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Dennis S, Kwok W, Alison J, Hassett L, Nisbet G, Refshauge K, Sherrington C, Williams A. How effective are allied health group interventions for the management of adults with long-term conditions? An umbrella review of systematic reviews and its applicability to the Australian primary health system. BMC PRIMARY CARE 2024; 25:325. [PMID: 39232663 PMCID: PMC11373467 DOI: 10.1186/s12875-024-02570-7] [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: 01/18/2024] [Accepted: 08/09/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Group allied health interventions for people with chronic conditions may be a solution to increasing access to allied health in primary care. This umbrella review aimed to determine the effectiveness of allied health group interventions to improve health-related outcomes for adults with chronic conditions and the applicability of the findings to the Australian primary health care context. METHODS An umbrella review of systematic reviews conducted April-July 2022, searching eight databases. Systematic reviews were eligible if they included randomised controlled trials (RCT) or quasi-RCTs, community dwelling adults aged ≥ 18, at least one chronic condition, group intervention in scope for allied health professionals, and published in English after 2000. Studies were excluded if interventions were conducted in hospital or aged care facilities, out of scope for allied health, or unsupervised. RESULTS Two thousand three hundred eighty-five systematic reviews were identified: after screening and full text review 154 were included and data extracted from 90. The chronic conditions included: cancer (n = 15), cardiovascular disease (n = 6), mixed chronic conditions (n = 3), kidney disease (n = 1), low back pain (n = 12), respiratory disease (n = 8), diabetes (n = 14), heart failure (n = 9), risk of falls (n = 5), hypertension (n = 4, osteoarthritis (n = 6) and stroke (n = 8). Most group interventions included prescribed exercise and were in scope for physiotherapists and exercise physiologists. Overall, allied health group exercise programs for community dwelling adults improved health outcomes for most chronic conditions. Aggregated data from the systematic reviews suggests programs of 45-60 min per session, 2-3 times per week for 12 weeks. Lifestyle education and support for people with type-2 diabetes improved glycaemic control. CONCLUSIONS Prescribed group exercise delivered by allied health professionals, predominantly by exercise physiologists and physiotherapists, significantly improved health outcomes for community dwelling adults with a broad range of chronic conditions.
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Affiliation(s)
- Sarah Dennis
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
- Ingham Institute of Applied Medical Research, Liverpool, Australia.
- South Western Sydney Local Health District, Liverpool, Australia.
| | - Wing Kwok
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Jennifer Alison
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Allied Health, Sydney Local Health District, Sydney, Australia
| | - Leanne Hassett
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- South Western Sydney Local Health District, Liverpool, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Gillian Nisbet
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kathryn Refshauge
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Anna Williams
- Faculty of Health, University of Technology Sydney, Sydney, Australia
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Comachio J, Ferreira ML, Mork PJ, Holtermann A, Ho EKY, Wang DXM, Lan Q, Stamatakis E, Beckenkamp PR, Ferreira PH. Clinical guidelines are silent on the recommendation of physical activity and exercise therapy for low back pain: A systematic review. J Sci Med Sport 2024; 27:257-265. [PMID: 38267294 DOI: 10.1016/j.jsams.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To synthesise and evaluate the quality of the recommendations for exercise therapy and physical activity from guidelines for the prevention and/or management of low back pain. DESIGN Systematic review. METHODS Included clinical practice guidelines for the management of low back pain published between 2014 and 2022 and searched in 9 databases until September 2022. The quality of evidence was evaluated with the Appraisal of Guidelines, Research and Evaluation tool (AGREE-II instrument). RESULTS After screening 3448 studies, 18 clinical practice guidelines were included in this review. Only five (27 %) guidelines were judged as having a satisfactory quality of evidence (i.e., rigour of development and applicability), and 13 (72 %) of guidelines are discussed and rated as critical. Regarding physical activity, no guidelines provided recommendations for the primary prevention of low back pain or incorporated adequate physical activity aspects considering type, dosage, frequency, and intensity. For exercises, all (100 %) guidelines recommended at least one type of supervised exercise in the management of low back pain, and 16 (88 %) provided an overall recommendation for people to stay active. CONCLUSIONS Guidelines offer minimal or, sometimes, no detail regarding physical activity or specific exercise regimens for the management and prevention of low back pain. When some guidance is provided, the recommendations typically lack specificity concerning the type, intensity, duration, and frequency of exercise and, in many cases, they represent a combination of scarce available evidence and stakeholder perspectives.
