozey and Vezina (2002) studied the ―Muscle activation during exercises to improve trunk stability in men with low back pain‖ All 3 exercises could be used as initial exercises in a dynamic stability progression when low-recruitment amplitudes of specific muscles

The research findings proved that swiss ball exercises contributed for the reduction of back paid through strengthening the muscles and floor exercises also contributed for muscle activation to improve trunk stability. This study aims at finding out the effect of floor exercises and swiss ball exercises on back pain.

The subjects for the study were selected from middle aged women who complained of back pain. They were of sixty women age between 35 to 45. The subjects expressed their willingness to participate in the study as they are interested to reduce their back pain.. They were selected at random for the study. The investigator has selected only one dependent variable, namely, back pain.

The researcher used the random group design in this study. In this research design randomly selected sixty women who suffered from back pain. They were measured of their back pain through administration of Questionnaire and their initial back pain was determined. The subjects were randomly divided into three experimental groups, consisting of twenty subjects each. First experimental group underwent floor exercises prescribed for rehabilitation of back pain, the second experimental group underwent swiss ball exercises and the third group acted as control group. The experimental period was for five weeks. After the experimental period of five weeks, the subjects were tested of their back pain level through administration of the questionnaire. The difference between the pre and post experimental scores were considered the effect of the respective trainings given. The data collected were statistically analysed through Analysis of Covariance (ANCOVA).

(Scores in Number) Table F-ratio at 0.05 level of confidence for 2 and 57 (df) =3.15, 2 and 56(df) =3.15 . *Significant Since significant improvements were recorded, the results were subjected to post hoc analysis using Scheffe‘s Confidence Interval test. The results were presented in Table II

(Scores in Number) * Significant The ordered adjusted means were presented through bar diagram for better understanding of the results of this study in Figure I.

complaints. In the U.S., acute low back pain (also called lumbago) is the fifth most common reason for physician visits. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year. As shown in Table I, the obtained F value on the scores of pre test means 1.29 was less than the required F value, which proved that the random assignment of the subjects were successful and their scores in back pain before the training were equal and there was no significant differences. Taking into consideration of the pre test means and post test means adjusted post test means were determined and analysis of covariance was done and the obtained F value 20.23 was greater than the required value of 3.15 and hence it was accepted that the floor exercises, and swiss ball exercises significantly reduced the back pain of the subjects compared to control group. The post hoc analysis of obtained ordered adjusted means proved that there was significant differences existed between swiss ball exercise group and control group and floor exercises group and control group. This proved that due to five weeks swiss ball exercises and five weeks floor exercises the subjects‘ back pain was reduced significantly. However, there was no significant reduction in back pain in the case of floor exercise group The results of this investigation made an attempt in rehabilitation of back pain among women. The findings of this study proved that all the two types of rehabilitation programmes reduced back pain. However, significant reduction in back pain were noted in swiss ball exercises group and floor exercises group than control group, as the obtained mean differences were greater than the required Scheffe‘s confidence interval. This study is in agreement with the studies of Verbunt JA. (2008) who found PAD questionnaire is reliable and valid in measuring back pain and physical activity reduced back pain.

It was concluded that swiss ball exercises and floor exercises can be suggested for reducing back pain among women.

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M.P.Ed Student, Pragathi College of Physical Education, (Recognized by the NCTE, Affiliated to Andhra university, Visakhapatnam).Kothavalasa, Vizianagaram (Dt). Andhra Pradesh-535183