EFFECTIVENESS OF THORACIC MOBILITY EXERCISE VERSUS MANUAL RELEASE TECHNIQUE IN MINIMIZING MECHANICAL UPPER BACK PAIN (UBP) AMONG UNDERGRADUATES IN SRI LANKA

Abstract

Introduction: Upper Back Pain refers to pain anywhere in between T1 to T12 area which referred as “Cinderella” region because of less research focus. Currently, Upper Back Pain common among young population significantly undergraduates due to poor ergonomics, academic work load and stress which is higher among Sri Lankan undergraduates. There are few studies focus on therapeutic techniques and effectiveness regarding Upper back Pain. Objective: Compare the effectiveness of thoracic mobility exercise in combination with breathing with manual release technique which includes thoracic mobilization technique and myofascial release technique in improving pain intensity, muscle strength, thoracic spine mobility and self-efficacy. Method: This Study was Double-Blinded randomized Control Trail, 60 participants were selected and randomly allocated in experimental and control group by lottery method. 57 were completed the study. Allocation was concealed and participants and accessors were blinded. Experiment group receives thoracic mobility exercise training and control group provided with manual therapy for 3 times a week for 2 weeks. Individuals were assessed for pain intensity, thoracic mobility, muscle strength of thoracic extensors and self-efficacy at baseline and after the intervention. Results: In demographic characteristics, BMI of participants associated with present intensity (p=0.006). Participants’ pain intensity who are under overweight (22.5-26.9kg/m2) and obese (>27kg/m2) shows increased tendency in VAS scale. Both groups are similar at baseline. After intervention, significant difference in present pain intensity, and pain intensity during sitting, forward bending, walking, and standing and in activities of daily living in experiment group than controls. Experiment groups indicated a significant improvement in thoraco-lumbar extension (p=0.036), muscle strength of thoracic spine extensors in Oxford grading Scale (p=0.000). Further, significant improvement in pain intensity except walking and standing, thoracic mobility except thoraco-lumbar extension in control group. Moreover, both group showed improvement in self-efficacy. Conclusion: Thoracic mobility exercises in combination of breathing are more effective exercises in managing upper back pain than manual release technique which 2 can effectively improve upper back pain and spine health among undergraduates or young population without any therapeutic assistance. Key word: Upper Back Pain, Undergraduates, Thoracic mobility exercises, Manual Release technique and Muscle strength