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Affiliation(s)
- Josielli Comachio
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia.
| | - Manuela Loureiro Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Australia
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
| | | | - Emma Kwan-Yee Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Daniel Xin Mo Wang
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Qianwen Lan
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Emmanuel Stamatakis
- School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Paula R Beckenkamp
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Paulo Henrique Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
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Godfrey N, Donovan-Hall M, Roberts L. A qualitative study exploring the ritual-like activity and therapeutic relationship between Pilates teachers and clients with persistent low back pain. J Bodyw Mov Ther 2024; 37:25-37. [PMID: 38432814 DOI: 10.1016/j.jbmt.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 10/02/2023] [Accepted: 11/06/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND AND PURPOSE Pilates is a commonly recommended exercise modality for the management of persistent low back pain. Whilst guidelines recommend the use of exercise for low back pain, research suggests that no one exercise is superior, creating a question over the mechanism of effect. The patient-practitioner relationship may be important in managing low back pain; however, the relationship between Pilates teachers and clients is not well understood. The purpose of this study was to identify the components of the relationship between Pilates teachers and clients with persistent low back pain, explore key influences on the relationship, and ascertain the nature of the relationship. METHOD We conducted a qualitative, ethnographically-informed study at eight sites in the South of England, observing 24 Pilates sessions and interviewing 9 Pilates teachers and 10 clients with persistent low back pain. Fieldnotes and interview transcripts were analysed thematically. RESULTS The findings demonstrate a complex, multi-faceted interaction that occurs during Pilates sessions, grounded within certain health perceptions, and predicated on expectations of individuality, choice and expertise. A key finding reveals the perceived importance of mastery of prescribed movements with control and precision, in which clients particularly value the authority of the teacher in a directive learning environment. CONCLUSION We contend that the role of the Pilates teacher in this study facilitated the alleviation of clients' distress through the application of ritual-like Pilates activity. We conclude that the relationship between Pilates teachers and clients with persistent low back pain may be considered a therapeutic relationship.
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Affiliation(s)
- Nicola Godfrey
- University of Southampton, Health Sciences, Highfield, Southampton, Hants, SO17 1BJ, UK.
| | - Maggie Donovan-Hall
- University of Southampton, Health Sciences, Highfield, Southampton, Hants, SO17 1BJ, UK.
| | - Lisa Roberts
- University of Southampton, Health Sciences, Highfield, Southampton, Hants, SO17 1BJ, UK.
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Parfenov VA. Treatment of acute non-specific back pain, the use of group B vitamins. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2022. [DOI: 10.14412/2074-2711-2022-6-98-102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- V. A. Parfenov
- Department of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
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Feital AMBDF, Gonçalves BM, de Souza TR, Christo PP, Scalzo PL. Pilates method for low back pain in individuals with Parkinson’s disease: A feasibility study. J Bodyw Mov Ther 2022; 32:19-28. [DOI: 10.1016/j.jbmt.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
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Bomberg H, Lorenzana D, Schlickeiser J, Dünki A, Farshad M, Eichenberger U. [Noninvasive Treatments for Acute and Chronic Back Pain]. PRAXIS 2022; 111:797-813. [PMID: 36285410 DOI: 10.1024/1661-8157/a003858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Noninvasive Treatments for Acute and Chronic Back Pain Abstract. The therapy of back pain - especially the medication with opioids - can be challenging for the treating physician. Specific back pain can often be diagnosed by imaging and successfully treated by surgery or medication. In contrast, nonspecific back pain can be worsened by inappropriate imaging, questionable surgical indications and uncontrolled drug use. For the therapy of nonspecific back pain, maintaining daily activity and exercise therapy is central. Opioids are effective drugs for short-term use. However, long-term use often leads to opioid-induced hyperalgesia and hormonal dysfunction with decreased quality of life and libido. Furthermore, opioids can lead to abuse and addiction. After an ineffective treatment with non-opioids, opioids may be given for a limited time period (if possible shorter than four weeks) according to international guidelines.
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Affiliation(s)
- Hagen Bomberg
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
- Diese Autoren haben gleichermassen zu dieser Arbeit beigetragen und teilen sich die Erstautorschaft
| | - David Lorenzana
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
- Diese Autoren haben gleichermassen zu dieser Arbeit beigetragen und teilen sich die Erstautorschaft
| | - Jannis Schlickeiser
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
| | - Alexandro Dünki
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
| | | | - Urs Eichenberger
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich, Schweiz
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Denham-Jones L, Gaskell L, Spence N, Pigott T. A systematic review of the effectiveness of Pilates on pain, disability, physical function, and quality of life in older adults with chronic musculoskeletal conditions. Musculoskeletal Care 2021; 20:10-30. [PMID: 34028164 DOI: 10.1002/msc.1563] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This systematic review aims to evaluate the effectiveness and delivery of Pilates to reduce pain and disability and to improve physical function and quality of life in middle-aged to older adults with a range of chronic musculoskeletal conditions. METHODS Searches were conducted using CENTRAL, CINAHL, SCOPUS, Pubmed, PsycInfo, Web of Science Core Collection and Google Scholar. Inclusion criteria were controlled trials and observational studies, population mean age 50 years and over with chronic musculoskeletal conditions, using mat-based Pilates exercise. Outcomes included pain, disability, physical function and quality of life. RESULTS Seven studies were included, with a combined total sample of 397 participants (73% female). Pilates was significantly effective (p ≤ 0.05) for reducing back pain, neck pain and pain associated with knee osteoarthritis and osteoporosis. Additional significant disability, physical functioning and quality of life effects were found for back pain, osteoporosis, and knee OA. Overall Pilates was as effective as other exercise. Adherence to group exercise was good, but poor for home exercise. No significant adverse effects were reported. CONCLUSION Pilates is a safe and effective exercise intervention for adults over 50 with a diverse range of musculoskeletal conditions which may otherwise put them at risk of becoming sedentary. Although no overall significant superiority was found over other exercise, participants reported psychosocial benefits particular to the Pilates group exercise, with enjoyment a possible positive factor in adherence. Further research on Pilates exercises for various pathologies could inform teaching and improve engagement with older adults, including those with chronic conditions.
