Treatment of low back pain: First extended follow up of an original trial (NCT00600197) comparing a multidisciplinary group-based rehabilitation program with oral drug treatment alone up to 24 months

2014 ◽  
Vol 20 (12) ◽  
pp. 1902-1909 ◽  
Author(s):  
Sedigheh Sadat Tavafian ◽  
Ahmad Reza Jamshidi ◽  
Barbara Shay
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Drug Treatment ◽  
Rehabilitation Program ◽  
Oral Drug ◽  
Low Back ◽  
Original Trial ◽  
Multidisciplinary Group

Identifying prognostic factors to determine the level of recovery in servicemembers with chronic low back pain: a prospective cohort study.

2020 ◽  
Author(s):  
Bianca Maria Pietertje Mourits ◽  
Mariette Zwanette Meulekamp ◽  
Peter van der Wurff ◽  
Cees Lucas
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rehabilitation Program ◽  
Service Members ◽  
Low Back ◽  
Regression Analyses

Abstract Background In the Dutch Armed Forces (DAF), low back pain is the third most reported musculoskeletal disorder. For the prognosis of chronic low back pain (CLBP) only limited evidence is available. This observation results in a lack of clarity on prognostic factors that might affect recovery from CLBP in service members.The main objective is to identify general and military-related factors that are associated with the level of recovery in DAF service members with CLBP who followed a rehabilitation program. Methods One hundred five consecutive service members with CLBP who completed the rehabilitation program have been included in this prospective observational cohort study. The primary outcome measurement, level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Disability and pain were measured at baseline and 12 weeks follow-up and self-perceived recovery only at follow-up. Differences were evaluated within and between the groups using the Student’s t-test, according to the normality of the data distribution. Bivariate logistic regression analyses were used for identifying the prognostic factors related to various outcomes of recovery. Results After following the rehabilitation program, 64.8% of the service members recovered from CLBP. In the recovered group, there are significant effect sizes of -6.72 (CI: -7.57 - -5.87) in the level of disability and − 2.58 (CI: -3.17- -1.98) in level of pain, whereas the non-recovered group shows a non-significant effect size of -0.49 (CI: -1.27 - -0.29) in level of disability and a significant effect size of -0.94 (CI: -1.62 - -0.25) in level of pain. The self-perceived recovery in the recovered group is on average “much improved” and in the non-recovered group “slightly improved”. The results of the bivariate regression analyses show no significant independent prognostic factors related to recovery. Conclusion In this study, no significant independent prognostic factors could be identified that are associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.

scholarly journals Effectiveness of Multidisciplinary Group-Based Intervention versus Individual Physiotherapy for Improving Chronic Low Back Pain in Nursing Staff: A Clinical Trial with 3- and 6-Month Follow-Up Visits from Tehran, Iran

2017 ◽  
Vol 11 (3) ◽  
pp. 396-404 ◽  
Author(s):  
Leila Ghadyani ◽  
Sedigheh Sadat Tavafian ◽  
Anoshirvan Kazemnejad ◽  
Joan Wagner
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Educational Program ◽  
Intervention Group ◽  
Low Back ◽  
Preventive Behaviors ◽  
Multidisciplinary Group

<sec><title>Study Design</title><p>Clinical trial.</p></sec><sec><title>Purpose</title><p>To evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran.</p></sec><sec><title>Overview of Literature</title><p>Although low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities.</p></sec><sec><title>Methods</title><p>Overall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16.</p></sec><sec><title>Results</title><p>There were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (<italic>p</italic>&lt;0.001). The mean scores of predictive constructs regarding LBP preventive behaviors in the intervention group were improved after 3 and 6 months (<italic>p</italic>&lt;0.001). Finally, in the intervention group, pain severity and disability were decreased significantly.</p></sec><sec><title>Conclusions</title><p>This study showed that a multidisciplinary educational program intervention can be an effective approach for reducing LBP and related disabilities among nurses.</p></sec>

PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Wawan Mulyawan ◽  
Yudi Yuwono Wiwoho ◽  
Syaiful Ichwan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hypertonic Saline ◽  
Failed Back Surgery Syndrome ◽  
Favourable Outcome ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Failed Back Surgery ◽  
Scale Scores

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up

scholarly journals Prognosis and Course of Disability in Patients With Chronic Nonspecific Low Back Pain: A 5- and 12-Month Follow-up Cohort Study

2013 ◽  
Vol 93 (12) ◽  
pp. 1603-1614 ◽  
Author(s):  
Karin Verkerk ◽  
Pim A.J. Luijsterburg ◽  
Martijn W. Heymans ◽  
Inge Ronchetti ◽  
Annelies L. Pool-Goudzwaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Short Form ◽  
Low Back ◽  
Multidisciplinary Therapy ◽  
Patient Reported ◽  
Specific Disability

Background Few data are available on the course of and predictors for disability in patients with chronic nonspecific low back pain (CNSLBP). Objective The purpose of this study was to describe the course of disability and identify clinically important prognostic factors of low-back-pain–specific disability in patients with CNSLBP receiving multidisciplinary therapy. Design A prospective cohort study was conducted. Methods A total of 1,760 patients with CNSLBP who received multidisciplinary therapy were evaluated for their course of disability and prognostic factors at baseline and at 2-, 5-, and 12-month follow-ups. Recovery was defined as 30% reduction in low back pain–specific disability at follow-up compared with baseline and as absolute recovery if the score on the Quebec Back Pain Disability Scale (QBPDS) was ≤20 points at follow-up. Potential prognostic factors were identified using multivariable logistic regression analysis. Results Mean patient-reported disability scores on the QBPDS ranged from 51.7 (SD=15.6) at baseline to 31.7 (SD=15.2), 31.1 (SD=18.2), and 29.1 (SD=20.0) at 2, 5, and 12 months, respectively. The prognostic factors identified for recovery at 5 and 12 months were younger age and high scores on disability and on the 36-Item Short-Form Health Survey (SF-36) (Physical and Mental Component Summaries) at baseline. In addition, at 5-month follow-up, a shorter duration of complaints was a positive predictor, and having no comorbidity and less pain at baseline were additional predictors at 12-month follow-up. Limitations Missing values at 5- and 12-month follow-ups were 11.1% and 45.2%, respectively. Conclusion After multidisciplinary treatment, the course of disability in patients with CNSLBP continued to decline over a 12-month period. At 5- and 12-month follow-ups, prognostic factors were identified for a clinically relevant decrease in disability scores on the QBPDS.

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