Physiotherapy interventions in the BTS guidelines on the management of asthma (2011): a need for change?

Effects of the active break intervention on nonspecific low back pain among young people: a randomized controlled trial

INTRODUCTION

Every end-range position maintained for a prolonged time causes a static load on the spine and may lead to musculoskeletal discomfort. Prolonged flexed sitting is a strong predictor of low back pain (LBP). The study aimed to evaluate the effectiveness of the Active Break program, implemented among young people, in reducing perceived low back pain and discomfort, as well as associated disability level resulting from prolonged sitting.

METHODS

A randomized controlled trial was conducted among young people with non-specific LBP. Participants were randomized into groups: an experimental group participating in the tested Active Break intervention (AB-group, n = 25), and a control group (C-group, n = 25) with self-administered care recommendations. The program took 12 weeks. The outcomes were average pain intensity (Visual Analogue Scale, VAS), disability (Oswestry Disability Index, ODI), perceived low back discomfort (LBD) during prolonged sitting (Borg scale), and global perceived improvement (Global Perceived Effect, GPE).

RESULTS

VAS, ODI, and LBD scores after the 12-week intervention were significantly lower than those at baseline in the AB-group. In the C-group, differences were not statistically significant. Post-intervention inter-group VAS, LBD, and GPE differences were significant.

CONCLUSIONS

The 12-week study of the Active Break intervention for young people with non-specific low back pain demonstrated significant improvement. Our research offers valuable evidence-based practices for managing and preventing low back pain, benefiting individuals, educators, healthcare professionals, personal trainers, and family physicians.

TRIAL REGISTRATION

The study was registered at ClinicalTrials.gov [NCT05810519], registration date: 31/03/2023.

Physiotherapy in asthma--seeking consensus

OBJECTIVE

The evidence base for or against physiotherapy interventions in asthmatic adults remains ambiguous, and there are discrepancies between different clinical practice guidelines. We evaluated the level of agreement between the recommendations about physiotherapy for adults with asthma in two major clinical practice guidelines: the Global Initiative for Asthma (GINA 2011) and the British Thoracic Society and the Association of Chartered Physiotherapists in Respiratory Care (BTS/ACPRC 2009).

METHODS

We used the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument to assess the methodological rigor of the guideline development, the Assessment of Multiple Systematic Reviews (AMSTAR) tool and the Physiotherapy Evidence Database (PEDro) scale to assess the methodological quality of systematic reviews and clinical trials included in the analyzed documents. Additionally, we compared the reference lists of the analyzed sections to establish the overlap in included primary and secondary studies.

RESULTS

We observed no agreement between the two guidelines in the choice of source research articles. Only two studies out of 18 used in BTS guidelines were used in the GINA. The reason why GINA developers did not use the body of evidence included in BTS is that it is not clear. Three independent investigators indicated higher scores in all domains of the AGREE II in the BTS/ACPRC document in comparison with the GINA guidelines.

CONCLUSIONS

The significant differences in the content and in the development processes of the examined sections of the two guidelines suggest the need for more frequent and careful updating or directing the readers of the GINA to the BTS/ACPRC, a guideline addressing specifically and more comprehensively physiotherapy interventions in asthma.