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Affiliation(s)
| | - Lynne Gaskell
- School of Health & Society, University of Salford, Salford, UK
| | - Nicola Spence
- School of Health & Society, University of Salford, Salford, UK
| | - Tim Pigott
- School of Health & Society, University of Salford, Salford, UK
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Nascimento DP, Gonzalez GZ, Araujo AC, Moseley A, Maher C, Costa LOP. Factors associated with the reporting quality of low back pain systematic review abstracts in physical therapy: a methodological study. Braz J Phys Ther 2021; 25:233-241. [PMID: 33246869 PMCID: PMC8134840 DOI: 10.1016/j.bjpt.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/03/2020] [Accepted: 10/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Abstracts of systematic reviews (SR) are frequently used to guide clinical decision-making. However, if the abstract is inadequately reported, key information may be missing and it may not accurately summarize the results of the review. OBJECTIVE We aimed to investigate 1) if abstracts are fully reported; 2) if abstract reporting is associated with review/journal characteristics in physical therapy for low back pain (LBP); and 3) if these abstracts are consistent with the corresponding full texts. METHODS We searched the Physiotherapy Evidence Database for SRs in physical therapy for LBP published between 2015 and 2017. Associations between abstract reporting quality and review/journal characteristics were explored with linear regression. Abstract reporting was assessed with the 12 item Preferred Reporting Items for Systematic Reviews and Meta-Analyses for abstracts (PRISMA-A) checklist. Consistency of reporting between abstracts and the full text was evaluated by comparing responses to each item of the PRISMA-A using Kappa coefficients. Methodological quality of the reviews was assessed with A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2). RESULTS We included 66 SRs, 9 Cochrane and 57 non-Cochrane. Review methodological quality ranged from 'high' (8%) to 'critically low' (76%). The mean ± SD of the "total number of PRISMA-A fully reported items" (range 0-12 points for fully reported items) was 4.1 ± 1.9 points for non-Cochrane review abstracts and 9.9 ± 1.1 points for Cochrane abstracts. Factors associated with reporting quality of abstracts were: journal impact factor (ß 0.20; 95% CI: 0.06, 0.35), number of words in abstract (ß 0.01; 95% CI: 0.00, 0.01) and review methodological quality ('critically low' with ß -3.06; 95% CI: -5.30, -0.82; with 'high' as reference variable). There was typically inconsistent reporting between abstract and full text, with most Kappa values lower than 0.60. CONCLUSIONS The abstracts of SRs in physical therapy for LBP were poorly reported and inconsistent with the full text. The reporting quality of abstracts was higher in journals with a higher impact factor, in abstracts with a greater number of words, and when the review was of higher methodological quality.
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Affiliation(s)
- Dafne Port Nascimento
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
| | - Gabrielle Zoldan Gonzalez
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Amanda Costa Araujo
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Anne Moseley
- The University of Sydney, Camperdown, Sydney, NSW, Australia; Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Christopher Maher
- The University of Sydney, Camperdown, Sydney, NSW, Australia; Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, Sydney, NSW, Australia
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9
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Hernando-Jorge A, Pérez-Del-Pozo D, Sánchez-Martín D, Beltran-Alacreu H. [Therapeutic exercise as treatment for spinal chronic pain: systematic review of randomized clinical trials]. Rehabilitacion (Madr) 2021; 55:49-66. [PMID: 32888707 DOI: 10.1016/j.rh.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of the present review was to analyze and compare the effectiveness of different types of therapeutic exercise in people with chronic spinal pain. METHODS Data search was conducted using the electronic database MEDLINE. Randomized clinical trials, conducted in patients between 18 and 65 years old with chronic pain in the spine region, were included. RESULTS Two independent reviewers performed the analysis of methodological quality using the PEDro scale, with 13 studies finally selected. The different types of therapeutic exercise had significant effects on pain reduction, decrease of disability and improvement of the quality of life of the patients. CONCLUSIONS The results show that there is no modality of therapeutic exercise superior to others. The combination of different therapeutic exercise modalities could be a complete tool for the management of chronic pain in the spine.
