Back pain and physiotherapy.
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ABSTRACT:
SUBMITTER: MacAuley D
PROVIDER: S-EPMC518881 | biostudies-literature | 2004 Sep
REPOSITORIES: biostudies-literature
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Project description:Low-back pain (LBP) is one of the most burdensome health problems in the world. Guidelines recommend simple treatments such as advice that may result in suboptimal outcomes, particularly when applied to people with complex biopsychosocial barriers to recovery. Individualised physiotherapy has the potential of being more effective for people with LBP; however, there is limited evidence supporting this approach. A series of studies supporting the mechanisms underpinning and effectiveness of the Specific Treatment of Problems of the Spine (STOPS) approach to individualised physiotherapy have been published. The clinical and research implications of these findings are presented and discussed. Treatment based on the STOPS approach should also be considered as an approach to individualised physiotherapy in people with LBP.
| S-EPMC6780711 | biostudies-literature
Project description:ObjectiveTo measure the effectiveness of routine physiotherapy compared with an assessment session and advice from a physiotherapist for patients with low back pain.DesignPragmatic, multicentre, randomised controlled trial.SettingSeven British NHS physiotherapy departments.Participants286 patients with low back pain of more than six weeks' duration.InterventionRoutine physiotherapy or advice on remaining active from a physiotherapist. Both groups received an advice book.Main outcome measuresPrimary outcome was scores on the Oswestry disability index at 12 months. Secondary outcomes were scores on the Oswestry disability index (two and six months), scores on the Roland and Morris disability questionnaire and SF-36 (2, 6 and 12 months), and patient perceived benefit from treatment (2, 6, and 12 months).Results200 of 286 patients (70%) provided follow up information at 12 months. Patients in the therapy group reported enhanced perceptions of benefit, but there was no evidence of a long term effect of physiotherapy in either disease specific or generic outcome measures (mean difference in change in Oswestry disability index scores at 12 months -1.0%, 95% confidence interval -3.7% to 1.6%). The most common treatments were low velocity spinal joint mobilisation techniques (72%, 104 of 144 patients) and lumbar spine mobility and abdominal strengthening exercises (94%, 136 patients).ConclusionsRoutine physiotherapy seemed to be no more effective than one session of assessment and advice from a physiotherapist.
| S-EPMC518892 | biostudies-literature
Project description:BackgroundFollowing reports of high prevalence of low back pain (LBP) in young physiotherapists, we investigated whether LBP was a problem for undergraduate physiotherapy students.MethodPhysiotherapy students enrolled in one Australian tertiary institution completed a validated self-administered questionnaire in April 2001, seeking information on LBP prevalence (lifetime, 12 month, one-month, one-week), and its risk factors. The survey incorporated the Nordic back questionnaire, questions on common risks for LBP, and purpose-built questions regarding educational exposures. Univariate logistic regression models were applied to test associations.Results and discussion72% students responded. LBP prevalence was 69% (lifetime), 63% (12-month), 44% (one-month), 28% (one-week). The risk of LBP increased significantly for students once they completed first year. Being aged 20 or 21 years (final year students) was significantly associated with all measures of LBP, compared with the youngest students. Exposure to tertiary study of greater than two years was associated with lifetime, 12 month and one-month LBP prevalence. Spending more than 20 hours in the past month 'sitting looking down' was significantly associated with one-month LBP prevalence. Similar exposure to 'treating patients' was significantly associated with one-month and one-week LBP prevalence.ConclusionsPhysiotherapy students should be alerted to the likelihood of LBP and is potential causes during their training, so that they enter the workforce with reduced risk of LBP. The potential for other undergraduate students to suffer LBP should also be considered.
| S-EPMC270026 | biostudies-literature
Project description:The present study examined the profile of physical and psychosocial changes that occur in physiotherapy intervention when patients also participate in a psychosocial intervention. The psychosocial intervention, delivered by physiotherapists, was designed to target catastrophic thinking, fear of pain, perceived disability, and depression.The study sample consisted of 48 individuals referred for the rehabilitation treatment of disabling back pain. Half the sample was enrolled in a physiotherapy intervention only; the other half was enrolled in a psychosocial intervention in addition to receiving a physiotherapy intervention.At post-treatment, the two treatment groups did not differ significantly on measures of pain severity, physical function, or self-reported disability. Patients who participated in the psychosocial intervention in addition to physiotherapy showed significantly greater reductions in pain catastrophizing, fear of movement, and depression than patients who received only the physiotherapy intervention. Reductions in psychosocial risk factors contributed to reduced use of the health care system, reduced use of pain medication, and improved return-to-work outcomes.The findings of the present study suggest that a psychosocial intervention provided by physiotherapists can lead to meaningful reductions in psychosocial risk factors for pain and disability and may contribute to more positive rehabilitation outcomes.
