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Peretro G, Ballico AL, Avelar NCD, Haupenthal DPDS, Arcêncio L, Haupenthal A. Comparison of aquatic physiotherapy and therapeutic exercise in patients with chronic low back pain. J Bodyw Mov Ther 2024; 38:399-405. [PMID: 38763585 DOI: 10.1016/j.jbmt.2023.10.006] [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: 01/24/2023] [Revised: 08/28/2023] [Accepted: 10/02/2023] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To investigate and compare the effectiveness of aquatic physiotherapy and therapeutic exercise in the physical and functional performance of patients with chronic low back pain. METHODS Twenty-six participants were randomized into 3 groups, namely an aquatic physiotherapy group (AG), a therapeutic exercise group (EG), and a control group (CG). The pain, disability, and quality of life were compared before and after the exercise protocols for 2 months, twice a week, on alternate days, for 60 min. For statistical analyses, the Kruskal-Wallis test was used to test the difference between the groups; the Wilcoxon test and the effect size were used for before-and-after comparisons. RESULTS Twenty participants completed the study. There was a significant difference improvement in pain between the AG and the EG (p = 0.004), between the EG and the CG (p = 0.05), and in social role functioning between the groups (p = 0.02). No differences were observed in the other analyzed variables between the groups. Compared to the pre-treatment state, there were significant improvements in the AG in terms of pain (p = 0.02), functionality (p = 0.03), and general health status (p = 0.04). CONCLUSION The AG group showed significant and clinical improvement in pain, disability, and quality of life. Improvements related to social aspects were found in the EG compared to the CG. The water provides a safe environment that facilitates the onset of exercise, so aquatic physiotherapy could be considered the first recommendation for patients with low back pain.
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Affiliation(s)
- Gabriela Peretro
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Physical Therapy, Ararangua, Brazil
| | - Aline Luana Ballico
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Physical Therapy, Ararangua, Brazil
| | - Núbia Carelli de Avelar
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Physical Therapy, Ararangua, Brazil
| | | | - Livia Arcêncio
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Physical Therapy, Ararangua, Brazil
| | - Alessandro Haupenthal
- Department of Health Sciences, Federal University of Santa Catarina (UFSC), Physical Therapy, Ararangua, Brazil.
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Babiloni-Lopez C, Fritz N, Ramirez-Campillo R, Colado JC. Water-Based Exercise in Patients With Nonspecific Chronic Low-Back Pain: A Systematic Review With Meta-Analysis. J Strength Cond Res 2024; 38:206-219. [PMID: 38085630 DOI: 10.1519/jsc.0000000000004635] [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: 12/18/2023]
Abstract
ABSTRACT Babiloni-Lopez, C, Fritz, N, Ramirez-Campillo, R, and Colado, JC. Water-based exercise in patients with nonspecific chronic low-back pain: a systematic review with meta-analysis. J Strength Cond Res 38(1): 206-219, 2024-This study aimed to systematically review and synthesize evidence (i.e., active [land-based training] and nonactive controls [e.g., receiving usual care]) regarding the effects of water-based training on patients with nonspecific chronic low-back pain (NSCLBP). Web of Science (WOS), PubMed (MEDLINE), EMBASE, EBSCO (SPORTDiscus; CINAHL), and PEDro were searched, with no date restrictions, until October 2021. The included studies satisfied the following criteria: (a) NSCLBP (≥12 weeks) patients, (b) water-based intervention, (c) control group (land-based trained; nonactive group), and (d) outcomes related to pain, disability, quality of life, or flexibility. The main outcome analyzed in the meta-analysis was pain intensity. Secondary outcomes included disability, body mass index, and flexibility. The random-effects model was used, and effect size (ES) values are presented with 95% confidence intervals (CIs). The impact of heterogeneity was assessed (I2 statistic), with values of <25%, 25-75%, and >75% representing low, moderate, and high levels, respectively. Alpha was set at p < 0.05. In conclusion, 15 studies (n = 524) were meta-analyzed. After intervention, pain intensity was reduced compared with nonactive controls (ES = -3.61; p < 0.001) and a similar reduction was noted when compared with land-based trained group (ES = -0.14; p = 0.359). Greater decrease in disability (ES = 2.15; p < 0.001) and greater increase in sit-and-reach (i.e., flexibility; ES = -2.44; p < 0.001) were noted after intervention compared with the nonactive group. In conclusion, water-based exercise therapy reduces pain intensity, disability, and increases flexibility in NSCLBP compared with nonactive subjects and was equally effective compared with land-based exercise to reduce pain. Favorable effects may be expected at ≤8 weeks. However, due to several methodological issues (e.g., high heterogeneity), for the improvement of most outcomes, we are unable to provide other than a weak recommendation in favor of intervention compared with control treatment.
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Affiliation(s)
- Carlos Babiloni-Lopez
- Research Group in Prevention and Health in Exercise and Sport, University of Valencia, Valencia, Spain
| | - Nicole Fritz
- Research Group in Prevention and Health in Exercise and Sport, University of Valencia, Valencia, Spain
- Department of Health, University of Los Lagos, Puerto Montt, Chile; and
| | - Rodrigo Ramirez-Campillo
- Research Group in Prevention and Health in Exercise and Sport, University of Valencia, Valencia, Spain
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Juan C Colado
- Research Group in Prevention and Health in Exercise and Sport, University of Valencia, Valencia, Spain
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Soufivand P, Gandomi F, Assar S, Abbasi H, Salimi M, Ezati M, Pournazari M, Shahsavari S. The effect of a six-week Aqua Pilates and Aqua Stretch intervention on pain, function, and quality of life in patients affected by ankylosing spondylitis: A rater-blind randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:355-367. [PMID: 37980643 DOI: 10.3233/bmr-230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND There has been a dearth of research into the benefits of water-based workouts for ankylosing spondylitis (AS) patients. OBJECTIVE This study aimed to compare the effect of Aqua Stretch and Aqua Pilates in improving quality of life (QOL), function, and pain in AS patients. METHODS This study was conducted on 40 patients, who were randomly assigned to the Aqua Pilates, Aqua Stretch, and control groups. The experimental groups attended interventions for six-week. QOL, pain intensity, function, and fatigue were measured before and after treatments. RESULTS Except for the chest expanding, all variables in the Aqua Stretch group changed significantly after six weeks (p< 0.05). QOL (p= 0.002), 6MWT (p= 0.016), and Schober flexion (p= 0.011) showed changes, while BASDAI (p= 0.0001), VAS (p= 0.0001), fatigue (p= 0.0001), and Schober extension (p= 0.028) showed significant decreases. Except for chest expansion and Schober extension, which did not alter significantly after six-week of Aqua Pilates (p> 0.05), all other variables did. There was an increasing trend in 6MWT and Schober flexion (p= 0.021) and a decreasing trend in BASDAI (p= 0.002), VAS (p= 0.0001) and fatigue (p= 0.002). Except for QOL (p= 0.016), no statistically significant differences were found between the groups. CONCLUSION All variables had a significant change after six-week Aqua Stretch, except for the chest expanding. Chest expanding and Schober extension were the variables which had no significant change after six-week Aqua Pilates. With the exception of QOL, no statistically significant differences were found between the groups. Aqua Stretch had the greatest effect on the VAS, as measured by the minimum clinically relevant differences (MCID). Moreover, in Aqua Stretch alone, there was a notable impact on fatigue, QOL, and the BASDAI.
