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Lai P, Cheng S, Chen X, Cheng F, Cheng J, Xin M, Zhu D, Li Z, Wu X, Zeng F. The Emotion Regulation of Acupuncture in Chronic Low Back Pain: A Clinical Neuroimaging Protocol. J Pain Res 2024; 17:817-825. [PMID: 38444878 PMCID: PMC10913808 DOI: 10.2147/jpr.s450589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Acupuncture is effective for patients with chronic low back pain (CLBP), which can relieve pain intensity and regulate negative emotional states such as pain-related anxiety and depression. Previous studies mainly discuss the analgesic mechanism of acupuncture treatment of CLBP, but there are multiple dimensions to pain, including sensation, emotion and cognition. Therefore, this study aims to investigate the central mechanism of acupuncture for CLBP from the perspective of emotional regulation by functional magnetic resonance imaging (fMRI). Methods and Analysis A total of 72 patients with CLBP will be recruited in the study and randomly assigned to the verum acupuncture group or the sham acupuncture group. The trail will last for 18 weeks including a 2-week baseline, a 4-week treatment and a 12-week for follow-up period. The primary outcomes are the visual analog scale (VAS) and the Japanese Orthopaedic Association Scores (JOA) score. The secondary outcomes are the 12-item short form health survey (SF-12), the state trait anxiety inventory (STAI), the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The VAS, JOA, STAI SAS and SDS will be collected at baseline, week 2, week 4, and after follow-up. The SF-12 will be evaluated at baseline, week 2 and week 4. Functional magnetic resonance imaging (MRI) data will be collected at baseline and the end of treatment. Emotion-related brain regions will be chosen as regions of interest (ROIs). The gray matter volume (GMV), amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), functional connectivity (FC), and large-scale functional brain network based on these ROIs will be analyzed within and between the two groups. Discussion This study will verify the emotional regulation of acupuncture and explore the mechanism of acupuncture for emotion regulation in patients with CLBP. Trial Registration Number https://www.chictr.org.cn/showproj.html?proj=195486, identifier: ChiCTR2300070557.
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Affiliation(s)
- Peng Lai
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
- Acupuncture & Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Shirui Cheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
- Acupuncture & Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Xingyao Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Fangdong Cheng
- Geriatric Diseases Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Department of Orthopedic, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
| | - Jun Cheng
- Geriatric Diseases Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Department of Orthopedic, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
| | - Ming Xin
- Geriatric Diseases Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Department of Rehabilitation, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
| | - Deliang Zhu
- Geriatric Diseases Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
- Department of Rehabilitation, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, People’s Republic of China
| | - Zhengjie Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
- Acupuncture & Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Xi Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
| | - Fang Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
- Acupuncture & Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China
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Villalba-Meneses F, Guevara C, Velásquez-López PA, Arias-Serrano I, Guerrero-Ligña SA, Valencia-Cevallos CM, Almeida-Galárraga D, Cadena-Morejón C, Marín J, Marín JJ. BackMov: Individualized Motion Capture-Based Test to Assess Low Back Pain Mobility Recovery after Treatment. SENSORS (BASEL, SWITZERLAND) 2024; 24:913. [PMID: 38339630 PMCID: PMC10857203 DOI: 10.3390/s24030913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
Low back pain (LBP) is a common issue that negatively affects a person's quality of life and imposes substantial healthcare expenses. In this study, we introduce the (Back-pain Movement) BackMov test, using inertial motion capture (MoCap) to assess lumbar movement changes in LBP patients. The test includes flexion-extension, rotation, and lateralization movements focused on the lumbar spine. To validate its reproducibility, we conducted a test-retest involving 37 healthy volunteers, yielding results to build a minimal detectable change (MDC) graph map that would allow us to see if changes in certain variables of LBP patients are significant in relation to their recovery. Subsequently, we evaluated its applicability by having 30 LBP patients perform the movement's test before and after treatment (15 received deep oscillation therapy; 15 underwent conventional therapy) and compared the outcomes with a specialist's evaluations. The test-retest results demonstrated high reproducibility, especially in variables such as range of motion, flexion and extension ranges, as well as velocities of lumbar movements, which stand as the more important variables that are correlated with LBP disability, thus changes in them may be important for patient recovery. Among the 30 patients, the specialist's evaluations were confirmed using a low-back-specific Short Form (SF)-36 Physical Functioning scale, and agreement was observed, in which all patients improved their well-being after both treatments. The results from the specialist analysis coincided with changes exceeding MDC values in the expected variables. In conclusion, the BackMov test offers sensitive variables for tracking mobility recovery from LBP, enabling objective assessments of improvement. This test has the potential to enhance decision-making and personalized patient monitoring in LBP management.
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Affiliation(s)
- Fernando Villalba-Meneses
- IDERGO (Research and Development in Ergonomics), I3A (Instituto de Investigación en Ingeniería de Aragón), University of Zaragoza, C/Mariano Esquillor s/n, 50018 Zaragoza, Spain; (J.M.); (J.J.M.)
- School of Biological Sciences and Engineering, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador; (P.A.V.-L.); (I.A.-S.); (S.A.G.-L.); (C.M.V.-C.); (D.A.-G.)
- Department of Design and Manufacturing Engineering, University of Zaragoza, C/Mariano Esquillor s/n, 50018 Zaragoza, Spain
| | - Cesar Guevara
- Centro de Investigación en Mecatrónica y Sistemas Interactivos—MIST, Universidad Tecnológica Indoamérica, Quito 170103, Ecuador;
| | - Paolo A. Velásquez-López
- School of Biological Sciences and Engineering, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador; (P.A.V.-L.); (I.A.-S.); (S.A.G.-L.); (C.M.V.-C.); (D.A.-G.)
| | - Isaac Arias-Serrano
- School of Biological Sciences and Engineering, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador; (P.A.V.-L.); (I.A.-S.); (S.A.G.-L.); (C.M.V.-C.); (D.A.-G.)
| | - Stephanie A. Guerrero-Ligña
- School of Biological Sciences and Engineering, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador; (P.A.V.-L.); (I.A.-S.); (S.A.G.-L.); (C.M.V.-C.); (D.A.-G.)
| | - Camila M. Valencia-Cevallos
- School of Biological Sciences and Engineering, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador; (P.A.V.-L.); (I.A.-S.); (S.A.G.-L.); (C.M.V.-C.); (D.A.-G.)
| | - Diego Almeida-Galárraga
- School of Biological Sciences and Engineering, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador; (P.A.V.-L.); (I.A.-S.); (S.A.G.-L.); (C.M.V.-C.); (D.A.-G.)
| | - Carolina Cadena-Morejón
- School of Mathematical and Computational Sciences, Yachay Tech University, Hacienda San José s/n, San Miguel de Urcuquí 100119, Ecuador;
| | - Javier Marín
- IDERGO (Research and Development in Ergonomics), I3A (Instituto de Investigación en Ingeniería de Aragón), University of Zaragoza, C/Mariano Esquillor s/n, 50018 Zaragoza, Spain; (J.M.); (J.J.M.)
- Department of Design and Manufacturing Engineering, University of Zaragoza, C/Mariano Esquillor s/n, 50018 Zaragoza, Spain
| | - José J. Marín
- IDERGO (Research and Development in Ergonomics), I3A (Instituto de Investigación en Ingeniería de Aragón), University of Zaragoza, C/Mariano Esquillor s/n, 50018 Zaragoza, Spain; (J.M.); (J.J.M.)
- Department of Design and Manufacturing Engineering, University of Zaragoza, C/Mariano Esquillor s/n, 50018 Zaragoza, Spain
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Rosenstein B, Montpetit C, Vaillancourt N, Dover G, Khalini-Mahani N, Weiss C, Papula LA, Melek A, Fortin M. Effect of aquatic exercise versus standard care on paraspinal and gluteal muscles morphology in individuals with chronic low back pain: a randomized controlled trial protocol. BMC Musculoskelet Disord 2023; 24:977. [PMID: 38110922 PMCID: PMC10726523 DOI: 10.1186/s12891-023-07034-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/10/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is one of the most disabling diseases and a major health issue. Despite the evidence of a link between paraspinal and gluteal muscle dysfunction and LBP, it is unknown whether aquatic exercises can lead to improvements in paraspinal and gluteal muscle morphology and function, and whether improvements in overall muscle health are associated with improvements in patients' outcomes. The unique properties of water allow a water-based exercise program to be tailored to the needs of those suffering from LBP. This study uses magnetic resonance imaging (MRI) to investigate the effect of an aquatic exercise program versus standard exercise on 1) paraspinal and gluteal muscle size, quality and strength and 2) pain, disability, and psychological factors (pain related fear, depression, anxiety, sleep quality) in chronic LBP. METHODS This study will include 34 participants with chronic non-specific LBP and moderate to severe disability, aged between 18 and 65, who will be randomly assigned (1:1) to the aquatic exercise group or land-based standard care exercise group. Both groups will receive 20 supervised sessions, twice per week over 10 weeks. MRIs will be obtained along the lumbosacral spine (L1-L5) and pelvis at the start and end of the intervention to assess the effect of each exercise intervention on paraspinal and gluteal muscle size and quality. Pre- to post-intervention changes in all outcomes between each group will be assessed, and the association between the changes in back muscle quality and clinical outcomes will be examined. Between-subjects repeated measure analysis of variance will be used to examine the changes in paraspinal muscle morphology over the different time points. Linear mixed models will be used to assess whether baseline scores can modify the response to the exercise therapy treatment. DISCUSSION This study will determine if water-based exercises targeting the lower back and gluteal muscles can lead to important changes in muscle quality and function, and their possible relation with patients' pain and functional improvements. Our findings will have strong clinical implications and provide preliminary data to design a community program to better support individuals with chronic LBP. TRIAL REGISTRATION NCT05823857, registered prospectively on April 27th, 2023.
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Affiliation(s)
- Brent Rosenstein
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, Montreal, QC, Canada
| | - Chanelle Montpetit
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, Montreal, QC, Canada
| | - Nicolas Vaillancourt
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, Montreal, QC, Canada
| | - Geoffrey Dover
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, Montreal, QC, Canada
- School of Health, Concordia University, Montreal, QC, Canada
| | - Najmeh Khalini-Mahani
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, Montreal, QC, Canada
| | - Christina Weiss
- School of Health, Concordia University, Montreal, QC, Canada
| | - Lee Ann Papula
- School of Health, Concordia University, Montreal, QC, Canada
| | - Antonys Melek
- School of Health, Concordia University, Montreal, QC, Canada
| | - Maryse Fortin
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street W, Montreal, QC, Canada.
- School of Health, Concordia University, Montreal, QC, Canada.
- CRIR - Centre de réadaptation Constance-Lethbridge du CIUSSS COMTL, Montreal, QC, Canada.
