THU0731-HPR The abdominal hypopressive technique can be used to treat low back pain?
Authors: L. Soriano, L. Carmona, J.B. Negrón
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In 1980, Dr. Marcel Caufriez created the abdominal hypopressive technique (AHT) with the goal of reprograming the core muscles. The term hypopressive refers to the decrease of the pressure related to the thoracic, abdominal and pelvic cavities. However most traditional exercises are hyperpressive – they increase the internal pressure. In addition, conventional core exercises train conscious control, but the core is designed to cope at a subconscious level. Publications testing AHT are surprisingly low and are mostly published in not indexed journals. Despite the lack of scientific evidence to support its benefits, AHT is gaining popularity among European physiotherapists as a recommended treatment for a wide spectrum of disorders. <h3>Objectives</h3> To test the effect of a structured AHT program on low back pain intensity and disability in women and the retention of effect after two-month. <h3>Methods</h3> A cross-over intervention trial with random assignment and blind assessments was carried-out. The experimental sequence included a first period of intervention or control (rest), and a second period in which the initial groups were switched to the complementary. The exercises included in the AHT program were standardised by two Doctors in Physiotherapy trained in this technique. Measures were taken by a trained physiotherapist blinded to the group allocation at baseline, after finishing the first period, and after completing the entire sequence. Efficacy was defined as changes between groups in low back pain intensity and disability, measured with a visual analogue scale (VAS) and the Oswestry Disability Index (ODI) respectively. <h3>Results</h3> Overall, 42 participants were randomly assigned to a sequence (n=21 for each group). From the initial sample, 88% have been diagnosed by a physician with low back pain at least once in their lives and 100% of them self-reported low back pain at baseline. Baseline low back pain intensity measures did not differ between groups. The VAS for the group that started as control was 4.0 (2.5 to 5.4) vs 4.3 (2.8 to 5.7) for the group that started with the AHT program (p=0.774). However, the difference (Δ) after two months was statistically significant between groups (group that started as control, 0.3 (-0.1 to 0.6) vs the group that started with AHT, −2.7 (-3.9 to −1.6); p=&lt;0.001). Improvements decayed by 0.87 after a two-month follow up (p=0.094). Regarding low back pain disability, similar results were found. ODI baseline measures between groups were not significantly different with 10.3 (5.7 to 14.9) for the group that started as control and 7.7 (4.1 to 11.3) for the group that started with the AHT program (p=0.368).The Δ after two months showed that both groups improved (started as control, −0.2 (-2.7 to 2.4)) but the improvement in the AHT group was greater (−3.5 (-7.1 to 0.3)); p=0.120. Improvements were maintained after a two-month follow. Is important to highlight that a sequence effect was noted, with residual effect of AHT; therefore, only results from the first sequence were analysed. <h3>Conclusions</h3> A structured AHT program produce benefits on low back pain intensity (short-term) and disability (long-term). However, further research is needed to test its effectiveness in comparison with conventional core exercises. <h3>Disclosure of Interest</h3> None declared