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Affiliation(s)
- Parviz Soufivand
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzaneh Gandomi
- Sport Injuries and Corrective Exercises Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran
| | - Shirin Assar
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Homayoun Abbasi
- Sports Management Department, Sport Sciences Faculty, Razi University, Kermanshah, Iran
| | - Mehran Salimi
- Health and Sport Medicine Department, Sport Sciences Faculty, Tehran University, Tehran, Iran
| | - Mozhgan Ezati
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehran Pournazari
- Rheumatology Department, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soodeh Shahsavari
- Health Information Technology Department, Faculty of Allied Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Heidari F, Mohammad Rahimi N, Aminzadeh R. Aquatic Exercise Impact on Pain Intensity, Disability and Quality of Life in Adults with Low Back Pain: A Systematic Review and Meta-analysis. Biol Res Nurs 2023; 25:527-541. [PMID: 36878886 DOI: 10.1177/10998004231162327] [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] [Indexed: 03/08/2023]
Abstract
BACKGROUND Low back pain is a common, multifaceted disorder that directly affects diverse aspects of people's lives in terms of health, personal and social lives. A variety of pathological disorders, including low back pain, may benefit from hydrotherapy. OBJECTIVE This study aimed to systematically analyze the efficacy of aquatic exercise on pain intensity, disability, and quality of life among adults with low back pain. DATA SOURCES A systematic search was conducted in PubMed, Web of Science, Medline, and Scopus up to February 2023 for randomized controlled trials (RCTs) that which examined the impact of aquatic exercise. The most relevant articles were selected based on research criteria. The PEDro scale was applied to assess the quality of the included studies. Review Manager 5.3 was used for conducting all analyses. STUDY SELECTION Out of 856 articles, 14 RCTs (n = 484 participants; 257 in the experimental groups and 227 in the control groups) met our inclusion criteria. RESULTS Pooled results illustrated that aquatic exercises significantly reduced pain (mean differences (MD): -3.82; p < 0.00,001), improved disability (standardized mean differences (SMD): 1.65; p < 0.00,001), and improved quality of life in both the physical component score (mean difference (MD), 10.13; p < 0.00,001) and the mental component score (MD, 6.45; p < 0.0001) when compared with a control group. CONCLUSION The current review showed that aquatic exercise regimens were effective among adults with low back pain. High-quality clinical investigations are still needed to support the use of therapeutic aquatic exercise in a clinical setting.
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Affiliation(s)
- Fatemeh Heidari
- Department of Sports Sciences, Imam Reza International University, Mashhad, Iran
| | | | - Reza Aminzadeh
- Department of Sports Sciences, Imam Reza International University, Mashhad, Iran
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Zhu H, Jin J, Zhao G. The effects of water-based exercise on body composition: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 52:101766. [PMID: 37167802 DOI: 10.1016/j.ctcp.2023.101766] [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: 11/18/2022] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
AIMS This study aimed to investigate the effects of water-based exercise (WBE) on body composition. METHODS Trials published up to October 28, 2022 were searched using the PubMed, EMBASE, Web of Science, Cochrane, Scopus, and Ovid databases. Randomized controlled trials of healthy adults published in English, comparing WBE and control groups, were included. Other studies with different research designs and participants with medical diagnoses were excluded. The main outcome measures were body weight (BW), body fat mass (BFM), body fat percentage (BFP), lean mass (LM), and skeletal muscle mass (SMM). RESULTS Overall, 17,458 potential studies were identified. After a closer inspection, 79 full-length articles were considered for further screening. Finally, 20 studies, involving 565 participants, were included in the meta-analysis. The WBE was beneficial in reducing BW, BFM, and BFP and increasing LM and SMM. Subgroup analyses were conducted based on different exercise intensities and times per week. Moderate- or moderate-vigorous-intensity exercise helped improve body composition, while lower-intensity WBE or aquatic high-intensity interval training (HIIT) seemed less helpful. Training for <120 min/week was insufficient to improve body composition. Training for >120 min/week was associated with improvements in body composition. CONCLUSIONS Moderate- or moderate-vigorous-intensity WBE helps improve body composition. Adults are encouraged to exercise for >120 min/week.
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Affiliation(s)
- Haifeng Zhu
- Taizhou People's Hospital, Taizhou City, Jiangsu Province, China
| | - Jing Jin
- Taizhou People's Hospital, Taizhou City, Jiangsu Province, China
| | - Gaonian Zhao
- Taizhou People's Hospital, Taizhou City, Jiangsu Province, China.
