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  • Article
    Role of Latissimus Dorsi-Thoracolumbar Fascia Complex Stretching on Pain and Pain-Related Parameters in Patients With Chronic Low Back Pain: A Randomised Clinical Trial
    (Wiley, 2025) Ulug, Naime; Kodak, Seyde Busra; Kodak, Muhammed Ihsan; Aslan, Sema Nur
    Background Fascial stretching is gaining interest as a potential intervention for pain management. However, evidence regarding the effect of latissimus dorsi-thoracolumbar fascia (LD-TLF) complex stretching in patients with chronic low back pain (CLBP) remains limited. Therefore, this study aimed to investigate the effects of LD-TLF complex stretching on pain-related factors and disability in patients with CLBP. Methods Thirty patients with CLBP were randomly assigned to a study group (n = 15; 7 men, 8 women) and a control group (n = 15; 7 men, 8 women). The study group received 4 weeks of LD-TLF complex stretching in combination with conventional physiotherapy, while the control group received conventional physiotherapy only. Outcomes were assessed before and after the interventions, including primary measures of pain pressure thresholds (PPT) at thoracolumbar fascia levels (L1, L3 and 12th costa), and secondary measures included the Pain Sensitivity Questionnaire (PSQ), the effects of pain on daily activities measured by the Brief Pain Inventory (BPI), and disability assessed by the Oswestry Disability Questionnaire (ODQ). Results Pre- and post-treatment PPTs, at the L1, L3 vertebrae and 12th costa levels, demonstrated significant differences between the study group and control groups. Post-treatment thresholds were significantly higher compared to pre-treatment thresholds (p < 0.001, eta p(2) = 0.67; p < 0.001, eta p(2) = 0.61; p < 0.001, eta p(2) = 0.74). Additionally, significant improvements were found in PSC, BPI and ODQ scores in the study group compared to the control group (p < 0.05). Conclusion The results of this study suggest that stretching the LD-TLF complex may be a beneficial addition to the conventional physiotherapy approach for patients with CLBP. Specifically, LD-TLF complex stretching, when used in combination with conventional physiotherapy, appears to provide improved pain thresholds, decreased pain sensitivity and pain during activity, as well as reduced disability compared to conventional physiotherapy alone in patients with CLBP.
  • Article
    Citation - WoS: 1
    Citation - Scopus: 2
    Effects of Reformer Pilates on Pain, Psychological Factors, and Sleep in Chronic Musculoskeletal Pain: A Randomized Controlled Trial
    (Springernature, 2025) Sahan, Nilay; Ulug, Naime; Ozeren, Aysenur
    BackgroundMusculoskeletal disorders that follow a chronic course are associated with many symptoms, the most striking one is chronic pain that gradually worsens. The aim of this randomized controlled and single- center study was to investigate the effect of Reformer Pilates exercises on pain severity, pain coping methods, pain beliefs, fear of movement, fatigue and sleep quality in young adult patients with chronic low back pain and neck pain.MethodsA total of 54 women aged between 30 and 50 were randomized into two groups. The Reformer Pilates (RP) group received a 6-week exercise program (45 min/twice per week), while the control group (CG) didn't receive any exercise program. Outcomes measured before and after the interventions were, Brief Pain Questionnaire, Pain Coping Scale, Pain Beliefs Scale, Tampa Kinesiophobia Scale, FACIT Fatigue Scale and Pittsburg Sleep Quality Index.ResultsThe groups were homogeneous at baseline. Statistical differences were found in favour of RP with small to large effect size in pain parameters (p < 0.05; Cohen's d = 0.17-1.45), large effect size in fear of movement, small effect size in fatigue and medium effect size in sleep quality (p < 0.05; Cohen's d = 0.43-0.86). No statistical difference between the groups was observed only in the pain beliefs organic sub-heading of the Pain Beliefs Scale and in the passive strategies sub-headings of the Pain Coping Scale (p > 0.05).DiscussionThe results of the current study suggest that Reformer Pilates increased active living in patients with chronic low back pain and chronic neck pain engenders a comprehensive enhancement in both physical and mental health, in addition to the capacity of patients to proactively manage their condition.Trial registrationRegistration number: NCT06706037. Date of registration: 11/25/2024.