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Affiliation(s)
- A Hernando-Jorge
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Pérez-Del-Pozo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - D Sánchez-Martín
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España
| | - H Beltran-Alacreu
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, España; CranioSPain Research Group. Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, España.
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Phuphanich ME, Droessler J, Altman L, Eapen BC. Movement-Based Therapies in Rehabilitation. Phys Med Rehabil Clin N Am 2020; 31:577-591. [PMID: 32981580 PMCID: PMC7476461 DOI: 10.1016/j.pmr.2020.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one's own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.
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Affiliation(s)
- Melissa E Phuphanich
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, 11301 Wilshire Boulevard (117) Los Angeles, CA 90073, USA.
| | - Jonathan Droessler
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, 11301 Wilshire Boulevard (117) Los Angeles, CA 90073, USA
| | - Lisa Altman
- Healthcare Transformation, VA Greater Los Angeles Health Care System, 11301 Wilshire Boulevard (117) Los Angeles, CA 90073, USA; University of California Los Angeles- UCLA, Los Angeles, CA, USA
| | - Blessen C Eapen
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, 11301 Wilshire Boulevard (117) Los Angeles, CA 90073, USA; University of California Los Angeles- UCLA, Los Angeles, CA, USA
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Mendes Tozim B, Thomaz de Aquino Nava G, Zuliani Stroppa Marques AE, Tavella Navega M. Efficacy of the Pilates versus general exercises versus educational workshops on neuromuscular parameters: A randomized controlled trial. J Bodyw Mov Ther 2020; 26:420-427. [PMID: 33992277 DOI: 10.1016/j.jbmt.2020.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 06/30/2020] [Accepted: 08/28/2020] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Muscle strength, flexibility and changes in muscle recruitment patterns are usually associated to low back pain (LBP). Physical exercises can reverse the adverse changes associated to LBP. OBJECTIVES Compare Pilates, general exercises and educational workshop on muscle flexibility, strength and recruitment of the trunk extensor muscles in women with LBP. METHODS Forty-six women were randomly divided into Pilates group (PG, n = 16), general exercise group (GEG, n = 15), and educational group (EG, n = 15). This study sought to determine flexibility, muscle strength, and muscle recruitment of right (RIL), left (LIL) iliocostalis lumbar; right (RMU) and left (LMU) lumbar multifidus muscles. Both PG and GEG performed 16 exercise sessions, while EG attended 4 workshops. Statistical analysis used data sample from Shapiro-Wilk test, Pearson's correlation, multivariate analysis, mixed variance analysis, and Cohen's index. RESULTS Flexibility showed no differences (p > 0.05). Muscle strength increased in the intragroup analysis for PG (p = 0.003) and GEG (p = 0.002); however, the intergroup analysis presented no difference. Intergroup showed statistically significant differences for the recruitment of RMU in PG (p < 0.001). Intragroup analysis presented differences after interventions in PG for RIL (p = 0.001); in GEG for LIL (p = 0.005); and in EG for RIL (p = 0.007), LIL (p = 0.002) and RMU (p < 0.001). CONCLUSIONS None of the groups showed flexibility improvements. PG and GEG increased muscle strength through intragroup analysis. Intergroup analysis showed an increase in recruitment of the RMU muscle in PG and all groups demonstrated significant improvements in the intragroup analysis.
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Affiliation(s)
- Beatriz Mendes Tozim
- Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Marília, São Paulo, Brazil.
| | - Guilherme Thomaz de Aquino Nava
- Department of Physical Education, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
| | | | - Marcelo Tavella Navega
- Faculty of Philosophy and Sciences, São Paulo State University (UNESP), Marília, São Paulo, Brazil; Department of Physical Education, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil
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12
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Domingues de Freitas C, Costa DA, Junior NC, Civile VT. Effects of the pilates method on kinesiophobia associated with chronic non-specific low back pain: Systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:300-306. [PMID: 32826004 DOI: 10.1016/j.jbmt.2020.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 12/11/2019] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Patients with chronic low back pain with higher levels of kinesiophobia have a 41% greater risk of developing a physical disability. The kinesiophobia model suggests that patients fear movements because of pain, associating movement with worsening of their state. Studies that apply the Pilates method for chronic low back pain achieve positive results in reducing pain and disability, and moderate results regarding kinesiophobia. OBJECTIVE The purpose of this review is to evaluate the effects of the Pilates method on kinesiophobia associated with chronic non-specific low back pain. SEARCH METHODS The following databases were searched from August to October 2018: MEDLINE, PEDro, SciELO, LILACS and the Cochrane Database of Systematic Reviews (CENTRAL), without restriction of language and year of publication. SELECTION CRITERIA Randomized clinical trials assessing the effectiveness of the Pilates method in the treatment of kinesiophobia in patients with chronic non-specific low back pain. DATA COLLECTION AND ANALYSIS Two authors independently selected the studies, assessed the risk of bias and extracted data. A third author was consulted in case of disagreements. The primary outcome was kinesiophobia as evaluated by the Tampa scale. RESULTS Our electronic searches resulted in 314 studies; 288 studies were excluded and 27 were selected for reading in full-text. Five articles were included in this review and four in the meta-analysis. CONCLUSION There is a favorable effect of the Pilates method compared to minimal intervention or no treatment in reducing kinesiophobia associated with chronic non-specific low back pain, with a moderate quality of evidence. DESCRIPTORS Low Back Pain, Exercise Movement Techniques, Exercises, Pilates-Based.