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Huijbers JCJ, Coenen P, Burchell GLB, Coppieters MW, Steenhuis IHM, Van Dieën JH, Koes BW, Kempen DHR, Anema JR, Kingma I, Voogt L, Williams CM, Van Dongen JM, Van der Ploeg HP, Ostelo RWJG, Scholten-Peeters GGM. The (cost-)effectiveness of combined lifestyle interventions for people with persistent low-back pain who are overweight or obese: A systematic review. Musculoskelet Sci Pract 2023; 65:102770. [PMID: 37167807 DOI: 10.1016/j.msksp.2023.102770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness of combined lifestyle interventions for overweight or obese people with LBP. AIM To assess whether combined lifestyle interventions are (cost-)effective for people with persistent LBP who are overweight or obese, based on a systematic review. DESIGN Systematic review METHOD: PubMed, Cochrane, Embase, CINAHL, PsycINFO and the Wiley/Cochrane Library were searched from database inception till January 6th 2023. Two independent reviewers performed study selection, data-extraction and risk of bias scoring using the Cochrane RoB tool 2 and/or the Consensus Health Economic Criteria list. GRADE was used to assess the level of certainty of the evidence. RESULTS In total 2510 records were screened, and 4 studies on 3 original RCTs with 216 participants were included. Low certainty evidence (1 study) showed that combined lifestyle interventions were not superior to usual care for physical functioning, pain and lifestyle outcomes. Compared to usual care, moderate certainty evidence showed that healthcare (-$292, 95%CI: 872; -33), medication (-$30, 95% CI -65; -4) and absenteeism costs (-$1000, 95%CI: 3573; -210) were lower for the combined lifestyle interventions. CONCLUSION There is low certainty evidence from 3 studies with predominantly small sample sizes, short follow-up and low intervention adherence that combined lifestyle interventions are not superior to physical functioning, pain and lifestyle outcomes compared to usual care, but are likely to be cost-effective.
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Affiliation(s)
- J C J Huijbers
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, the Netherlands
| | - P Coenen
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - G L B Burchell
- Medical Library, Vrije Universiteit Amsterdam, the Netherlands
| | - M W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, the Netherlands; Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
| | - I H M Steenhuis
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - J H Van Dieën
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, the Netherlands
| | - B W Koes
- Erasmus Medical Center, University Medical Center Rotterdam, Department of General Practice, the Netherlands
| | - D H R Kempen
- Department of Orthopedic Surgery, Joint Research, OLVG Amsterdam, Amsterdam, the Netherlands
| | - J R Anema
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands
| | - I Kingma
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, the Netherlands
| | - L Voogt
- NVVR, Dutch Society of Back Pain, the Netherlands
| | - C M Williams
- School of Health Sciences, University of Sydney, Australia; Research and Knowledge Translation Directorate, Mid-North Coast Local Health District, Australia
| | - J M Van Dongen
- Faculty of Science and the Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Faculty of Science and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - H P Van der Ploeg
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands
| | - R W J G Ostelo
- Department of Health Sciences, Faculty of Science and Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - G G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Program Musculoskeletal Health, the Netherlands
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Peng MS, Wang R, Wang YZ, Chen CC, Wang J, Liu XC, Song G, Guo JB, Chen PJ, Wang XQ. Efficacy of Therapeutic Aquatic Exercise vs Physical Therapy Modalities for Patients With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2142069. [PMID: 34994794 PMCID: PMC8742191 DOI: 10.1001/jamanetworkopen.2021.42069] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Therapeutic aquatic exercise is frequently offered to patients with chronic low back pain, but its long-term benefits are unclear. OBJECTIVE To assess the long-term effects of therapeutic aquatic exercise on people with chronic low back pain. DESIGN, SETTING, AND PARTICIPANTS This 3-month, single-blind randomized clinical trial with a 12-month follow-up period was performed from September 10, 2018, to March 12, 2019, and the trial follow-up was completed March 17, 2020. A total of 113 people with chronic low back pain were included in the experiment. INTERVENTIONS Participants were randomized to either the therapeutic aquatic exercise or the physical therapy modalities group. The therapeutic aquatic exercise group received aquatic exercise, whereas the physical therapy modalities group received transcutaneous electrical nerve stimulation and infrared ray thermal therapy. Both interventions were performed for 60 minutes twice a week for 3 months. MAIN OUTCOMES AND MEASURES The primary outcome was disability level, which was measured using the Roland-Morris Disability Questionnaire; scores range from 0 to 24, with higher scores indicating more severe disability. Secondary outcomes included pain intensity, quality of life, sleep quality, recommendation of intervention, and minimal clinically important difference. Intention-to-treat and per-protocol analyses were performed. RESULTS Of the 113 participants, 59 were women (52.2%) (mean [SD] age, 31.0 [11.5] years). Participants were randomly allocated into the therapeutic aquatic exercise group (n = 56) or the physical therapy modalities group (n = 57), and 98 patients (86.7%) completed the 12-month follow-up. Compared with the physical therapy modalities group, the therapeutic aquatic exercise group showed greater alleviation of disability, with adjusted mean group differences of -1.77 (95% CI, -3.02 to -0.51; P = .006) after the 3-month intervention, -2.42 (95% CI, -4.13 to -0.70; P = .006) at the 6-month follow-up, and -3.61 (95% CI, -5.63 to -1.58; P = .001) at the 12-month follow-up (P < .001 for overall group × time interaction). At the 12-month follow-up point, improvements were significantly greater in the therapeutic aquatic exercise group vs the physical therapy modalities group in the number of participants who met the minimal clinically important difference in pain (at least a 2-point improvement on the numeric rating scale) (most severe pain, 30 [53.57%] vs 12 [21.05%]; average pain, 14 [25%] vs 11 [19.30%]; and current pain, 22 [39.29%] vs 10 [17.54%]) and disability (at least a 5-point improvement on the Roland-Morris Disability Questionnaire) (26 [46.43%] vs 4 [7.02%]). One of the 56 participants (1.8%) in the therapeutic aquatic exercise group vs 2 of the 57 participants (3.5%) in the physical therapy modalities group experienced low back pain and other pains related to the intervention. CONCLUSIONS AND RELEVANCE The therapeutic aquatic exercise program led to greater alleviation in patients with chronic low back pain than physical therapy modalities and had a long-term effect up to 12 months. This finding may prompt clinicians to recommend therapeutic aquatic exercise to patients with chronic low back pain as part of treatment to improve their health through active exercise rather than relying on passive relaxation. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR1800016396.
