scholarly journals Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain

2021 ◽  
Vol 3 (1) ◽  
pp. 24-31
Author(s):  
Faria Aqil ◽  
Muhammad Affan Iqbal ◽  
Suhail Karim ◽  
Muhammad Umar Iqbal ◽  
Muhammad Junaid Akram ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Functional Status ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Post Intervention ◽  
Lumbar Stabilization ◽  
Numeric Pain Rating Scale

Introduction: Lumbar stabilization and McKenzie exercises are becoming a popular trend for managing chronic low back pain though it is currently not known whether lumbar stabilization exercises produce better results in improving functional status compared to McKenzie approach. The purpose of this study was to determine the effectiveness of the McKenzie approach versus lumbar stabilization in the treatment of chronic low back pain. Material & Methods: This was a randomized controlled trial. Lottery method was used to randomly divide individuals who fulfilled inclusion criteria into 2 groups. Assessments of the patients were done in OPD. Baseline assessment was done on day 1 and post intervention assessment was done after 2 weeks. A total of 8 treatment sessions spread across 2 weeks were given (4 days per week). Data were assessed at baseline level and post intervention. Data was entered and analysed by SPSS version 21. Results: A total of 28 females and 02 males (mean age of 50.88 ±12.29) participated in the study. After 02 weeks of intervention, both treatment groups showed improvement in decreasing pain and improving functional status. The lumber stabilization group showed significant gains on Numeric Pain Rating Scale and (p=0.001) and Modified Oswestry Disability Index (p=0.001) compared to the Mckenzie group. Conclusion: Patients in both lumber stabilisation and McKenzie groups showed significant improvement, however, the patients in lumbar stabilization group were superior than the patients in McKenzie group on the selected outcomes.

scholarly journals Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial

2014 ◽  
Vol 10 (5) ◽  
pp. 323 ◽  
Author(s):  
Aleksandra Zgierska, MD, PhD ◽  
Margaret L. Wallace, PharmD, BCACP ◽  
Cindy A. Burzinski, MS ◽  
Jennifer Cox, BS ◽  
Miroslav Backonja, MD
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Drug Testing ◽  
Illicit Drugs ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Cross Sectional ◽  
Toxicological Profile

Objective: Refractory chronic low back pain (CLBP) often leads to treatment with long-term opioids. Our goal was to describe the pharmaco-toxicological profile of opioid-treated CLBP patients and identify potential areas for care optimization.Design: Cross-sectional analysis.Setting: Outpatient primary care.Participants: CLBP patients prescribed ≥ 30 mg/d of morphine-equivalent dose (MED) for ≥3 months.Outcome Measures: Self-reported clinical, medication (verified) and substance use, and urine drug testing (UDT) data were collected.Results: Participants (N = 35) were 51.8 ± 9.7 years old, 80 percent female with CLBP for 14.2 ± 10.1 years, treated with opioids for 7.9 ± 5.7 years, with severe disability (Oswestry Disability Index score: 66.7 ± 11.4), and average pain score of 5.6 ± 1.5 (0-10 rating scale). Participants reported using tobacco (N = 14), alcohol (N = 9) and illicit drugs or unprescribed medications (N = 10). On average, participants took 13.4 ± 6.8 daily medications, including 4.7 ± 1.8 pain-modulating and 4.7 ± 2.0 sedating medications. Among prescribed opioids, 57.1 percent were long-acting and 91.4 percent were short-acting, with a total of 144.5 ± 127.8 mg/d of MED. Sixteen participants were prescribed benzodiazepines and/or zolpidem/zaleplon. Fifteen participants had UDT positive for illicit drugs or unprescribed medications; in addition, eight tested positive for alcohol and 19 for cotinine. Compared to those with negative UDTs, those with positive UDTs (N = 15) received lower daily “total” and “extended release” opioid doses, and were more likely to test positive for cotinine (p < 0.05).Conclusions: Study findings corroborate existing evidence for high medication burden and high likelihood of substance misuse among opioid-treated CLBP patients. Further research is needed to help understand causality and ways to optimize care and clinical outcomes.

Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial

2020 ◽  
Vol 29 (2) ◽  
pp. 179-185 ◽  
Author(s):  
TaeYeong Kim ◽  
JaeHyuk Lee ◽  
SeJun Oh ◽  
Seungmin Kim ◽  
BumChul Yoon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Oswestry Disability Index ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Low Back ◽  
Baseline Values ◽  
Numeric Rating

Context: A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Design: A randomized controlled trial. Settings: Community and university campus. Participants: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Interventions: The exercises were performed for 30 minutes, 2 days per week for 8 weeks. Main Outcome Measures: Numeric rating scale, functional disabilities (Oswestry disability index and Roland–Morris disability), and fear-avoidance beliefs questionnaire (FABQ) scores were measured at baseline and at 4 weeks, 8 weeks, and 6 months. Results: A 2-way repeated analysis of variance identified that between-group comparisons showed significant differences in the FABQ related to work scale (F = 21.422; P = .01). There were no significant differences in the numeric rating scale (F = 1.696; P = .21), Oswestry disability index (F = 1.848; P = .20), Roland–Morris disability (F = 0.069; P = .80), and FABQ related to physical scale (F = 1.579; P = .24). In within-group comparisons, both groups presented significant differences in numeric rating scale (both SHR and STB after 4 wk), Oswestry disability index (both SHR and STB after 6 mo), and Roland–Morris disability (SHR after 6 mo and STB after 8 wk) compared with baseline values. In FABQ-related physical (SHR after 4 wk) and work scales (SHR after 6 mo), there were only significant differences in the SHR compared with baseline values. Conclusions: SHR exercise for 8 weeks had a greater effect than STB exercise for reducing work-related FABQ. The SHR exercise performed in a seated position could substantially decrease pain-related fear disability in young adults with chronic low back pain.

Does a Program of Pilates Improve Chronic Non-Specific Low Back Pain?

2006 ◽  
Vol 15 (4) ◽  
pp. 338-350 ◽  
Author(s):  
Valerie Gladwell ◽  
Samantha Head ◽  
Martin Haggar ◽  
Ralph Beneke
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
General Health ◽  
Controlled Trial ◽  
Core Stability ◽  
Control Group ◽  
Low Back ◽  
Post Intervention

Objective:To evaluate the effect of a program of modified Pilates for active individuals with chronic non-specific low back pain.Design:A single blind randomized controlled trial.Participants:49 individuals with chronic low back pain were randomly allocated to control (n = 24) or Pilates group (n = 25). Thirty-four individuals completed the study (14 and 20 individuals for control and Pilates group, respectively).Intervention:The Pilates group undertook a six week program of Pilates. Both groups continued with normal activity.Main Outcome Measures:An assessor blinded to group allocation conducted functional and questionnaire-based assessments pre- and post- intervention.Results:Improvements were seen in the Pilates group post- intervention period with increases (P < 0.05) in general health, sports functioning, flexibility, proprioception, and a decrease in pain. The control group showed no significant differences in the same measures post- intervention.Conclusions:These data suggest that Pilates used as a specific core stability exercise incorporating functional movements can improve non-specific chronic low back pain in an active population compared to no intervention. Additionally, Pilates can improve general health, pain level, sports functioning, flexibility, and proprioception in individuals with chronic low back 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.

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