Effects of physiotherapy associated to virtual games in pain perception and heart rate variability in cases of low back pain

Introduction: The virtual games when appropriately used can stimulate brain activity and excite the creative energy. Therefore, it is important to assess the implications of their use in pain perception in individuals with low back pain (LBP), a disease that affects about 80% of the world’s population. Objective: was to evaluate the effects of virtual games combined with a physiotherapy program on the pain perception and Heart Rate Variability (HRV) in people with LBP. Method: the participants were 21 adults with clinical diagnosis of LBP, aged 24-61 years, of both sexes, divided into two groups. Five weekly meetings were provided. Group 1 participated in a physical therapy program and group 2 participated in the same physical therapy program plus joint sessions with virtual games. The instruments used were a heart rate monitor; a tablet for games; a shortwave equipment; visual analogue scale (VAS); and McGill’s Pain Questionnaire. The measurements were performed before and after the program. Results: Reduction in pain was observed in both groups, being higher in group 2, the one that used the games. Conclusion: There was a decrease in parasympathetic activity in group 2, which indicates that the distraction factor promoted by the games influenced the pain perception.

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Comparison between Kinesio Taping and a Traditional Physical Therapy Program in Treatment of Nonspecific Low Back Pain

Journal of Physical Therapy Science ◽

10.1589/jpts.26.1185 ◽

2014 ◽

Vol 26 (8) ◽

pp. 1185-1188 ◽

Cited By ~ 29

Author(s):

Shaji John Kachanathu ◽

Aqeel M. Alenazi ◽

Hamada Eid Seif ◽

Ashraf Ramadan Hafez ◽

Abdulmohsen Meshari Alroumim

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Low Back ◽

Kinesio Taping ◽

Therapy Program ◽

Physical Therapy Program

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Detection of Changes on Parameters Related to Heart Rate Variability after Applying Current Interferential Therapy in Subjects with Non-Specific Low Back Pain

Diagnostics ◽

10.3390/diagnostics11122175 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2175

Author(s):

Luis Espejo-Antúnez ◽

Carlos Fernández-Morales ◽

María de los Ángeles Cardero-Durán ◽

José Vicente Toledo-Marhuenda ◽

Juan Antonio Díaz-Mancha ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Low Back Pain ◽

Back Pain ◽

Pain Perception ◽

Current Therapy ◽

Low Back ◽

Activity Increase ◽

Perceived Pain ◽

Experimental Group

Interferential current therapy (ICT) is an electrotherapeutic intervention that combines the advantages of high permeability from middle frequency currents and efficient tissue stimulation from low frequency currents, delivering the maximum current with high tissue permeability. The aim was to evaluate the effects of ICT on heart rate variability (HRV) and on pain perception in patients with non-specific chronic low back pain (NSCLBP). In the study, 49 patients with NSCLBP were randomly divided into an experimental (EG) and a sham group (SG). All participants received a single intervention, ICT, or simulated intervention. Outcome measures including baseline (sit-down position) and postintervention (prone position) pain, heart rate (HR), time domain parameter (rMSSD), diameters of the Poincaré plot (SD1, SD2), stress score (SS), and sympathetic/parasympathetic (S/PS) ratio were investigated. In both groups, significant statistical differences were found in perceived pain and in all HRV parameters except in HRmax. Between-group comparisons showed statistically significant differences in all variables except for HRmin and HRmean in favor of the experimental group. These changes reported an increase in parasympathetic activity (rMSSD) (p < 0.05) and a decrease in sympathetic activity (increase in SD2 and decrease in SS) (p < 0.001) and perceived pain (p < 0.001), with a greater size effect (η2 = 0.44) in favor of the experimental group. In conclusion, a single session of ICT can shift the autonomic balance towards increase parasympathetic dominance and decrease the sympathetic dominance and intensity of pain perceived by patients with NSCLBP.