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Affiliation(s)
- Meng-Si Peng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yi-Zu Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Chang-Cheng Chen
- Department of Rehabilitation Medicine, Qingtian People’s Hospital, Lishui, China
| | - Juan Wang
- Department of Rehabilitation Medicine, Changzhou Seventh People’s Hospital, Jiangsu Changzhou, China
| | - Xiao-Chen Liu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Ge Song
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jia-Bao Guo
- The Second School of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
| | - Pei-Jie Chen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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Faíl LB, Marinho DA, Marques EA, Costa MJ, Santos CC, Marques MC, Izquierdo M, Neiva HP. Benefits of aquatic exercise in adults with and without chronic disease-A systematic review with meta-analysis. Scand J Med Sci Sports 2021; 32:465-486. [PMID: 34913530 DOI: 10.1111/sms.14112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/02/2021] [Accepted: 12/14/2021] [Indexed: 01/06/2023]
Abstract
Aquatic exercise is being increasingly recommended for healthy individuals as well as people with some special health conditions. A systematic review with meta-analysis was performed to synthesize and analyze data on the effects of water-based training (WT) programs on health status and physical fitness of healthy adults and adults with diseases to develop useful recommendations for health and sports professionals. We searched three databases (PubMed, Web of Science, and Scopus) up to June 2021 for randomized trials that examined WT in adults. A total of 62 studies were included, of which 26 involved only healthy individuals and 36 focused on adults with chronic diseases. In the healthy group, the effects of WT on strength, balance, and cardiorespiratory fitness were beneficial, indicating the usefulness of performing WT for at least 12 weeks (2-3x/week, 46-65 min/session). Among adults with diseases, improvements were observed in patients with fibromyalgia (in balance and cardiorespiratory fitness), bone diseases (pain, balance, flexibility, and strength), coronary artery disease (strength and anthropometry), hypertension (quality of life), stroke (quality of life), diabetes (balance and quality of life), multiple sclerosis (quality of life and balance), and Parkinson's disease (pain, gait, cardiorespiratory fitness, and quality of life). Research is required to determine the effects of WT on patients with heart disease, especially coronary artery disease. In adults with chronic disease, benefits in physical fitness and/or other health-related measures were mainly observed after 8-16 weeks of training. WT is an effective physical activity when the intention is to enhance health and physical fitness in healthy adults and adults with chronic diseases.
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Affiliation(s)
- Luís B Faíl
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal
| | - Daniel A Marinho
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, Portugal
| | - Elisa A Marques
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, Portugal.,Department of Physical Education and Sports, University Institute of Maia, Maia, Portugal
| | - Mário J Costa
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, Portugal.,Department of Sport Sciences, Polytechnic Institute of Guarda, Guarda, Portugal
| | - Catarina C Santos
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, Portugal
| | - Mário C Marques
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, Portugal
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Henrique P Neiva
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Covilhã, Portugal
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Effects of eight-week water versus mat pilates on female patients with chronic nonspecific low back pain: Double-blind randomized clinical trial. J Bodyw Mov Ther 2020; 24:70-75. [PMID: 33218568 DOI: 10.1016/j.jbmt.2020.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/07/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effects of water and mat Pilates on pain, disability, and static and dynamic balance in patients with chronic nonspecific low back pain (CNLBP). METHODS Twenty-four participants with CNLBP were randomly allocated into two groups (n = 12) that perform water and mat Pilates exercises for 24 sessions (8-week, 3 sessions per week). The value for pain, disability and balance were measured before and after the exercise program using the Visual Analogue Scale, Oswestry Disability Questionnaire and Biodex Balance System respectively. RESULTS A paired t-test revealed significant differences in pain severity and disability in both groups after they performed the Pilates program (P ≤ 0.05). Mat Pilates improved static balance as the participants performed the tests with their eyes open and closed (P = 0.02, P = 0.04). Its effect on dynamic balance, however, was not statistically significant (ES = 0/33, P = 0/34). The same Pilates program performed in water did not show significant effects on balance despite a decline in body sway (P˃0/05). There was no difference between the two groups (P˃0/05). CONCLUSION The results suggest that both mat and water Pilates exercise program have beneficial effects on the treatment of LBP. Nevertheless, the low impact of the mat and water Pilates program on balance improvement suggests more investigation on Pilates training or complementary exercises to improve balance in patients with CNLBP.
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Carvalho RGS, Silva MF, Dias JM, Olkoski MM, Dela Bela LF, Pelegrinelli ARM, Barreto MST, Campos RR, Guenka LC, Facci LM, Cardoso JR. Effectiveness of additional deep-water running for disability, lumbar pain intensity, and functional capacity in patients with chronic low back pain: A randomised controlled trial with 3-month follow-up. Musculoskelet Sci Pract 2020; 49:102195. [PMID: 32861359 DOI: 10.1016/j.msksp.2020.102195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Aquatic exercise (AQE) programme is commonly used as an alternative to the chronic low back pain (CLBP) treatment. The addition of aquatic aerobic exercises to AQE may be beneficial to patients with CLBP. DESIGN Randomised controlled trial. OBJECTIVES To assess the effectiveness of AQE with the addition of aerobic exercise - deep-water running (DWR) - compared to exclusive AQE in improving disability, lumbar pain intensity, and functional capacity in patients with CLBP. METHODS Fifty-four adult patients with CLBP were randomised either to the experimental group (AQE + DWR) or the control group (AQE). An assessor who was blinded to the group allocation performed both pre- and post-interventions assessments. Both treatments lasted 9 weeks, with a 3-month follow-up. The primary outcome was disability, as evaluated using the Roland Morris Disability Questionnaire. The secondary outcomes were pain and functional capacity; pain was assessed using a visual analogue scale (VAS), and functional capacity (travelled distance) was measured using the 6-min walk test (6WT). RESULTS A significant difference in pain was observed between groups after intervention in favour of DWR (mean difference -1.3 cm [95% confidence interval (CI) -2.17 to -0.45], d‾ = 0.80 [95% CI 0.22 to 1.33]). CONCLUSION Treatment with DWR was effective in the short term for achieving the desired outcome of pain reduction when compared with AQE only but not for disability and functional capacity.
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Affiliation(s)
- Rodrigo G S Carvalho
- Colegiado de Educação Física, Universidade Federal do Vale do São Francisco, Petrolina-PE, Brazil.
| | - Mariana F Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil.
| | - Josilainne M Dias
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil; Medicine School, Universidade Estadual de Mato Grosso do Sul, Campo Grande-MS, Brazil.
| | - Mabel M Olkoski
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil; Department of Forest Engineering, Agroveterinary Sciences Center, Universidade do Estado de Santa Catarina, Lages-SC, Brazil.
| | - Laís F Dela Bela
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil; Universidade Positive, Curitiba-PR, Brazil.
| | - Alexandre R M Pelegrinelli
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil; Laboratory of Applied Biomechanics, Universidade Estadual de Londrina, Londrina-PR, Brazil.
| | - Maria S T Barreto
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil.
| | - Renata R Campos
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil.
| | - Leandro C Guenka
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil.
| | - Ligia M Facci
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil.
| | - Jefferson R Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina-PR, Brazil.
