scholarly journals Osteopathic Manual Treatment vs Kaltenborn-Evjenth Orthopedic Manual Therapy for Chronic Low Back Pain: A Proposal for a Protocol for Randomized Trials

2020 ◽  
Vol 1 (8) ◽  
pp. 383-388
Author(s):  
Pawel Lizis ◽  
Wojciech Kobza ◽  
Grzegorz Manko ◽  
Jaroslaw Jaszczur-Nowicki ◽  
Joanna Bukowska ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Randomized Trials ◽  
Rating Scale ◽  
Small Sample Size ◽  
Randomized Study ◽  
Small Sample ◽  
Random Allocation ◽  
Low Back

Introduction: Numerous modalities of conservative therapeutic interventions are available to achieve the best health benefits in people with Low Back Pain (LBP), e.g., kinesiotherapy, physical therapy, behavior therapy. People with LBP continue to experience pain and disability despite receiving the best evidence based therapy. Osteopathic Manual Therapy (OMT) and Kaltenborn-Evjenth Ortopedic Manual Therapy (KEOMT) are the other options, although their effectiveness remains controversial. The aim of this study is a proposal for a protocol for randomized trials to compare the effectiveness of OMT vs. KEOMT on pain and disability in people suffering from LBP. Methods and analysis: It's a randomized study with two-arms parallel, designed with concealed allocation, the assessor's blinding with intention to-treat analysis. It will include 34 people a group with severe disability ranged from 41 to 60% in Oswestry Disability Index (ODI). There will be two groups: a treatment group (OMT) and a comparison group (KEOMT). All the patients in both groups will receive 2 treatments a week for 5 weeks. Each session in both groups will not exceed 30 minutes. During each session OMT and KEOMT techniques will be repeated 3 times. A baseline assessment will be performed pre and post intervention, two days later. The following parameters will be assessed during the evaluations: Numeric Pain Rating Scale – NPRS, ODI. Ethics and dissemination: The trial was approved by the Scientific Research Ethics Committee of University of Warmia and Mazury, Olsztyn, Poland. Registration approval number: 9/2018. Trial registration: The study protocol was prospectively registered in the Chinese Clinical Trial Registry on December 28, 2019 (registration ID: ChiCTR1900028580). Strengths and Limitations of this Study The participants' random allocation to the experimental and the control groups. The same experienced physiotherapist, blind to the outcome measures, provides the interventions. The same assistant, blind to the group allocation, administrates the outcomes. The same number of the interventions, the compared contact time with the physiotherapist providing the interventions. A short follow-up period and/or a rather small sample size.

scholarly journals What is the incidence of cauda equina syndrome? A systematic review

2020 ◽  
Vol 32 (6) ◽  
pp. 832-841 ◽  
Author(s):  
Ingrid Hoeritzauer ◽  
Matthew Wood ◽  
Phillip C. Copley ◽  
Andreas K. Demetriades ◽  
Julie Woodfield
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Adult Population ◽  
Cauda Equina ◽  
Small Sample ◽  
Low Back ◽  
Patient Pathways