| S-EPMC2909858 | biostudies-other
Project description:[Purpose] The aim of this study was to compare the effects of "McGill stabilization exercises" and "conventional physiotherapy" on pain, functional disability and active back flexion and extension range of motion in patients with chronic non-specific low back pain. [Subjects and Methods] Thirty four patients with chronic non-specific low back pain were randomly assigned to McGill stabilization exercises group (n=17) and conventional physiotherapy group (n=17). In both groups, patients performed the corresponding exercises for six weeks. The visual analog scale (VAS), Quebec Low Back Pain Disability Scale Questionnaire and inclinometer were used to measure pain, functional disability, and active back flexion and extension range of motion, respectively. [Results] Statistically significant improvements were observed in pain, functional disability, and active back extension range of motion in McGill stabilization exercises group. However, active back flexion range of motion was the only clinical symptom that statistically increased in patients who performed conventional physiotherapy. There was no significant difference between the clinical characteristics while compared these two groups of patients. [Conclusion] The results of this study indicated that McGill stabilization exercises and conventional physiotherapy provided approximately similar improvement in pain, functional disability, and active back range of motion in patients with chronic non-specific low back pain. However, it appears that McGill stabilization exercises provide an additional benefit to patients with chronic non-specific low back, especially in pain and functional disability improvement.
| S-EPMC5908986 | biostudies-other
Project description:Low back pain (LBP) is the world's leading cause of years lived with disability. Digital exercise-based interventions have shown great potential in the management of musculoskeletal conditions, promoting access and easing the economic burden. However, evidence of their effectiveness for chronic LBP (CLBP) management compared to in-person physiotherapy has yet to be unequivocally established. This randomized controlled trial (RCT) aims to compare the clinical outcomes of patients with CLBP following a digital intervention versus evidence-based in-person physiotherapy. Our results demonstrate that patient satisfaction and adherence were high and similar between groups, although a significantly lower dropout rate is observed in the digital group (11/70, 15.7% versus 24/70, 34.3% in the conventional group; P = 0.019). Both groups experience significant improvements in disability (primary outcome), with no differences between groups in change from baseline (median difference: -0.55, 95% CI: -2.42 to 5.81, P = 0.412) or program-end scores (-1.05, 95% CI: -4.14 to 6.37; P = 0.671). Likewise, no significant differences between groups are found for secondary outcomes (namely pain, anxiety, depression, and overall productivity impairment). This RCT demonstrates that a remote digital intervention for CLBP can promote the same levels of recovery as evidence-based in-person physiotherapy, being a potential avenue to ease the burden of CLBP.
| S-EPMC10329005 | biostudies-literature
Project description:BackgroundAlthough low back pain (LBP) beliefs have been well investigated in mainstream healthcare discipline students, the beliefs within sports-related study students, such as Sport and Exercise Science (SES), Sports Therapy (ST), and Sport Performance and Coaching (SPC) programmes have yet to be explored. This study aims to understand any differences in the beliefs and fear associated with movement in students enrolled in four undergraduate study programmes-physiotherapy (PT), ST, SES, and SPC.Method136 undergraduate students completed an online survey. All participants completed the Tampa Scale of Kinesiophobia (TSK) and Back Beliefs Questionnaire (BBQ). Two sets of two-way between-subjects Analysis of Variance (ANOVA) were conducted for each outcome of TSK and BBQ, with the independent variables of the study programme, study year (1st, 2nd, 3rd), and their interaction.ResultsThere was a significant interaction between study programme and year for TSK (F(6, 124) = 4.90, P < 0.001) and BBQ (F(6, 124) = 8.18, P < 0.001). Post-hoc analysis revealed that both PT and ST students had lower TSK and higher BBQ scores than SES and SPC students particularly in the 3rd year.ConclusionsThe beliefs of clinicians and trainers managing LBP are known to transfer to patients, and more negative beliefs have been associated with greater disability. This is the first study to understand the beliefs about back pain in various sports study programmes, which is timely, given that the management of injured athletes typically involves a multidisciplinary team.
