scholarly journals Efficacy of Habb-e-Hindi in low back pain: a comparative clinical trial with historical control

2021 ◽  
Vol 8 (2) ◽  
pp. 114
Author(s):  
Fasihur Rehman Ansari ◽  
Mohd Aleemuddin Quamri ◽  
Kunwar Alam Chaudhary ◽  
Mariyam Ahad

<p class="abstract"><strong>Background:</strong> Low Back Pain is one of the common conditions encountered in clinical practice. An estimated 65% to 80% of population will experience it during lifetime. As far as the various documented side effects of analgesics and NSAIDs have been concerned, complementary and alternative treatment options have, therefore, gained popularity. In Unani classical literature, <em>Habb-e-Hindi</em> is being indicated for joint’s pain in general and can be evaluated as safe, effective and alternative treatment of LBP.</p><p class="abstract"><strong>Methods:</strong> This historical control clinical trial testing the superiority of <em>Habb-e-Hindi</em> with Unani formulation used in previous study carried out at NIUM Hospital, Bengaluru. The comparison of the efficacy was made between the test group and historical control group. Primary outcome measures were improvement in LBP (VAS in NRS) and the secondary outcome measures included improvement in QOL (ODI scores and QBPDS scores). Data were analyzed by using Fisher’s Exact/Chi-Square/Repeated measures and One-way ANOVA with Tukey post hoc multiple comparison test for both intergroup and intragroup comparisons.</p><p class="abstract"><strong>Results:</strong> The test and the control group both equally had significant results. Test drug showed better results (in VAS). LBP associated disability (in ODI) got reduced significantly in control group as compared to the test group. The Significant Disability Change (in QBPDS) was recorded in all 20 patients of the control group as compared to that of the test group where only 4 patients showed significant reduction.</p><p class="abstract"><strong>Conclusions: </strong>The results of this study suggest that the Unani formulations are effective in the treatment of Low back pain.</p>

Author(s):  
Chantip Juntakarn, MA ◽  
Thavat Prasartritha, MD ◽  
Prapoj Petrakard, MD

Background: Non-specific low back pain (LBP) is a common health problem resulting from many risk factors and human behaviors. Some of thesemay interact synergistically and have been implicated in the cause of low back pain. Massage both traditional Thai massage and joint mobilization as a common practice has been shown to be effective for some subgroup of nonspecific LBP patients.Purpose and Setting: The trial compared the effectiveness between traditional Thai massage and joint mobilization for treating nonspecificLBP. Some associated factors were included. The study was conducted at the orthopedic outpatient department, Lerdsin General Hospital, Bangkok, Thailand.Methods: Prospective, randomized study was developed without control group. The required sample size was estimated based on previouscomparative studies for effectiveness between techniques. Two primary outcome measures were a 0 to 10 visual analog scale (VAS) of pain andOswestry Disability Index (ODI). Secondary outcome measures were satisfaction of patients and adverse effects of the treatment. The ‘‘intention to treat’’ (ITT) and per protocol approach were used to compare the significance of the difference between treatment groups.Participants: One hundred and twenty hospital outpatients, 20 (16.7%) male and 100 (83.3%) female, were randomized into traditional Thai massage and joint mobilization therapy. The average age of traditional Thai massage and joint mobilization was 50.7 years and 48.3 years, respectively. Both groups received each treatment for approximately 30 minutes twice per week over a four-week period. Total course did not exceed eight sessions.Result: With ITT, the mean VAS of traditional Thai massage group before treatment was 5.3 (SD = 1.7) and ODI was 24.9 (SD = 14.7), while in jointmobilization groups, the mean VAS was 5.0 (SD = 1.6) and ODI was 24.6 (SD = 15). After treatment, the mean VAS and ODI were significantlyreduced (VAS = 0.51 (SD = 0.89) and ODI = 8.1 (SD = 10.7) for traditional Thai massage, VAS = 0.86 (SD = 1.49) and ODI = 8.26 (SD = 12.97) for joint mobilization). Constipation was found in 34 patients (28.3%).Conclusion: The traditional Thai massage and joint mobilization used in this study were equally effective for short-term reduction of pain and disability in patients with chronic nonspecific LBP. Both techniques were safe with short term effect in a chosen group of patients.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae-Hong Kim ◽  
Chang-Su Na ◽  
Gwang-Cheon Park ◽  
Jeong-Soon Lee