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Different Dosage Regimens of Tanezumab for the Treatment of Chronic Low Back Pain: A Meta-analysis of Randomized Controlled Trials. Clin Neuropharmacol 2023; 46:6-16. [PMID: 36542785 DOI: 10.1097/wnf.0000000000000530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to assess the efficacy of different dosage regimens of tanezumab among individuals living with chronic low back pain (CLBP). METHODS PubMed, Embase, The Cochrane Library, and other databases were searched from inception until August 2021. Randomized controlled trials investigating the efficacy and safety of tanezumab in individuals with CLBP were included. Data were extracted independently by 2 investigators and assessed the study quality by the Cochrane risk-of-bias tool. The measurements include low back pain intensity and Roland-Morris Disability Questionnaire. The incidence of adverse events and serious adverse events was set to assess the safety of tanezumab for CLBP. RESULTS AND DISCUSSION Three high-quality randomized controlled trials with 3414 patients were finally included in our analysis. Tanezumab, respectively, led to a notable decrease compared with placebo in low back pain intensity (mean difference, -0.62; 95% confidence interval [CI], -0.77 to -0.46; P < 0.01) and Roland-Morris Disability Questionnaire (mean difference, -0.64; 95% CI, -0.80 to -0.47; P = 0.01). In addition, no significant difference existed between tanezumab and placebo groups (risk ratio, 1.10; 95% CI, 0.81-1.49; P = 0.55) in the adverse events and (risk ratio, 1.06; 95% CI, 0.34-3.27; P = 0.93) serious adverse events. CONCLUSIONS Intravenous and subcutaneous tanezumab injections as treatment for improving CLBP have promising clinical application as its great improvement on all efficacy and its controllable safety issues. Furthermore, intravenous and subcutaneous tanezumab injections were proved to achieve excellent and long-term curative effect on CLBP through our subgroup analysis and comparison.
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Abdi A, Bagheri SR, Shekarbeigi Z, Usefvand S, Alimohammadi E. The effect of repeated flexion-based exercises versus extension-based exercises on the clinical outcomes of patients with lumbar disk herniation surgery: a randomized clinical trial. Neurol Res 2023; 45:28-40. [PMID: 36039973 DOI: 10.1080/01616412.2022.2116686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Valuable impact of postoperative exercises on the clinical outcomes of patients with lumbar discectomy has been demonstrated. However, there is a lack of consensus on the best kind of postoperative exercises. This study aimed to evaluate the impact of the early postoperative flexion-based and extension-based exercises on the clinical outcomes of patients with lumbar discectomy. METHODS In this single-blind randomized clinical trial (RCT), 90 subjects with lumbar discectomy were randomly assigned to three groups. The flexion-based and extension-based exercises were planned for the first and the second groups, respectively. The third group was considered as the control group. Subjects in the experimental groups started their exercise program at the end of the 6th postoperative week and continued exercises for 8 weeks. We used Visual analogue scale (VAS), Oswestry Disability Index (ODI), modified Biering-Sorensen test (mBST), and Trunk Flexion Endurance Test (TFET) to evaluate back pain, disability, back and abdominal muscle endurance, respectively. The outcomes were investigated before starting the exercises program as well as at the end of the study. Moreover, return to work was evaluated at the end of the study. Data were analyzed using descriptive and inferential statistics by SPSS-24 software. RESULTS Our results showed that the VAS pain diminished in all the groups. However, this reduction was most in the McKenzie group (P < 0.001). Moreover, extension-based exercises reduced ODI more than other groups (P < 0.001). We found that extension-based and flexion-based exercises had more efficacy in increasing the back and trunk flexion endurance, respectively (P < 0.001). There was not a significant difference between the three groups in the term of returning to work (P = 0.06). CONCLUSIONS Both flexion-based and extension-based exercises could reduce postoperative back pain and disability. However, the impact of the extension-based program was more dominant. Moreover, these exercises could increase back and abdominal muscle endurance. Therefore, prescribing such low-cost home-based exercises could be very helpful for patients with lumbar discectomy.
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Affiliation(s)
- Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Zahra Shekarbeigi
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soheila Usefvand
- Master of Science of Sports Biomechanics, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
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Ma J, Zhang T, He Y, Li X, Chen H, Zhao Q. Effect of aquatic physical therapy on chronic low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2022; 23:1050. [PMID: 36460993 PMCID: PMC9717486 DOI: 10.1186/s12891-022-05981-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Chronic low back pain is a common musculoskeletal disease. With the increasing number of patients, it has become a huge economic and social burden. It is urgent to relieve the burden of patients. There are many common rehabilitation methods, and aquatic physical therapy is one of them. The purpose of this systematic review and meta-analysis is to summarize the existing literature and analyze the impact of aquatic physical therapy on pain intensity, quality of life and disability of patients with chronic low back pain. METHODS Through 8 databases, we searched randomized controlled trials on the effect of aquatic physical therapy on patients with chronic low back pain. These trials published results on pain intensity, quality of life, and disability. This review is guided by Cochrane Handbook for systematic reviews of interventions version 5.1.0. The level of evidence was assessed through GRADE. RESULTS A total of 13 articles involving 597 patients were included. The results showed that compared with the control group, aquatic physical therapy alleviated the pain intensity (Visual Analogue Scale: SMD = -0.68, 95%CI:-0.91 to -0.46, Z = 5.92, P < 0.00001) and improved quality of life (physical components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.63, 95%CI:0.36 to 0.90, Ζ = 4.57, P < 0.00001; mental components of 36-Item Short Form Health Survey or Short-Form 12: SMD = 0.59, 95%CI:0.10 to 1.08, Ζ = 2.35, P = 0.02), and reduced disability (Roland Morris Disability Questionnaire: SMD = -0.42, 95%CI:-0.66 to -0.17, Ζ = 3.34, P = 0.0008; Oswestry Disability Index or Oswestry Low Back Pain Disability Questionnaire: SMD = -0.54, 95%CI:-1.07 to -0.01, Ζ = 1.99, P = 0.05). However, aquatic physical therapy did not improve patients' pain at rest (Visual Analogue Scale at rest: SMD = -0.60, 95%CI:-1.42 to 0.23, Ζ = 1.41, P = 0.16). We found very low or low evidence of effects of aquatic physical therapy on pain intensity, quality of life, and disability in patients with chronic low back pain compared with no aquatic physical therapy. CONCLUSIONS Our systematic review showed that aquatic physical therapy could benefit patients with chronic low back pain. However, because the articles included in this systematic review have high bias risk or are unclear, more high-quality randomized controlled trials are needed to verify.
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Affiliation(s)
- Ji Ma
- grid.464423.3The Orthopaedic Spinal Ward, Shanxi Provincial People’s Hospital, 29Th Shuangta Temple Street, Taiyuan, Shanxi 030012 People’s Republic of China
| | - Teng Zhang
- grid.263452.40000 0004 1798 4018School of Nursing, Shanxi Medical University, Yingze District, 56Th Xinjian South Road, Taiyuan, Shanxi 030012 People’s Republic of China
| | - Yapeng He
- grid.263452.40000 0004 1798 4018School of Nursing, Shanxi Medical University, Yingze District, 56Th Xinjian South Road, Taiyuan, Shanxi 030012 People’s Republic of China
| | - Xin Li
- grid.263452.40000 0004 1798 4018School of Nursing, Shanxi Medical University, Yingze District, 56Th Xinjian South Road, Taiyuan, Shanxi 030012 People’s Republic of China
| | - Haoyang Chen
- grid.260483.b0000 0000 9530 8833Department of Nursing, Nantong University Affiliated Rehabilitation Hospital, No. 298, Xinhua Road, Nantong, 226000 Jiangsu People’s Republic of China
| | - Qian Zhao
- grid.464423.3Department of Nursing, Shanxi Provincial People’s Hospital, 29Th Shuangta Temple Street, Taiyuan, 030012 Shanxi People’s Republic of China
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Bemani S, Dehkordi SN, Sarrafzadeh J, Talebian S, Salehi R, Zarei J. Efficacy of a multidimensional versus usual care physiotherapy on pain and electroencephalography (EEG) spectrum in chronic nonspecific low back pain: study protocol for a randomized controlled trial. Trials 2021; 22:679. [PMID: 34620205 PMCID: PMC8499517 DOI: 10.1186/s13063-021-05580-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Non-specific chronic low back pain (NSCLBP) is a major public health and global socioeconomic burden associated with a complex interplay of biopsychosocial factors. Despite scientific signs of progress, treatment of NSCLBP often tends to stick to a biomechanical model, without targeting psychological and social factors. To enhance the clinical efficacy of usual physiotherapy for NSCLBP, the development of clinical strategies is to be pursued. This study aims to assess the effectiveness of multidimensional physiotherapy based on a biopsychosocial approach compared to usual care physiotherapy, on clinical findings and electroencephalography spectrum in non-specific chronic low back pain. METHODS This study is a triple-blind, two-arm (1:1) randomized controlled trial with a 4 months follow-up. Seventy NSCLBP patients will be randomly allocated to either the experimental (multidimensional physiotherapy) or the active control group (usual physiotherapy); each group will receive 6 weeks of physiotherapy. The main outcome is pain and secondary outcomes are brain function, quality of life, disability, lumbar flexion range of motion, and psychosocial correlates. Assessment will be performed at baseline, post-treatment, and at 1 and 4 months follow-up. DISCUSSION Findings may provide evidence on the effectiveness of multidimensional physiotherapy on clinical findings and brain characteristics and might provide evidence towards showing the role of brain and biopsychosocial factors on chronic pain. TRIAL REGISTRATION ClinicalTrials.gov NCT04270422 , Registered on 17 February 2020, IRCT Identifier: IRCT20140810018754N11.
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Affiliation(s)
- Sanaz Bemani
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blv, Tehran, Iran
| | - Shohreh Noorizadeh Dehkordi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blv, Tehran, Iran.
| | - Javad Sarrafzadeh
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blv, Tehran, Iran
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Jamileh Zarei
- Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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Efficacy and Effectiveness of Physical Agent Modalities in Complex Regional Pain Syndrome Type I: A Scoping Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041857] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Complex regional pain syndrome type I (CRPS-I) is a rare condition with huge variability in triggering factors and clinical scenarios. The complexity of the pathophysiology of this condition fosters the proposal of several therapeutic options with different mechanisms of action in both research and clinical practice. An interdisciplinary and multimodal approach, including pharmacological and non-pharmacological interventions, particularly physical therapy, is recommended by international guidelines, but the benefits and harms of available interventions are poorly known. In this scoping review, the clinical rationale for use of physical agent modalities for patients with CRPS-I will be presented. We found 10 studies addressing the role of electromagnetic field therapy, electrotherapy, and laser therapy. Our findings suggest that physical therapy modalities, in particular transcutaneous electrical nerve stimulation (TENS) and pulsed electromagnetic field therapy (PEMF), may contribute to reduce pain and improve function in patients with CRPS-1.
