scholarly journals Preoperative pain neurophysiology education for lumbar radiculopathy: A randomized-controlled trial

2021 ◽  
Vol 67 (3) ◽  
pp. 328-335
Author(s):  
İsmail Saraçoğlu ◽  
İsmail Kaya ◽  
İlker Deniz Cingöz ◽  
Hasan Emre Aydın
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Length Of Stay ◽  
Intervention Group ◽  
Leg Pain ◽  
Control Group ◽  
Low Back ◽  
Lumbar Radiculopathy ◽  
Short Term ◽  
Preoperative Pain

Objectives: This study aims to investigate the postoperative short-term effectiveness of preoperative pain neurophysiology education on pain severity, kinesiophobia, and disability in patients undergoing lumbar surgery for radiculopathy. Patients and methods: Between April 2019 and August 2019, a total of 41 patients (22 males, 19 females; mean age 52.1±9.5 years; range, 37 to 64 years) scheduled for lumbar radiculopathy surgery were randomized to receive either preoperative routine education only (control group, n=20) or a 70-min pain neurophysiology education in addition to preoperative routine education (intervention group, n=21). The patients were evaluated for the following outcomes prior to surgery (baseline) and at 12 weeks after surgery: low back pain and leg pain using Numeric Pain Rating Scale, disability using Oswestry Disability Index), and kinesiophobia using Tampa Scale for Kinesiophobia. Results: There were no statistically significant differences in low back pain (p=0.121), leg pain (p=0.142), and the length of stay hospital (p=0.110) between the groups. However, the interaction effects of intervention group were superior to control group regarding disability (p=0.042) and kinesiophobia (p<0.001). Conclusion: The addition of pain neurophysiology education to routine education following lumbar radiculopathy surgery yields significant improvements for disability and kinesiophobia, although no additional benefits is seen regarding the pain severity and length of stay in hospital in the short-term.

scholarly journals Ultrasound-guided caudal epidural steroid injection in chronic radicular low back pain: short-term electrophysiologic benefits

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20190006
Author(s):  
Maha Emad Ibrahim ◽  
Magdy Ahmed Awadalla ◽  
Aziza Sayed Omar ◽  
Mohammad al-Shatouri
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Control Group ◽  
Low Back ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Short Term ◽  
F Wave ◽  
Epidural Steroid ◽  
Caudal Epidural

Objective: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. Methods: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml−1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. Results: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). Conclusion: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. Advances in knowledge: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

The Effects of a Digital Health Program Using Chatbot Through a Mobile Messaging App on Musculoskeletal Problems: Randomized Controlled Trial of the Self-Management Program in Workers with Neck/Shoulder Pain/Stiffness and Low Back Pain (Preprint)

2021 ◽  
Author(s):  
Tomomi Anan ◽  
Shigeyuki Kajiki ◽  
Hiroyuki Oka ◽  
Tomoko Fujii ◽  
Kayo Kawamata ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Shoulder Pain ◽  
Health Program ◽  
Digital Health ◽  
Intervention Group ◽  
Musculoskeletal Symptoms ◽  
Control Group ◽  
Low Back ◽  
Musculoskeletal Problems

BACKGROUND Musculoskeletal symptoms, such as neck and shoulder pain and stiffness and low back pain, are common health problems in the working population. They are the leading causes of presenteeism (employees being physically present at work but unable to be fully engaged). However, current medical systems do not spare sufficient resources for non-specific musculoskeletal problems. OBJECTIVE This study aimed to evaluate the improvements in musculoskeletal symptoms after use of an exercise-based artificial intelligence (AI)-assisted interactive health promotion system that operates through a mobile messaging app (the AI-assisted health program). METHODS We conducted a two-armed, randomized, controlled, and unblinded trial in workers with neck/shoulder stiffness and/or low back pain. We recruited participants with these symptoms through email notifications. We obtained 48 participants in the intervention group and 46 in the control group. The intervention group received the AI-assisted health program, in which the chatbot sent messages to users with the exercise instructions at a fixed time every day through the smart phone’s chatting app (LINE) for 12 weeks. The exercises could be performed within 1 minute. The control group continued with their usual care routines, which included exercising for 3 minutes at recess time provided by the company to prevent stiff shoulders and back pain. We assessed the subjective severities of the neck and shoulder pain/stiffness and low back pain in participants using a scoring scale of 1 to 5 for both the intervention and the control group at baseline and after 12 weeks of intervention using an online form. RESULTS We analyzed 47 patients in the intervention group and 40 in the control group. The participants in the intervention group showed significant improvements in the severities of the neck/shoulder pain/stiffness and low back pain compared to those in the control group (OR 12.74, P <.001). Based on the subjective assessment of the improvement of the pain/stiffness at 12 weeks, 36 (77%) participants in the intervention group and 3 (8%) in the control group had improved (improved, slightly improved) (OR 54.23, P <.001). CONCLUSIONS This study showed that the short exercises provided by the AI-assisted health program improved both neck/shoulder pain/stiffness and low back pain in 12 weeks. Digital health programs are low cost and safe and can save experts’ working hours and labor costs. Further studies are needed to identify the elements of the AI-assisted health program that worked. CLINICALTRIAL University hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000033894; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000038307.