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Affiliation(s)
| | | | - Nelson Carvas Junior
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Universidade Paulista (UNIP), Brazil
| | - Vinicius Tassoni Civile
- Universidade Metodista de São Paulo for Universidade Federal de São Paulo (UNIFESP), Universidade Paulista (UNIP), Brazil
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de Medeiros SA, de Almeida Silva HJ, do Nascimento RM, da Silva Maia JB, de Almeida Lins CA, de Souza MC. Mat Pilates is as effective as aquatic aerobic exercise in treating women with fibromyalgia: a clinical, randomized and blind trial. Adv Rheumatol 2020; 60:21. [DOI: 10.1186/s42358-020-0124-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/25/2020] [Indexed: 01/07/2023] Open
Abstract
Abstract
Background
The mat Pilates method is the therapeutic modalities which can be used in fibromyalgia treatment. Although there are no well-designed studies that prove the effectiveness of the mat Pilates method in this population. The objective was to evaluate the effectiveness of the mat Pilates method for improving symptoms in women with fibromyalgia.
Methods
A single blind randomized controlled trial in which 42 women with fibromyalgia were randomized into two groups: mat Pilates and aquatic aerobic exercise. The exercises were performed twice a week for 12 weeks. Two evaluations were performed: one at baseline (T0), and another at 12 weeks after randomization (T12). The primary outcome was pain measured by the Visual Analogue Scale (VAS). Secondary outcomes were function (Fibromyalgia Impact Questionnaire), sleep (Pittsburgh Sleep Quality Index [PSQI]), quality of life (Short Form 36 [SF-36]), fear avoidance (Fear Avoidance Beliefs Questionnaire [FABQ-BR]) and pain catastrophizing (Pain-Related Catastrophizing Thoughts Scale [PRCTS]).
Results
There was improvement in both groups in relation to pain and function (p < 0.05). The aspects related to quality of life and the FABQ questionnaire only showed improvement in the mat Pilates group (p < 0.05). There was improvement in the PSQI and PRCTS variables only in the aquatic aerobic exercise group (p < 0.05), but no differences were observed between the groups for any of the evaluated variables.
Conclusion
Significant improvements were observed in the two groups in relation to the disease symptoms, and no differences were observed between mat Pilates and aquatic aerobic exercise in any of the measured variables.
Trial registration
ClinicalTrials.gov Identifier (NCT03149198), May 11, 2017. Approved by the Ethics Committee of FACISA/UFRN (Number: 2.116.314).
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How to care for adults with low back pain in the primary care setting. Nursing 2020; 50:48-55. [PMID: 31977806 DOI: 10.1097/01.nurse.0000651624.64152.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Low back pain (LBP) is one of the most frequent patient complaints in primary care. This article discusses the assessment and treatment of patients with LBP, including nonpharmacologic and pharmacologic approaches.
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Kaartinen S, Aaltonen S, Korhonen T, Rottensteiner M, Kujala UM, Kaprio J. Cross-sectional associations between the diversity of sport activities and the type of low back pain in adulthood. Eur J Sport Sci 2020; 20:1277-1287. [PMID: 31854241 DOI: 10.1080/17461391.2019.1706642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Leisure-time physical activity has a complex relationship with low back pain (LBP). Thus, we aimed to investigate whether the diversity of sport activities is associated with the type of LBP. In the FinnTwin16 study, 4246 (55% females) Finnish twins at mean age 34.1 years replied to a health behaviour survey in 2010-2012. Based on the participation in different sport activities, we created two measures of diversity: quantity (i.e. the number of sport activities: 1, 2, 3, 4 and ≥5) and quality (i.e. the type of sport activity: endurance, strength, body care, etc.). Based on the frequency, duration and type of LBP, we created three groups: no history of LBP lasting more than one day, radiating LBP and non-radiating LBP. The associations between the quantity and quality of sport activities and the type of LBP were investigated with logistic regression analyses. Participation in ≥5 sport activities associated with less radiating and non-radiating LBP in analyses pooled across sex (odds ratio 0.46, 95% CI 0.30-0.69 and 0.66, 0.44-0.99, respectively). However, the associations attenuated after adjusting for several confounders. Participation in endurance sports was associated with less radiating (0.58, 0.43-0.76) and non-radiating (0.60, 0.44-0.81) LBP, whereas strength sports and body care only with less radiating LBP (0.76, 0.58-1.00 and 0.26, 0.09-0.74, respectively) adjusted for all sport types. On a sport-specific level, running and cycling were associated with less radiating and non-radiating LBP. In adulthood, the diversity of sport activities, particularly participation in endurance sports, may be associated with less radiating and non-radiating LBP.