OBJECTIVECauda equina syndrome (CES) is a surgical emergency requiring timely operative intervention to prevent symptom progression. Accurately establishing the incidence of CES is required to inform healthcare service design and delivery, including out-of-hours imaging arrangements.METHODSA systematic literature search of MEDLINE, EMBASE, and Scopus was undertaken to identify original studies stating the incidence of CES, and the estimates were combined in a meta-analysis as described in the protocol registered with PROSPERO (registration no. CRD42017065865) and reported using the PRISMA guidelines.RESULTSA total of 1281 studies were identified, and 26 studies were included in the review. Data about CES incidence were available from 3 different populations: asymptomatic community populations, patients with nontraumatic low-back pain, and patients presenting as an emergency with suspected CES. The incidence of CES was 0.3–0.5 per 100,000 per year in 2 asymptomatic community populations, 0.6 per 100,000 per year in an asymptomatic adult population, and 7 per 100,000 per year in an asymptomatic working-age population. CES occurred in 0.08% of those with low-back pain presenting to primary care in 1 study, and a combined estimate of 0.27% was calculated for 4 studies of those with low-back pain presenting to secondary care. Across 18 studies of adults with suspected CES, 19% had radiological and clinical CES. Difficulties in comparison between studies resulted from the heterogeneous definitions of CES and lack of separation of more advanced CES with retention, which is unlikely to be reversible. In the studies of patients with suspected CES, the small sample size, the high number of single-center studies (18/18), the high number of studies from the United Kingdom (17/18), the retrospective nature of the studies, and the high number of abstracts rather than full texts (9/18) reduced the quality of the data.CONCLUSIONSFrom current studies, it appears that CES occurs infrequently in asymptomatic community populations and in only 19% of those presenting with symptoms. Determining accurate incidence figures and designing a bespoke service for investigation of patients with suspected CES would require a consensus clinical and radiological definition of CES and international multisite studies of patient pathways of investigation and management.

A randomized study of manual therapy with steroid injections in low-back pain

1994 ◽  
Vol 3 (5) ◽  
pp. 246-254 ◽  
Author(s):  
S. Blomberg ◽  
K. Svärdsudd ◽  
G. Tibblin
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Randomized Study ◽  
Low Back ◽  
Steroid Injections

scholarly journals Ozone Therapy: two projects of treatment in Vietnam population for back pain and stroke [abstract]

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Lorenzo Stangoni ◽  
Nguyen Thi-Hoa ◽  
Trinh Duy-Thang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sample Size ◽  
Small Sample Size ◽  
Small Sample ◽  
Low Back ◽  
Ozone Therapy ◽  
Traditional Treatment ◽  
Primary Evaluation ◽  
Positive Results

INTRODUCTION: Here we show the results of two clinical projects carried out in Vietnamese patients suffering from low back pain or stroke aftermath comparing with our protocols with and without ozone therapy. MATERIAL and METHODS: We did a first evaluation (project 1 - 179 patients) of adding ozone therapy in our protocols for low back pain and stroke aftermath. After realizing of the positive results, we started the second proyect (207 patients), comparing directly our old and new protocols that include ozone therapy. The treatment from low back pain were executed with classical paraverteberal injections of ozone. The treatment of stroke were executed with intramuscular injections of ozone in the affected area. RESULTS: Comparing with our traditional treatment methods, ozone can improve the speed and the efficacy of the treatment. CONCLUSION: Due to the small sample size, the results has limitations. However the primary evaluation is a reference which requires to have better collaboration with other physicians in order to increase the sample size and validite strongly this technique.

Implementing Yoga Into the Management of Patients With Refractory Low Back Pain in an Outpatient Clinic Setting

2018 ◽  
Vol 37 (3) ◽  
pp. 238-247
Author(s):  
Karen Lewis ◽  
Sharon Metcalfe ◽  
Tamera Pearson ◽  
Ramona Whichello
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Small Sample Size ◽  
Small Sample ◽  
Low Back ◽  
Qualitative Feedback ◽  
Feedback Method ◽  
Individual Scores ◽  
Back Pain Management

Purpose: To evaluate the effectiveness of implementing yoga into the treatment of patients with chronic low back pain. Design: Quantitative analysis with opportunity for qualitative feedback. Method: Effectiveness of this complementary treatment was assessed using a pretest/posttest design of patients who volunteered to participate in yoga classes as part of their back pain management. Measurements included low back pain rating, perception of back pain interference with daily activities, and self-efficacy in dealing with chronic low back pain. Findings: Although no statistically significant findings were found due to the small sample size, most participants demonstrated improved individual scores on all measurement surveys including qualitative comments. Conclusion: Based on the findings of this pilot study, further studies on implementing yoga into the treatment of chronic low back pain are encouraged.