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Mirmoezzi M, Irandoust K, H'mida C, Taheri M, Trabelsi K, Ammar A, Paryab N, Nikolaidis PT, Knechtle B, Chtourou H. Efficacy of hydrotherapy treatment for the management of chronic low back pain. Ir J Med Sci 2021; 190:1413-1421. [PMID: 33409843 DOI: 10.1007/s11845-020-02447-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
AIMS The study investigated the influence of hydrotherapy method-based McKenzie and Williams among patients with non-specific low back pain (NSLBP). METHODS Semi-experimental pretest-posttest with a control group design trial was conducted at Health Service Center, Qazvin, Iran. Twenty-eight NSLBP patients (16 men and 12 women, age: 42.5 ± 7 years) were recruited. Hydrotherapy program developed based on McKenzie and Williams therapy was performed individually 3 days per week for 20 sessions. Therefore, the study compared a hydrotherapy group (based on McKenzie and Williams therapy) to a control group. Participants attended a hydrotherapy program under the supervision of a hydrotherapist. The Numeric Pain Rating Scale (NPRS), Roland-Morris Disability Questionnaire (RMDQ), and Straight Leg Raise Test (SLRT) were measured at the beginning, middle, and at the end of the 20 sessions to determine pain and functionality of the patient's improvement. RESULTS Overall, NPRS, RMDQ, and SLRT scores were improved in hydrotherapy group in the 10th session and 20th session compared with baseline (p ≤ 0.001) and control group (p ≤ 0.001). No difference in the treatment variables between the 10th session and the 20th session was observed (p > 0.05). CONCLUSIONS The results indicated that the NSLBP symptom was improved after 10 sessions of hydrotherapy program developed based on McKenzie and Williams therapy.
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Affiliation(s)
- Masoud Mirmoezzi
- Faculty of Physical Education and Sport Science, Islamic Azad University, Tehran, Iran
| | | | - Cyrine H'mida
- Institut Supérieur du Sport et de l'éducation physique de Sfax, Université de Sfax, Sfax, Tunisia.,Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Khaled Trabelsi
- Institut Supérieur du Sport et de l'éducation physique de Sfax, Université de Sfax, Sfax, Tunisia.,Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Achraf Ammar
- Institute of Sport Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.,Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2-2APS), UFR STAPS UPL, Paris Nanterre University, 92000, Nanterre, France
| | - Nesa Paryab
- Imam Khomeini International University, Qazvin, Iran
| | | | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland. .,Medbase St. Gallen Am Vadianplatz, Vadianstr. 26, 9001, St. Gallen, Switzerland.
| | - Hamdi Chtourou
- Institut Supérieur du Sport et de l'éducation physique de Sfax, Université de Sfax, Sfax, Tunisia.,Activité Physique, Sport et Santé, UR18JS01, Observatoire National du Sport, Tunis, Tunisia
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10
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Rezai V, Mahdavi-Nejad R, Zolaktaf V. Comparing the Effects of Different Types of Aquatic Walking on Endurance and Electrical Activities of Spine Extensor Muscles in Men with Nonspecific Chronic Back Pain. Int J Prev Med 2020; 11:168. [PMID: 33312477 PMCID: PMC7716608 DOI: 10.4103/ijpvm.ijpvm_403_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 06/10/2020] [Indexed: 11/04/2022] Open
Abstract
Background Chronic back pain is one of the most challenging medical problems worldwide that results in disability, physical problems, and high costs for the family and society. Therefore, it can be very beneficial to find an appropriate treatment with minimum side-effects for this disease. The present study attempted to compare the effects of different water gait protocols on the endurance and electrical activity of spine extensor muscles in men with nonspecific chronic back pain. Methods The study adopted an experimental design in which 30 men with non-specific chronic back pain were selected through convenience sampling and using simple randomization method assigned into three groups of forward walking, backward walking, and sideways walking. Walking exercises were performed for 8 weeks, three sessions per week for 30 min. Twenty-four hours before and 48 h after the intervention, the endurance of spine extensor muscles and electrical activities were measured using the Ito test and electromyography, respectively. Data were analyzed in SPSS 23 using paired sample t-test and analysis of variance. Results The results showed that backward walking in water significantly increases endurance and electromyography activities of spine extensor muscles (P < 0.05), while forward and sideways walking had no significant effect on these variables (P > 0.05). The results obtained from Bonferroni post-hoc test showed a significant difference between the strength of trunk extensor muscles and EMG of spinal cord extensor muscles in forward and backward water gait groups (P = 0.001, 0.006). Conclusions According to the findings of this study, it seems that walking backward can be an effective therapeutic method for patients with chronic back pain.
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Affiliation(s)
- Vahid Rezai
- Department of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran
| | - Reza Mahdavi-Nejad
- Department of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran
| | - Vahid Zolaktaf
- Department of Corrective Exercises, Faculty of Physical Education, University of Isfahan, Isfahan, Iran
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11
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Castro-Sanchez AM, Matarán-Peñarrocha GA, Gómez-García S, García-López H, Andronis L, Albornoz-Cabello M, Lara Palomo IC. Study protocol randomised controlled trial comparison of cost-utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain. BMJ Open 2020; 10:e040633. [PMID: 33310802 PMCID: PMC7735081 DOI: 10.1136/bmjopen-2020-040633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Chronic lower back pain is a highly prevalent medical condition in Western countries, which that incurs a considerable social and economic burden. Although prescription exercise at home for chronic pain has become a widely used alternative to reduce healthcare costs, the evidence regarding patient adherence and decreased in costs in European countries is scarce and inconclusive. The objective of this study is to examine the cost-utility and cost-effectiveness in patients with chronic lower back pain treated with the McKenzie Method and electroanalgesia via a telemedicine programme versus a face-to-face programme. METHODS AND ANALYSIS This study reports the protocol for a randomised, two-arm, multicentre, parallel controlled trial. A total of 540 patients with chronic lower back pain (onset time ≥3 months, Roland Morris Disability Questionnaire ≥4) will be recruited in three hospitals in Andalusia. Participants will be assigned to one of two groups (n=270, respectively) to receive electroanalgesia and Mckenzie method exercises through a telemedicine or a face-to-face programme. A total of 24 sessions will be administered three times a week for 8 weeks. Since the study design does not allow participant blinding, the outcome assessor and the statistician will be blinded. Use of helth care resources and costs due to work absenteeism will be captured and analysed. In addition, pain, intensity, fear of movement, quality of life and strength of the core muscle and anteflexion lumbar will be recorded at 2 and 6 months after the start of treatment. ETHICS AND DISSEMINATION Human Research and Local Ethics Committee of the 'Hospital Complex Torrecárdenas of Almeria, University Hospital of Granada and Virgen Macarena de Sevilla Hospital-Andalusian Health Service'. Study findings will be released to the research, clinical and health service through publication in international journals and conferences. TRIAL REGISTRATION NUMBER NCT04266366.
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Affiliation(s)
| | | | - Silvia Gómez-García
- Clinical Rehabilitation Management Unit, Torrecárdenas University Hospital of Almería, Almería, Spain
| | - Héctor García-López
- Department Physical Therapy, Universidad De Almeria Facultad de Ciencias de la Educacion Enfermeria y Fisioterapia, Almeria, Spain
| | - Lazaro Andronis
- Division of Clinical Trials, Warwick Meidical School, University of Warwick, Birmingham and Coventry, UK
| | | | - Inmaculada C Lara Palomo
- Department Physical Therapy, Universidad De Almeria Facultad de Ciencias de la Educacion Enfermeria y Fisioterapia, Almeria, Spain
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12
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A Randomized Controlled Trial Investigating the Effects of Equine Simulator Riding on Low Back Pain, Morphological Changes, and Trunk Musculature in Elderly Women. ACTA ACUST UNITED AC 2020; 56:medicina56110610. [PMID: 33202928 PMCID: PMC7696898 DOI: 10.3390/medicina56110610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/20/2023]
Abstract
Background and objectives: Studies on the effects of an equine riding simulator (ERS) program on back pain, spinal alignment, and isokinetic moments in subjects with chronic low back pain (CLBP) remain limited. The purpose of this study was to analyze changes in elderly women with CLBP who participate in an ERS program. Materials and Methods: The 80 participants were all women aged 61–84 years who were randomly assigned to either the control group (CON) or ERS group (ERSG). ERS exercise was performed for a duration of 12 weeks (three times each week). The degree of pain was measured using the Oswestry Disability Index and the visual analog scale. Body composition and spinal alignment were measured using bioelectrical impedance and raster stereography. The isokinetic moments of trunk extensor and flexor were measured before and after the training period. Results: The ERSG showed a significant decrease in back pain compared to the CON. There was a significant decrease in levels of fat in the ERSG, although no differences were shown in terms of muscle mass. However, there was an increased basal metabolic rate (BMR) in the ERSG. Spinal alignment in the ERSG significantly improved. The peak torques of the trunk extensor in the ERSG were also significantly increased. Conclusion: It can be inferred that the ERS exercise can decrease fat and improve the trunk extensor strength through increased BMR, leading to better spinal alignment and reducing back pain in elderly women with CLBP.
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Seo UH, Kim JH, Lee BH. Effects of Mulligan Mobilization and Low-Level Laser Therapy on Physical Disability, Pain, and Range of Motion in Patients with Chronic Low Back Pain: A Pilot Randomized Controlled Trial. Healthcare (Basel) 2020; 8:E237. [PMID: 32751064 PMCID: PMC7551517 DOI: 10.3390/healthcare8030237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 12/01/2022] Open
Abstract
This study aimed to determine the combined treatment effects of Mulligan sustained natural apophyseal glides (SNAGs) and low-level laser therapy (LLLT) on function, pain, and range of motion (ROM) in patients with chronic low back pain. A total of 49 adults participated in this study and were randomly divided into three groups (SNAGs with LLLT group, SNAGs group, and control group). The participants in the SNAGs with LLLT group received SNAGs for 10 min, LLLT for 10 min, and electrotherapy for 10 min. The SNAGs group received SNAGs for 10 min and electrotherapy for 20 min. The control group received electrotherapy for 30 min. All participants received the assigned treatment for 30 min a day, 3 times a week, for 4 weeks. We used the visual analogue scale (VAS) to measure pain, the modified-modified Schober test (MMST) to measure ROM, and the Roland Morris disability questionnaire (RMDQ) to measure physical disability. Compared to the pre-intervention values, the VAS and MMST scores significantly increased after the intervention in the SNAGs with LLLT group (p = 0.000) and the SNAGs group (p = 0.000). The RMDQ score significantly improved in the SNAGs with LLLT (p = 0.000), SNAGs (p = 0.000) and control (p = 0.025) group after the intervention. The inter-group differences were greater for the SNAGs with LLLT and SNAGs groups than for the control group (p = 0.001), and the difference was greater for the SNAGs with LLLT than for the SNAGs (p = 0.001) with respect to the VAS, MMST, and RMDQ scores. These results indicate that significant improvement in pain, function, and ROM may be achieved by a combination of SNAGs and LLLT to treat chronic low back pain.
