Clinical Evaluation of the Peak Expiratory Flow Rate in Patients with Chronic Low Back Pain: A Cross-sectional Study

Abstract

Introduction: Stabilisation of the spine is done by the abdominal and extensor muscles of the back. In chronic Low Back Pain (cLBP) patients, atrophy of these muscles lead to neuromuscular weakness and this may result in instability of the spine. Spinal instability and ineffective forced expiration due to weak contraction of the muscles may reduce the pulmonary function. Aim: To find the alteration of Peak Expiratory Flow Rate (PEFR) in patients with cLBP and the factors responsible for it. Materials and Methods: The cross-sectional study done in Maharashtra Institute of Physiotherapy, Latur, Maharashtra, India, from June 2019 to January 2020. Hundred patients with cLBP were recruited. Age, gender, weight, height and duration of the symptoms were recorded for demographic values. The PEFR was measured by Mini-Wright peak flow meter. Highest value of the three repetitions was documented for analysis. Statistical Package for the Social Sciences (SPSS) version 20.0 version was used to calculate the Pearson’s correlation between the variables. Results: Mean age of the participants were 37.31 years, and there were 50 males. Correlation coefficient between the patient value and their expected value of PEFR was 0.906 (p-value <0.01). Calculated t-value of 52.0733 (p-value <0.0001) showed a statistically significant reduction of PEFR value in cLBP patients in comparison to their expected PEFR value, calculated by the machine based on the age, height and weight of the individual person. Conclusion: It was found that the reduction in PEFR among cLBP patients is due to core muscle weakness, instability of the spine, pain and kinesiophobia. Thus, clinicians should design their treatment to include the exercise to increase the PEFR in the management of cLBP.

Keywords

• forced expiration
• peak flow
• pulmonary function
• spirometry