Sustainability of a Motor Control Exercise Intervention: Analysis of Long-Term Effects in a Low Back Pain Study

Development of chronic pain after a low back pain episode is associated with increased pain sensitivity, altered pain processing mechanisms and the influence of psychosocial factors. Although there is some evidence that multimodal therapy (such as behavioral or motor control therapy) may be an important therapeutic strategy, its long-term effect on pain reduction and psychosocial load is still unclear. Prospective longitudinal designs providing information about the extent of such possible long-term effects are missing. This study aims to investigate the long-term effects of a homebased uni- and multidisciplinary motor control exercise program on low back pain intensity, disability and psychosocial variables. 14 months after completion of a multicenter study comparing uni- and multidisciplinary exercise interventions, a sample of one study center (n = 154) was assessed once more. Participants filled in questionnaires regarding their low back pain symptoms (characteristic pain intensity and related disability), stress and vital exhaustion (short version of the Maastricht Vital Exhaustion Questionnaire), anxiety and depression experiences (the Hospital and Anxiety Depression Scale), and pain-related cognitions (the Fear Avoidance Beliefs Questionnaire). Repeated measures mixed ANCOVAs were calculated to determine the long-term effects of the interventions on characteristic pain intensity and disability as well as on the psychosocial variables. Fifty four percent of the sub-sample responded to the questionnaires (n = 84). Longitudinal analyses revealed a significant long-term effect of the exercise intervention on pain disability. The multidisciplinary group missed statistical significance yet showed a medium sized long-term effect. The groups did not differ in their changes of the psychosocial variables of interest. There was evidence of long-term effects of the interventions on pain-related disability, but there was no effect on the other variables of interest. This may be partially explained by participant's low comorbidities at baseline. Results are important regarding costless homebased alternatives for back pain patients and prevention tasks. Furthermore, this study closes the gap of missing long-term effect analysis in this field.

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Long-Term Effect of a Combined Exercise and Motivational Program on the Level of Disability of Patients With Chronic Low Back Pain

Spine ◽

10.1097/01.brs.0000160844.71551.af ◽

2005 ◽

Vol 30 (9) ◽

pp. 995-1000 ◽

Cited By ~ 78

Author(s):

Martin Friedrich ◽

Georg Gittler ◽

Martin Arendasy ◽

Klaus M. Friedrich

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Term Effect ◽

Low Back ◽

Combined Exercise ◽

Long Term Effect

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Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial

Lasers in Medical Science ◽

10.1007/s10103-013-1472-5 ◽

2013 ◽

Vol 29 (3) ◽

pp. 1065-1073 ◽

Cited By ~ 55

Author(s):

Mohamed Salaheldien Mohamed Alayat ◽

Azza Mohamed Atya ◽

Mohamed Mohamed Ebrahim Ali ◽

Tamer Mohamed Shosha

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Term Effect ◽

Low Back ◽

Long Term Effect ◽

High Intensity Laser ◽

Intensity Laser

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Correction to: Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial

Lasers in Medical Science ◽

10.1007/s10103-019-02926-x ◽

2019 ◽

Vol 35 (1) ◽

pp. 297-297 ◽

Cited By ~ 1

Author(s):

Mohamed Salaheldien Mohamed Alayat ◽

Azza Mohamed Atya ◽

Mohamed Mohamed Ebrahim Ali ◽

Tamer Mohamed Shousha

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Term Effect ◽

Low Back ◽

Long Term Effect ◽

High Intensity Laser ◽

Intensity Laser

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SHORT AND LONG-TERM EFFECT OF SPA THERAPY IN CHRONIC LOW BACK PAIN

Rheumatology ◽

10.1093/rheumatology/33.2.148 ◽

1994 ◽

Vol 33 (2) ◽

pp. 148-151 ◽

Cited By ~ 86

Author(s):