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Affiliation(s)
- U-Hyeok Seo
- Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Korea;
| | - Jung-Hee Kim
- Department of Physical Therapy, Andong Science College, Andong 36616, Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Korea
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14
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Martin S, Tallian K, Nguyen VT, van Dyke J, Sikand H. Does early physical therapy intervention reduce opioid burden and improve functionality in the management of chronic lower back pain? Ment Health Clin 2020; 10:215-221. [PMID: 32685332 PMCID: PMC7337997 DOI: 10.9740/mhc.2020.07.215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction Chronic lower back pain is a leading cause of disability in US adults. Opioid use continues to be controversial despite the Centers for Disease Control and Prevention guidance on chronic pain management to use nonpharmacologic and nonopioid pharmacologic interventions. The objectives of the study were to assess the impact of early physical therapy (PT) intervention on improving functionality and reducing opioid burden in patients with chronic lower back pain. Methods A single-center, retrospective chart review of patients receiving ≥6 PT visits and treated with either opioids first (OF) or PT first (PTF) therapy for chronic lower back pain were evaluated. Concomitant use of nonopioid and nonpharmacologic therapy was permitted. The Oswestry Disability Index (ODI), a survey measuring functionality, was recorded for PTF group. Pain scores and medication use including opioids were collected at treatment initiation and completion. Results One hundred and eighty patients were included in three groups: OF group (n = 60), PTF group (n = 60), and PTF + ODI group (n = 60). The PTF + ODI group had mean ODI reduction of 11.9% (P < .001). More OF patients were lost to follow up (68.3%) or failed PT (60%) compared to the PTF group, 38.3% and 3.3% (P < .001). Reduction in both opioid and nonopioid medications as well as pain scores were observed but not statistically significant. Discussion Early PT resulted in improved functionality, decreased pain, and reduced medication use upon PT completion. These findings suggest PT, along with nonopioid modalities, are a viable first-line option for the management of chronic lower back pain.
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Affiliation(s)
- Shedrick Martin
- Clinical Pharmacist Specialist, Santa Rosa Memorial Hospital, Santa Rosa, California
| | - Kimberly Tallian
- Clinical Pharmacist Specialist, Santa Rosa Memorial Hospital, Santa Rosa, California.,Clinical Pharmacist, Providence Little Company of Mary Medical Center, San Pedro, California.,Director of Physical Rehabiliation Services, Family Health Centers of San Diego, San Diego, California.,Director of Clinical Services and Residency Programs, Department of Pharmacy, Scripps Mercy Hospital, San Diego, California
| | - Victoria T Nguyen
- Clinical Pharmacist, Providence Little Company of Mary Medical Center, San Pedro, California
| | - Jason van Dyke
- Director of Physical Rehabiliation Services, Family Health Centers of San Diego, San Diego, California
| | - Harminder Sikand
- Director of Clinical Services and Residency Programs, Department of Pharmacy, Scripps Mercy Hospital, San Diego, California
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16
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A Comparison of 6 Weeks of Aquatic Exercise and Kinesio Taping in Patients With Chronic Nonspecific Low Back Pain. J Sport Rehabil 2020; 30:37-42. [PMID: 32087600 DOI: 10.1123/jsr.2019-0185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 11/13/2019] [Accepted: 01/02/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT In many societies, although chronic low back pain (LBP) is a significant problem, there is no consensus on the optimal therapeutic intervention. OBJECTIVE To compare the impact of aquatic exercise (AE) and kinesio taping (KT) on the pain intensity and functional incapacity in women with chronic nonspecific LBP. DESIGN Randomized controlled trial. SETTING Outpatient clinic. PARTICIPANTS Thirty-six women with chronic nonspecific LBP (mean [SD]: age = 50.69 [4.187] y) participated. INTERVENTIONS Participants randomly assigned to AE (n = 12), KT (n = 12), and nontreatment control (n = 12) groups for 6 weeks. MAIN OUTCOME MEASURES Pain intensity and functional disability were evaluated at baseline and the end of the intervention. RESULTS Pain intensity decreased more in the AE group than in the KT group (5.9-0.5 cm [91.6% decrease] vs 5.7-2.4 cm [58.1% decrease], respectively; P < .001 for both after Bonferroni post hoc test); the values decreased more in the 2 treatment groups than in the control group (P < .001 for between-group comparisons). Disability decreased more in the AE group (43.2%-18.8% [55.6% decrease]) than the KT group (37.8%-19.3% [48.3% decrease]) (P < .001 for both comparisons), but increased in the control group (38.7%-41.2% [6.5% increase]; P = .045). CONCLUSION These results suggest AE and KT treatment methods provide pain intensity and disability improvements in women with chronic nonspecific LBP. Nevertheless, AE was more effective than KT.
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CEYLAN A, AŞIK İ, ÖZGENCİL GE, ERKEN B. Clinical results of intradiscal hydrogel administration (GelStix) in lumbar degenerative
disc disease. Turk J Med Sci 2019; 49:1634-1639. [PMID: 31655507 PMCID: PMC7518664 DOI: 10.3906/sag-1901-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022] Open
Abstract
Background/aim Degenerative disc disease (DDD) is one of the main causes of lower back pain. In this study, we evaluate the efficacy of percutaneous intradiscal GelStix administration in patients with discogenic pain due to lumbar DDD who were unresponsive to conservative methods. Materials and methods A total of 29 patients were included in the study, which took place between 2013 and 2017. Sedation was performed in the prone position in the operating room, and a C-arm was located so as to provide a lateral view of the surgical field. A 22-G, 3.5-inch needle was inserted into the center of the disc under fluoroscopy guidance, and a percutaneous intradiscal GelStix implantation was performed. All patients were evaluated using the Oswestry Disability Index (ODI) and a visual analogue scale (VAS) before and after treatment, and using the Patient Satisfaction Scale at 12 months following treatment. Results The mean VAS scores were 7.14 ± 0.64 at baseline and 2.48 ± 0.63 at 12 months (P < 0.001). The mean ODI scores were 28.14 ± 1.81 at baseline and 17.35 ± 0.67 at 12 months (P < 0.001). There was a statistically significant decrease in the VAS and ODI scores before and after treatment. A total of 86.2% of the patients rated the procedure as very good or good at 12 months. Conclusion Our study results suggest that GelStix treatment is useful in pain relief in patients with DDD from the first month of treatment.
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Affiliation(s)
- Ayşegül CEYLAN
- Department of Anesthesiology and Reanimation, Gülhane Training and Research Hospital, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - İbrahim AŞIK
- Department of Anesthesiology and Reanimation, Ankara University Medical Faculty Hospital, AnkaraTurkey
| | - G. Enver ÖZGENCİL
- Department of Anesthesiology and Reanimation, Ankara University Medical Faculty Hospital, AnkaraTurkey
| | - Burak ERKEN
- Department of Anesthesiology and Reanimation, Ankara University Medical Faculty Hospital, AnkaraTurkey
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Edgerton K, Hall J, Bland MK, Marshall B, Hulla R, Gatchel RJ. A physical therapist’s role in pain management: A biopsychosocial perspective. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/jabr.12170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - Jarod Hall
- Greater Therapy Centers Lewisville Texas
| | - Michelle K. Bland
- Department of Psychology University of Texas at Arlington Arlington Texas
| | - Blaine Marshall
- Department of Psychology University of Texas at Arlington Arlington Texas
| | - Ryan Hulla
- Department of Psychology University of Texas at Arlington Arlington Texas
| | - Robert J. Gatchel
- Department of Psychology University of Texas at Arlington Arlington Texas
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Occupational and Ergonomic Factors Associated With Low Back Pain Among Car-patrol Police Officers. Clin J Pain 2018; 34:960-966. [DOI: 10.1097/ajp.0000000000000617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Şahin N, Karahan AY, Albayrak İ. Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial. Turk J Phys Med Rehabil 2018; 64:52-58. [PMID: 31453489 PMCID: PMC6709610 DOI: 10.5606/tftrd.2018.1238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 05/18/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study aims to investigate the effect of physical therapy modalities on pain and functional status in patients with non-specific low back pain. PATIENTS AND METHODS Between February 2011 and August 2013, a total of 104 patients (38 males, 66 females; mean age 49.3±12.5 years; range 34 to 62 years) with non-specific chronic low back pain for more than 12 weeks without any neurological deficit were included in this randomized-controlled study. The patients were divided into two groups: physical therapy group (n=52) and control group (n=52). Both groups were given exercise and medical treatment; physiotherapy modalities were also applied in the physical therapy group. The patients were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Istanbul Low Back Pain Disability Index (ILBP) before treatment and at two weeks, three months, and one year after treatment. RESULTS A total of 100 patients completed one-year follow-up. In both groups, the VAS, ODI, and ILBP significantly improved after treatment (p<0.01), compared to before treatment values. There were statistically significant differences in the VAS, ODI, and ILBP scores at three months and one year after treatment between the physical therapy group and control group (p<0.05). CONCLUSION Multidisciplinary approaches including physical therapy should be implemented to provide long-term improvement in pain and functional status in the treatment of non-specific chronic low back pain.
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Affiliation(s)
- Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Medical Faculty of Balıkesir University, Balıkesir, Turkey
| | - Ali Yavuz Karahan
- Department of Physical Medicine and Rehabilitation, Konya Training and Research Hospital, Konya, Turkey
| | - İlknur Albayrak
- Department of Physical Medicine and Rehabilitation, Medical Faculty of Selcuk University, Konya, Turkey
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Machado PM, Alves MC, Hendler KG, Benetti VB, Souza Neto RJD, Barbosa RI, Marcolino AM, Kuriki HU. Effectiveness of the Pilates method for individuals with nonspecific low back pain: clinical and electromyographic aspects. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-6574201700040009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Quebec Serve and Protect Low Back Pain Study: A Web-based Cross-sectional Investigation of Prevalence and Functional Impact Among Police Officers. Spine (Phila Pa 1976) 2017; 42:1485-1493. [PMID: 28248895 DOI: 10.1097/brs.0000000000002136] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Web-based cross-sectional study. OBJECTIVE The aim of this study was to describe the prevalence and the burden of low back pain (LBP) and chronic low back pain (CLBP) among Quebec police officers. SUMMARY OF BACKGROUND DATA Police officers have work-related factors associated with LBP, but chronicity and impacts of this condition have been little explored among this population. METHODS Between May and October 2014, a web-based cross-sectional study was conducted among police officers working in the province of Quebec (Canada). Nine police organizations accepted to disseminate the email invitation to their members. The survey included the French-Canadian version of the Nordic Musculoskeletal Questionnaire and other items regarding functional impact of LBP and associated treatments. RESULTS A total of 3589 police officers completed the questionnaire. Mean age was 38.5 ± 8.7 years, 32.0% were women, and 67.4% reported being car-patrol officers. A majority reported LBP symptoms in the past 12 months (67.7%) and 96.5% of them perceived that presence of LBP was totally/partially linked to their work in the police force. Prevalence of CLBP among all responders was 28.7%. Police officers reporting CLBP, as compared to those reporting acute or subacute LBP symptoms in the past 12 months, were more likely to report LBP-related reduction of work activities (64.4% vs. 45.7%; P < 0.001) and more working days lost in the past 12 months (average of 11.9 ± 43.5 vs. 1.5 ± 9.8; P < 0.001). A greater proportion also reported LBP-related health care visits in the past 12 months (86.2% vs. 64.2%; P < 0.001) and current use of pain medications/complementary alternative medicines (90.1% vs. 69.7%; P < 0.001). CONCLUSION CLBP is a frequent and burdensome condition among Quebec police officers. Our results underline the importance for police organizations to promote CLBP prevention and to implement workplace management programs. LEVEL OF EVIDENCE 3.