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11
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Abadi FH, Sankaravel M, Zainuddin FF, Elumalai G, Razli AI. The effect of aquatic exercise program on low-back pain disability in obese women. J Exerc Rehabil 2020; 15:855-860. [PMID: 31938709 PMCID: PMC6944883 DOI: 10.12965/jer.1938688.344] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 11/25/2022] Open
Abstract
Low-back pain (LBP) is one of the most current causes to reduce work performance, limit daily activities and raising health cost, and it is in-creasing as obesity growing as a public health concern. While obese LBP people cannot avoid weight load on the spine in any exercise, they can easily carry out exercise in water. This study aimed to investigate the effect of aquatic exercise on LBP disability among obese women. In this study, a total of 39 women with body mass index (BMI)≥27 kg/m2 who suffering from nonspecific chronic LBP were purposively selected. They randomly assigned in two groups; aquatic and control. The aquatic group carried out aquatic exercise, twice per week, 60 min per session, for 12 weeks. LBP disability was measured using modified Oswestry questionnaire with ten sections; pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and employment. Results showed no significant difference in age, weight, BMI, waist to hip ratio, and percentage of body fat in both groups. An analyzing of multivariate analysis of covariance revealed that there was significant improvement on pain intensity, personal care, sitting, standing, sleeping, employment and total disability score in aquatic group, while there was no significant difference in lifting, walking, social life, and traveling abilities after 12 weeks between the groups. As a conclusion, this progressive aquatic exercise was a convenience and effective intervention program to reduce pain intensity, and improve personal care, sitting, standing, sleeping, and employment abilities in obese LBP women.
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Affiliation(s)
- Fariba Hossein Abadi
- Department of Sports Rehabilitation, Faculty of Sports Science and Coaching, Sultan Idris Education University (UPSI), Tanjung Malim, Malaysia
| | - Mohansundar Sankaravel
- Department of Sports Rehabilitation, Faculty of Sports Science and Coaching, Sultan Idris Education University (UPSI), Tanjung Malim, Malaysia
| | - Fairus Fariza Zainuddin
- Department of Sports Rehabilitation, Faculty of Sports Science and Coaching, Sultan Idris Education University (UPSI), Tanjung Malim, Malaysia
| | - Gunathevan Elumalai
- Department of Sports Rehabilitation, Faculty of Sports Science and Coaching, Sultan Idris Education University (UPSI), Tanjung Malim, Malaysia
| | - Azira Iqlima Razli
- Department of Sports Rehabilitation, Faculty of Sports Science and Coaching, Sultan Idris Education University (UPSI), Tanjung Malim, Malaysia
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12
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Beneficial Effects of Regular Physical Activity on Exercise-Induced Analgesia in Adolescent Males. Pediatr Exerc Sci 2019; 31:425-431. [PMID: 31043128 DOI: 10.1123/pes.2018-0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 01/21/2019] [Accepted: 02/03/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate exercise-induced analgesia (EIA) effectiveness in healthy adolescent males and to investigate possible associations between EIA and physiological/psychological variables. METHODS Twenty-eight healthy adolescent males (14-17 y) participated in this study. EIA was evaluated by comparing perceptions of heat pain stimulations before and after an increasing maximal load test on a cycle ergometer (VO2max). RESULTS Pain intensity for mild and strong heat pain stimulations significantly decreased following physical exercise (mild: EIA = 28.6%; 95% confidence interval, 0.9-1.9; P < .001 and strong: EIA = 11.3%; 95% confidence interval, 0.3-1.4; P = .002). The number of physical activity hours per week was positively correlated with the effectiveness of EIA for mild and strong pain intensity (r = .41, P = .03 and r = .43, P = .02, respectively). CONCLUSIONS Intense physical exercise decreases perception of intensity of experimental heat pain in healthy adolescent males. The least physically active adolescents have reduced EIA effectiveness to experimental heat pain stimulations compared with physically active ones. Adolescents adopting an active lifestyle have more endogenous pain inhibition and could, therefore, potentially be less disposed to suffer from chronic pain later in life.
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13
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Teng M, Zhou HJ, Lin L, Lim PH, Yeo D, Goh S, Tjan SY, Lim BP. Cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders in Singapore. J Public Health (Oxf) 2019. [PMID: 29534234 DOI: 10.1093/pubmed/fdy044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore. METHODS A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR). Subgroup analyses were carried out to determine the cost-effectiveness of hydrotherapy in individual MSDs. Relative treatment effects were obtained through a systematic review of published data. RESULTS Compared to land-based therapy, hydrotherapy was associated with an incremental cost-effectiveness ratio (ICER) of SGD 27 471 per quality-adjusted life-year (QALY) gained, which was below the willingness-to-pay threshold of SGD 70 000 per QALY (one gross domestic product per capita in Singapore in 2015). For the respective MSDs, hydrotherapy were dominant (more effective and less costly) in THR and TKR, cost-effective for LBP and RA, and not cost-effective for OA. Treatment adherence and cost of hydrotherapy were key drivers to the ICER values. CONCLUSIONS Hydrotherapy was a cost-effective rehabilitation compared to land-based therapy for a population with MSDs in Singapore. However, the benefit of hydrotherapy was not observed in patients with OA.