F. GUILLEMIN ◽

F. CONSTANT ◽

J. F. COLLIN ◽

M. BOULANGE

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Term Effect ◽

Spa Therapy ◽

Low Back ◽

Long Term Effect ◽

Short And Long Term

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Recovering the capability to work among patients with chronic low Back pain after a four-week, multidisciplinary biopsychosocial rehabilitation program: 18-month follow-up study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2831-6 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Maha E. Ibrahim ◽

Kerstin Weber ◽

Delphine S. Courvoisier ◽

Stéphane Genevay

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Term Effect ◽

Anxiety And Depression ◽

Low Back ◽

Long Term Effect ◽

Work Capability

Abstract Background Chronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsychosocial model of chronic pain. Despite extensive evidence of its short-term benefits, few studies have reported on its long-term effect and more specifically on indirect outcomes such as return to work and quality of life (QoL). The present study evaluated the long-term effect of a multidisciplinary biopsychosocial rehabilitation (MBR) program for patients with chronic LBP, for which short- and intermediate-term efficacy had been established, with an emphasis on recovering work capability. Methods This prospective cohort study enrolled 201 patients on a four-week MBR program incorporating physical and occupational therapies and psychological counselling. Assessments occurred at program admission and discharge and at 6 and 18 months. Work capability, Oswestry Disability Index, Tampa Scale for Kinesiophobia, Core Outcome Measures Index (COMI), and Hospital Anxiety and Depression Scale were assessed. Multiple mixed models were used to detect changes in each outcome. Logistic regressions were calculated to identify predictors of recovery of work capability. Results Of the 201 patients who fulfilled the eligibility criteria, 160 (79.8%) attended the discharge assessment, 127 (63.2%) attended the 6-month follow-up, and 107 (53.3%) continued to the 18-month follow-up. Initially, 128 patients (71.5%) had been on sick leave. At 6 and 18 months, 72 (56.7%) and 84 (78.5%) participants had recovered their work capability, respectively. There were significant improvements in pain, disability, kinesiophobia, and anxiety and depression scores over time. Patients who recovered work capability showed significantly greater improvements in their total COMI score, general QoL, and disability, which were the best three predictors of recovering work capability. Conclusions This study extends previous results confirming the program’s contribution to recovering work capability among chronic LBP patients.

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Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial

Disability and Rehabilitation ◽

10.3109/09638288.2015.1090485 ◽

2015 ◽

Vol 38 (13) ◽

pp. 1300-1308 ◽

Cited By ~ 12

Author(s):

David Cruz-Díaz ◽

Antonio Martínez-Amat ◽

M. C. Osuna-Pérez ◽

M. J. De la Torre-Cruz ◽

Fidel Hita-Contreras

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Back Pain ◽

Physical Therapy ◽

Controlled Trial ◽

Low Back ◽

Long Term Effects ◽

Randomized Controlled ◽

Short And Long Term

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Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

The Neuroscientist ◽

10.1177/1073858418809074 ◽

2018 ◽

Vol 25 (6) ◽

pp. 583-596 ◽

Cited By ~ 6

Author(s):

Michael Lukas Meier ◽

Andrea Vrana ◽

Petra Schweinhardt

Keyword(s):

Low Back Pain ◽

Motor Control ◽

Back Pain ◽

Control Strategies ◽

Intervertebral Discs ◽

Cortical Reorganization ◽

Potential Contribution ◽

Low Back ◽

Output Side

Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception. Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.

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Meditation for adults with non-specific low back pain: a systematic review and meta-analysis

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0096 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Larissa O. Soares ◽

Giovanni E. Ferreira ◽

Leonardo O. P. Costa ◽

Leandro C. Nogueira ◽

Ney Meziat-Filho ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Usual Care ◽

Pain Intensity ◽

Cochrane Library ◽

Low Back ◽

Short Term ◽

Minimal Intervention ◽

Better Than

Abstract Objectives We aim to determine the effectiveness of meditation for adults with non-specific low back pain. Methods We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability. Results We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = −0.22; 95% CI = −0.42 to −0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = −0.28; 95% CI = −0.54 to −0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period. Conclusions We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.

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