Short-term outcomes of a back school program for chronic low back pain

2001 ◽  
Vol 82 (8) ◽  
pp. 1099-1105 ◽  
Author(s):  
Audy P. Hodselmans ◽  
Sonja M. Jaegers ◽  
Ludwig N. Göeken
Author(s):  
Adriane Behring Bianchi ◽  
Livia Nóbrega Meneguetti ◽  
Salmia Mendes Baladeli ◽  
Ligia Maria Facci

Introduction: Due to the high incidence of low back pain in the population, is very important to study methods of prevention and treatment for this disease. The Back School, an approach that aims to provide to participants the increase of self-care, associating primary prevention to health education, has been suggested for the treatment of patients with chronic low back pain. Objective: The aim of this study was to evaluate the benefits of Back School on functional capacity and pain intensity, in short and medium term, at patients with chronic low back pain. Methods: Fifty eight patients with chronic low back pain, selected at UniCesumar physical therapy's clinic, were evaluated, by an independent examiner, using Roland-Morris Questionnaire, Pain Visual Analogue Scale and asked about consumption of medications. In sequence, all the pacients were randomized into two groups: 1) School Program and 2) Control. The group 1 patients participated of Back School program, composed of theoretical-practical classes, twice per week, totaling ten classes of 60 minutes; and group 2 were followed only by phone calls. The data were statistically analyzed by Mann-Whitney U test, Friedman and Wilcoxon, using the significant values of p < 0,05. Results: Fifty three patients finished the study and were analyzed after the treatment protocol, as well as three and six months sequent. The improvement in pain intensity and functional capacity was statistically significant only in the Back School group. Conclusion: In this study, it was found effectiveness of Back School program in the improve of functional capacity and pain intensity of patients with chronic low back pain.


2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.


2006 ◽  
Vol 14 (2) ◽  
pp. 21-31 ◽  
Author(s):  
Christophe Demoulin ◽  
Didier Maquet ◽  
Marco Tomasella ◽  
Jean-Louis Croisier ◽  
Jean-Michel Crielaard ◽  
...  

BMJ ◽  
2019 ◽  
pp. l689 ◽  
Author(s):  
Sidney M Rubinstein ◽  
Annemarie de Zoete ◽  
Marienke van Middelkoop ◽  
Willem J J Assendelft ◽  
Michiel R de Boer ◽  
...  

Abstract Objective To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, and trial registries up to 4 May 2018, including reference lists of eligible trials and related reviews. Eligibility criteria for selecting studies Randomised controlled trials examining the effect of spinal manipulation or mobilisation in adults (≥18 years) with chronic low back pain with or without referred pain. Studies that exclusively examined sciatica were excluded, as was grey literature. No restrictions were applied to language or setting. Review methods Two reviewers independently selected studies, extracted data, and assessed risk of bias and quality of the evidence. The effect of SMT was compared with recommended therapies, non-recommended therapies, sham (placebo) SMT, and SMT as an adjuvant therapy. Main outcomes were pain and back specific functional status, examined as mean differences and standardised mean differences (SMD), respectively. Outcomes were examined at 1, 6, and 12 months. Quality of evidence was assessed using GRADE. A random effects model was used and statistical heterogeneity explored. Results 47 randomised controlled trials including a total of 9211 participants were identified, who were on average middle aged (35-60 years). Most trials compared SMT with recommended therapies. Moderate quality evidence suggested that SMT has similar effects to other recommended therapies for short term pain relief (mean difference −3.17, 95% confidence interval −7.85 to 1.51) and a small, clinically better improvement in function (SMD −0.25, 95% confidence interval −0.41 to −0.09). High quality evidence suggested that compared with non-recommended therapies SMT results in small, not clinically better effects for short term pain relief (mean difference −7.48, −11.50 to −3.47) and small to moderate clinically better improvement in function (SMD −0.41, −0.67 to −0.15). In general, these results were similar for the intermediate and long term outcomes as were the effects of SMT as an adjuvant therapy. Evidence for sham SMT was low to very low quality; therefore these effects should be considered uncertain. Statistical heterogeneity could not be explained. About half of the studies examined adverse and serious adverse events, but in most of these it was unclear how and whether these events were registered systematically. Most of the observed adverse events were musculoskeletal related, transient in nature, and of mild to moderate severity. One study with a low risk of selection bias and powered to examine risk (n=183) found no increased risk of an adverse event (relative risk 1.24, 95% confidence interval 0.85 to 1.81) or duration of the event (1.13, 0.59 to 2.18) compared with sham SMT. In one study, the Data Safety Monitoring Board judged one serious adverse event to be possibly related to SMT. Conclusion SMT produces similar effects to recommended therapies for chronic low back pain, whereas SMT seems to be better than non-recommended interventions for improvement in function in the short term. Clinicians should inform their patients of the potential risks of adverse events associated with SMT.


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