Abstract Background Chronic non-specific low back pain (CLBP) is a common musculoskeletal disorder for which patients seek complementary and alternative medical treatments, including laser acupuncture (LA). Invasive LA (ILA) involves the simultaneous application of invasive acupuncture treatment at acupoints and focused laser irradiation. The efficacy of ILA for CLBP remains controversial owing to the insufficient clinical trial data. We intend to obtain basic data regarding the efficacy and safety of ILA for CLBP by comparing the effects of different wavelengths of ILA on CLBP. Methods This will be a prospective, patient-blinded, parallel-arm, single-center (DongShin University Gwangju Korean Medicine Hospital, Republic of Korea), pilot randomized controlled clinical trial. Forty-five participants with CLBP will be randomized in equal numbers into the control, 650-nm ILA (650 ILA), or 830-nm ILA (830 ILA) group. The control group will receive sham ILA for 10 min and real electroacupuncture (EA) for 10 min. The 650 and 830 ILA groups will receive real ILA (i.e., 650 ILA group, 650-nm wavelength; 830 ILA group, 830-nm wavelength) for 10 min and real EA for 10 min once/day, twice a week for 4 weeks, at bilateral Shenshu (BL23), Qihaishu (BL24), Dachangshu (BL25), and Huantiao (GB30). The primary outcome will be an improvement in pain intensity assessed using the visual analog scale. Scores in the Korean version of the Oswestry Disability Index and the European Quality of Life Five Dimension Five Level scale will be recorded as secondary outcome measures. All scores will be recorded at baseline (before intervention), 4 weeks after the first intervention (at the end of the intervention), and 4 weeks after completion of the intervention. Discussion The study is expected to provide preliminary evidence regarding the efficacy, safety, and usefulness of ILA for the treatment of CLBP. Trial registration This trial was registered with the Clinical Research Information Service (registration No. KCT0004610; http://cris.nih.go.kr). Registered on 7 January 2020.


2009 ◽  
Vol 27 (3) ◽  
pp. 94-100 ◽  
Author(s):  
Gregory Glazov ◽  
Peter Schattner ◽  
Derrick Lopez ◽  
Kerrie Shandley

Objective The primary aim was to determine if laser acupuncture (LA) is more effective than sham laser in reducing pain and disability in adults with chronic non-specific low back pain. Methods The design was a double blind, two-group parallel randomised controlled trial. The active intervention was an 830 nm (infrared), 10 mW, Ga-Al-As laser diode laser for acupuncture and a sham control. The primary outcome measures were changes in pain (visual analogue scale) and disability (Oswestry Disability Index) at the end of 5–10 treatment sessions. Secondary outcomes were patient global assessment, psychological distress (Depression Anxiety Stress Scale) and subjective wellbeing (Personal Wellbeing Index). Follow up was performed at 6 weeks and 6 months after completion of treatment. Results 100 participants were enrolled and treated in a general practice setting. Per protocol analysis of the primary outcome measures using ANOVA suggested that although there was a significant overall improvement in pain and disability after the course of treatments (p<0.01), there was no significant difference between the intervention and control group in both the primary and most secondary outcome measures. Conclusion This study did not show a specific effect for LA using infrared laser at 0.2 Joules per point for chronic low back pain. The overall intervention appeared effective because of placebo and other factors. As there was some concern about baseline inequality between the groups further research using tighter inclusion criteria should attempt to replicate the result and examine if a dose response may exist.


2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  

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.


Author(s):  
Ecenur Atli ◽  
Dilber Karagozoglu Coskunsu ◽  
Zeynep Turan ◽  
Ozden Ozyemisci Taskiran

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.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026874 ◽  
Author(s):  
Saurab Sharma ◽  
Mark P Jensen ◽  
G Lorimer Moseley ◽  
J Haxby Abbott