Effect of a 12-week workplace interview intervention on physical activity and low back pain: a single-center, randomized controlled study

2020 ◽  
Author(s):  
Kazuhiro Shimo ◽  
Mami Hasegawa ◽  
Seiko Mizutani ◽  
Tomomi Hasegawa ◽  
Takahiro Ushida
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapist ◽  
Intervention Group ◽  
Office Workers ◽  
Controlled Study ◽  
Control Group ◽  
Low Back ◽  
Face To Face

Abstract Background Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear if workplace PA interventions can improve LBP. This study aimed to investigate the effects of workplace interview intervention on increasing PA and improving LBP among office workers. Methods We recruited 37 workers of a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention group (n=20) or control group (n=17). We affixed waist-worn accelerometers to monitor PA in all participants, and provided face-to-face counseling with a physical therapist or nurse once a week for 12 weeks as workplace PA program to reassurance and encourage participants to keep high levels of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. Results Baseline characteristics were similar in both groups, but PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, was PA significantly increased at 3 and 6 months from baseline and LBP severity improved significantly at 6 months from baseline. We calculated the effect size of the interview intervention, and found that workplace interview intervention had a medium to large effect on PA and LBP severity. Conclusions Our data suggests that workplace PA intervention can increase PA and improve LBP among office workers. Trial registration UMIN-CTR Clinical Trial UMIN000038864 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044321). Registered 12 December 2019, retrospectively registered.

scholarly journals The effect of the local cold application on low back pain and vascular complications of patients undergoing coronary angiography

2020 ◽  
Vol 11 (4) ◽  
pp. 7754-7762
Author(s):  
Fariba Ebrahimi-Shalmani ◽  
Farideh Hasavari ◽  
Salman Nikfarjam ◽  
Ehsan Kazemnejad Leili ◽  
Nazila Javadi-Pashaki
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Coronary Angiography ◽  
Interaction Analysis ◽  
Intervention Group ◽  
Vascular Complications ◽  
Control Group ◽  
Low Back ◽  
Time Interaction ◽  
Cold Application

Coronary angiography due to the risk of vascular complications and low back pain development can lead to undesirable outcomes. This clinical trial was performed on 110 patients undergoing CAG through the femoral artery in 2019. Low back pain was assessed by VAS at baseline, 2, 4, 6 and 24 hours after angiography and vascular complications were investigated 9 times in this period. Results of group and time interaction analysis revealed that pain and vascular complications were significantly different between these two groups (P <0.001). After controlling for individual, clinical and technical variables, the scores of low back pain were associated with the intervention group compared to the control group (P <0.001), Body Mass Index (P=0/035) and INR (P <0.001). The extent of hematoma was associated with group (P = 0.003) and also the extent of ecchymosis was associated with group (P = 0.002), education (P = 0.44) and BMI (P = 0.035). In this study, the local cold was effective in back pain and vascular complications in patients undergoing CAG.

Does Dynamic Taping Affect Pain, Endurance, Disability, Mobility, and Kinesiophobia in Individuals with Chronic Nonspecific Low Back Pain? A Randomized Controlled Trial

2021 ◽  
pp. 47
Author(s):  
Kanagaraj Rengaramanujam
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Control Group ◽  
Low Back ◽  
Short Term ◽  
Randomized Controlled ◽  
Pain Disability

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.

The effectiveness of 12 weeks of Pilates intervention on disability, pain and kinesiophobia in patients with chronic low back pain: a randomized controlled trial

2018 ◽  
Vol 32 (9) ◽  
pp. 1249-1257 ◽  
Author(s):  
David Cruz-Díaz ◽  
Marta Romeu ◽  
Carmen Velasco-González ◽  
Antonio Martínez-Amat ◽  
Fidel Hita-Contreras
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Low Back ◽  
Randomized Controlled ◽  
Disability Questionnaire

Objective: To assess the effectiveness of 12 weeks of Pilates practice on disability, pain and kinesiophobia in patients with chronic non-specific low back pain. Design: This is a randomized controlled trial. Setting: This study was conducted in the university laboratory. Subjects: A total of 64 participants with chronic non-specific low back pain were included. Interventions: Participants were randomly allocated to intervention group consisted in Pilates intervention during 12 weeks ( n = 32) or control group who received no treatment ( n = 32). Main measures: Disability, pain and kinesiophobia were assessed by Roland Morris Disability Questionnaire, visual analogue scale and Tampa Scale of Kinesiophobia, respectively. Measurements were performed at baseline, at 6 and 12 weeks after study completion. Results: There were significant differences between groups with observed improvement in Pilates intervention group in all variables after treatment ( P < 0.001). Major changes on disability and kinesiophobia were observed at six weeks of intervention with no significant difference after 12 weeks ( P < 0.001). Mean changes of the intervention group compared with the control group were 4.00 (0.45) on the Roland Morris Disability Questionnaire and 5.50 (0.67) in the Tampa Scale of Kinesiophobia. Pain showed better results at six weeks with a slightly but statistically significant improvement at 12 weeks with Visual Analogue Scale scores of 2.40 (0.26) ( P < 0.001). Conclusion: Pilates intervention in patients with chronic non-specific low back pain is effective in the management of disability, pain and kinesiophobia.

