Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial

2020 ◽  
Vol 29 (2) ◽  
pp. 179-185 ◽  
Author(s):  
TaeYeong Kim ◽  
JaeHyuk Lee ◽  
SeJun Oh ◽  
Seungmin Kim ◽  
BumChul Yoon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Oswestry Disability Index ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Low Back ◽  
Baseline Values ◽  
Numeric Rating

Context: A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Design: A randomized controlled trial. Settings: Community and university campus. Participants: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Interventions: The exercises were performed for 30 minutes, 2 days per week for 8 weeks. Main Outcome Measures: Numeric rating scale, functional disabilities (Oswestry disability index and Roland–Morris disability), and fear-avoidance beliefs questionnaire (FABQ) scores were measured at baseline and at 4 weeks, 8 weeks, and 6 months. Results: A 2-way repeated analysis of variance identified that between-group comparisons showed significant differences in the FABQ related to work scale (F = 21.422; P = .01). There were no significant differences in the numeric rating scale (F = 1.696; P = .21), Oswestry disability index (F = 1.848; P = .20), Roland–Morris disability (F = 0.069; P = .80), and FABQ related to physical scale (F = 1.579; P = .24). In within-group comparisons, both groups presented significant differences in numeric rating scale (both SHR and STB after 4 wk), Oswestry disability index (both SHR and STB after 6 mo), and Roland–Morris disability (SHR after 6 mo and STB after 8 wk) compared with baseline values. In FABQ-related physical (SHR after 4 wk) and work scales (SHR after 6 mo), there were only significant differences in the SHR compared with baseline values. Conclusions: SHR exercise for 8 weeks had a greater effect than STB exercise for reducing work-related FABQ. The SHR exercise performed in a seated position could substantially decrease pain-related fear disability in young adults with chronic low back pain.

scholarly journals Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial

2014 ◽  
Vol 10 (5) ◽  
pp. 323 ◽  
Author(s):  
Aleksandra Zgierska, MD, PhD ◽  
Margaret L. Wallace, PharmD, BCACP ◽  
Cindy A. Burzinski, MS ◽  
Jennifer Cox, BS ◽  
Miroslav Backonja, MD
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Drug Testing ◽  
Illicit Drugs ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Cross Sectional ◽  
Toxicological Profile

Objective: Refractory chronic low back pain (CLBP) often leads to treatment with long-term opioids. Our goal was to describe the pharmaco-toxicological profile of opioid-treated CLBP patients and identify potential areas for care optimization.Design: Cross-sectional analysis.Setting: Outpatient primary care.Participants: CLBP patients prescribed ≥ 30 mg/d of morphine-equivalent dose (MED) for ≥3 months.Outcome Measures: Self-reported clinical, medication (verified) and substance use, and urine drug testing (UDT) data were collected.Results: Participants (N = 35) were 51.8 ± 9.7 years old, 80 percent female with CLBP for 14.2 ± 10.1 years, treated with opioids for 7.9 ± 5.7 years, with severe disability (Oswestry Disability Index score: 66.7 ± 11.4), and average pain score of 5.6 ± 1.5 (0-10 rating scale). Participants reported using tobacco (N = 14), alcohol (N = 9) and illicit drugs or unprescribed medications (N = 10). On average, participants took 13.4 ± 6.8 daily medications, including 4.7 ± 1.8 pain-modulating and 4.7 ± 2.0 sedating medications. Among prescribed opioids, 57.1 percent were long-acting and 91.4 percent were short-acting, with a total of 144.5 ± 127.8 mg/d of MED. Sixteen participants were prescribed benzodiazepines and/or zolpidem/zaleplon. Fifteen participants had UDT positive for illicit drugs or unprescribed medications; in addition, eight tested positive for alcohol and 19 for cotinine. Compared to those with negative UDTs, those with positive UDTs (N = 15) received lower daily “total” and “extended release” opioid doses, and were more likely to test positive for cotinine (p < 0.05).Conclusions: Study findings corroborate existing evidence for high medication burden and high likelihood of substance misuse among opioid-treated CLBP patients. Further research is needed to help understand causality and ways to optimize care and clinical outcomes.

scholarly journals The effect of an integrated multidisciplinary rehabilitation programme alternating inpatient interventions with home-based activities for patients with chronic low back pain: a randomized controlled trial