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Affiliation(s)
- Monica Teng
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
| | - Hui Jun Zhou
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
| | - Liang Lin
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
| | - Pang Hung Lim
- Rehabilitation Centre Allied Health Services, Tan Tock Seng Hospital, Singapore
| | - Doreen Yeo
- Rehabilitation Centre Allied Health Services, Tan Tock Seng Hospital, Singapore
| | - Suzanne Goh
- Allied Health Services and Pharmacy Operations Division, Tan Tock Seng Hospital, Singapore
| | - Soon Yin Tjan
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore
| | - Boon Peng Lim
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
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14
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Chrétien R, Lavoie S, Chalaye P, de Vette E, Counil FP, Dallaire F, Lafrenaye S. Reduced endogenous pain inhibition in adolescent girls with chronic pain. Scand J Pain 2018; 18:711-717. [PMID: 30007060 DOI: 10.1515/sjpain-2018-0071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/20/2018] [Indexed: 01/21/2023]
Abstract
Background and aims Chronic pain is affecting a growing number of individuals including adolescents. Different endogenous pain inhibitory systems could confer protection against development of chronic pain. Decreased pain perception can be observed following intense pain (i.e. conditioned pain modulation - CPM) or after physical exercise (i.e. exercise-induced analgesia - EIA). Reduced effectiveness of pain inhibitory mechanisms have been reported in several chronic pain conditions. However, the extent of these dysfunctions has not been thoroughly investigated in adolescents suffering from chronic pain. Our hypothesis was that adolescents suffering from chronic pain have less effective CPM and EIA than pain-free teenagers. Methods Twenty-five healthy adolescent girls and 16 teenage girls with chronic pain participated in this study. Only girls were included in this investigation, since chronic pain is more prevalent in females. The effectiveness of CPM was assessed by comparing heat pain stimulations (individually adapted to induce mild pain intensity) performed with a thermode before and after a cold pressor test (CPT; 2 min, 10 °C). EIA was evaluated by comparing pain intensity produced by an ice cube placed on the forearm before and after a graded exercise test on a cycle ergometer. Results Pain intensity produced by heat pain stimulations decreased following CPT in healthy (p<0.05), but not in chronic pain adolescent girls (p=0.4). Pain intensity induced by the ice cube was reduced after exercise in healthy (p<0.05), but not in chronic pain adolescents (p=0.9). The effectiveness of CPM and EIA was inferior in teenage girls suffering from chronic pain compared to healthy participants (p<0.05). Conclusions Endogenous pain inhibitory mechanisms triggered by intense pain or by physical exercise are effective in healthy adolescent girls. Teenage girls living with chronic pain do not show diminished pain perception after a CPT or a graded exercise test. These results suggest that pain inhibitory mechanisms such as CPM and EIA are ineffective in adolescent girls suffering from chronic pain. Implications In a wider context, the findings of the present research could help understand better the mechanisms involved in the development of chronic pain. Improved comprehension of this subject might help prevent chronic pain conditions and thus, reduce the negative impacts of this burden.
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Affiliation(s)
- Raphaëlle Chrétien
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sarah Lavoie
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Philippe Chalaye
- Centre de Recherche Clinique Étienne-Le Bel (CRCELB), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Emmanuelle de Vette
- Centre de Recherche Clinique Étienne-Le Bel (CRCELB), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Frédéric Dallaire
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sylvie Lafrenaye
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre de Recherche Clinique Étienne-Le Bel (CRCELB), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
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15
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Scala E, Decosterd I, Faouzi M, Burnand B, Rodondi PY. Level of readiness of chronic pain patients to practise active self-care. Eur J Pain 2018; 22:1800-1812. [PMID: 29956872 DOI: 10.1002/ejp.1276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Given the limited alleviation of chronic pain with pharmacological treatments, various nonpharmacological and self-care approaches are often proposed that require patients' motivation. OBJECTIVE To evaluate the level of readiness (LOR) to practise different types of active self-care among chronic pain patients. METHOD A quantitative cross-sectional survey was conducted among all chronic pain patients seeking care at the Pain Center of an academic hospital from June 2013 to March 2015. Sociodemographic data, pain characteristics, treatments and the LOR to practise active self-care were investigated. RESULTS Among the 1524 eligible patients, 639 (41.9%) were included. The median pain duration was 8.5 years (interquartile range = 7.5). Two-thirds (63.7%) of the patients reported high pain-related disability, and 64.6% had used opioids during the previous six months. Most patients had a high (44.1%) or moderate (24.6%) LOR to practise active self-care. Multivariable multinomial regression analysis showed that independent factors associated with a high LOR were a higher level of education (relative risk ratio (RRR) = 3.42, 95% confidence interval (CI): 1.90-6.13, p < 0.001), unemployed status due to medical condition (RRR = 2.92, 95% CI: 1.30-6.56, p = 0.009), the use of dietary supplements 'against pain' (RRR = 2.77, 95% CI: 1.52-5.04, p = 0.001) and neuropathic pain characteristics (RRR = 1.80, 95% CI: 1.40-3.12, p = 0.036). Older age was a factor predicting a lower LOR (RRR = 0.97, 95% CI: 0.94-0.99, p = 0.039). Long-term chronic pain, severe pain-related disability and the presence of a mood disorder were not associated with a lower LOR. CONCLUSION Most chronic pain patients, including those severely affected, indicated their readiness to practise active self-care methods. SIGNIFICANCE Most chronic pain patients, even those severely affected, appeared to be ready to practise active self-care therapies and we believe that further studies are needed to investigate their impact on pain and quality of life.
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Affiliation(s)
- E Scala
- Pain Center and Center for integrative and complementary medecine (CEMIC), Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
| | - I Decosterd
- Pain Center and Center for integrative and complementary medecine (CEMIC), Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland
| | - M Faouzi
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - B Burnand
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - P-Y Rodondi
- Institute of Social and Preventive Medicine, Lausanne University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.,Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
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16
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Maddalozzo GF, Kuo B, Maddalozzo WA, Maddalozzo CD, Galver JW. Comparison of 2 Multimodal Interventions With and Without Whole Body Vibration Therapy Plus Traction on Pain and Disability in Patients With Nonspecific Chronic Low Back Pain. J Chiropr Med 2016; 15:243-251. [PMID: 27857632 PMCID: PMC5106425 DOI: 10.1016/j.jcm.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The purpose of this secondary data analysis was to compare the effect of 2 multimodal exercise-based physical therapy interventions (one with and one without whole-body vibration [WBV] therapy plus traction) on pain and disability in patients with nonspecific chronic low back pain (NSCLBP). METHODS We conducted a secondary analysis of data from 2 distinct samples. One sample was from the Focus on Therapeutic Outcomes Inc. (FOTO) group (n = 55, age 55.1 ± 19.0 years), and the other was the Illinois Back Institute (IBI) (n = 70, age 47.5 ± 13.4 years). Both groups of patients had NSCLBP for more than 3 months and a pain numeric rating scale (NRS) score of ≥7. Both groups received treatment consisting of flexibility or stretching exercises, core stability training, functional training, and postural exercises and strengthening exercises. However, the IBI group also received WBV plus traction. NSCLBP was measured before and after therapeutic trials using the NRS for pain and Oswestry Disability Index (ODI). RESULTS The NRS scores were significantly improved in both groups, decreasing by 2 points in the FOTO group and by 5 points in the IBI group. The ODI scores were significantly improved in both groups; the FOTO group score improved by 9 points and the IBI group improved by 22 points. CONCLUSIONS The results of this preliminary study suggest that NPS and ODI scores statistically improved for both NSCLBP groups receiving multimodal care. However, the group that included WBV therapy plus traction in combination with multimodal care had greater clinical results. This study had several limitations making it difficult to generalize the results from this study sample to the entire population.
