scholarly journals Physiotherapy Based on a Biobehavioral Approach with or Without Orthopedic Manual Physical Therapy in the Treatment of Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2571-2587 ◽  
Author(s):  
Mónica Grande-Alonso ◽  
Luis Suso-Martí ◽  
Ferran Cuenca-Martínez ◽  
Joaquín Pardo-Montero ◽  
Alfonso Gil-Martínez ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Low Back ◽  
Psychological Variables ◽  
Randomized Controlled

Abstract Objective To compare the effectiveness of a biobehavioral approach with and without orthopedic manual physical therapy on the intensity and frequency of pain in patients diagnosed with nonspecific chronic low back pain. Methods A single-blind randomized controlled trial. Fifty patients were randomly allocated into two groups: one group received biobehavioral therapy with orthopedic manual physical therapy, and the other group received only biobehavioral therapy. Both groups completed a total of eight sessions, with a frequency of two sessions per week. The somatosensory, physical, and psychological variables were recorded at baseline and during the first and third month after initiation of treatment. Results In both groups, the treatment was effective, presenting significant differences for all the variables in the time factor. There were no significant differences between groups in intensity or frequency of pain, with a large effect size (>0.80), but there were intragroup differences for both intervention groups at one- and three-month follow-up. There were also no significant differences between groups in the secondary variables during the same follow-up period. Conclusions The results of this study suggest that orthopedic manual physical therapy does not increase the effects of a treatment based on biobehavioral therapy in the short or medium term, but these results should be interpreted with caution.

scholarly journals Motor Control Exercises, Sling Exercises, and General Exercises for Patients With Chronic Low Back Pain: A Randomized Controlled Trial With 1-Year Follow-up

2010 ◽  
Vol 90 (10) ◽  
pp. 1426-1440 ◽  
Author(s):  
Monica Unsgaard-Tøndel ◽  
Anne Margrethe Fladmark ◽  
Øyvind Salvesen ◽  
Ottar Vasseljen
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Low Back ◽  
Randomized Controlled

BackgroundExercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown.ObjectiveThis study compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain.DesignThis was a randomized controlled trial with a 1-year follow-up.SettingThe study was conducted in a primary care setting in Norway.PatientsThe participants were patients with chronic nonspecific low back pain (n=109).InterventionsThe interventions in this study were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physical therapists, once a week for 8 weeks.MeasurementsThe primary outcome measure was pain reported on the Numeric Pain Rating Scale after treatment and at a 1-year follow-up. Secondary outcome measures were self-reported activity limitation (assessed with the Oswestry Disability Index), clinically examined function (assessed with the Fingertip-to-Floor Test), and fear-avoidance beliefs after intervention.ResultsThe postintervention assessment showed no significant differences among groups with respect to pain (overall group difference) or any of the outcome measures. Mean (95% confidence interval) group differences for pain reduction after treatment and after 1 year were 0.3 (−0.7 to 1.3) and 0.4 (−0.7 to 1.4) for motor control exercises versus sling exercises, 0.7 (−0.6 to 2.0) and 0.3 (−0.8 to 1.4) for sling exercises versus general exercises, and 1.0 (−0.1 to 2.0) and 0.7 (−0.3 to 1.7) for motor control exercises versus general exercises.LimitationsThe nature of the interventions made blinding impossible.ConclusionsThis study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain.

scholarly journals Efficacy of a multidimensional versus usual care physiotherapy on pain and electroencephalography (EEG) spectrum in chronic nonspecific low back pain: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sanaz Bemani ◽  
Shohreh Noorizadeh Dehkordi ◽  
Javad Sarrafzadeh ◽  
Saeed Talebian ◽  
Reza Salehi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Usual Care ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Clinical Findings ◽  
Low Back ◽  
Randomized Controlled

Abstract Background Non-specific chronic low back pain (NSCLBP) is a major public health and global socioeconomic burden associated with a complex interplay of biopsychosocial factors. Despite scientific signs of progress, treatment of NSCLBP often tends to stick to a biomechanical model, without targeting psychological and social factors. To enhance the clinical efficacy of usual physiotherapy for NSCLBP, the development of clinical strategies is to be pursued. This study aims to assess the effectiveness of multidimensional physiotherapy based on a biopsychosocial approach compared to usual care physiotherapy, on clinical findings and electroencephalography spectrum in non-specific chronic low back pain. Methods This study is a triple-blind, two-arm (1:1) randomized controlled trial with a 4 months follow-up. Seventy NSCLBP patients will be randomly allocated to either the experimental (multidimensional physiotherapy) or the active control group (usual physiotherapy); each group will receive 6 weeks of physiotherapy. The main outcome is pain and secondary outcomes are brain function, quality of life, disability, lumbar flexion range of motion, and psychosocial correlates. Assessment will be performed at baseline, post-treatment, and at 1 and 4 months follow-up. Discussion Findings may provide evidence on the effectiveness of multidimensional physiotherapy on clinical findings and brain characteristics and might provide evidence towards showing the role of brain and biopsychosocial factors on chronic pain. Trial registration ClinicalTrials.gov NCT04270422, Registered on 17 February 2020, IRCT Identifier: IRCT20140810018754N11

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