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Pourahmadi MR, Ebrahimi Takamjani I, Jaberzadeh S, Sarrafzadeh J, Sanjari MA, Mohsenifar H, Bagheri R, Taghipour M. The Effect of Core Stabilization Exercise on the Kinematics and Joint Coordination of the Lumbar Spine and Hip During Sit-to-Stand and Stand-to-Sit in Patients With Chronic Nonspecific Low Back Pain (COSCIOUS): Study Protocol for a Randomized Double-Blind Controlled Trial. JMIR Res Protoc 2017; 6:e109. [PMID: 28572078 PMCID: PMC5472842 DOI: 10.2196/resprot.7378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 04/30/2017] [Accepted: 05/02/2017] [Indexed: 11/18/2022] Open
Abstract
Background Chronic nonspecific low back pain (CNLBP) is among the most prevalent health problems. Lumbar spine and hips kinematics and coordination can be affected in CNLBP. The effects of exercises on the kinematics and coordination of lumbar spine and hips during sit-to-stand (STS) and its reverse have not been evaluated. Objective The aim of this study is to investigate the effect of core stabilization exercise on the kinematics and joint coordination of the lumbar spine and hip during STS and its reverse in CNLBP patients. Methods COSCIOUS is a parallel randomized double-blind controlled trial. A total of 30 CNLBP patients and 15 asymptomatic participants will be included. The kinematics and joint coordination of the lumbar spine and hips will be evaluated during STS and its reverse using a motion capture system. The participants will be asked to sit in their usual posture on a stool. Reflective markers will be placed over the T12, S2, anterior and posterior superior iliac spines, greater trochanters, and lateral femoral epicondyles of both legs. The participants will be instructed to stand up at natural speed, remain in the erect posture for 3 seconds, and then sit down. Kinematic variables of the lumbar spine and hip will be computed. Afterward, the CNLBP participants will be allocated at random to receive one of 2 interventions: core stabilization or general exercise. Treatment sessions will be held 3 times per week for 16 sessions. After intervention, CNLBP participants will be assessed again. Results Funding for the study was provided in 2016 by Iran University of Medical Sciences. The study is expected to last approximately 12 months, depending on recruitment. Findings on the study’s primary outcomes are expected to be finalized by December 2017. The results of the study will be published in a peer-reviewed journal. Conclusions This investigation will evaluate the effects of core stabilization exercise on the kinematics and joint coordination of the lumbar spine and hip during STS and its reverse in patients with CNLBP. In addition, the effects of CNLBP on STS and its reverse will be investigated in COSCIOUS. Trial Registration Iranian Registry of Clinical Trials IRCT2016080812953N2; http://en.search.irct.ir/view/32003?format=xml (Archived by WebCite at http://www.webcitation.org/6qjTWd4Az)
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Affiliation(s)
- Mohammad Reza Pourahmadi
- School of Rehabilitation Sciences, Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Ismail Ebrahimi Takamjani
- School of Rehabilitation Sciences, Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Shapour Jaberzadeh
- School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University Peninsula Campus, Melbourne, Australia
| | - Javad Sarrafzadeh
- School of Rehabilitation Sciences, Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Mohammad Ali Sanjari
- School of Rehabilitation Sciences, Department of Rehabilitation Basic Sciences, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Holakoo Mohsenifar
- School of Rehabilitation Sciences, Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Rasool Bagheri
- School of Rehabilitation Sciences, Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Islamic Republic Of Iran
| | - Morteza Taghipour
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic Of Iran
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Pereira ILR, Queiroz B, Loss J, Amorim C, Sacco ICN. Trunk Muscle EMG During Intermediate Pilates Mat Exercises in Beginner Healthy and Chronic Low Back Pain Individuals. J Manipulative Physiol Ther 2017; 40:350-357. [PMID: 28413116 DOI: 10.1016/j.jmpt.2017.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/16/2016] [Accepted: 03/30/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the electromyographic pattern of core muscles during intermediate Pilates mat exercises between healthy people and those with low back pain. METHODS We evaluated healthy participants (n = 19; mean ± standard deviation [SD]: age 28 ± 8 years, body mass 65 ± 10 kg, height 160.0 ± 9.1 cm) and a low back pain group (n = 13; mean ± SD: age 30 ± 9 years, body mass 67 ± 12 kg, height 170.0 ± 6.6 cm). Electromyographic analysis assessed the multifidus, external oblique, internal oblique, and rectus abdominis muscles during classical Pilates exercises (single leg stretch, criss-cross, and dead bug). We calculated the root mean square normalized by maximum voluntary contraction, and the time of peak activation was provided by a linear envelope and normalized by the total movement cycle. RESULTS The criss-cross exercise presented the highest values of root mean square for trunk flexors (rectus abdominis and oblique) compared with the other exercises, followed by the single leg stretch and the dead bug, which had similar muscle activation. The single leg stretch presented more activation of the rectus abdominis and oblique, whereas the criss-cross and dead bug created more activation of the oblique compared with the multifidus and rectus. CONCLUSIONS The Pilates exercises presented different muscle recruitment patterns, and allowed the activation of the lumbopelvic stabilizing muscles even in the first session for healthy individuals and those with chronic low back pain.
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Affiliation(s)
- Ivye L R Pereira
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Bergson Queiroz
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jefferson Loss
- Physical Education Department, Federal University of Rio Grande do Sul, Sao Paulo, Brazil
| | - César Amorim
- Physical Therapy Department, University of the City of Sao Paulo, Sao Paulo, Brazil
| | - Isabel C N Sacco
- Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.
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Kim ST, Lee JH. The effects of Pilates breathing trainings on trunk muscle activation in healthy female subjects: a prospective study. J Phys Ther Sci 2017; 29:194-197. [PMID: 28265138 PMCID: PMC5332969 DOI: 10.1589/jpts.29.194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/27/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effects of Pilates breathing on trunk muscle activation.
[Subjects and Methods] Twenty-eight healthy female adults were selected for this study.
Participants’ trunk muscle activations were measured while they performed curl-ups,
chest-head lifts, and lifting tasks. Pilates breathing trainings were performed for 60
minutes per each session, 3 times per week for 2 weeks. Post-training muscle activations
were measured by the same methods used for the pre-training muscle activations. [Results]
All trunk muscles measured in this study had increased activities after Pilates breathing
trainings. All activities of the transversus abdominis/internal abdominal oblique, and
multifidus significantly increased. [Conclusion] Pilates breathing increased activities of
the trunk stabilizer muscles. Activation of the trunk muscle indicates that practicing
Pilates breathing while performing lifting tasks will reduce the risk of trunk
injuries.
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Affiliation(s)
- Sung-Tae Kim
- Department of Physical Therapy, Graduate School of Health Sciences, Cheongju University, Republic of Korea
| | - Joon-Hee Lee
- Department of Physical Therapy, Cheongju University, Republic of Korea
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Abstract
Perception is seen as a process that utilises partial and noisy information to construct a coherent understanding of the world. Here we argue that the experience of pain is no different; it is based on incomplete, multimodal information, which is used to estimate potential bodily threat. We outline a Bayesian inference model, incorporating the key components of cue combination, causal inference, and temporal integration, which highlights the statistical problems in everyday perception. It is from this platform that we are able to review the pain literature, providing evidence from experimental, acute, and persistent phenomena to demonstrate the advantages of adopting a statistical account in pain. Our probabilistic conceptualisation suggests a principles-based view of pain, explaining a broad range of experimental and clinical findings and making testable predictions.
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Affiliation(s)
- Abby Tabor
- Centre for Pain Research, University of Bath, North East Somerset, United Kingdom
| | - Michael A. Thacker
- Centre for Human and Aerospace Physiological Sciences/Pain Section, Neuroimaging, Institute of Psychiatry, Kings College London, London, United Kingdom
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - G. Lorimer Moseley
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Konrad P. Körding
- Rehabilitation Institute of Chicago, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
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Roh HS, Cho WJ, Ryu WJ, Park SJ, An CS. The change of pain and lumbosacral sagittal alignment after sling exercise therapy for patients with chronic low back pain. J Phys Ther Sci 2016; 28:2789-2792. [PMID: 27821936 PMCID: PMC5088127 DOI: 10.1589/jpts.28.2789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/16/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was conducted to quantify the effect of sling exercise therapy in
the recovery of lumbosacral sagittal alignment (LSA) and in the control of low back pain.
[Subjects and Methods] A total of 102 chronic low back pain patients were divided into two
groups, a physical therapy group and a sling exercise group. In both groups, programs were
conducted thrice a week for twelve weeks. With respect to LSA, pelvic tilt (PT), sacral
slope (SS), and pelvic incidence (PI) were measured with plain radiography. Pain was
measured on a visual analogue scale (VAS). [Results] Differences were found in visual
analogue scale, delta score of visual analogue scale, pelvic tilt, delta score of pelvic
tilt, and delta score of pelvic incidence between sling exercise therapy and physical
therapy groups. VAS, pelvic tilt, and pelvic incidence was positively changed after sling
exercise. However, only the visual analogue scale was found to be improved after physical
therapy. [Conclusion] Sling exercise therapy and physical therapy were effective in
reducing pain. However, pelvic tilt and pelvic incidence were positively changed after
sling exercise therapy for Lumbosacral Sagittal Alignment, but were unchanged after
physical therapy. Therefore, sling exercise therapy is more effective than physical
therapy for the recovery of Lumbosacral Sagittal Alignment in patients with chronic low
back pain.
