Effect of Diaphragmatic Breathing Exercise on Hamstring Length and Functional Disability in Subjects with Chronic Low Backache: A Quasi-experimental Study

Abstract

Introduction: The diaphragm is one of the most significant skeletal muscles in the human body, performing vital respiratory functions. It is not only the primary inspiratory muscle but is also involved in non respiratory activities and plays a dynamic role in Postural stabilisation. Low Back Pain (LBP) is the leading cause of disability worldwide, presenting a significant health issue that imposes substantial social and economic costs on both the community and healthcare systems. Although the precise cause of non specific LBP is still unknown, its progression has been greatly affected by mechanical factors that are generally agreed upon. Aim: To determine the effect of diaphragmatic breathing exercises on hamstring length and functional disability in subjects with chronic LBP. Materials and Methods: A single-group pre- to post-test quasi-experimental study was conducted with 66 subjects at the Padmashree Rehabilitation Centre, Bengaluru, Karnataka, India from June 2023 to August 2023. Ethical clearance was obtained from the Padmashree Institutional Ethical Committee, and the subjects were recruited based on specific selection criteria. Baseline variables, including age, gender, and Body Mass Index (BMI), were recorded. The main outcomes measured were the Active Knee Extension (AKE) test and the Oswestry Disability Index (ODI) Questionnaire. Values before and after the intervention were recorded and a paired sample t-test was used to compare the scores before and after the intervention. Results: The pretest mean score was 27.85±2.40, while the post-test mean score was 24.77±2.26 (AKE RT). The paired t-test indicated a significant improvement in AKE postintervention for both the right and left lower limb (p-value<0.001). The ODI scores significantly decreased from a pretest mean of 40.41±12.86 to a post-test mean of 36.30±10.08 (p-value<0.001). Conclusion: The diaphragmatic breathing exercise demonstrated a significant improvement in AKE scores and the disability index. The improvements were statistically significant, indicating the effectiveness of the intervention in enhancing flexibility and reducing disability in participants with chronic LBP.

Keywords

• active knee extension test
• chronicity
• extensibility