Repeatability of Clinical, Biomechanical, and Motor Control Profiles in People with and without Standing-Induced Low Back Pain

A major research focus is optimization of interventions for low back pain (LBP). Predisposing factors for LBP development have been previously identified. To differentiate changes in these factors with intervention, factor stability over time must be determined. Twenty-three volunteers without LBP participated in a LBP-inducing standing protocol on two separate days. Outcome measures included visual analog scale (VAS) for LBP and trunk/hip muscle coactivation patterns. Intraclass correlation coefficients (ICCs) were used to examine repeatability. Between-day repeatability of outcome measures was excellent (ICCs>0.80). Individuals were consistent in subjective LBP, with 83% reporting similar day-to-day VAS levels. Muscle co-activation patterns and LBP reports are stable measures over time for this LBP-inducing protocol. Changes in these measures following intervention can be considered to be treatment effects and are not due to natural variability. This provides support for use of this protocol in studying interventions for standing-induced LBP.

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Hip-Abduction Torque and Muscle Activation in People With Low Back Pain

Journal of Sport Rehabilitation ◽

10.1123/jsr.2013-0112 ◽

2015 ◽

Vol 24 (1) ◽

pp. 51-61 ◽

Cited By ~ 6

Author(s):

Mark A. Sutherlin ◽

Joseph M. Hart

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Repeated Measures ◽

Muscle Function ◽

Muscle Activation ◽

Low Back ◽

Hip Muscle ◽

Hip Abduction ◽

History Of

Context:Individuals with a history of low back pain (LBP) may present with decreased hip-abduction strength and increased trunk or gluteus maximus (GMax) fatigability. However, the effect of hip-abduction exercise on hip-muscle function has not been previously reported.Objective:To compare hip-abduction torque and muscle activation of the hip, thigh, and trunk between individuals with and without a history of LBP during repeated bouts of side-lying hip-abduction exercise.Design:Repeated measures.Setting:Clinical laboratory.Participants:12 individuals with a history of LBP and 12 controls.Intervention:Repeated 30-s hip-abduction contractions.Main Outcome Measures:Hip-abduction torque, normalized root-mean-squared (RMS) muscle activation, percent RMS muscle activation, and forward general linear regression.Results:Hip-abduction torque reduced in all participants as a result of exercise (1.57 ± 0.36 Nm/kg, 1.12 ± 0.36 Nm/kg; P < .001), but there were no group differences (F = 0.129, P = .723) or group-by-time interactions (F = 1.098, P = .358). All participants had increased GMax activation during the first bout of exercise (0.96 ± 1.00, 1.18 ± 1.03; P = .038). Individuals with a history of LBP had significantly greater GMax activation at multiple points during repeated exercise (P < .05) and a significantly lower percent of muscle activation for the GMax (P = .050) at the start of the third bout of exercise and for the biceps femoris (P = .039) at the end of exercise. The gluteal muscles best predicted hip-abduction torque in controls, while no consistent muscles were identified for individuals with a history of LBP.Conclusions:Hip-abduction torque decreased in all individuals after hip-abduction exercise, although individuals with a history of LBP had increased GMax activation during exercise. Gluteal muscle activity explained hip-abduction torque in healthy individuals but not in those with a history of LBP. Alterations in hip-muscle function may exist in individuals with a history of LBP.

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

BMJ Open Quality ◽

10.1136/bmjoq-2020-001068 ◽

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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Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university’s employees with non-specific low back pain: A pilot study

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.4.49 ◽

2019 ◽

Vol 35 (4) ◽

Author(s):

Nermeen Mohamed Abdelhalim ◽

Ahmed Fathy Samhan ◽

Walid Kamal Abdelbasset

Keyword(s):

Electromagnetic Field ◽

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Low Back ◽

Pulsed Electromagnetic Field ◽

Middle Aged ◽

Short Term ◽

Pulsed Electromagnetic ◽

Pulsed Electromagnetic Field Therapy

Objective: Non-specific low back pain (non-specific LBP) is common problem between office-work employees. This study aimed to evaluate the short-term impacts of Pulsed Electromagnetic Field (PEMF) therapy in the treatment of non-specific LBP symptoms as pain, back mobility, LBP disabilities, and Health–Related Quality of Life (HRQOL). Methods: Forty-two University’s employees with non-specific LBP and aged from 35 to 55 years who participated in this study from January to June 2018 were divided into two groups: group A; received PEMF therapy and group B; received sham treatment. The outcome measures were; numerical rating scale, Modified Oswestry LBP Disability Score, Modified Schober test, and the Short Form-36 questionnaire. Evaluations were performed for both groups before and after finishing treatment. Results: All outcome measures were significantly improved statistically in the experimental group at the end of the intervention (p<0.05). On the other hand, there were non-significant differences in all outcome measures in the sham group (p>0.05). Conclusions: PEMT therapy may decrease pain, LBP disability, increase lumbar spine mobility, and improve HRQOL in middle-aged university’s employees with nonspecific LBP. doi: https://doi.org/10.12669/pjms.35.4.49 How to cite this:Abdelhalim NM, Samhan AF, Abdelbasset WK. Short-Term impacts of pulsed electromagnetic field therapy in middle-aged university’s employees with non-specific low back pain: A pilot study. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.49 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effect of Global Postural Reeducation Exercise on Pain and Hip Muscle Flexibility in Patients with Chronic Low Back Pain and Movement Control Dysfunction

International journal of basic science in medicine ◽

10.34172/ijbsm.2019.05 ◽

2019 ◽

Vol 4 (4) ◽

pp. 148-154

Author(s):