ObjectivesThe aims of this study were to: (1) develop pain education materials in Nepali and (2) determine the feasibility of conducting a randomised clinical trial (RCT) of a pain education intervention using these materials in Nepal.DesignA two-arm, parallel, assessor-blinded, feasibility RCT.SettingA rehabilitation hospital in Kathmandu, Nepal.ParticipantsForty Nepalese with non-specific low back pain (mean [SD] age 41 [14] years; 12 [30%] women).InterventionsEligible participants were randomised, by concealed, 1:1 allocation, to one of two groups: (1) a pain education intervention and (2) a guideline-based physiotherapy active control group intervention. Each intervention was delivered by a physiotherapist in a single, 1-hour, individualised treatment session.Primary outcome measuresThe primary outcomes were related to feasibility: recruitment, retention and treatment adherence of participants, feasibility and blinding of outcome assessments, fidelity of treatment delivery, credibility of, and satisfaction with, treatment. Assessments were performed at baseline and at 1 week post-treatment.Secondary outcome measuresPain intensity, pain interference, pain catastrophising, sleep disturbance, resilience, global rating of change, depression and quality of life. Statistical analyses were conducted blind to group allocation.ResultsForty participants were recruited. Thirty-eight participants (95%) completed the 1-week post-treatment assessment. Most primary outcomes surpassed the a priori thresholds for feasibility. Several findings have important implications for designing a full trial. Secondary analyses suggest clinical benefit of pain education over the control intervention, with larger decrease in pain intensity (mean difference=3.56 [95% CI 0.21 to 6.91]) and pain catastrophising (mean difference=6.16 [95% CI 0.59 to 11.72]) in the pain education group. Pain intensity would seem an appropriate outcome for a full clinical trial. One minor adverse event was reported.ConclusionWe conclude that a full RCT of pain education for back pain in Nepal is feasible and warranted.Trial registration numberNCT03387228; Results.


2021 ◽  
pp. 47
Author(s):  
Kanagaraj Rengaramanujam

Introduction: Evidence suggests that the application of Kinesio tape (KT) on patients with chronic nonspecific low back pain (CNLBP) is inconclusive. Dynamic tape (DT) is a relatively new treatment technique, which is increasingly being used as an adjunctive method to treat musculoskeletal problems. To the best of our knowledge, no study has investigated the application of DT in individuals with CNLBP. Thus, there is a need to compare the immediate and short-term effects of DT versus KT and no tape among patients with CNLBP on pain, endurance, disability, mobility, and kinesiophobia. Methodology: Forty-five patients with CNLBP were randomly divided into three groups: the DT group (n = 15), the KT group (n = 15), and the control group (n = 15). No tape was applied to the control group. The allocation and assessment procedures were blinded. The outcome measures were assessed before the tape application (baseline), 15 min after the tape application (immediate effect), and on the third day post tape application (short-term effect). The primary outcomes of pain, endurance, and disability were measured through the visual analog scale (VAS), Biering–Sorensen test, and Oswestry disability index (ODI), respectively. Secondary outcome measures of mobility and kinesiophobia were measured using the modified Schober test and the Tampa Scale of Kinesiophobia, respectively. Result: The demographic and baseline characteristics between groups were compared by the one-way analysis of variance (ANOVA) for parametric variables and the Chi-square test for nonparametric variables. A mixed-methods ANOVA (3 ´ 3) was used to analyze the main effect (group effect and time effect) and time ´ group interaction. No significant immediate and short-term differences were found between DT and KT in pain, disability, mobility, and kinesiophobia. Improved back extensor endurance was observed for the DT group compared to the KT (p = 0.023) and control (p = 0.006) groups. Conclusion: This randomized controlled trial showed that the DT does not have a significant additional effect on pain, disability, mobility, and kinesiophobia among individuals with CNLBP compared to KT. However, participants experienced significant improvement in back muscular endurance after the application of DT. This finding suggests that DT controls the processes that lead to back muscle fatigue. Therefore, more studies are required to examine the therapeutic benefits of DT in treating patients with CNLBP.


Author(s):  
Khadijeh Otadi ◽  
Noureddin Nakhostin Ansari ◽  
Shahriar Sharify ◽  
Zahra Fakhari ◽  
Hadi Sarafraz ◽  
...  