| S-EPMC10118113 | biostudies-literature
Project description:Non-specific low back pain (LBP) is one of the leading causes of global disability. Multidisciplinary pain treatment (MPT) programs comprising educational, physical, and psychological interventions have shown positive treatment effects on LBP. Nonetheless, such programs are costly and treatment opportunities are often limited to specialized medical centers. mHealth and other digital interventions may be a promising method to successfully support patient self-management in LBP. To address these issues, we investigated the clinical effects of a multidisciplinary mHealth back pain App (Kaia App) in a randomized controlled trial (registered at German Clinical Trials Register under DRKS00016329). One-hundred one adult patients with non-specific LBP from 6 weeks to 1 year were randomly assigned to an intervention group or a control group. In the intervention group, the Kaia App was provided for 3 months. Control treatment consisted of six individual physiotherapy sessions over 6 weeks and high-quality online education. The primary outcome, pain intensity, was assessed at 12-week follow-up on an 11-point numeric rating scale (NRS). Our per-protocol analysis showed no significant differences between the groups at baseline (Kaia App group: M = 5.10 (SD = 1.07) vs. control group: M = 5.41 (SD = 1.15). At 12-week follow-up the Kaia App group reported significantly lower pain intensity (M = 2.70 (SD = 1.51)) compared to the control group (M = 3.40 (SD = 1.63)). Our results indicate that the Kaia App as a multidisciplinary back pain app is an effective treatment in LBP patients and is superior to physiotherapy in combination with online education.
| S-EPMC6550294 | biostudies-literature
Project description:AimTo determine the feasibility of conducting a definitive randomised control trial (RCT) to answer the following questions: (1) Is early physiotherapy treatment acceptable and feasible for patients and direct healthcare providers? and (2) Is early physiotherapy intervention associated with better disability and psychosocial outcomes compared with the practice of routine MRIs?MethodsIn a feasibility RCT in Riyadh City from 01 March 2018 until 29 July 2018, chronic low back pain (CLBP) patients presenting to spine clinics were randomised to receive an MRI (intervention) plus physiotherapy rehabilitation or physiotherapy alone (control group). The acceptability of randomisation to the control group (non-MRI) was tested during the recruitment by qualitatively interviewing study participants and referring physicians. Moreover, interviews with study participants explored the broader social, political, economic, and environmental (context) aspects that may influence trial delivery and intervention implementation.ResultsThe recruitment target was not met: 16/24 (66%) participants were recruited in 4 months (12.4% of those screened); 33% declined. The process evaluation identified numerous factors that may affect the success of a definitive RCT in Saudi Arabia. These were research resources, the lack of research infrastructure to support recruitment to trials, limited research capacity in terms of knowledge and skills of the healthcare team, and limited funding.ConclusionA definitive RCT to test the influence of MRI diagnosis on the psychosocial and disability outcomes in people with CLBP treated with physiotherapy in Saudi Arabia is feasible. However, the lack of research infrastructure, research capacity, the impact of MRI on patient outcomes, and a lack of clinical equipoise in the treatment and management of CLBP in Saudi Arabia pose major barriers to clinical trials.
| S-EPMC7702682 | biostudies-literature
Project description:This study aimed to evaluate the effectiveness of connective tissue manipulation (CTM) for improving pain, mobility, and well-being in chronic low back pain (CLBP). Sixty-six patients with CLBP were randomized to three groups: CTM, sham massage (SM) and control groups. The groups got standardized physiotherapy and the related applications 5 days/wk, 3 weeks. Pain intensity, mobility, and well-being (Hospital Anxiety and Depression Scale [HADS], Oswestry Disability Index [ODI], and Short Form-36 [SF-36]) were assessed before and after the applications. Pain, mobility, and disability improved in all groups (P<0.05). There were differences in resting pain, HADS, and SF-36 scores in CTM, resting pain in SM, and SF-36 scores in controls (P<0.05). Activity pain, HADS scores decreased, mobility and physical component of the SF-36 in-creased in CTM compared to SM (P<0.05). Pain, ODI, and HADS scores decreased, mobility and SF-36 increased in CTM, and ODI scores decreased in SM compared to controls (P<0.05). In conclusion, pain intensity during activity and at night and disability decreased, and spinal mobility increased in all groups. However, CTM showed superiority in improving pain, mobility, and well-being in patients with CLBP.
| S-EPMC6509448 | biostudies-literature