scholarly journals THERAPEUTIC EFFECT OF CUPPING ON NON-SPECIFIC NECK AND LOW BACK PAIN - A SYSTEMATIC REVIEW

2020 ◽  
Vol 9 (1) ◽  
pp. 4-10
Author(s):  
Danish Rasool
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Sample Size ◽  
Small Sample Size ◽  
Research Work ◽  
Cupping Therapy ◽  
Small Sample ◽  
Low Back ◽  
Eligibility Criteria

ABSTRACT BACKGROUND & AIMS Neck and low back pain are the major musculoskeletal problems effecting people around the globe. Increasing number of researches underpin the effects of cupping in neck and low back pain. However, empirical studies are required to confirm the efficiency of cupping therapy. Therefore, the aim of this review was to examine the efficacy of cupping treatment in non-specific neck and low back pain. STUDY SELECTION & ELIGIBILITY CRITERIA This systematic review included Randomized Controlled Trials focused on cupping therapy and its effects on neck and low back pain. Extensive search was performed on Google Scholar, PubMed, MEDLINE and Pedro databases. Studies published from 2009 to 2017 were included. RESULTS Eight RCT’s with a 659 sample size were selected for review. Compared to other cupping methods ‘wet cupping’, ‘fire cupping’ and ‘cupping massage’ were superior in reducing pain in neck and low back pain P<0.001. However, a few cupping techniques showed relatively less significant P<0.133, P<0.05, and P<0.037 in comparison to previously mentioned methods. CONCLUSION Cupping therapy can be beneficial in alleviation of non-specific cervicalgia and lumbago in short-term. However, due to weak evidence and a small sample size, the study was restricted from drawing a definite conclusion. Future high-level evidence and research work is required for confirmative and conclusive recommendation of cupping in clinical settings for musculoskeletal pain.

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.

Does early change predict long-term (6 months) improvements in subjects who receive manual therapy for low back pain?

2017 ◽  
Vol 33 (9) ◽  
pp. 716-724 ◽  
Author(s):  
Chad Cook ◽  
Shannon Petersen ◽  
Megan Donaldson ◽  
Mark Wilhelm ◽  
Ken Learman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Manual Therapy ◽  
Low Back ◽  
Early Change

scholarly journals Association of Serum Serotonin and Pain in Patients with Chronic Low Back Pain before and after Spinal Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Afshin Farhanchi ◽  
Behrouz Karkhanei ◽  
Negar Amani ◽  
Mashhood Aghajanloo ◽  
Elham Khanlarzadeh ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Low Back ◽  
Significant Difference ◽  
Before And After ◽  
Postoperative Serum ◽  
Serum Serotonin

Introduction. In this study we are aiming to evaluate the changes of serum serotonin and its association with pain in patients suffering from chronic low back pain before and after lumbar discectomy surgery. Patients and Methods. A prospective study was performed on the patients referring to the outpatient clinic in Besat hospital, Hamadan University of Medical Sciences, Hamadan, Iran, during 2016. A 2 mL fasting blood sample was collected from each patient at preoperative day 1 and postoperative day 14 and they were measured for level of serum serotonin. Besides, all patients were asked for severity of their low back pain in preoperative day 1 and postoperative day 14 and scored their pain from zero to ten using a Numerical Rating Scale. Results. Forty patients with the mean age of 47 ± 13 yrs/old (range 25–77) including 15 (37.5%) males were enrolled into the study. The overall mean score of preoperative pain was significantly decreased from 7.4 ± 2.18 (range 4–10) to the postoperative pain score 3.87 ± 2.92 (range 0–10) (P < .001). The overall levels of pre- and postoperative serum serotonin were 3.37 ± 1.27 (range 1.1–6.4) and 3.58 ± 1.32 (range .94–7.1) ng/mL, respectively, with no significant difference (P = .09). The levels of pre- and postoperative serum serotonin were significantly higher in males and patients older than 50 yrs/old compared to the females and patients younger than 50 yrs/old, respectively (P = .03 and .005, respectively). A significant inverse correlation between the postoperative levels of pain and serum serotonin was observed (r = -.36 and P = .02). Conclusion. A negative medium strength linear relationship may exist between the postoperative serum serotonin and low back pain.

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