2020 ◽  
Vol 34 (3) ◽  
pp. 382-393 ◽  
Author(s):  
Anne Mette Schmidt ◽  
Berit Schiøttz-Christensen ◽  
Nadine E Foster ◽  
Trine Bay Laurberg ◽  
Thomas Maribo
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Oswestry Disability Index ◽  
Controlled Trial ◽  
Rehabilitation Programme ◽  
Low Back ◽  
Oswestry Disability Index Score ◽  
Home Based

Objective: To compare the effectiveness of an integrated rehabilitation programme with an existing rehabilitation programme in patients with chronic low back pain. Design: A single-centre, pragmatic, two-arm parallel, randomized controlled trial (1:1 ratio). Setting: A rheumatology inpatient rehabilitation centre in Denmark. Subjects: A total of 165 adults (aged ⩾ 18 years) with chronic low back pain. Interventions: An integrated rehabilitation programme comprising an alternation of three weeks of inpatient stay and 12 weeks of home-based activities was compared with an existing rehabilitation programme of four weeks of inpatient stay. Main measures: Patient-reported outcomes were collected at baseline and at the 26-week follow-up. The primary outcome was back-specific disability (Oswestry Disability Index). Secondary outcomes included pain intensity (Numerical Rating Scale), pain self-efficacy (Pain Self-Efficacy Questionnaire), health-related quality of life (EuroQol-5 Domain 5-level (EQ-5D)), and depression (Major Depression Inventory). A complete case analysis was performed. Results: A total of 303 patients were assessed for eligibility of whom 165 (mean age: 50 years (SD 13) and mean Oswestry Disability Index score 42 (SD 11)) were randomized (83 to existing rehabilitation programme and 82 to integrated rehabilitation programme). Overall, 139 patients provided the 26-week follow-up data. Baseline demographic and clinical characteristics were comparable between programmes. The between-group difference in the Oswestry Disability Index score when adjusting for the corresponding baseline score was −0.28 (95% confidence interval (CI): −4.02, 3.45) which was neither statistically nor clinically significant. No significant differences were found in the secondary outcomes. Conclusion: An integrated rehabilitation programme was no more effective than an existing rehabilitation programme at the 26-week follow-up.

scholarly journals A randomised controlled trial of ‘clockwise’ ultrasound for low back pain

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Adriaan Louw ◽  
Kory Zimney ◽  
Merrill R. Landers ◽  
Mark Luttrell ◽  
Bob Clair ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Leg Pain ◽  
Control Group ◽  
Low Back ◽  
Lumbar Flexion ◽  
Experimental Group

Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP).Methods: Sixty-seven patients with LBP < 3 months were randomly allocated to one of three groups – traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm2 for 10 minutes at 1 Megahertz, pulsed 20% over a 20 cm2 area), but received different explanations (CG, EG or EEG). Before and immediately after US,measurements of LBP and leg pain (numeric rating scale), lumbar flexion (distance to floor) and straight leg raise (SLR) (inclinometer) were taken. Statistical analysis consisted of mixed-factorial analyses of variance and chi-square analyses to measure differences between the three groups, as well as meeting or exceeding minimal detectable changes (MDCs) for pain, lumbar flexion and SLR.Results: Both EG and EEG groups showed a statistically significant improvement for SLR (p < 0.0001), while the CG did not. The EEG group participants were 4.4 times (95% confidence interval: 1.1 to 17.5) more likely to improve beyond the MDC than the CG. No significant differences were found between the groups for LBP, leg pain or lumbar flexion.Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment.

scholarly journals Utilization of Back Movement Technique to Intensity of Low Back Pain in Third Trimester Pregnant Women

2020 ◽  
Vol 9 (2) ◽  
pp. 535-542
Author(s):  
Putri Maretyara Saptyani ◽  
Ari Suwondo ◽  
Runjati Runjati
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Low Back ◽  
Third Trimester ◽  
Control Group Design ◽  
Numeric Rating

One of the discomforts in third-trimester pregnancy is lower back pain.The prevalence of back pain during pregnancy can reach 80%. The study aims to prove the use of back movement technique to decrease the intensity of low back pain in third trimester pregnant women. The study used quasy-experimental, pretest-posttest with control group design. The sample of the study was third-trimester pregnant women with low back pain totaling 40 respondents. The instrument used to measure back pain in pregnancy is the Numeric Rating Scale (NRS). Data analysis used wilcoxon and man-whitney. There was a decrease in intensity of low back pain before treatment by 4.75 cm and after being given a back movement technique of 1.55 cm (p = 0.001). Back movement technique is proven to be more effective in reducing the intensity of low back pain in third-trimester pregnant women.