scholarly journals The Effectiveness of Thai Massage and Joint Mobilization

2017 ◽  
Vol 10 (2) ◽  
pp. 3
Author(s):  
Chantip Juntakarn, MA ◽  
Thavat Prasartritha, MD ◽  
Prapoj Petrakard, MD
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Randomized Study ◽  
Secondary Outcome ◽  
Control Group ◽  
Low Back ◽  
Short Term ◽  
Joint Mobilization ◽  
The Mean

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.

scholarly journals A randomised controlled trial of ‘clockwise’ ultrasound for low back pain

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Adriaan Louw ◽  
Kory Zimney ◽  
Merrill R. Landers ◽  
Mark Luttrell ◽  
Bob Clair ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Leg Pain ◽  
Control Group ◽  
Low Back ◽  
Lumbar Flexion ◽  
Experimental Group

Aims: To examine how the choice of words explaining ultrasound (US) may influence the outcome of physiotherapy treatment for low back pain (LBP).Methods: Sixty-seven patients with LBP < 3 months were randomly allocated to one of three groups – traditional education about US (control group [CG]), inflated education about US (experimental group [EG]) or extra-inflated education about US (extra-experimental group [EEG]). Each patient received the exact same application of US that has shown clinical efficacy for LBP (1.5 Watts/cm2 for 10 minutes at 1 Megahertz, pulsed 20% over a 20 cm2 area), but received different explanations (CG, EG or EEG). Before and immediately after US,measurements of LBP and leg pain (numeric rating scale), lumbar flexion (distance to floor) and straight leg raise (SLR) (inclinometer) were taken. Statistical analysis consisted of mixed-factorial analyses of variance and chi-square analyses to measure differences between the three groups, as well as meeting or exceeding minimal detectable changes (MDCs) for pain, lumbar flexion and SLR.Results: Both EG and EEG groups showed a statistically significant improvement for SLR (p < 0.0001), while the CG did not. The EEG group participants were 4.4 times (95% confidence interval: 1.1 to 17.5) more likely to improve beyond the MDC than the CG. No significant differences were found between the groups for LBP, leg pain or lumbar flexion.Conclusion: The choice of words when applying a treatment in physiotherapy can alter the efficacy of the treatment.

Effects of whole-body vibration exercise for non-specific chronic low back pain: an assessor-blind, randomized controlled trial

2019 ◽  
Vol 33 (9) ◽  
pp. 1445-1457 ◽  
Author(s):  
Xue-Qiang Wang ◽  
Wei Gu ◽  
Bing-Lin Chen ◽  
Xin Wang ◽  
Hao-Yu Hu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Functional Disability ◽  
Whole Body Vibration ◽  
Intervention Group ◽  
Whole Body ◽  
Control Group ◽  
Low Back ◽  
Body Vibration

Objective: To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: Eighty-nine patients with non-specific chronic low back pain met the inclusion criteria, they were randomly allocated to either the intervention group ( n = 45) or the control group ( n = 44). Intervention: The intervention group received whole-body vibration exercises three times a week for 12 weeks. The control group received general exercise protocol three times a week for 12 weeks. Main outcomes: The primary outcome measures were pain intensity and functional disability measured by the visual analog scale scores and Oswestry Disability Index. The secondary outcome measures included lumbar joint position sense, quality of life (Short Form Health Survey 36) and overall treatment effect (Global Perceived Effect). Results: A total of 84 subjects completed the 12-week study program. After 12 weeks, compared with the control group, the mean visual analog scale and Oswestry Disability Index scores decreased by additional 1 point (95% confidence interval (CI) = –1.22 to −0.78; P < 0.001), 3.81 point (95% CI, −4.98, −2.63; P < 0.001) based on adjusted analysis in the intervention group. And the intervention group provided additional beneficial effects for in terms of lumbar joint position sense ( P < 0.05), quality of life ( P < 0.05), and Global Perceived Effect ( P = 0.012). Conclusion: The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.

scholarly journals Effects of seated lumbar rotation manipulation in treating degenerative lumbar instability: a protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui Xie ◽  
Long Liang ◽  
Kaiming Li ◽  
Jie Yu ◽  
Minshan Feng ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Low Back ◽  
Lumbar Instability ◽  
Randomized Controlled ◽  
Lumbar Traction

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.

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