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Affiliation(s)
- Sara Kaartinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Sari Aaltonen
- Institute of Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - Tellervo Korhonen
- Institute of Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - Mirva Rottensteiner
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute of Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
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Eight in Every 10 Abstracts of Low Back Pain Systematic Reviews Presented Spin and Inconsistencies With the Full Text: An Analysis of 66 Systematic Reviews. J Orthop Sports Phys Ther 2020; 50:17-23. [PMID: 31443622 DOI: 10.2519/jospt.2020.8962] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Overview study. BACKGROUND Abstracts of systematic reviews have presented 'spin' (i.e. overstated interpretation of study results) and inconsistency with the full text. OBJECTIVES 1. Do abstracts of low back pain reviews contain spin? 2. Do these abstracts consistently represent the full text? 3. Is abstract spin associated with the type of conclusion? METHODS We searched the Physiotherapy Evidence Database (PEDro) on 10th January 2018. Data were extracted from systematic reviews of physiotherapy interventions for low back pain, published between 2015 and 2017. Spin was assessed using a 7-item checklist. We evaluated consistency by comparing information contained in the abstract and the full text using the 7-item checklist with Kappa coefficient analysis. We used logistic regression analysis to evaluate the association between spin in the abstract and type of conclusion. We evaluated methodological quality using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews). RESULTS We included 66 eligible systematic reviews, subdivided into Cochrane (n=9) and non-Cochrane (n=57) reviews. There was some form of spin in 80% of abstracts. Abstracts of non-Cochrane reviews were not consistent with the full text (fair to moderate agreement). Cochrane review abstracts had substantial to almost perfect agreement with the full text. Spin was not associated with the type of conclusion in all systematic reviews (P < 0.05). The methodological quality ranged from 'high' to 'critically low'. CONCLUSIONS The abstracts of systematic reviews evaluating physiotherapy interventions for low back pain need improvement. J Orthop Sports Phys Ther, Epub 23 Aug 2019. doi:10.2519/jospt.2020.8962.
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Pfieffer ML. Evaluating and managing low back pain in primary care. Nurse Pract 2019; 44:40-47. [PMID: 31335502 DOI: 10.1097/01.npr.0000574664.42110.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Low back pain (LBP) is one of the most frequent patient complaints in primary care. Common LBP diagnoses include nonspecific LBP, radicular pain, lumbar-disk herniation, spinal infection, and ankylosing spondylitis. A thorough history and physical exam are imperative. LBP treatment is multifactorial and blends pharmacologic and nonpharmacologic approaches.
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Affiliation(s)
- Mary Lauren Pfieffer
- Mary Lauren Pfieffer is an instructor at the Vanderbilt University School of Nursing in Nashville, Tenn
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Malfliet A, Ickmans K, Huysmans E, Coppieters I, Willaert W, Bogaert WV, Rheel E, Bilterys T, Wilgen PV, Nijs J. Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain. J Clin Med 2019; 8:E1063. [PMID: 31331087 PMCID: PMC6679058 DOI: 10.3390/jcm8071063] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/03/2019] [Accepted: 07/16/2019] [Indexed: 02/07/2023] Open
Abstract
Chronic Low Back Pain (CLBP) is a major and highly prevalent health problem. Given the high number of papers available, clinicians might be overwhelmed by the evidence on CLBP management. Taking into account the scale and costs of CLBP, it is imperative that healthcare professionals have access to up-to-date, evidence-based information to assist them in treatment decision-making. Therefore, this paper provides a state-of-the-art overview of the best evidence non-invasive rehabilitation for CLBP. Taking together up-to-date evidence from systematic reviews, meta-analysis and available treatment guidelines, most physically inactive therapies should not be considered for CLBP management, except for pain neuroscience education and spinal manipulative therapy if combined with exercise therapy, with or without psychological therapy. Regarding active therapy, back schools, sensory discrimination training, proprioceptive exercises, and sling exercises should not be considered due to low-quality and/or conflicting evidence. Exercise interventions on the other hand are recommended, but while all exercise modalities appear effective compared to minimal/passive/conservative/no intervention, there is no evidence that some specific types of exercises are superior to others. Therefore, we recommend choosing exercises in line with the patient's preferences and abilities. When exercise interventions are combined with a psychological component, effects are better and maintain longer over time.