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Affiliation(s)
- Hee Sook Roh
- Department of Physical Therapy, College of Health Science, Eulji University: 212 Yangji-dong, Sujeong-gu, Seongnam-si, Gyeonggi-do 461-713, Republic of Korea
| | - Won Je Cho
- Department of Physical Education, Dankook University, Republic of Korea
| | - Won Jong Ryu
- Department of Physical Therapy, Collage of Health Science, Seonam University, Republic of Korea
| | - Seung Jin Park
- Department of Physical Education, Dankook University, Republic of Korea
| | - Chang Sik An
- Department of Physical Therapy, College of Health Science, Eulji University: 212 Yangji-dong, Sujeong-gu, Seongnam-si, Gyeonggi-do 461-713, Republic of Korea
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Lee SB, Cho WJ. The effect of sling exercise on sagittal lumbosacral angle and intervertebral disc area of chronic low back pain patients. J Exerc Rehabil 2016; 12:471-475. [PMID: 27807527 PMCID: PMC5091064 DOI: 10.12965/jer.1632676.338] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/02/2016] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to observe the change of lumbosacral angle and intervertebral disc (IVD) area. The study was conducted on chronic low back pain (CLBP) female patients for 12 weeks by operating sling exercise and general physical therapy. The 57 CLBP were divided into 2 groups which, sling exercise group (SEG, n=34) and general physical therapy group (PTG, n=23). The experiment was conducted three times a week for 12 weeks. The lumbosacral angle, which means the angle between the L1–L2 lumbar was measured by plain radiography. The IVD area, which means the IVD height and volume was measured by magnetic resonance imaging. The pain was measured by visual analogue scale (VAS). As a result, after 12-week exercise, VAS had decreased in all groups. The angle of L3–4 and L4–5 and the height of IVD had increased in SEG. Also, IVD height and volume has more improved in SEG compare the PTG. Therefore, the sling exercise is proper treatment for CLBP patients’ recovery because It improve the lumbosacral angle and IVD area.
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Affiliation(s)
- Seung-Bum Lee
- Department of Physical Education, Gyeongin National University of Education, Incheon, Korea
| | - Won-Je Cho
- Department of Physical Education, College of Education, Dankook University, Yongin, Korea
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Oliveira NTBD, Freitas SMSF, Fuhro FF, Luz MAD, Amorim CF, Cabral CMN. Muscle Activation During Pilates Exercises in Participants With Chronic Nonspecific Low Back Pain: A Cross-Sectional Case-Control Study. Arch Phys Med Rehabil 2016; 98:88-95. [PMID: 27693691 DOI: 10.1016/j.apmr.2016.09.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/31/2016] [Accepted: 09/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the amplitude of the electromyographic activity of trunk muscles during Pilates exercises in women with and without chronic low back pain (LBP). DESIGN Case-control study. SETTING University physical therapy clinic. PARTICIPANTS Women (N=60) divided into an LBP group and a control group. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Amplitude of the electromyographic activity (root mean square values) of the gluteus maximus and external oblique muscles collected during 3 Pilates exercises: Shoulder Bridge performed on the mat, and Hip Roll and Breathing performed in equipment. Pain intensity was assessed in the LBP group. RESULTS The amplitude of the electromyographic activity was similar between groups (P≥.05). For both groups, the amplitude of the gluteus maximus was higher in the Shoulder Bridge exercise compared with the Hip Roll with 2 springs (control group: mean difference [MD]=.18; 95% confidence interval [CI], .05-.41; LBP group: MD=.29; 95% CI, .16-.31) and the Breathing exercise (control group: MD=-.40; 95% CI, -.55 to -.26; LBP group: MD=-.36; 95% CI, -.52 to -.20). The amplitude of the external oblique muscle was higher in the Shoulder Bridge compared with the Hip Roll with 2 springs (control group: MD=.13; 95% CI, .05-.21; LBP group: MD=.18; 95% CI, .03-.33). Pain intensity increased after exercises, but this increase was lower for the mat exercises. CONCLUSIONS Similar muscle activation between groups was found. The findings suggest that mat exercises caused less pain and a greater difference in the amplitude of muscle activation compared with the equipment-based exercises.
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Affiliation(s)
| | | | - Fernanda Ferreira Fuhro
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
| | | | - Cesar Ferreira Amorim
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo SP, Brazil
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Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial. Phys Ther 2016; 96:382-9. [PMID: 26294680 DOI: 10.2522/ptj.20150404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/09/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness. OBJECTIVE The aim of this study will be to investigate the effectiveness and cost-effectiveness of the Pilates method with different weekly frequencies in the treatment of patients with nonspecific low back pain. DESIGN This is a randomized controlled trial with blinded assessor. SETTING This study will be conducted at a physical therapy clinic in São Paulo, Brazil. PARTICIPANTS Two hundred ninety-six patients with nonspecific low back pain between the ages of 18 and 80 years will be assessed and randomly allocated to 4 groups (n=74 patients per group). INTERVENTION All groups will receive an educational booklet. The booklet group will not receive additional exercises. Pilates group 1 will follow a Pilates-based program once a week, Pilates group 2 will follow the same program twice a week, and Pilates group 3 will follow the same program 3 times a week. The intervention will last 6 weeks. MEASUREMENTS A blinded assessor will evaluate pain, quality-adjusted life-years, general and specific disability, kinesiophobia, pain catastrophizing, and global perceived effect 6 weeks, 6 months, and 12 months after randomization. LIMITATIONS Therapists and patients will not be blinded. CONCLUSIONS This will be the first study to investigate different weekly frequencies of treatment sessions for nonspecific low back pain. The results of this study will contribute to a better definition of treatment programs for this population.
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Ribeiro IA, Oliveira TDD, Blois CR. Effects of Pilates and Classical Kinesiotherapy on chronic low back pain: a case study. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.004.ao13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction : Chronic low back pain (LBP) is characterized by daily lower back pain lasting more than three consecutive months. It may lead to functional disability and can be treated by several physical therapy techniques, including therapeutic exercise. The aim of this study was to investigate the effects of pilates and classical kinesiotherapy on the treatment of pain and functional disability in patients with chronic low back pain. Materials and methods : The study sample consisted of five patients with a diagnosis of chronic low back pain and a mean age of 32.4 ± 15.6 years. A Visual Analogue Scale (VAS) was used for pain assessment, and the Oswestry Disability Index was used to assess functional disability at the beginning and at the end of the intervention. Patients were divided into two groups and received 20 individual sessions of therapeutic exercise at a frequency of two sessions per week. Group A was treated with classical kinesiotherapy and group B was treated with pilates exercises. Statistical analysis was performed using Wilcoxon's test. The significance level was set at 5%. Results : There was a significant reduction in pain (p = 043) and functional disability (p = 042) in both groups. We found no significant differences between the effects of pilates and classical kinesiotherapy on pain and functional disability. Conclusions : We conclude that, in the population studied here, both pilates and classical kinesiotherapy were effective in treating chronic low back pain symptoms, with no significant difference between them.
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Homayouni K, Naseri M, Zaravar F, Zaravar L, Karimian H. COMPARISON OF THE EFFECT OF AQUATIC PHYSICAL THERAPY AND CONVENTIONAL PHYSICAL THERAPY IN PATIENTS WITH LUMBAR SPINAL STENOSIS (A RANDOMIZED CONTROLLED TRIAL). ACTA ACUST UNITED AC 2015. [DOI: 10.1142/s0218957715500025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To assess and compare the effect of aquatic and conventional physical therapy, two well-known non-operative therapeutic options in patients with lumbar spinal stenosis (LSS). Methods: 50 patients with low back pain and the diagnosis of LSS were recruited in this prospective parallel randomized controlled trial. Patients in group one were enrolled in aquatic therapy program and those in group two attended physical therapy sessions through application of physical modalities and receiving a home-based exercise program. Pain and walking ability were measured in each group before therapy, immediately after therapy and three months later. Results: Patients in both groups improved regarding pain either assessed immediately after therapy (repeated measure test, p < 0.001) or three months later (Wilcoxon test, p < 0.001 for group one and p = 0.005 for group two). Functioning improved in both groups (repeated measure test, p < 0.001) but this advantage did not remain significant after three months follow up in group two (repeated measure test, p = 0.002 in group one and p = 0.181 in group two). Patients in group one had significantly more favorable outcome than group two regarding functioning (independent samples t-test, p = 0.02) and pain (Mann–Whitney test, p = 0.001); however, this superiority didn't sustain in long term follow up. Conclusion: Aquatic therapy can provide greater short term improvement in pain and functioning than conventional physical therapy in patients with LSS especially those with limited capability for exercise on land.
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Affiliation(s)
- Kaynoosh Homayouni
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahshid Naseri
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Foroozandeh Zaravar
- School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Zaravar
- School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hajar Karimian
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
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Miyamoto GC, Costa LOP, Cabral CMN. Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis. Braz J Phys Ther 2015; 17:517-32. [PMID: 24346291 PMCID: PMC4207151 DOI: 10.1590/s1413-35552012005000127] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 06/18/2013] [Indexed: 11/23/2022] Open
Abstract
Objective To systematically review the available evidence on the efficacy of the
Pilates method in patients with chronic nonspecific low back pain. Method Searches were performed in MEDLINE, EMBASE, PEDro, SciELO, LILACS, CINAHL and
CENTRAL in March 2013. Randomized controlled trials that tested the
effectiveness of the Pilates method (against a nontreatment group, minimal
intervention or other types of interventions) in adults with chronic low
back pain were included regardless the language of publication. The outcome
data were extracted from the eligible studies and were combined using a
meta-analysis approach. Results The searches identified a total of 1,545 articles. From these, eight trials
were considered eligible, and seven trials were combined in the
meta-analysis. The comparison groups were as follows: Pilates versus other
types of exercises (n=2 trials), and Pilates versus no treatment group or
minimal intervention (n=4 trials) for short term pain; Pilates versus
minimal intervention for short-term disability (n=4).We determined that
Pilates was not better than other types of exercises for reducing pain
intensity. However, Pilates was better than a minimal intervention for
reducing short-term pain and disability (pain: pooled mean difference=1.6
points; 95% CI 1.4 to 1.8; disability: pooled mean difference=5.2 points;
95% CI 4.3 to 6.1). Conclusions Pilates was better than a minimal intervention for reducing pain and
disability in patients with chronic low back pain. Pilates was not better
than other types of exercise for short-term pain reduction.
