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Salik Sengul Y, Yilmaz A, Kirmizi M, Kahraman T, Kalemci O. Effects of stabilization exercises on disability, pain, and core stability in patients with non-specific low back pain: A randomized controlled trial. Work 2021; 70:99-107. [PMID: 34487008 DOI: 10.3233/wor-213557] [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: 11/15/2022] Open
Abstract
BACKGROUND Many studies have emphasized the importance of stabilization exercises (SE) for the management of non-specific low back pain (NSLBP), yet there is no study assessing all aspects of core stability in comparing SE and other exercises. OBJECTIVE To investigate the effects of SE on pain and core stability by using core stability tests that focus on all aspects of core stability in patients with NSLBP. METHODS Thirty-seven individuals with chronic NSLBP were randomly divided into two groups as SE and conventional exercises (CE). Both groups underwent the progressive exercise program three days per week for six weeks. The assessments were conducted before and after the exercise programs. The outcome measures included pain, disability, trunk strength, trunk flexor, extensor and lateral flexor endurance, function, flexibility, and motor control during eyes open/closed. RESULTS All assessment parameters except motor control during eyes open improved after SE (p < 0.05). Also, all assessment parameters except motor control during eyes open/closed and lateral trunk endurance improved after CE (p < 0.05). When comparing groups for gain scores, there were more significant improvements in pain during activity, endurance and function after SE (p < 0.05). CONCLUSIONS SE is more effective than CE in reducing pain during activity and improving core stability regarding functionality and endurance.
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Affiliation(s)
- Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Alev Yilmaz
- Graduate School of Health Sciences, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Muge Kirmizi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Cigli, Izmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Balcova, Izmir, Turkey
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Does manual therapy affect functional and biomechanical outcomes of a sit-to-stand task in a population with low back pain? A preliminary analysis. Chiropr Man Therap 2020; 28:5. [PMID: 31998472 PMCID: PMC6979331 DOI: 10.1186/s12998-019-0290-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction Manual therapy (MT) hypothetically affects discrepant neuromuscular control and movement observed in populations with low back pain (LBP). Previous studies have demonstrated the limited influence of MT on movement, predominately during range of motion (ROM) testing. It remains unclear if MT affects neuromuscular control in mobility-based activities of daily living (ADLs). The sit-to-stand (STS) task represents a commonly-performed ADL that is used in a variety of clinical settings to assess functional and biomechanical performance. Objective To determine whether MT affects functional performance and biomechanical performance during a STS task in a population with LBP. Methods Kinematic data were recorded from the pelvis and thorax of participants with LBP, using an optoelectronic motion capture system as they performed a STS task before and after MT from November 2011 to August 2014. MT for each participant consisted of two high-velocity low-amplitude spinal manipulations, as well as two grade IV mobilizations of the lumbar spine and pelvis targeted toward the third lumbar vertebra and sacroiliac joint in a side-lying position; the order of these treatments was randomized. Pelvis and thorax kinematic data were used to derive the time-varying lumbar angle in the sagittal plane for each STS trial. The difference between the maximum and minimum lumbar angles during the STS trial determined the sagittal ROM that was used as the biomechanical outcome. Time to complete each STS trial was used as a functional measure of performance. Pre-MT and post-MT values for the lumbar sagittal ROM and time to completion were statistically analysed using paired samples t-tests. Results Data were obtained from 40 participants with 35 useful datasets (NRS = 3.3 ± 1.2; 32.4 ± 9.8 years; 16 females, 19 males). After MT, lumbar sagittal ROM increased by 2.7 ± 5.5 degrees (p = 0.007). Time to complete the STS test decreased by 0.4 ± 0.4 s (p < 0.001). Discussion These findings provide preliminary evidence that MT might influence the biomechanical and functional performance of an STS task in populations with LBP. The MT intervention in this study involved a combination of spinal manipulations and mobilizations. Future work will expand upon these data as a basis for targeted investigations on the effects of either spinal manipulation and mobilization on neuromuscular control and movement in populations with LBP.