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Affiliation(s)
| | - Brian Kuo
- School of Biological and Population Health Sciences, Corvallis, OR
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17
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DiAngelo DJ, Hillyard DC. A novel distractive and mobility-enabling lumbar spinal orthosis. J Rehabil Assist Technol Eng 2016; 3:2055668316670534. [PMID: 31186910 PMCID: PMC6453089 DOI: 10.1177/2055668316670534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 08/28/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose Lumbar spinal orthoses are often used as non-surgical treatment and serve to
support the spine and alleviate low back pain. More recently, dynamic
orthoses claiming to decompress the spine have been introduced. A previously
developed prototype of dynamic mobility orthosis (DMO1) was designed that
provided a distractive load across the lumbar spine but required higher
sagittal bending moments and was unable to maintain spinal off-loading
throughout extended ranges of movement. The objective was to design a new
orthosis (DMO2) that reduced bending moment buildup and sustained spinal
off-loading throughout daily living ranges of flexion and extension
movement. Methods A mechanical analog upper torso model and programmable robotic testing
platform were used to design features of DMO2: a mobility-enabling component
and a distractive force component. Test conditions for DMO2 were
300 N of applied vertical torso load over a range of
25° flexion to 10° extension. Loads carried by the brace were determined
throughout flexion and extension ranges. Applied moments to the upper torso
model and transferred moments to the spine were measured. The difference in
applied and transferred moments represented brace moment effects. Results The DMO2 prototype improved spinal off-loading capacity from
172 N to 290 N at end-range flexion
and from 247 N to 293 N at end range
extension compared to the original DMO1 prototype. End-range applied moments
(flexion-DMO1: 32.4 Nm/DMO2: 21.7 Nm; extension-DMO1: 15.0 Nm/DMO2: 10.9 Nm)
and brace moments (flexion-DMO1: 18.6 Nm/DMO2: 6.6 Nm; extension-DMO1:
15.0 Nm/DMO2: 4.4 Nm) were also reduced. Conclusions A novel dynamic spinal orthosis was designed that maintained spinal
off-loading throughout extended ranges of flexion and extension movement
without buildup of adverse bending moments.
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Affiliation(s)
- Denis J DiAngelo
- Department of Orthopaedic Surgery and Biomedical Engineering, The University of Tennessee Health Science Center, USA
| | - Daniel C Hillyard
- Department of Orthopaedic Surgery and Biomedical Engineering, The University of Tennessee Health Science Center, USA
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18
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Keane LG. Comparing AquaStretch with supervised land based stretching for Chronic Lower Back Pain. J Bodyw Mov Ther 2016; 21:297-305. [PMID: 28532872 DOI: 10.1016/j.jbmt.2016.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Chronic Lower Back Pain (CLBP) is a major health problem affecting 70-85% of the population in the UK. AquaStretch, a new form of assisted stretching in water, is compared with supervised land based stretching (LBS) for subjects with CLBP looking at pain reduction, kinesiophobia and disability. METHOD 29 subjects were randomly allocated into three groups, LBS (N = 10), AquaStretch (N = 10) and Control (N = 9). Modified Oswestry Low Back Pain Questionnaire (MOLBPQ) and Tampa Scale of Kinesiophobia (TSK) questionnaires were completed in weeks 1, 6, and 12. Visual Analogue Scale (VAS) pain scores were collected weekly till week 12. Treatment groups received two 30 min sessions per week for 12 weeks, control group continued their normal physical activity. RESULTS & CONCLUSION Statistical significance (p < 0.05) was observed in the AquaStretch group for pain reduction (P = 0.006), kinesiophobia (P = 0.029), and perceived disability (P = 0.001). Both techniques are suggested to be beneficial for CLBP patients however AquaStretch has key additional benefits including time efficiency, cost effectiveness and the ability to be performed by qualified individuals other than physiotherapists. A reduction in pain post eight weeks of treatment using AquaStretch versus twelve weeks of land based stretching could result in potentially less treatment time needed and a possibility of less medication. Future research is recommended to determine the duration of AquaStretch benefits, and to compare AquaStretch with land based physical therapy programmes for CLBP and to research the potential reduction of Medication required for chronic pain conditions for both its relative clinical effectiveness together with potential health cost savings.
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19
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Wasser JG, Vasilopoulos T, Zdziarski LA, Vincent HK. Exercise Benefits for Chronic Low Back Pain in Overweight and Obese Individuals. PM R 2016; 9:181-192. [PMID: 27346092 DOI: 10.1016/j.pmrj.2016.06.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 06/09/2016] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
Abstract
Overweight and obese individuals with chronic low back pain (LBP) struggle with the combined physical challenges of physical activity and pain interference during daily life; perceived disability increases, pain symptoms worsen, and performance of functional tasks and quality of life (QOL) decline. Consistent participation in exercise programs positively affects several factors including musculoskeletal pain, perceptions of disability due to pain, functional ability, QOL, and body composition. It is not yet clear, however, what differential effects occur among different easily accessible exercise modalities in the overweight-obese population with chronic LBP. This narrative review synopsizes available randomized and controlled, or controlled and comparative, studies of easily accessible exercise programs on pain severity, QOL, and other outcomes, such as physical function or body composition change, in overweight-obese persons with chronic LBP. We identified 16 studies (N = 1,351) of various exercise programs (aerobic exercise [AX], resistance exercise [RX], aquatic exercise [AQU], and yoga-Pilates) that measured efficacy on LBP symptoms, and at least one other outcome such as perceived disability, QOL, physical function, and body composition. RX, AQU, and Pilates exercise programs demonstrated the greatest effects on pain reduction, perceived disability, QOL, and other health components. The highest adherence rate occurred with RX and AQU exercise programs, indicating that these types of programs may provide a greater overall impact on relevant outcomes for overweight-obese LBP patients. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Joseph G Wasser
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL∗
| | - Terrie Vasilopoulos
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(†)
| | - Laura Ann Zdziarski
- Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL(‡)
| | - Heather K Vincent
- Department of Orthopedics and Rehabilitation, Division of Research, UF Orthopaedics and Sports Medicine Institute (OSMI), PO Box 112727, Gainesville, FL 32611(§).