scholarly journals Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain

2021 ◽  
Vol 3 (1) ◽  
pp. 24-31
Author(s):  
Faria Aqil ◽  
Muhammad Affan Iqbal ◽  
Suhail Karim ◽  
Muhammad Umar Iqbal ◽  
Muhammad Junaid Akram ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Post Intervention ◽  
Lumbar Stabilization ◽  
Numeric Pain Rating Scale

Introduction: Lumbar stabilization and McKenzie exercises are becoming a popular trend for managing chronic low back pain though it is currently not known whether lumbar stabilization exercises produce better results in improving functional status compared to McKenzie approach. The purpose of this study was to determine the effectiveness of the McKenzie approach versus lumbar stabilization in the treatment of chronic low back pain. Material & Methods: This was a randomized controlled trial. Lottery method was used to randomly divide individuals who fulfilled inclusion criteria into 2 groups. Assessments of the patients were done in OPD. Baseline assessment was done on day 1 and post intervention assessment was done after 2 weeks. A total of 8 treatment sessions spread across 2 weeks were given (4 days per week). Data were assessed at baseline level and post intervention. Data was entered and analysed by SPSS version 21. Results: A total of 28 females and 02 males (mean age of 50.88 ±12.29) participated in the study. After 02 weeks of intervention, both treatment groups showed improvement in decreasing pain and improving functional status. The lumber stabilization group showed significant gains on Numeric Pain Rating Scale and (p=0.001) and Modified Oswestry Disability Index (p=0.001) compared to the Mckenzie group. Conclusion: Patients in both lumber stabilisation and McKenzie groups showed significant improvement, however, the patients in lumbar stabilization group were superior than the patients in McKenzie group on the selected outcomes.

scholarly journals HUBUNGAN POSTUR TUBUH DAN LAMA BERDIRI DENGAN KEJADIAN LOW BACK PAIN PADA PEKERJA DI CIKARANG

2021 ◽  
pp. 331-342
Author(s):  
Mayang Ameilia Putri ◽  
Mila Citrawati ◽  
Riezky Valentina Astari
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Simple Random Sampling ◽  
Numeric Rating Scale ◽  
Entire Body ◽  
Low Back ◽  
Body Map ◽  
Rapid Entire Body Assessment ◽  
Numeric Rating

Low back pain (LBP) merupakan sebuah sindrom klinis ditandai dengan timbulnya gejala nyeri di sekitar punggung bawah yang tanpa atau dapat disertai penjalaran pada tungkai bawah. Posisi tidak ergonomis seperti membungkuk, memiringkan badan, dan posisi menggapai atau berlutut yang dapat menyebabkan beberapa dampak, salah satunya LBP. Penelitian ini dilakukan untuk menganalisis hubungan postur tubuh dan lama berdiri dengan kejadian LBP pada pekerja bidang produksi dan logistik di Cikarang. Penelitian ini menggunakan analitik observasional dengan desain penelitian potong lintang karena membahas dua variabel (independen dan dependen) selanjutnya diobservasi atau diukur hanya sekali pada setiap variabel dalam waktu yang sama. Sampel penelitian berjenis kelamin lakilaki, berjumlah 62 responden, berusia 18-40 tahun dengan kata lain termasuk kriteria inklusi dan teknik pengambilan sampel berupa simple random sampling. Analisis postur tubuh menggunakan Rapid Entire Body Assessment (REBA), untuk lokasi serta pengukuran intensitas nyeri LBP menggunakan kuesioner Nordic Body Map (NBM) dan Numeric Rating Scale (NRS), analisis bersifat kuantitatif karena didasarkan pada skala yang tersedia pada kategori setiap instrumen penelitian. Hasil uji Fisher hubungan postur tubuh dengan kejadian LBP diperoleh nilai signifikansi p=1,000 (p> 0,05) dan untuk lama berdiri dengan kejadian LBP didapatkan nilai signifikansi p=0,067 (p> 0,05). Kesimpulan hasil tersebut tidak terdapat hubungan antara postur tubuh dan lama berdiri dengan kejadian LBP pada pekerja. Hal ini dapat dipengaruhi usia pekerja yang dominan termasuk kategori usia produktif sehingga sifat fisiologis otot masih sangat menunjang produktivitas kerja. Selain itu disela-sela kegiatan, para pekerja dapat leluasa melakukan peregangan minimal pada tubuhnya sehingga kekakuan pada otot di sekitar punggung bawah dapat dihindari.