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Affiliation(s)
- Anneleen Malfliet
- Research Foundation-Flanders (FWO), 1090 Brussels, Belgium.
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
- Pain in Motion International Research Group, 1090 Brussels, Belgium.
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussel, Belgium.
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium.
| | - Kelly Ickmans
- Research Foundation-Flanders (FWO), 1090 Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussel, Belgium
| | - Eva Huysmans
- Research Foundation-Flanders (FWO), 1090 Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussel, Belgium
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Iris Coppieters
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium
| | - Ward Willaert
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium
| | - Wouter Van Bogaert
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
| | - Emma Rheel
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium
| | - Thomas Bilterys
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
| | - Paul Van Wilgen
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Transcare, Transdisciplinary Pain Management Centre, 9728 EE Groningen, The Netherlands
| | - Jo Nijs
- Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
- Pain in Motion International Research Group, 1090 Brussels, Belgium.
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussel, Belgium.
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Suh JH, Kim H, Jung GP, Ko JY, Ryu JS. The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine (Baltimore) 2019; 98:e16173. [PMID: 31261549 PMCID: PMC6616307 DOI: 10.1097/md.0000000000016173] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Various exercises have been proposed to mitigate chronic low back pain (LBP). However, to date, no one particular exercise has been shown to be superior. Hence, the aim of this study was to compare the efficiency between 2 exercises: the individualized graded lumbar stabilization exercise (IGLSE) and walking exercise (WE). METHODS A randomized controlled trial was conducted in 48 participants with chronic LBP. After screening, participants were randomized to 1 of 4 groups: flexibility exercise, WE, stabilization exercise (SE), and stabilization with WE (SWE) groups. Participants underwent each exercise for 6 weeks. The primary outcome was visual analog scale (VAS) of LBP during rest and physical activity. Secondary outcomes were as follows: VAS of radiating pain measured during rest and physical activity; frequency of medication use (number of times/day); Oswestry disability index; Beck depression inventory; endurances of specific posture; and strength of lumbar extensor muscles. RESULTS LBP during physical activity was significantly decreased in all 4 groups. Exercise frequency was significantly increased in the SE and WE groups; exercise time was significantly increased in the SE group. The endurance of supine, side lying, and prone posture were significantly improved in the WE and SWE groups. CONCLUSIONS Lumbar SE and WE can be recommended for patients with chronic LBP because they not only relieve back pain but also prevent chronic back pain through improving muscle endurance.
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Affiliation(s)
- Jee Hyun Suh
- Department of Rehabilitation Medicine, Bobath Children's Clinic, Yongin, Gyeonggi-do, South Korea
| | - Hayoung Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
| | - Gwang Pyo Jung
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
| | - Jin Young Ko
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
| | - Ju Seok Ryu
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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Heinrich M, Steiner S, Bauer CM. The effect of visual feedback on people suffering from chronic back and neck pain – a systematic review. Physiother Theory Pract 2019; 36:1220-1231. [DOI: 10.1080/09593985.2019.1571140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Martin Heinrich
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Simon Steiner
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Christoph Michael Bauer
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
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Luomajoki HA, Bonet Beltran MB, Careddu S, Bauer CM. Effectiveness of movement control exercise on patients with non-specific low back pain and movement control impairment: A systematic review and meta-analysis. Musculoskelet Sci Pract 2018; 36:1-11. [PMID: 29631119 DOI: 10.1016/j.msksp.2018.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 03/04/2018] [Accepted: 03/26/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with low back pain (LBP) and movement control impairment (MVCI) show altered spinal movement patterns. Treatment that aims to change movement behaviour could benefit these patients. OBJECTIVE To assess the effectiveness of movement control exercise (MVCE) in terms of clinically relevant measures (disability and pain) on patients with NSLBP. METHODS A systematic review and meta-analysis were conducted. CINAHL, MEDLINE, PUBMED and PEDro databases were searched for RCT's evaluating MVCE treatment in patients with NSLBP from review inception to April 2017. Authors were contacted to obtain missing data and outcomes. PEDro was used to assess methodological quality of the studies and the GRADE approach was used to assess the overall quality of evidence Data were combined using a random effects meta-analysis and reported as standardized mean differences (SMD). RESULTS Eleven eligible RCT's including a total of 781 patients were found. Results show 'very low to moderate quality' evidence of a positive effect of MVCE on disability, both at the end of treatment and after 12 months (SMD -0.38 95%CI -0.68, -0.09 respectively 0.37 95%CI -0.61,-0.04). Pain intensity was significantly reduced after MVCE at the end of treatment (SMD -0.39 95%CI -0.69, -0.04), but not after 12 months (SMD -0.27, 95%CI -0.62, 0.09). CONCLUSIONS MVCE intervention for people with NSLBP and MVCI appears to be more effective in improving disability compared to other interventions, both over the short and long term. Pain was reduced only in the short term. An important factor is the initial identification of patients with MVCI. Registration of the study: The study protocol registration number is CRD42016036662 on PROSPERO.