Bahram Sheikhi

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Movement Control ◽

Rectus Femoris ◽

Low Back ◽

Significance Level ◽

Hip Muscle ◽

Hamstring Muscles ◽

Hip Muscles ◽

Tensor Fasciae Latae

Introduction: Patients with non-specific low back pain (NSLBP) and movement control dysfunction demonstrate alternation in hip muscles flexibility and spinal movement patterns. Therapeutic modalities that augment hip muscles flexibility could help these patients. The aim of this study was to investigate the effect of global postural reeducation (GPR) on pain and hip muscle flexibility in patients with NSLBP and movement control dysfunction. Materials and Methods: A total of 27 men with a mean age of 31.21±2.5147 years, height of 166.44±6.11 cm, and weight of 64.21±5.25 kg participated in this study. The visual analogue scale (VAS) was used to evaluate pain. The flexibility of hip muscles (rectus femoris, tensor fasciae latae, external rotators and hamstring) was measured using universal goniometer. All data were assessed at baseline and after the intervention. The Shapiro-Wilk test and paired t test were used for statistical analysis at significance level of P=0.05. Results: Our results revealed a decline in pain (P<0.004) and an increase in the flexibility of the hamstring muscles in the right (P<0.003) and left (P<0.003) legs. There were no statistically significant differences in the flexibility of rectus femoris muscle, external rotators, and tensor fasciae latae. Conclusion: The results suggest that GPR had a significant effect on the level of pain. Further, it affected the flexibility of hamstring muscles in legs. Using GPR is recommended for pain relief and improving the flexibility of hamstring muscles in patients with NSLBP.

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Optimizing management of low back pain through the pain and disability drivers management model: A feasibility trial

PLoS ONE ◽

10.1371/journal.pone.0245689 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245689

Author(s):

Christian Longtin ◽

Simon Décary ◽

Chad E. Cook ◽

Marc O. Martel ◽

Sylvie Lafrenaye ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Clinical Practice ◽

Data Collection ◽

Outcome Measures ◽

Pragmatic Trial ◽

Attrition Rate ◽

Feasibility Trial ◽

Clinical Settings ◽

Low Back

Introduction Self-reported levels of disability in individuals with low back pain (LBP) have not improved in the last decade. A broader perspective and a more comprehensive management framework may improve disability outcomes. We recently developed and validated the Low Back Pain and Disability Drivers Management (PDDM) model, which aims to identify the domains driving pain and disability to guide clinical decisions. The objectives of this study were to determine the applicability of the PDDM model to a LBP population and the feasibility of conducting a pragmatic trial, as well as to explore clinicians’ perceived acceptability of the PDDM model’s use in clinical settings. Methods This study was an one-arm prospective feasibility trial. Participants included physiotherapists working with a population suffering from LBP and their patients aged 18 years or older presenting with a primary complaint of LBP that sought a new referral and deemed fit for rehabilitation from private and public clinical settings. Clinicians participated in a one-day workshop on the integration of the PDDM model into their clinical practice, and were asked to report various LBP-related outcomes via self-reported questionnaires (i.e., impact of pain on physical function, nervous system dysfunctions, cognitive-emotional factors, work disabilities) at baseline and at six-week follow-up. Physiotherapists’ acceptability of the use of the PDDM model and appreciation of the training were assessed via semi-structured phone interviews. Analyses focused on a description of the model’s applicability to a LBP population, feasibility outcomes and acceptability measures. Results Applicablity of the PDDM model was confirmed since it successfully established the profile of patients according to the elements of each categories, and each of the 5 domains of the model was represented among the study sample. Trial was deemed feasible contingent upon few modifications as our predefined success criteria for the feasibility outcomes were met but feasibility issues pertaining to data collection were highlighted. Twenty-four (24) clinicians and 61 patients were recruited within the study’s timeframe. Patient’s attrition rate (29%) and clinicians’ compliance to the study protocol were adequate. Clinicians’ perceived acceptability of the use of the model in clinical settings and their appreciation of the training and online resources were both positive. Recommendations to improve the model’s integration in clinical practice, content of the workshop and feasibility of data collection methods were identified for future studies. A positive effect for all patients’ reported outcome measures were also observed. All outcome measures except for the PainDetect questionnaire showed a statistically significant reduction post-intervention (p<0.05). Conclusion These findings provide preliminary evidence of the potential of the PDDM model to optimize LBP management as well as conducting a future larger-scale pragmatic trial to determine its effectiveness. Trial registration Clinicaltrial.gov: NCT03949179.

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Outcome Measures for Studying Patients with Low Back Pain

Spine ◽

10.1097/00007632-199409151-00003 ◽

1994 ◽

Vol 19 (Supplement) ◽

pp. 2032S-2036S ◽

Cited By ~ 159

Author(s):

Richard A. Deyo ◽

Gunnar Andersson ◽

Claire Bombardier ◽

Daniel C. Cherkin ◽

Robert B. Keller ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Outcome Measures ◽

Low Back

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A qualitative study of changes in expectations over time among patients with chronic low back pain seeking four CAM therapies

BMC Complementary and Alternative Medicine ◽

10.1186/s12906-015-0531-9 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 27

Author(s):

Emery R Eaves ◽

Karen J Sherman ◽

Cheryl Ritenbaugh ◽

Clarissa Hsu ◽

Mark Nichter ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Qualitative Study ◽

Chronic Low Back Pain ◽

Low Back ◽

Over Time

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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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