MCKENZIE EXERCISE DAN WILLIAM’S FLEXION EXERCISE EFEKTIF MENURUNKAN INTENSITAS LOW BACK PAIN

2020 ◽  
pp. 42-52
Author(s):  
Muhammad Afrian Wiji Pratama ◽  
Nurfitri Bustamam ◽  
Fajriati Zulfa
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Exercise Group ◽  
Wilcoxon Test ◽  
Low Back ◽  
Purposive Sampling ◽  
Before And After ◽  
Numeric Rating

Low Back pain (LBP) merupakan sindroma klinis yang ditandai dengan nyeri pada regio punggung bawah dengan atau tanpa disertai nyeri tungkai. Pembatik berisiko mengalami LBP. McKenzie Exercise dan William’s Flexion Exercise merupakan back exercise yang mudah dilakukan. Penelitian ini bertujuan membandingkan efektivitas McKenzie Exercise dan William‘s Flexion Exercise untuk menurunkan intensitas LBP pada pembatik. Penelitian menggunakan two-group pretest-posttest design. Sebanyak 20 orang pembatik di Kampung Batik Giriloyo dipilih dengan teknik purposive sampling. Subjek penelitian dibagi menjadi dua, yaitu kelompok yang melakukan McKenzie Exercise dan kelompok yang melakukan William’s Flexion Exercise. Kedua kelompok melakukan latihan tersebut dengan frekuensi tiga kali seminggu selama dua minggu. Sebelum dan sesudah latihan, intensitas LBP diukur menggunakan Numeric Rating Scale.  Uji Wilcoxon digunakan untuk mengetahui apakah terdapat perbedaan intensitas LBP sebelum dan sesudah latihan. Uji Mann-Whitney digunakan untuk mengetahui apakah terdapat perbedaan efektivitas McKenzie Exercise dan William’s Flexion Exercise  dalam menurunkan intensitas LBP. Analisis data menunjukkan intensitas LBP  pada kedua kelompok sebelum melakukan back exercise adalah 5 (4-6). Pada kelompok yang melakukan McKenzie Exercise maupun kelompok yang melakukan William’s Flexion Exercise didapatkan penurunan intensitas LBP menjadi 2 (1-3). Terdapat perbedaan intensitas LBP sebelum dan sesudah latihan pada kelompok McKenzie Exercise (p = 0,004) dan pada kelompok William Flexion Exercise (p = 0,004). Tidak ada perbedaan penurunan intensitas LBP antara kelompok McKenzie Exercise dan kelompok William’s Flexion Exercise (p = 0,328). Low Back Pain (LBP) is a clinical syndrome that consists of pain at the lower back region with or without limb pain. Batik workers were at risk of LBP. McKenzie Exercise and William’s Flexion Exercise are an easy back exercise. This study was aimed to compare the effectiveness of McKenzie Exercise and William’s Flexion Exercise for reducing LBP among batik workers. This study used a two-group pretest-posttest design. A total of 20 batik workers in Kampung Batik Giriloyo were selected by purposive sampling technique. The research subjects were divided into two, namely the group doing the McKenzie Exercise and the group doing the William’s Flexion Exercise. Both groups did the exercise three times a week for two weeks. Before and after the exercise, the intensity of LBP was measured using the Numeric Rating Scale. The Wilcoxon test was used to determine whether there were differences in LBP intensity before and after exercise. The Mann-Whitney test was used to determine whether there was a difference in the effectiveness of the McKenzie Exercise and William's Flexion Exercise in reducing LBP intensity. Data analysis showed LBP intensity in both groups before doing back exercise was 5 (4-6). In the group that did the McKenzie Exercise and the group that did the William’s Flexion Exercise, the LBP intensity decreased to 2 (1-3). There were differences in LBP intensity before and after exercise in the McKenzie Exercise group (p = 0.004) and the William’s Flexion Exercise group (p = 0.004). There was no difference in the decrease in LBP intensity between the McKenzie Exercise group and the William’s Flexion Exercise group (p = 0.328).

scholarly journals Long-term improvements following a residential combined physical and psychological programme for chronic low back pain

2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Low Back ◽  
Residential Setting ◽  
Wide Range

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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