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Effectiveness of a home-based physical therapy program in patients with chronic low back pain

Timisoara Physical Education and Rehabilitation Journal ◽

10.1515/tperj-2015-0010 ◽

2015 ◽

Vol 8 (15) ◽

pp. 12-16

Author(s):

Elena Sîrbu

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Chronic Low Back Pain ◽

Low Back ◽

Therapy Program ◽

Home Based ◽

Number Of Patients ◽

Inflammatory Drugs ◽

Physical Therapy Program

Abstract Aim: To demonstrate the effectiveness of a home-based physical therapy program on pain, spine mobility and quality of daily activities in patients with chronic low back pain (CLBP). We also want to show that patients who undergo this program decreased their intake in analgesic and anti-inflammatory drugs. Methods: 18 patients with chronic low back pain were assessed with the following tests: VAS pain scale, Schober’s test and Rolland-Morris questionnaire. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAID) consumption was recorded. Over a period of six months all subjects participated in a 45 minutes home-based physical therapy program, three times per week. Before starting this intervention all patients were instructed and exercises were demonstrated in front of them by a physical therapist. Moreover, they received written brochures in order to exercise correctly at home. Follow-up examinations took place at baseline and six months later. Results: We obtained significant differences between pre- and post-intervention assessments of pain (p=0.001), lumbar flexion (p=0.0001) and functional status (p=0.0005) in our group. Moreover, the number of patients who were taken analgesics decreased from 7 (39%) to 5 patients (28%). Likewise the number of patients who were taken anti-inflammatory drugs decreased from 11 (61%) to 8 (44%). Conclusion: The home-based rehabilitation program was effective in improving the ranges of active lumbar flexion and in decreasing the physical disability caused by low back pain, as well as in reducing the levels of pain. We note that a larger number of patients have given up to the intake of NSAIDs comparative to those who have given up to analgesics.

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Effects of tDCS on Heart Rate Variability in Chronic Low Back Pain

Case Medical Research ◽

10.31525/ct1-nct04077632 ◽

2019 ◽

Author(s):

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Low Back

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Measurement of acute nonspecific low back pain perception in primary care physical therapy: reliability and validity of the brief illness perception questionnaire

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-14-53 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 18

Author(s):

Joannes M Hallegraeff ◽

Cees P van der Schans ◽

Wim P Krijnen ◽

Mathieu HG de Greef

Keyword(s):

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Pain Perception ◽

Illness Perception ◽

Reliability And Validity ◽

Low Back ◽

Illness Perception Questionnaire ◽

Brief Illness Perception Questionnaire

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Heart rate variability in chronic low back pain patients randomized to yoga or standard care

BMC Complementary and Alternative Medicine ◽

10.1186/s12906-016-1271-1 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 9

Author(s):

Shirley Telles ◽

Sachin Kumar Sharma ◽

Ram Kumar Gupta ◽

Abhishek Kumar Bhardwaj ◽

Acharya Balkrishna

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Standard Care ◽

Low Back ◽

Pain Patients

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Heart rate variability in patients with low back pain: a systematic review

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0006 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Pamela M. Bandeira ◽

Felipe J.J. Reis ◽

Vanessa C.C. Sequeira ◽

Anna C.S. Chaves ◽

Orlando Fernandes ◽

...

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Healthy Controls ◽

Low Back ◽

Inclusion Criteria ◽

Limited Evidence

Abstract Objectives Heart rate variability (HRV) is an important physiological measure of the capacity for neurogenic homeostatic regulation, and an indirect measure of emotional processing. We aimed to investigate whether HRV parameters are altered in people with chronic low back pain when compared to healthy controls. Methods We searched on PubMed, Scopus, CINAHL, Web of Science, Cochrane Library, and PsycINFO from inception to January 2018. The inclusion criteria were: patients with non-specific chronic low back pain, absence of radiculopathy, age from 18 to 65 years, and comparison with healthy controls. Data extraction was performed by two independent review authors. The methodological quality of the studies was assessed using the appraisal tool for cross-sectional studies. Results After screening 2,873 potential articles, two studies met the inclusion criteria. Studies were composed of 153 patients with chronic low back pain and 62 healthy controls. An electrocardiogram was used to record HRV and linear methods (time and frequency) were used to analyze the results. The main findings indicate that patients with chronic low back pain have a significant reduction in HRV, with sympathetic predominance compared to healthy controls. Conclusions There is limited evidence suggesting that chronic low back pain patients presented a lower vagal activity evidenced by HRV, when compared to healthy controls. The results of this systematic review should be interpreted with caution due to the restricted number of included studies, small sample sizes and different protocols used to measure HRV. The limited evidence about HRV alterations in low back pain also suggests the need of future studies to investigate if HRV parameters can be a useful measure in chronic pain samples or even if it can be used as an outcome in clinical trials aiming to investigate the effectiveness of interventions based on emotion regulation.

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