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Cox decompression manipulation and guided rehabilitation of a patient with a post surgical c6-c7 fusion with spondylotic myelopathy and concurrent L5-s1 radiculopathy. J Chiropr Med 2015; 13:110-5. [PMID: 25685119 DOI: 10.1016/j.jcm.2014.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 04/17/2014] [Accepted: 04/20/2014] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The purpose of this case report is to describe combined treatment utilizing Cox distraction manipulation and guided rehabilitation for a patient with spine pain and post-surgical C6-7 fusion with spondylotic myelopathy and L5-S1 radiculopathy. CLINICAL FEATURES A 38-year-old man presented to a chiropractic clinic with neck pain and a history of an anterior cervical spine plate fusion at C6-7 after a work related accident 4 years earlier. He had signs and symptoms of spondolytic myelopathy and right lower back, right posterior thigh pain and numbness. INTERVENTION AND OUTCOME The patient was treated with Cox technique and rehabilitation. The patient experienced a reduction of pain on a numeric pain scale from 8/10 to 3/10. The patient was seen a total of 12 visits over 3 months. No adverse effects were reported. CONCLUSIONS A patient with a prior C6-7 fusion with spondylotic myelopathy and concurrent L5-S1 radiculopathy improved after a course of rehabilitation and Cox distraction manipulation. Further research is needed to establish its efficiency.
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Irandoust K, Taheri M. The effects of aquatic exercise on body composition and nonspecific low back pain in elderly males. J Phys Ther Sci 2015; 27:433-5. [PMID: 25729184 PMCID: PMC4339154 DOI: 10.1589/jpts.27.433] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/02/2014] [Indexed: 01/11/2023] Open
Abstract
[Purpose] The purpose of this study was to investigate the effect of aquatic exercises on
nonspecific low back pain (LBP) in elderly males. [Subjects and Methods] Thirty-two
elderly men aged 65 or older were recruited and randomly allocated to two groups: aquatic
training (3 d/wk for 12 wk) or a control group. Body mass index (BMI), percentage of body
fat (PBF), waist-hip ratio (WHR), and trunk muscle mass were measured before and after
training. [Results] The results suggested that all obesity variables including BMI, WHR,
and PBF of the aquatic training group were decreased significantly, while the trunk muscle
mass of the aquatic training group was increased significantly. Furthermore, low back pain
was decreased in the subjects after the intervention. [Conclusion] The water-based program
improved LBP and body composition in the elderly men.
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Affiliation(s)
- Khadijeh Irandoust
- Department of Physical Education, Imam Khomeini International University: Qazvin 34149-16818, Iran
| | - Morteza Taheri
- Department of Physical Education, Imam Khomeini International University: Qazvin 34149-16818, Iran
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Abstract
A phenomenological approach was used to explore the experiences of 11 adults attending Awareness Through Movement lessons in the Feldenkrais Method to manage chronic-episodic back pain. Semistructured interviews were analyzed. The results suggest improving self-efficacy through somatic education and awareness potentially offers a way forward given the back pain epidemic.
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Santos RBDC, Carneiro MIS, Oliveira DMD, Maciel ABDR, Monte-Silva KKD, Araújo MDGR. Impact of dry needling and ischemic pressure in the myofascial syndrome: controlled clinical trial. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.004.ao03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Musculoskeletal pain is a common clinical condition and about 10% of the population have musculoskeletal disorder. Objective The aim of this study was to evaluate whether ischemic pressure and dry needling techniques are able to reduce the pain of patients with myofascial pain syndrome. Method 22 patients aged 20-75 years were randomized into 3 groups: ischemic pressure (IPG = 8), dry needling (DNG = 7) and control (CG = 7). Patients in the IPG and DNG were assessed before and after 10 intervention sessions, which occurred 3 times per week. The CG was assessed initially and reassessed three weeks later. The assessment of pain was done through Visual Analogic Scale (VAS) and quality of life through WHOQOL-BREF (5 domains: global, physical, psychological, social and environmental). Results There was no significant difference for clinical and demographic data of all groups at baseline, except for age (p = 0.042). The results of the VAS expressed that IPG had pain relief in most sessions, the same was not observed for DNG. Comparing the 2 groups was obtained difference in the 4th and 8th sessions. The results of the WHOQOL-BREF showed that the three groups had a significant increase in the psychological domain. The same was not true for global domains, physical, environmental and social. Conclusion Ischemic pressure and dry needling were able to reduce the pain of patients and also change their quality of life, specifically the psychological aspect.
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Vasconcellos MHOD, Silva RDSD, Santos SMBD, Merlo JRDC, Conceição TMA. The Pilates® Method in the treatment of lower back pain. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.003.ar01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction The Pilates® method incorporates a number of the guidelines recommended for therapeutic exercises considered to be effective in the treatment of chronic lower back pain, such as the contraction of the transversus abdominis and multifidus muscles, associated with breathing, while taking into account the individual characteristics of patients. Objective To assess the effects of the Pilates® method on the treatment of lower back pain. Method This systematic review includes papers published from 2000 to 2010 in the BIREME, LILACS, MEDLINE and SciELO databases. The keywords used were spinal stabilization, Pilates®, and back pain and their equivalents in Portuguese. Results Imbalance among the trunk’s agonist-antagonist muscles and the ineffective activation of the transversus abdominis are risk factors for the onset of lower back pain that can be mitigated with the practice of Pilates®-based exercises. Conclusion The method has clinical effects similar to those obtained with traditional stabilization exercises and Back School exercises in the treatment of chronic lower back pain and are considered more satisfactory than conservative treatments.
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Hough PA, Van Rooyen FC, Bredenkamp E, Brough K, Ferreira M, Myburgh H, Snyman C, Van Niekerk C. Guidelines prescribed by general practitioners to patients with acute low back pain regarding ‘return to work’. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2006.10873476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Yoo JH, Kim SE, Lee MG, Jin JJ, Hong J, Choi YT, Kim MH, Jee YS. The effect of horse simulator riding on visual analogue scale, body composition and trunk strength in the patients with chronic low back pain. Int J Clin Pract 2014; 68:941-9. [PMID: 25039929 DOI: 10.1111/ijcp.12414] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders, and thus effective treatments are required. Recently, real horseback riding has been reported to be beneficial for the patients. However, it has some limitations, such as limited approaches and safety issues. OBJECTIVE The purpose of this study was to investigate the effect of horse simulator riding on back pain, body composition and trunk strength in the patients with CLBP. PARTICIPANTS Forty-seven men with CLBP (mean age 20.55 ± 1.38 years) were randomly divided into a control group (n = 23) and a horse simulator riding group (n = 24), and visual analogue scale (VAS), body composition and isokinetic trunk strength were measured after 8 weeks for which subjects in a horse simulator riding group had performed the horse simulator exercise (HSE). RESULTS Horse simulator exercise significantly reduced pain scores of VAS and enhanced isokinetic torques of trunk at 30 and 90°/s. There were also significantly increased muscle mass and decreased fat mass in horse simulator riding group. CONCLUSION It can be inferred that HSE may be helpful in relief of back pain and recovery of back function through developing trunk strength and balancing the ratio of trunk flexor/extensor muscles.
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Affiliation(s)
- J-H Yoo
- Health Management, Sahmyook University, Seoul, Korea
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Natour J, Cazotti LDA, Ribeiro LH, Baptista AS, Jones A. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil 2014; 29:59-68. [DOI: 10.1177/0269215514538981] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To assess the effectiveness of pilates method on patients with chronic non-specific low back pain (LBP). Method: A randomized controlled trial was carried out in sixty patients with a diagnosis of chronic non-specific LBP. Patients were randomly assigned to one of two groups: Experimental Group (EG) that maintained medication treatment with use of NSAID and underwent treatment with the pilates method and Control Group (CG) that continue medication treatment with use of NSAID and did not undergo any other intervention. A blinded assessor performed all evaluations at baseline (T0), after 45, 90, and 180 days (T45, T90 and T180) for: pain (VAS), function (Roland Morris questionnaire), quality of life (SF-36), satisfaction with treatment (Likert scale), flexibility (sit and reach test) and NSAID intake. Results: The groups were homogeneous at baseline. Statistical differences favoring the EG were found with regard to pain ( P < 0.001), function ( P < 0.001) and the quality of life domains of functional capacity ( P < 0.046), pain ( P < 0.010) and vitality ( P < 0.029). Statistical differences were also found between groups regarding the use of pain medication at T45, T90 and T180 ( P < 0.010), with the EG taking fewer NSAIDs than the CG. Conclusions: The pilates method can be used by patients with LBP to improve pain, function and aspects related to quality of life (functional capacity, pain and vitality). Moreover, this method has no harmful effects on such patients.
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Affiliation(s)
- Jamil Natour
- Universidade Federal de São Paulo, Rheumatology Division, São Paulo, SP, Brazil
| | | | | | | | - Anamaria Jones
- Universidade Federal de São Paulo, Rheumatology Division, São Paulo, SP, Brazil
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Park WM, Kim K, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. ACTA ACUST UNITED AC 2014; 19:527-33. [PMID: 24913413 DOI: 10.1016/j.math.2014.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 04/09/2014] [Accepted: 05/09/2014] [Indexed: 11/25/2022]
Abstract
Traction therapy is one of the most common conservative treatments for low back pain. However, the effects of traction therapy on lumbar spine biomechanics are not well known. We investigated biomechanical effects of two-step traction therapy, which consists of global axial traction and local decompression, on the lumbar spine using a validated three-dimensional finite element model of the lumbar spine. One-third of body weight was applied on the center of the L1 vertebra toward the superior direction for the first axial traction. Anterior translation of the L4 vertebra was considered as the second local decompression. The lordosis angle between the superior planes of the L1 vertebra and sacrum was 44.6° at baseline, 35.2° with global axial traction, and 46.4° with local decompression. The fibers of annulus fibrosus in the posterior region, and intertransverse and posterior longitudinal ligaments experienced stress primarily during global axial traction, these stresses decreased during local decompression. A combination of global axial traction and local decompression would be helpful for reducing tensile stress on the fibers of the annulus fibrosus and ligaments, and intradiscal pressure in traction therapy. This study could be used to develop a safer and more effective type of traction therapy.
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Affiliation(s)
- Won Man Park
- Department of Mechanical Engineering, Kyung Hee University, Yongin-si, Gyeonggi-do 446-701, Republic of Korea
| | - Kyungsoo Kim
- Department of Applied Mathematics, Kyung Hee University, Yongin-si, Gyeonggi-do 446-701, Republic of Korea
| | - Yoon Hyuk Kim
- Department of Mechanical Engineering, Kyung Hee University, Yongin-si, Gyeonggi-do 446-701, Republic of Korea.
