Can We Convert Between Outcome Measures of Disability for Chronic Low Back Pain?

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.

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Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1577-9849 ◽

2021 ◽

Author(s):

Ecenur Atli ◽

Dilber Karagozoglu Coskunsu ◽

Zeynep Turan ◽

Ozden Ozyemisci Taskiran

Keyword(s):

Electrical Stimulation ◽

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Neuromuscular Electrical Stimulation ◽

Muscle Thickness ◽

Transversus Abdominis ◽

Control Group ◽

Low Back

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p<0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p>0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p>0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.

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A comparative study of the therapeutic efficacy of vertical oscillatory pressure and transverse oscillatory pressure in the management of Chronic Low Back Pain

Revista Pesquisa em Fisioterapia ◽

10.17267/2238-2704rpf.v8i2.1916 ◽

2018 ◽

Vol 8 (2) ◽

pp. 216-222

Author(s):

Oluwadare Akanni Ogundipe ◽

Olufemi Opeyemi Ogundiran

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Low Back ◽

Significant Difference ◽

Before And After ◽

Treatment Data ◽

Quasi Experimental ◽

Oscillatory Pressure

BACKGROUND: The use of physical modalities in treatment of Chronic Low Back Pain (CLBP) is potentially beneficial, but the general evidence still leaves questions about its security application. OBJECTIVE: This study sought to investigate and compare the relative efficacy of Vertical Oscillatory Pressure (VOP) and Transverse Oscillatory Pressure (TOP) in the management chronic low back pain (CLBP) of mechanical origin. METHODS: A two-group, quasi-experimental design was utilized, involving a total of forty-two participants purposively recruited with due consideration of the specific inclusion and exclusion criteria. Five research questions were raised with corresponding hypotheses formulated for them, which were tested at 0.05 level of significance. The participants were randomly assigned to the VOP and TOP groups, and were subsequently managed thrice weekly for a duration of six weeks. The pain intensity rating, straight leg raising, and spinal range of motion were the outcome measures selected, which were assessed before and after treatment. Data were collected, organized, and analyzed using descriptive and T-Student test analytical statistics. RESULTS: The results of the study showed a significant difference in each of the outcome measures for both groups (p<0,05). CONCLUSION: This suggested that both VOP and VOP were relatively effective in managing CLBP.

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Responsiveness of Objective, Disease-Specific, and Generic Outcome Measures in Patients With Chronic Low Back Pain: An Assessment for Improving, Stable, and Deteriorating Patients

Spine ◽

10.1097/01.brs.0000207257.64215.03 ◽

2006 ◽

Vol 31 (7) ◽

pp. 815-822 ◽

Cited By ~ 36

Author(s):

Helen Campbell ◽

Oliver Rivero-Arias ◽

Katharine Johnston ◽

Alastair Gray ◽

Jeremy Fairbank ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Chronic Low Back Pain ◽

Low Back ◽

Disease Specific

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Prospective Placebo-controlled Randomized Trial to compare the Efficacy of Ketamine as an Adjuvant to Epidural Steroids in preventing Repeat Blocks in Chronic Low Back Pain

Current Trends in diagnosis & Treatment ◽

10.5005/jp-journals-10055-0004 ◽

2017 ◽

Vol 1 (1) ◽

pp. 15-21

Author(s):

Saru Singh ◽

Ruchi Gupta ◽

Chashamjot Bawa ◽

Lakshmi Mahajan ◽

Bhanupreet Kaur ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Randomized Trial ◽

Outcome Measures ◽

Normal Saline ◽

Chronic Low Back Pain ◽

Low Back ◽

Group Ii ◽

Epidural Steroid ◽

Epidural Steroids

ABSTRACT Introduction Low back pain behaves as a “silent epidemic,” ranking first among complications related to work. Often there is a large gap between a patient's desired pain reduction and the minimum percentage of improvement that would make a treatment worthwhile. Consequently, debate continues as to the value of epidural steroid injections, supremacy of one adjuvant over others, various doses, and concentrations in optimizing pain management. Objective To compare the efficacy of ketamine vs normal saline as an adjuvant to epidural steroids in chronic low back pain. Study design Randomized prospective placebo-controlled study. Materials and methods The study was conducted on 60 patients of age group 18 to 70 years having chronic lower backache with or without radiculitis of minimum 3 months duration and having no relief with conventional treatment. The patients selected were randomly allocated into two groups of 30 patients each: Group I (n = 30) given triamcinolone 40 mg, preservative-free ketamine 30 mg (0.6 mL) made up to 6 mL solution with 0.25% bupivacaine and group II (n = 30) given 0.6 mL normal saline instead of ketamine. Outcome measures The primary outcome measured was number of patients requiring repeat blocks and number of repeat blocks administered in 3 months. Other outcome measures were functional improvement quantified by visual analog scale (VAS) and Oswestry disability index (ODI) as well as improvement in psychological status by depression scoring, all taken at 2 weeks interval for 3 months. The periprocedural complications were also noted at the end of the study. Results In managing lumbar radicular pain with lumbar epidural steroid injection (LESI), ketamine's role as an adjuvant proved to be advantageous for long-term relief by its inhibition of dorsal horn “wind up” phenomenon through N-methyl-D-aspartate (NMDA) receptor antagonism, thus reducing frequency of repeat blocks in group II (ketamine). Conclusion Thus to conclude, ketamine's advantage as a drug that prolongs pain relief from LESI is an avenue for further research and promises a bright future in the field of interventional pain medicine. How to cite this article Gupta R, Bawa C, Singh S, Mahajan L, Kaur B, Kaur T. Prospective Placebo-controlled Randomized Trial to compare the Efficacy of Ketamine as an Adjuvant to Epidural Steroids in preventing Repeat Blocks in Chronic Low Back Pain. Curr Trends Diagn Treat 2017;1(1):15-21.

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

Physical Therapy ◽

10.2522/ptj.20090421 ◽

2010 ◽

Vol 90 (10) ◽

pp. 1426-1440 ◽

Cited By ~ 82

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.

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