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Affiliation(s)
- Hannu Antero Luomajoki
- Zurich University of Applied Sciences ZHAW, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, Postfach, 8401 Winterthur, Switzerland.
| | - Maria Beatriz Bonet Beltran
- Zurich University of Applied Sciences ZHAW, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, Postfach, 8401 Winterthur, Switzerland.
| | - Silvia Careddu
- Zurich University of Applied Sciences ZHAW, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, Postfach, 8401 Winterthur, Switzerland; Physio & Sport Luzern, Bruchstrasse 11, 6003 Luzern, Switzerland.
| | - Christoph Michael Bauer
- Zurich University of Applied Sciences ZHAW, School of Health Professions, Institute of Physiotherapy, Technikumstrasse 71, Postfach, 8401 Winterthur, Switzerland; University of Tampere, School of Medicine, Kalevantie 4, FI-33014, University of Tampere, Tampere, Finland.
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22
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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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23
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Pourahmadi MR, Taghipour M, Ebrahimi Takamjani I, Sanjari MA, Mohseni-Bandpei MA, Keshtkar AA. Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis. BMJ Open 2016; 6:e012426. [PMID: 27678542 PMCID: PMC5051468 DOI: 10.1136/bmjopen-2016-012426] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Lumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH. The aim of this systematic review is to evaluate the effectiveness of motor control exercise (MCE) for symptomatic LDH. METHODS AND ANALYSIS We will include all clinical trial studies with a concurrent control group which evaluated the effect of MCEs in patients with symptomatic LDH. We will search PubMed, SCOPUS, PEDro, SPORTDiscus, CINAHL, CENTRAL and EMBASE with no restriction of language. Primary outcomes of this systematic review are pain intensity and functional disability and secondary outcomes are functional tests, muscle thickness, quality of life, return to work, muscle endurance and adverse events. Study selection and data extraction will be performed by two independent reviewers. The assessment of risk of bias will be implemented using the PEDro scale. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. Heterogeneity will be evaluated using the I2 statistic and the χ2 test. In addition, subgroup analyses will be conducted for population and the secondary outcomes. All meta-analyses will be performed using Stata V.12 software. ETHICS AND DISSEMINATION No ethical concerns are predicted. The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences. TRIAL REGISTRATION NUMBER CRD42016038166.
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Affiliation(s)
- Mohammad Reza Pourahmadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Morteza Taghipour
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ismail Ebrahimi Takamjani
- Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Mohammad Ali Sanjari
- Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran
| | - Mohammad Ali Mohseni-Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Faculty of Allied Health Sciences, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Abbas Ali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences and Health Services, Tehran, Iran
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Beattie PF, Silfies SP, Jordon M. The evolving role of physical therapists in the long-term management of chronic low back pain: longitudinal care using assisted self-management strategies. Braz J Phys Ther 2016; 20:580-591. [PMID: 28001268 PMCID: PMC5176195 DOI: 10.1590/bjpt-rbf.2014.0180] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/15/2016] [Indexed: 12/12/2022] Open
Abstract
Background Longitudinal studies have shown that the symptoms of chronic low back pain (CLBP) will follow an episodic trajectory characterized by periods of high and low pain intensity that can persist for many years. There is a growing belief that the contemporary approach of limiting physical therapy to short, but intense courses of treatment for (CLBP) may be sub-optimal because these limited “windows” of clinical care are not congruent with the natural history of this condition. Recent research has suggested that people with CLBP undergo substantial, and individualized long-term variations in the neural processing of nociception over time. This has led to the concept of a “unique biosignature of pain” that may explain much of the variation in a person’s clinical picture. These and other findings have led to the reconceptualization of CLBP as an individualized, and continually evolving condition that may be more suitably managed by empowering the patient toward self-management strategies that can be modified as needed over time by the PT. Objectives The purpose of this Master Class Paper is to describe an emerging approach for the treatment of CLBP that emphasizes the formation of a long-term therapeutic alliance between the patient and the PT with an emphasis on individualized, patient-preferred approaches for activity-based self-management as an alternative to the contemporary approach of short, intense episodes of care directed toward pain reduction. Conclusion Longitudinal care using assisted self-management strategies is more congruent with the natural history of CLBP than are traditional approaches for PT intervention. This approach may empower patients to undergo lifestyle changes that will favorably influence long-term outcomes; however additional research is needed.
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Affiliation(s)
- Paul F Beattie
- Doctoral Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sheri P Silfies
- Department of Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Max Jordon
- Physical Therapist, Mobility Research Clinic, Richland-Palmetto Health, Columbia, SC, USA
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