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20
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Ramírez-Villada JF, León-Ariza HH, Argüello-Gutiérrez YP, Porras-Ramírez KA. [Effect of high impact movements on body composition, strength and bone mineral density on women over 60 years]. Rev Esp Geriatr Gerontol 2015; 51:68-74. [PMID: 26522490 DOI: 10.1016/j.regg.2015.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 08/27/2015] [Accepted: 09/09/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Osteoporosis is characterised by loss of bone mass and deterioration of bone tissue microarchitecture that leads to fragility related to the risk of fractures. The aim of the study is to analyse the effects of a training program based on explosive movements and impact, assessed in a swimming pool, on body composition, explosive strength and bone mineral density in women over 60 years old. MATERIAL AND METHODS A total of 35 healthy physically active women (60±4.19 years) were divided into a training pool group using multi jumps (JG) and a control group (CG). JG trained for 24 weeks, 3 times a week, an hour and a half per session. Body composition testing, explosive strength, and bone mineral density were assessed before and after the program. RESULTS There were differences in the explosive force (JG vs CG=P<.05 to .001) and the estimated power (JG vs CG=P<.05 to .002) between JG vs CG, with significant increases in JG. There were no significant differences in the percentage of fat and lean mass, bone mineral density lumbar and femoral between groups, although slightly significant increases in bone mineral density lumbar and femoral could be seen in JG after program implementation (JG pre-test vs JG post- test=P<.05). CONCLUSIONS The training program with impact and explosive movements assessed in a pool induces gains in muscle strength and power with slight adaptations in body mass index in women over 60 years.
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Affiliation(s)
- Jhon F Ramírez-Villada
- División de Ciencias de la Salud, Universidad Santo Tomás-Colombia. Grupo de Investigación en Ciencias Aplicadas a la Actividad Física, el Deporte y la Salud (GICAEDS), Bogotá, Colombia.
| | - Henry H León-Ariza
- Facultad de Medicina, Universidad de la Sabana, Chía, Cundinamarca, Colombia
| | - Yenny P Argüello-Gutiérrez
- División de Ciencias de la Salud, Universidad Santo Tomás-Colombia. Grupo de Investigación en Ciencias Aplicadas a la Actividad Física, el Deporte y la Salud (GICAEDS), Bogotá, Colombia
| | - Keyla A Porras-Ramírez
- División de Ciencias de la Salud, Universidad Santo Tomás-Colombia. Grupo de Investigación en Ciencias Aplicadas a la Actividad Física, el Deporte y la Salud (GICAEDS), Bogotá, Colombia
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Pilot randomized controlled trial to evaluate the effect of aquatic and land physical therapy on musculoskeletal dysfunction of sickle cell disease patients. Rev Bras Hematol Hemoter 2015; 37:82-9. [PMID: 25818817 PMCID: PMC4382580 DOI: 10.1016/j.bjhh.2014.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/25/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the effect of aquatic and land-based physiotherapy in reducing musculoskeletal hip and lower back pain and increasing overall physical capabilities of sickle cell disease patients. METHODS Informed written consent was obtained from all volunteers who were submitted to evaluations using different functional scales: Lequesne's Algofunctional Questionnaire and Oswestry Disability Index, trunk and hip range of motion, goniometry, trunk and hip muscle strength assessment using load cell, and surface electromyography of the iliocostalis, long dorsal (longissimus), gluteus maximus, gluteus medius and tensor fasciae latae muscles. Ten patients were randomized into two groups: aquatic physiotherapy with a mean age of 42 years (range: 25-67) and conventional physiotherapy with a mean age of 49 years (range: 43-59). Both groups were submitted to a twelve-week program of two sessions weekly. RESULTS After the intervention, significant improvements were observed regarding the Lequesne index (p-value=0.0217), Oswestry Disability Index (p-value=0.0112), range of motion of trunk extension (p-value=0.0320), trunk flexion muscle strength (p-value=0.0459), hip extension and abduction muscle strength (p-value=0.0062 and p-value=0.0257, respectively). Range of motion of trunk and hip flexion, extension, adduction and abduction, trunk extensor muscle strength and all surface electromyography variables showed no significant statistical difference. CONCLUSION Physical therapy is efficient to treat musculoskeletal dysfunctions in sickle cell disease patients, irrespective of the technique; however, aquatic therapy showed a trend toward improvement in muscle strength. Further studies with a larger patient sample and longer periods of therapy are necessary to confirm these results.
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Baena-Beato PÁ, Delgado-Fernández M, Artero EG, Robles-Fuentes A, Gatto-Cardia MC, Arroyo-Morales M. Disability Predictors in Chronic Low Back Pain After Aquatic Exercise. Am J Phys Med Rehabil 2014; 93:615-23. [DOI: 10.1097/phm.0000000000000123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Jung J, Chung E, Kim K, Lee BH, Lee J. The effects of aquatic exercise on pulmonary function in patients with spinal cord injury. J Phys Ther Sci 2014; 26:707-9. [PMID: 24926136 PMCID: PMC4047236 DOI: 10.1589/jpts.26.707] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/03/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the effects of aquatic exercise on pulmonary function of patients with spinal cord injury. [Subjects] The subjects were randomly allocated to an aqua group (n=10) and a land group (n=10). [Methods] Both groups trained for 60 minutes, 3 times a week for 8 weeks. Pulmonary function was assessed by measuring the forced vital capacity (FVC), forced expiratory flow rate (FER), force expiratory volume at one second (FEV1) and force expiratory volume at one second/forced vital capacity (FEV1/FVC). [Results] Following the intervention, the aqua group showed significant changes in FVC, FER, FEV1, and FEV1/FVC. The land group showed only significant differences FER. [Conclusion] The results of this study suggest the effects on the aqua group were significantly higher than those on the land group in patients with spinal cord injury.
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Affiliation(s)
- JaeHyun Jung
- Department of Physical Therapy, Daegu University, Republic of Korea
| | - EunJung Chung
- Department of Physical Therapy, Andong Science College, Republic of Korea
| | - Kyoung Kim
- Department of Physical Therapy, Daegu University, Republic of Korea
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - JiYeun Lee
- Department of Physical Therapy, Andong Science College, Republic of Korea
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Freund W, Schuetz UH, Weber F, Birklein F. Correspondence to Tesarz et al. Alterations in endogenous pain modulation in endurance athletes: An experimental study using quantitative sensory testing and the cold-pressor task. PAIN® 154, 1022–29, 2013. Pain 2013; 154:2234-2235. [DOI: 10.1016/j.pain.2013.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 07/07/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
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