Abstract Background It is unknown how diaphragm training combined with electrical stimulation affects pain, function, static stability, and balance in athletes with chronic low back pain (CLBP). This study aimed to explore the effects of combining diaphragm training with electrical stimulation on pain, function, static stability, and dynamic balance in athletes with nonspecific CLBP. Methods The design was a randomized clinical trial. A total of 24 amateur athletes (12 women, 12 men, mean age: 35.2 ± 9.8) with nonspecific CLBP were randomly allocated into two groups. The experimental group (n = 12) received diaphragm training plus Transcutaneous Electrical Nerve Stimulation (TENS), while the control group (n = 12) received TENS alone. Both groups underwent 12 sessions over a four-week period. Static stability, dynamic balance, pain, and function were measured pre- and post-intervention. Results Analysis of variance 2 × 2 revealed greater improvements in pain (p < 0.001), static stability (p < 0.001), and dynamic balance (p < 0.01) in the experimental group compared to the control group. Function was improved in both groups following the interventions (p < 0.001), and there was a trend of a larger improvement in the experimental group than the control group (p = 0.09). Fisher’s exact test showed that the experimental group reported ≥50% improvement only in the pain score, not function, compared to the group that received TENS alone (p = 0.005). Conclusions Pain, function, static stability, and dynamic balance were improved in both groups following 12 intervention sessions. However, pain, static stability, and dynamic balance were improved to a greater extent in diaphragm training plus TENS than TENS alone in amateur athletes with CLBP. Therefore, it seems beneficial to add diaphragm training to the rehabilitation program for athletes with nonspecific CLBP. Trial registration The trial was retrospectively registered in the Iranian Registry of Clinical Trials (www.irct.ir) on September 10, 2020 as IRCT20090228001719N8.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui Xie ◽  
Long Liang ◽  
Kaiming Li ◽  
Jie Yu ◽  
Minshan Feng ◽  
...  

Abstract Background Degenerative lumbar instability (DLI) is a common disease that causes low back pain (LBP) in clinic. It is difficult to completely recover from DLI, and it occurs repeatedly, which seriously affects the quality of life of patients. The epidemiological survey showed that 20–30% of low back pain was related to lumbar instability. Increasing evidence shows that seated lumbar rotation manipulation can effectively improve the clinical symptoms of patients with low back pain. The primary aim of this clinical trial is to observe the intervention effect of seated lumbar rotation manipulation on DLI patients. Method/design A total of 60 participants with DLI will be recruited and randomly allocated into the seated lumbar rotation manipulation group (the intervention group) or lumbar traction in supine position group (the control group) in this prospective, outcome assessor-blind, two-arm randomized controlled clinical trial. The treatment of the two groups lasted for 3 weeks, and the manipulation of the intervention group would be carried out once every other day, three times a week, a total of 9 times; the control group would be given lumbar traction once a day, five times a week, a total of 15 times. JOA (Japanese Orthopaedic Association) and VAS (Visual Analogue Scales) scores will be recorded as the primary outcomes before the treatment and at the 1st, 3rd, 5th, 8th, 10th, 12th, 15th, 17th, and 19th days after treatment and follow-up visit at the first, third, and sixth months. JOA efficacy evaluation standard will be used to evaluate the overall efficacy as the secondary outcomes. Discussion The results of this prospective, randomized controlled trial will provide a clinical evidence for the treatment of DLI with seated lumbar rotation manipulation. Trial registration Chinese Clinical Trial Registry ChiCTR2000032017. Registered on 18 April 2020, Prospective registration.


2020 ◽  
Author(s):  
Xuesong Hu ◽  
Shaoxing Dong ◽  
Bing Zhang ◽  
Xuan Wang ◽  
Yanwei Yin ◽  
...  

Abstract Background: Chronic nonspecific low back pain (CNSLBP) troubles approximately 30% of people worldwide. Silver needle therapy (SNT) is a treatment method to relieve soft tissue pain through heating. Therefore, this study aimed to observe the effects of SNT on CNSLBP.Methods: In this study, 100 patients were randomly divided into 2 groups: silver needle (SN) group and control group (n = 50). In the SN group, patients received SNT and physiotherapy, while patients received physiotherapy alone in the control group. At the 6-month follow-up, the numerical rating scale (NRS), Oswestry Disability Index (ODI), Short-Form 12 of quality of life (SF-12), the natural logarithms of low frequency measurement (InLF) and the natural logarithms of high frequency measurement (InHF) of heart rate variability (HRV) were recorded.Results: In both groups, NRS, ODI, SF-12 scores, and HRV at 2 weeks after treatment were improved and maintained for 6 months. Compared with the control group, more significant improvements were observed in the NRS and SF-12 scores at 1, 2, 3, and 6 months and in the ODI scores at 1 and 2 months in the SN group (P < 0.05). However, there was no significant difference between the groups in the ODI scores at 3 and 6 months. InLF and InHF in the SN group were higher than those in the control group at 3 and 6 months (P < 0.05).Conclusions: SNT relieved pain and improved quality of life and autonomic nerve activity, especially parasympathetic nerve, in patients with CNSLBP, without serious complications.Trial registration: This work has registered in the Chinese Clinical Trial Registry (No. ChiCTR-OOC-17013237; Date: 2017.11.09).


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