Effects of conventional physiotherapy treatment on kinesiophobia, pain, and disability in patients with mechanical low back pain

Virtually Administered Intervention Through Telerehabilitation for Chronic Non-specific Low Back Pain: A Review of Literature

The most frequent reason for individuals to seek medical attention in both primary care settings and immediate care centers is low back pain (LBP). Over a duration of time, the disability caused by lower back pain has risen enough, particularly in countries with low or moderate incomes. In the coming years, there may be an increase in LBP-related impairment and expenses in countries with low or medium incomes, particularly when fragile medical systems are unable to handle this growing load. Hence, this review focuses on the effectiveness of telerehabilitation (TR) on LBP. The significant advantages of TR may include greater interaction and remote accessibility to medical treatments. The exchange of knowledge and health information is made possible through a more effective interaction, which benefits patients, families, carers, physicians, and researchers. People who live in distant places now have the opportunity to get medical attention assisting families in caring for patients with poor responsiveness. In addition, it provides the potential for prompt detection, the beginning of treatment in the midst of an emergency, a shorter stay in the hospital, ongoing monitoring of those at risk, and overall time and expense savings. Therefore, this study supports the application of TR in conditions of LBP for early management and relief of pain for patients in low-resource areas.

The effect of treadmill walk with abdominal bracing versus usual care on functional limitation and fear-avoidance behaviours in the management of non-specific low back pain—a randomized control study

Background

The use of a combined abdominal bracing technique concurrently with treadmill walking exercise seems not to have been widely investigated, The use of either abdominal bracing and treadmill walk as a single individual method of treatment has proven to be of immense benefit in athletic training and amelioration of pain and functional limitation among different age groups suffering from chronic low back pain. Thus, the need to investigate whether the combination of abdominal bracing and treadmill walking would produce greater benefits than when the exercises are carried out in isolation in the management of chronic low back pain patients.

Study design

The study was a randomized control.

Participants

Thirty-three participants who met the inclusion criteria with age from 18 to 65 participated in the study.

Aim

This study aimed to compare the effects of treadmill walk with and without abdominal bracing versus usual care on pain, functional limitation and fear-avoidance behaviours among patients with non-specific chronic low back pain.

Methods

Thirty-three non-specific chronic low back pain (NSCLBP) patients were randomized into three groups treadmill walk without abdominal bracing (TWW), treadmill walk with abdominal bracing (TWAB) and usual care (UC). Interventions were carried out for 6 weeks.

Outcome measure

Pre and post-intervention scores of pain intensity, functional limitation, and fear-avoidance belief were assessed with box numerical pain rating scales, Oswestry disability index and Fear-Avoidance Belief Questionnaire, respectively.

Results

Pre-intervention scores of pain intensity functional disability and fear-avoidance belief did not show significant differences among the groups (P >0.05). Within-group analysis with paired t-test showed that pain intensity and functional limitation were significantly reduced after 6 weeks of intervention among the 3 groups. Fear-avoidance belief recorded statistical reduction among the 2 treadmill procedures (TWAB and TWW) groups (P<0.05) but not in the usual care groups (P>0.05). Participants in the TWW group showed greater improvement than those in TWAB in terms of reduction in pain intensity (24.17±16.49), functional limitation (7.00±5.97, P = 0.001) and fear- avoidance (30.83±17.90, P = 0.003)

Conclusion

Treadmill walk with and without abdominal bracing as well as usual care could be effective in reducing pain. However, treadmill walk without abdominal bracing was more effective in improving back function in terms of reduction in pain intensity, functional limitation (as reported by the Oswestry scale) and reducing fear-avoidance behaviour (as reported by fear-avoidance belief scores).

Trial registration

PACTR, PACTR201910691645076. Registered on 22 October 2019.