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Francescato Torres S, Brandt de Macedo AC, Dias Antunes M, Merllin Batista de Souza I, Dimitre Rodrigo Pereira Santos F, de Sousa do Espírito Santo A, Ribeiro Jacob F, Torres Cruz A, de Oliveira Januário P, Pasqual Marques A. Effects of electroacupuncture frequencies on chronic low back pain in older adults: triple-blind, 12-months protocol for a randomized controlled trial. Trials 2019; 20:762. [PMID: 31870456 PMCID: PMC6929454 DOI: 10.1186/s13063-019-3813-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/22/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is the most frequent complaint in clinical practice. Electroacupuncture treatment may be effective; however, the supporting evidence is still limited, especially in older adults. OBJECTIVE The current study is a randomized controlled trial that aims to evaluate the clinical efficacy of electroacupuncture in older adults with LBP. METHODS A five-arm randomized controlled trial with patients and evaluators blinded to the group allocation. A total of 125 participants with non-specific LBP will be randomly assigned into one of five groups: three electroacupuncture groups (low, high, and alternating frequency); one control group; and one placebo group. The electroacupuncture will be applied twice a week (30 min per session) for five weeks. The primary clinical outcome measure will be pain intensity. The secondary outcomes include: quality of pain; physical functioning; perceived overall effect; emotional functionality; patient satisfaction; and psychosocial factors. Patients will be evaluated before the first session, immediately after the last, and followed up after six and 12 months to check the medium- and long-term effects. DISCUSSION Although electroacupuncture is increasingly used to treat LBP, there is no guidance regarding the parameters used, which leads to inconsistent results. Thus, the effect of electroacupuncture (EA) on LBP remains controversial and requires more studies, especially in the older adult population. CONCLUSION This is the first randomized controlled trial to evaluate the efficacy of different frequencies of electroacupuncture for treating chronic LBP in older adults. This study will provide evidence on the effectiveness of electroacupuncture as an alternative treatment method for LBP and will entail wider debate about an appropriate acupuncture intervention in this population. TRIAL REGISTRATION Clinicaltrials.gov, NCT03802045. Registered on 14 January 2019.
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Affiliation(s)
- Sarina Francescato Torres
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
- Postgraduate Program in Rehabilitation Sciences, Department of Physical Therapy, Speech Therapy and Occupational Therapy, University of Sao Paulo, Rua Cipotânea, 51, São Paulo, São Paulo 05360-160 Brazil
| | | | - Mateus Dias Antunes
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Ingred Merllin Batista de Souza
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Adriana de Sousa do Espírito Santo
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Flávia Ribeiro Jacob
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Ariela Torres Cruz
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Priscila de Oliveira Januário
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Amélia Pasqual Marques
- School of Medicine, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Postgraduate Program in Rehabilitation Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Jakobsson M, Gutke A, Mokkink LB, Smeets R, Lundberg M. Level of Evidence for Reliability, Validity, and Responsiveness of Physical Capacity Tasks Designed to Assess Functioning in Patients With Low Back Pain: A Systematic Review Using the COSMIN Standards. Phys Ther 2019; 99:457-477. [PMID: 30566577 PMCID: PMC6488491 DOI: 10.1093/ptj/pzy159] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 10/23/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Physical capacity tasks (ie, observer-administered outcome measures that comprise a standardized activity) are useful for assessing functioning in patients with low back pain. PURPOSE The purpose of this study was to systematically review the level of evidence for the reliability, validity, and responsiveness of physical capacity tasks. DATA SOURCES MEDLINE, CINAHL, PsycINFO, Scopus, the Cochrane Library, and relevant reference lists were used as data sources. STUDY SELECTION Two authors independently selected articles addressing the reliability, validity, and responsiveness of physical capacity tasks, and a third author resolved discrepancies. DATA EXTRACTION AND QUALITY ASSESSMENT One author performed data extraction, and a second author independently checked the data extraction for accuracy. Two authors independently assessed the methodological quality with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) 4-point checklist, and a third author resolved discrepancies. DATA SYNTHESIS AND ANALYSIS Data synthesis was performed by all authors to determine the level of evidence per measurement property per physical capacity task. The 5-repetition sit-to-stand, 5-minute walk, 50-ft (∼15.3-m) walk, Progressive Isoinertial Lifting Evaluation, and Timed "Up & Go" tasks displayed moderate to strong evidence for positive ratings of both reliability and construct validity. The 1-minute stair-climbing, 5-repetition sit-to-stand, shuttle walking, and Timed "Up & Go" tasks showed limited evidence for positive ratings of responsiveness. LIMITATIONS The COSMIN 4-point checklist was originally developed for patient-reported outcome measures and not physical capacity tasks. CONCLUSIONS The 5-repetition sit-to-stand, 50-ft walk, 5-minute walk, Progressive Isoinertial Lifting Evaluation, Timed "Up & Go," and 1-minute stair-climbing tasks are promising tests for the measurement of functioning in patients with chronic low back pain. However, more research on the measurement error and responsiveness of these tasks is needed to be able to fully recommend them as outcome measures in research and clinical practice.