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Haladay DE, Miller SJ, Challis JH, Denegar CR. Responsiveness of the double limb lowering test and lower abdominal muscle progression to core stabilization exercise programs in healthy adults: a pilot study. J Strength Cond Res 2013; 28:1920-7. [PMID: 24343322 DOI: 10.1519/jsc.0000000000000336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Low back pain (LBP) is one of the most prevalent and expensive health care problems in the United States. Studies suggest that stabilization exercise may be effective in the management of people with LBP. To accurately assess the effect of stabilization programs on muscle performance, clinicians need an objective measure that is both valid and reliable. The purpose of this study was to determine whether the double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) can detect a change in abdominal muscle performance after stabilization exercises. Eleven healthy participants (4 men and 7 women) were randomly assigned to either a specific stabilization exercise (SSE) or general stabilization exercise (GSE) group and were evaluated by the DLLT and LAMP before, during, and at the end of 8 weeks of training. Subjects attended exercise sessions twice per week over 8 weeks. No significant difference in pretest performance existed between the 2 groups. No significant difference was detected with the DLLT for either the SSE or GSE over time or when groups were combined. The LAMP detected a significant difference for the combined groups and GSE but not SSE over time. These data indicate that the LAMP is sensitive to change after a spinal stabilization program, whereas the DLLT does not detect a change after these programs. Furthermore, the GSE was more effective in producing these changes. Additional testing of these assessments is necessary to further validate these tests and to identify specific populations for which these tests may be most appropriate.
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Affiliation(s)
- Douglas E Haladay
- 1School of Physical Therapy and Rehabilitation Sciences, University of South Florida, Tampa, Florida; 2Department of Kinesiology, Pennsylvania State University; and 3Department of Kinesiology, University of Connecticut
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Odebiyi DO, Henschke N, Ferreira ML, Tella A. Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain. Hippokratia 2013. [DOI: 10.1002/14651858.cd010500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Daniel Oluwafemi Odebiyi
- College of Medicine, University of Lagos, Lagos; Department of Physiotherapy, Faculty of Clinical Sciences; PMB 12003, Idi-araba, Surulere Lagos Lagos Nigeria 101014
| | - Nicholas Henschke
- University of Heidelberg; Institute of Public Health; Im Neuenheimer Feld 324 Heidelberg Germany 69120
| | | | - Abidemi Tella
- University of Lagos, Nigeria; Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine; PMB 12003, Surulere, Lagos Lagos Lagos Nigeria 101014
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Quality of systematic reviews on specific spinal stabilization exercise for chronic low back pain. J Orthop Sports Phys Ther 2013; 43:242-50. [PMID: 23321935 DOI: 10.2519/jospt.2013.4346] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Systematic literature review. OBJECTIVE To evaluate the quality of systematic reviews (SRs) on specific stabilization exercises for chronic low back pain (LBP). BACKGROUND Multiple SRs regarding the effectiveness of lumbar stabilization exercises for people with chronic LBP have been published. As more SRs are published, the more it is recognized that, like other forms of research, methodological quality affects the validity of, and conclusions drawn from, the data. METHODS A search of MEDLINE, CINAHL, and Embase was completed. Additionally, the PEDro database was screened and hand searching was completed. Included SRs had to contain randomized controlled trials examining a specific stabilization exercise program for the treatment of chronic LBP. Additionally, the assessed outcome measures had to include pain and/or disability measures. Literature reviews and clinical practice guidelines were excluded. Three reviewers independently assessed each SR for methodological quality. RESULTS The search produced 665 SRs for review, of which 8 fulfilled the inclusion criteria. Consensus quality assessment scores ranged from 13/26 to 26/26, with an average of 20.7 points. Percent agreement and kappa values for individual criteria scores ranged from 50% to 92% and 0.25 to 0.85, respectively. Agreement was moderate to substantial across individual items, except for criterion 1. The intraclass correlation coefficient for overall score was 0.98 (95% confidence interval: 0.96, 0.99). CONCLUSION This review of SRs identified several high-quality reviews that indicated some benefit of specific stabilization exercise programs for patients with nonspecific chronic LBP. LEVEL OF EVIDENCE Therapy, level 1a.
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Miyamoto GC, Costa LOP, Galvanin T, Cabral CMN. The efficacy of the addition of the Pilates method over a minimal intervention in the treatment of chronic nonspecific low back pain: a study protocol of a randomized controlled trial. J Chiropr Med 2013; 10:248-54. [PMID: 22654682 DOI: 10.1016/j.jcm.2011.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 05/02/2011] [Accepted: 06/21/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE There is little high-quality evidence on the efficacy of the Pilates-based exercises for the treatment of chronic nonspecific low back pain. Therefore, the objective of this paper is to present a study protocol to investigate the efficacy of adding Pilates-based exercises to a minimum intervention in patients with chronic non-specific low back pain. METHODS This randomized controlled trial will recruit 86 patients of both sexes, aged between 18 and 60 years, with chronic non-specific low back pain. The participants will be randomly allocated into 2 treatment groups: the Booklet Group, which will receive a booklet with postural orientations, and the Pilates Group, which will receive the same booklet in addition to a Pilates-based exercises program. The general and specific functional capacities of the patient, kinesiophobia, pain intensity, and the global perceived effect will be evaluated by a blinded assessor before randomization and at 6 weeks and 6 months after randomization. In addition, the expectations of the participants and their confidence in the treatment will be evaluated before the randomization and after the first treatment session, respectively. CONCLUSIONS It is hoped that the results of this study will provide high-quality evidence on the usefulness of Pilates-based exercises in the treatment of chronic non-specific low back pain.
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Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews. BMC Med Res Methodol 2013; 13:7. [PMID: 23331384 PMCID: PMC3563510 DOI: 10.1186/1471-2288-13-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 01/16/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. METHODS This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. RESULTS A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. CONCLUSION There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words).
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Affiliation(s)
- Cherie Wells
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Gregory S Kolt
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Paul Marshall
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Bridget Hill
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Jeon JK, Lim HS, Shin SR, Kim BH, Lee SM. Effects of Three Bridging Exercises on Local and Global Muscles of Middle Aged Women. J Phys Ther Sci 2013; 25:853-6. [PMID: 24259869 PMCID: PMC3820385 DOI: 10.1589/jpts.25.853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/08/2013] [Indexed: 12/05/2022] Open
Abstract
[Purpose] This study investigated the muscle activity differences of three different
lumbar stabilization exercises in a comparison of middle-aged and young women. [Subjects]
Seventeen middle-aged women and fifteen young women were enrolled in this study. Patients
with a history of any neurologic disorders, orthopedic disorders, or cardiopulmonary
problems that would have affected their lumbar stabilization exercise performance were
excluded. [Methods] All subjects performed 3 exercises while the surface electromographic
activity was recorded of the rectus abdominis, internal oblique, multifidus, and
iliocostalis lumbolum. The mean electromyographic amplitudes obtained during the exercise
were normalized to the amplitude of maximal voluntary isometric contraction (%MVIC) to
produce an inter-individually comparable muscle activity index. [Results] The highest
muscle activity of middle-aged women was observed in the ring bridging exercise. The
middle-aged women had higher levels of all muscle activaties than the young women,
particularly in the multifidus muscle and iliocostalis lumborum. No significant difference
in muscle activity ratio was observed between the local muscles and global muscles in the
three different exercises, though the muscle activity ratio was the highest in the ring
bridging exercise. The young women group showed a higher ratio of the internal
oblique/rectus abdominus than the middle aged women in the bridging exercise. [Conclusion]
The ring bridging exercise should be used for stabilizing the lumbar area because the
young women showed a higher ratio than the middle aged women.
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Affiliation(s)
- Ji Kyeng Jeon
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung2-dong, Nowon-gu, Seoul 139-742, Republic of Korea
| | - Hee Sung Lim
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung2-dong, Nowon-gu, Seoul 139-742, Republic of Korea
| | | | - Bo Hyun Kim
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung2-dong, Nowon-gu, Seoul 139-742, Republic of Korea
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung2-dong, Nowon-gu, Seoul 139-742, Republic of Korea
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Baena-Beato PA, Arroyo-Morales M, Delgado-Fernández M, Gatto-Cardia MC, Artero EG. Effects of different frequencies (2-3 days/week) of aquatic therapy program in adults with chronic low back pain. A non-randomized comparison trial. PAIN MEDICINE 2012; 14:145-58. [PMID: 23279214 DOI: 10.1111/pme.12002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the effects of an aquatic therapy program with different frequencies (2 vs 3 days per week) in chronic low back pain. DESIGN [corrected] Non-randomized comparison trial. SETTING Sport and spa community health club. SUBJECTS Fifty-four adults with chronic low back pain (48.9 ± 10.0 years). INTERVENTION Eight-week aquatic therapy program. OUTCOME MEASURES Pain (visual analog scale [VAS]), disability (Oswestry Disability Index), and quality of life (Short-Form Health Survey 36), body composition (weight, body mass index, body fat mass, body fat percentage, and skeletal muscle mass), and health-related fitness (sit and reach, handgrip strength, curl-up, Rockport 1-mile test). RESULTS Both experimental groups presented significant improvements in low back pain and disability (P < 0.001) compared with control group. The 3 days/week group showed significantly greater benefits at VAS flexion and disability (P < 0.001) than the 2 days/week group. Regarding quality of life, both intervention groups presented significant differences for Physical Role (P < 0.05), Bodily Pain (P < 0.001), General Health (P = 0.012), and Standardized Physical Component (P < 0.001) compared with control group. Both experimental groups significantly improved all health-related fitness parameters (P < 0.01). The 3 days/week group showed significantly greater benefits at curl-up and heart rate (P < 0.001) than the 2 days/week group. No significant changes between treatment groups and control were found in body composition. CONCLUSIONS Eight weeks of aquatic therapy program decrease levels of back pain and disability, increase quality of life, and improve health-related fitness in adults with chronic low back pain without effects in body composition. A dose-response effect was observed in some parameters, with greater benefits when exercising 3 days per week compared with 2 days.
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Aladro-Gonzalvo AR, Araya-Vargas GA, Machado-Díaz M, Salazar-Rojas W. Pilates-based exercise for persistent, non-specific low back pain and associated functional disability: a meta-analysis with meta-regression. J Bodyw Mov Ther 2012; 17:125-36. [PMID: 23294694 DOI: 10.1016/j.jbmt.2012.08.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 07/29/2012] [Accepted: 08/17/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purposes of this study were to systematically review and apply regression analysis to randomised controlled trials [RCTs] that evaluated the effectiveness of Pilates exercise in improving persistent, non-specific low back pain and functional disability. METHODS Electronic databases were searched from January 1950 to March 2011. Articles were eligible for inclusion if they were RCTs comparing Pilates exercise with a placebo treatment [PT], minimal intervention [MI] or another physiotherapeutic treatment [APT]. RESULTS Nine trials were included. Pilates was moderately superior to APT (pooled Effect Size [ES] weighted = -0.55, 95% confidence interval [CI] = -0.08 to -1.03) in reducing disability but not for pain relief. Pilates provided moderate to superior pain relief compared to MI (pooled ES weighted = -0.44, 95% CI = -0.09 to -0.80) and a similar decrease in disability. The statistical model used did not detect any predictor variable. CONCLUSIONS Due to the presence of co-interventions and the low methodological quality of some studies, these conclusions should be interpreted with caution.
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