Efficacy of Graded Activity with and without Daily-Monitored- Walking on Pain and Back Endurance among Patients with Concomitant Low-Back Pain and Type-2 Diabetes: A Randomized Trial

BACKGROUND: There is evidence supporting the efficacy of Graded Activity (GA) in managing clinical attributes of patients with Low-Back Pain (LBP) in the general population. However, it is unknown whether GA alone is efficacious in managing these clinical attributes in patients with concomitant LBP and Type-2 Diabetes (T2D) or additional daily-monitored walking will be required.METHODS: A single-blind controlled trial involving 58 patients (mean age: 48.3±9.4 years, 64.7% females) with concomitant LBP and T2D who received treatment twice weekly for twelve weeks was conducted. Participants were randomized into GA or GA with daily-monitored-walking (GAMW) groups. Pain Intensity (PI), Static Back Extensors Endurance (SBEE), Static Abdominal Muscular Endurance (SAME) and Glycaemic Control (GC) were assessed using Visual Analogue Scale, Biering-Sorensen test, flexor endurance test, and in2itTM device respectively at baseline, 4th, 8th and 12th week. Data were analysed using repeatedmeasures ANOVA and Unpaired t-tests at α = 0.05.RESULTS: There were significant differences in PI, SAME and SBEE among participants in each of GA and GAMW groups respectively (p<0.05). Within-group difference on GC was significant for GAMW (6.3±0.9%, 5.7±0.7%) but not GA (6.3±0.9%, 6.3±0.9%). There was significant difference (p<0.05) between GA and GAMW group participants for SBEE (7.2±0.1 sec, 7.3±0.1 sec) at week 8 of the study and GC (-0.5±0.2%, -0.6±0.5%) at the end of the study. No differences were found between GA and GAMW groups for PI and SAME.CONCLUSION: Graded activity with daily-monitored-walking produced positive effects on GC and yielded a better improvement on SAME and SBEE.

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FRI0712-HPR EFFICACY OF GRADED ACTIVITY WITH AND WITHOUT DAILY-MONITORED-WALKING ON SELECTED CLINICAL ATTRIBUTES OF PATIENTS WITH CONCOMITANT LOW-BACK PAIN AND TYPE-2 DIABETES

10.1136/annrheumdis-2019-eular.724 ◽

2019 ◽

Cited By ~ 1

Author(s):

Opeyemi Idowu ◽

Ade Adeniyi

Keyword(s):

Type 2 Diabetes ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Graded Activity

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Whole body vibration exercise for chronic low back pain: study protocol for a single-blind randomized controlled trial

Trials ◽

10.1186/1745-6215-15-104 ◽

2014 ◽

Vol 15 (1) ◽

pp. 104 ◽

Cited By ~ 11

Author(s):

Xue-Qiang Wang ◽

Yan-Lin Pi ◽

Pei-Jie Chen ◽

Bin-Lin Chen ◽

Lei-Chao Liang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Back Pain ◽

Controlled Trial ◽

Whole Body Vibration ◽

Whole Body ◽

Low Back ◽

Vibration Exercise ◽

Randomized Controlled ◽

Single Blind

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Predicting Response to Motor Control Exercises and Graded Activity for Patients With Low Back Pain: Preplanned Secondary Analysis of a Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20140014 ◽

2014 ◽

Vol 94 (11) ◽

pp. 1543-1554 ◽

Cited By ~ 44

Author(s):

Luciana Gazzi Macedo ◽

Christopher G. Maher ◽

Mark J. Hancock ◽

Steve J. Kamper ◽

James H. McAuley ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Low Back Pain ◽

Motor Control ◽

Back Pain ◽

Controlled Trial ◽

Secondary Analysis ◽

Low Back ◽

Randomized Controlled ◽

Clinical Instability ◽

Graded Activity

Background Current treatments for low back pain have small effects. A research priority is to identify patient characteristics associated with larger effects for specific interventions. Objective The aim of this study was to identify simple clinical characteristics of patients with chronic low back pain who would benefit more from either motor control exercises or graded activity. Design This study was a secondary analysis of the results of a randomized controlled trial. Methods One hundred seventy-two patients with chronic low back pain were enrolled in the trial, which was conducted in Australian physical therapy clinics. The treatment consisted of 12 initial exercise sessions over an 8-week period and booster sessions at 4 and 10 months following randomization. The putative effect modifiers (psychosocial features, physical activity level, walking tolerance, and self-reported signs of clinical instability) were measured at baseline. Measures of pain and function (both measured on a 0–10 scale) were taken at baseline and at 2, 6, and 12 months by a blinded assessor. Results Self-reported clinical instability was a statistically significant and clinically important modifier of treatment response for 12-month function (interaction: 2.72; 95% confidence interval=1.39 to 4.06). Participants with high scores on the clinical instability questionnaire (≥9) did 0.76 points better with motor control exercises, whereas those who had low scores (<9) did 1.93 points better with graded activity. Most other effect modifiers investigated did not appear to be useful in identifying preferential response to exercise type. Limitations The psychometric properties of the instability questionnaire have not been fully tested. Conclusions A simple 15-item questionnaire of features considered indicative of clinical instability can identify patients who respond best to either motor control exercises or graded activity.

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