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Affiliation(s)
- Max Jakobsson
- Back in Motion Research Group, Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Mölndal Hospital, Göteborgsvägen 31, 431 80 Mölndal, Gothenburg, 41326 Sweden
| | - Annelie Gutke
- Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg
| | - Lidwine B Mokkink
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Rob Smeets
- Department of Rehabilitation Medicine, Research School of CAPHRI, Maastricht University, Maastricht, the Netherlands; and CIR Revalidatie, Eindhoven, the Netherlands
| | - Mari Lundberg
- Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg; Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden; and Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
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Rose-Dulcina K, Vuillerme N, Tabard-Fougère A, Dayer R, Dominguez DE, Armand S, Genevay S. Identifying Subgroups of Patients With Chronic Nonspecific Low Back Pain Based on a Multifactorial Approach: Protocol For a Prospective Study. JMIR Res Protoc 2018; 7:e104. [PMID: 29685875 PMCID: PMC5938595 DOI: 10.2196/resprot.9224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023] Open
Abstract
Background Low back pain, especially nonspecific chronic low back pain (LBP), the leading cause of disability worldwide, represents both social and economic problems. Different therapeutic management techniques can be used, but their effects vary. Clinicians and researchers attribute the variation in the efficacy of therapeutic and management techniques to the heterogeneity of the nonspecific chronic low back pain population, and they agree that nonspecific chronic LBP must be subgrouped. Objective This study aims to identify nonspecific chronic LBP subgroups based on a multifactorial approach, including biomechanical, physical, and psychosocial data. Methods A total of 100 nonspecific chronic LBP patients and 30 healthy participants aged between 18 and 60 years will be recruited for this prospective study. A psychosocial profile will be established using questionnaires on anxiety, depression, functional disability, pain, fear of pain, avoidance belief, and physical activity. A physical capacity evaluation will be conducted. It will evaluate flexibility of the hips, lumbar spine, and lateral thoracolumbar segment, as well as trunk (extensor and flexor) muscle endurance. The subjects will perform functional daily life activities, such as walking, object lifting, forward bending, sit-to-stand, stand-to-sit, balance, and usual postures. Full body kinematics, kinetics, and surface electromyography of the trunk and hip muscles will be assessed during these tasks. The clustering classification methods for the statistical analysis will be determined according to the data and will be used to identify the subgroups of nonspecific chronic LBP patients. Results Data collection started in September 2017 and will be completed with the inclusion of all the participants (100 nonspecific chronic LBP and 30 control). The study results will be published in peer-reviewed journals and presented at relevant international conferences. Conclusions Numerous studies have showed that the therapeutic management of nonspecific chronic LBP is difficult and has inconstant effects caused by the complexity and heterogeneity of nonspecific chronic LBP. Identifying subgroups with a multifactorial approach is more comprehensive and closer to the pathophysiology of nonspecific chronic LBP. It also represents benefit interests and a challenge both clinically and socially. The perspective of this study is expected to support clinicians for a more adapted therapeutic management for each subgroup.
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Affiliation(s)
- Kevin Rose-Dulcina
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Nicolas Vuillerme
- Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Anne Tabard-Fougère
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Romain Dayer
- Division of Paediatric Orthopaedics, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dennis E Dominguez
- Division of Orthopaedic and Trauma Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Armand
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Stéphane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Denteneer L, Van Daele U, Truijen S, De Hertogh W, Meirte J, Stassijns G. Reliability of physical functioning tests in patients with low back pain: a systematic review. Spine J 2018; 18:190-207. [PMID: 28882521 DOI: 10.1016/j.spinee.2017.08.257] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/21/2017] [Accepted: 08/29/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to provide a comprehensive overview of physical functioning tests in patients with low back pain (LBP) and to investigate their reliability. DATA SOURCES A systematic computerized search was finalized in four different databases on June 24, 2017: PubMed, Web of Science, Embase, and MEDLINE. STUDY SELECTION Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed during all stages of this review. Clinical studies that investigate the reliability of physical functioning tests in patients with LBP were eligible. The methodological quality of the included studies was assessed with the use of the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. To come to final conclusions on the reliability of the identified clinical tests, the current review assessed three factors, namely, outcome assessment, methodological quality, and consistency of description. DATA SYNTHESIS A total of 20 studies were found eligible and 38 clinical tests were identified. Good overall test-retest reliability was concluded for the extensor endurance test (intraclass correlation coefficient [ICC]=0.93-0.97), the flexor endurance test (ICC=0.90-0.97), the 5-minute walking test (ICC=0.89-0.99), the 50-ft walking test (ICC=0.76-0.96), the shuttle walk test (ICC=0.92-0.99), the sit-to-stand test (ICC=0.91-0.99), and the loaded forward reach test (ICC=0.74-0.98). For inter-rater reliability, only one test, namely, the Biering-Sörensen test (ICC=0.88-0.99), could be concluded to have an overall good inter-rater reliability. None of the identified clinical tests could be concluded to have a good intrarater reliability. CONCLUSIONS Further investigation should focus on a better overall study methodology and the use of identical protocols for the description of clinical tests. The assessment of reliability is only a first step in the recommendation process for the use of clinical tests. In future research, the identified clinical tests in the current review should be further investigated for validity. Only when these clinimetric properties of a clinical test have been thoroughly investigated can a final conclusion regarding the clinical and scientific use of the identified tests be made.
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Affiliation(s)
- Lenie Denteneer
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Ulrike Van Daele
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Steven Truijen
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Willem De Hertogh
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Jill Meirte
- Faculty of Medicine and Health Sciences, Rehabilitation and Physiotherapy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Gaetane Stassijns
- Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Physical Medicine and Rehabilitation, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
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